M.S., L.P.C., CSAC

Dawn Haller1/13/2023If you've heard of or read about mindfulness — a form of meditation — you might be curious about how to practice it. Find out how to do mindfulness exercises and how they might benefit you.Use mindfulness to improve well-being<p>If you've heard of or read about mindfulness — a form of meditation — you might be curious about how to practice it. Find out how to do mindfulness exercises and how they might benefit you.</p> <h2>What is mindfulness?</h2> <p>Mindfulness is the act of being fully present and aware of what you're sensing and feeling in the moment — without interpretation or judgment.</p> <p>You may think about things that occurred yesterday or last week, what's happening tomorrow or what to make for dinner. Spending too much time planning, problem-solving, daydreaming or thinking negative or random thoughts can be draining. It also can make you more likely to experience stress, anxiety and symptoms of depression. Practicing mindfulness exercises can help you direct your attention away from this kind of thinking and engage with the world around you in the here and now.</p> <h2>What are the benefits of mindfulness exercises?</h2> <h3>Practicing mindfulness exercises can have many possible benefits, including:</h3> <ul> <li>Reduced stress, anxiety and depression</li> <li>Less negative thinking and distraction</li> <li>Improved mood</li> <li>A tool to cope with pain management</li> </ul> <h2>What are ways to practice mindfulness?</h2> <h3>Simple activities can help you practice mindfulness. Examples include:</h3> <ul> <li><strong>Pay attention.</strong><br /> Listen closely to a person's words the next time you meet someone. Think about the meaning and uniqueness. Aim to develop a habit of understanding others, and delaying your own judgments and criticisms.</li> <li><strong>Make the familiar new again.</strong><br /> Find a few small, familiar objects — such as a toothbrush, apple or cellphone — in your home or office. Look at the objects with fresh eyes. Identify one new detail about each object that you didn't see before. As you become more aware of your world, you might become fonder of the things around you.</li> <li><strong>Focus on your breathing.</strong><br /> Sit in a quiet place with your back straight, but relaxed. Feel your breath move in and out of your body. Let your awareness of everything else fall away. Pay attention to your nostrils as air passes in and out. Notice the way your abdomen expands and collapses with each breath. When your mind wanders, gently redirect your attention to your breath. Don't judge yourself. Remember that you're not trying to become anything, such as a good meditator. You're simply becoming aware of what's happening around you, breath by breath.</li> <li><strong>Awaken your senses.</strong><br /> Get a raisin. Sit in a quiet place with your back straight, but relaxed. Look at the raisin. Smell it, feel it and anticipate eating it. Taste the raisin, and slowly and deliberately chew it. Notice how the raisin's taste changes, your impulse to swallow the raisin, your response to that impulse and any thoughts or emotions that arise along the way. Paying close attention to your senses and body's reaction to the raisin might reveal insight into your relationship with eating and food.</li> <li><strong>Do a morning coffee exercise.</strong><br /> Start your day with a couple of deep breaths, inhaling through your nose and exhaling slowly through your mouth. Select a coffee cup. Notice the mug — the pattern, color, weight, imperfections, such as chips you may not have seen before. Notice the steam as the water is heating. Notice the sounds the coffee machine makes while brewing your coffee. Take a moment to notice the aroma. Take a sip and notice the taste. Notice the warmth of the coffee mug in your hands.</li> </ul> <p>For other mindfulness exercises, such as focused breathing, you'll need to set aside time when you can be in a quiet place without distractions or interruptions. You might choose to practice this type of exercise early in the morning before you begin your daily routine.</p> <p>Aim to practice mindfulness every day for about six months. Over time, you might find that mindfulness becomes second nature. Think of it as a commitment to reconnecting with and nurturing yourself. Work smarter, not harder. Find ways to incorporate mindfulness into your daily routine. This could be while enjoying your morning coffee, showering, washing the dishes, spending time with a pet or looking out a window.</p> <p><a href="/providers/nicole-houge-lpc"><em>Nicole Sobkowiak</em></a><em> is a licensed professional counselor in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Community health and wellness</li> <li>Mindfulness</li> </ul> <div> </div>M.S., L.P.C., CSAC<p>Patients can expect individualized care. To accomplish this, I will ask what their goals are for counseling and what things will look like for them when their goals are met. We will work together to develop S.M.A.R.T. (specific, measurable, attainable, realistic and time-sensitive) goals and objectives for treatment designed to help them make progress towards reaching their goals. Evidence-based practices are utilized as treatment interventions. Patients are taught a new skills and techniques to practice as "homework," which we will talk about at their next therapy session.</p> <p>My past work experiences include working in outpatient behavioral health, residential treatment facilities, inpatient chemical dependency consultations, community counseling, in-school mental health counseling and private practice. I started working in the mental health and addiction field in 2013 and have worked with a variety of populations including co-occurring/dual-diagnosis.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Psychology/Substance Abuse Counseling), Viterbo University</li> <li>Master's degree, Clinical Mental Health Counseling, Winona State University</li> </ul> <p><strong>Internships</strong></p> <ul> <li>Peace of Mind Counseling, In-home, Outpatient, School-based, Private Practice</li> <li>Coulee Council on Addictions</li> <li>Mayo Clinic Psychiatry & Psychology Child and Adolescent Department, placement at the Boys & Girls Club of Greater La Crosse, Erickson Club</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>National Board for Certified Counselors, Inc.</li> <li>Substance Abuse Counselor (SAC), Department of Safety and Professional Services</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Counseling Association</li> <li>Chi Sigma Iota, Counseling Academic & Professional Honor Society International</li> <li>National Board for Certified Counselors, Inc.</li> </ul>Sobkowiak<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/nicole-houge-lpc.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4437709F69D8ACB741AE3A2E82101125" alt="Nicole Houge, M.S., L.P.C., CSAC" width="280" height="280" DisableNVelocity="true" />Nicole<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16226046Nicole Houge, M.S., L.P.C., CSAC1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2022/using-earphones-to-practice-mindfulness.jpg?h=370&iar=0&w=660&sc_lang=en&hash=34C9B20D11E49BE0D14C6E07EFDBBDFB" alt="Using earphones to practice mindfulness" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.DepressionDepression is a medical illness that causes a persistent feeling of sadness, loss of interest and, sometimes, physical symptoms. It's also called major depression, major depressive disorder and clinical depression.AnxietyFeelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. Symptoms may start during childhood or the teen years and continue into adulthood. We have the experts who can help diagnose and treat anxiety concerns.Stress ManagementGuidance to help you reduce and manage daily stress.Dawn Haller7/7/2022Tampons and pads typically are the first products women think of to manage menstrual flow. But are you familiar with a menstrual cup and how it works? Learn why the benefits have increased its use.Menstrual cups: Why the recent increase in popularity?<p>Not quite sure what a menstrual cup is or how it works? You're not alone. Menstrual cups have been around since the early 1930s, but use has only recently gained popularity. </p> <p>The flexible cup is made of silicone, natural rubber, latex or thermoplastic elastomers. The menstrual cup is inserted into your vagina during your period to catch and collect menstrual flow. </p> <p>How often you empty the menstrual cup depends on the size of the cup and your menstrual flow. The cup can hold up to three times as much fluid as a regular tampon.</p> <p>With the increased popularity of the menstrual cup, more options are available for women. A variety of cup shapes and sizes accommodate each woman's body type and needs. </p> <h2>What are the benefits of menstrual cups over tampons or pads?</h2> <h3>Women have reported preference to the menstrual cup over other products for: </h3> <ul style="list-style-type: disc;"> <li>Increased comfort</li> <li>Less interference with activities</li> <li>Less irritation</li> <li>Decreased odor</li> <li>Ability to wear the cup for longer periods of time than a pad or tampon</li> </ul> <h2>How much do menstrual cups cost?</h2> <p>The average woman spends between $50–$150 per year on tampons or pads. On average, a menstrual cup costs between $20–$40, lasting from six months to 10 years. Depending on which brand of cup is chosen and how often replacements are required, this can add up to significant financial savings.</p> <h2>Are menstrual cups convenient?</h2> <p>A menstrual cup can be worn up to 12 hours. Typically, tampons or pads should be changed every four to six hours. The cup allows for more time between emptying, especially on light days. </p> <p>Using a menstrual cup prevents the need to carry extra pads or tampons, which many women find burdensome and even embarrassing. </p> <p>Unlike tampons, the menstrual cup can be inserted around the time of an expected period, to avoid first-day leakage. Women of any age can use a menstrual cup, regardless of if she has had a child. Because menstrual flow is kept internally, there is a decrease in odor. </p> <h2>Do menstrual cups promote sustainability?</h2> <p>People often attribute disposable diapers to filling landfills, but tampons and pads also accumulate in landfills. The menstrual cup is reusable and significantly reduces the environmental impact. </p> <p>Although the Food and Drug Administration does not require tampons and pads to list ingredients on packaging, you may have concerns about reports of tampons containing bleached cotton, rayon or viscose fibers and toxic chemicals. The menstrual cup is made of medical-grade materials, alleviating concerns of fibers left in the vagina from tampons. </p> <h2>What are the drawbacks of using a menstrual cup?</h2> <p>Women may find that emptying the cup can be messy, particularly if changing the cup in a public restroom. Rinsing the cup after removing is preferred, which can be difficult in a public restroom. </p> <p>Disposable menstrual cups are available, which increases the cost of use of the product and decreases the sustainability for the environment. Disposable brands can be worn during intercourse. </p> <p>Some women find it challenging to manipulate the menstrual cup in and out of the vagina. The cups are not one-size-fits-all. Until you find the right fit, the cup may feel uncomfortable, or there may be leakage. </p> <p>The menstrual cup should be sterilized between periods. This is typically done by placing the cup in boiling water. </p> <p>Although rare, toxic shock syndrome has been associated with tampon use. Menstrual cups also may be a cause of this rare condition. The exact risk is unknown for menstrual cup use, but it is believed to be less than with tampon use. </p> <p>Women with an intrauterine device, or IUD, for birth control can wear a menstrual cup. You should ensure not to pull on the IUD strings when removing the menstrual cup. This may dislodge the IUD. </p> <p>Overall, the menstrual cup appears to be a safe option for women during their period with many potential benefits. Individual preferences may vary, but if you have concerns or questions, discuss them with your health care team.</p> <p><em><a href="/providers/alison-grajkowski-md" target="_self" title="Opens in same window.">Alison Grajkowski, M.D.</a>, is an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/tomah" target="_self" title="Opens in same window.">Tomah</a>, Wisconsin.</em></p><ul> <li>Contraception</li> <li>Menopause transition</li> <li>Minimally invasive surgery</li> <li>Vulvar disorders</li> </ul>M.D.<p>In my practice, I aim to deliver a full-spectrum of evidence-based care to women from puberty through menopause. I work to empower women with education and shared decision making, so they can make informed decisions and receive care that reflects their individual priorities. </p> <p>I was born and raised in rural Wisconsin, which is where my immediate family still resides. I have served in the military as both an enlisted soldier and an officer, which where I met my spouse. We enjoy traveling and the outdoors.</p><p><strong>Medical School:</strong></p> <ul> <li>Saint Louis University School of Medicine, Missouri </li> </ul> <p><strong>Internship</strong>:</p> <ul> <li>Obstetrics and Gynecology – Madigan Army Medical Center, Tacoma, Washington</li> </ul> <p><strong>Residency</strong>:</p> <ul> <li style="margin-bottom: 12px;">Obstetrics and Gynecology – Madigan Army Medical Center, Tacoma, Washington</li> </ul> <p><strong>Certification</strong>:</p> <ul> <li>Board-certified, <span>American College of Obstetrics and Gynecology</span></li> </ul> <p><strong>Memberships</strong>:</p> <ul> <li>American Association of Gynecologic Laparoscopists  </li> <li>American Congress of Obstetricians and Gynecologists</li> <li>American Medical Association</li> </ul>Grajkowski<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/alison-grajkowski-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=5E6ADA4F4DC1FFC176D08E8F37E2E9D4" alt="Alison Grajkowski MD" width="280" height="280" DisableNVelocity="true" />{80954D36-F4DB-4E5F-9457-6E1DBBDBE85D}Alison<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21711011Alison Grajkowski, M.D.1{54693F31-87AF-4B21-91DB-1DEC1E21F878}<img src="/-/media/national-files/images/hometown-health/2022/person-wet-from-swimming-and-smiling.jpg?h=370&iar=0&w=660&sc_lang=en&hash=267B95E7650CC17EA0DE2E5DFC7AFE33" alt="Person wet from swimming and smiling" width="660" height="370" DisableNVelocity="true" />Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller4/16/2014<p>The emotional and psychological improvements after body contouring can be more dramatic than the physical improvements.</p>Body contouring after bariatric surgery: Benefits go beyond appearance<p>As a bariatric surgery coordinator, I'm often asked questions about body contouring in relation to bariatric surgery. Following are some of the common questions asked and answers to them.</p> <h4>What is body contouring? </h4> <p>Body contouring is plastic surgery that removes excess skin and fat and shapes the underlying support tissue.</p> <h4>Will I need body contouring after bariatric surgery?</h4> <p>Not everyone needs body contouring after bariatric surgery. When you lose weight rapidly, your skin may not shrink along with the rest of your body, leaving you with loose folds of skin. Problems related to extra skin include:</p> <ul> <li>Difficulties with personal hygiene </li> <li>Rashes or sores </li> <li>Issues with body image </li> <li>Challenges with extra skin getting in the way </li> <li>Difficulty finding clothes that fit </li> </ul> <h4>Is body contouring the same thing as a tummy tuck?</h4> <p>There are different types of body contouring surgery, including:</p> <ul> <li>Abdominoplasty — More commonly referred to as a tummy tuck. This surgery removes excess abdominal skin, often referred to as an apron. </li> <li>Mastopexy — More commonly referred to as a breast lift. </li> <li>Brachioplasty — Also referred to as an arm lift. This procedure removes excess skin under your arms. </li> <li>Lower body lift — Removal of sagging skin from the abdomen, buttocks, groin and outer thighs. </li> </ul> <h4>What are the risks of body contouring surgery?</h4> <p>As with any surgery, there are risks associated with body contouring surgery. These include:</p> <ul> <li>Bleeding or infection </li> <li>Wound healing issues </li> <li>Blood clots </li> <li>Numbness around the incisions </li> <li>Scars </li> <li>Unsatisfactory results </li> </ul> <h4>How long do I have to wait before having body contouring surgery?</h4> <p>Your weight should be stable before you have body contouring surgery. For most people, this occurs about two years after bariatric surgery.</p> <h4>Will insurance cover body contouring surgery?</h4> <p>Many insurance companies consider body contouring surgery cosmetic and do not cover the procedure or any complications that may occur after surgery. Some insurance companies will cover body contouring surgery if you have issues with rashes or sores related to excess skin.</p> <h4>Is body contouring just about appearances?</h4> <p>The benefits of body contouring are more than just cosmetic. The emotional and psychological improvements can be more dramatic than the physical improvement. Imagine losing 100 pounds but still feeling “flabby” because of excess skin. Getting rid of that skin can improve self-confidence and self-esteem. In fact, a recent study showed that bariatric surgery patients who have body contouring surgery experience less weight regain and have an improved quality of life than those who do not have body contouring. </p> <p><strong>Learn more about:</strong></p> <ul> <li><a rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/cosmetic-surgery/about/pac-20385138?_ga=2.175117602.1034370612.1597669955-498619545.1597669955" target="_blank" title="Opens in a new window.">Mayo Clinic cosmetic surgery</a></li> <li><a rel="noopener noreferrer" href="https://www.plasticsurgery.org/cosmetic-procedures/body-contouring" target="_blank" title="Opens in a new window.">American Society of Plastic Surgeons</a></li> <li><a rel="noopener noreferrer" href="https://www.nbcnews.com/health/health-news/after-huge-weight-loss-sagging-skin-remains-n44481" target="_blank" title="Opens in a new window.">NBC's body contouring surgery feature story</a></li> </ul> <p><em><a href="/providers/heidi-bednarchuk-cns" target="_self" title="Opens in same window.">Heidi Bednarchuk</a> is a certified nutrition specialist in <a href="/services-and-treatments/bariatric-surgery" target="_self" title="Opens in same window.">Bariatric Surgery</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a> and <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Weight-loss surgery</li> <li>Weight management</li> </ul>APRN, CNS<p>Weight is a very emotional issue and I like to think of my office as a “no blame, no shame zone.” My goal is to listen and understand my patient’s struggles and work together to develop a plan to address them. </p> <p>I have struggled with weight myself for most of my adult life and have a close family member that had bariatric surgery.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Nursing, Minnesota State University-Mankato</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Adult Health Clinical Nurse Specialist, American Nurses Credentialing Center</li> <li>Certified Bariatric Nurse, American Society for Metabolic and Bariatric Surgery</li> </ul> <p><strong>Membership</strong></p> <ul> <li>President-Elect, American Society for Metabolic and Bariatric Surgery</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Surgery, Mayo Clinic College of Medicine and Science</li> </ul>Bednarchuk<img src="/-/media/shared-files/images/medical-professionals/full/mankato/heidi-bednarchuk-cns.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4FA8ABD1C131281B9AB8444BFA59FB44" alt="Heidi Bednarchuk, C.N.S." width="280" height="280" DisableNVelocity="true" />Heidi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15681548Heidi Bednarchuk, APRN, CNS1{94B2E140-AEF8-44BA-B6A9-4538B77501BC}<img src="/-/media/shared-files/images/medical-professionals/full/mankato/heidi-bednarchuk-cns.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4FA8ABD1C131281B9AB8444BFA59FB44" alt="Heidi Bednarchuk, C.N.S." width="280" height="280" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Dawn Haller12/1/2021The holiday season can be one of the most difficult times of the year when you have experienced the death of a loved one. Get tips for working through your grief and instructions on how to make a keepsake ornament.Grief during the holidays: Finding hope<p>The holiday season can be one of the most difficult times of the year when you have experienced the death of someone you love. Holidays — a time of family togetherness, traditions, joy and thankfulness — can suddenly bring sadness, loss and a feeling of emptiness. It's a time when your senses are confronted with sights, sounds and smells that can trigger memories of the past, resulting in a renewed sense of personal grief.</p> <p>This year, there is a new layer of grief for thousands of families who have lost loved ones during the COVID-19 pandemic. New or long-lasting grief can make you feel like you' re all turned around, going in circles or out of balance. Understanding how you and other family members respond to grief can bring back a sense of balance, which can help you explore ways to embrace loving memories and recognize your needs during this difficult time.</p> <p>It's also important to remember that adults are not the only family members who grieve. Children often are the forgotten mourners. Unlike adults, they can move in and out of their grief quickly, which is normal. Children can benefit from having opportunities to express how they feel, along with reassurance and loving support. Including children in sharing memories and activities with family and friends can be an important part of the healing process.</p> <h4>During this holiday season, keep these tips in mind:</h4> <ul> <li><strong>Plan ahead.</strong><br> Consider where the challenges may come so you can make a plan that is comfortable for you. Tell family members and friends of your needs ahead of time so they understand that things may be different this year.</li> <li><strong>Grant yourself permission to change traditions.</strong><br> It's OK to shift or forgo some traditions this year. Alterations in family traditions don't need to become new traditions. Do what feels right at this time.</li> <li><strong>Ask for help.</strong><br> Accept offers for assistance with shopping, decorating, cooking and other holiday activities.</li> <li><strong>Share memories with family and friends.</strong><br> Your loved one is missed but not forgotten. Memories can bring laughter and tears. Both are OK and can be healing.</li> <li><strong>Light a special holiday candle.</strong><br> Place the candle in an important spot as a symbol that love lives on.</li> <li><strong>Create a tribute.</strong><br> Honor your loved one's passions by crafting something to serve as a long-lasting reminder. For example, you could make a scrapbook, build a birdhouse, plant a tree or make keepsake ornaments with family and friends.</li> </ul> <h4>Cinnamon dough keepsake ornaments</h4> <p>This easy-to-make ornament, with its warm cinnamon fragrance, is something that can be hung on your Christmas tree or around the house. It's also a wonderful gift that can be given to others who have been touched by your loved one. Be creative. Use different cookie cutters to create shapes that bring a smile and fond memories to mind. Use paint, markers or other items to decorate the ornament, or write your loved one's name on it. It's meant to be a keepsake that's personal to you.</p> <p><strong>Supplies needed</strong></p> <ul> <li>1 cup of flour</li> <li>1/2 cup of salt</li> <li>1/2 cup of cinnamon</li> <li>3/4 cup of very warm water</li> <li>Bowl</li> <li>Plastic food wrap</li> <li>Rolling pin</li> <li>Wax paper</li> <li>Cookie cutters</li> <li>Straw</li> <li>Paint, glue, beads, markers or other decorations</li> <li>Ribbon or yarn for hanging</li> </ul> <p><strong>Instructions</strong></p> <ol> <li>Combine ingredients together in a bowl and mix well, finishing by kneading the dough with clean, dry hands. If the dough is sticky, dust your hands with a little flour and knead.</li> <li>Roll out the cinnamon dough on waxed paper until it's about ¼" thick.</li> <li>Cut out desired shapes using cookie cutters.</li> <li>Use a straw to punch a hole in the ornaments for the ribbon to hang. The circle of dough will pull out with the straw.</li> <li>Gently place the shapes on a piece of clean wax paper.</li> <li>Dry completely (about 24 hours).</li> <li>Once dry, thread a ribbon through the hole you created with the straw, and decorate with paint, markers, etc. You also can use Mod Podge or a clear finishing spray to add a shiny appearance.</li> </ol> <p><em>Lisa De Sieno is director of Bereavement Services in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2021/heart-cookie-ornaments.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4379F16987D0DD4FD1B225F8FFEDC589" alt="Heart cookie ornaments" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.GriefGrief is the natural reaction to loss. It will be unique to you, depending on your own personality and circumstances.Dawn Haller6/8/2016<p>When you get sick, you probably call your provider or message your care team. Sometimes, you are diagnosed over the phone and a prescription is sent to your pharmacy. This is a typical healthcare experience in the U.S., but to someone from Somalia, navigating our health system is a new, foreign experience.</p>Helping Somalis connect with U.S. healthcare<img alt="SpeakingofHealth_SomaliHealth" src="/-/media/national-files/images/hometown-health/2016/spring-2016/speakingofhealth_somalihealth.jpg?h=222&w=207&sc_lang=en&hash=BA8CFA0FE30882489D7E0842F2375286" style="height: 222px; width: 207px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>When you get sick, you probably call your provider or message your care team. Sometimes, you are diagnosed over the phone and a prescription is sent to your pharmacy.</p> <p>This is a typical healthcare experience in the U.S., but to someone from Somalia, navigating our health system is a new, foreign experience.</p> <h2>A different system</h2> <p>Farhiyo Said, a native Somali, has lived in the U.S. for seven years. She has spent the last three in St. Peter, Minn. </p> <p>"The health environment is different in Somalia," says Said. "People walk everywhere, it's sunny and you burn off the food you eat. Here, people drive everywhere. Somalis gain weight because we eat the same, but don't walk as much."</p> <p>Reduced physical activity and an often misunderstood view of U.S. healthcare have caused a health decline in the St. Peter Somali population. In 2014, Fardousa Jama, a Mayo Clinic Health System translator and a Somali community facilitator in St. Peter, and her father, worked with the University of Minnesota's Family Medicine Residency Program to survey Somalis in the community. They found that Somalis needed help understanding how to navigate health systems.</p> <p>With Mayo Clinic Health System administrative staff, nursing and physician support, the University of Minnesota Family Medicine Residency faculty and residents wrote a grant on behalf of Mayo Clinic Health System to address the healthcare needs identified by the Somali community, developed a curriculum and delivered 12 monthly seminars to the Somali community in St. Peter from June 2015 to June 2016. During the classes, which were open to any Somalis, Mayo Clinic Health System family medicine resident providers taught nutrition and exercise, and discussed how to take advantage of services that healthcare systems offer. Providers also addressed basic healthcare questions, such as "What is health?" and "When should you go to the doctor?" Owing to the great success of the sessions, Mayo Clinic Health System offered to take over the Somali Health Literacy Project starting July 1, 2016.</p> <p>Nadia Malik, M.D., a Family Medicine physician at Mayo Clinic Health System in St. Peter, has been involved with the project from the beginning. "Dr. Malik is highly spoken of in the Somali community," says Jama. "Mayo staff members teach us about staying healthy, but doctors hear our perspectives too. The class is a learning experience between doctor and patient. Dr. Malik is meeting us where we are. She's a phenomenal woman."</p> <p>Dr. Malik is Said's primary provider and recommended her for the program because of Said's active involvement in the community.</p> <p>Said says she has learned a lot from the program, especially about mental health, which is a taboo topic for Somalis. "I share what I learned with everybody who wasn't able to come to the classes," she says. "Everybody is different within our community. Some are quick to trust, some need to build it. But I have trust, and I believe the doctors here can do good."</p> <p>As for Dr. Malik, she says she learns something new about Somali culture every day. "I've learned about their health, their diets, and their daily habits and routines," she says. "I've learned how to best explain the clinic visit to them, and that taking medication is not easy for them — but that's improving. It shows us that we're definitely making a difference."</p> <p>The University of Minnesota Family Medicine Residency faculty and residents will continue their investigation by examining how their project impacted patient care statistics for Somali patients being seen at Mayo Clinic Health System in St. Peter.</p><img src="/-/media/national-files/images/hometown-health/2016/spring-2016/somalihealth_sm.jpg?h=76&iar=0&w=76&sc_lang=en&hash=4397CA3BECCC9A4DFC315F2F843E8CD6" alt="SomaliHealth_sm" width="76" height="76" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller6/14/2016<p>Inflammation from a confused immune system can go beyond your joints. Learn about the different types of arthritis and rheumatic diseases, and where to go for help.</p>A better understanding of rheumatology and arthritis<img alt="Arthritis" src="/-/media/national-files/images/hometown-health/2016/2016-general/arthritis.jpg?h=300&w=350&sc_lang=en&hash=5EA935C99018A0171666750E4B2D61CB" /> <p>"Oh, my rheumatism!" You've probably heard this phrase from time to time. It's quite an old saying, with the word "rheuma" first recorded in the first century A.D. in Greece. Many centuries ago, people believed that flowing substances in the body, like phlegm, were the culprit of most body ailments and pains. </p> <p>Modern understanding has changed over several thousands of years. Today's rheumatology practice diagnoses and manages autoimmune and inflammatory diseases. Some examples include rheumatoid arthritis, lupus, gout, psoriatic arthritis, polymyalgia rheumatica and ankylosing spondylitis. Medical professionals have also since discovered it's our immune system and not flowing substances that is the source of rheumatic disease.</p> <p>Under normal conditions, the immune system recognizes foreign invaders, like bacteria and viruses, and sweeps them away. However, when the immune system gets confused, it can attack normal body tissues, producing pain and swelling known as inflammation.</p> <p>Often, these inflammatory effects are first felt in the joints and are referred to as arthritis. A deeper understanding made by practitioners has found that inflammation from a confused immune system can go beyond the joints and also attack the connective tissues, muscles, blood vessels and organs in the body. In some cases, inflammation may even be life-threatening.</p> <h2>Osteoarthritis or rheumatoid arthritis</h2> <p>We need to be careful with the term arthritis, because like the word "rheuma," it's an old general word. Interestingly, there are more than 100 types of arthritis, and they're all treated quite differently. Many people are only familiar with one type of arthritis: osteoarthritis. Osteoarthritis, often described as wear-and-tear arthritis, is the most common form of arthritis, affecting 27 million people in the U.S.. However, osteoarthritis is not an autoimmune inflammatory disease, and it's not the type of arthritis usually managed in a rheumatology practice.</p> <h3>Rather, an inflammatory arthritis like rheumatoid arthritis has these types of features:</h3> <ol> <li>Severe pain in the joints, muscles or bones that lasts more than three to four days. Commonly, walking or lifting a spoon to eat is difficult during a flare.</li> <li>Stiffness in the joints lasting more than an hour in the early morning.</li> <li>Swelling and redness in one or more joints.</li> </ol> <h2>Who can develop an autoimmune condition?</h2> <p>While no one knows exactly what triggers the immune system to make the mistake of attacking healthy tissue, some studies indicate a genetic component, combined with environment, may increase the risk for certain arthritis. This explains why people who experience symptoms associated with inflammatory arthritis usually have a relative who also has some form of autoimmune disease. Smoking tobacco can also be a trigger and should be avoided for numerous reasons.</p> <p>An inflammatory autoimmune condition can occur at any age. Right now in the U.S., there are 300,000 children with inflammatory juvenile arthritis. In fact, rheumatic disease often strikes at the prime of life, with two-thirds of patients under age 65.</p> <p>In many cases, the diseases are dramatic and debilitating at the time of onset. These are chronic conditions that cannot be cured. As a result, a diagnosis of an autoimmune or inflammatory disease can be stressful for the patient and his or her family.</p> <h2>Steps to take</h2> <p>If you or someone you know is experiencing signs or symptoms of an autoimmune or inflammatory condition, your primary care provider can refer you to Rheumatology for a detailed history and examination. In addition, laboratory tests on blood and urine, X-rays and, sometimes, samples of joint fluid are used to reach a diagnosis. Rheumatologic conditions can be challenging to diagnose and, in most, cases take several visits.</p> <p>Many times, rheumatic diseases are treated with medications, which have an effect on the immune system. Additionally, exercise, physical therapy, dietary modifications, adequate sleep, stress reduction and avoiding tobacco all play critical roles in successful treatment plans.</p> <p>While rheumatic autoimmune and inflammatory conditions cannot be cured, current treatment aims to limit the symptoms of the diseases. Many people with rheumatic disease lead productive, happy, satisfying lives. As your local rheumatology experts, we're here to help. </p> <p><em><a href="/providers/sarah-davis-cnp" target="_self" title="Opens in same window.">Sarah Davis</a> is a nurse practitioner in <a href="/services-and-treatments/rheumatology" target="_self" title="Opens in same window.">Rheumatology</a> in <a href="/locations/mankato">Mankato</a>, Minnesota.</em></p><ul> <li>Radiation oncology</li> <li>Wellness</li> </ul>APRN, C.N.P.<p><strong>Education</strong></p> <ul> <li>Bachelor's degrees, Nursing, French and Psychology, University of Wisconsin</li> <li>Master's degree, Nursing, Wichita State University</li> <li>Certificate, Massage Therapy, Lakeside School of Massage Therapy</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Academy of Nurse Practitioners</li> </ul>Davis<img src="/-/media/shared-files/images/medical-professionals/full/mankato/sarah-davis-np.jpg?h=280&iar=0&w=280&sc_lang=en&hash=D75301AB43EA384A23B16E6A368426F1" alt="Sarah Davis, APRN, C.N.P." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/12515991/" target="_blank" title="Opens in a new window.">Conducting intervention research through the Cancer Information Service: a feasibility study</a>, February 2003.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/8952439/" target="_blank" title="Opens in new window">1995 tobacco control ordinances survey: Wisconsin counties, cities and villages</a>, November 1996.</li> </ul>{2752D8CB-9B74-40AA-9712-180EC18E84A9}Sarah<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16344740Sarah Davis, APRN, C.N.P.1{BCFC3BDC-CF55-458E-A41C-9360527B6CCC}<img src="/-/media/national-files/images/hometown-health/2016/2016-general/arthritis.jpg?h=300&iar=0&w=350&sc_lang=en&hash=578056315DD0E7A18B4A805248148027" alt="Arthritis" width="350" height="300" DisableNVelocity="true" />ArthritisArthritis is inflammation of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis.Dawn Haller11/29/2021Vaginal dryness can cause discomfort with daily activities and painful intercourse. It's more common with menopausal women, but also affects younger women. Read simple ways to reduce symptoms, and find out when to seek care.Vaginal dryness: Symptoms, causes, remedies<p>Vaginal dryness can cause <a href="/hometown-health/speaking-of-health/womens-sexual-health-when-being-intimate-hurts" target="_self" title="Opens in same window.">painful intercourse</a> and persistent pelvic pain, among other symptoms. While it's more common in menopausal women, it also affects younger women.</p> <p>A handful of factors can affect <a rel="noopener" href="https://www.mayoclinic.org/symptoms/vaginal-dryness/basics/definition/sym-20151520" target="_blank" title="Opens in a new window.">vaginal dryness</a>. Estrogen is the most important hormonal influence on the health of the vulva and vagina. Low estrogen can contribute to dryness. Diet and the use of certain medications also are important factors. You can expect any medications that cause dry eyes and dry mouth to have a similar effect on the vagina.</p> <p>Estrogen levels in the blood vary during the month and follow a common pattern to each menstrual cycle. For women who are not on hormonal birth control, levels are lowest in the days just before and after the start of menstrual bleeding. This low level sometimes can contribute to vulvar and vaginal dryness. Very low-dose hormonal birth control can contribute to dryness.</p> <p>Women bothered by vaginal dryness should have a thorough discussion and exam with their health care provider to determine the most likely cause for these symptoms. Other causes of vulvovaginal pain and irritation may be responsible for the symptoms.</p> <p>An exam will ensure the correct diagnosis is made and less common, but more serious, conditions are not missed. Your provider will help you determine the best course of treatment.</p> <p>Many times, women inadvertently worsen their symptoms by using multiple creams or other home treatments before seeing their provider.</p> <h4>Here are a few things you can try to reduce vaginal dryness:</h4> <ul> <li>Consider using a vaginal moisturizer two to three times per week.</li> <li>For intercourse-related symptoms, a small amount of pure vegetable oil or olive oil can be helpful.</li> <li>Avoid bath soaps, lotions or gels that contain perfumes.</li> <li>Avoid all bubble baths, bath salts and scented oils.</li> <li>Do not use hot water while bathing or showering.</li> <li>Avoid all feminine hygiene sprays and perfumes.</li> <li>Do not use adult or baby wipes on the area.</li> <li>Avoid tight-fitting clothing and pantyhose. Wear white, 100% cotton underwear.</li> <li>Avoid all over-the-counter creams and ointments, except A&D Ointment. But do not use A&D Ointment if you have a wool allergy.</li> </ul> <p>While these recommendations can be helpful for many women, if symptoms persist despite these changes, your health care provider can suggest treatment options for vaginal dryness. This is a manageable condition for most women, and treatment can be life-changing for those with severe symptoms.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2021/arms-resting-over-sofa-back.jpg?h=370&iar=0&w=660&sc_lang=en&hash=FA88F1D43DDD89BE921BC4B3064E6312" alt="Sitting with arms crossed over the back of sofa looking out" width="660" height="370" DisableNVelocity="true" />Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller5/24/2016<p>It’s that time of the month and you’re feeling some painful bloating and cramping. Sometimes, the pain makes it difficult to perform normal household, job or school-related activities for a few days during each menstrual cycle. Although some pain during your period is normal, excessive pain is not.</p>When periods are painful<img alt="Is your period too painful" src="/-/media/national-files/images/hometown-health/2016/2016-womens-health-month/period-crampsa.jpg?h=297&w=400&sc_lang=en&hash=45D544724F0F97580752C9C6ECFC1D9A" style="height: 297px; width: 400px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>It's that time of the month and you're feeling some painful bloating and cramping. Sometimes, the pain makes it difficult to perform normal household, job or school-related activities for a few days during each menstrual cycle. Although some pain during your period is normal, excessive pain is not.</p> <p>It's normal for otherwise healthy young women to experience menstrual pain at the beginning of a menstrual cycle. Increased activity of the hormone prostaglandin, which is produced by the uterus, is thought to play a role in this condition. This pain is usually not related to a specific problem with the uterus or other pelvic organs. </p> <h2>Try these self-care tips if you're experiencing painful periods:</h2> <ul> <li>Try anti-inflammatory medicine, such as ibuprofen 600–800 milligrams, two to three times per day at the start of the pain. Ibuprofen works better than acetaminophen, such as Tylenol.</li> <li>Apply a heating pad to your lower belly area.</li> <li>Massage your lower belly area in light, circular motions.</li> <li>Drink warm beverages and eat light, but frequent, meals.</li> <li>Follow a diet rich in whole grains, fruits, and vegetables, but low in salt, sugar, alcohol and caffeine.</li> <li>Lie down with your legs elevated.</li> <li>Practice meditation, yoga or other relaxation techniques.</li> <li>Take warm showers or baths.</li> <li>Walk or exercise regularly.</li> </ul> <h2>When to contact your healthcare professional:</h2> <p>If the pain is unbearable and self-care treatments don't provide relief, it's time to talk to your primary care professional. You may be prescribed additional medications or further testing.</p> <p> </p> <h3>You also should contact your provider if:</h3> <ul> <li>Treatments don't relieve your pain after three months.</li> <li>You pass blood clots or have other symptoms with the pain.</li> <li>Your pain occurs at times other than menstruation, begins more than five days before your period or continues after your period is over.  </li> </ul> <p><a href="/providers/tiffany-casper-do"><em>Tiffany Casper, D.O.</em></a><em>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/tomah">Tomah</a>, Wisconsin.</em></p><ul> <li>Pediatrics</li> <li>Skin conditions</li> <li>Women's health</li> </ul>D.O.<p><strong>Education</strong></p> <ul> <li>Doctor of Osteopathic Medicine, A.T. Still University – Kirksville College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Mercy Health System</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Medicine </li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Osteopathic Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Casper<img src="/-/media/shared-files/images/medical-professionals/full/tomah/tiffany-casper-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=1A30A61D9D6C113EA2C621F6A4AD3702" alt="Tiffany Casper DO" width="280" height="280" DisableNVelocity="true" />Tiffany<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15595587Tiffany Casper, D.O.1<img src="/-/media/national-files/images/hometown-health/2016/2016-womens-health-month/period-crampsa.jpg?h=375&iar=0&w=504&sc_lang=en&hash=902D1C7F6ED791E2B3988F5B780B0F5F" alt="period crampsA" width="504" height="375" DisableNVelocity="true" />Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller10/13/2020When you hear "3D" you may think of glasses at a movie theater or printing. Digital breast tomosynthesis, also known as 3D mammograms, are becoming a best practice for detecting breast cancer. Discover the benefits.3D technology provides enhanced breast cancer detection<p>As you transition from bikinis to briefs, your risk for cancers can increase. Women of all ages should perform <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.mayoclinic.org/tests-procedures/breast-exam/basics/what-you-can-expect/prc-20020418" target="_blank" title="Opens in a new window.">self-breast examinations</a> to observe any changes that may signal something serious, such as breast cancer. Once you turn 40, it is time to schedule your yearly <a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">mammogram</a>.</p> <p>Digital breast tomosynthesis, also known as 3D mammography, is becoming a best practice in women’s health for breast cancer-detecting technology. It is the next evolution of digital mammography producing 3D images that allow breast tissue to be viewed in individual segments. This allows doctors to evaluate glandular tissue in greater detail, which decreases your chance of getting a call to come back for another screening to confirm findings.</p> <p>You may benefit most from tomosynthesis if you have a history of breast cancer in your family, are premenopausal or were told by your provider that you have dense tissue.</p> <p>Check with your insurance carrier before scheduling a 3D mammography exam to confirm coverage.</p> <p>Mayo Clinic Health System offers tomosynthesis at many locations. Contact your <a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">local Mayo Clinic Health System location</a> to find out if it is available near you.</p> <p>I can’t stress enough that you should not skip your annual mammogram appointment beginning at age 40. The sooner cancer is detected, the better your outcome.</p> <h4>View a video demonstrating how digital breast tomosynthesis, also known as 3D mammography, allows breast tissue to be viewed in individual slices:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/pdDMXaOvJkg" title="Digital breast tomosynthesis" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p><em><a href="/providers/megan-meyers-md" target="_self" title="Opens in same window.">Megan Meyers, M.D.</a>, is a <a href="/services-and-treatments/radiology-and-imaging" target="_self" title="Opens in same window.">radiologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p> <ul> <li>Musculoskeletal, breast and diagnostic imaging</li> </ul>M.D.<p>In my spare time, I enjoy golf, downhill and cross-country skiing and spending time with family.</p><p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Diagnostic Radiology, University of Minnesota</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Musculoskeletal Radiology, Mayo Clinic</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Board-eligible, American Board of Radiology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Radiology</li> <li>Radiological Society of North America</li> </ul>Meyers<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/megan-meyers-md.jpg?h=200&iar=0&w=200&sc_lang=en&hash=45694589DE6324F967703C6F97118CFD" alt="Megan Meyers, M.D." width="200" height="200" DisableNVelocity="true" />Megan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15856721Megan Meyers, M.D.1<img src="/-/media/national-files/images/hometown-health/2020/3d-tomography.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EC70B6930A773C63745E9F9BAA37689E" alt="3D tomography" width="660" height="370" DisableNVelocity="true" />Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller6/6/2022Summertime events, like graduations, family reunions and vacations, come with their own set of stressors. Learn what can you do to stress less and have more fun this summer.Manage your stress so it doesn’t manage you this summer<p> Many kids and their families look forward with excitement to summer and picture long summer days of ease and contentment. The reality is that while summer should usher in a time of minimal stress, it often brings different kinds of stress.</p> <h2>While stress can't be eliminated, it can be better controlled with these tips:</h2> <h3>Practice good sleep hygiene.</h3> <p>Summertime hits, and sleep schedules often are altered when kids are going to bed at different times each night. This results in some kids sleeping in six to seven hours past their normal school year wake time. Studies have shown that a lack of sleep and erratic sleep schedules can influence stress.</p> <p>The most important sleep hygiene measure is to maintain a regular wake and sleep pattern seven days per week. While most people don't like the idea of waking to an alarm during the summer, it will help with the summer sleep cycle.</p> <p>Another measure to improve sleep involves screen time. The use of screen time before bed, which includes television, computer, smartphones and tablets, has been shown to decrease melatonin, the hormone produced by the body to help regulate sleep. If melatonin production is suppressed, sleep is negatively affected. Increased screen time has been the culprit of many lost hours of sleep for children and adults.</p> <p>Screens act as a stimulant before bed, alerting the brain rather than relaxing the brain. Most of us wouldn't allow our child to have a cup of coffee before bed, yet allow multiple screens in the bedroom. For good sleep, it is recommended that families consider the practice of putting the electronics to bed 30 to 60 minutes before bedtime for kids to relax and wind down.</p> <h3>Cultivate a sense of humor.</h3> <p>A good laugh doesn't just lighten a mood, it also lowers cortisol, the body's stress hormone. Letting out a giggle boosts those feel-good brain chemicals called endorphins. A deep chuckle relaxes your muscles and lowers stress hormones. In other words, a big unrestrained burst of laughter could be thought of as a massage for your inside. Families can find ways to laugh together by watching comedies, reading comics and helping each other to find the funny in life. One of the most essential keys, in my opinion, is to surround yourself with people who also seek out and embrace the humor in life.</p> <h3>Strengthen family time through play.</h3> <p> Strong family connections help children to manage stress better. The best way to improve that connection is through play. Physical activity plays a big part in helping kids manage stress. If you can incorporate physical activity, play, and family together, you are providing what I call a super-charged stress buster.</p> <p>Play as a form of physical activity has a key role in reducing and preventing the effects of stress. With summer vacation here, there are so many opportunities to play as a family.</p> <h4>Here are a few easy activities to incorporate into your schedule:</h4> <ul> <li>Play some music and have a dance fest.</li> <li>Take the bikes on trails in your area or around your local neighborhood.</li> <li>Geocache around your town. Geocaching is an outdoor recreational activity in which participants use a GPS to locate hidden treasures. Apps can be downloaded on any smartphone. There are hundreds of caches places on trails and around communities waiting to be found by families who like to treasure hunt.</li> <li>Try out a kayak or canoe. Many communities located near water have rent kayaks, canoes, paddleboards and fishing equipment. These all are activities that even young kids can try out.</li> <li>Walk your dog and explore new areas.</li> <li>Have a campfire, and play party games as a family.</li> <li>Free activities, such as tennis, volleyball and disc golf are great, because most communities have courts. Directions for these activities can be found online.</li> </ul> <p>Good sleep hygiene, cultivating humor and playing as a family may not erase stress, but all three methods are essential for managing and reducing stress. When parents use these simple methods to manage stress, they are modeling healthy ways for their children to manage stress not only in the present, but for a lifetime.</p> <p><a href="/providers/janice-schreier-lcsw" target="_self" title="Opens in same window."> <em>Janice Schreier</em></a><em>, is a psychotherapist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Anxiety</li> <li>Attention deficit hyperactivity disorder</li> <li>Bipolar disorders</li> <li>Chemical dependency</li> <li>Depression</li> <li>Eating disorders</li> <li>Facilitates social skills groups for adolescents with autism spectrum disorders</li> <li>Individual, family and group therapy</li> <li>Obsessive-compulsive disorders</li> <li>Post-traumatic stress disorder</li> <li>Reactive attachment disorder</li> <li>Trauma</li> <li>Treatment for children 7–17 and young adults</li> </ul>L.C.S.W.<p><strong>Education</strong></p> <ul> <li>Addiction Counseling, Viterbo University</li> <li>Bachelor's degree, Social Work, University of Wisconsin-La Crosse</li> <li>Master's degree, Social Work, University of Wisconsin-Milwaukee</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Autism Spectrum Disorders</li> <li>Licensed Clinical Social Worker, Substance Abuse Specialty</li> </ul>Schreier<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/janice-schreier-msw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=42215A8A31EDEE2903AC5F89E6D23B11" alt="Janice Schreier MSW" width="280" height="280" DisableNVelocity="true" />Janice<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15449963Janice Schreier, L.C.S.W.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2022/kicking-soccer-ball.jpg?h=370&iar=0&w=660&sc_lang=en&hash=671E7AD1A264D143BDDD43E13DDB32DD" alt="Kicking soccer ball" width="660" height="370" DisableNVelocity="true" />Stress ManagementGuidance to help you reduce and manage daily stress.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Dawn Haller5/4/2016<p>Although risks of exposure to the Zika virus still are largely unknown, find out what you can do to protect yourself and your unborn baby.</p>Pregnant women and Zika virus: What we know, what we don’t know<img alt="Pregnant women and Zika virus: What we know, what we don’t know" src="/-/media/national-files/images/hometown-health/2016/2016-womens-health-month/pregnancy-and-zika-virus.jpg?h=309&w=309&sc_lang=en&hash=38E313FBEA8954B7F06A9664FDDAB421" style="height: 309px; width: 309px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>Although the Zika virus was first discovered in 1947, it has been in the last two years that physicians and researchers have identified a link between the Zika virus and birth defects. Zika is transmitted primarily by mosquitoes. When mosquitoes bite an infected person, they transfer the virus to an unaffected person through an additional bite. At this time, the Aedes species of mosquito passes the virus, although new reports may demonstrate that all types of mosquitoes can pass the virus. The Zika virus also can be passed from mother to fetus, through sexual contact and through blood transfusions. To date, no reports are present that show Zika is spread through breast milk.</p> <p>Usually, symptoms of Zika are mild, and many patients do not know they have the virus. The most common symptoms are fever, rash, joint pain and red eyes. These symptoms appear to be the same in pregnant women.</p> <p>Currently, there has been no local transmission of Zika virus in the U.S.</p> <h2>Risks to pregnant women</h2> <p>What is the risk in pregnancy? The risk largely still is unknown. Brazil is one of the largest affected countries from the Zika virus, and has documented cases of microcephaly and mental retardation. Microcephaly is an abnormally small head, due to a decrease or stopping in brain growth. Microcephaly also can occur due to malnutrition, other infections, certain drugs and toxins. The severity of microcephaly can vary. Usually, a diagnosis can be made from an ultrasound; however, the severity is determined after delivery. There is no known cure or treatment for microcephaly or mental retardation.</p> <p>As of late January, Zika has been identified in at least three Minnesotans and at least one who is pregnant. All people had traveled or lived outside of the United States in areas of high transmission. As of late February, there have been no reports of Zika in Wisconsin.</p> <h2>Zika virus prevention</h2> <h3>Pregnant women should protect themselves with these actions:</h3> <ul> <li>Avoid traveling to infected countries, including Mexico, Brazil and most Caribbean countries.</li> <li>Avoid sex, or use condoms to if you have concerns that your partner may have Zika or is at high risk for Zika.</li> <li>Wear long-sleeved shirts and long pants.</li> <li>Use <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.epa.gov/insect-repellents/find-repellent-right-you" target="_blank" title="Opens in a new window.">Environmental Protection Agency (EPA)-registered insect repellents</a>, which according to the Centers for Disease Control (CDC), are safe and effective in pregnancy.</li> <li>Be sure your repellents include one of these ingredients: DEET, picaridin, IR3535, oil of lemon eucalyptus, or para-menthane-diol.</li> <li>Visit your health care provider immediately if you develop symptoms and have traveled to infected area or have concerns about a mosquito bite.</li> </ul> <p>At this time, there are many unknowns about the virus. Researchers are unsure if there is a safe time to travel to an infected area during pregnancy or if you are bitten by an infected mosquito, how likely you are to contract the Zika virus. Also, if a pregnant woman has Zika, it is unknown what the likelihood is of transmitting the virus with birth defects to her fetus. At this time, no cure or vaccine exists — there only are prevention methods to reduce transfer of the virus.</p> <p>As more research continues to be discovered, the <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.cdc.gov/zika/index.html" target="_blank" title="Opens in a new window.">Centers for Disease Control (CDC)</a> and your health care provider are two resources for more information.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2016/2016-womens-health-month/pregnancy-and-zika-virus.jpg?h=309&iar=0&w=309&sc_lang=en&hash=5CFB5EA13DEE648F488D62D238E2C484" alt="Pregnant women and Zika virus: What we know, what we don’t know" width="309" height="309" DisableNVelocity="true" />Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller6/4/2015<p>In times of stress, anxiety or frustration, you've probably been told to relax, take a deep breath and calm down. Have you tried it? Learn how children can benefit from this simple relaxation technique.</p>Blow the pain away: Breathing tips to help children relax<p>In times of stress, anxiety or frustration, you've probably been told to "relax, take a deep breath and calm down." Have you tried it? Many <a rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/meditation/basics/definition/prc-20013692" target="_blank" title="Opens in a new window.">meditation</a> practices use breathing techniques to promote a state of calm. You don't need years of meditative practice to benefit from this technique, nor do your children. In fact, kids are generally good at embracing this simple relaxation technique.</p> <h2>Deep breathing technique</h2> <p><a rel="noopener noreferrer" href="http://www.mayoclinic.org/tests-procedures/stress-management/basics/definition/prc-20021046" target="_blank" title="Opens in a new window.">Deep breathing</a> increases the supply of oxygen to your brain and stimulates the parasympathetic nervous system, which promotes a state of calmness, according to the American Institute of Stress. Controlled breathing, also known as belly breathing or abdominal breathing, describes a deep, slow intake of air that expands the diaphragm downward and draws air deep into the lungs, pushing the belly out as the lungs fill with air. It's followed by a long controlled breath out as the strong diaphragm muscle relaxes and air flows out. This type of breathing technique can take you from an excited state of mind with the "fight or flight" instinct on high alert to a state where heart rate slows, blood pressure goes down and pain decreases.</p> <h2>Help for children and teenagers</h2> <p>Young children — and teenagers — can learn and practice deep breathing to <a href="/hometown-health/speaking-of-health/tips-to-help-children-relax" target="_self" title="Opens in same window.">strengthen their mind/body connection</a> and manage emotions that may seem overwhelming at times. Kids, especially, can use this technique when they're worried, sad or in pain. Adding imagery and phrasing often can help enhance the effectiveness of deep breathing: "Breathe in the good, breathe out the bad," or "Blow the pain away." Some kids may respond better to images that invoke familiar sights, sounds or smells of a favorite place rather than movement. For instance, bubbles and pinwheels can be used as a distraction and fun way to promote deep breathing when pediatric patients need their blood drawn or when receiving a shot.</p> <h3>How to get started:</h3> <ul> <li>Find a comfortable position. If possible, lie down on a flat surface.</li> <li>Place a hand on your belly or an object, such as a stuffed animal or even a book. Your hand or the object should rise as you take a big breath, and your hand should fall as you let the air out slowly over a period of several seconds.</li> <li>Breathe in through your nose and out through your mouth. Let your shoulders and neck relax with the movement in your abdomen. Repeat 15 to 20 times.</li> <li>Consider adding a short phrase in your mind with the breathing, such as "I am" on the inhalation, "relaxed" on the exhalation. You could also slowly count to four on each breath.</li> </ul> <p>Deep breathing also can be part of a bedtime routine that promotes calmness and relaxation. This type of daily practice makes it easier to use the deep breathing technique when other situations arise. It can help relieve the pain of frequent headaches or stomachaches. Deep breathing can help ease transitions to new places or events. It can even be part of a time out for your child or you as your child learns to manage strong emotions.</p> <p>Consider teaching your teenager to take a few deep breaths before answering a difficult question at school or before an athletic performance. Elite basketball players do this all the time at the free throw line.</p> <p>There are multiple ways to learn the technique: written instructions, audio or video recordings, or smartphone apps. Choose and practice the one that works the best for you and your child, and enjoy a calmer body, mind and spirit.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2015/little-girl-meditating_small.jpg?h=200&iar=0&w=200&sc_lang=en&hash=7AA3B51905B13DC20495D393812A2FE5" alt="Little Girl Meditating_Small" width="200" height="200" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Stress ManagementGuidance to help you reduce and manage daily stress.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller5/12/2016Eating disorders are complex, affecting the mind, body and spirit. Like a cancer, it does not discriminate by age, size, gender, religious beliefs, race or socioeconomic status.Reflections from an eating disorders therapist<img alt="HTH_Eating Disorder 350x350_513 (2)" src="/-/media/national-files/images/hometown-health/2016/2016-womens-health-month/hth_eating-disorder-350x350_513-(2).jpg?h=400&w=400&sc_lang=en&hash=1927FF0A1B0C7E7FC95502266939E66E" style="height: 400px; width: 400px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>I can recall the moment, 25 years ago, when I truly learned about eating disorders. I was interning at a college counseling center at the university while pursuing a Master of Science degree in community counseling. I looked forward to working with this population as they embarked on their various paths of self-discovery. Early into the experience, I facilitated an eating disorders support group on campus. I learned little, if anything, about eating disorders in my undergraduate years. What I discovered over the next year opened my heart and mind to the challenges, successes and overall journey those with eating disorders endure.</p> <p>It sparked my lifelong passion to work with those afflicted by this disease and to raise awareness about eating disorders, body image complexes and the impact of mainstream media. Though knowledge and treatment have increased over the years, they are still misunderstood diseases. Eating disorders are complex, affecting the mind, body and spirit. Like a cancer, it doesn't discriminate by age, size, gender, religious beliefs, race or socioeconomic status. Eating disorders are not a choice. Though they can be life-threatening, with the right treatment, people do and can fully recover.</p> <h2>Complexity and confusion</h2> <p>Food choices can be confusing in today's culture. Changes in how, what, where and when people eat may create disordered eating patterns. Some people may experience a disordered eating pattern without having an eating disorder. However, eating disorders are serious conditions related to persistent eating behaviors that negatively impact health, emotions and the ability to function in important areas of life. Research studies show those who have eating disorders, such as <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/anorexia/home/ovc-20179508" target="_blank" title="Opens in a new window">anorexia nervosa</a>, <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/bulimia/home/ovc-20179821" target="_blank" title="Opens in a new window">bulimia nervosa</a>, eating disorder unspecified and <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/binge-eating-disorder/home/ovc-20182926" target="_blank" title="Opens in a new window">binge-eating disorder</a>, have a biological imbalance in their brain chemistry. This creates a preoccupation with weight and food, which interferes with a person's ability to experience joy, healthy relationships, freedom, self-love and peace.</p> <p>The clients I have had the honor of working with throughout the years stress the importance of educating others to see the person rather than their weight or what they eat. They want to be seen for more than their disease. The journey to recovery is one of many detours, twists and turns. But there is a light at the end for those with the courage, strength and support to get the help they need.</p> <h2>Recovery goals</h2> <p>The ultimate goals of recovery are to find a balance with all relationships and learn healthy ways to express emotions without using weight and food to cope with life's challenges.</p> <h3>Some goals may include:</h3> <ul> <li>Finding peace within and acceptance of one's body no matter what size.</li> <li>Reclaiming a relationship with food so it is enjoyable and nurturing.</li> <li>Finding body movement or exercise that is enjoyable.</li> <li>Developing healthy relationships with people who are supportive and kind.</li> <li>Renewing the spirt and be grateful to the body it resides in.</li> </ul> <p>Each person, no matter where they are on the path in life can start by taking a moment to appreciate one thing the body does. Your whole self will feel grateful.</p> <p><a href="/providers/sarah-stinson-lpc" target="_self" title="Opens in same window."><em>Sarah Stinson</em></a><em> is a counselor in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/red-wing" target="_self" title="Opens in same window.">Red Wing</a>, Minnesota.</em></p><ul> <li>Eating disorders treatment and prevention</li> <li>Healing Touch</li> <li>Mindfulness</li> <li>Stress Management and Resiliency Training (SMART)</li> </ul>M.S., L.P.C., L.P.C.C.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Psychology, Winona State University</li> <li>Master's degree, Community Counseling, St. Cloud State University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Certified Healing Touch Instructor (CHTP/I)</li> <li>Certified Healing Touch Practitioner (CHTP/I)</li> <li>Certified Massage Therapist</li> <li>Licensed Professional Counselor, Minnesota and Wisconsin</li> </ul> <p><strong>Fellowship</strong></p> <li>Fellow, Academy of Integrative Health and Medicine (AIHM)</li>Stinson<img src="/-/media/shared-files/images/medical-professionals/full/red-wing/sarah-stinson.jpg?h=280&iar=0&w=280&sc_lang=en&hash=59889EC2825310D74211E2DC2531FB57" alt="Sarah Stinson" width="280" height="280" DisableNVelocity="true" />Sarah <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15830667Sarah Stinson, M.S., L.P.C., L.P.C.C.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2016/2016-womens-health-month/hth_eating-disorder-350x350_513-(2).jpg?h=467&iar=0&w=467&sc_lang=en&hash=DF841B3BF11208E6B68C9144B83B35E7" alt="HTH_Eating Disorder 350x350_513 (2)" width="467" height="467" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller5/25/2022Spring and summer are exciting seasons. With increased exposure to the sun, risk of skin damage increases, including development of skin cancer. The good news? Most skin cancers are preventable.5 simple steps to help prevent skin cancer<p>In parts of the country where winter seems to drag on forever, spring and summer are exciting seasons. The air becomes warmer, the sun gets brighter and outdoor activities are frequent. Naturally, your skin's exposure to the sun increases during this time of year, which results in a greater risk of skin damage, including development of skin cancer. The good news? Most skin cancers are preventable.</p> <h2>What is skin cancer?</h2> <p>Specifically, skin cancer is the abnormal growth of skin cells, and usually the result of overexposure to the sun and harmful ultraviolet (UV) rays. Although skin that's most exposed accounts for the majority of cases, well-covered areas of the body, like your palms or genital area, also can be affected. All pigmentations — dark and light — are subject to skin cancer.</p> <p>According to the American Cancer Society, skin cancer is the most common cancer in America, with 5.4 million basal and squamous cell skin cancers and more than 76,000 melanoma cases diagnosed each year. Melanoma, the deadliest form of skin cancer, kills more than 10,000 Americans each year — nearly 75% of all skin cancer deaths in the U.S.</p> <h2>What common forms does skin cancer take?</h2> <h4>Skin cancer can take many forms, but the three most common are:</h4> <ul> <li><strong><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/basal-cell-carcinoma/basics/definition/con-20028996" target="_blank" title="Opens in a new window.">Basal cell carcinoma</a></strong><br /> Beginning in the basal cells in the outer layer of skin, basal cell carcinomas may appear as a pearly or waxy bump, as well as a flat, flesh-colored or brown scar-like lesion.</li> <li><strong><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/squamous-cell-carcinoma/basics/definition/con-20037813" title="Opens in a new window." target="_blank">Squamous cell carcinoma</a></strong><br /> Also in the outer layer of skin, this type of skin cancer forms in squamous cells. Signs often are a firm, red nodule or a flat lesion with a scaly, crusty surface.</li> <li><strong><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/melanoma/basics/definition/con-20026009" target="_blank" title="Opens in a new window.">Melanoma</a></strong><br /> Melanoma makes up a small fraction of skin cancers, but it's also the most deadly. Symptoms of melanoma include: <ul> <li>A large brown spot with darker speckles</li> <li>A mole that changes in color, size or feel, or that bleeds</li> <li>A small lesion with an abnormal border, and sections that appear red, white, blue or bluish-black</li> <li>Dark lesions on your palms, soles, fingertips or toes, or on mucous membranes lining your nose, mouth, vagina or anus</li> </ul> </li> </ul> <h2>What can I do to prevent skin cancer?</h2> <h4>Leading medical experts, including Mayo Clinic, recommend these five steps for preventing skin cancer:</h4> <ol> <li>Avoid the sun between 10 a.m. and 4 p.m., which are the peak hours of sun strength in North America, even in the winter and on cloudy days.</li> <li>Wear sunscreen — at least sun protection factor (SPF) 30 — throughout the entire year. Reapply sunscreen every two hours or more frequently if you're swimming or sweating.</li> <li>Wear sun-protective clothing with ultraviolet protection factor (UPF) of 50+, which blocks 98% of the sun's rays. Hats with wide brims and sun-protective clothing that covers your arms and legs are helpful to protect your skin from harmful UV damage. Sunscreen doesn't block all UV rays, which cause skin cancer.</li> <li>Avoid tanning beds. Tanning beds operate with UV lights, damaging your skin and potentially leading to cancer.</li> <li>Self-check your skin. If you notice differences, talk with your health care team.</li> </ol> <h2>Who's most at risk for skin cancer?</h2> <h4>Anyone can get skin cancer, but those at a higher risk include:</h4> <ul> <li>Experiencing heavy exposure to UV rays</li> <li>Having lighter skin</li> <li>Having a family history of skin cancer</li> <li>Having prevalent moles</li> <li>Experiencing numerous severe sunburns in the past</li> <li>Having a weakened immune system</li> <li>Living in sunny or high-altitude climates</li> </ul> <p>Any change in your natural skin color, such as a tan, burn or freckle, is dangerous for your skin and increases your risk of skin cancer. Contact your health care team if you have concerns about skin abnormalities. Skin cancer is treatable when caught in its early stages.</p> <p>Have fun as the warm days roll in, but always keep skin cancer prevention in mind.</p> <p><em><a href="/providers/elizabeth-demaree-do" target="_self" title="Opens in same window.">Elizabeth Demaree, D.O.</a>, specializes in <a href="/services-and-treatments/dermatology" target="_self" title="Opens in same window.">dermatology</a> and <a href="/services-and-treatments/cosmetic-services" target="_self" title="Opens in same window.">cosmetic services</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Acne</li> <li>Cosmetics — neurotoxin and fillers</li> <li>Eczema</li> <li>Hidradenitis suppurativa</li> <li>Moles</li> <li>Psoriasis</li> <li>Skin cancer</li> <li>Warts</li> </ul>D.O.<p>I believe in a friendly, down-to-earth approach to patient care, and take great joy in educating my patients and answering all questions.</p> <p>I am a South Dakota native who completed my medical training in Missouri before moving to the lovely state of Wisconsin. I spend my free time cooking, reading and playing with my two young children.</p><p><strong>Education</strong></p> <ul> <li>A.T.S.U. Kirksville College of Osteopathic Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Traditional Rotating Internship, Capital Region Medical Center</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Dermatology, Northeast Regional Medical Center</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Dermatology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Dermatology</li> <li>American Osteopathic College of Dermatology </li> </ul> <p> <strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Dermatology, Mayo Clinic College of Medicine and Science</li> </ul>Demaree<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/elizabeth-demaree-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7433C8F47B411169AECB297766035EE5" alt="Elizabeth Demaree, D.O." width="280" height="280" DisableNVelocity="true" />Elizabeth<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30082632Elizabeth Demaree, D.O.1{276FDCB2-F341-4C45-B04B-F71FB963B8CB}|{20D94572-B26A-4FB7-8C9D-7555CE785162}<img src="/-/media/national-files/images/hometown-health/2022/reflective-sunglasses-brimmed-hat.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0057DBDBC46FBD0B3A54CAA990690196" alt="Reflective sunglasses brimmed hat" width="660" height="370" DisableNVelocity="true" />Skin CancerSkin cancer — the abnormal growth of skin cells — most often develops on skin exposed to the sun. But this common form of cancer can also occur on areas of your skin not ordinarily exposed to sunlight.Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Dawn Haller5/13/2022Miscarriages are common. When it happens, it can't be blamed upon anyone, especially yourself. Learn what you can do and how to cope.Miscarriage: It’s not your fault<p>As an OB-GYN, I see couples who have difficulty staying pregnant. It is certainly disappointing and saddening when they realize they have lost their baby.</p> <p>When a miscarriage happens, it cannot be blamed on anyone, especially yourself. Unfortunately, miscarriages are common.</p> <p>It's estimated that 10% of clinically recognized pregnancies end in a miscarriage. The most common cause of miscarriage is chromosomal abnormalities in the embryo. This means it's neither mom nor dad's fault.</p> <p>Women often want to know if having one miscarriage means they'll likely have another. There is no way to say for sure. Most women who have a miscarriage go on to have healthy pregnancies. Still, women who have had a miscarriage could have other miscarriages. After two consecutive clinical miscarriages, it's recommended to be medically evaluated by your health care team.</p> <p>There's no way to ensure you will not have a miscarriage. But you can reduce your chances of having a miscarriage by having preconception and prenatal visits. Most miscarriages happen during the first trimester of pregnancy.</p> <p>It's important to avoid alcohol, drugs and tobacco while <a href="/hometown-health/speaking-of-health/thinking-about-getting-pregnant-5-things-to-think-about-first" target="_self" title="Opens in same window.">trying to get pregnant</a>. It's also recommended to take prenatal vitamins, or at least folic acid, three months before conception.</p> <h2>Signs of a miscarriage</h2> <p>You will be able to tell you're going through a miscarriage if you start experiencing heavier vaginal bleeding accompanied by the passage of fetal tissue. This looks similar to a white mass covered with blood. It's also common to feel severe cramping afterward.</p> <p>Not every episode of pain or bleeding during pregnancy is a miscarriage. Heavy, prolonged bleeding can be associated with a normal pregnancy. If you experience these symptoms, it's important to contact your health care team. If bleeding is heavy enough to soak one pad per hour, or you start feeling dizzy and lightheaded, go to the emergency department.</p> <h2>You don't need to go through miscarriage alone</h2> <p>Miscarriages are <a href="/hometown-health/speaking-of-health/seeking-support-when-grieving" target="_self" title="Opens in same window.">difficult to go through</a>, but it's important to not give up. Many women who have miscarriages are able to have a baby in the future. After two consecutive clinical miscarriages, it's recommended to have a medical evaluation. Having a miscarriage can be tough to deal with. If you're having a hard time coping, talk to your health care provider. They will be able to help you find a counselor to speak with.</p> <p><a href="/providers/gabriela-cardenas-palecek-md" target="_self" title="Opens in same window."><em>Gabriela Cardenas Palecek, M.D.</em></a><em>, sees patients in <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">Obstetrics & Gynecology</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire, Wisconsin</a>.</em></p><p>Infertility<br /> Women's health</p>M.D.<p>Spanish-speaking</p><p><strong>Medical School</strong> <br />Facultad de Medicine, Universidad, Mexico City, Mexico</p> <p><strong>Residency</strong> <br />OB/GYN, Universidad Nacional Autonoma de Mexico, Mexico City</p> <p><strong>Fellowship</strong> <br />Reproductive Endocrinology & Infertility, Universidad Nacional Autonoma de Mexico, Mexico City</p> <p><strong>Internship & Residency</strong> <br />OB/GYN, Mercy Hospital, Chicago, IL</p>Cardenas Palecek<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/gabriela-cardenas-palecek-md.jpg?h=200&iar=0&w=200&sc_lang=en&hash=221E2E24A7B9DEE0B3229A684E1EF148" alt="Gabriela Cardenas Palecek, M.D." width="200" height="200" DisableNVelocity="true" />{653B65E0-3D6C-43E6-8EAA-3B88F479F022}Gabriela<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15995674Gabriela Palecek, M.D.1{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}<img src="/-/media/national-files/images/hometown-health/2022/stuffed-animal-tucked-in-covers.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D6EE1923C61AA856F1155E428BF156E9" alt="Blog_miscarriage_couple" width="660" height="370" DisableNVelocity="true" />Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller3/1/2024During and after pregnancy, some people use aromatherapy with essential oils to relieve discomfort and promote relaxation. Find out which oils are helpful, and what to consider if you want to try them.Aromatherapy use and safety: What to know about essential oils during pregnancy<p>People often have questions about using essential oils before, during and after pregnancy. These natural oils are distilled from plants or other sources and retain their characteristic fragrance. Aromatherapy is the therapeutic use of essential oils, but research on its effectiveness is limited. Some studies have shown that aromatherapy may relieve <a href="/hometown-health/speaking-of-health/addressing-your-mental-health-by-identifying-the-signs-of-anxiety-and-depression" target="_self" title="Opens in same window.">anxiety and depression</a>. </p> <p>The Food and Drug Administration (FDA) doesn't regulate essential oils used for aromatherapy, but they have been shown to be safe when used as directed. Essential oils are becoming more common to use during pregnancy, labor and the <a href="/hometown-health/speaking-of-health/too-embarrassed-to-ask-i-just-had-a-baby-whats-wrong-with-my-moods" target="_self" title="Opens in same window.">postpartum period</a> to treat anxiety, aches and lack of focus.</p> <h2>With various oils to choose from, these types may help pregnant people:</h2> <h3>Peppermint oil</h3> <p>Peppermint oil can be helpful for headaches, nausea, <a href="/hometown-health/speaking-of-health/chronic-sinusitis-more-than-a-stuffy-nose" target="_self" title="Opens in same window.">nasal congestion</a> and muscle aches during pregnancy. Peppermint oil inhalation has even been found to be beneficial for postpartum people who have difficulty emptying their bladder.</p> <h3>Lavender and rose oils</h3> <p>Studies have found that lavender and rose essential oils can decrease anxiety in labor. A person's perception of pain also can decrease when they're relaxed. The sense of smell is strongly <a href="/hometown-health/speaking-of-health/5-tips-to-keep-your-brain-healthy" target="_self" title="Opens in same window.">linked with memory</a>. If you've experienced relaxation with the scent of lavender or rose in the past, inhaling it during labor likely will help you recall those relaxing experiences.</p> <p>Some studies show that lavender oil aromatherapy may improve sleep for people who are in the hospital. The oil can be mixed with water and sprayed on a pillow to promote restful sleep. This technique might be beneficial for postpartum people as well.</p> <h2>Want to try essential oil?</h2> <h3>If you're pregnant and would like to try essential oils, here are some points to consider:</h3> <ul> <li><strong>More is not necessarily better.</strong><br /> I recommend that pregnant people start with one drop of their chosen essential oil and increase it to three to five drops based on their tolerance. Pregnancy can increase sensitivity to smell, and some people find aromatherapy overwhelming. It may even trigger symptoms such as nausea. Try placing the oil on a tissue or cotton ball for inhalation, which can easily be removed if you don't tolerate the fragrance.</li> <li><strong>Avoid placing essential oils on your skin.</strong><br /> Essential oils often require a carrier oil, such as coconut or almond oil, to dilute them. Essential oils applied directly to the skin can cause side effects, such as allergic reactions, irritation or sun sensitivity. A qualified aromatherapist can give more details for preparing specific oils.</li> <li><strong>Don't ingest essential oils during pregnancy or while breastfeeding.</strong><br /> There isn't enough research to support that this is safe for your baby.</li> </ul> <p>Since the research on essential oils for aromatherapy is limited, <a href="/hometown-health/speaking-of-health/is-virtual-prenatal-care-right-for-you" target="_self" title="Opens in same window.">talk with your healthcare team</a> if you're considering aromatherapy while pregnant or <a href="/hometown-health/speaking-of-health/breastfeeding-101-tips-for-new-moms" target="_self" title="Opens in same window.">breastfeeding</a>.</p> <p><a href="/providers/emily-sisco-cnm"><em>Emily Sisco</em></a><em> is a certified <a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">nurse-midwife</a> in <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Women's health</li> </ul>CNM, A.P.N.P.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Nursing, The College of St. Scholastica</li> <li>Master's degree, Nursing, Nurse-midwifery, Frontier Nursing University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Midwifery Certification Board</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Obstetrics and Gynecology, Mayo Clinic College of Medicine and Science</li> </ul>Sisco<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/emily-sisco-cnm-apnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A4F2BDD68011B1A02C60E704EBCA1AFA" alt="Emily Sisco, CNM, A.P.N.P." width="280" height="280" DisableNVelocity="true" />{AEF7E618-7BAA-41EA-B194-D06AEEC89C79}Emily<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15640680Emily Sisco, CNM, A.P.N.P.1{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{54693F31-87AF-4B21-91DB-1DEC1E21F878}<img src="/-/media/national-files/images/hometown-health/2024/essential-oil-atomizer-and-mug.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6EB3F80CD05F4B18415539892530D55F" alt="Essential oil atomizer and mug" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller11/12/2021<p>Making healthy lifestyle choices before you conceive can decrease complication risk and increase chances of having a healthy baby. Find out what you can do to benefit you and your baby in the future.</p>Thinking about getting pregnant? 6 things to think about first<p>Making healthy lifestyle choices before you conceive can decrease your risk of complications during pregnancy and increase the chances of having a healthy baby. Making changes now will benefit you and your baby in the future.</p> <h3>Here are 6 things to consider before getting pregnant:</h3> <h4>1. Healthy diet</h4> <p>A well-balanced diet that consists of all food groups is important to supply the nutrients necessary for your body to grow and provide energy for you and your developing baby. Your daily diet should include fruits, vegetables, whole grains, proteins, and dairy in appropriate amounts. Limit foods that are high in sugar and fat.</p> <h4>2. Healthy weight</h4> <p>Achieving and maintaining a healthy weight prior to pregnancy is an important goal. Carrying excess weight in pregnancy can put you at risk for pregnancy and childbirth complications, including blood pressure problems, preterm birth and gestational diabetes, as well as an increased risk of birth injury and cesarean section delivery. Being underweight can increase your risk for a low-birth-weight baby and preterm labor.</p> <h4>3. Vitamin supplements</h4> <p>All women of childbearing age should consume 400 micrograms of folic acid per day by taking a daily multivitamin containing folic acid. This has been found to help prevent neural tube defects. To do this, an over-the-counter prenatal vitamin supplement is recommended before pregnancy to provide all the recommended daily vitamins and minerals you will need before and during your pregnancy.</p> <h4>4. Exercise</h4> <p>Regular exercise is important for good health at any time in your life. An established exercise routine prior to pregnancy can be continued during pregnancy with adaptations, as needed. If you need to get started with exercise, take it slow at first, and try walking, swimming or bicycling. Talk to your health care provider before starting a strenuous workout program.</p> <h4>5. Substance use or abuse</h4> <p>If you smoke cigarettes, drink alcohol or use drugs, including marijuana, it is important to stop use prior to becoming pregnant. Your baby is most vulnerable to the harmful effects of tobacco, alcohol and drugs during the first trimester ― the initial 12 weeks ― of pregnancy. Many women don't realize they are pregnant until some or most of this time period has passed. If you need help quitting, ask for help and support from your health care provider.</p> <h4>6. Immunizations</h4> <p>Check with your health care provider to make sure you are up to date with recommended vaccinations for your age and health status. Some infections, including influenza and <a href="/hometown-health/featured-topic/covid-19-vaccines-and-pregnancy" target="_self" title="Opens in same window.">COVID-19</a>, have higher risks of severe disease in women who are pregnant. Other vaccinations, such as chickenpox, have risks to the developing baby. It is best to get vaccinated prior to pregnancy to prevent these diseases and any associated complications. Contact your health care provider if you have questions or concerns.</p> <p><em><a href="/providers/randy-foss-md" target="_self" title="Opens in same window.">Randy Foss, M.D.</a>, and <a href="/providers/katie-hinderaker-md" target="_self" title="Opens in same window.">Katie Hinderaker, M.D.</a>, specialize in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">family medicine</a> and <a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">prenatal care</a> in <a href="/locations/lake-city" target="_self" title="Opens in same window.">Lake City</a> and <a href="/locations/red-wing" target="_self" title="Opens in same window.">Red Wing</a>, Minnesota.</em></p><ul> <li>Caring for the whole family, pediatrics and adults</li> <li>Obstetrics, including prenatal and postnatal care</li> <li>Labor and delivery</li> <li>Women's health</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>North Colorado Family Medicine Residency Program</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Family Medicine, American Academy of Family Physicians</li> <li>Family Medicine, American Board of Family Practice</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Foss<img src="/-/media/shared-files/images/medical-professionals/full/lake-city/randy-foss-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=2D61DF8D17FFC1BC3775AF4AC0BB1AB1" alt="Randy Foss, M.D." width="280" height="280" DisableNVelocity="true" />{C76C2D3A-DE4A-4C88-ADB3-558ACFE75DB2}Randy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15321673Randy Foss, M.D.1M.D.<p><strong>Medical School</strong></p> <ul> <li>University of Minnesota Medical School, Minneapolis</li> </ul> <p><strong>Residency</strong></p> <ul> <li>University of Minnesota St. Joseph's Family Medicine Residency Program, Minneapolis</li> </ul>Hinderaker<img src="/-/media/shared-files/images/medical-professionals/full/lake-city/katie-hinderaker-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=55E6688C14C7EC08C10F876B57E679F5" alt="Katie Hinderaker MD" width="280" height="280" DisableNVelocity="true" />Katie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16276710Katie Hinderaker, M.D.1<img src="/-/media/national-files/images/hometown-health/2021/cutting-banana-into-bowl.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EB1B252E2853A21F9D89E22D0444957D" alt="Cutting banana into bowl" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller5/4/2023It can be hard to tell whether an illness requires antibiotics or if there are other ways to treat symptoms effectively. Read how to treat certain symptoms at home and when to seek care.Does my child need antibiotics or will home remedies do?<p>For parents, it can be hard to tell whether their children's illness requires antibiotics or if there are other ways to treat symptoms effectively. Knowing which illnesses can safely be treated using home remedies instead of antibiotics is important to prevent the overuse of these drugs. The more children are treated with antibiotics, the more likely they are to become ill with <a href="/hometown-health/speaking-of-health/your-role-in-stopping-superbugs" target="_self" title="Opens in same window.">antibiotic-resistant infections</a> in the future.</p> <h2>Ear infections</h2> <p>When children have <a href="/hometown-health/speaking-of-health/questions-about-earaches-and-ear-infections" target="_self" title="Opens in same window.">ear pain</a>, consider using over-the-counter pain relievers to start. Not all ear pain indicates an ear infection. If an ear infection is the cause of the pain, children's ear infections usually improve within two to three days, especially for kids two years or older. Talk with their health care team if symptoms don't improve within two to three days.</p> <h3>Experts recommend antibiotics for ear infections for children:</h3> <ul> <li>Age 6 months or younger</li> <li>Age 6 months to 2 years with moderate-to-severe symptoms</li> <li>Age 2 or older with severe symptoms</li> </ul> <p>Severe symptoms to watch for are a fever over 102.2 degrees and severe ear pain lasting over two days that is not improving. </p> <p>Health care professionals may recommend antibiotic eardrops instead of oral antibiotics for children with ear tubes who have developed <a href="/hometown-health/speaking-of-health/do-ear-infections-always-need-to-be-treated-with-antibiotics" target="_self" title="Opens in same window.">ear infections</a>. Eardrops can be more effective than oral antibiotics in these cases because the tubes allow the medication to travel straight into the middle ear, where most infections are located. Eardrops are also not as likely to cause resistant bacteria as oral antibiotics.</p> <p>However, you should ask about oral antibiotics if symptoms are severe and the infection does not improve with the eardrops. </p> <h2>Cold, flu and other respiratory infections</h2> <p>Antibiotics are not recommended to treat children's <a href="/hometown-health/speaking-of-health/7-ways-to-combat-coughs-and-colds" target="_self" title="Opens in same window.">colds</a>, flu, or other <a href="/hometown-health/featured-topic/what-parents-should-know-about-rsv" target="_self" title="Opens in same window.">respiratory infections</a>. Viruses cause most respiratory infections. Antibiotics fight bacterial infections, not viral infections. </p> <p>At-home care for these illnesses should include hydration, which helps thin and loosen mucous in the nose and sinuses. Offer children water or try an electrolyte drink if their appetite is low. Warm liquids, such as soup or broth, also can be helpful. Over-the-counter saline nasal drops or saline spray can help loosen mucous in the nose. Try running a humidifier or having the child sit in the bathroom in the steam from a hot shower for additional relief.</p> <h2>Strep throat and cough</h2> <p>A sore throat can be a sign of strep throat, which is caused by bacteria. However, most children with a sore throat have a virus. Your health care team will need to perform a test for strep throat. If the results are positive, they will use antibiotics to treat the illness. </p> <p>Ice cream, frozen fruit pops or cold beverages may help soothe a sore throat. Older children can try gargling salt water or sucking on throat lozenges. Always encourage children to get plenty of rest so their bodies can recover.</p> <p>Children also should be evaluated by their health care team if they have a persistent cough lasting longer than 14 days without improvement, or if new or worsening symptoms develop. Illnesses that begin as viral infections can lead to a secondary bacterial infection requiring antibiotics. </p> <p><a href="/providers/joslyn-hager-md" target="_self" title="Opens in same window."><em>Joslyn Hager, M.D.</em></a><em>, is a <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">pediatrician</a> in <a href="/locations/chippewa-falls" target="_self" title="Opens in same window.">Chippewa Falls</a>, Wisconsin.</em></p><ul> <li>Adolescent medicine for acne, contraception and menstrual disorders</li> <li>Baby-led weaning</li> <li>Breastfeeding support and education</li> <li>Mental health – attention-deficit/hyperactivity disorder, anxiety and depression</li> <li>Newborn care</li> <li>Nutrition </li> <li>Providing care to prevent future illness</li> <li>Providing wellness visits with anticipatory guidance – what to expect at each age and stage</li> </ul>M.D.<p>I became a pediatrician to give a voice to those who do not have one yet, to help children grow into happy, healthy young adults and develop their own voices. I enjoy helping children and their families through all stages of life, from the early newborn days to the teenage and college years, when patients are coming into their own.</p> <p>My goal is to build strong and lasting bonds with patients and families. I believe in working as a team, we are stronger together.</p> <p>I grew up in the Upper Peninsula of Michigan, and my training has taken me all over the United States. My heart belongs to the Midwest, and I could not be happier to be here in Northwest Wisconsin. My family is incredibly important to me, and you will find me spending most of my spare moments with my husband, daughter and our Labradoodle. I love traveling, trying new restaurants, being on the water and appreciating nature in all of it's forms.</p><p><strong>Education</strong></p> <ul> <li>Rush Medical College</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Pediatrics, Helen DeVos Children’s Hospital – Grand Rapids Medical Education Partners</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Pediatrics</li> <li>Certified Lactation Counselor</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Academy of Pediatrics</li> </ul>Hager<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/joslyn-hager-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=230DE33E6FEC55F46FF1F218CCB7D93B" alt="Joslyn Hager, M.D." width="280" height="280" DisableNVelocity="true" />{10B96AFD-A682-4276-A141-1128B941B027}Joslyn<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30236620Joslyn Hager, M.D.1{61776FD2-05E8-47E9-AB55-EE465BD29A19}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}|{C4130004-0F31-48C4-AC9F-A4350A75AB24}|{2B88C934-922C-4130-B661-197B59D83899}|{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2023/toddler-eating-icepop.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CA1BE5FD6F87ACE055AADED1234FBE9E" alt="Toddler eating icepop" width="660" height="370" DisableNVelocity="true" />Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller4/26/2016<p>If you experience regular bowel issues, such as diarrhea, bloating, gas or urgent bowel movements, you may have irritable bowel syndrome, or IBS. Find out if you should get an evaluation.</p>Managing irritable bowel syndrome<img alt="IBS_300x250" src="/-/media/national-files/images/hometown-health/2016/2016-general/ibs_300x250.jpg?h=250&w=300&sc_lang=en&hash=C8298CF3EDB1BCC1BB9E4D3105419EA5" style="width: 300px; height: 250px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /> <p>Most adults experience occasional constipation, diarrhea, bloating, gas, urgent bowel movements and cramping abdominal pain. However, for some people, these symptoms are a more regular occurrence affecting their quality of life and daily routine. Unfortunately, many of these individuals have what is known as irritable bowel syndrome (IBS) yet don’t know it because they’ve never received an evaluation or diagnosis.</p> <p>Often, people feel embarrassed discussing the symptoms of IBS with their medical provider. While as many as one in five American adults have signs and symptoms of IBS, fewer than one in five who has these symptoms seeks medical help. For most people, IBS is a chronic condition, which can fluctuate from producing mild to severe symptoms — and sometimes symptoms disappear completely.</p> <h2>Impact and triggers</h2> <p>The impact of IBS and the way it manifests varies from person to person. Oftentimes, stimuli that fail to bother certain people may in turn trigger symptoms in others with IBS. For example, certain foods, emotional stress, hormones and other illnesses can all incite the symptoms of IBS.</p> <h2>Risk and susceptibility</h2> <h3>While IBS can affect almost anyone, certain risk factors do exist, including people who are:</h3> <ul style="list-style-type: disc;"> <li>Young</li> <li>Female</li> <li>Have a family history of IBS</li> <li>Have a history of anxiety or depression</li> </ul> <p>It’s distinctly less common to have IBS as the cause of your symptoms if the onset of your symptoms occurs after the age of 50 or if you’re experiencing the symptoms at night during normal sleeping hours. These and other signs, such as blood with bowel movements, unintentional weight loss, fevers, nausea with recurrent vomiting and abdominal pain that is unrelieved by having a bowel movement, require further evaluation by a medical professional. </p> <p>It’s best to seek the advice and expertise of a medical professional if you experience symptoms suggestive of IBS. Importantly, serious conditions can initially appear with the same set of symptoms as IBS. A healthcare provider will help sort out these possibilities. Start with your primary care provider, who may then refer you to another provider with special expertise in IBS.  </p> <p>If your symptoms fit the typical IBS criteria and you’re not displaying more worrisome signs or symptoms, your doctor may suggest a course of treatment without requiring additional testing. But if you don't respond to that treatment, you may still require additional testing.</p> <h2>Causes</h2> <p>Currently, there’s no cure for IBS, but medical experts know IBS doesn’t result in permanent harm to the intestines and doesn’t cause cancer. Because it's not clear what causes IBS, current treatment focuses on the relief of symptoms so you can live as normally as possible. In most cases, you can successfully control mild symptoms of IBS by learning to manage stress and making healthy changes to your diet and lifestyle. This includes exercising regularly, drinking plenty of fluids and getting enough sleep. Your healthcare provider may prescribe other specific dietary changes, medications and supplementary treatments. </p> <h2>Support</h2> <p>While living with IBS can present daily challenges, your healthcare team is available to help. They can guide you through appropriate evaluation of your symptoms and provide treatments to assist you in optimizing your quality of life. In addition, consider talking with other IBS sufferers or looking for local and online IBS support groups to help you cope with and manage your condition.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2016/2016-general/ibs_300x250.jpg?h=250&iar=0&w=300&sc_lang=en&hash=9A8B3E90E58767FD10354D11A3C93E35" alt="IBS_300x250" width="300" height="250" DisableNVelocity="true" />Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Dawn Haller4/26/2016<p>Questions about bullying are pretty universal, but what about answers? Well, they are a little more complex.</p>Some answers to your questions about bullying<p><img alt="Blog_bullyTease" src="/-/media/national-files/images/hometown-health/2016/2016-general/blog_bullytease.jpg?h=233&w=350&sc_lang=en&hash=4355D450526696769246F483BF9FAA6C" style="height: 233px; width: 350px; float: right; margin-bottom: 10px; margin-left: 10px;" />“Is my child being bullied?” “Is my child a bully?”</p> <p>“What can I do to help? “What can my child do to help?”</p> <p>“How can I help my child?” “Who can help my child?”</p> <p>The questions are universal, whether a child is experiencing bullying behavior or is the bullying offender. The topic of bullying has received a lot of attention in the news in recent years. In the wake of school shootings and suicides where bullying is blamed as the cause, parents worry if their child may be next. Many parents come to my office wondering how to help their child.</p> <p>The answers to these questions are, in most cases, complex. Social, biological and environmental factors need to be considered to find the best solutions. It is important to not over- or under-recognize bullying behavior. To avoid either of these extremes of labeling, we must understand the difference between teasing and bullying.</p> <p>Teasing and bullying are socially unacceptable behaviors. However, according to Nancy Darling, Ph.D., in her article “Thinking About Kids” (Psychology Today, 2010), teasing is an ambiguous social exchange that can be friendly, neutral or negative, and how this interchange proceeds really depends on how the person being teased reacts.” Teasing never involves intentional physical harm or intimidation. It, generally, is done for the sake of fun. Occasionally, in younger children who are still learning how to regulate their emotions and responded to social interactions, teasing can go too far and result in physical behavior. This is not bullying nor is it a sign that bullying will follow. Although teasing is not socially acceptable, it is a developmental experience for children, providing opportunity for growth and development of social-emotional skills.</p> <p>Bullying, on the other hand, involves an imbalance of power between the individual engaging in the bullying behavior and the individual experiencing bullying behavior. Bullying behavior is harmful, purposeful and repeated (stopbullying.gov). There are many forms of bullying. Physical bullying can be pushing, hitting or other forms of physical aggression. Verbal bullying consists not solely of name calling, but also unrelenting criticism, threats or rumor spreading that can be sexual in nature or belittlement. Cyber bullying has been in the news lately and typically takes the form of criticism over social media, such as Facebook, Instagram or Snapchat. Social bullying involves exclusion from a social group, such as a teen not getting invited to a social gathering or being uninvited. Bullying can lead to psychological damage that, for some, can last a lifetime. Young children and teens typically cannot stop bullying on their own and need the support of peers and adults to do so.</p> <table> <tbody> <tr> <td> <table align="center" class="telerik-reTable-3" style="border: 0px solid;"> <tbody> <tr class="telerik-reTableHeaderRow-3" style="color: #3a4663; margin: 10px; padding: 10px; border-spacing: 10px; background-color: #c4d1e3;"> <td colspan="3" class="telerik-reTableHeaderFirstCol-3" style="padding: 0in 5.4pt; text-align: center;"><strong>Teasing Vs. Bullying</strong><br /> </td> </tr> <tr class="telerik-reTableOddRow-3" style="color: #666666;"> <td class="telerik-reTableFirstCol-3" style="padding: 0in 5.4pt; text-align: center; background-color: #e7ebf7;"><strong>Teasing</strong></td> <td colspan="2" class="telerik-reTableLastCol-3" style="padding: 0in 5.4pt; text-align: center; background-color: #e7ebf7;"><strong>Bullying</strong></td> </tr> <tr class="telerik-reTableFooterRow-3" style="color: #3a4663; background-color: #c4d1e3;"> <td class="telerik-reTableFooterFirstCol-3" style="padding: 0in 5.4pt; text-align: left;"><br /> <ul> <li>Done for the sake of fun</li> <li>Mostly verbal, such as name calling, teasing about clothing</li> <li>Involves copying of actions</li> <li>Never involves intimidation</li> <li>Tends not to be repetitive</li> </ul> </td> <td colspan="2" class="telerik-reTableFooterLastCol-3" style="padding: 0in 5.4pt; text-align: left;"><br /> <ul> <li>Purposeful</li> <li>Imbalance of power</li> <li>Takes many forms, such as physical, social, verbal, cyber</li> <li>Can involve threats and intimidation to induce submission</li> <li>Can be repetitive</li> <li>Can cause physical harm</li> <li>Causes psychological harm</li> </ul> </td> </tr> </tbody> </table> <br /> </td> <td> </td> </tr> </tbody> </table> <p>If your child is experiencing teasing, it is important to support them by recognizing their feelings and teaching them how to respond in a way that does not reward the teasing behavior of the other child. For a child or teen experiencing bullying, it is important for parents to be calm and first consult the child about how they would like to handle the bullying. Many children and teens fear that confronting the bullying behavior can make it worse. Children and teens need a support network that includes peers and supportive adults to feel safe in the environment where the bullying occurs.</p> <p>If your child or teen has been engaging in bullying behavior, it is important to seek understanding about the behavior. Identifying the behavior that is socially unacceptable and setting clear rules and limits about what is expected in family and community settings is essential.</p> <p>It is important for parents or adults supporting the child or teen who is experiencing or engaging in bullying behavior to model good citizenship. It is all too easy to let emotion take charge in defending our children, whatever the details of an instance of bullying. As our children's guide in life, we do not want to reinforce either victim or bully roles. By avoiding labels such as victim or bully, we can address the facts of the behavior without judgment and teach socially responsible behaviors.</p> <p>If you are concerned that your child is struggling with teasing or bullying, contacting a professional can provide you and your child with a resource to identify the best solution. More information on bullying can be found at <a rel="noopener" href="http://www.stopbullying.gov/" target="_blank" title="Opens in a new window">stopbullying.gov</a>.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2016/2016-general/blog_bullytease.jpg?h=698&iar=0&w=1050&sc_lang=en&hash=B985CE397DB41DCCC884EA682B320EC9" alt="Blog_bullyTease" width="1050" height="698" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Child DevelopmentWe all want our children to grow up happy and healthy. The reality is most all of them do — but at vastly different rates. Experts across Mayo Clinic Health System see thousands of children each year, and have the experience and resources to know what is normal and what may be cause for closer observation. This includes not only physical and motor skills development, but psychological and social skill advancement.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller4/19/2016<p>There's a lot of societal focus on body weight. Even the most educated people can become confused. But, it's this simple: If the weight-loss solution sounds too good to be true, it probably is.</p>Fad diets: They come and go<img alt="fad diets dont work 300x250" src="/-/media/national-files/images/hometown-health/2016/2016-general/fad-diets-dont-work-300x250.jpg?h=250&w=300&sc_lang=en&hash=E0D51D277520D9EBFCD4BEB7CB816566" style="width: 300px; height: 250px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>We all stress about weight at some point in our lives. Whether it comes from society or the media, there’s a lot of focus on body weight today. No wonder many consumers fall prey to fad diets and bogus weight-loss products. Even the most educated people can become confused after listening to testimonials or claims from the so-called experts. It's this simple: If the weight-loss solution sounds too good to be true, it probably is.</p> <p>There is no product, pill or weird foods that will instantaneously make fat disappear. No incredible food will change your genetic code. In fact, some ingredients in supplements and herbal products can be dangerous for you.</p> <h2>Registered dietitians recommend that Americans steer clear of any diet plans that include:</h2> <ul> <li><strong>Rapid weight loss</strong><br /> Gradual weight loss is ideal — and lasting. Dramatic and quick weight changes are not healthy. Healthy weight-loss plans aim for half to one pound of weight loss per week. Quick weight loss is likely a result of muscle and water loss.</li> <li><strong>Quantities and limitations</strong><br /> Avoid diets that allow unlimited quantities of any food. Avoid diets that eliminate or severely restrict an entire food group, such as carbohydrates. A low-calorie, well-balanced diet is the best way to go. Even if you take a multivitamin, you'll miss out on critical nutrients by avoiding entire food groups.</li> <li><strong>Specific food combinations</strong><br /> No evidence shows that combining certain foods or eating foods at specific times of the day will cause weight loss. Furthermore, eating the wrong combinations of foods doesn't cause rapid fat production or produce toxins in the body.</li> <li><strong>Rigid menus</strong><br /> Before you start a new fad diet, ask yourself, "Can I eat this way for the rest of my life?" If your answer is no, then the plan is not for you. Following rigid menus can be hard, overwhelming, costly and simply not necessary.</li> <li><strong>No need to exercise</strong><br /> Regular exercise is essential for good health and weight management. Your goal should be to discover physical activities you enjoy and strive to complete those for 30 to 60 minutes most days of the week.</li> </ul> <p>The moral to the story is: If you want to maintain a healthy weight, build muscle and lose fat — all while enjoying life to its fullest — eat smart and get moving. For a more personalized plan, consult a <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">registered dietitian</a> for more assistance.</p> <p><em>Anne Harguth is a clinical dietitian in Nutrition Services in <a href="/locations/waseca">Waseca</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2016/2016-general/fad-diets-dont-work-300x250.jpg?h=250&iar=0&w=300&sc_lang=en&hash=D1A8A0A0D35EB435E6413575D02411D5" alt="fad diets dont work 300x250" width="300" height="250" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller4/14/2016<p>Individuals' motivations for having bariatric surgery are as unique as the people discussing them. If you're looking for some reasons to make the decision for yourself, here are 10 activities that people who have gone through the procedure report looking forward to after surgery.</p>10 activities to look forward to after bariatric surgery<p><img alt="Blog_barriatric (2)" src="/-/media/national-files/images/hometown-health/2016/2016-general/blog-bariatric.jpg?h=266&w=400&sc_lang=en&hash=581B66700B6CC9FA91D08A810E9CFA20" style="height: 266px; width: 400px; float: right; margin-bottom: 10px; margin-left: 10px;" />Weight loss is a personal journey. Every day, people tell their primary care providers about their individual motivations and goals for losing weight. There are common themes, but many goals are as unique as the people who discuss them.</p> <p>A list was created by bariatric surgery patients during education sessions held before surgery was discussed. Members of this group meet before having bariatric surgery to discuss the psychological changes that can occur with substantial weight loss and how to adjust their behaviors for their new lifestyles after surgery.</p> <h2>The 10 activities to look forward to after bariatric surgery are:</h2> <ol> <li>Riding on a zip line</li> <li>Flying in an airplane without having to use a seatbelt extender</li> <li>Riding a roller coaster at the amusement park</li> <li>Exploring a cave</li> <li>Driving a go kart</li> <li>Getting on the floor to play with grandchildren</li> <li>Fitting into a stadium seat comfortably</li> <li>Getting into and out of a boat without difficulty</li> <li>Riding a horse</li> <li>Fitting into cowboy boots</li> </ol> <p>If you are considering <a href="/services-and-treatments/bariatric-surgery" target="_self" title="Opens in same window.">bariatric surgery</a> for long-term weight loss, bariatric surgery professionals can help you work through your goals to determine if it is right for you. Well-planned goals can help you convert your thoughts into action.</p><img src="/-/media/national-files/images/hometown-health/2016/2016-general/blog-bariatric.jpg?h=335&iar=0&w=504&sc_lang=en&hash=56A2DE0D6A2BC64C4D1FC5D67D11D497" alt="New you, new adventures: Bariatric surgery" width="504" height="335" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller1/28/2016The paradoxical adoption of psychiatric symptoms in language have been addressed, which would indicate acceptance. Yet, the continued stigma someone with an actual mental illness faces is alive and well.Obsessively pursuing the correct usage of the term OCD<img alt="Blog_OCD" src="/-/media/national-files/images/hometown-health/2016/2016-general/blog_ocd.jpg?h=266&w=400&sc_lang=en&hash=E963CC3D998DBFF499A648FF5C85F359" style="height: 266px; width: 400px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>There is paradoxical adoption of psychiatric symptoms in language, which would indicate acceptance. Yet, the continued stigma someone with an actual mental illness faces is alive and well. OCD, or obsessive compulsive disorder, is no different. Somewhere along the way, it not only became an adjective, but also a rather cool quirk people use in day-to-day language. "Oh, my OCD is acting out — I had to tidy the kitchen," "She orders the same thing when she comes to this restaurant. She's so OCD" or "My mom makes me clean my closet — so OCD."</p> <p>Contrary to what the popular misuse of the term would have you believe, OCD is not just something that propels people to clean. OCD is an anxiety spectrum disorder characterized by, in simple terms, unreasonable, repetitive thoughts or fears that cause anxiety and then a compulsion to act in a manner to attempt to decrease the anxiety.</p> <p>Take the example of a young boy who felt the need to circle his desk counterclockwise five times before sitting down. He irrationally thought if he did not do this his parents would die. His teachers declined to stop this behavior forcibly, as this would lead to increased anxiety and failure to function.</p> <p>There are other themes for obsessions and compulsions. Fear of contamination can lead to elaborate hand washing. Counting stairs, avoiding walking on patterned floors, checking doors and locks multiple times or in multiples of a particular number and starting over if the routine is disrupted, all are associated with OCD. All of these can be time- and energy-consuming, taking over a person's life and keeping them from functioning. They may miss work, be late for assignments and isolate from people for fear of judgment.</p> <p>There needs to be a change in our approach. Using a serious OCD diagnosis nonchalantly as an adjective trivializes the ordeal these people go through daily. This increases stigma and keeps people from getting the medical help they need.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2016/2016-general/blog_ocd.jpg?h=335&iar=0&w=504&sc_lang=en&hash=53F6A713AAB7381AAC146619CE6066CF" alt="Blog_OCD" width="504" height="335" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller3/21/2016It's well known that exercise decreases the risk of developing cancer. But did you know exercise is helpful during and after cancer treatment?Keep moving — The importance of exercise in cancer survivorship<p><img alt="Blog_activeCancerTreat" src="/-/media/national-files/images/hometown-health/2016/2016-general/blog_activecancertreat.jpg?h=266&w=400&sc_lang=en&hash=C89B7FD48B2124724C4516F608038A5A" style="height: 266px; width: 400px; float: right; margin-bottom: 10px; margin-left: 10px;" />It's well known that exercise decreases the risk of developing cancer. Studies have shown there is a 25% reduction in the risk of breast cancer among the most physically active women compared with those who are least active. </p> <p>This protective role of exercise is noted in many other cancers, including lung, endometrial, colon and prostate. But, did you know exercise is helpful during and after cancer treatment?</p> <p>According to the American Cancer Society, research shows exercise during cancer treatment can improve physical functioning and quality of life.</p> <h2>Moderate exercise can:</h2> <ul> <li>Increase strength and endurance</li> <li>Strengthen the cardiovascular system</li> <li>Reduce depression</li> <li>Decrease anxiety</li> <li>Diminish fatigue</li> <li>Improve mood</li> <li>Raise self-esteem</li> <li>Lessen pain</li> <li>Improve sleep</li> </ul> <p>Of course, there may be certain issues that prevent or affect a person's ability to exercise due to disease or type of treatment, including:</p> <ul> <li>Anemia — having a low number of red blood cells or quantity of hemoglobin or protein</li> <li>A weak immune system</li> <li>Radiation treatment</li> </ul> <p>Others should use extra care to reduce risk of injury, including older people and those with bone disease, arthritis or nerve damage, also called peripheral neuropathy.</p> <p>There are exciting studies that show regular physical activity is linked to increased life expectancy after a diagnosis of cancer and, in many cases, a decrease in the risk of cancer recurrence. At least 20 studies of people with breast, colorectal, prostate and ovarian cancer have suggested physically active cancer survivors have a lower risk of cancer recurrence and improved survival compared with those who are inactive.</p> <p>The American Cancer Society, the World Cancer Research Fund, the American Institute for Cancer Research, the American College of Sports Medicine and the U.S. Department of Health and Human Services all advocate physical activity for cancer patients and survivors.</p> <h2>The American Cancer Society recommends cancer survivors take these actions:</h2> <ul> <li>Participate in regular physical activity.</li> <li>Avoid inactivity, and return to normal daily activities as soon as possible after diagnosis.</li> <li>Exercise at least 150 minutes per week.</li> <li>Include strength training exercises at least two days per week.</li> </ul> <p>Not everyone is ready to head to the gym during or after cancer therapy. However, reconnecting with an activity you like to do can increase your enjoyment and ability to stick with an exercise program. Exercise may include a bike ride with friends or chasing your dog around the park. Walking is a great activity for almost everyone, and swimming can be a wonderful alternative for those with joint issues. Yoga is fantastic for strengthening, flexibility and balance concerns.</p> <p><em><a href="/providers/kaye-sturz-np">Kaye Holt</a> is a nurse practitioner who sees patients in <a href="/services-and-treatments/radiation-oncology">radiation oncology</a> at Mayo Clinic Health System in <a href="/locations/eau-claire">Eau Claire</a>, Wis</em>.</p><ul> <li>Symptom management in patients undergoing cancer treatment</li> </ul>N.P.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Nursing, University of Wisconsin-Eau Claire</li> <li>Master's degree, Nursing, University of Utah</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Adult Nurse Practitioner, American Nurses Credentialing Center</li> <li>Advanced Oncology Certified Nurse, Oncology Nursing Certification Corporation</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Oncology, Mayo Clinic College of Medicine and Science</li> </ul>Sturz<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/kaye-sturz-np.jpg?h=280&iar=0&w=280&sc_lang=en&hash=284244307377E45F8F32C9628894A3E3" alt="Kaye Sturz, N.P." width="280" height="280" DisableNVelocity="true" />{F24183E4-E12B-4952-AEE0-0180C2798AEE}Kaye<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14571617Kaye Sturz, N.P.1{BCFC3BDC-CF55-458E-A41C-9360527B6CCC}|{0DD9D3C9-86C5-47FC-A2CF-8AEEA4717B70}<img src="/-/media/national-files/images/hometown-health/2016/2016-general/blog_activecancertreat.jpg?h=335&iar=0&w=504&sc_lang=en&hash=0ECCBB95168CF0DF1CC85B5DFE378E1F" alt="Blog_activeCancerTreat" width="504" height="335" DisableNVelocity="true" />CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Dawn Haller2/25/2022Among the sea of information regarding nutrition is a tide of inaccuracies. Common myths are debunked so you can feel more confident about your food choices.10 nutrition myths debunked<p>Among the sea of information regarding nutrition is a tide of inaccuracies. Let's debunk a few common myths so you can feel more confident about your food choices.</p> <h2>1. Eating healthy is too expensive.</h2> <p>It may take some planning and time in the kitchen, but eating healthy on a budget is possible.</p> <h3>Some helpful hints include:</h3> <ul> <li>Plan meals and snacks around sales.</li> <li>Shop seasonally, especially with fruits and vegetables.</li> <li>Create a shopping list and stick to it.</li> <li>Stock up on staples, such as brown rice, whole-wheat pasta, dried beans and lentils, when on sale.</li> <li>Consider purchasing frozen or canned fruits and vegetables as an alternative to fresh products. Be sure to check the ingredient list to avoid items with added sugars or salt.</li> </ul> <h2>2. Everyone should follow a gluten-free diet.</h2> <p>Unless you have celiac disease or gluten intolerance, you don't need to avoid gluten, which is the protein found in wheat, barley and rye. Whole-wheat products have great nutritional benefits, including essential B vitamins and fiber.</p> <p>Be mindful when manufacturers remove gluten, as additional sugar, salt or refined starches are often added to make up the difference in flavor and texture. If you follow a gluten-free diet for medical reasons, check the ingredient list and nutrition facts to make sure you are choosing a healthy option.</p> <h2>3. Use unrefined sugars, such as honey, maple syrup or coconut sugar in place of white table sugar.</h2> <p>Sugar is sugar, although unrefined sugar options may contain a small number of vitamins and minerals. The advantage is minimal as they are still considered added sugar and contribute to the recommended daily limit on added sugar in the diet.</p> <h2>4. Full-fat products equal weight gain.</h2> <p>The fat-free and low-fat diet trend is a thing of the past — 80s and 90s to be exact. Yet, some individuals are still scared of fat. This shouldn't be the case as fat has beneficial functions like protecting our organs, maintaining cell membranes, promoting growth and development, and absorbing essential vitamins.</p> <p>Be aware that fats aren't created equal. Choose heart-healthy unsaturated fats, such as olive and canola oil, nuts, nut butters and avocados over those that are high in saturated and trans fats, including fatty meats and high-fat dairy products.</p> <h2>5. Avoid carbs if you want to lose weight.</h2> <p>The low-carb diet is a fad diet that has continued to make an appearance over the years. It gives carbohydrates — fruit and whole grains included — a bad reputation. Individuals who followed this diet had success with weight loss. But anytime anyone eliminates highly processed carbohydrates foods, such as chips, cookies, white bread and potatoes smothered in butter and gravy, they would be expected to have the same results. Any diet or eating program that eliminates an entire food group gets a red flag from me as you likely will miss out on vital nutrients.</p> <h2>6. A detox diet will clean toxins out of the body.</h2> <p>There's little evidence that dietary cleanses do any of the things they promise. The fact is you don't need to purchase a product to cleanse your body. Your liver, kidneys and gastrointestinal tract do a good job of detoxing it every day. If you're looking to rejuvenate your body, focus on eating more whole foods, drinking water and removing highly processed foods from your diet.</p> <h2>7. You shouldn't eat anything after 7 p.m. — not even a grape.</h2> <p>While late-night snacking can lead to weight gain or prevent weight loss, it's not because of the time on the clock. Instead, it's about why you're eating. It's common to reach for food for reasons other than physical hunger in the evening, whether it be a habit, boredom or craving.</p> <h2>8. Certain foods, such as grapefruit, cayenne pepper or vinegar, can burn fat.</h2> <p>Sorry, no foods burn fat, make you lose weight more quickly or increase your metabolism enough to have an effect on weight loss. Diets that focus on single foods, like those mentioned above, are restrictive and lack nutrients the body needs. They're also unsustainable, and any weight loss that may occur is a result of calorie restriction and likely will come back once you discontinue.</p> <h2>9. The best way to decrease your sodium intake is to stop using the salt shaker.</h2> <p>The 2020–2025 dietary guidelines for Americans recommend having no more than 2,300 milligrams of sodium per day. The average American consumes 3,400 milligrams of sodium per day. The problem isn't as easy as taking the salt shaker off the table. Much of the excess sodium that Americans consume from their diet comes from the salts added to processed, ready-to-eat foods and restaurant meals. Limit the processed foods, and enjoy more fresh, home cooked meals.</p> <h2>10. Low-fat or fat-free products are healthier choices.</h2> <p>Many products labeled low-fat or fat-free contain added sugar or sodium to help make up for the loss of flavor when removing or reducing fat. In addition, fat helps with satiety — making you feel fuller longer. Choosing a fat-free product to reduce calories can backfire as you may find yourself snacking soon after.</p> <p>Always look at the nutrition label when choosing between fat-free, low-fat and regular. Pay attention to sugar and sodium content.</p> <p><em><a href="/providers/allyn-wergin-rdn">Allie Wergin</a> is a registered <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">dietitian nutritionist</a> in <a href="/locations/new-prague">New Prague</a>, Minnesota.</em></p><ul> <li>Bariatric surgery</li> <li>Diabetes management</li> <li>Oncology</li> <li>Weight management</li> </ul>RDN<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, St. Catherine University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration </li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul>Mahowald<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/allyn-wergin-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=74F690ED261F537AA65B66929A3356D1" alt="Allie Mahowald, RDN" width="280" height="280" DisableNVelocity="true" />{9209F8EC-1016-41AA-985F-014D9B877417}Allie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15971546Allyn Mahowald, RDN1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2022/cutting-tomatoes-on-wood-board.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4241FE3F96CC4B95F8A9820D649651BF" alt="Cutting tomatoes on wood board" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller3/11/2019<span style="color: #141823; background-color: #ffffff;">Energy drinks are a great way to get a blast of energy, but are you aware of what that extra caffeine is doing to your body? Maybe it’s time to rethink your caffeine drink.</span>Rethink your energy drink: Beware of extreme caffeine<img alt="Energy drink can tops" src="/-/media/national-files/images/hometown-health/2019/energy-drink-can-tops.jpg?h=300&w=300&sc_lang=en&hash=CE18FBEAAA75B32320CF0F9473F462F9" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /> <p> People love their caffeine, whether it’s coffee, tea, <a href="/hometown-health/speaking-of-health/rethink-your-drink-beware-of-hidden-sugar" target="_self" title="Opens in same window.">soda</a> or energy drinks. With all of the different energy drinks on the market, you might be getting a much bigger caffeine buzz than you realize. There are extra vitamins and minerals in energy drinks, raising their caffeine level. </p> <p>Consuming too much caffeine isn’t good for your body. Here’s why: </p> <ul> <li>Increases heart rate and blood pressure</li> <li>Makes you shaky and nervous</li> <li>Is addicting</li> <li>Makes brain and heart work harder</li> </ul> <p>Energy drinks have multiple sources of caffeine, but are often listed under other ingredients. Many times, these ingredients are lumped together and called an energy blend on the label, but it’s really just extra caffeine. When you add up the amount of caffeine in one energy drink, it can equal up to at least five times the amount of caffeine found in one cup of coffee. </p> <p>Instead of choosing energy drinks as your source of caffeine, try these alternatives: </p> <ul> <li>Coffee</li> <li>Herbal tea</li> <li><a href="/hometown-health/speaking-of-health/tips-for-drinking-more-water" target="_self" title="Opens in same window.">Fruit-infused water</a></li> </ul> <p>If you stay hydrated throughout the day, you are more likely to prevent the dreaded caffeine crash or pounding headaches.</p> <h2>Watch nutrition educator Katie Johnson to learn more about energy drinks and caffeine consumption:</h2> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/dAPgOUoOe9k" title="Energy drinks and caffeine" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p><img src="/-/media/national-files/images/hometown-health/2019/energy-drink-can-tops.jpg?h=504&iar=0&w=504&sc_lang=en&hash=03C3D12AF22D93918A185D807B6424AD" alt="Energy drink can tops" width="504" height="504" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller3/8/2016<p>Many of our successful weight loss patients share <span>stories</span><span> along their journeys with us. This is an example of a story that would not be unusual for us to hear.</span></p>Why can't I eat like that?<img alt="Why Cant I Eat Like That" src="/-/media/national-files/images/hometown-health/2016/2016-general/why-cant-i-eat-like-that.jpg?h=233&w=350&sc_lang=en&hash=50F963240AD638AEB934E697BF579FFA" style="width: 350px; height: 233px; float: right; margin-bottom: 5px; margin-left: 5px;"> <p>Many of our successful weight loss patients share <span>stories</span><span> along their journeys with us. This is an example of a story that would not be unusual for us to hear:</span></p> <p>I used to think that my friends could eat burgers and fries, pasta dishes and deep-fried appetizers — literally anything — and still stay trim. We would meet for lunch, and it seemed they would order whatever they wanted. Not only that, but on TV, I’d see everyone eating all the burgers, pizza, chips, donuts, cookies, ice cream…you know the drill. They have gorgeous models biting into bacon burgers, etc. So, I thought “What the heck?” and did the same.</p> <p>As I lost my trim figure, I switched to a healthier eating style. I would eat salads, but others continued to eat burgers and fries and look fit and cute. Now that was not fair! I needed to find out the secret, so I started to pay attention and asked myself, “What was it they were doing differently?” As I consumed each bite of my lettuce, I intently watched them. This is what I found.</p> <p>The fact is you just can’t eat that stuff on a regular basis, maintain your weight and be healthy and fit. I discovered that they were actually only eating a fourth of the burger and two fries, and they were doing exercise for one hour a day. Hmm…they were not eating burgers and fries every day or every week.  They were eating fruits, veggies, lean protein and whole grains 99.9 percent of the time, or close to that, anyway.</p> <p>I have to say my own version of the Serenity prayer — it helps me start each day. “Lord, help me to control what I can control to live a healthier lifestyle.” I learned some strategies to help me control the unhealthy foods. I would postpone, telling myself I could have it, but not right now. I would substitute a healthier choice, like making pizza on whole-wheat tortillas or eating before I went out. As for exercise, I told myself I only had to do it for five minutes and found once I got moving, it wasn’t so hard.</p> <p>I also made some commandments for healthy living:</p> <ul> <li>I decided if I watched a TV show, I would make myself do some exercise during the commercials. Boy, those commercials can be long.</li> <li>No eating in front of the TV.</li> <li>Fruits and veggies are a free for all. Eat at least five servings a day.</li> <li>Eat lean protein.</li> <li>Write down daily calories in and calories out. Keep records of everything that goes into my mouth.</li> </ul> <p>Oh, some days are hard, some are easy. That’s why surrounding yourself with supportive people really helps. For example, some days I need someone who will help unglue me from the couch and get me out to walk. Exercising with a buddy really is more fun and keeps me accountable. Weight-loss groups are another good way to build healthy lifestyle skills and keep me motivated.</p> <p>We all need some support. I hope you find yours! Someday, someone will be wondering how you can eat those burger and fries and keep looking so fit.</p> <p><em>Eileen Dutter is a registered dietitian <a href="/locations/eau-claire">in Eau Claire</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2016/2016-general/why-cant-i-eat-like-that.jpg?h=335&iar=0&w=504&sc_lang=en&hash=E20FEF6FF84876E74909DBA0CBD0F7BC" alt="Why Cant I Eat Like That" width="504" height="335" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller5/23/2022Acute sinusitis can accompany a common cold, allergies, and bacterial and fungal infections. Learn why antibiotics aren't the best treatment and what you can instead.Will my sinus infection clear up on its own?<p>The first few weeks of the common cold aren' fun, but the acute sinusitis that can develop afterwards doesn't help either. Unfortunately, sinus congestion and the common cold go hand in hand. Acute sinusitis frequently is caused by the common cold, but also can be caused by allergies and bacterial and fungal infections.</p> <h2>Sinus infection causes</h2> <p>Sinus infections are caused when the cavities around your nasal passages become inflamed and swollen. This inflammation eventually interferes with drainage and causes mucus to build up. This tends to get annoying, because it makes breathing through the nose difficult. It also affects the area around your eyes and face, and can cause a throbbing headache.</p> <h2>Antibiotics and sinus infections</h2> <p>When a sinus infection hits, it seems worse than what you remembered from the last time you had one. This may give you the idea that you need antibiotics, but most clear up without them. Antibiotics have no effect on viruses and aren't recommended within the first week of developing a cold. About 70% of sinus infections go away within two weeks without antibiotics.</p> <h4>Consider these other forms of treatments instead of antibiotics:</h4> <ul> <li><strong>Decongestants</strong><br> These medications are available for over-the-counter purchase. Be careful to only take these medications for a few days at most, as they can cause the return of more severe congestions.</li> <li><strong>Over-the-counter pain relievers</strong><br> Aspirins, acetaminophen or ibuprofen can help relieve temporary pain.</li> <li><strong>Saline nasal spray</strong><br> This is used to spray into your nose several times a day to rinse your nasal passages. It can help to prevent and treat inflammation.</li> </ul> <p>Antibiotics only will be needed if the infection is severe, recurrent or persistent.</p> <h4>The likelihood of bacterial infection increases when:</h4> <ul> <li>Symptoms last seven days or more, particularly when symptoms initially improve and then worsen.</li> <li>Mucus is thick and yellow or green in color.</li> <li>There is facial or sinus tenderness, particularly if it's worse on one side of the face.</li> <li>Pain is present in the upper teeth and is worse on one side of the face.</li> </ul> <p>If the infection becomes severe, recurrent or persistent, contact your provider.</p> <h2>Read more about your sinuses:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/chronic-sinusitis-more-than-a-stuffy-nose" target="_self" title="Opens in same window.">Chronic sinusitis: More than a stuffy nose</a></li> <li><a href="/hometown-health/speaking-of-health/solve-chronic-stuffy-nose-with-intense-cooling" target="_self" title="Opens in same window.">Solve chronic stuffy nose with intense cooling</a></li> <li><a href="/hometown-health/speaking-of-health/your-sinus-headache-may-not-be-what-you-think" target="_self" title="Opens in same window.">Your sinus headache may not be what you think</a></li> <li><a href="/hometown-health/speaking-of-health/unlocking-the-mystery-of-your-sinuses" target="_self" title="Opens in same window.">Unlocking the mystery of your sinuses: Answers to 8 common questions</a></li> </ul> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/hand-on-forehead-eyes-closed.jpg?h=370&iar=0&w=660&sc_lang=en&hash=63DD23C2EA9773B432FCCBA7F539CFDB" alt="person with hand on forehead, eyes closed" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller9/15/2022<p>Healthy foods, sitting down to meals and even a glass of red wine are elements that make the Mediterranean diet one of the highest-rated eating plans. Learn why it also helps reduce risk of certain diseases.</p>Mediterranean diet blends healthy foods, lifestyle<p>Take naps, set aside time to be more social, drink wine — all while lowering your risk for numerous chronic diseases and cancer.</p> <p>What's this enticing program?</p> <p>It's the <a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801" target="_blank" title="Opens in a new window.">Mediterranean diet</a>. But it's more than a diet — it's a model eating plan for good health.</p> <p>U.S. News & World Report ranks the Mediterranean diet the No. 1 best diet overall, the No. 1 plant-based diet and the No. 1 diet for healthy eating. The Mediterranean diet ties for the best heart-healthy diet.</p> <p>The Mediterranean diet became popular in the 1960s after researchers compared various diets of people living in southern Italy, Greece, northern Europe and the U.S. People in Mediterranean countries were found to have a lower risk of heart disease. Further study has found the Mediterranean diet to be a good eating plan for promoting weight loss and reducing the risk of cardiovascular disease, stroke, diabetes, cancer, and Alzheimer's and Parkinson's diseases.</p> <h4>Built around plant-based foods, the Mediterranean diet provides a wide range of nutrients that promote overall health, including:</h4> <ul> <li>Flavonols and anthocyanins, which reduce heart-disease risk</li> <li>Carotenes and other types of antioxidants that may reduce inflammation</li> <li>Monounsaturated fat, which has been found to lower total cholesterol and low-density lipoprotein, also known as LDL or "bad" cholesterol levels</li> </ul> <h2>Change up what you eat</h2> <h3>If you're interested in trying the Mediterranean diet, these tips will help you get started:</h3> <ul> <li><strong>Aim for seven to 10 servings per day of fruit and vegetables.</strong><br /> Expand your fruit and veggie horizon with pomegranates, figs, grapes, peaches, nectarines, cantaloupe, spinach, kale, Swiss chard, and collard and mustard greens. Wander through a farmers market for local choices.</li> <li><strong>Opt for whole grains.</strong><br /> Switch to whole-grain bread, cereal and pasta. Experiment with whole grains, such as bulgur and farro.</li> <li><strong>Add in nuts and seeds.</strong><br /> These foods are high in fiber, protein and healthy fats.</li> <li><strong>Use healthy fats.</strong><br /> Try olive oil instead of butter when cooking. Rather than putting butter or margarine on bread, try dipping it in flavored olive oil.</li> <li><strong>Eat fish twice a week.</strong><br /> Fresh or water-packed tuna, salmon, trout, mackerel and herring, along with seafood like shrimp, crab and mussels, are healthy choices. Grilled fish and seafood taste good and require little cleanup. Avoid deep-fried fish.</li> <li><strong>Reduce red meat.</strong><br /> Substitute fish, poultry or beans for meat. If you eat meat, make sure it's lean and keep portions small, usually about 3 ounces of cooked meat.</li> <li><strong>Enjoy some dairy.</strong><br /> Eat low-fat Greek or plain yogurt and a variety of cheeses. Try cheeses made from goat or sheep milk, like chevre and feta.</li> <li><strong>Spice it up.</strong><br /> Herbs and spices boost flavor and lessen the need for salt.</li> <li><strong>Sip wine, but in moderation.</strong><br /> In moderate amounts, alcohol can reduce the risk of heart disease. Typically, red wine — rather than white — is a Mediterranean choice. Limit your intake to one glass per day and drink it with a meal. Keep in mind, wine is optional.</li> </ul> <p>Download the <a rel="noopener" href="https://mcforms.mayo.edu/mc6800-mc6899/mc6815-01.pdf" target="_blank" title="Opens in a new window.">Mediterranean Diet Pyramid: Guidelines for Adults</a>.</p> <h2>Modify your lifestyle</h2> <p>While much of the Mediterranean diet revolves around healthy eating, a large part includes slowing down and enjoying life — something most of us can benefit from for our well-being and mental health.</p> <h3>The basics of Mediterranean-style eating include:</h3> <ul> <li>Sitting down at a table for at least two lunches or dinners per week.</li> <li>Taking time to enjoy the meal.</li> <li>Eating with friends and family.</li> </ul> <p>Plenty of eating plans are out there — dietary approaches to stop hypertension, or DASH; flexitarian; therapeutic lifestyle changes; keto; paleo; and mind diets. But the Mediterranean diet is a holistic approach that encompasses healthy, delicious food and lifestyle choices that promote well-being. Many people who switch to this style of eating say they'll never eat any other way.</p> <p>A simple way to get started is with some Mediterranean <a rel="noopener" href="http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet-recipes/art-20046682" target="_blank" title="Opens in new window">recipes</a>. For more information, talk to your health care professional or dietitian.</p> <p><em><a href="/providers/janet-mccann-rd" target="_self" title="Opens in same window.">Janet McCann</a> is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition Services</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><p>Adult diabetes education <br /> Weight loss counseling </p>R.D.N.<p><strong>Education</strong><br /> Dietetics, University of Wisconsin-Stout-Menomonie</p> <p><strong>Internship</strong><br /> Dietetic, University of Wisconsin Hospital & Clinics</p>McCann<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/janet-mccann-rdn.JPG?h=280&iar=0&w=280&sc_lang=en&hash=DC88BD848148543EEBD3ED0E1D36D70C" alt="Janet McCann, R.D.N." width="280" height="280" DisableNVelocity="true" />Janet<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13398601Janet McCann, R.D.N.1{137191DF-266C-47EA-897F-817D98AEA7BC}|{2BEE5070-65FF-4406-9E59-103E06C5A535}<img src="/-/media/national-files/images/hometown-health/2022/mediterranean-diet-food.jpg?h=370&iar=0&w=660&sc_lang=en&hash=184E6321D7AC9D6880B9D5E0E700C9D2" alt="Mediterranean diet food" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller1/4/2023With the holidays in the rearview mirror, is weight loss on your to-do list? For the best success, here's how to make a plan before you start.Make a plan for weight-loss success<p>If losing weight is on your to-do list, now's the time to organize your weight-loss plan. Why? Effective, lifelong weight-loss interventions take time and planning. And there's a lot to think about: What is your weight goal? What will you eat? Will you count calories? When will you exercise, and how much time will you spend exercising? What type of exercises will you do?</p> <h2>The key word is simplify. Here are some helpful tips for you to make achieving your weight-loss goals easier:</h2> <h3>Simplify your menu, and plan ahead.</h3> <p>Planning a weekly menu saves money and time. Before the week begins, write down what you’ll eat each night for supper. Eat leftovers for lunch. A good goal is to eat out or get food delivered only once a week or less.</p> <h3>Avoid grocery shopping on an empty stomach.</h3> <p>When you shop on an empty stomach, you're much more likely to purchase unnecessary and unhealthy items. Shop for groceries after eating. Stick to your list of healthy items needed for the week. First, shop the perimeter of the store where most healthy items are located. Then, enter the middle aisles, if needed, while avoiding highly processed foods.</p> <h3>Shoot for a meal with less than 500 calories.</h3> <p>Do the math: three meals at 500 calories or less is, at most, 1,500 calories per day. One pound of fat is 3,500 calories. This is how much you’ll have to cut from your daily diet or burn through exercise to lose one pound of stored fat. It seems like a lot, but you can do it. You may want to contact your local dietitian to discuss your personal calorie needs.</p> <h3>Read the nutrition facts label.</h3> <p>Most packages have a nutrition facts label on the side. Take note of the serving size and total calories per serving. Other areas to watch include added sugars and fat content.</p> <h3>Plan exercises.</h3> <p>Next to your weekly menu, write down what type of exercise you'll complete each morning or evening, along with the time frame. This will help hold you accountable and keep you committed. Even 20 minutes of daily exercise will support your weight and health goals.</p> <h3>Switch up your exercise routine.</h3> <p>Varying your exercises also is helpful. Not only is it more fun, but different activities also work different parts of your body. Swimming, running, biking, yoga, walking and weightlifting are just a few options.</p> <h3>Have fun and bring back memories.</h3> <p>Try to enjoy yourself while improving your wellness. Eating healthy and exercising can be fun. Get a partner to join you. Be creative when planning your menu. Find a picture of yourself when you weighed less. Tape this picture in the bathroom or on the fridge to remind yourself each morning and throughout the day of your goals. </p> <p><em>Anne Harguth is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2022/reading-label-in-grocery-store.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2311C122D88ADB824C157B92B3884C8A" alt="Reading label in grocery store" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller3/20/2019<p>Sugary drinks are everywhere and, even worse, can be quite tempting. They taste good, and our taste buds have been trained to love them. But they serve no nutritional value and can be detrimental to your health and waistline.</p>Rethink your drink: Beware of hidden sugar<p>Sugary drinks are everywhere and, even worse, can be quite tempting. We know they taste good, and our taste buds have been trained to love them, but they serve no nutritional value and can be detrimental to your health and waistline. Drinking just one regular soda each day equals up to 32 pounds of sugar each year.</p> <p>Consuming drinks full of sugar and nothing nutritious can lead to an increased risk of Type 2 diabetes and obesity. Many people are getting too much sugar from unnatural foods and drinks. Natural sugar comes from fruit, honey, maple syrup, cane sugar, agave nectar and others. Although you don't want to consume too much sugar, it's better to get it from natural sources rather than sugary drinks and unnatural foods.</p> <p>Sports drinks, <a href="/hometown-health/speaking-of-health/rethink-your-energy-drink" target="_self" title="Opens in same window.">energy drinks</a> and fruit juice can have just as much sugar in them as a regular soda, meaning you should limit your consumption of those, too. Start limiting your intake of sugary drinks by taking small steps to decrease the amount of soda and other drinks you consume each day.</p> <p><strong>Watch this video in which nutrition educator Katie Johnson explains more about sugary drinks and how you can change your habits:</strong></p> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/Vq3VoR0PQUY" title="Beware of hidden sugar" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p><img src="/-/media/national-files/images/hometown-health/2018/sugary-drink.jpg?h=458&iar=0&w=458&sc_lang=en&hash=83DF0AE493FE5A0089F96E8F5B502123" alt="Sugary Drink" width="458" height="458" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller5/27/2022In the aftermath of gun violence, you may ask how you can help your children feel safe or reassure yourself that your children are safe. Here's how.Helping children feel safe<p>In the aftermath of gun violence in schools, many parents are asking "How can I help my children feel safe" or "How do I reassure myself that my children are safe?"</p> <p>As parents, it is important to acknowledge and gain a healthy perspective of your fears for the safety of your children. With the news media's ability to report tragic events involving children instantly and repetitively, your perceptions of levels of threat can be distorted. After all, your children are precious to you, and you want to protect them.</p> <p>Each time you hear, see or read about a single violent crime in the news, your brain interprets this as an increasing threat. You can begin to believe that you are living in an unsafe environment, even if the violence occurred many hundreds or thousands of miles away from where you live.</p> <p>When parents are afraid, children are more afraid. This fear can interfere with the social-emotional development needed for academic and social success throughout life.</p> <h2>Understanding reactions to tragedy</h2> <p>Your children might experience fear, shock, anger, <a href="/hometown-health/speaking-of-health/9-tools-for-helping-your-child-manage-anxiety">anxiety</a> and <a href="/hometown-health/speaking-of-health/do-children-grieve">grief</a>. Your children's age will affect how they handle the stress of a tragedy.</p> <h4>Keep these reactions and behaviors in mind based on your children's ages:</h4> <ul> <li><strong>Preschool children</strong><br /> Children in this age range become clingy or want to stay in a place that makes them feel safe. Some children might revert to wetting the bed or sucking their thumbs. Avoid criticizing your children for this behavior.</li> <li><strong>Elementary and early middle school children</strong><br /> At these ages, children might be scared to go to school, have trouble sleeping and paying attention, or become aggressive. They might grieve in short segments and show persistent concern for their safety.</li> <li><strong>Upper middle school and high school children</strong><br /> Older children might deny that they're upset. Some children might complain about aches because they're unable to identify what's bothering them. Others might start arguments or resist authority. Some children might experience depression, anger and sleep problems.</li> </ul> <p>These reactions are normal. However, if your children continue to display these behaviors for more than two to four weeks, they might need more help coping. If you're concerned about your children's reaction, talk to a mental health professional.</p> <h2>Steps to help your children cope</h2> <h4>To help your children process what happened:</h4> <ul> <li><strong>Remain calm.</strong> <br /> Your children will look to you for cues about how to react. It's OK for children to see adults sad or crying, but consider excusing yourself if you're experiencing intense emotions.</li> <li><strong>Reassure your children that they are safe.</strong> <br /> Point out factors that ensure your children's immediate safety. Review your home safety procedures. Make your home a comforting space for your children. Know your children's school emergency procedures for weather, fire or an intruder. This can help your own reassurance to communicate about procedures confidently to your children.</li> <li><strong>Limit media exposure.</strong> <br /> Constantly watching news coverage of a tragedy can heighten anxiety. Limit your child's exposure to violence on TV and in the news. When older children watch or read news reports, try to do it with them. When violence is in the news, ask what your child knows or has heard so you can correct misperceptions.</li> <li><strong>Avoid placing blame.</strong> <br /> If the tragedy was caused by human violence or error, be careful not to blame a cultural, racial or ethnic group, or people who have mental illnesses.</li> <li><strong>Maintain the routine.</strong> <br /> To give your children a sense of normalcy, keep up your family's usual dinner, homework and bedtime routines.</li> <li><strong>Spend extra time together.</strong> <br /> This can foster your children's sense of security. If your children are having trouble sleeping, allow them to sleep with a light on or to sleep in your room for a short time.</li> <li><strong>Encourage the expression of feelings.</strong> <br /> Explain that it's OK to be upset. Let your children write about or draw what they are feeling. Encourage time with friends. Physical activity might be an outlet for frustration.</li> <li><strong>Do something.</strong> <br /> Consider ways to help people affected by tragedy and their families. Hold a service related to the tragedy. You might work with your children to write thank-you notes to first responders.</li> </ul> <p>If your child is feeling unsafe because of events in their school, community or in the news, and following these guidelines does not help you or your child feel more secure, professional help may be needed. Contacting your health care team can help you and your children restore a sense of safety.</p> <h2>Starting a conversation with children</h2> <h4>When you talk to your children about safety or their worries about safety, follow these guidelines:</h4> <ul> <li><strong>Teach your children to trust their instincts.</strong><br /> If they feel afraid or think something is not right, they should find a trusted adult for help.</li> <li><strong>Answer children's questions honestly.</strong><br /> Be calm and matter-of-fact, giving them only necessary information. Younger children only need simple explanations; whereas, older children or teens may want more discussion.</li> <li><strong>It's important not to promise your children that violence will never occur.</strong><br /> Children know that bad things happen. Making promises about things you can't control compromises trust and can ultimately increase your child's anxiety.</li> </ul> <p>Caring for yourself after a tragedy is important. Pay attention to your feelings and lean on loved ones or talk to a mental health professional. Get enough sleep, eat a healthy diet and stay active. This will enable you to care for your children and be a role model for how to cope.</p> <p><em><a href="/providers/janice-schreier-lcsw" target="_self" title="Opens in same window.">Janice Schreier</a> is a clinical therapist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Anxiety</li> <li>Attention deficit hyperactivity disorder</li> <li>Bipolar disorders</li> <li>Chemical dependency</li> <li>Depression</li> <li>Eating disorders</li> <li>Facilitates social skills groups for adolescents with autism spectrum disorders</li> <li>Individual, family and group therapy</li> <li>Obsessive-compulsive disorders</li> <li>Post-traumatic stress disorder</li> <li>Reactive attachment disorder</li> <li>Trauma</li> <li>Treatment for children 7–17 and young adults</li> </ul>L.C.S.W.<p><strong>Education</strong></p> <ul> <li>Addiction Counseling, Viterbo University</li> <li>Bachelor's degree, Social Work, University of Wisconsin-La Crosse</li> <li>Master's degree, Social Work, University of Wisconsin-Milwaukee</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Autism Spectrum Disorders</li> <li>Licensed Clinical Social Worker, Substance Abuse Specialty</li> </ul>Schreier<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/janice-schreier-msw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=42215A8A31EDEE2903AC5F89E6D23B11" alt="Janice Schreier MSW" width="280" height="280" DisableNVelocity="true" />Janice<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15449963Janice Schreier, L.C.S.W.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2022/adult-with-arms-over-childs-shoulders.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E064D0150BCDB2B718D9B9ACA857E5AB" alt="Adult with arms over childs shoulders" width="660" height="370" DisableNVelocity="true" />Child DevelopmentWe all want our children to grow up happy and healthy. The reality is most all of them do — but at vastly different rates. Experts across Mayo Clinic Health System see thousands of children each year, and have the experience and resources to know what is normal and what may be cause for closer observation. This includes not only physical and motor skills development, but psychological and social skill advancement.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Dawn Haller6/1/2020When thinking about staying healthy, your home may seem like the safest place. A big part of being healthy means preventing accidents and injuries in your own home. Consider these safety tips.Healthy home advice: Falls, chemicals, medications, sharps<p>When thinking about staying healthy, your home may seem like the safest place. A big part of being healthy means preventing accidents and injuries in your own home.</p> <h2>To improve your well-being, consider these tips:</h2> <h3>Fall prevention</h3> <p>Falls are quite common, especially among the senior citizen population and during the winter months.</p> <h4>Here are a few strategies to help you avoid slips and falls:</h4> <ul> <li><strong>Light it up.</strong><br /> Keep your house, inside and out, well lit. Dark rooms and areas pose greater risks than spaces with adequate lighting.</li> <li><strong>Remove clutter.</strong><br /> Excess boxes, cords and rugs should be stored in a safe place. These things, among others, are all fall hazards.</li> <li><strong>Use support as needed.</strong><br /> If you move around better with a cane or walker, use that device. And make sure you have hand railings, seating and nonslip treads throughout your home, including in your bathroom and shower.</li> <li><strong>Wear practical shoes.</strong><br /> Choose sturdy, well-fitting shoes with skid-proof soles. High heels, sandals, slippers and stocking feet can be a catalyst for falling.</li> <li><strong>Stay active.</strong><br /> Physical activity keeps you moving, and enhances your strength, balance, coordination and flexibility — all of which help reduce falls.</li> <li><strong>Talk with your healthcare provider.</strong><br /> Discuss medications and health conditions that could possibly contribute to falls. Additionally, cover your fall history and what led to those incidents.</li> </ul> <h3>Medication safety</h3> <p>Always keep your medications in their original containers, except for medications you choose to place in a daily pill box. Use this pill box to assist with compliance, and always store medication in a safe place. Never take another person's medication, share your medications or take more or less of a medication than directed. Dispose of unused or unneeded controlled substances and all old medications.</p> <p>Another common and often overlooked danger in the home is the common chemicals you have on shelves, benches and countertops.</p> <h4>Follow this advice when it comes to household chemicals:</h4> <ul> <li>Store chemicals in original containers. If that's not an option, be sure to clearly label the bottle or can.</li> <li>Keep cleaners and other toxins out of the reach of children.</li> <li>Read warning labels.</li> <li>Follow safety instructions.</li> <li>Have the <a rel="noopener" href="https://aapcc.org/" target="_blank" title="Opens in new window.">poison control center</a> phone number available: 800-222-1222.</li> <li>Properly dispose of expired, leaking or contaminated chemicals.</li> <li>Don't combine chemicals.</li> <li>Keep chemicals far from food items.</li> <li>Stay diligent about hand-washing after using cleaners and other chemicals.</li> </ul> <h3> Sharps disposal</h3> <p>According to the <a rel="noopener" href="https://www.pca.state.mn.us/" target="_blank" title="Opens in new window.">Minnesota Pollution Control Agency</a>, sharps, including needles, lancets and syringes, should be stored in a sharps disposal container or a laundry detergent bottle with a cap. Sharps disposal containers are available for purchase at most pharmacies.</p> <p>Destroy sharps at home by using an incinerating device or needle cutter. Melted metal and remaining parts of syringes can then be safely deposited in the garbage — not the recycling bin. Dispose of clipped needles at a sharps collection site or via a sharps mail-back program.</p> <p>Keep these fall prevention, chemical handling, medication management and sharps disposal tips in mind to ensure you, your family and your visitors are safer in your home.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2020/front-porch-view-of-door.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6D85876130E708584EFBA5C89EE6F702" alt="Front porch view of door" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Medication ManagementNearly 70% of Americans take at least one prescription drug, and more than half take two.Dawn Haller4/30/2015<p>Sifting through birth control options can be daunting. Start with these questions and tips.</p>Choosing the right birth control<img alt="Women talking" src="/-/media/national-files/images/hometown-health/2015/women-talking.jpg?h=300&w=200&sc_lang=en&hash=CB611B1D35F828AE5BB3BF6864117DC4" style="height: 300px; width: 200px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>There are many safe, effective birth control options. However, choosing the right one can be confusing. There are several factors to consider when choosing a birth control option, such as your desire for future pregnancy, hopes for the type of bleeding you might have and some health considerations. You and your partner becoming familiarized with the many options can help you choose the right method.</p> <h3>Do you prefer to have a regular, predictable cycle?</h3> <p>A hormonal option, such as an estrogen/progesterone combination, might be a good choice for you. With this type, you will still have predictable bleeding. The downfall of this type is that you have to remember to use it daily, weekly or monthly. This can be difficult and puts you at an increased risk for pregnancy.</p> <ul> <li>Oral contraceptive pill (use daily)</li> <li>Contraceptive patch (use weekly)</li> <li>Vaginal ring (use monthly)</li> </ul> <p>If you are starting with regular cycles and prefer a reliable form of birth control, you also may want to consider the copper IUD (see below).</p> <h3>Do you prefer no bleeding at all?</h3> <p>A progesterone-only product may be best for you. With this type, you may not have any bleeding or you may have light bleeding. This often is used for women who need effective birth control and have difficulties with heavy periods. The downfall is that the bleeding can be unpredictable.</p> <ul> <li>Contraceptive injection (injection every three months)</li> <li>Contraceptive implant (rod placed into arm, effective for three years)</li> <li>Hormonal IUD (T-shaped device placed into uterus, effective for three or five years)</li> </ul> <h3>Is your main goal to prevent pregnancy long-term?</h3> <p>Long-acting reversible contraception (or LARC) may be best for you. LARC methods are some of the most highly effective forms of birth control and are effective for three to 10 years. In fact, LARC methods are as effective as permanent options. However, they are all reversible; therefore, you still can have children in the future.</p> <ul> <li>Contraceptive implant (effective for three years)</li> <li>Hormonal IUD (effective for three to five years) </li> <li>Copper IUD (effective for 10 years)</li> </ul> <h3>Are you done having children or do not desire to have any?</h3> <p>Permanent birth control may be best for you. This option is permanent; therefore, you should not choose this option if there is any chance you may want children in the future.</p> <ul> <li>Tubal ligation (female sterilization) is done in the operating room and requires abdominal incisions.</li> <li>Vasectomy (male sterilization) is done as an outpatient office procedure.</li> </ul> <p>Consult with your health care provider about your medical history and how it might affect your choice of birth control.</p> <p>Read about <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/combination-birth-control-pills/in-depth/birth-control-options/art-20045571" target="_blank" title="Opens in new window.">popular birth control methods</a> to help you determine what best fits your pregnancy prevention goals and your options for accomplishing them.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2015/women-talking-small.jpg?h=200&iar=0&w=200&sc_lang=en&hash=68AF6F58ED55BCE1D0AAA99CF57F9899" alt="Women talking small" width="200" height="200" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller10/19/2022When your child has an ear infection, it's common to think an antibiotic is necessary. Learn why that may not always be the case and how you can treat it at home.Do ear infections always need to be treated with antibiotics?<p>Many parents bring their children to a health care professional with ear infections and request antibiotics, but antibiotics sometimes aren't the right choice. Most ear infections cure themselves without the help of antibiotics.</p> <h2>What is an ear infection?</h2> <p>Let's first discuss what an ear infection is and alternative treatments to antibiotics. An ear infection is a bacterial or viral infection that affects the ear. It becomes painful when buildups of fluid and inflammation occur in the air-filled space behind the eardrum. Signs and symptoms of infection will quickly show. Children are more likely than adults to get ear infections.</p> <h2>Ear infection symptoms</h2> <h3>You can tell if children have an ear infection if they start showing any of these symptoms:</h3> <ul> <li>Pain in the ear, especially while lying down</li> <li>Pulling or tugging the ear</li> <li>Difficulty sleeping</li> <li>Difficulty hearing or responding to sounds</li> <li>Fever or headache</li> </ul> <h2>Home remedies for ear infections</h2> <p>Home remedies can help manage children's pain. Try placing a warm, damp washcloth over the affected ear.</p> <p>Most health care professionals recommend over-the-counter medication to relieve pain, such as ibuprofen or acetaminophen. Use these medications as directed on the label.</p> <h2>How to treat ear infections</h2> <p>Generally, an ear infection will improve within the first couple days and clear up within one to two weeks without any treatment.</p> <h3>It's recommended to use the wait-and-see approach for:</h3> <ul> <li>Children age 6 to 23 months with mild inner ear pain in one ear for less than 48 hours and a temperature less than 102.2 F</li> <li>Children age 2 and older with mild inner ear pain in one or both ears for less than 48 hours and a temperature less than 102.2 F</li> </ul> <p>Your health care professional can suggest the best treatment for your children. Antibiotics may be beneficial for certain children with ear infections. A health care professional can explain the potential side effects and concerns about antibiotics creating strains of resistant disease.</p> <p>If antibiotics are prescribed, be sure to use the entire antibiotic as directed. Failing to do so can result in recurring infection and resistance of bacteria to antibiotic medication.</p> <h2>Reduce ear infection risk</h2> <h3>Before an ear infection occurs, you can reduce the risk of ear infection with these tips:</h3> <ul> <li>Teach children to wash their hands properly and frequently. Encourage children to cough or sneeze into their elbow.</li> <li>Avoid secondhand smoke by staying in smoke-free environments.</li> <li>Consider breastfeeding your baby for a minimum of 6 months. Breast milk contains antibodies that may protect from ear infections.</li> <li>When bottle-feeding, hold your baby upright and avoid propping the bottle while your baby is lying down.</li> <li>Talk to your children's primary care provider about vaccines, including the seasonal flu shot for children 6 months and older.</li> </ul> <p><em><a href="/providers/timothy-slama-do" target="_self" title="Opens in same window.">Timothy Slama, D.O.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a>, Minnesota.</em></p><ul> <li>Dermatology</li> <li>Pediatrics</li> <li>Sports medicine</li> </ul>D.O.<p>I grew up 30 minutes from Fairmont. I'm married with three kids and coach tennis at the Fairmont High School. I'm also a medical consultant for public health in Martin and Faribault counties.</p><p><strong>Education</strong></p> <ul> <li>Des Moines University College of Osteopathic Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Iowa Lutheran Hospital, University of Iowa</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Iowa Lutheran Hospital</li> </ul> <p><strong>Certifications</strong> </p> <ul> <li>Family Medicine, American Board of Family Medicine</li> <li>Certified Medical Examiner, Department of Transportation</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Medical Association </li> <li>Minnesota Academy of Family Physicians</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Slama<img src="/-/media/shared-files/images/medical-professionals/full/fairmont/timothy-slama-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=FCCFA79564EA50EAAA4C53E2DE19802C" alt="Timothy Slama, D.O." width="280" height="280" DisableNVelocity="true" />{F6F9D4D2-2155-4F19-885A-FEFABCBBB330}Timothy <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15345599Timothy Slama DO1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}<img src="/-/media/national-files/images/hometown-health/2022/child-sleeping-on-adult-lap.jpg?h=370&iar=0&w=660&sc_lang=en&hash=DFCE5F544BF969262D7B80A23E4BE5EF" alt="Child sleeping on adult lap" width="660" height="370" DisableNVelocity="true" />Ear HealthAn audiologist specializes in evaluating and treating people of all ages with hearing loss, dizziness and balance disorders. Specialty audiology consultation is available for assessment and treatment of hearing loss, tinnitus, dizziness and balance disorders.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller2/15/2023What's the simplest, most effective way to stay healthy? Spoiler alert: It's washing your hands frequently. Read about the power of hand-washing, and get more tips for keeping children healthy.Keep your children healthy at school<p>It may seem as though school-age children frequently get sick, especially during certain times each year. Why do children this age tend to get sick so often? </p> <p>In the early school years, your children's immune systems are put to the test. Young children in large group settings tend to quickly spread organisms that cause illness.</p> <p>Viruses cause many common childhood illnesses. All it takes is for one child to bring a virus to school for the <a href="/hometown-health/speaking-of-health/steps-to-prevent-norovirus" target="_self" title="Opens in same window.">spread of illness</a> to begin.</p> <h2>The power of hand-washing</h2> <p>What's the best way to keep your children healthy in school? <a href="/hometown-health/speaking-of-health/clean-up-your-hand-washing-skills" target="_self" title="Opens in same window.">Frequent hand-washing</a> is the simplest, most effective way to stay healthy. </p> <h3>Remind your children to wash their hands when doing these activities:</h3> <ul> <li>Before eating a meal or snack</li> <li>After going to the bathroom</li> <li>After coughing, sneezing or blowing their nose</li> <li>After playing outside.</li> </ul> <p>Children should soap up their hands for as long as it takes to sing the "Happy Birthday" song twice through, or at least 20 seconds.</p> <h2>Staying healthy with simple tips</h2> <h3>Here are more tips for keeping kids healthy in school:</h3> <ul> <li>Give your children alcohol-based hand sanitizer to keep in their desks or backpacks. When hand-washing is not an option, children should use hand sanitizer before eating snacks or lunch and after using shared objects, such as a computer, pencil sharpener or water fountain.</li> <li>Give your children a package of tissues to keep in their desks or backpacks. Encourage your children to sneeze into a tissue. If a tissue is not available, they should cough or sneeze into the crook of their elbow.</li> <li>Remind children to keep their hands away from their eyes and out of their mouths because hands often are covered in germs.</li> <li>Teach children to not share water bottles, food or other personal items. Use this simple rule: If you put the item in your mouth, keep it to yourself.</li> </ul> <p>It's also important for your children to eat a healthy diet, get plenty of sleep and stay current on their <a href="/hometown-health/speaking-of-health/the-facts-about-vaccinations" target="_self" title="Opens in same window.">vaccinations</a> to help fend off illness-causing organisms.</p> <p>Keep your children at home if they have symptoms, including fever, cough, sore throat or rashes. </p> <p><em><a href="/providers/michael-rogge-md" target="_self" title="Opens in same window.">Michael Rogge, M.D.</a>, is a physician in <a href="/locations/prairie-du-chien/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/prairie-du-chien" target="_self" title="Opens in same window.">Prairie du Chien</a>, Wisconsin.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>University of Iowa College of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Mayo Clinic Family Medicine Residency Program</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Board of Family Practice</li> <li>American Medical Association</li> <li>Wisconsin Academy of Family Physicians</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Rogge<img src="/-/media/shared-files/images/medical-professionals/full/prairie-du-chien/michael-rogge-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=05D5A341B6BA0DFB616B81ACE1BBAA1A" alt="Michael Rogge MD" width="280" height="280" DisableNVelocity="true" />Michael <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12518492Michael Rogge, M.D.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}<img src="/-/media/national-files/images/hometown-health/2023/child-washing-hands.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C7FBF97E3FF1731A97FCE471EFFA76A6" alt="Child washing hands" width="660" height="370" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller1/19/2024Winter is filled with fun outdoor sports that improve your health. But what happens when muscle and joint injuries occur? Learn about common injuries, and get prevention tips.From ski slopes to skating rinks, winter sports hold risks for ortho injuries<p>Winter is filled with fun outdoor sports, including ice skating, sledding and downhill skiing. These activities are excellent for improving cardiovascular health and provide enjoyable entertainment for all ages. But what happens when muscle and joint injuries occur? At the ice rink or on the slopes, injuries can happen in the blink of an eye. Musculoskeletal injuries can be debilitating and may require medical intervention from an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedics specialist</a>.</p> <h2>Be aware of these common winter sports-related injuries and some tips for preventing them from occurring.</h2> <h3>Torn ACL</h3> <p>The <a href="/hometown-health/speaking-of-health/how-one-tendon-can-throw-off-stride" target="_self" title="Opens in same window.">anterior cruciate ligament, or ACL</a>, is one of the major stabilizing ligaments in the knee, and injury to it can result in an unstable knee. ACL reconstruction surgery is done to reconstruct the torn ligament and restore stability to the knee. ACL injuries commonly occur during winter sports involving sudden stops, changes in direction or twisting, such as downhill skiing. </p> <p>During ACL reconstruction surgery, the torn ligament is removed and replaced with a piece of tendon from another part of your knee or a deceased donor. This surgery is an outpatient procedure that's performed through small incisions around your knee joint. </p> <h3>Torn meniscus</h3> <p>The <a href="/hometown-health/speaking-of-health/treating-your-knees-shock-absorbers" target="_self" title="Opens in same window.">meniscus</a> is a C-shaped piece of cartilage in your knee, with one in the inside and one in the outside of the knee compartment. A torn meniscus is one of the most common knee injuries. Actions that forcefully twist or rotate your knee, especially when putting the pressure of your full weight on it, can lead to a torn meniscus.</p> <h4>If you have torn your meniscus, you may experience these signs and symptoms in your knee:</h4> <ul> <li>A popping sensation</li> <li>Swelling or stiffness</li> <li>Pain, especially when twisting or rotating your knee</li> <li>Difficulty straightening your knee fully</li> <li>Experiencing what feels like a block to moving your knee, as if your knee were locked in place</li> </ul> <p>If, after an injury, you can't move your knee in the usual way, it's important to see your doctor as soon as possible. Conservative treatment, such as rest, ice, medication and possibly an injection, sometimes is enough to relieve the pain and maintain normal knee function. In other cases, a torn meniscus requires surgical treatment. If your knee remains painful, stiff or locked, your doctor may recommend surgery. Depending on the location of the tear, it may be possible to repair it. If the tear can't be repaired, the meniscus may be surgically trimmed. Surgery may be done through tiny incisions using an arthroscope. After surgery, you'll need to do exercises to regain knee range of motion, strength and stability.</p> <h3>Wrist fracture</h3> <p>A broken wrist, or <a href="/locations/austin/services-and-treatments/orthopedic-surgery/hand" target="_self" title="Opens in same window.">wrist fracture</a>, can involve the small bones in the wrist or the ends of the forearm bones. Wrist fractures most commonly occur when people try to catch themselves during a fall and land on an outstretched hand.</p> <p>Treatment may include a splint, cast or surgery, depending on the severity and amount of displacement of the fracture. Surgery often involves using pins or plates and screws to hold the broken bones in the appropriate position while they heal.</p> <p><a href="/services-and-treatments/physical-medicine-and-rehabilitation" target="_self" title="Opens in same window.">Rehabilitation</a> is an integral part of the healing process, with the primary goals of restoring range of motion, strength and function.</p> <h2>Preventing injury</h2> <h3>It's impossible to prevent the unforeseen events that often cause musculoskeletal injuries, but these essential tips may help you:</h3> <ul> <li>Eat a nutritious diet with adequate calcium and vitamin D.</li> <li>Get plenty of weight-bearing exercise.</li> <li>Incorporate resistance training to strengthen muscles, bones and connective tissue.</li> <li>Loosen up tight muscles by stretching eight to 10 minutes before and after exercise.</li> <li>Move regularly throughout the day to stimulate blood flow to your arms and legs.</li> <li>Quit smoking if you're a smoker.</li> </ul> <p>Don't let the frigid weather or fear of injuries keep you from enjoying wintertime sports. Whether you're hitting the slopes or sledding down a hill with your kids, listen to your body and enjoy winter activities safely.</p> <h2>Next steps:</h2> <ul> <li><a href="https://www.mayoclinichealthsystem.org/providers?service=Orthopedic%20Surgery" target="_self" title="Opens in same window.">Find an orthopedic specialist near you.</a></li> <li><a href="/hometown-health/speaking-of-health/winter-weather-are-falls-and-slips-avoidable" target="_self" title="Opens in same window.">Learn how to avoid winter slips and falls.</a></li> <li><a href="/hometown-health/speaking-of-health/get-the-facts-about-knee-pain" target="_self" title="Opens in same window.">Get the facts about knee pain.</a></li> <li><a href="/hometown-health/speaking-of-health/keeping-your-winter-balance" target="_self" title="Opens in same window.">Practice walking safely in winter.</a></li> </ul> <p><a href="/providers/robert-cates-do" target="_self" title="Opens in same window."><em>Robert Cates, D.O.</em></a><em>, is an <a href="/locations/austin/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgeon in Austin</a>, Minnesota.</em></p><ul> <li>Adult and pediatric care</li> <li>Knee injuries, such as cartilage injuries, meniscal tears, ACL tears, ligament tears and arthritis</li> <li>Shoulder and knee joint preservation and total joint replacement</li> <li>Shoulder injuries, such as rotator cuff tears, labral tears/shoulder instability, arthritis and shoulder fractures</li> <li>Sports medicine</li> </ul>D.O.<p>My philosophy is to provide outstanding patient care in an individualized fashion. Every patient is unique with regard to injury, activity level and goals.</p> <p>I will gather your history, perform a thorough exam, review all imaging and discuss treatment options - both nonsurgical and surgical. Together, you and I will formulate an individualized care plan. I believe this is essential to optimizing the outcomes and improving your quality of life. I will strive to make your experience the absolute best while always remembering that needs of the patient come first.</p><p><strong>Education</strong></p> <ul> <li>Doctor of Osteopathic Medicine, University of North Texas Health Science Center</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Orthopedic Sports Medicine, University of Iowa</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Orthopaedic Surgery</li> <li>Certified Strength and Conditioning Specialist</li> <li>National Strength and Conditioning Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Orthopedics, Mayo Clinic College of Medicine and Science</li> </ul>Cates<img src="/-/media/shared-files/images/medical-professionals/full/austin/robert-cates-do.JPG?h=280&iar=0&w=280&sc_lang=en&hash=63C2E704655A01B51DD915D898D0F91B" alt="Robert Cates DO" width="280" height="280" DisableNVelocity="true" />Robert<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15728790Robert Cates DO1{DEF55970-853F-4E96-9A4D-3413874FF059}|{7CBD4F38-8554-4F2D-B828-ADDCE770E65A}|{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2019/couple-crosscountry-skiing.jpg?h=370&iar=0&w=660&sc_lang=en&hash=18E4242B76AD3BDF0BF011B049BBBDA7" alt="Couple cross-country skiing" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller5/16/2023It’s easy to get a minor burn from a hot pan while cooking. Instead of relying on myths, like slathering butter on a burn, find out what you really should do. Hint: Save the butter for your toast.Ouch! I've burned my hand on a hot pan — now what?<p>It's easy to get a burn on your arm or hand from a hot pan while cooking. Extremely hot water — over 110 degrees Fahrenheit — can cause burns, as can stoves, fires, hot food and the sun.</p> <p>Most burns are minor and you can manage them at home, but it's important to know the signs of a more serious burn. More severe burns can cause serious complications and may require emergency treatment. One of the most important things to do is to act fast.</p> <h2>Burns cause different degrees of damage.</h2> <ul> <li>A first-degree burn is minor. It affects only the outer layer of the skin.</li> <li>A second-degree burn affects the second layer of skin, called the dermis.</li> <li>A third-degree burn reaches into the deeper layers beneath the skin.</li> </ul> <h2>Treating a minor burn</h2> <p>There are many myths about how to treat a minor burn. Your questions may include: Should you pop the blister? Do you use hot or cold water on it? Is it good to cover a burn with a bandage?</p> <h3>Follow these tips for treating a minor burn:</h3> <ul> <li>Place the burned area under running water slightly colder than room temperature for 10 to 15 minutes or until the pain eases. Or put a cool, clean, damp cloth on the burn.</li> <li>Be aware that the burned area may swell. Remove tight items, such as rings or clothing, from the burned area as quickly as possible.</li> <li>Do not break a blister if it's bigger than your little fingernail. If the blister does break, clean it with mild soap and water. Apply an antibiotic ointment, and cover the area with a bandage or gauze.</li> <li>Applying moisturizer, aloe vera gel or other pain relief gels may provide temporary relief. Don't slather on butter — sometimes mentioned as a home remedy — because it retains heat and could be contaminated with bacteria.</li> <li>Keep the wound covered with a loose dressing to help it stay clean and decrease pain.</li> <li>Ease the pain with an over-the-counter pain reliever, such as Ibuprofen, naproxen or acetaminophen.</li> <li>Make sure you've had a tetanus shot within the last 10 years because you can get tetanus through an open wound in the skin.</li> </ul> <h2>When to see your health care team after a burn</h2> <p>See your health care team if the symptoms worsen or a larger blister develops. Large blisters are best removed by health care professional as they rarely will remain intact on their own.</p> <h3>Also, seek care if the burn:</h3> <ul> <li>Covers a large area of the body</li> <li>Has other associated injuries</li> <li>Has infection-like signs, such as oozing from the wound, increased pain, redness and swelling</li> <li>Involves the area around the eyes, nose or mouth</li> <li>Is severe or deep</li> </ul> <p>Call 911 for emergency medical help for major burns.</p> <h2>Get more safety tips:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/toy-safety-keep-your-kids-safe" target="_self" title="Opens in same window.">Don't let unsafe toys spoil holiday fun</a></li> <li><a href="/hometown-health/speaking-of-health/use-caution-with-fireworks" target="_self" title="Opens in same window.">Use caution with fireworks</a></li> <li><a href="/hometown-health/speaking-of-health/should-super-glue-be-in-your-first-aid-kit" target="_self" title="Opens in same window.">Should super glue be in your first-aid kit?</a></li> <li><a href="/hometown-health/speaking-of-health/household-safety-checklist-for-senior-citizens" target="_self" title="Opens in same window.">Household safety checklist for senior citizens</a></li> </ul> <p><em><a href="/providers/paul-horvath-md" target="_self" title="Opens in same window.">Paul Horvath, M.D.</a>, practices <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">emergency medicine</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/menomonie" target="_self" title="Opens in same window.">Menomonie</a>, Wisconsin.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>University of Wisconsin Medical School-Madison</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Kalamazoo Center for Medical Studies</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Emergency Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Emergency Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Horvath<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/paul-horvath-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=6D9F9FFCF71AD564DF6A3FD125A4F235" alt="Paul Horvath, M.D." width="280" height="280" DisableNVelocity="true" />Paul<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13467174Paul Horvath, M.D.1<img src="/-/media/national-files/images/hometown-health/2022/gas-stove-open-flame.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9AAC5F0BE40A6473A690E64544736769" alt="Gas stove open flame" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Dawn Haller12/16/2024A prediabetes diagnosis means your blood sugar levels aren’t high enough to be classified as type 2 diabetes but indicate a need for a change. Learn when to get your blood sugar levels tested.I've been diagnosed with prediabetes. What does that mean?<p>If you've been diagnosed with prediabetes, it means your blood sugar levels aren't high enough to be classified as type 2 diabetes but are high enough to indicate a need for changes to your lifestyle.</p> <h3>What is prediabetes?</h3> <p>A healthy fasting blood sugar level is below 100, whereas a person with <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/prediabetes/basics/definition/con-20024420" target="_blank" title="Opens in a new window">prediabetes</a> has a fasting blood sugar level between 100 and 126. </p> <p>Once levels have surpassed 126, it's classified as <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/basics/definition/con-20031902" target="_blank" title="Opens in a new window">type 2 diabetes</a>. This indicates that the body resists insulin or doesn't produce enough to maintain healthy blood sugar levels. </p> <p>Other names used for prediabetes are impaired fasting glucose, glucose intolerance, impaired glucose tolerance and borderline diabetes.</p> <p>Foods high in carbohydrates raise blood sugar more than other foods. During digestion, the pancreas produces insulin, which then binds to carbohydrates in the blood and takes it into cells as a source of energy. </p> <p>If you have prediabetes, sugar builds up in the bloodstream rather than fueling the cells. </p> <p>A healthy weight allows insulin to work more efficiently and can help keep blood sugars within a healthy range. A nutritious diet and regular exercise are two of the best ways to bring your blood sugar levels back to a <a href="/hometown-health/speaking-of-health/diabetes-what-you-need-to-know-and-do" target="_self" title="Opens in same window">healthy range</a>.</p> <h3>What factors increase the risk of developing prediabetes?</h3> <p><strong>The same factors that may increase the risk of a person getting type 2 diabetes also may increase the risk of prediabetes, including:</strong></p> <ul style="list-style-type: disc;"> <li>Age 35 or older</li> <li>Excess weight in the abdomen</li> <li>Family history of diabetes</li> <li><a href="/hometown-health/speaking-of-health/6-ways-to-manage-high-blood-pressure" target="_self" title="Opens in same window">High blood pressure</a></li> <li>High cholesterol</li> <li>Overweight or obesity</li> <li>Previous <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/basics/definition/con-20014854" target="_blank" title="Opens in a new window">gestational diabetes</a> diagnosis</li> <li>Race or ethnicity, as African American, Hispanic, American Indian and Asian American people are more likely to develop prediabetes</li> <li>Sedentary lifestyle</li> </ul> <h3>When should someone be tested for prediabetes?</h3> <p>If you're 35 or older, your fasting blood sugar should be checked yearly during your physical exam. If you've had gestational diabetes, it's crucial to have your blood sugar checked each year since this condition increases your risk of developing prediabetes or type 2 diabetes.</p> <h3>What are prediabetes symptoms?</h3> <p>People often don't know they have prediabetes because they may not experience any symptoms.</p> <p><strong>People with prediabetes and people with type 2 diabetes may experience some of these symptoms:</strong></p> <ul style="list-style-type: disc;"> <li>Blurred vision</li> <li>Fatigue</li> <li>Frequent urination</li> <li>Increased hunger</li> <li>Increased thirst</li> </ul> <h3>Can prediabetes be reversed?</h3> <p>After a diagnosis of prediabetes, you may be referred to a <a href="/services-and-treatments/diabetes-education" target="_self" title="Opens in same window">diabetes educator</a> who can customize a plan to help you manage your health and well-being.</p> <p>You also will <a href="/hometown-health/speaking-of-health/how-to-live-well-with-diabetes" target="_self" title="Opens in same window">learn lifestyle skills</a> to manage prediabetes and type 2 diabetes. These skills may include meal planning, exercise programs, medication management, stress management and sleep hygiene. </p> <p>People with prediabetes may be able to prevent or significantly <a href="/hometown-health/speaking-of-health/diabetes-definition-prevention-and-warning-signs" target="_self" title="Opens in same window">delay the development of type 2 diabetes</a> through lifestyle changes, including achieving and maintaining a healthy weight.</p> <p>Most prediabetes treatment plans do not include medications or routine monitoring of blood sugar.</p> <h3>What are the consequences of diabetes?</h3> <p>Diabetes can have long-term health consequences.</p> <p><strong>Your risk of developing type 2 diabetes is higher if you have prediabetes. Uncontrolled type 2 diabetes increases your health risk for:</strong></p> <ul style="list-style-type: disc;"> <li><a href="/hometown-health/speaking-of-health/diabetes-and-your-eyes" target="_self" title="Opens in same window">Eye damage</a>, including blindness</li> <li>Heart disease</li> <li>Increased infections</li> <li>Kidney disease or kidney failure</li> <li>Limb amputation</li> <li>Nerve damage</li> <li>Poor wound healing</li> <li>Stroke</li> </ul> <p>Talk to your healthcare team if you have any questions or concerns about your blood sugar level or if you develop any symptoms of prediabetes or type 2 diabetes.</p> <h3>Watch this video about prediabetes risk factors and the next step after a diagnosis:</h3> <p><iframe width="560" height="315" src="https://www.youtube.com/embed/twEV6tAqWGU?si=Goak0l1fk4a0xqy0" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin"></iframe></p> <p><em>Tara Wilde</em><em> is a <a href="/services-and-treatments/diabetes-education" target="_self" title="Opens in same window.">certified diabetes educator</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2022/lifting-bottle-of-water-to-drink.jpg?h=370&iar=0&w=660&sc_lang=en&hash=95769878B9E1D4AD927946A90132D0FC" alt="Lifting bottle of water to drink" width="660" height="370" DisableNVelocity="true" />DiabetesIf you have diabetes, no matter what type, it means you have too much glucose in your blood, although the reasons may differ. Too much glucose can lead to serious health problems.Dawn Haller1/12/2016Get answers to common questions or concerns about bariatric, or weight-loss, surgery.Q&A: Weight-loss surgery<img alt="QandAweightlosssurgery300x200" src="/-/media/national-files/images/hometown-health/2016/2016-general/qandaweightlosssurgery300x200.jpg?h=200&w=300&sc_lang=en&hash=E481EE73CCBF8918CA56F8083071F7AC" style="width: 300px; height: 200px; float: right; margin-bottom: 10px; margin-left: 10px;"> <h2>We face high levels of obesity in the U.S. What constitutes obesity, and what are some of the surgical options to assist with weight loss?</h2> <p>In the U.S., 69% of adults are overweight and 35.1% are obese. In adolescents, 8.4–20.5% of children under 20 suffer from obesity. Obesity is defined by using a complicated formula that takes into account your height and weight. The result of this formula is a two-digit number called a <a href="http://www.mayoclinic.org/diseases-conditions/obesity/in-depth/bmi-calculator/itt-20084938" target="_parent" title="Opens in new window"> BMI</a>, or body mass index.</p> <p>Obesity is defined as having a BMI greater than 30. The most important thing for people considering weight-loss, or bariatric, surgery is to let go of the guilt and shame associated with their weight, and choose to take control of their life and health.</p> <p>I often hear patients talk about how friends and family think they're taking the easy way out by choosing weight-loss surgery. Understand the physiology — the science — behind how we gain weight and how we lose weight are not simply the opposite of each other. It's much more complicated than most people realize.</p> <p>The process of getting ready for surgery takes about six months and involves working with a team to make sustained changes. People start their journey at Mayo Clinic Health System by attending a free <a href="/classes-and-events" target="_self" title="Opens in same window.">bariatric surgery information session</a> at a location near them.</p> <h2>With weight-loss or bariatric surgery, how does a team approach benefit patients?</h2> <p>Weight-loss surgery professionals have learned over the last 10 to 15 years the importance of a team approach. Collaborating with a team of experts has become so effective that many insurance companies actually require multidisciplinary clearance. We believe in multidisciplinary clearance and in a multidisciplinary team. Working together and communicating across disciplines is the best way to support patients in making sustainable changes to their lifestyles. For example, a physical therapist will help develop an exercise program and a psychologist might help the patient overcome barriers to initiating the program. Psychologists are wonderful at helping people overcome the barriers of self-control, self-confidence and motivation. Our team of experts regularly meets, and these touchpoints provide the members of the team a chance to discuss how they can give consistent support to individual patients. Dietitians, physical therapists, psychologists and diabetes educators are able to collaborate and develop individualized strategies for patients preparing for surgery.</p> <h2>Certain misconceptions about bariatric surgery exist. What are some common examples?</h2> <h3>It's the easy way out.</h3> <p>Prepping for bariatric surgery is time consuming and involves intense lifestyle modification. Patients often have a lifetime of habits and ideas about weight and weight loss that have to change. For example, most of these patients have the majority of their adult lives — and for some, their entire lives — thinking about how to lose weight. Unfortunately, many of these thoughts and habits we develop aren't healthy. As medical specialists, we teach patients how to maintain their weight. The surgery will get the weight off; the patients need to learn how to maintain that new weight. Thought patterns change entirely.</p> <h3>Everyone I know regained their weight.</h3> <p>Regaining weight can certainly happen, which is a key reason why a team approach has become so important. We better understand surgery works for a couple years, and then the body is able to adjust. At that time, lifestyle changes are integral to allowing patients to maintain their new weight. If you talk to someone who had surgery 10 to 15 years ago, their experience getting ready and following up after surgery is quite different from what patients do now to prepare for surgery and for long-term follow-up.</p> <p>Another important distinction revolves around <a rel="noopener" href="https://connect.mayoclinic.org/webinar/video-qa-about-endoscopic-sleeve-gastroplasty-esg-what-it-is-and-what-it-does/" target="_blank" title="Opens in new window.">lap band surgery</a>, which was popular for many years. Unfortunately, we know now that weight loss is suboptimal and long-term complications are high with lap band operations. Weight loss and the ability to keep the weight off are much better with <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/bariatric-surgery/in-depth/weight-loss-surgery/art-20045334?pg=2" target="_blank" title="Opens in a new window.">procedures that are considered metabolic</a> in nature, such as sleeve gastrectomy, Roux-en-Y and duodenal switch with biliopancreatic diversion.</p> <h3>It's too dangerous.</h3> <p>Bariatric surgery has become one of the safest general surgery procedures conducted. <a rel="noopener" href="https://asmbs.org/" target="_blank" title="Opens in new window.">The American Society of Metabolic and Bariatric Surgery</a> (ASMBS) has changed the focus of its accreditation from volume to quality. Surgeons are trained by doing specialized year-long fellowships under experienced surgeons who are able to teach advanced techniques. Additionally, the stapling technology we use to divide the stomach and bowel has improved tremendously, leading to safer surgeries. Mayo Clinic Health System is dedicated to the quality of care provided and has recently achieved accreditation in Mankato from the ASMBS and <a rel="noopener" href="https://www.facs.org/" target="_blank" title="Opens in new window.">American College of Surgeons</a> through a program called the <a rel="noopener" href="https://www.facs.org/quality-programs/mbsaqip" target="_blank" title="Opens in new window.">Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program</a>.</p> <h2>If someone has bariatric surgery, what should they expect in terms of weight loss?</h2> <p>In bariatric surgery, we talk about excess body weight and the excess body weight that's lost. The way we determine excess weight is by figuring out a patient's ideal body weight. Anything over their ideal body weight is considered excess. So, as an example, if a patient weighs 300 pounds and their ideal body weight is 200 pounds, that patient would have 100 pounds of excess weight.</p> <p>We offer two procedures: the sleeve gastrectomy and the Roux-en-Y. Patients who have a Roux-en-Y can expect to lose about 70% of their excess body weight, and patients who have a sleeve gastrectomy can expect to lose about 60% of their excess body weight.</p> <p>In the above example, the patient could expect to weigh 230 pounds after a Roux-en-Y procedure and 240 pounds after a sleeve gastrectomy. Keep in mind that everybody's ideal body weight is different. Many people who weigh 300 pounds could expect to lose more weight if they have a lower ideal body weight.</p> <p>At your initial appointment, we're able to help calculate your expected weight loss.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2016/2016-general/qandaweightlosssurgery300x200.jpg?h=200&iar=0&w=300&sc_lang=en&hash=8BDD0146634E4D46651A67C794513615" alt="QandAweightlosssurgery300x200" width="300" height="200" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller1/28/2016<p>Weight management is a skill. And like any skill, you need to practice it over and over again. You may be under the misunderstanding that you should be able to “just do it.”</p>Weight-loss strategies for success<p><img alt="Woman with hand weight next to healthy food" src="/-/media/national-files/images/hometown-health/2016/2016-general/shutterstock_31170856_72ppi.jpg?h=286&w=400&sc_lang=en&hash=47A4D58A99FD0F3F8AC74E2B40AA0785" style="height: 286px; width: 400px; float: right; margin-bottom: 10px; margin-left: 10px;" />Have you often asked yourself “Why can’t I keep the weight off?” </p> <p>Weight management is a skill; and, like any skill, you need to practice it over and over again. You may be under the misunderstanding that you should be able to “just do it.” That would be like telling someone who wants to play the piano to “just do it” or saying “What do you mean you won’t let me operate on you? I read the ‘Surgery for Dummies’ book.” </p> <p> You also may have had obesity behaviors for your entire life. Changing is more difficult than learning a new behavior, because you have to undo the old behaviors. Be tolerant with yourself — skill development takes time and a lot of practice. We often tell our patients that we are looking for progress, not perfection. </p> <p>When you look at weight management as a skill, it makes sense that you need to make healthy choices. Two proven strategies include:</p> <p>Eating a healthy diet, such as the <a rel="noopener noreferrer" href="http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/multimedia/mediterranean-diet/sls-20077104" target="_blank" title="Opens in a new window">Mediterranean diet</a>, which includes lots of vegetables and fruits; healthy fats, such as olive oil in moderation; small portions of lean meats, such as fish and poultry; and moderate amounts of whole grains. Eating five or more cups of vegetables and fruits a day not only fills you up, but they are packed with vitamins, minerals and phytochemicals that help prevent some major diseases and illnesses, such as diabetes, heart disease and some cancers.</p> <p><a rel="noopener noreferrer" href="http://www.mayoclinic.org/healthy-lifestyle/fitness/expert-answers/exercise/faq-20057916" target="_blank" title="Opens in a new window">Exercise</a> is critical for keeping weight off. Research suggests 60 to 90 minutes a day is needed. Find activities and exercises you enjoy, schedule time in your day and make it a priority. Try getting 15 to 30 minutes in before work, take health breaks at work and do something at night before you sit down. Move while you are at your children’s sporting events. Make excuses to move your body through space. </p> <p> With regular practice, you will soon change your behaviors, feel better, have more energy, improve your health and manage your weight by creating healthy habits. </p> <p><a href="/providers/rhonda-jenson"><em>Rhonda Jenson</em></a><em> is a weight management educator with <a href="/services-and-treatments/weight-management">Weight Management Services</a> in <a href="/locations/eau-claire">Eau Claire, Wisconsin</a>.</em></p><ul> <li>Lifestyle and behavior changes</li> <li>Nutrition</li> <li>Weight management</li> </ul>I am a weight management educator. I help patients with behavior, lifestyle and nutrition changes to help them get to and maintain a healthy weight.<p><strong>Education </strong></p> <ul> <li>Vocational Rehabilitation, University of Wisconsin-Stout</li> </ul>Jenson<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/rhonda-jenson.JPG?h=280&iar=0&w=280&sc_lang=en&hash=65B478A03A514D221E16B99AB77490D3" alt="Rhonda Jenson" width="280" height="280" DisableNVelocity="true" />Rhonda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13783599Rhonda Jenson1{94B2E140-AEF8-44BA-B6A9-4538B77501BC}<img src="/-/media/national-files/images/hometown-health/2016/2016-general/blog_weightaskill116.jpg?h=335&iar=0&w=504&sc_lang=en&hash=CE9E190B9151B5903D56D7C3A312B41F" alt="blog_WeightASkill116" width="504" height="335" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Dawn Haller12/23/2020Exposing kids to cooking and baking can lead to good habits and family memories. Here's some tips to help parents get kids in the kitchen.Kids in the kitchen: Early involvement yields oodles of fun <p>As a young child, I remember always wondering what was going on in the kitchen. It seemed to be the place to be, with all the commotion, sounds and smells.</p> <p>One day, my dad propped me up on the counter beside him while cooking dinner, and I got to see firsthand what the fuss was all about. And I loved it.</p> <p>From that day on, I was always in the kitchen ― supervised, of course. I was the "official stirrer," mixing up everything from cookie batter to sauces on the stove. As I grew older, my responsibilities changed. I learned how to cut foods like a chef and make my grandmother's recipes.</p> <p>If your kids are interested in cooking, even from an early age, involve them in the kitchen. <span>The holiday season is an excellent time to have your children help more in the kitchen.</span></p> <p>During the COVID-19 pandemic, you and your children may be spending more time at home. Instead of playing video games, get them in the kitchen. It's a place to bond, learn and create.</p> <p>Start by involving your little sous-chef. Holiday cookies, anyone?</p> <p>It's also a great way help your kids expand their food choices. The more children are involved in the process, the more likely they will want to try different foods other than pizza or chicken nuggets.</p> <h4>Here are a few guidelines for various ages and education levels:</h4> <ul> <li><sh5><strong>Toddlers with supervision</strong><br /> </sh5>Younger children can help out in the kitchen. Being involved makes them feel as though they are part of something special. Give them the opportunity to do simple and safe tasks, such as pouring measured ingredients into a bowl. Allow them to watch and learn at the same time.</li> <li><strong>Kindergarten and first graders with direct supervision</strong><br /> Ask them to measure items using a measuring cup, simultaneously developing great hands-on math skills; wash fruits and vegetables; and hand-mix items that are not sticky in a large bowl.</li> <li><strong>Second and third graders with supervision</strong><br /> If you feel comfortable as a parent, this age group can try peeling vegetables, grating cheese and mixing sticky items in bowls.</li> <li><strong>Fourth and fifth graders with supervision</strong><br /> Start using a can opener, stirring stovetop items, pounding chicken and scraping bowls.</li> <li><strong>Sixth and seventh graders with limited supervision</strong><br /> If you feel comfortable as a parent, this age group can start using a knife and being more independent with cooking after instruction, and proving they are capable and safe.</li> </ul> <p>Remember, children's skills will differ, so you will need to decide what you feel comfortable letting them try in the kitchen. The holidays are a great time to help them develop culinary skills that can last a lifetime. You might be surprised at what your children can do.</p> <p><em><a href="/providers/amanda-halls-rd-ld" target="_self" title="Opens in same window.">Amanda Halls</a> is a registered <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">dietitian nutritionist</a> in <a href="/locations/lake-city">Lake City</a>, Minnesota.</em></p><ul> <li>Diabetes</li> <li>Overall nutritional changes are lifelong changes for patients and their families</li> <li>Weight Management</li> </ul>RDN, LD<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Dietetics, College of Saint Benedict</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Registered Dietitian</li> <li>Licensed Dietitian</li> </ul>Halls<img src="/-/media/shared-files/images/medical-professionals/full/lake-city/amanda-halls-rdn-ld.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B0FA1017FC839B7CCA36917E15C4BB68" alt="Amanda Halls, R.D.N., L.D." width="280" height="280" DisableNVelocity="true" />Amanda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16305141Amanda Halls, R.D., L.D.1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2020/kids-in-the-kitchen.jpg?h=370&iar=0&w=660&sc_lang=en&hash=166CA61640CFD260AF71EF6D7A9476DC" alt="Kids in the kitchen" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Child DevelopmentWe all want our children to grow up happy and healthy. The reality is most all of them do — but at vastly different rates. Experts across Mayo Clinic Health System see thousands of children each year, and have the experience and resources to know what is normal and what may be cause for closer observation. This includes not only physical and motor skills development, but psychological and social skill advancement.Childhood ObesityUnderstanding what causes obesity and providing healthy alternatives can help lead your child down a lifelong path of wellness.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Dawn Haller1/10/2023Macular degeneration is a common cause of age-related vision loss. Learn how it makes reading, recognizing faces and driving difficult, and what you can do to lower your risk.How age-related macular degeneration blurs vision<p>Age-related macular degeneration is a common cause of age-related vision loss. It's the No. 1 cause of vision loss for adults over age 50. It affects the retina, particularly the macula, a portion of the retina with specialized cells that allow you your sharpest vision. Your retina consists of layers of neural tissue that line the back part of the eye that sends information from the eyes to the brain.</p> <img alt="Macular degeneration illustration" src="/-/media/national-files/images/hometown-health/2022/macular-degeneration-illustration.jpg?h=362&w=225&sc_lang=en&hash=827750597728F46E7401D4BC091536E6" style="width: 225px; height: 362px; float: right; margin-bottom: 5px; margin-left: 5px;" /> <p>Just like a baseball diamond infield is where most of the action happens, most of the important vision tasks are done by the cells in the macula. This includes things like reading, recognizing faces and viewing road signs.</p> <p>Degeneration means a deterioration of vision. Exudative age-related macular degeneration, also called wet macular degeneration, can cause permanent and rapid central vision loss. Nonexudative age-related macular degeneration, also called dry macular degeneration, may take a long time and proceed slowly but can also cause severe central vision loss over time.</p> <h2>Dry macular degeneration</h2> <p>This form of macular degeneration develops first and a physician who specializes in eye care — an optometrist or an ophthalmologist — can detect it during a dilated eye examination.</p> <p>It's the most common form of age-related macular degeneration and can be associated with gradual blurriness of the central vision or occasional waviness of straight lines, such as light poles or the edge of a doorway. If the retina is a baseball infield, dry macular degeneration is like getting pebbles, dry patches, large pot holes or the entire loss of the infield grass.</p> <p>Dry macular degeneration may be asymmetric, and one eye can be more affected than another. Over time, vision worsens and affects the ability to perform everyday tasks. Having dry macular degeneration doesn't mean you will lose all your sight. Vision loss involves your central field, and you will never go completely blind. You lose your ability to read and recognize faces.</p> <h2>Wet macular degeneration</h2> <p>Wet age-related macular degeneration, the exudative form of the disease, can cause sudden blurriness to complete loss of central vision. Wet or exudative refers to the growth of abnormal blood vessels called neovascularization. This can leak serum and blood under and into the retina. This would be like the infield grass getting soggy from leaky pipes underground. It leads to slippery localized conditions, presenting as distortion and small spots, to a complete washout, presenting as a total central loss.</p> <h2>Preventing macular degeneration</h2> <p>The exact cause of macular degeneration is unknown, but the condition can develop with age and can run in families, although not always.</p> <h3>If you're over 50 and have a parent or sibling with macular degeneration, follow these tips:</h3> <ul> <li><strong>Get routine dilated eye exams.</strong><br /> Inform your optometrist or an ophthalmologist if you have a family member with macular degeneration and would like to be checked for any signs. Have your eyes examined as recommended by your health care team.</li> <li><strong>Aim for good overall health.</strong><br /> Maintaining a healthy weight, and normal blood pressure and cholesterol levels are good for the eyes as well as the body. Follow your health care team's instructions for managing other medical conditions to keep your eyes healthy.</li> <li><strong>Stop smoking.</strong><br /> Don't start smoking and if you do smoke, quit. People who smoke have a greater chance of getting macular degeneration at an earlier age and often, their disease is more severe than people who don't smoke. </li> <li><strong>Eat lots of vegetables.</strong><br /> Eating leafy greens, such as kale, spinach and collard greens, provides key vitamins that improve the health of your retinas.</li> <li><strong>Be proactive.</strong><br /> Ask your health care team what level of age-related macular degeneration you have, such as early, intermediate or advanced. If you have intermediate or advanced, you can decrease your risk of severe vision loss by taking a mixture of antioxidants that were studied as part of <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/age-related-macular-degeneration/nutritional-supplements-age-related-macular-degeneration" target="_blank" title="Opens in a new window.">age-related eye disease studies</a> (AREDS2).</li> </ul> <h2>Macular degeneration treatments</h2> <p>You can't reverse damage caused by macular degeneration, but treatments can slow the progression and preserve existing vision when started early.</p> <p>If you have dry macular degeneration and have maintained your peripheral vision, low-vision rehabilitation can help you adapt to your changing vision. Taking high doses of antioxidant vitamins and minerals may help reduce vision loss. Some people can benefit from a telescopic lens implant that magnifies their vision. This is surgically placed and can improve a narrow field of view.</p> <p>For wet macular degeneration, the goal of treatment is to shrink or decrease leakage from abnormal blood vessels. Commonly, this can be done with medications injected into the eye. Sometimes, treatment includes thermal or nonthermal lasers. These treatments usually need to be repeated as leakage from the abnormal blood vessels can recur over time.</p> <p>An optometrist or an ophthalmologist can perform comprehensive eye examinations to screen for macular degeneration. Visit an optometrist or an ophthalmologist for routine exams as well as sudden central vision loss.</p> <p><a href="/providers/michael-scott-md" target="_self" title="Opens in same window."><em>Michael Scott, M.D.</em></a><em>, is an <a href="/services-and-treatments/ophthalmology" target="_self" title="Opens in same window.">ophthalmologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin. </em></p> <ul> <li>Age-related macular degeneration</li> <li>Diabetic retinopathy</li> <li>Vascular diseases</li> </ul> M.D. <p><strong>Education</strong></p> <ul> <li>University of Iowa Carver College of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Medical Ophthalmology, University of Utah School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Ophthalmology, University of Utah School of Medicine</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Vitreoretinal, St. Michael's Hospital</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Ophthalmology, American Board of Ophthalmology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Medical Association</li> <li>Iowa Academy of Ophthalmology</li> <li>Iowa Medical Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Ophthalmology, Mayo Clinic College of Medicine and Science</li> </ul> Scott<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/michael-scott-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=506E266232A34EBD3629C8E80B6F4F1A" alt="Michael Scott MD" width="280" height="280" DisableNVelocity="true" /> {2CF9E5FE-6503-4D62-80FB-F6C9A723CA13}Michael<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>11751711Michael Scott MD 1{C5680DDD-C649-4B63-AFCC-B52A244736B7}<img src="/-/media/national-files/images/hometown-health/2022/reading-with-glasses-and-light.jpg?h=370&iar=0&w=660&sc_lang=en&hash=AAF71D9B13FACDED38AA1253753BD47F" alt="Reading with glasses and light" width="660" height="370" DisableNVelocity="true" />Eye HealthYour eyes are responsible for providing you with vision, perhaps the most important of the senses. However, the eye is a delicate and complicated structure that needs protection. The ugly truth is that eye injuries can happen at any time and place.Dawn Haller1/25/2022While cervical cancer cases have decreased in recent years, it remains a significant threat to the well-being of women. Learn about your personal risk factors and what you can do to prevent and detect this disease.Screenings, awareness help prevent cervical cancer<p>Cases of cervical cancer, which once was the leading cause of deaths in women, have decreased in recent years. However, the Centers for Disease Control and Prevention notes that more than 12,700 cases of cervical cancer were diagnosed and more than 4,100 women died from the disease in 2018. These figures show that cervical cancer remains a major threat to the health and well-being of women.</p> <h4>What is cervical cancer?</h4> <p>Cervical cancer begins when healthy cells in the cervix, the lower part of the uterus that connects to the vagina, develop mutations in their DNA. A cell's DNA contains instructions that tell the cell what to do. Healthy cells grow and multiply at a set rate, eventually dying at a set time. The mutations tell the cells to grow and multiply out of control, and they don't die. The accumulating abnormal cells form a mass, or tumor. Cancer cells invade nearby tissues and can break off from a tumor to spread, or metastasize, elsewhere in the body.</p> <p>The most common types are squamous cell carcinoma, which occurs in squamous cells, which line the outer part of the cervix, and adenocarcinoma, which develops in glandular cells in the cervical canal.</p> <p>Many strains of the human papillomavirus (HPV), a sexually transmitted infection, contribute to the growth of cervical cancer cells. Many women's immune systems combat HPV, preventing the virus from causing cancer. Yet, some women are more susceptible to cervical cancer, as HPV lives in their bodies for years and aids in the emergence of cancer cells.</p> <h4>Are symptoms of cervical cancer obvious?</h4> <p>Symptoms of cervical cancer are not obvious. Most women with cervical cancer don't experience any signs in early stages.</p> <h5>As the disease progresses, symptoms could include:</h5> <ul> <li>Vaginal bleeding after intercourse, between periods or after menopause</li> <li>Watery, bloody vaginal discharge that may be heavy and have a foul odor</li> <li>Pelvic pain or lower back pain</li> </ul> <p>Talk to your primary care provider as soon as possible if you have worrisome symptoms.</p> <h4>What elevates the risk of cervical cancer?</h4> <h5>Risk factors for cervical cancer include:</h5> <ul> <li>Multiple sexual partners</li> <li>Sexual activity at a young age</li> <li>Other sexually transmitted infections</li> <li>Weak immune system</li> <li>Smoking</li> </ul> <h4>How can you prevent cervical cancer?</h4> <h5>The most effective ways to reduce cervical cancer risk include:</h5> <ul> <li><strong>Getting vaccinated against HPV.</strong><br /> The two-dose HPV vaccine is recommended for all 11- and 12-year-olds. This is the best age to receive the vaccine to protect against the virus. Children as young as 9 can receive the vaccine. Teens and young adults, from ages 15 to 26, also can receive three doses of the vaccine. Some adults ages 27 to 45 might decide to get the HPV vaccine based on a conversation with their health care providers.</li> <li><strong>Having routine Pap tests.</strong><br /> Most health care experts recommend Pap tests, which detect precancerous conditions of the cervix, beginning at age 21. Read the <a href="/hometown-health/speaking-of-health/too-embarrassed-to-ask-an-update-on-pap-tests" target="_self" title="Opens in same window.">updated recommendation for Pap tests</a>.</li> <li><strong>Practicing safe sex.</strong><br /> Limiting sexual partners, using condoms and abstaining from sex at early ages helps limit risk.</li> <li><strong>Not smoking.</strong><br /> Don't smoke, or quit if you do. Smoking is linked to squamous cell cervical cancer.</li> </ul> <h4>Can cervical cancer be treated?</h4> <p>Cervical cancer can be treated. Treatment options are available depending on the stage of the disease, your health status and personal preferences. The earlier cervical cancer is detected, the more successful treatment tends to be. Common treatments include surgery, radiation, chemotherapy or a combination of these treatments.</p> <p>After consulting with their health care team, some women may choose to have a hysterectomy, which is a removal of the uterus, to cure early stage cervical cancer and prevent recurrence. A hysterectomy makes it impossible to conceive a child in the future.</p> <p>Through awareness and diligent health management, patients and health care providers can continue to reduce the instances of, and deaths from, cervical cancer.</p> <p><em><a href="/providers/ruta-kirstein-np" target="_self" title="Opens in same window.">Ruta Kirstein</a> is an nurse practitioner in <a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">Oncology</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/menomonie" target="_self" title="Opens in same window.">Menomonie</a>, Wisconsin.</em></p> <ul> <li>Cancer prevention, treatment and survivorship, including the role of palliative care</li> </ul> N.P. <p>I was drawn to Mayo Clinic Health System by the mission and values of the organization. The culture of compassion and inclusiveness promotes comprehensive, collaborative care for patients whether they are recently diagnosed or years out from completing treatment. In a time of great advances in cancer treatment, it is a pleasure to partner with an organization with a tradition of innovation and excellence.</p> <p>In my free time, I enjoy spending time outdoors, backpacking, paddling and bicycling.</p> <p><strong>Education</strong></p> <ul> <li>Master’s degree, Nurse Practitioner Studies, State University of New York Institute of Technology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Advanced Practitioner Society of Hematology and Oncology</li> <li>Oncology Nursing Society</li> <li>Sigma Theta Tau Honor Society of Nursing</li> </ul> Kirstein<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/ruta-kirstein-np.JPG?h=280&iar=0&w=280&sc_lang=en&hash=ED3C7E7F6B48623712C4598983024E45" alt="Ruta Kirstein, N.P." width="280" height="280" DisableNVelocity="true" /> {3DB466EE-EB31-4EE3-8309-E0BF4DC80D82}Ruta<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21166099Ruta Kirstein, N.P. 1{BCFC3BDC-CF55-458E-A41C-9360527B6CCC}|{0DD9D3C9-86C5-47FC-A2CF-8AEEA4717B70}|{5AB5D42E-3625-4D5D-9685-35585C564C3D}|{20D94572-B26A-4FB7-8C9D-7555CE785162}|{BFAFB863-D571-4781-ADD9-1398B77B549E}|{DC3A2E5F-C54B-4BFA-AE04-95AE79DD4488}<img src="/-/media/national-files/images/hometown-health/2022/using-earbuds-and-smiling.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8A3FDED199DAEEC467820E72ECD17532" alt="Using earbuds and smiling" width="660" height="370" DisableNVelocity="true" />CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller4/11/2023Emotional pain almost always is associated with self-harm in teenagers. Read why creating a crisis plan of things to do when in such a frame of mind can be beneficial.Help! I think my teenager is cutting<p>Self-injury or cutting often starts in the preteen or early teen years. Parents, siblings, friends, teachers or mentors may identify behaviors that indicate self-harm, such as:</p> <ul> <li>"She's been wearing long sleeves even when it's really hot out."</li> <li>"She refuses to go swimming even though it was her favorite summer activity."</li> <li>"He stays in his room most of the time and spends longer than usual in the bathroom."</li> <li>"She is sensitive, moody and gets very angry, very quickly."</li> <li>"I discovered razor blades under his mattress."</li> </ul> <p>No simple reason or diagnosis can explain why someone engages in self-harming behavior, but emotional pain almost always is a constant.</p> <h2>Risk factors that place teens at an elevated risk for self-harm include:</h2> <ul> <li>Borderline personality disorder</li> <li>Conduct disorders</li> <li><a href="/hometown-health/speaking-of-health/how-to-support-a-loved-one-with-depression" target="_self" title="Opens in same window.">Depression</a> and anxiety</li> <li>Developmental disorders, including autism and intellectual disability</li> <li>Post-traumatic stress disorder</li> <li><a href="/hometown-health/speaking-of-health/how-teen-marijuana-use-impacts-brain-development" target="_self" title="Opens in same window.">Substance use</a></li> </ul> <p>Self-harm behavior can lead to significant problems including infection, permanent scarring and disfigurement. In extreme cases, the injury could be fatal.</p> <p>Self-injury typically is not meant as a <a href="/hometown-health/speaking-of-health/suicide-crisis-develop-safety-plan" target="_self" title="Opens in same window.">suicide attempt</a>, although it still is serious and is associated with elevated suicide risk. Seek medical help if you suspect such behavior. Many patients report that before engaging in such behavior, they experience either an uncomfortable sense of numbness inside, or they feel overwhelming or confusing emotions and don't know what to do with them. </p> <p>Cutting or other modes of self-injury, such as burning, biting, scratching, head banging, hitting oneself, or self-inflicted piercing or tattooing, all relieve these feelings — albeit momentarily. The temporary relief experienced after self-injury leads to a flood of other emotions — guilt, shame, fears and return of the previous emotional pain. This can lead to a vicious cycle of self-harm.</p> <p>There is no one-size-fits-all kind of treatment for someone who is exhibiting self-harm behaviors. A treatment plan will include therapy to get to the root of the emotional pain and, at times, medications to help with underlying <a href="/hometown-health/speaking-of-health/5-things-you-need-to-know-about-mental-health-and-girls" target="_self" title="Opens in same window.">mental health</a> issues, such as depression or anxiety. </p> <p>Management of cutting or other such behaviors will require time, hard work and a desire to learn healthier coping skills. A specific kind of therapy called <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/self-injury/diagnosis-treatment/drc-20350956" target="_blank" title="Opens in a new window.">dialectical behavioral therapy</a>, or DBT, may be helpful.</p> <h3>Creating a crisis plan of things to do when in such a frame of mind also will be beneficial. This can include:</h3> <ul> <li>Doing activities such as walking or listening to music to distract oneself until the impulse to self-harm passes.</li> <li>Having a crisis number at hand, such as the <a href="tel:988">988</a> Suicide and Crisis Lifeline.</li> <li>Identifying <a href="/hometown-health/speaking-of-health/strengthen-youth-mental-health" target="_self" title="Opens in same window.">someone to call</a> or talk to when one feels like they might cut.</li> <li>Using free apps available to help with a safety plan.</li> </ul> <p>If, despite a crisis plan, the person does not feel safe, they should go to the nearest <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">emergency department</a> for help.</p> <p><a href="/providers/patrick-bigaouette-md" target="_self" title="Opens in same window."><em>Patrick Bigaouette, M.D.</em></a><em>, is a psychiatrist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Anxiety disorders</li> <li>LGBTQIA+ populations</li> <li>Medical education</li> <li>Mood disorders</li> <li>Peripartum psychiatry</li> <li>Psychopharmacology</li> <li>Trauma- and stressor-related disorders</li> <li>Women's health</li> </ul>M.D.<p>I enjoy working with patients in managing a wide spectrum of psychiatric disorders across psychosocial stages of life. I work in a collaborative, shared decision-making approach based on biologic, psychologic and social factors. My goal is to provide high-quality, evidence-based, patient-centered care to achieve the best possible outcomes in managing psychiatric distress.</p> <p>Outside of my clinical work, I am passionate about medical education and enjoy working with resident physicians and students.</p> <p>In moving back to Minnesota from the East Coast, I enjoy staying active outdoors, going to local theater, and I am always open to book recommendations.</p><p><strong>Education</strong></p> <ul> <li>Georgetown University School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Psychiatry, Mount Sinai-Beth Israel, Icahn School of Medicine at Mount Sinai</li> </ul> <p> <strong>Residency</strong> </p> <ul> <li>Psychiatry, Mount Sinai-Beth Israel, Icahn School of Medicine at Mount Sinai, New York</li> </ul> <p><strong>Certification</strong> </p> <ul> <li>Psychiatry, American Board of Psychiatry and Neurology </li> </ul> <p><strong>Membership</strong> </p> <ul> <li>American Psychiatric Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Psychiatry, Mayo Clinic College of Medicine and Science</li> </ul>Bigaouette<img src="/-/media/shared-files/images/medical-professionals/full/mankato/patrick-bigaouette-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4A09A81BD845D197A88A6FB7DC116F24" alt="Patrick Bigaouette MD" width="280" height="280" DisableNVelocity="true" />Patrick<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30014612Patrick Bigaouette, M.D.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2023/teen-sitting-leg-up-hands-crossed.jpg?h=370&iar=0&w=660&sc_lang=en&hash=34ED221C2CCFD5B965226D364E0AEEEC" alt="Teen sitting with leg up, hands crossed over shin" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Suicide PreventionSuicide is a major concern in the U.S. According to the Centers for Disease Control and Prevention, suicide was among the top nine leading causes of death for people ages 10–64 and the second leading cause of death for people ages 10–14 and 25–34. The positive news is that with the right information and willingness to reach out to someone in need, we all can help prevent suicide.<br /><br /><strong>If you are having suicidal thoughts, call the 988 Suicide and Crisis Lifeline at <a href="tel:988">988</a>, or chat at <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://988lifeline.org/" target="_blank" title="Opens in a new window.">988lifeline.org</a>.</strong>Dawn Haller1/8/2016<p>Daily cleaning of supplies is important in keeping your airway open while you sleep by maintaining a good seal between your face and the mask. Find out why.</p>Why cleaning your positive airway pressure (PAP) supplies is important<img alt="Blog_CPAP" src="/-/media/national-files/images/hometown-health/2016/2016-general/blog_cpap.jpg?h=266&w=400&sc_lang=en&hash=918998B0D94F4FC78EF22CDF915113AD" style="height: 266px; width: 400px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive"> <p><em>By Mayo Clinic Health System staff</em> </p> <p>You made a smart and important decision involving your health the day that you decided to move forward and start positive airway pressure, or PAP, treatment for your sleep apnea. You have invested time and money when purchasing and acclimating to this device and supplies. Why not get the most out of that investment?</p> <p>Daily cleaning of supplies is important in keeping your airway open while you sleep by maintaining a good seal between your face and the mask. If your cushion starts to lose that grip to your face, your mask will start to allow the airflow from the device to leak out. When you lose too much airflow out of the sides of your mask, you no longer have an adequate seal that allows your airway to remain open. This could lead to you stopping breathing, and defeat of the purpose of using the mask and device.</p> <p>Daily cleaning of the mask cushion — the part that touches your face — is a vital part of maintaining the integrity of the seal for as long as possible. First, you should wash the cushion in warm, soapy water using a mild dishwashing detergent and allow to air dry. The detergent acts as a grease cutter to wash away oils from your skin left on the mask. Second, be sure to wash the cushion soon after you wake up to limit the amount of time these oils are allowed to remain on your mask cushion. These two steps can go a long way to extend the lifetime of your cushion and ensure an adequate mask seal.</p> <p>Routine cleaning and replacement of your PAP supplies also is important in keeping you healthy. You should replace the distilled water in your heated humidifier chamber daily. Do not allow this water to sit for extended periods of time, as bacteria love a warm, wet place to grow. Be sure to clean the entire mask, headgear and tubing each week to get rid of dust and germs. If you are ill, daily cleaning of all your supplies is a good practice until your symptoms are gone.</p> <p>It’s time to replace your mask, cushion, headgear and other supplies when you can no longer maintain a good seal despite regular cleaning and proper mask fit and placement. Regular replacement of all of your disposable supplies is an important part of keeping you healthy and the equipment working properly.</p> <p>You have made a valuable investment in your present and future health. Do the most you can to get the most out of your investment.</p><img src="/-/media/national-files/images/hometown-health/2016/2016-general/blog_cpap.jpg?h=335&iar=0&w=504&sc_lang=en&hash=B46F29F172AFBECACB2BE35D761D025E" alt="Blog_CPAP" width="504" height="335" DisableNVelocity="true" />SleepSleep is essential to good health. It's one of the body's basic needs. But, what do you do when you have troubles sleeping, or getting enough hours of sleep? BreathingMost cases of shortness of breath are due to heart or lung conditions. Your heart and lungs are involved in transporting oxygen to your tissues and removing carbon dioxide, and problems with either of these processes affect your breathing.PulmonologyTreatment for diseases and conditions affecting lung and airway function.Dawn Haller12/28/2022If the busyness of your schedule has left you wondering if you can tackle New Year's resolutions, don't worry. Consider these feel-good elements of motivation.Need motivation to tackle your New Year's resolutions?<p>It's plain and simple. Motivation is essential for successful changes to your lifestyle. Challenges and changes in your life may have you questioning if you can tackle new resolutions. Don't let the busyness of your schedule stop you. You can capture motivation and make it work for you.</p> <h2>Start by asking yourself these questions:</h2> <h4>How do I get motivated?</h4> <p> Perhaps you get motivated by singer James Brown's song "I Feel Good," or by participating in virtual workout classes and seeing how hard others work. Decide what works for you. Setting goals will make it easier to stay committed.</p> <h4>What is motivation made of?</h4> <p> It's energy that predicts the strength and persistence of behavior. Like vitamins, you must take some motivation every day. Sometimes, that means acting as if you have it when you're not feeling it. People often wait for motivation to occur before taking action, but action can create motivation.</p> <h4>Where does motivation come from?</h4> <p>Internally, motivation is your optimism and your history. There's nothing more motivating than success, so how can you plan to be successful? What is the smallest step you can confidently take? Consider small successes and build on those for larger successes.</p> <p>Externally, look at how your environment is motivating. Are people around you encouraging you to be the best version of yourself? What small goals can you reach until your internal motivation kicks in? What has worked well in the past to motivate you?</p> <h4>What does motivation look like?</h4> <p> Consider your body posture. Is it a confident pose? Believe in yourself.</p> <h4>What does motivation sound like?</h4> <p> What is your internal coach's voice saying to you? Think "You can do it" and "You are awesome."</p> <h4>What does motivation act like?</h4> <p> Motivation involves activation, persistence and intensity. Activation is deciding to change. Persistence is the act of continuing to work toward change. Intensity is the concentration or vigor of pursuing change. The level of intensity will vary with each goal, as some will be easier to achieve than others. </p> <h3>Next, remember the acronym "FEEL GOOD" as you consider elements of motivation:</h3> <ul> <li><strong>Find the first step.</strong><br /> What is the first step towards building your motivation? How can you shine on the habits you already have? What does it look like to take those habits one step further?</li> <li><strong>Energize your environment.</strong><br /> Who in my environment is uplifting? How can I tap into that energy? How is my environment exercise inducing? Are shoes readily available wherever you are? Are exercise clothes fun and fashionable? Does your environment and social network promote healthy choices? If not, how can you lead the way? Begin with a baby step. Share your goals with family and friends for accountability. Research shows sharing your goals with a mentor can be helpful.</li> <li><strong>Enlarge your view.</strong><br /> What if your blood glucose level was within normal range? Or you were within 10 pounds of your ideal weight? In what ways would your life be different? Where does the journey begin? What is working well for you? How do you build on that? Ensure your goals are realistic and measurable.</li> <li><strong>Love yourself.</strong><br /> By taking care of your body, you are giving yourself the best gift of all. Think of one thing now that you love about yourself. Think about one thing every day. There is room for making a change and loving yourself.</li> <li><strong>Get ready.</strong><br /> The way to success is 90% preparation. What do you have to do to get ready to embark on this healthy journey? What do you have to get rid of? What do you have to leave behind? What can you do today to get ready?</li> <li><strong>Obtain an optimistic viewpoint.</strong><br /> Put on your rose-colored glasses, and plant a smile on your face. Shrink your inner critic down to microscopic size. When evaluating your efforts, think first and foremost about what went well. What did you learn?</li> <li><strong>Overcome obstacles.</strong><br /> Yes, there will be setbacks, off-road trails and dead ends. Your attitude must be one of optimism. What about this setback is of value to you? Maybe early on you realized something about yourself that you never knew. What is your response to obstacles? Is this where your motivation falters? What can you do to build your resiliency physically, mentally and spiritually? What can you not do to let the excuses get in the way of reaching your goals, yet still keep you and others safe?</li> <li><strong>Discover your determination.</strong><br /> It's never done. Once you are on the healthy journey path, you'll want to stick to the course. Yes, a few side trips and some wanderings might happen along the way, but no hijackings 50 miles off the path. When veering too far from the path, the hard part is finding your way back. That takes determination.</li> </ul> <p>Get more <a href="/topics/exercise-and-fitness" target="_self" title="Opens in same window.">exercise, fitness</a> and <a href="/topics/weight-loss-and-bariatric-surgery" target="_self" title="Opens in same window.">weight loss</a> information to help you get started.</p> <p><em><a href="/providers/kayla-wojciechowski-licsw" target="_self" title="Opens in same window.">Kayla Wojciechowski</a> is a clinical social worker in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Adjustment disorders</li> <li>Anxiety disorders</li> <li>Attention-deficit/hyperactivity disorder (ADHD) assessments</li> <li>Cognitive behavioral therapy (CBT) techniques</li> <li>Depressive disorders</li> <li>Grief and loss</li> <li>Mac Initiative support (organization that helps cope with stillborn birth or infant loss)</li> <li>Mindfulness techniques</li> <li>Postpartum mood disorders</li> <li>Psychoeducation</li> <li>Trauma </li> </ul>L.I.C.S.W.<p>I provide short-term therapy for individuals from childhood to adulthood. My approach to therapy is based on many different modalities but primarily focuses on cognitive behavioral therapy and solution-focused therapy.</p> <p>My collaborative approach to therapy will assist you in identifying goals and finding the best solution to meet those goals. By treating you as an expert in your own life, I can further assist you in seeing your strengths.</p> <p>During my free time, I enjoy spending time with my French bulldog, Bentley, as well as my husband, family and friends. I love spending time outdoors, whether it be walking my dog, fishing on the lake or just enjoying the sunshine.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Social Work, Winona State University</li> <li>Master's degree, Clinical Social Work, University of St. Thomas/St. Catherine's University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Mental Health, U.S. Department of Veterans Affairs</li> <li>Skilled Nursing Social Work, Ebenezer Ridges Care Center</li> </ul>Wojciechowski<img src="/-/media/shared-files/images/medical-professionals/full/mankato/kayla-wojciechowski-licsw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=CB02CD9ABAAC1503DD0349B4D48271E3" alt="Kayla Wojciechowski, L.I.C.S.W." width="280" height="280" title="Kayla Scott, L.G.S.W." DisableNVelocity="true" />Kayla<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21158134Kayla Wojciechowski, L.I.C.S.W.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}|{C4130004-0F31-48C4-AC9F-A4350A75AB24}|{F26710D2-A52B-47C8-986C-0B3D1DA0A9D0}<img src="/-/media/national-files/images/hometown-health/2022/sunset-behind-snowy-trees.jpg?h=370&iar=0&w=660&sc_lang=en&hash=01F9F30CE55E9F33DB3BC538B0E9830F" alt="Sunset behind snowy trees" width="660" height="370" DisableNVelocity="true" />Life CoachingThe life coach works with the whole person, taking the time to listen to concerns and asking powerful questions to help motivate you in your desire to make and sustain changes. Through coaching, you are empowered to reach your highest level of physical, emotional and spiritual health.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller4/14/2023<p>While there are some benefits of moderate alcohol use, there are no health benefits for heavy or binge drinking. Here's how it affects your body, including your brain, immune system and liver.</p>Binge drinking and your body<p>Drinking alcohol is common in the U.S. About 84% of adults report drinking alcohol at some point in their lives, with 51% reporting drinking in the last month. Some people drink to feel sociable, celebrate a special occasion or to complement a meal. Others drink alcohol to escape from or avoid problems.</p> <p>Moderate alcohol use for healthy adults generally means up to one drink a day for women and up to two drinks a day for men. Examples of one drink include:</p> <ul> <li>12 fluid ounces of beer</li> <li>5 fluid ounces of wine</li> <li>1.5 fluid ounces of distilled spirits (80 proof)</li> </ul> <p>Moderate alcohol use may have some benefits, but heavy or binge drinking has no health benefits. It's defined as three drinks in a day or more than seven drinks a week for women and for men older than 65, and more than four drinks in a day or more than 14 drinks a week for men 65 and younger.</p> <h2>Here are answers to questions about the effects of heavy drinking on the body:</h2> <h3>Q: Does drinking alcohol kill brain cells?</h3> <p>A: Alcohol is a neurotoxin that can disrupt communications of the brain. It also affects the functions of brain cells. This can lead to intellectual impairment, headaches, memory loss, slowed thinking, slurred speech, and trouble with balance and coordination. Excessive drinking can affect your nervous system, causing numbness and pain in your hands and feet, seizures and dementia.</p> <p>Alcohol also is toxic to a developing brain during pregnancy and can cause congenital disabilities, including developmental disorders.</p> <h3>Q: Can drinking alcohol improve mood?</h3> <p>A: Short-term, moderate use can help you feel relaxed and less inhibited, but alcohol is a depressant. Heavy drinking increases your risk for depression, anxiety, irritability and rapid mood changes. This can lead to relationship problems and impaired judgment. In severe cases, heavy alcohol consumption can cause a person to hallucinate, become paranoid and lose touch with reality.</p> <h3>Q: Is alcohol good for heart health?</h3> <p>A: Research has shown that drinking moderate amounts of alcohol can benefit your heart health. Studies have found that drinking alcohol in moderation increases your high-density lipoprotein (HDL), or "good" cholesterol, which helps carry away and break down extra cholesterol in the blood that could otherwise block your arteries. Alcohol thins your blood, too, making it less likely that your arteries will form a blood clot. Moderate alcohol intake can lower inflammation throughout your body.</p> <p>However, drinking more than the recommended amount of alcohol can lead to heart problems. Too much alcohol may raise your blood pressure and triglyceride levels, putting you at higher risk for heart disease.</p> <h3>Q: Does binge drinking lead to liver disease?</h3> <p>A: Possibly. People who drink alcohol excessively have an increased risk of developing liver disease or liver failure, but not every person will develop these conditions.</p> <p>The liver is essential for digesting foods and beverages. It breaks down alcohol and eliminates it from the body. Each person has a different alcohol metabolism, which is the ability to break down and eliminate alcohol. This metabolism is controlled by genetic factors, the amount of alcohol consumed and overall nutrition. Heavy drinking can cause increased fat and inflammation in the liver. Over time, this can cause irreversible damage and scarring of liver tissue, called cirrhosis. If left untreated, advanced cirrhosis can develop into liver failure, a life-threatening condition.</p> <h3>Q: Does alcohol protect against cancer?</h3> <p>A: No. Long-term, excessive alcohol use has been linked to a higher risk for many cancers, including mouth, throat, liver, esophagus, colon and breast cancers. Even moderate drinking can increase the risk of breast cancer.</p> <h3>Q: Does drinking alcohol increase the odds of catching a cold?</h3> <p>A: Yes. Alcohol can weaken your immune system. This can make it harder for your body to resist diseases and increase your risk for illnesses like colds, COVID-19 and pneumonia.</p> <h3>Q: My eye twitches when I drink. Is that normal?</h3> <p>A: Over time, heavy drinking can cause involuntary rapid eye movement or weakness and paralysis of your eye muscles. This is due to a vitamin B-1 deficiency, which causes other changes to your brain, like dementia, if not promptly treated. You should talk with your health care team about your symptoms.</p> <p>If you're experiencing problems with alcohol, speak with your primary care provider or a licensed counselor.</p> <p><em>Mayo Clinic Health System <a href="/services-and-treatments/addiction-treatment" target="_self" title="Opens in same window.">Fountain Centers</a> is a chemical dependency treatment program that helps patients safely address substance-use problems and the life circumstances surrounding them.</em></p> <p><em><a href="/providers/danica-reiser-ladc" target="_self" title="Opens in same window.">Danica Reiser</a></em><em> is a licensed <a href="/services-and-treatments/addiction-treatment" target="_self" title="Opens in same window.">alcohol and drug counselor</a> and clinical supervisor in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a>, <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a> and <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota. </em></p><ul> <li>Addiction</li> <li>Chemical dependence</li> </ul>L.A.D.C.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Alcohol and Drug Studies and Corrections, Minnesota State University-Mankato</li> <li>Master's degree, Clinical Mental Health Counseling, Walden University</li> </ul>Reiser<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/fountain-centers/reiser_danica_l_m060182.JPG?h=280&iar=0&w=280&sc_lang=en&hash=EB7A7358BA21B533FFEF4FD46F6EC342" alt="Reiser_Danica_L_M060182" width="280" height="280" DisableNVelocity="true" />Danica<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15105296Danica Reiser, L.A.D.C.1{67744200-E25F-439A-8B70-572A5A091172}<img src="/-/media/national-files/images/hometown-health/2023/hand-holding-class-of-alcohol.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9781DA3EE927752DADB66AC34B0EAB5D" alt="Hand holding class of alcohol" width="660" height="370" DisableNVelocity="true" />Substance AbuseInformation for helping those with alcohol and other drug abuse concerns.Dawn Haller3/10/2023Snow shoveling can be great winter exercise. But to avoid injury, it's important to do it correctly. Try these tips as you tackle snowy driveways and sidewalks.Tips for safe snow shoveling<p>Shoveling snow can be good exercise when done correctly. But taking on more than your body can handle or ignoring signs that you need to take a break may prove harmful.</p> <h2>To ensure you stay injury-free as you clear driveways and sidewalks, here are some tips for safe snow shoveling:</h2> <h3>Be heart conscious.</h3> <p>If you have a history of heart problems and are physically inactive, it’s best to consult with your health care team before starting heavy exercise like shoveling. In addition, don’t shovel while smoking, eating or right after consuming caffeine since this may place extra stress on your heart.</p> <h3>Dress for the weather.</h3> <p>Wear several layers of clothing. You can remove a layer if needed. Avoid wearing cotton next to your body. If you perspire, it can become damp, and you'll get chilled. Protect your hands, feet and face since these are common areas for <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/frostbite/symptoms-causes/syc-20372656" target="_blank" title="Opens in a new window.">frostbite</a>. Wear a hat that covers your ears and a scarf to protect your lower face. Mittens are generally warmer than gloves.</p> <h3>Drink plenty of water.</h3> <p>Remaining hydrated during cold-weather months is just as important as during warm-weather months. Drink water or sports drinks before, during and after your shoveling session, even if you're not thirsty.</p> <h3>Warm up.</h3> <p>Before beginning to shovel, stretch your arms, legs, shoulders and back. You're less likely to injure muscles and joints when they're warmed up.</p> <h3>Shovel snow while it's fresh.</h3> <p>Freshly fallen snow is lighter than snow that has started melting or has been moved by a plow.</p> <h3>Watch out for ice.</h3> <p>There may be ice under the snow. Be careful, so you don’t slip, fall and injure yourself. Learn how to <a href="/hometown-health/speaking-of-health/keeping-your-winter-balance" target="_self" title="Opens in same window.">walk like a penguin</a> on icy surfaces.</p> <h3>Take it slow.</h3> <p>Pace yourself and take breaks if you need to. Safety is more important than speed.</p> <h3>Protect your back.</h3> <p>Bend at the knees, not the back when lifting the shovel. Lift with your legs bent, stand with your feet hip-width apart for balance and keep the shovel close to your body. Also, don’t pick up too much snow at once. Consider using a smaller shovel or filling a larger shovel no more than halfway.</p> <h3>Beware of shoulder strain.</h3> <p>Shoveling snow can place a lot of strain on your shoulders. Lifting and throwing heavy piles of snow or hitting hard ice hidden beneath the snow can result in shoulder damage. Lifting too much snow can aggravate arthritis or further injure a worn rotator cuff.</p> <h3>Listen to your body.</h3> <p>This is the No. 1 snow shoveling tip. If something doesn't feel normal or you’re tired, it’s time to stop. Go inside, warm up, rest and drink water, tea or coffee. Reevaluate how your body feels before picking up where you left off.</p> <h3>Be careful around machinery.</h3> <p>If you use a snowblower or plow, be especially cautious around moving parts and sharp edges. Be sure the equipment is turned off before clearing any snow jams. Keep children and pets away while you're operating machinery.</p> <h3>Have your phone handy.</h3> <p>If you're experiencing an emergency, call 911 immediately.</p> <p>Stay safe while shoveling, and enjoy the exercise and being outside on a brisk winter day.</p> <p><a href="/providers/paul-horvath-md" target="_self" title="Opens in same window."><em>Paul Horvath, M.D.</em></a><em>, practices <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">emergency medicine</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/menomonie" target="_self" title="Opens in same window.">Menomonie</a>, Wisconsin.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>University of Wisconsin Medical School-Madison</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Kalamazoo Center for Medical Studies</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Emergency Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Emergency Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Horvath<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/paul-horvath-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=6D9F9FFCF71AD564DF6A3FD125A4F235" alt="Paul Horvath, M.D." width="280" height="280" DisableNVelocity="true" />Paul<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13467174Paul Horvath, M.D.1<img src="/-/media/national-files/images/hometown-health/2023/shoveling-snow.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2F23A3D1C625FD80E5D8A2D9249E808C" alt="Shoveling snow" width="660" height="370" DisableNVelocity="true" />Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller12/3/2021The holidays are a time for family and cheer, but it can be overwhelming as well. Follow these 9 tips to keep holiday stress in check.9 tips to fend off holiday stress<p>The holidays are a time for family and cheer, but making sure the house is clean, the food is ready, and the presents are wrapped and ready to be opened can be overwhelming. These factors can bring unwanted stress and depression in a time meant for happiness.</p> <p>Some important, practical tips can help minimize the stress that accompanies the holidays. These tips may even help you enjoy the holidays more than expected.</p> <h3>Through the endless parties, cooking, shopping and cleaning, try taking one of 9 steps to ensure you have a stress-free holiday:</h3> <h4>1. Plan ahead.</h4> <p>Between co-workers, friends and family, it's inevitable that some commitments will end up on the same day. Make sure to plan on what you can attend in person or virtually. If you're hosting the holidays, create a menu to help you stay organized and make grocery shopping easier.</p> <h4>2. Say no.</h4> <p>With holiday commitments, it is OK to say no to a few or all of them. It also will help relieve some stress. Try sharing your to-do list with other family members.</p> <h4>3. Plan spending.</h4> <p>The holidays mean spending money. Make a budget and stick to it. Spending money on your loved ones is important, but it's also important to pay your energy bill. Don't buy gifts that you'll be paying off for the rest of the year.</p> <h4>4. Create relaxing surroundings.</h4> <p>Turn on some music, light some candles or open the windows on a sunny day. Research has found that listening to music and the scent of citrus can boost feelings of well-being, and vitamin D is always a happiness booster. </p> <h4>5. Maintain healthy habits.</h4> <p>The holidays are notorious for ruining healthy habits. A short workout each morning will help your decision-making throughout the day. Encourage your family to try snow shoeing or sledding to get in extra exercise. Eat healthy snacks like fresh fruit or vegetables throughout the season and to fill up before a dinner party or celebration with tempting, but unhealthy, foods. </p> <h4>6. Share feelings.</h4> <p>Spending a holiday after a loss in the family can be difficult. Accept your feelings and open up about them to others. It may make you feel better to share. Try to switch up old traditions to ease the loss. </p> <h4>7. Respect differences.</h4> <p>Family members will have different viewpoints than your own. Try your best to forgive and forget this holiday season. Focus on your similarities, and replace tension with something productive. </p> <h4>8. Be realistic.</h4> <p>You are only one person, and you can only do so much. Be realistic with how much you can handle this season. Forget about perfection, and relax and enjoy the company surrounding you.</p> <h4>9. Take a break.</h4> <p>Don't forget about your own needs. Take a nap, go for a short walk, read a book or watch a funny movie. Laughing relaxes the whole body, and can relieve physical tension and stress. </p> <p>Holidays are meant to be a fun, enjoyable time with friends and family. These tips can help ensure you truly enjoy your holidays when stress starts to set in.</p> <p><a href="/providers/peter-reisner-md" target="_self" title="Opens in same window."><em>Peter Reisner, M.D.</em></a><em> is a <a href="/locations/chetek/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/chetek" target="_self" title="Opens in same window.">Chetek</a>, Wisconsin.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>University of Texas Medical Branch</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Practice</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Reisner<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/peter-reisner-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=E4299ECA7A6FB83591D4D4F91D0769D6" alt="Peter Reisner, M.D." width="280" height="280" DisableNVelocity="true" />Peter<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13818422Peter Reisner, M.D.1<img src="/-/media/national-files/images/hometown-health/2021/bowl-of-cranberries-cinnamon-orange.jpg?h=370&iar=0&w=660&sc_lang=en&hash=18D2E9A48AB9F82AEF92449CECF29DF7" alt="Bowl of cranberries with cinnamon sticks and orange peel" width="660" height="370" DisableNVelocity="true" />Stress ManagementGuidance to help you reduce and manage daily stress.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller12/18/2015During the holiday season, it's important to recognize this can be a difficult time for those who have experienced loss in the recent months or years. Learn how to cope with the grief.Grief during the holidays<img alt="Broken frosted heart cookie" src="/-/media/national-files/images/hometown-health/2015/blog_350x350.jpg?h=300&w=300&sc_lang=en&hash=FB5CE2A69B8BE09EF3EA57E2E248087A" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /> <p><em>By Mayo Clinic Health System staff</em></p> <p>With the holiday season approaching, it's important to recognize this can be a difficult time for those who have experienced loss in the recent months or years.</p> <p>Grief — it doesn't follow a linear progression of recovery. Emotions wax and wane. Months of calm may pass before a simple smell or sighting evokes intense sadness or loneliness, or a number of consecutive blue days to muddle through before any sunshine creeps back in.</p> <p>Birthdays, anniversaries and holidays are anticipated times of longing. The person missing from the holiday celebration and family traditions is most palpable. Their presence is particularly missed in the church pew on Christmas Eve or at the dinner table on Thanksgiving.</p> <h4>What can you do if you are either grieving or know a close friend who is?</h4> <p>Remember to be kind to yourself and others who are grieving. Be patient with the person mourning. In some cultures, a mourner is actually considered legally insane for a year. The mourner is allowed to lie, break promises, wake people up at night, change his or her mind repeatedly and express emotions, sometimes even including anger, at the one who has died. A mourner is known to be at a higher-than-usual risk for dying, getting sick, becoming malnourished and having a difficult time sleeping or sleeping too much. While our culture does not always show as much understanding, mourners deserve a break.</p> <p>A big surprise to some might be that grief does not end. It certainly lessens with time for most, but sometimes the second or third year of grief is noted to be even harder because people believe the mourner should be over the loss, and we either forget to acknowledge the grief or judge the one still grieving. The mourner may experience more isolation and sadness.</p> <p>This holiday season, remember those grieving and reach out with a kind word or compassionate touch. Those mourning deserve to mourn at their own pace and be embraced with understanding, especially during a potentially difficult time of year laden with fond memories of their beloved.</p> <p>If you would like to talk about your grief, please visit your primary care provider.</p><img src="/-/media/national-files/images/hometown-health/2015/blog_350x350.jpg?h=350&iar=0&w=350&sc_lang=en&hash=525484825DDFCF24E2ADDFBA939FAB6C" alt="Blog_350x350" width="350" height="350" DisableNVelocity="true" />GriefGrief is the natural reaction to loss. It will be unique to you, depending on your own personality and circumstances.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller11/21/2019If you smoke, today is a great day to quit. But, really, any day is a great day to quit. It's not easy, but is worth it because it lowers your chance of developing lung cancer. Learn about a screening tool designed to detect lung cancer at the earliest stages when it's more likely to be effectively treated.Lung cancer hard to catch, early screening helps<p>Lung cancer is the No. 1 cause of cancer deaths in American men and women. According to the American Lung Association, more than 158,000 men and women in the U.S. are expected to die from lung cancer by the end of the year. Catching lung cancer or its initial indicators early can vastly improve outcomes. However, signs and symptoms are often subtle or non-existent until the disease progresses. Lung screening programs, which are becoming more common and increasingly effective, are the best way to discover lung cancer before it advances.</p> <h4>What is a lung screening?</h4> <p>The goal of lung screening is to detect lung cancer at an early stage — when it’s more likely to be treated effectively. Studies show lung screening reduces the risk of dying of lung cancer.</p> <p>Screenings start with an initial telephone assessment with a pulmonology specialist. For patients who meet established criteria, a face-to-face visit and a low-dose CT scan will be scheduled. During the face-to-face visit, the patient's education regarding the process is completed, and all questions and concerns are addressed in person. Follow-up appointments will be scheduled if needed after that.</p> <h4>Who qualifies for a lung screening?</h4> <p>Lung screening is a test to look for signs of lung cancer in people who are at an increased risk for developing this life-threatening disease. Typical criteria to qualify for screening include current or past smokers between ages 55 and 80 who smoked an average of one pack per day for 30 years.</p> <p>While this is the basic criteria, other factors usually also are considered when evaluating patients for lung screening. Talk to your health care team for more information.</p> <h4>What are the symptoms of lung cancer?</h4> <p>In most cases, signs of lung cancer don’t appear until the later stages of the disease. Symptoms may include:</p> <ul> <li>A new cough that doesn’t subside</li> <li>Changes in a chronic cough</li> <li>Coughing up blood, even a small amount</li> <li>Shortness of breath</li> <li>Wheezing</li> <li>Hoarseness</li> <li>Unexpected weight loss</li> <li>Bone pain</li> <li>Headache</li> </ul> <p>You should contact your health care provider if you have any concerning symptoms.</p> <p>Lung cancer is serious and deadly in many cases. But catching physical warning signs and traces of cancer early on increases your likelihood of survival. A lung screening program is the best way to detect lung cancer before it becomes too advanced to cure.</p> <p>Mayo Clinic Health System sites in <a href="/locations/mankato/services-and-treatments/pulmonology/lung-screening">Mankato, Minnesota</a>, <a href="/locations/la-crosse/services-and-treatments/pulmonology/lung-screening">La Crosse, Wisconsin</a>, and <a href="/locations/eau-claire/services-and-treatments/pulmonology/lung-screening">Eau Claire, Wisconsin</a>, offer the lung screening program.</p> <p><em><a href="/providers/jamil-taji-md">Jamil Taji, M.D.</a>, is a pulmonologist <a href="/locations/mankato">Mankato</a>, Minnesota.</em></p> <ul> <li>Lung cancer</li> <li>Pulmonary artery hypertension</li> </ul>M.D.<p><strong>Medical School</strong></p> <ul> <li>University of <span class="RadEWrongWord" id="RadESpellError_0">Szeged</span> Medical School, Hungary</li> </ul> <p><strong>Residency</strong></p> <ul> <li>University of Toledo Medical School, Ohio</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>University of Toledo Medical School, Ohio</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Internal Medicine </li> <li>Pulmonology and critical care</li> </ul> <p> </p>Taji<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jamil-taji-md.jpg?h=200&iar=0&w=200&sc_lang=en&hash=56CAAF52CF62D9FF8B802873FF147F31" alt="Jamil Taji MD" width="200" height="200" DisableNVelocity="true" />Jamil<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13999001Jamil Taji MD1<img src="/-/media/national-files/images/hometown-health/2019/breathing-fresh-air-outdoors.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2632AA1403A40D8624E723285CC5EC4F" alt="Breathing fresh air outdoors" width="660" height="370" DisableNVelocity="true" />Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.BreathingMost cases of shortness of breath are due to heart or lung conditions. Your heart and lungs are involved in transporting oxygen to your tissues and removing carbon dioxide, and problems with either of these processes affect your breathing.CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Lung CancerLung cancer is a type of cancer that begins in the lungs. It is the leading cause of cancer deaths in the U.S., among both men and women. Lung cancer claims more lives each year than do colon, prostate, ovarian and breast cancers combined. <br/><br/>Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller12/9/2015<p>For many of us, the holiday season brings multiple parties and family gatherings, all accompanied by favorite foods that we look forward to all year. This overabundance can be daunting for anyone, but it’s especially stressful after bariatric surgery. Taking a mindful approach to eating can help you maintain your weight loss during the holidays.</p>Maintaining your weight loss over the holidays<img alt="Heidi Bednarchuk C.N.S." src="/-/media/shared-files/images/medical-professionals/full/mankato/heidi-bednarchuk-cns.ash" style="width: 200px; height: 200px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /> <p>For many of us, the holiday season brings multiple parties and family gatherings, all accompanied by favorite foods that we look forward to all year. This overabundance can be daunting for anyone, but it’s especially stressful after bariatric surgery. Taking a mindful approach to eating can help you maintain your weight loss during the holidays.</p> <h4>Think about this: Most of the foods you look forward to during the holidays are actually available year-round.</h4> <p>Rather than using “I only get to have this once a year” as an excuse to overindulge, remind yourself that you can have your favorites any time. Who says you can’t cook a turkey in June?</p> <h4>Eat the foods you truly enjoy. Leave the rest on your plate.</h4> <p>Too many choices? Take a small portion of each item that appeals to you. Take a bite of each and really pay attention to how it tastes to you. Did it taste as good as you remembered? If it did, take the time to savor the taste. If not, leave it on the plate.</p> <h4>Listen to your body. You don’t have to clean your plate or eat just because it’s time for supper.</h4> <p>Eat slowly and pay attention to how you feel. If you start feeling full, stop and remind yourself you can have these foods any time of the year. If it’s time for the next meal and you’re still feeling full from the last one, wait to eat until you actually start feeling hungry again.</p> <h4>Remind yourself that everything you put in your mouth counts.</h4> <p>Your surgery may limit the total amount of food you can eat at one time, but it won’t keep you from taking numerous small bites and tastes, and those can add up to more than you realize. For example, one popular bite-size piece of chocolate has 22 calories. If you grab a piece every time you pass the candy dish, say 15 times throughout the day, you could consume an extra 330 calories.</p> <h4>Don’t be too hard on yourself.</h4> <p>We’re all guilty of eating with our eyes rather than our stomachs from time to time. Don’t be too hard on yourself or use your slipup as an excuse to overindulge the rest of the day. Use it as a learning experience, remind yourself why you started your weight loss journey and move forward.</p> <p><em><a href="/providers/heidi-bednarchuk-cns" target="_self" title="Opens in same window.">Heidi Bednarchuk</a> is a clinical nurse specialist in <a href="/services-and-treatments/bariatric-surgery" target="_self" title="Opens in same window.">Bariatric Surgery</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a> and <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Weight-loss surgery</li> <li>Weight management</li> </ul>APRN, CNS<p>Weight is a very emotional issue and I like to think of my office as a “no blame, no shame zone.” My goal is to listen and understand my patient’s struggles and work together to develop a plan to address them. </p> <p>I have struggled with weight myself for most of my adult life and have a close family member that had bariatric surgery.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Nursing, Minnesota State University-Mankato</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Adult Health Clinical Nurse Specialist, American Nurses Credentialing Center</li> <li>Certified Bariatric Nurse, American Society for Metabolic and Bariatric Surgery</li> </ul> <p><strong>Membership</strong></p> <ul> <li>President-Elect, American Society for Metabolic and Bariatric Surgery</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Surgery, Mayo Clinic College of Medicine and Science</li> </ul>Bednarchuk<img src="/-/media/shared-files/images/medical-professionals/full/mankato/heidi-bednarchuk-cns.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4FA8ABD1C131281B9AB8444BFA59FB44" alt="Heidi Bednarchuk, C.N.S." width="280" height="280" DisableNVelocity="true" />Heidi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15681548Heidi Bednarchuk, APRN, CNS1{94B2E140-AEF8-44BA-B6A9-4538B77501BC}<img src="/-/media/shared-files/images/medical-professionals/full/mankato/heidi-bednarchuk-cns.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4FA8ABD1C131281B9AB8444BFA59FB44" alt="Heidi Bednarchuk, C.N.S." width="280" height="280" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller4/23/2025Looking to improve or maintain your healthy lifestyle goals during the festive holiday season? These tips can help you savor a healthier holiday.6 tips for a healthy holiday makeover<p>Holiday gatherings with friends, family or co-workers are just around the corner. Spending time with loved ones also means being faced with calorie-rich meals, extra portions, alcoholic beverages and tempting desserts.</p> <p>If you're trying to maintain a healthy lifestyle, you may be wondering what foods you should prepare and how to stay on track with your goals.</p> <p>Here are six tips for savoring a healthier holiday season.</p> <h2>Portions matter.</h2> <p>It may be challenging to pass up your favorite foods. If you're going to indulge, take bite-size servings. Try a little bit of those favorites so you get the flavors you look forward to without eating a plateful. Also, avoid going back for second helpings. Your body needs time to feel full, so give yourself 20 minutes before you reach for more.</p> <h2>Try a new tradition.</h2> <p>You may not be the only person at the gathering trying to maintain their healthy eating goals. Why not try a healthier recipe that may become a new tradition? Check out the chart comparing traditional side dishes with more nutritional value, but just as appealing.</p> <h3>Traditional sides versus healthier sides:</h3> <table class="telerik-reTable-1"> <tbody> <tr class="telerik-reTableEvenRow-1"> <td class="telerik-reTableEvenCol-1"><strong>Mashed potatoes with gravy</strong><br /> Serving: 1 cup potatoes, 1/4 cup gravy<br /> 443 calories, 25 grams fat, 45 grams carbohydrates</td> <td class="telerik-reTableOddCol-1"><strong>Roasted potatoes with garlic and herbs</strong><br /> Serving: 2/3 cup<br /> 104 calories, 2 grams fat, 15 grams carbohydrates<br /> </td> </tr> <tr class="telerik-reTableOddRow-1"> <td class="telerik-reTableEvenCol-1"><strong>Apple pie</strong><br /> Serving: 1 piece of a 9-inch pie<br /> 227 calories, 13 grams fat, 40 grams carbohydrates</td> <td class="telerik-reTableOddCol-1"><strong>Apple dumplings</strong><br /> Serving: 1 dumpling<br /> 178 calories, 2.5 grams fat, 36 grams carbohydrates</td> </tr> <tr class="telerik-reTableEvenRow-1"> <td class="telerik-reTableEvenCol-1"><strong>Green bean casserole</strong><br /> Serving: 1 cup<br /> 165 calories, 12 grams fat, 12 grams carbohydrates</td> <td class="telerik-reTableOddCol-1"><strong>Tangy green beans</strong><br /> Serving: 1/3 cup<br /> 39 calories, 2 grams fat, 5 grams carbohydrates</td> </tr> </tbody> </table> <style type="text/css" id="telerik-reTable-1"> .telerik-reTable-1 { border-width: 0px; border-style: none; border-collapse: collapse; font-family: Tahoma; } .telerik-reTable-1 tr.telerik-reTableHeaderRow-1 { margin: 10px; padding: 10px; color: #3F4D6B; background: #D6E8FF; text-align: left; font-size: 10pt; font-style: normal; font-family: Tahoma; text-transform: capitalize; font-weight: bold; border-spacing: 10px; line-height: 14pt; vertical-align: top; } .telerik-reTable-1 td.telerik-reTableHeaderFirstCol-1 { padding: 0in 5.4pt 0in 5.4pt; color: #3a4663; line-height: 14pt; } .telerik-reTable-1 td.telerik-reTableHeaderLastCol-1 { padding: 0in 5.4pt 0in 5.4pt; color: #3a4663; line-height: 14pt; } .telerik-reTable-1 td.telerik-reTableHeaderOddCol-1 { padding: 0in 5.4pt 0in 5.4pt; color: #3a4663; line-height: 14pt; } .telerik-reTable-1 td.telerik-reTableHeaderEvenCol-1 { padding: 0in 5.4pt 0in 5.4pt; color: #3a4663; line-height: 14pt; } .telerik-reTable-1 tr.telerik-reTableOddRow-1 { color: #666666; background-color: #F2F3F4; font-size: 10pt; vertical-align: top; } .telerik-reTable-1 tr.telerik-reTableEvenRow-1 { color: #666666; background-color: #E7EBF7; font-size: 10pt; vertical-align: top; } .telerik-reTable-1 td.telerik-reTableFirstCol-1 { padding: 0in 5.4pt 0in 5.4pt; } .telerik-reTable-1 td.telerik-reTableLastCol-1 { padding: 0in 5.4pt 0in 5.4pt; } .telerik-reTable-1 td.telerik-reTableOddCol-1 { padding: 0in 5.4pt 0in 5.4pt; } .telerik-reTable-1 td.telerik-reTableEvenCol-1 { padding: 0in 5.4pt 0in 5.4pt; } .telerik-reTable-1 tr.telerik-reTableFooterRow-1 { background-color: #D6E8FF; color: #4A5A80; font-weight: 500; font-size: 10pt; font-family: Tahoma; line-height: 11pt; } .telerik-reTable-1 td.telerik-reTableFooterFirstCol-1 { padding: 0in 5.4pt 0in 5.4pt; border-top: solid gray 1.0pt; text-align: left; } .telerik-reTable-1 td.telerik-reTableFooterLastCol-1 { padding: 0in 5.4pt 0in 5.4pt; border-top: solid gray 1.0pt; text-align: left; } .telerik-reTable-1 td.telerik-reTableFooterOddCol-1 { padding: 0in 5.4pt 0in 5.4pt; text-align: left; border-top: solid gray 1.0pt; } .telerik-reTable-1 td.telerik-reTableFooterEvenCol-1 { padding: 0in 5.4pt 0in 5.4pt; text-align: left; border-top: solid gray 1.0pt; } </style> <br /> <h2>Include some healthy options.</h2> <p>A platter of enticing raw veggies or fruit with a low-fat dip can be a colorful and healthier alternative to a tray of sliced cheese, deli meats and crackers. People frequently choose the fresh, crunchy options if they're offered on the table. Or replace the charcuterie board with a bowl of icy cold large shrimp with cocktail sauce. A serving of 15 large shrimp contains about 100 calories.</p> <h2>Be active after a big meal.</h2> <p>Not only does activity help you burn off some calories but you may also feel more energized. Go for a brisk walk around the neighborhood or play outdoors with the kids, doing activities like sledding, shooting baskets in the driveway or building a snowman. If it's too cold to go outside, turn on the tunes and have a dance session the whole family can enjoy. If you feel ambitious, vacuum the house right after the guests leave.</p> <h2>Limit alcoholic beverages.</h2> <p>Extra calories in alcoholic drinks can add up fast. If you choose to <a href="/hometown-health/speaking-of-health/effects-of-alcohol-on-your-health-and-liver" target="_self" title="Opens in same window.">drink alcohol</a>, do so in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men. It's important to note that one drink equals one 12 oz. beer, 5 oz. glass of wine or 1.5 oz. distilled spirits.</p> <p>Set an example for your children. By incorporating some of these ideas, you can create healthy traditions for your kids. As these traditions are passed down from one generation to the next, your family will learn that it's possible to make positive lifestyle choices while still enjoying the holiday season.</p> <p>Remember, a healthy holiday makeover doesn't require drastic changes to have a significant impact. Modifying a few choices and behaviors can lead to health benefits that can last a lifetime. </p> <p><em><a href="/providers/amanda-halls-rd-ld" target="_self" title="Opens in same window.">Amanda Halls</a> is a registered dietitian nutritionist in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition Services</a> in <a href="/locations/lake-city" target="_self" title="Opens in same window.">Lake City</a>, Minnesota.</em></p><ul> <li>Diabetes</li> <li>Overall nutritional changes are lifelong changes for patients and their families</li> <li>Weight Management</li> </ul>RDN, LD<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Dietetics, College of Saint Benedict</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Registered Dietitian</li> <li>Licensed Dietitian</li> </ul>Halls<img src="/-/media/shared-files/images/medical-professionals/full/lake-city/amanda-halls-rdn-ld.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B0FA1017FC839B7CCA36917E15C4BB68" alt="Amanda Halls, R.D.N., L.D." width="280" height="280" DisableNVelocity="true" />Amanda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16305141Amanda Halls, R.D., L.D.1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2023/healthy-holiday-meal.jpg?h=370&iar=0&w=660&sc_lang=en&hash=AAB502A91CD1BB5949A6FCA974EB363C" alt="Healthy holiday meal" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller12/9/2021Holidays mean spending time with family and friends, and celebrating the joys in life, including food. Follow these 8 tips to enjoy a healthier holiday season without the extra weight.8 tips for celebrating without sabotaging <p>The holidays are a busy time of year and filled with many annual celebrations. For many people, the holidays mean spending with family and friends and celebrate the joys in life. Some even may view this year as an opportunity to make up for canceled or postponed holiday gatherings during the COVID-19 pandemic. Gatherings often includes special foods and temptations. But fat and calories can easily add up as you enjoy your favorite traditional holiday foods.</p> <p>Remember that the holidays don't need sabotage your healthy diet habits.</p> <h2>Follow these eight tips to enjoy a healthier holiday season as you celebrate with others:</h2> <h3>1. Don’t skip meals.</h3> <p>Skipping a meal with the goal of saving calories prior to a holiday event can often backfire and lead to overeating due to ravenous feelings of hunger. Having a filling snack, such as fruit, string cheese, yogurt or a small handful of nuts, can curb your appetite and prevent overeating.</p> <h3>2. Bring your own dish.</h3> <p>Ensure at least one nutritious choice is available at potlucks by contributing a healthy dish, such as a fruit or vegetable plate. Make it festive by arranging the ingredients in a holiday design like a wreath or tree.</p> <h3>3. Choose your splurges.</h3> <p>Scan the buffet or dinner table and choose a couple holiday favorites to splurge on instead of foods that you can have any other day of the year. Make sure you take time to really taste and enjoy that special treat when you have it.</p> <h3>4. Choose drinks wisely.</h3> <p>Stick to calorie-free drinks, such as water, tea or seltzer, instead of high-calorie festive drinks. Alcoholic beverages contribute empty calories and can cause you to make poor judgments with food. If you choose to drink alcohol, do so in moderation. Alternate each alcoholic drink with a glass of water.</p> <h3>5. Visit the people, not the food.</h3> <p>Move socializing away from the buffet or appetizer table to prevent mindless eating.</p> <h3>6. Say no to food pushers.</h3> <p>Remember that you are in control of what you eat. Be confident, decisive and polite. You should not feel shame with wanting to stick to your goals.</p> <h3>7. Eat until you are satisfied, not stuffed.</h3> <p>No one likes that icky, overstuffed feeling after a meal. Eat slowly and check your fullness levels while you’re eating. Remember — there are always leftovers.</p> <h3>8. Don’t feel guilty.</h3> <p>If you overindulged, don’t beat yourself up. Just make sure your next meal is healthy and you incorporate exercise into your routine.</p> <p><em><a href="/providers/allyn-wergin-rdn" target="_self" title="Opens in same window.">Allie Wergin</a> is a registered dietitian in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Bariatric surgery</li> <li>Diabetes management</li> <li>Oncology</li> <li>Weight management</li> </ul>RDN<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, St. Catherine University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration </li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul>Mahowald<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/allyn-wergin-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=74F690ED261F537AA65B66929A3356D1" alt="Allie Mahowald, RDN" width="280" height="280" DisableNVelocity="true" />{9209F8EC-1016-41AA-985F-014D9B877417}Allie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15971546Allyn Mahowald, RDN1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2021/holiday-table-place-setting.jpg?h=370&iar=0&w=660&sc_lang=en&hash=33B4A6EBD78DE0110C4C7008EB76FF79" alt="Holiday table place setting" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller7/15/2020Knee pain is one of the most common complaints of Americans of all ages, and the location and severity varies with each person. Get the facts on common causes and solutions.Get the facts about knee pain<p>Knee pain is one of the most common complaints of Americans of all ages. The pain can result from an injury, arthritis or other condition. The location and severity of knee pain often varies with each person depending on the cause of the problem.</p> <h2>Signs and symptoms of knee pain include:</h2> <ul> <li>Swelling</li> <li>Redness</li> <li>Stiffness</li> <li>Weakness or instability</li> <li>Popping or crunching noises</li> <li>Inability to fully straighten the knee</li> </ul> <p>The pain in your knee can be caused by a number of factors.</p> <h2>Common causes of knee pain are:</h2> <h3>Injury</h3> <p>A knee injury can affect any of the many ligaments, tendons, cartilage or bursae sacs that surround or consist of the knee joint.</p> <h4>Some of the most common knee injuries are:</h4> <ul> <li>Anterior cruciate ligament (ACL)</li> <li>Meniscus</li> <li>Bursitis</li> <li>Tendinitis</li> </ul> <h3>Arthritis</h3> <p>More than 100 different types of arthritis exist.</p> <h4><span style="color: #131313;">Examples of arthritis that might cause knee pain are:</span></h4> <ul> <li>Osteoarthritis</li> <li>Rheumatoid arthritis</li> <li>Gout</li> <li>Pseudogout</li> </ul> <h3>Mechanical problems</h3> <h4> Often caused by an underlying injury, overuse or normal wear and tear, mechanical problems might include: </h4> <ul> <li>Loose piece of cartilage or bone</li> <li>Dislocated kneecap</li> <li>Gait change because of hip or foot pain</li> </ul> <h2>Knee pain treatment</h2> <p>Not all knee pain is serious, but some injuries and conditions can lead to increased pain, joint damage and disability if left untreated. There are many ways to treat knee pain, depending on the severity of the pain and the damage to the knee.</p> <h3>Examples of knee pain treatment include:</h3> <ul> <li>Medication</li> <li>Injections</li> <li>Physical therapy</li> <li>Osteopathic manipulation</li> <li>Surgery</li> </ul> <p>There are also ways that you can treat your knee pain at home, such as over-the-counter pain medication, ice, rest, elevation and compression.</p> <h4>While it is not always possible to prevent knee pain, there are some things you can do in your life to help prevent future knee problems, including:</h4> <ul> <li>Maintain a healthy weight.</li> <li>Warm up and stretch before physical activity.</li> <li>Exercise appropriately for your body.</li> <li>Build up muscle.</li> <li>Wear proper shoes.</li> </ul> <p>Persistent knee pain can negatively affect your quality of life and can lead to future disability. If you are concerned about knee pain, contact your health care provider team.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2020/hands-holding-knee-pain.jpg?h=370&iar=0&w=660&sc_lang=en&hash=05D98E3DF0AE824144F456C01EC4DDAA" alt="Hands holding knee because of pain" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.ArthritisArthritis is inflammation of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis.Dawn Haller12/12/2022Many toys that children play with can produce levels equal to 90 decibels, which typically requires hearing protection. Get tips to help you choose toys and games that protect kids' hearing.Protect children's hearing from noisy toys, gifts<p>Hearing loss often is thought of as something that happens to the elderly. But we live, work and play in a noisy environment, and hearing loss affects the lives of people of all ages.</p> <p>The <a rel="noopener" href="https://hearinghealthfoundation.org/" target="_blank" title="Opens in a new window.">Hearing Health Foundation</a> reports that nearly 50 million people in the U.S. suffer from hearing loss in at least one ear, including 20% of teens. In younger children, hearing loss may be caused by playing with noisy toys.</p> <h2>Are toys really that loud?</h2> <p>Many toys that young children play with can produce levels equal to 90 decibels, which is as loud as or louder than a lawn mower. These levels typically require hearing protection. The volume can turn up as high as 120 decibels, which is as loud as an airplane taking off because kids often play with toys near their faces, ears and mouths.</p> <h2>Do a sound test before buying</h2> <p>Your child's ears are delicate, and every home with kids has its share of noisy toys.</p> <p>As a parent, it's a good idea to test toys in the store before buying. Test the volume of a toy closer to your face, not at arm's length. Play like a child — hold the toy up by your ear, or crouch to a child's height and play with it on the ground. If a toy sounds too loud to you, it's too loud for your child.</p> <p>Also research the Noisy Toys List from the <a rel="noopener" href="https://sightandhearing.org/" target="_blank" title="Opens in a new window.">Sight & Hearing Association</a>.</p> <h2>How to lower the sound level</h2> <h4>Toys</h4> <p>Try placing clear tape over the speaker. Some tests have shown this lowers the sound level and may be safer for kids' ears. Every now and then, turn the sound off or down on audible playthings.</p> <h4>Music and headphones</h4> <p>For children and teens glued to their music player or smart device, parents should stand near their child when they have headphones on and the music is playing. If you can hear the music, it's too loud.</p> <p>Output-limiting headphones are an excellent gift option. In most cases, they automatically limit the output level to about 85 decibels, which is a safe volume for up to eight hours. These headphones may be available at many Mayo Clinic Health System sites and through local and online retailers. Many devices, such as cellphones and tablets, have noise output-limiting settings that can be activated.</p> <p>You also can invest in custom earbuds or noise-canceling headphones that help block background noise, allowing you to decrease the volume.</p> <h4>Instruments</h4> <p>Did someone receive an instrument for the holidays?</p> <h5>These are fun, creative gifts, but consider these tips so hearing isn't sacrificed to make music:</h5> <ul> <li>For all musicians, but especially drummers, smart hearing health care is essential. Older musicians may benefit from musician earplugs that limit sound without compromising musical integrity.</li> <li>Drummers should try practicing with drum pads as much as possible. This will eliminate loud noises while still offering a surface for rehearsing stick strokes.</li> <li>Another approach is to limit practice to intervals. Try practicing, with ear protection, for 30 to 60 minutes, taking a break for the same amount of time to give your ears a rest, then going back to practice.</li> </ul> <p>Don't forget about hearing health care when you're shopping for gifts during the holidays — and throughout the year — or when your children receive toys. Make sure your gifts protect hearing and support healthy ears.</p> <p><a href="/providers/katie-dease-aud" target="_self" title="Opens in same window."><em>Katie Dease, Au.D.</em></a><em>, is an <a href="/services-and-treatments/audiology" target="_self" title="Opens in same window.">audiologist</a> in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em></p><ul> <li>Amplification/hearing aids</li> <li>Audiometry</li> <li>Pediatrics</li> <li>Tinnitus</li> </ul>Au.D.<p><strong>Education</strong></p> <ul> <li>Doctor of Audiology, University of Wisconsin-Stevens Point</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Audiology</li> <li>Certificate of Clinical Competence, American Speech-Language-Hearing Association</li> <li>Hearing Instrument Dispenser</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Speech-Language-Hearing Association</li> </ul>Dease<img src="/-/media/shared-files/images/medical-professionals/full/mankato/katie-dease-aud.jpg?h=280&iar=0&w=280&hash=2A9E758AE48ADAA463D9362B7EE868C8" alt="Katie Dease, Au.D." width="280" height="280" DisableNVelocity="true" />{A4D89010-062B-42B7-830A-2F6D0A2BD079}Katie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15263924Katie Dease, Au.D.1{18E5E65E-45C8-4C48-BD32-A914794E2AA4}<img src="/-/media/national-files/images/hometown-health/2022/child-wearing-earphones-using-tablet.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6B743085FF5AD29AAF489CC577E26B70" alt="Child wearing earphones using tablet" width="660" height="370" DisableNVelocity="true" />Ear HealthAn audiologist specializes in evaluating and treating people of all ages with hearing loss, dizziness and balance disorders. Specialty audiology consultation is available for assessment and treatment of hearing loss, tinnitus, dizziness and balance disorders.Dawn Haller10/27/2015Halloween has always been about filling up on chocolate and candies. With growing concern about childhood obesity and overall adult health, learn how to treat yourself the healthy way.Treat yourself to the best this Halloween<img alt="Healthy Halloween_Medium" src="/-/media/national-files/images/hometown-health/2015/healthy-halloween_medium.jpg?h=250&w=300&sc_lang=en&hash=153203C7D3DEF84C89F1A1CFD61BAED4" style="width: 300px; height: 250px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>Halloween has always been about dressing up, going door to door visiting friends and neighbors, and filling up on chocolate and candies each step of the way. With growing concern about childhood obesity and overall adult health, we need to treat ourselves the right way — the healthy way. Treat yourself to fruits and vegetables this year.</p> <h2>Here are some tips for a healthy, happy Halloween:</h2> <ol> <li>Plan to consume a healthy, balanced supper before venturing out that night. It's never a good idea to go trick-or-treating on an empty stomach.</li> <li>Put a number on how many houses you'll visit. This will help set the candy limit and put a safe end to the night. </li> <li>Encourage family, friends and neighbors to set out healthier snacks and treats for kids. </li> <li>Decide in advance how much candy you will get that night and how much will be eaten. This might prevent your child from having a meltdown later that night.</li> <li>When you're done trick-or-treating, put the candy away in the cupboard and keep fresh fruit in sight. Dont feel bad about throwing away unused candy after a few weeks. </li> <li>Start some new family traditions this year that don't involve candy. For example, pumpkin carving, raking leaves, apple picking and fall decorating. </li> </ol> <p><em>Anne Harguth is a registered dietitian in clinical Nutrition Services in <a href="/locations/waseca">Waseca</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2015/healthy-halloween_small.jpg?h=150&iar=0&w=200&sc_lang=en&hash=03B568884BC61E3AB895D0AD15438987" alt="Healthy Halloween_Small" width="200" height="150" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller10/23/2015<p>You can prevent a trip to the emergency room by keeping safety in mind when you use ATVs around the farm.</p>All-terrain vehicles at work on the farm<img alt="ATV Safety" src="/-/media/national-files/images/hometown-health/2015/atv-safety.jpg?h=343&w=343&sc_lang=en&hash=209623BE66B70C1EE57D3EA9C619167B" style="width: 343px; height: 343px; float: right; margin-bottom: 10px; margin-left: 10px;"> <p>As a farmer, as well as a physician, I know that ATVs can be extremely useful around the farm. In fact, ATVs are now used extensively in agriculture. They serve as a substitute for the work formerly done by pick-up trucks and horses. Originally introduced as recreation vehicles, their useful utility in other areas was soon recognized. On a farm, they can be used in tasks ranging from inspecting crops to mowing grass and plowing snow. Whatever the use, there are basic safety rules that can help prevent many types of injuries.</p> <h2>It’s important to remember and follow these ATV/UTV guidelines:</h2> <ul> <li>ATVs are not toys. They require quick adjustments, speeding up and slowing down, and shifting weight to help turn the ATV. Anyone under age 16 is less likely to have the physical strength and decision-making experience needed for safe riding.</li> <li>Wear an approved helmet and eye protection. The best helmets will have a full face shield.</li> <li>ATVs are not stable vehicles and have a tendency to tip. If that happens, drivers often fall off. Be sure to wear long pants, long sleeves, gloves and over-the-ankle boots.</li> <li>Never ride under the influence of alcohol or drugs.</li> <li>Never ride an ATV at night.</li> <li>Never exceed the limit of passengers allowed by the manufacturer.</li> <li>Ride at a safe speed.</li> <li>ATVs are not designed to ride on pavement. It can make turning difficult.</li> </ul> <h2>Watch this video for tips on ATV/UTV safety recommendations when it comes to hunting and recreational riding:</h2> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/z037Hn97Yp" title="ATV and UTV safety" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p>ATVs can be a great asset on the farm. Be sure to keep these safety rules in mind to prevent an unnecessary visit to the emergency room.</p> <p><em>Greg Kays, M.D., is an Emergency Department and Urgent Care physician at <a href="/locations/red-wing" target="_self" title="Opens in same window.">Mayo Clinic Health System in Red Wing</a>.</em></p><img src="/-/media/national-files/images/hometown-health/2015/atv-safety.jpg?h=343&iar=0&w=343&sc_lang=en&hash=93F225A787C6FA0AC5808D7EF9A778D8" alt="ATV Safety" width="343" height="343" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Dawn Haller10/20/2020You may want decorative contact lenses as a way to enhance your Halloween look. Learn why tinted eyewear may risk your eye health.Halloween safety: Decorative lenses can be dangerous<p>Looking good on Halloween often comes at a price, but that price should be in dollars and cents — not compromising your health. This year, some people may turn to decorative contact lenses as a way to enhance their Halloween look. But misuse of decorative contact lenses and supplementing costumes with tinted eyewear may risk your eye health.</p> <p>Decorative contacts are lenses that change the appearance of your eyes without correcting vision. They can modify eye color, include your favorite team's logo or create a scary, wild eye appearance for a creature you're embodying on Halloween. They're also known as cosmetic or fashion lenses and are promoted like an accessory, such as jewelry, scarves or no-correction glasses, in stores that do not specialize in eye care. However, decorative lenses are not as harmless as they seem.</p> <p>Contact lenses are medical devices that need proper fitting, and they should be purchased from a store that requires a prescription. Buying them elsewhere and not having a proper fitting can lead to significant eye health risks. The risks to your eyes include <a rel="noopener noreferrer" href="https://www.mayoclinic.org/first-aid/first-aid-corneal-abrasion/basics/art-20056659" target="_blank" title="Opens in a new window.">corneal abrasions</a>, infections, allergic reactions, decreased vision and blindness.</p> <p>If your eyes become red, sore, painful or light-sensitive, or your vision is altered, you should seek prompt treatment from an eye care provider. Left untreated, these issues can lead to blindness. The more common sense approach is to see an eye care provider for an exam, lenses fitting and prescription when considering decorative lenses.</p> <p>Also, wearing tinted glasses, goggles and masks while walking the streets on Halloween, especially at night, can inhibit your vision, limiting your ability to see vehicles, fall hazards and other people. It's best to reserve any eyesight-impeding props for well-lighted indoor functions or avoid them altogether.</p> <p>Enjoy the fun of decorative contacts and Halloween costumes, but do so in a manner that doesn't put you in danger. You can learn more about the dangers of decorative contact lenses on the <a rel="noopener noreferrer" href="https://www.fda.gov/medical-devices/contact-lenses/decorative-contact-lenses-halloween-and-more" target="_blank" title="Opens in a new window.">Food and Drug Administration website</a>.</p> <p><em><a href="/providers/robert-friese-od" target="_self" title="Opens in same window.">Bob Friese, O.D.</a>, is an <a href="/services-and-treatments/ophthalmology" target="_self" title="Opens in same window.">optometrist</a> in <a href="/locations/fairmont">Fairmont</a>, Minnesota.</em></p><ul> <li>Comprehensive eye exams</li> <li>Contact lens fitting</li> <li>Diabetes</li> <li>Diagnoses and treatment of eye diseases</li> <li>Dry eye disease</li> <li>Glaucoma</li> <li>Macular degeneration</li> </ul>O.D.<p>I provide comprehensive eye exams, diagnoses and treatment of eye disease, dry eye disease and contact lens fitting. </p> <p>I have lived in Fairmont for 30 years. </p><p><strong>Education</strong></p> <ul> <li>Doctor of Optometry, University of California - Berkeley School of Optometry</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Diplomate, American Board of Optometry</li> </ul>Friese<img src="/-/media/shared-files/images/medical-professionals/full/fairmont/robert-friese-od.jpg?h=280&iar=0&w=280&hash=28DC7F4D3B18AA7644C9CBBA5B19C874" alt="Robert Friese OD" width="280" height="280" DisableNVelocity="true" />{D85012E4-9C42-474E-AFB0-A40376EC9035}Robert<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14474077Robert Friese, O.D.1{C5680DDD-C649-4B63-AFCC-B52A244736B7}<img src="/-/media/national-files/images/hometown-health/2020/halloween-contact-lenses.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3E2514906FD14FF1F773AF7EA85EBCA9" alt="Halloween contact lenses" width="660" height="370" DisableNVelocity="true" />Eye HealthYour eyes are responsible for providing you with vision, perhaps the most important of the senses. However, the eye is a delicate and complicated structure that needs protection. The ugly truth is that eye injuries can happen at any time and place.COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Dawn Haller10/10/2023Finding a change or lump in your breast is not a reason to panic. Most breast changes aren't cancer. Get answers to common lump questions, and learn when to talk with your healthcare team.When is a lump more than a lump?<p>A breast self-exam is an inspection of your breasts that you do on your own. To help increase your breast awareness, you use your eyes and hands to regularly observe the look and feel of your breasts.</p> <p>Many breast changes detected during a breast self-exam have benign causes. This means they are not caused by cancer. Other changes may signal something serious like breast cancer.</p> <p>A breast self-exam that you do for breast awareness helps you understand the usual look and feel of your breasts.</p> <p>These self-exams aren't as effective as routine mammograms in detecting cancer or improving survival for women who have breast cancer.</p> <p>Still, many healthcare professionals believe there is value in women becoming familiar with their breasts so they understand what's typical for them and can promptly report changes to their healthcare teams.</p> <h2>What does a breast lump feel like? </h2> <p>A breast lump is a growth of tissue that develops within your breast. It may be described as a mass, growth, swelling, thickness or fullness. A breast lump can vary in the way it looks and feels.</p> <p>Many women find lumps or changes in their breasts at various points in their menstrual cycles. These are typical changes that occur, and finding a change or lump in your breast is not a reason to panic. Breasts often feel different in different places. The look and feel of your breasts will also change as you age.</p> <h3>Watch for these breast changes:</h3> <ul> <li>A distinct lump with definite borders.</li> <li>A thickened, slightly more prominent area in your breast that's different from surrounding breast tissue.</li> <li>Breast pain or tenderness.</li> <li>Nipple changes, such as a nipple pulled inward (nipple inversion) or spontaneous fluid discharge from your nipple.</li> <li>One breast that's noticeably larger than the other.</li> <li>Other breast changes, such as redness, dimpling or pitting of the skin.</li> </ul> <p>Sometimes, a breast lump is a sign of breast cancer. That's why you should seek prompt medical evaluation. However, many breast lumps result from noncancerous, or benign, conditions like <a href="/hometown-health/speaking-of-health/benign-breast-disease" target="_self" title="Opens in same window.">benign breast disease</a>, especially in women under 50.</p> <p>Your family's cancer history can affect your cancer risk and the chance that a lump might be a more serious concern.</p> <h2>What causes breast lumps?</h2> <h3>A breast lump can develop as a result of conditions, such as:</h3> <ul> <li>Breast cancer</li> <li>Breast cysts</li> <li>Fibrocystic breasts</li> <li>Hamartoma, a noncancerous tumor in the breast</li> <li>Injury or trauma to the breast</li> <li>Mastitis</li> </ul> <h2>Can a mammogram determine what is causing a breast lump?</h2> <p>In some cases, yes. A mammogram can help your healthcare team determine the cause of the lump and if additional treatment is necessary. They also may recommend additional tests and procedures, such as ultrasound or biopsy.</p> <p>Early detection and routine mammogram screenings are key to reducing death from breast cancer. That's why Mayo Clinic Health System recommends that women with an average risk of breast cancer start screening mammograms yearly at 40. Average risk of breast cancer means women with no family history of breast cancer and no other risk factors for breast cancer. Women with a family history or other risks may need earlier or more frequent mammograms at the guidance of their healthcare team.</p> <h2>When should a breast lump be evaluated?</h2> <p>Any breast symptoms, such as a breast lump, nipple discharge or breast pain, should be evaluated by a medical professional.</p> <h3>Schedule an appointment with your healthcare team if you notice:</h3> <ul> <li>A breast lump is new or unusual and feels different from the surrounding tissue or tissue in your other breast.</li> <li>A breast lump doesn't go away or gets bigger after your next menstrual period.</li> <li>A breast lump changes and becomes bigger, firmer or more defined from surrounding breast tissue, especially if you have not had it examined by a healthcare professional previously.</li> <li>Bloody, possibly spontaneous, discharge from your nipple.</li> <li>Skin changes on your breast, such as redness, crusting, dimpling or puckering.</li> <li>Your nipple is turned inward, or inverted, although it typically isn't positioned that way.</li> </ul> <p>Your healthcare team may recommend additional tests and procedures to determine the cause of your breast changes.</p> <p><em><a href="/providers/bongi-rudder-mbbs" target="_self" title="Opens in same window."><em>Bongi Rudder, M.B.B.S.</em></a>, is an <a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">oncologist</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a> </em><em>and <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, </em><em>Minnesota. </em></p><ul> <li>Breast cancer</li> <li>Cancer care</li> <li>Hematology</li> <li>Lymphoma</li> <li>Multiple myeloma</li> </ul>M.B.B.S.<p>With a cancer diagnosis comes a lot of uncertainty and questions. In my practice, communication and compassion is a main component, and I will work with you to determine a care plan that is personalized for you. Through education and awareness of all available treatment options and clinical trial opportunities, you are able to make impactful care decisions that fit your individual needs.</p> <p>I'm part of a multi-disciplinary team, which means I work with colleagues in various specialties, not only at Mayo Clinic Health System, but also Mayo Clinic, to ensure the best possible outcomes for cancer treatment and survivorship.</p> <p>In my time away from work, I enjoy playing the piano and watercolor painting. </p><p><strong>Education</strong></p> <ul> <li>University of the West Indies School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li> Internal Medicine, State University of New York-Brooklyn</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Hematology & Oncology, State University of New York-Brooklyn</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Internal Medicine</li> <li>Hematology, American Board of Internal Medicine</li> <li>Medical Oncology, American Board of Internal Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Medical Association </li> <li>American Society of Clinical Oncology</li> <li>American Society of Hematology</li> <li>International Society on Thrombosis and Hemostasis</li> </ul>Rudder<img src="/-/media/shared-files/images/medical-professionals/full/mankato/bongi-rudder-mbbs.jpg?h=280&iar=0&w=280&sc_lang=en&hash=8ED297B8D12E7BDF3179DA1F605E56F3" alt="Bongi Rudder, M.B.B.S." width="280" height="280" DisableNVelocity="true" />Bongi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30215411Bongi Rudder, M.B.B.S.1{BCFC3BDC-CF55-458E-A41C-9360527B6CCC}|{0DD9D3C9-86C5-47FC-A2CF-8AEEA4717B70}<img src="/-/media/national-files/images/hometown-health/2023/person-with-fingertips-together.jpg?h=370&iar=0&w=660&sc_lang=en&hash=058671E951220B09C42DD7199630ACD4" alt="Person with fingertips together" width="660" height="370" DisableNVelocity="true" />Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.Dawn Haller10/14/2015<p>Stress urinary incontinence is the unintentional loss of urine during an activity that causes increased pressure. Find out more about the causes and treatment options available.</p>Don't stress over urinary incontinence<p><em>By Mayo Clinic staff</em></p> <p>Stress urinary incontinence (SUI) is the unintentional loss of urine during an activity that causes increased pressure. The most common activities that cause SUI are running, jumping, laughing and coughing. According to the <a rel="noopener noreferrer" href="http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/UroGynSurgicalMesh/ucm284109.htm" target="_blank" title="Opens in new window">U.S. Food and Drug Administration</a>, it is the most common form of incontinence for women. Although SUI can affect women of all ages, symptoms are most common in women after vaginal delivery, surgery or during menopause.</p> <h4>Cause and effect</h4> <p>SUI occurs when the urethra falls or descends due to weakening muscles. The weakened muscles are unable to keep the urethra from falling during activity of increased pressure, including exercise and coughing.</p> <p>SUI can cause significant burden, distress and embarrassment for women. Many women avoid normal activities and exercise due to loss of urine. Conditions such as urinary tract infections, obesity, chronic cough, diabetes and certain medications can make it worse. However, treatment of other chronic conditions can often decrease symptoms of SUI.</p> <h4>Treatment options</h4> <p>Nonsurgical treatment options may include a combination of behavioral modifications and supportive techniques and treatments, including: </p> <ul> <li><strong>Avoiding certain foods and drinks.</strong><br /> Alcohol, caffeinated soda, spicy and citrus foods can irritate the bladder. Consider eliminating the foods which may trigger SUI. </li> <li><strong>Losing weight.</strong> <br /> Some women see an improvement in symptoms by losing at little as 10 lbs. Before starting a weight loss program, it is a good idea to consult with your health care provider.</li> <li><strong>Exercising pelvic floor muscles by doing Kegel exercises on a regular basis.</strong><br /> Kegel exercises strengthen the pelvic and urinary sphincter muscles. </li> <li><strong>Exploring biofeedback.</strong><br /> Biofeedback is a technique that helps you focus on controlling your body’s functions by receiving feedback from electrical sensors. In essence, biofeedback gives you the power to use your thoughts to control your body.</li> </ul> <p>Another treatment option is using a vaginal pessary, which is a small ring that is placed in the vagina to support the bladder and urethra. This is a removable device that helps support the bladder base to prevent urine leakage.</p> <p>When nonsurgical treatments are unsuccessful, surgery may be considered. One surgical option is a tension-free vaginal tape, or TVT, which is an outpatient procedure performed by placing a sling under the urethra.</p> <p>It is important to meet with your provider to discuss all surgical and nonsurgical options. He or she will perform a pelvic exam, review your medical conditions and medications, and may perform lab tests. You and your provider should discuss the results of any tests and decide how they impact your treatment strategy.</p> <p>Stress urinary incontinence doesn’t have to hinder your lifestyle. With the right treatment, you'll likely be able to manage incontinence and improve your overall well-being.</p>Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Urinary IncontinenceThe loss of bladder control is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that's so sudden and strong you don't get to a toilet in time. For most people, simple lifestyle changes or medical treatment can ease discomfort or stop urinary incontinence.Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Dawn Haller4/20/2023Allergies affect 25% of U.S. adults and are nothing to sneeze at. Symptoms can make you feel miserable. Here are answers to four FAQ about seasonal allergies and how to manage them.Allergy season is here: FAQ on managing symptoms<p>Seasonal allergies are nothing to sneeze at. About 25% of U.S. adults have some symptoms each year. Unfortunately, this condition brings sneezing, congestion, runny nose, itchy eyes and other symptoms that can make you feel miserable.</p> <h2>Here are answers to FAQ about seasonal allergies and how to manage them:</h2> <h3>Q. What causes sneezing, itchy eyes and other symptoms?</h3> <p>A. If you have sensitivities to an <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.mayoclinic.org/diseases-conditions/allergies/home/ovc-20270181" target="_blank" title="Opens in a new window.">allergen</a>, your body's immune system mistakes it for something harmful. To fight it off, the immune system creates proteins known as immunoglobulin antibodies. These antibodies trigger cells in the nasal passages that release histamine and other mediators that lead to a stuffy and runny nose, watery eyes, itching and other allergy symptoms.</p> <h3>Q. What tests are necessary to confirm an allergy?</h3> <p>A. An allergy skin test can help determine if you're allergic to different things, such as pollen, pet dander, dust mites, latex, penicillin or bee venom. It also can help diagnose skin allergies and some food allergies.</p> <p>The most common form of skin testing involves pricking, or scratching, or an injection to expose the skin to a suspected allergy-causing substance. If a raised, red bump develops at one of the pricks, it indicates a likely allergy. Sometimes another form of skin testing, called patch testing, is used to help diagnose skin allergies. Treated patches are placed on the skin and watched for a reaction. Talk with your health care team if you suspect you or your child has an allergy that could be diagnosed by a skin test.</p> <h3>Q. What are some tips for managing seasonal allergies?</h3> <p>A. Don't let your seasonal allergy keep you from enjoying the outdoors this summer. A variety of over-the-counter treatment options are available to offer symptom relief, including antihistamine pills, nasal sprays and eye drops. Better yet, taking these medications before planned outdoor activity can help prevent symptoms from developing in the first place. Some medications can cause insomnia, elevated blood pressure or drowsiness, so watch for these side effects. You may need to try a few different medications before you find the one that works best for you.</p> <p>You also can limit your exposure to allergens. Wear a mask outside when pollen counts are high. Resist the urge to open windows to let the breeze — and the pollen — blow inside your home. Don't use the clothesline to dry sheets or clothing because pollens and mold may collect in them. Consider staying inside on dry, windy days, and avoid gardening chores, such as lawn mowing, that stir up allergens.</p> <h3>Q. What is allergen immunotherapy?</h3> <p>A. Allergen immunotherapy is another term for allergy shots. This involves a series of shots given over a period of time to help familiarize the body with the offending allergens, thereby reducing the abnormal allergic response. This can be quite helpful in reducing symptoms related to environmental allergies for people with tree, grass, weed, mold, animal, insect or dust mite sensitivities. Allergen immunotherapy induces long-term tolerance, which means that people continue to enjoy a decrease in allergy symptoms and associated medication needs long after completing the full treatment course. Ask your health care team if you might be a good candidate for allergen immunotherapy.</p> <p><a href="/providers/mansi-kanuga-md" target="_self" title="Opens in same window."><em>Mansi Kanuga, M.D.</em></a><em>, is an <a href="/services-and-treatments/immunology" target="_self" title="Opens in same window.">allergy specialist</a> in <a href="/locations/red-wing" target="_self" title="Opens in same window.">Red Wing</a>, Minnesota.</em></p><ul> <li>Allergy treatment</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Medicine and Dentistry of New Jersey</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Internal medicine, Albert Einstein College of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal medicine, Albert Einstein College of Medicine</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Allergy/Immunology, University of Medicine and Dentistry of New Jersey</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Allergy and Immunology, American Board of Allergy and Immunology</li> <li>Internal Medicine, American Board of Internal Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Kanuga<img src="/-/media/shared-files/images/medical-professionals/full/red-wing/mansi-kanuga-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=432CB15325D16BF0824E37CF27D4755E" alt="Mansi Kanuga, M.D." width="280" height="280" DisableNVelocity="true" />Mansi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15619184Mansi Kanuga, M.D.1{9D6C5FE2-E6DA-4A63-9DD8-CE124BD4E4B7}<img src="/-/media/national-files/images/hometown-health/2023/ragweed.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D51DA6B6B880B6CB5EA419E4141CE2A0" alt="Ragweed" width="660" height="370" DisableNVelocity="true" />Allergy and AsthmaOur allergists provide care for your allergies, asthma and conditions that affect the immune system's ability to defend the body against foreign or abnormal cells. The main treatment goal is your satisfaction when your condition is under control and quality of life is improved.Dawn Haller10/16/2015<p>One in eight women will be diagnosed with breast cancer at some point in their lifetime. Learn why everyone should continually be mindful of the measures they can take in breast cancer awareness.</p>Defend yourself against breast cancer<p style="line-height: 150%;"><img alt="Amy Lloyd MD" src="/-/media/shared-files/images/medical-professionals/full/la-crosse/amy-lloyd-md.jpg?h=200&w=200&sc_lang=en&hash=7474B6DA8791985DFEA83EAD678585E5" style="height: 200px; width: 200px; float: right; margin-bottom: 10px; margin-left: 10px;" />According to the National Breast Cancer Foundation, one in eight women will be diagnosed with breast cancer at some point in their lifetime; in essence, breast cancer affects everyone in some way, shape or form. We encourage women and men to be continually mindful of the measures they can take in breast cancer awareness.  </p> <p style="line-height: 150%;">There are several types of breast cancer which can be diagnosed at different stages of development and can grow at different rates.</p> <h2 style="line-height: 150%;">To enhance early detection and to reduce your overall risk, I recommend taking these defensive and precautionary measures:</h2> <ul> <li>Women need to become familiar with their breasts in order to detect abnormalities or changes.</li> <li>If you discover any type of abnormality with your breasts, make an appointment to see your doctor.</li> <li>Schedule annual mammogram screenings and clinical breast exams performed by a health care provider beginning at age 40.</li> <li>Select a diet that is rich in plant-based foods.  Plant based foods provide phytochemicals which can potentially protect cells from damage by cancer-causing agents.</li> <li>Drink alcohol only in moderation, if you do at all.  Alcohol increases your risk of breast cancer.  The amount of that risk is in proportion to the quantity of alcohol you consume.</li> <li>Regular exercise and weight gain prevention can also help to reduce your risk of breast cancer formation.</li> </ul> <p style="line-height: 150%;">It is crucial to be conscious and proactive about breast cancer. Breast cancer is normally detected when it is in an aggressive stage, however, getting regular mammograms can help detect it earlier.</p> <p style="line-height: 150%;">Contact your health care provider for further questions or to schedule an appointment.</p> <p style="line-height: 150%;"><em><a href="/providers/amy-lloyd-md">Amy Lloyd, M.D.</a>, is a general, vascular, thoracic and breast surgeon in<a href="/locations/la-crosse"> La Crosse</a>, Wisconsin.</em><br />  </p><ul> <li>Breast surgery</li> <li>General surgery</li> <li>Nissen fundoplication for gastroesophageal reflux disease (GERD)</li> <li>Robotic surgery for hernias, gallbladders/cholecystectomy</li> <li>Thoracic surgery</li> <li>Vascular surgery</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Saba University School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>General Surgery, St. Elizabeth Health Center</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Surgery, Mayo Clinic College of Medicine and Science</li> </ul>Lloyd<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/amy-lloyd-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=DF2DEF25B25672CBE538A25D953FD64B" alt="Amy Lloyd, M.D." width="280" height="280" title="Amy Lloyd, M.D." DisableNVelocity="true" />{1148CC0A-FEE9-493B-89F5-71559AD8DAA9}Amy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15804593Amy Lloyd, M.D.1{CE631A85-B409-4C11-907C-39868E49E636}<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/amy-lloyd-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=DF2DEF25B25672CBE538A25D953FD64B" alt="Amy Lloyd, M.D." width="280" height="280" title="Amy Lloyd, M.D." DisableNVelocity="true" />Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller9/14/2015<p>From a biological perspective, a mother’s instincts and her baby’s responses are naturally designed for breastfeeding. New moms may experience soreness and difficulty getting the baby to latch correctly to the breast. But if a baby could tell mom anything to make it all go smoother, what would it be?</p>If babies could talk, what would they say?<img alt="Baby Breastfeeding_Medium" src="/-/media/national-files/images/hometown-health/2015/baby-breastfeeding_medium.jpg?h=275&w=400&sc_lang=en&hash=3482D3BE352D34B828D30148BFEB0ABD" style="width: 400px; height: 275px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive"> <p>From a biological perspective, a mother’s instincts and her baby’s responses are naturally designed for <a href="http://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/breastfeeding-nutrition/art-20046912" target="_blank" title="Opens in new window">breastfeeding</a>. Sometimes it might feel unnatural — at least right away. New moms may experience soreness and difficulty getting the baby to latch correctly to the breast. They may worry about the baby getting enough milk and if they are making enough. These concerns may cause frustration for anyone, especially a sleep-deprived, new mom. But if a baby could tell mom anything to make it all go smoother, what would it be?</p> <h4>A BABY'S PERSPECTIVE</h4> <p><strong></strong></p> <p>“The first drops of milk you make are all I need to start my body growing. The<em> </em>colostrum contains directions, amazing nutrition and protection to last a lifetime.</p> <p>Don’t worry about making enough milk for me. If you hold me so close our skin touches and have patience with how often I have to practice finding my place, I can actually help tell you how much food I need.</p> <p>My tummy is my happy place. It takes a few weeks for me to stretch out and unfold. On my tummy, on your body, is the best place for that to happen. Our hormones rise, more milk is made, I learn to feed even better and we are both happier.</p> <p>Making milk is your superpower. The five different sugars in breast milk protect my tummy from germs, keep all of me healthy and even tell my brain to grow. No one else makes food that is just right for me.</p> <p>You can get tired learning something new. We both need to rest a lot. And to have energy to make milk, you need to eat, too. Supportive relationships give you energy, too, so introduce me to your family, and take time to share your new adventure with your friends.</p> <p>So, keep me close, feed me your milk often, let me practice until I find the right place to nurse comfortably for both of us and trust me to order up the right amount of milk as our eyes meet while you watch me grow.”</p> <p><em>Anne Beckman is a registered nurse and international board-certified lactation consultant in<a href="/locations/red-wing"> Red Wing</a>, Minnesota. She specializes in the clinical management of breastfeeding and is a founding member of the Goodhue, Wabasha and Pierce Counties Breastfeeding Coalition.</em></p><img src="/-/media/national-files/images/hometown-health/2015/baby_small.jpg?h=200&iar=0&w=200&sc_lang=en&hash=3456BB149E89BEEC2338F7C25BD79545" alt="Baby_Small" width="200" height="200" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Dawn Haller10/1/2015<p>It's pumpkin season. While highly nutritious, some pumpkin-flavored food items aren't good for you. Get ways to use pumpkin and enjoy a tasty recipe.</p>Pumpkin: Loaded with scary-good nutrients<img alt="Pumpkin_Medium" src="/-/media/national-files/images/hometown-health/2015/pumpkin_medium.jpg?h=200&w=300&sc_lang=en&hash=BEDC5C254320DED0F052F3891E244295" style="width: 300px; height: 200px; float: right;" /> <p>It’s that time of year again: pumpkin season. If you’ve gone to the store lately, you must’ve noticed that pumpkin-flavored food items are everywhere. Pumpkin-flavored cereal, yogurt, coffee, lattes, ravioli, pie, cookies, candies and even pumpkin-flavored chips cover the shelves. And the list goes on and on.</p> <p>Although pumpkin-flavored items may launch our taste buds into the fall season, many of these pumpkin products are not necessarily the most nutritious choices. Many are high in sugar, fat and refined carbohydrates. But real pumpkin is extremely nutritious.</p> <p>Pumpkin is nutrient-rich due to its bright-orange color. This orange color comes from beta-carotene, an antioxidant and precursor to vitamin A — meaning beta-carotene is converted to vitamin A in the body. Pumpkin is an excellent source of vitamin A, with one cup providing 245% of our recommended daily intake. Vitamin A is important to preserve vision, fight infections, maintain healthy skin and bones, and regulate cell growth and division. </p> <p>Pumpkin is also low in calories and a good source of fiber, containing 50 calories and 3 grams fiber per 1-cup serving. It’s also an excellent source of potassium at 564 milligrams, which helps your muscles contract, regulate fluids, maintain normal blood pressure, and balance minerals in and out of body cells.</p> <h2>Pumpkin seeds</h2> <p>Don’t forget about the pumpkin seeds after you carve your jack-o-lantern. Pumpkin seeds are packed with protein, fiber and many other minerals, such as iron, copper, magnesium, manganese, phosphorous, zinc, potassium, folate, niacin and selenium. They also contain healthy poly- and mono-unsaturated fats. Pair 1 ounce of pumpkin seeds with a piece of fruit, such as an apple, for a filling snack.</p> <h2>Simple ways to enjoy pumpkins</h2> <p>When adding pumpkin flavor to your recipes, be sure to purchase 100% pumpkin and not pumpkin pie mix, which has added sugar.</p> <h3>Here are a few ways to enjoy pumpkin in common dishes:</h3> <ul> <li>Stir pumpkin puree into soups, chilies and stews.</li> <li>Add canned or mashed cooked pumpkin to pancakes or quick breads.</li> <li>Layer low-fat vanilla yogurt with pumpkin puree and low-fat granola. Top with a pinch of cinnamon and nutmeg.</li> <li>Drizzle pumpkin wedges with olive oil, season with salt and pepper, and roast for about 25 minutes at 400⁰ F.  </li> </ul> <h2>Pumpkin oatmeal recipe</h2> <p>Serves 2</p> <p>1 small apple, chopped<br /> 1 cup skim milk<br /> 3/4 cup water<br /> 1/2 cup canned pumpkin<br /> 1/ teaspoon pumpkin pie spice<br /> 1 cup old-fashioned oats<br /> 1/4 teaspoon vanilla<br /> Chopped pecans, optional</p> <p>In a two-quart sauce pan, combine water, milk, chopped apples, oats, pumpkin and pumpkin pie spice. Bring to a boil. Cook and stir for five minutes or until liquid is absorbed. <span style="color: #131313;">Remove from heat. Stir in vanilla extract. Top with chopped pecans.</span></p> <p>Nutrition per 1 cup serving: 185 calories, 2 grams total fat, 0  grams saturated fat, 67 milligrams sodium, 34 grams total carbohydrates, 6 grams dietary fiber, 11 grams sugars, 8 grams protein.</p> <p><em style="font-family: Arial, Helvetica, sans-serif; font-size: 13px; line-height: 20px;"><a href="/providers/allyn-wergin-rdn">Allie Wergin</a> is a registered dietitian in Nutrition in <a href="/locations/new-prague">New Prague</a>, Minnesota.</em></p><ul> <li>Bariatric surgery</li> <li>Diabetes management</li> <li>Oncology</li> <li>Weight management</li> </ul>RDN<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, St. Catherine University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration </li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul>Mahowald<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/allyn-wergin-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=74F690ED261F537AA65B66929A3356D1" alt="Allie Mahowald, RDN" width="280" height="280" DisableNVelocity="true" />{9209F8EC-1016-41AA-985F-014D9B877417}Allie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15971546Allyn Mahowald, RDN1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller6/25/2015<p>Naturally nutrient-rich strawberries are packed with essential vitamins, minerals, dietary fiber, antioxidants and phytochemicals — a natural plant compound. The majority of health-promoting phytochemicals in strawberries are anthocyanins, which give strawberries their bright red color.  </p>Strawberries: A nutrient powerhouse <p>Naturally nutrient-rich strawberries are packed with essential vitamins, minerals, dietary fiber, antioxidants and phytochemicals — a natural plant compound. The majority of health-promoting phytochemicals in strawberries are anthocyanins, which give strawberries their bright-red color.  </p> <p>One cup of strawberries (or about eight medium strawberries) has only 45 calories, 3 grams of dietary fiber (12 percent of your daily value) and more vitamin C than an orange. Vitamin C is a known antioxidant that helps protect the body against oxidative stress. Strawberries are also naturally low in sugar and contain only 7 grams of natural sugar per 1-cup serving. </p> <p>Current research suggests that consuming 1 cup of strawberries may help improve heart health by reducing total cholesterol levels and lowering blood pressure, reduce the risk of some cancers, have anti-inflammatory effects and support cognitive function.  </p> <p>Fresh strawberries are extremely versatile and are easily eaten whole. They also can be sprinkled on top of whole-grain cereal, oatmeal or yogurt, as well as added to leafy greens or combined with low-fat or fat-free yogurt or milk to create a fruit smoothie. </p> <p>When selecting fresh strawberries, be sure to choose shiny, firm strawberries with a bright-red color. The caps should be fresh, green and intact. Avoid mushy or shriveled berries. If any berries are damaged, throw those away immediately before they spoil the rest. Rinse berries in cold water just before eating. Washing too soon can increase the likelihood of molding. </p> <h4>Strawberry spinach salad with poppy seed dressing recipe</h4> <p><strong>Serves 4</strong> (2 cup serving size)<br> Total time: 20 minutes or less</p> <p><strong>Ingredients:</strong></p> <ul> <li>6 cups of fresh baby spinach, washed and dried</li> <li>1 pint strawberries, washed, hulled and sliced</li> <li>¼ cup of chopped pecans </li> <li>Half a small red onion, thinly sliced</li> </ul> <p><strong>Dressing:</strong></p> <ul> <li>½ cup olive oil</li> <li>3 tablespoon apple cider vinegar</li> <li>2 tablespoon honey</li> <li>1 tablespoon poppy seeds</li> <li>Pinch of ground dry mustard (optional)</li> <li>Salt and ground black pepper to taste </li> </ul> <p><strong>Directions</strong></p> <p>To make the dressing, whisk all ingredients together until combined.</p> <p>To make the salad, toss all ingredients together with your desired amount of dressing until combined. Serve immediately.</p> <p><strong>Nutritional Information </strong>(per 2 cup serving with 2 tablespoons of dressing)</p> <p>Calories: 245; Total fat: 22 grams; Saturated fat: 22 grams; Monounsaturated fat: 15 grams; Polyunsaturated fat: 3 grams; Trans fat: 0 grams, Cholesterol: 0 milligrams; Sodium: 26 grams (without added salt); Total carb: 12 grams; Dietary fiber: 2.5 grams; Sugars: 9 grams; Protein: 2 grams</p> <p><em><a href="/providers/allyn-wergin-rdn" target="_self" title="Opens in same window.">Allie Wergin</a> is a registered dietitian in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Bariatric surgery</li> <li>Diabetes management</li> <li>Oncology</li> <li>Weight management</li> </ul>RDN<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, St. Catherine University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration </li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul>Mahowald<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/allyn-wergin-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=74F690ED261F537AA65B66929A3356D1" alt="Allie Mahowald, RDN" width="280" height="280" DisableNVelocity="true" />{9209F8EC-1016-41AA-985F-014D9B877417}Allie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15971546Allyn Mahowald, RDN1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller10/7/2022Each year, 3,000 to 4,000 people in the U.S. are injured after falling out of a tree stand. Get practical tips for hunting season prep and while climbing to lower the risk of a significant injury.Aim for safety in your tree stand<p>Hunting is a popular activity in the U.S. It is a great opportunity for people of all ages to spend time in nature while making memories with loved ones. I am an avid hunter and understand the camaraderie of spending time together and teaching a younger generation to embrace the sport.</p> <p>Overall, hunting can be a safe and enjoyable time. However, it poses some dangers, and tree stand injuries are common throughout the hunting season. Each year, between 3,000 to 4,000 people in the U.S. are injured after falling out of a tree stand.</p> <p>Tree stand falls can lead to significant injuries like broken bones, concussions and internal bleeding. Occasionally, a fall can lead to a head injury or spine damage that results in paralysis.</p> <p>Most trauma injuries, including falls from tree stands, are preventable. They are almost always related to three factors: alcohol or drug use, risk-taking behaviors, and poor judgment.</p> <p>Some hunters unintentionally make poor judgments or behave in a risky manner. The most common is not wearing a safety harness.</p> <p>It could be that they set up a stand in an unsafe way or rush to take advantage of the last minutes of daylight. Perhaps the stand is not in good working order, or the straps are worn. Rushing or not being aware of the surroundings can increase the risk of injuries.</p> <p>Here's what hunters can do to mitigate tree stand injuries by avoiding poor judgment and risk-taking behaviors:</p> <h2>Before the hunt</h2> <p>Like other hunters, I spend months preparing for an upcoming hunting season.</p> <h4>In addition to getting your license, scouting spots and setting up trail cameras, develop a safety plan for the season, including these parts:</h4> <ul> <li><strong>Invest in a five-point harness.</strong><br /> A harness is the cornerstone of safety equipment if you use a tree stand. Look for one that fits you well and most importantly one you will wear while hunting.</li> <li><strong>Find the perfect tree.</strong><br /> While scouting locations before season, I recommend that you look for a live tree that will support your weight. You may find what I call a "squirrel tree." This tree is in a prime spot for spotting wildlife but is too small to support your weight. It is way better to find a different spot or tree.</li> <li><strong>Rest up.</strong><br /> Accidents can happen when people are tired, including falling asleep in the stand. Try to get at least seven hours of sleep the night before season opener.</li> <li><strong>Skip alcohol and drugs.</strong><br /> Hunting while under the influence of alcohol or drugs can be a deadly combination. Avoid drinking or drugs throughout the hunt, especially the night before season opener.</li> <li><strong>Assess your physical abilities.</strong><br /> Safely climbing in and out of a stand requires considerable physical effort. You may need to skip the tree stand for a year, or indefinitely, if you recently had surgery, faced a health crisis, or just do not have the strength or stamina needed anymore.</li> <li><strong>Provide hunt details.</strong><br /> Before you head out into the wood, tell your family or friends where you will be and what time you expect to return. Keep in contact throughout the day through text messages, and make a point to report when you are safely back on the ground. Cell signal coverage can be spotty, so duplicate safety by drawing a map of your location as well.</li> </ul> <h2>Safe climbing</h2> <p>The most dangerous time for falls is when hunters are climbing in and out of stands.</p> <h4>Remember these tips as you make your way up the tree:</h4> <ul> <li><strong>Warm up.</strong> <br /> Climbing is always easier and safer when your muscles are warmed up. This raises your body temperature and increases blood flow. You can warm up on your walk to the stand. Walking slowly avoids spooking the deer and gives you the opportunity to be warm when you arrive at your stand without being too hot.</li> <li><strong>Use a climbing rope.</strong><br /> Remain continuously strapped to the tree with a climbing rope. Use a climbing rope equipped with the classic prusik knot and connect it to your five-point harness using a carabiner. A Prusik knot slides easily along the rope but will tighten fully if you slip.</li> <li><strong>Remember three contact points.</strong><br /> As you are climbing the tree, make sure that three of your appendages are always attached to the tree. This means one hand and two feet or two hands and one foot. This increases the chances that you can catch yourself if you slip or lose hold.</li> <li><strong>Climb higher than the stand.</strong><br /> As you ascend, climb a few steps higher than the seat of your stand. This gives you a better angle to get to the seat and allows you to check that the stand is secure before transitioning.</li> <li><strong>Use the rope to lift or lower your weapon and pack.</strong><br /> Focus on getting yourself up and down from the tree stand without worrying about your weapon. Gently raise and lower bows, rifles and packs with separate ropes.</li> <li><strong>Clip yourself in.</strong><br /> Secure your harness to the tree stand once you are firmly in place. Only then can you safely disconnect your harness from the climbing rope. While strapped to the tree stand, you still will have freedom of movement.</li> </ul> <p>Coming down from the tree involves the same steps in reverse order. Lower weapons and packs slowly to the ground first. Then take extra care to secure your harness to the climbing rope before unclipping from the stand and swinging your legs out to the ladder. Finally, contact your family or hunting party after you have safely reached the ground.</p> <h2>Watch this video for more tips on tree stand safety: </h2> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/VkHabhxESbw" title="Tree stand safety" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe> </p> <p>You are responsible for your own safety. Don't let risk-taking behaviors or poor judgment lead to a tree stand injury. Know and respect your physical limitations and take extra time to make sure your safety gear is in good condition and used properly.</p> <p>Always call 911 in an emergency.</p> <p><em><a href="/providers/david-ciresi-md" target="_self" title="Opens in same window.">David Ciresi, M.D.</a>, is a general and trauma <a href="/services-and-treatments/surgery" target="_self" title="Opens in same window.">surgeon</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin. He has been an avid hunter for years.</em></p><ul> <li>Trauma surgery</li> </ul>M.D.<p>Deer hunting is a time-honored tradition across the Midwest. However, without the proper safety equipment and procedures, deer season can be a time of tragedy. In this video, I explain how to keep yourself safe while tracking that big buck or doe:</p> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/VkHabhxESbw" title="Tree stand safety" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p><p><strong>Education</strong></p> <ul> <li>Mayo Clinic College of Medicine and Science</li> </ul> <p><strong>Residency</strong></p> <ul> <li>General Surgery, Butterworth Hospital</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Surgical Critical Care, Butterworth Hospital</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>General Surgery, American Board of Surgery</li> <li>Surgical Critical Care, American Board of Surgery</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Eastern Association for the Surgery of Trauma</li> <li>Fellow, American College of Surgeons</li> <li>Society of Critical Care Medicine</li> <li>Wisconsin Medical Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Surgery, Mayo Clinic College of Medicine and Science</li> </ul>Ciresi<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/david-ciresi-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=423ECB4A21837551BA1812CD785BF913" alt="David Ciresi, M.D." width="280" height="280" DisableNVelocity="true" />{BB78FE6C-5B08-464C-BABB-1479FE0A3025}David<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>10732853David Ciresi, M.D.1{CE631A85-B409-4C11-907C-39868E49E636}<img src="/-/media/national-files/images/hometown-health/2022/trail-in-woods.jpg?h=370&iar=0&w=660&sc_lang=en&hash=FC01A3930227310B722B470EB2CEC4EC" alt="Trail in woods" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Dawn Haller5/26/2022For some people, severe anxiety interferes with daily life. It begins in the brain, but it's not just all in your head. Learn about the symptoms of anxiety, and get management tips.Anxiety disorders: Is it really all in your head?<p>Everyone experiences some anxiety at some point. Negative emotions often serve an important purpose. They are the brain's way of getting ready to deal with stressful situations or escaping danger. For example, anxiety before exams could make you study more and lead you to perform better on a test.</p> <p>For some people, anxiety can be severe and out of proportion to the actual danger or situation. This can cause more harm than good. People with anxiety disorders have intense, persistent worry and fear about everyday situations. These feelings can interfere with daily activities, are difficult to control and can last a long time. These people may avoid places or situations to prevent these feelings. In these instances, it's important to talk to your health care team about treatment.</p> <p>People with anxiety disorders often feel that their concerns are not taken seriously or that "it's all in their heads." This minimizes their pain and discomfort, and leaves psychiatric and associated medical conditions unaddressed.</p> <p>It should be noted that the statement "it's all in your head" is not entirely wrong. Psychiatric distress often manifests physically. Anxiety begins in the brain, but it manifests as various symptoms.</p> <h2>Mental symptoms of anxiety</h2> <p>Many symptoms of anxiety cannot be seen by others and offer no outward signs of distress. Since people can't read the minds of others, concerning thought processes and worries need to be shared to be understood.</p> <h4>Some common mental symptoms of anxiety include:</h4> <ul> <li>Feeling nervous, restless or tense</li> <li>Having a sense of impending danger, panic or doom</li> <li>Trouble concentrating or thinking about anything other than the present worry</li> <li>Having difficulty controlling worry</li> <li>Having the urge to avoid things that trigger anxiety</li> </ul> <h2>Physical symptoms of anxiety</h2> <p>The brain is a powerful organ and the central command center for the rest of the body. When anxiety hijacks this central command system, the anxiety has free reign to cause havoc in the different organ systems. This can create actual physical symptoms, even though there is nothing wrong with the organ itself.</p> <p>Anxiety can feel like you are having a heart attack, asthma, acid reflux, insomnia or a stroke.</p> <h4>Some common physical symptoms of anxiety include:</h4> <ul> <li>Having an increased heart rate</li> <li>Breathing rapidly (hyperventilation)</li> <li>Sweating</li> <li>Trembling</li> <li>Feeling weak or tired</li> <li>Having trouble sleeping</li> <li>Experiencing gastrointestinal problems</li> <li>Avoidance behaviors</li> </ul> <p>The good news is that various approaches can be used to manage anxiety disorders.</p> <p>Medications can help with short- and long-term symptom control. Cognitive behavioral therapy, which teaches your brain to change thought patterns can help. Also, many nonmedication ways of managing anxiety can be used, like reducing stress, exercising, practicing breathing exercises and yoga techniques.</p> <p>So if you hear "it's an anxiety disorder," don't despair or think no one is taking you seriously. Your health care team is available to help you alleviate symptoms and gain back control over anxiety.</p> <p><em><a href="/providers/patrick-bigaouette-md" target="_self" title="Opens in same window.">Patrick Bigaouette, M.D.</a>, is a psychiatrist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota. </em></p><ul> <li>Anxiety disorders</li> <li>LGBTQIA+ populations</li> <li>Medical education</li> <li>Mood disorders</li> <li>Peripartum psychiatry</li> <li>Psychopharmacology</li> <li>Trauma- and stressor-related disorders</li> <li>Women's health</li> </ul>M.D.<p>I enjoy working with patients in managing a wide spectrum of psychiatric disorders across psychosocial stages of life. I work in a collaborative, shared decision-making approach based on biologic, psychologic and social factors. My goal is to provide high-quality, evidence-based, patient-centered care to achieve the best possible outcomes in managing psychiatric distress.</p> <p>Outside of my clinical work, I am passionate about medical education and enjoy working with resident physicians and students.</p> <p>In moving back to Minnesota from the East Coast, I enjoy staying active outdoors, going to local theater, and I am always open to book recommendations.</p><p><strong>Education</strong></p> <ul> <li>Georgetown University School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Psychiatry, Mount Sinai-Beth Israel, Icahn School of Medicine at Mount Sinai</li> </ul> <p> <strong>Residency</strong> </p> <ul> <li>Psychiatry, Mount Sinai-Beth Israel, Icahn School of Medicine at Mount Sinai, New York</li> </ul> <p><strong>Certification</strong> </p> <ul> <li>Psychiatry, American Board of Psychiatry and Neurology </li> </ul> <p><strong>Membership</strong> </p> <ul> <li>American Psychiatric Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Psychiatry, Mayo Clinic College of Medicine and Science</li> </ul>Bigaouette<img src="/-/media/shared-files/images/medical-professionals/full/mankato/patrick-bigaouette-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4A09A81BD845D197A88A6FB7DC116F24" alt="Patrick Bigaouette MD" width="280" height="280" DisableNVelocity="true" />Patrick<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30014612Patrick Bigaouette, M.D.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2022/hand-on-chest-white-shirt.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BF3A94694BF1BEBED98DB4B2BFF91C50" alt="Sitting cross-legged with hand on chest, wearing white shirt" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.AnxietyFeelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. Symptoms may start during childhood or the teen years and continue into adulthood. We have the experts who can help diagnose and treat anxiety concerns.ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller7/28/2022Testing for hepatitis C can be the difference between serious health complications later in life or a manageable condition. Get answers to common questions to understand more about hepatitis C.Testing for hepatitis C could save your life<p>If a simple blood test could improve your long-term health or possibly save your life, would you have it performed? The answer for most people is a resounding yes. </p> <p>Testing for <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/hepatitis-c/basics/definition/con-20030618" target="_blank" title="Opens in a new window.">hepatitis C</a>, which involves a basic blood draw and analysis, can be the difference between serious health complications later in life or a manageable condition that is curable in most cases when it's treated.</p> <h2>Here are answers to common questions about chronic hepatitis C:</h2> <h3>What is hepatitis C?</h3> <p>Hepatitis C is a viral infection that targets the liver, leading to inflammation and scarring if untreated. Of the several hepatitis viruses, hepatitis C is one of the most severe forms. <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/hepatitis-a/basics/definition/con-20022163" target="_blank" title="Opens in a new window.">Hepatitis A</a>, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/hepatitis-b/basics/definition/con-20022210" target="_blank" title="Opens in a new window.">hepatitis B</a>, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/hepatitis-c/symptoms-causes/syc-20354278" target="_blank" title="Opens in a new window."> hepatitis C</a> and hepatitis E are different diseases.</p> <p>Passed through contact with contaminated blood, hepatitis C is often contracted by sharing contaminated needles or snorting drugs. However, receiving a blood transfusion, clotting factor or organ transplant before 1992, getting piercings or tattoos in an unsterile environment, and having a history of incarceration also are risks for contracting hepatitis C.</p> <h3><strong>What are the symptoms of hepatitis C?</strong></h3> <p>Many people with hepatitis C don't know they are infected. Symptoms typically don't appear until years later in the course of chronic infection.</p> <h4>Signs of chronic infection include:</h4> <ul style="list-style-type: disc;"> <li>Bleeding easily</li> <li>Bruising easily</li> <li>Itchy skin</li> <li>Fluid accumulation in your abdomen</li> <li>Swelling in the legs</li> <li>Weight loss</li> <li>Confusion, drowsiness and slurred speech</li> <li>Spiderlike blood vessels on your skin</li> </ul> <p>Because symptoms usually don't appear until after hepatitis C has caused years of liver damage, the importance of screening is vital.</p> <h3>Who should be tested for hepatitis C?</h3> <h4>Consider a hepatitis C test if you:</h4> <ul> <li>Were born between 1945 and 1965. This population includes the highest rate of infection in the general public</li> <li>Have injected or snorted drugs — current user or history of use</li> <li>Had gotten a tattoo in an unprofessional or unsterile environment</li> <li>Were incarcerated</li> <li>Received a blood transfusion, organ transplant or clotting factor before 1992</li> </ul> <p>As of March 2020, the U.S. Preventive Services Task Force recommends screening for all adults aged 18–79.</p> <p>Talk to your health care professional if you have questions or concerns about being tested for hepatitis C.</p> <h3>What are the potential complications of hepatitis C?</h3> <h4>Left untreated or undetected, hepatitis C can cause serious complications, such as:</h4> <ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/cirrhosis/basics/definition/con-20031617" target="_blank" title="Opens in new window.">Cirrhosis</a> (scarring) of the liver tissue, which impedes the liver function</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/liver-cancer/basics/definition/con-20025222" target="_blank" title="Opens in new window.">Liver cancer</a></li> <li>Liver failure</li> </ul> <h3>Is treatment available for hepatitis C?</h3> <p>Again, diagnosing hepatitis C infection early is integral to optimal long-term health. Antiviral medications are available to treat and eliminate hepatitis C from your body. </p> <p>Older forms of these medications, which required patients to be on a regimen for 24–72 weeks, often elicited serious side effects, including depression, flu-like symptoms and loss of healthy blood cells. On the other hand, new antiviral medications are oral pills with a low risk of side effects and much better cure rates. New therapies also can be as short as eight weeks.</p> <p>Overall, the new treatments are superior to older agents, which excluded people with mental illness or a history of suicide. Newer agents have few exclusion criteria. People who were barred from treatment in the past now can possibly be treated and cured. If people underwent treatment in the past and were not cured, they should be reevaluated.</p> <p>Your health care team may recommend lifestyle changes to keep you and others healthy if you are diagnosed with hepatitis C. Common measures are refraining from consuming alcohol, avoiding medications that may cause liver damage and taking extra precautions to protect others from contact with your blood.</p> <p>If you're at risk of hepatitis C, talk to your health care professional about testing. Identifying and treating health issues early can improve your well-being for years to come.</p> <p><em><a href="/providers/victoria-louwagie-pac" target="_self" title="Opens in same window.">Victoria Louwagie</a>, is a physician assistant in <a href="/services-and-treatments/gastroenterology-and-hepatology" target="_self" title="Opens in same window.">Gastroenterology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Celiac disease</li> <li>Cirrhosis</li> <li>Eosinophilic esophagitis, also called chronic immune system disease</li> <li>Liver disease</li> </ul>P.A.-C., M.S.<p>I have been a practicing physician assistant in the Mankato area for nearly 10 years. I am a grateful clinician, assistant professor and researcher. It brings me joy to care for my patients and provide disease-oriented, evidence-based medical care. I practice shared decision-making with each of my patients and their loved ones. </p> <p>I am an avid reader, and enjoy spending time with my family, camping and being on the water. </p><p><strong>Education</strong></p> <ul> <li>Master's degree, Physician Assistant Studies, Le Moyne College</li> <li>Certificate, Healthcare Administration and Management, University of Lynchburg</li> <li>Advanced Professional Practice degree, University of Lynchburg</li> </ul> <p><strong>Certification</strong></p> <ul> <li>National Commission on Certification of Physician Assistants (NCCPA)</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Academy of Doctoral Physician Assistants</li> <li>American Academy of Physician Assistants</li> <li>American College of Gastroenterology</li> <li>American Gastroenterological Association</li> <li>Minnesota Academy of Physician Assistants</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li><strong></strong>Assistant Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul> <br /> <br />Louwagie<img src="/-/media/shared-files/images/medical-professionals/full/mankato/victoria-louwagie-pac.jpg?h=280&iar=0&w=280&sc_lang=en&hash=79728B1A24856BB2CA6CA11472FCFFCE" alt="Victoria Louwagie PAC" width="280" height="280" DisableNVelocity="true" />{0EA59485-82F3-48D7-8DCC-7F3F87220D3F}Victoria<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15653421Victoria Louwagie, P.A.-C., M.S.1{DC3A2E5F-C54B-4BFA-AE04-95AE79DD4488}|{CDA27FD1-23E5-4D31-BD85-567A48B862F7}<img src="/-/media/national-files/images/hometown-health/2022/bearded-person-smiling.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D6605EA7817F91B8839FB0E83C88F55B" alt="Bearded person smiling" width="660" height="370" DisableNVelocity="true" />Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Dawn Haller2/16/2022Before your baby is born, you should create a plan leading up to delivery and immediately following birth. Get answers to frequently asked questions about a birth plan.The importance of a birth plan<p>If a baby is in your future, you've likely been planning — stocking up on diapers, newborn clothes and blankets, as well as considering what you'll name your new little one. Before your baby is born, you should create a plan leading up to the delivery and immediately following the birth. This is known as a birth plan, and it's an important piece of two-way communication between you and your health care team.</p> <h3>Review this Q&A to learn more about birth plans and considerations to help you design a plan to best meet your needs:</h3> <h4>Why is a birth plan necessary?</h4> <p>A birth plan is a way for you to communicate your wishes to your health care team during your labor and after the birth of your baby. Each birth is a unique experience.</p> <p>Creating a birth plan empowers you to become informed of all your options during labor. At the same time, it's a tool to let the team caring for you know about your preferences.</p> <h4>Do you need to write your own birth plan?</h4> <p>You don't have to create your birth plan from scratch. Many hospitals have a standard form or booklet you can complete at your convenience.</p> <p>It's recommended to review your birth plan with your primary health care professional during your pregnancy. For example, if your <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/high-risk-pregnancy/art-20047012" target="_blank" title="Opens in a new window.">pregnancy is high risk</a>, your health care team may recommend certain things on your birth plan. It's a good idea to have this conversation before you arrive at the hospital for the delivery.</p> <h4>What needs to be included in the birth plan?</h4> <p>Although you may have in your mind how you want your baby's birth to be, your choices may not be shared effectively with your health care team if you don't have a birth plan.</p> <h5>Some questions you may answer in your birth plan include:</h5> <ul> <li>Who do you want present in the delivery room?</li> <li>Do you want to be offered medication for <a href="/hometown-health/speaking-of-health/pain-management-options-with-midwifery" target="_self" title="Opens in same window.">pain management</a>? If so, what type of medication?</li> <li>Do you want a natural birth and to use alternate measures for comfort?</li> <li>Do you want to move freely during labor?</li> <li>Do you want to use hydrotherapy?</li> <li>Do you want your baby continuously monitored?</li> </ul> <p>These are just a few items that can be included in your birth plan.</p> <h4>After the baby is born, how do you indicate your preferences?</h4> <p>A birth plan does not end with the delivery of your new baby. The care team will want to know how you want your baby to be cared for in the hospital. For example, explain who will cut the umbilical cord, change the baby's first diaper and give the baby his or her first bath.</p> <p>In addition, the birth plan can indicate how you wish to feed your baby. Identifying <a href="/hometown-health/speaking-of-health/breastfeeding-101-tips-for-new-moms" target="_self" title="Opens in same window.">breast milk</a> or formula as a nutritional preference is an important item for your birth plan. Religious or cultural preferences should be included in your plan as well.</p> <h4>Make your plan adaptive</h4> <p>Your birth plan is tailored to meet your personal wishes. Keep in mind, your health care team may need to depart from the plan to ensure the safest possible delivery. The goal during delivery is to have a healthy mom and a healthy baby. Your birth plan can help communicate your preferences to the care team during one of the most exciting times of your life.</p> <p><em><a href="/providers/jana-brand-cnp" target="_self" title="Opens in same window.">Jana Brand</a> is a nurse practitioner in <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/red-wing" target="_self" title="Opens in same window.">Red Wing</a>, Minnesota.</em></p><ul> <li>Preventive care</li> <li>Pregnancy care</li> <li>Women's health</li> </ul>C.N.P.<p><strong>Education</strong></p> <ul> <li>Winona State University, Winona, Minnesota</li> <li>Planned Parenthood Women's Health Care Nurse Practitioner Program</li> </ul> <p><strong>Certification</strong></p> <ul> <li><strong></strong>The American Academy of Nurse Practitioners</li> </ul>Brand<img src="/-/media/shared-files/images/medical-professionals/full/red-wing/jana-brand.jpg?h=280&iar=0&w=280&sc_lang=en&hash=8D8E531B74E52A86F7B2F64F5B4A50E4" alt="Jana Brand" width="280" height="280" DisableNVelocity="true" />{EDA6B3B3-8BCA-4482-82A3-95FF9155E0A2}Jana<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15593291Jana Brand, C.N.P.1<img src="/-/media/national-files/images/hometown-health/2022/pregnant-woman-writing-in-notebook.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C14237526A44781CA2DC52B497DA4637" alt="Pregnant woman writing in notebook" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Prenatal CareOB-GYN and Family Medicine providers offer exactly the care you need for starting or growing your family, including pregnancy planning and prenatal care.Dawn Haller7/17/2015<p>Some people take supplements to get nutrients lacking through diet. Before you get out your wallet, it's important to understand the exact impact supplements will have on your body.</p>Multivitamins and supplements: To take or not to take?<img alt="Vitamins on a Spoon_Medium" src="/-/media/national-files/images/hometown-health/2015/vitamins-on-a-spoon_medium.jpg?h=200&w=300&sc_lang=en&hash=F70C68395FB3FA40B5C7BCE3C6F60D64" style="width: 300px; height: 200px;" /> <p>People ask me this question quite often: "Should I be taking certain vitamins and supplements?" And the answer is, quite honestly, "It depends." According to the Dietary Guidelines for Americans, you should meet your nutritional needs primarily through diet. For some, however, taking certain supplements may be the best way to get nutrients you may be lacking through diet. Before you get out your wallet, it's important to understand the exact impact supplements will have on your body.</p> <p>According to Mayo Clinic, whole food is not to be replaced by supplements, as supplements cannot replicate all the health benefits of whole foods. For example, fruits and vegetables carry many different nutrients that provide health benefits to the human body. Depending on your diet and current physical state, spending money on supplements may not be necessary.</p> <h2>According to Mayo Clinic, the main benefits of whole foods versus supplements are:</h2> <ul> <li><strong>Greater nutrition</strong><br /> Whole foods are complex, containing a variety of the micronutrients your body needs — not just one. An orange, for example, provides vitamin C plus some beta carotene, calcium and other nutrients. It's likely these compounds work together to produce their beneficial effect.</li> <li><strong>Essential fiber</strong><br /> Whole foods, such as whole grains, fruits, vegetables and legumes, provide dietary fiber. Most high-fiber foods are also packed with other essential nutrients. Fiber, as part of a healthy diet, can help prevent certain diseases, such as type 2 diabetes and heart disease, and it can also help manage constipation.</li> <li><strong>Protective substances</strong><br /> Whole foods contain other substances important for good health. For example, fruits and vegetables contain naturally occurring substances called phytochemicals, which may help protect you against cancer, heart disease, diabetes and high blood pressure. Many are also good sources of antioxidants — substances that slow down oxidation, a natural process that leads to cell and tissue damage.</li> </ul> <p>Vitamin and mineral supplementation is recommended for some people with certain conditions.</p> <h3>Mayo Clinic says supplements may be appropriate for people who:</h3> <ul> <li>Don't eat well or consume less than 1,600 calories a day.</li> <li>Are a vegan or a vegetarian who eats a limited variety of foods.</li> <li>Don't obtain two to three servings of fish a week. If you have difficulty achieving this amount, some experts recommend adding a fish oil supplement to your daily regimen.</li> <li>Are a woman who experiences heavy bleeding during your menstrual period.</li> <li>Have a medical condition that affects how your body absorbs or uses nutrients, such as chronic diarrhea, food allergies, food intolerance, or a disease of the liver, gallbladder, intestines or pancreas.</li> <li>Have had surgery on your digestive tract and are not able to digest and absorb nutrients properly.</li> </ul> <p>To sum it up, if you're a pretty healthy person with a well-balanced diet containing a wide variety of foods — including fruits, vegetables, reduced fat dairy products, whole grains, legumes, lean meats and fish — you most likely don't need supplements. Talk to your healthcare team and dietitian if you have questions or concerns about supplements.</p> <p><em>Anne Harguth is a registered dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/waseca">Waseca</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2015/vitamins-on-a-spoon_small.jpg?h=200&iar=0&w=200&sc_lang=en&hash=714B7D5DAB05AE10368E55416DA491D7" alt="Vitamins on a Spoon_Small" width="200" height="200" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller10/13/2023You take 20,000 breaths every day, and your lungs work 24/7 to keep you alive. Test your knowledge of COPD, and learn why it's vital to be aware of the risk factors and symptoms of the disease.Checking the facts of COPD<p>On average, people take 20,000 breaths every day. Your lungs are one of the largest organs of the body, and they do a lot of work 24/7 to keep you alive.</p> <p>If you have <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/copd/symptoms-causes/syc-20353679" target="_blank" title="Opens in new window">chronic obstructive pulmonary disease</a>, or COPD, it can change your life. The disease causes obstructed airflow of the lungs and produces symptoms such as coughing, wheezing and shortness of breath.</p> <h2>Let's examine a few facts and fallacies regarding COPD so that you can keep your lungs healthy:</h2> <h3>COPD is caused by smoking.</h3> <p>True. Smoking tobacco with cigarettes, cigars or pipes is, by far, the No. 1 cause of COPD in the U.S. Over time, smoking does irreversible damage to the inside of the lungs. Other causes of COPD include prolonged exposure to second-hand smoke, <a href="/hometown-health/speaking-of-health/breathing-issues-from-wildfires-smoke" target="_self" title="Opens in same window.">air pollution</a>, and occupational dust, smoke or chemical fumes. Rare cases of COPD result from a genetic disorder.</p> <h3>COPD is easy to catch early.</h3> <p>False. COPD develops slowly over many years, so most people are at least 40 when symptoms begin. Some people lose nearly 50% of their lung function before noticing any breathing problems. At that time, much of the <a href="/hometown-health/speaking-of-health/lung-health-tips-for-healthy-living" target="_self" title="Opens in same window.">damage to the lungs</a> has already been done. Your healthcare professional may recommend a chest X-ray, CT scan or a pulmonary function test to properly diagnose you with COPD.</p> <h3>Chronic bronchitis and emphysema are other types of COPD.</h3> <p>True. Chronic bronchitis is an inflammation and narrowing of the airways that carry air to the lungs. It typically causes symptoms like a chronic, phlegmy cough and wheezing, and can be an early sing of lunch damage. Emphysema is a lung disease in which the fragile alveoli (air sacs) in the lungs become damaged which can go unnoticed for many years. You may develop a need for long-term oxygen therapy if the conditions are not detected early.</p> <h3>COPD can be cured.</h3> <p>False. Once the damage to the lungs has been done, it cannot be reversed. However, COPD can be treated and managed to reduce its effect on your quality of life. The first and most important thing to do is eliminate the cause. For most people, that means <a href="/hometown-health/speaking-of-health/a-smokers-guide-to-quitting" target="_self" title="Opens in same window.">stopping smoking</a>. Treatments for COPD include medications, such as inhalers, steroids and antibiotics. COPD patients may also benefit from lung cancer screenings, oxygen therapy, lung rehabilitation, lung volume reduction or a lung transplant.</p> <h3>COPD leads to other health concerns.</h3> <p>True. While COPD may not be the cause of death, it can cause other more deadly diseases and conditions like lung cancer. COPD makes you are more susceptible to respiratory infections, such as colds, influenza and pneumonia. It also increases your risk of heart disease, <a href="/hometown-health/speaking-of-health/know-your-heart-health-numbers" target="_self" title="Opens in same window.">high blood pressure</a> and depression.</p> <h3>If you've smoked most of your life, stopping now won't make a difference.</h3> <p>False. As it turns out, you can add years to your life expectancy and slow the decline in your health as soon as you stop smoking. It's never too late to quit. You also can lower your risk of developing lung cancer by stopping smoking and enrolling in a <a href="/hometown-health/speaking-of-health/lung-cancer-hard-to-catch-early-screening-helps" target="_self" title="Opens in same window.">lung screening</a> program. Regular screenings can help detect cancer earlier with a low-dose CT scan of your lungs.</p> <h3>If you have a cough or wheeze, and are a smoker, then you have COPD.</h3> <p>False. COPD is commonly misdiagnosed, so it's vital to not assume this diagnosis. Former smokers often are told that they have COPD when they have deconditioning of the lungs. COPD should be diagnosed by a healthcare professional. Many people with COPD aren't diagnosed until the disease is advanced and treatment is less effective, so getting a diagnosis as early as possible is important.</p> <p>If you have concerns about respiratory symptoms, contact your healthcare team.</p> <h2>In this video, I speak about COPD symptoms, treatment and prevention:</h2> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/1RpbhzjinLs" title="COPD symptoms, treatment and prevention" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p><em><a href="/providers/sunny-khosa-md">Sunny Khosa, M.D.</a>, is a <a href="/services-and-treatments/pulmonology" target="_self" title="Opens in same window.">pulmonologist</a> in <a href="/locations/mankato">Mankato</a>, Minnesota.</em></p><ul> <li>Bedside, point-of-care ultrasonography</li> <li>Bronchoscopy and endobronchial ultrasound</li> <li>Community pulmonary Medicine</li> <li>Lung cancer</li> </ul>M.D.<p>I provide high-quality, evidence-based care to patients with a patient-centered approach. I see pulmonary patients in outpatient and inpatient hospital settings, and perform diagnostic procedures in the bronchoscopy suite. I also have expertise to care for patients in the ICU during times of critical illness.</p> <p>When I'm not working, I enjoy spending time with family, traveling, exercising, and woodworking.</p><p><strong>Education</strong></p> <ul> <li>Saba University School of Medicine</li> </ul> <p><strong>Internship & Residency</strong></p> <ul> <li>Internal Medicine, MetroHealth Campus, Case Western Reserve University</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Pulmonary and Critical Care, MetroHealth Campus, Case Western Reserve University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Diplomate, American Board of Internal Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Chest Physicians</li> <li>American Thoracic Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Khosa<img src="/-/media/shared-files/images/medical-professionals/full/mankato/sunny-khosa-md.jpg?h=200&iar=0&w=200&sc_lang=en&hash=0F2A729608206BC95A0290A180682E2A" alt="Sunny Khosa MD" width="200" height="200" DisableNVelocity="true" />{490F7583-FC15-495E-9C7E-8C73A8B66305}Sunny<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16124812Sunny Khosa, M.D.1<img src="/-/media/national-files/images/hometown-health/2023/blowing-up-balloon.jpg?h=370&iar=0&w=660&sc_lang=en&hash=06DA2BB77D26F41A01C9C7E008823AC5" alt="Blowing up balloon" width="660" height="370" DisableNVelocity="true" />PulmonologyTreatment for diseases and conditions affecting lung and airway function.Smoking and Tobacco UseSmokers and other tobacco users are more likely to develop disease and die earlier than are people who don't use tobacco. If you smoke, you may worry about what it's doing to your health. You probably worry too about how hard it might be to quit smoking. Nicotine is highly addictive, and to quit smoking — especially without help — can be difficult. In fact, most people don't succeed the first time they try to quit smoking. It may take more than one try, but you can stop smoking.BreathingMost cases of shortness of breath are due to heart or lung conditions. Your heart and lungs are involved in transporting oxygen to your tissues and removing carbon dioxide, and problems with either of these processes affect your breathing.Lung CancerLung cancer is a type of cancer that begins in the lungs. It is the leading cause of cancer deaths in the U.S., among both men and women. Lung cancer claims more lives each year than do colon, prostate, ovarian and breast cancers combined. <br/><br/>Dawn Haller8/12/2015<p>Done correctly, water workouts can give you gains similar to those on land, including aerobic fitness, muscular strength and endurance, flexibility and better balance.</p>Aquatic exercise: Gentle on your bones, joints, muscles<img alt="Water Exercise_Medium" src="/-/media/national-files/images/hometown-health/2015/water-exercise_medium.jpg?h=200&w=300&sc_lang=en&hash=B8F71316384640FDBDF91905DFED93BC" style="width: 300px; height: 200px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>Done correctly, water workouts can give you gains similar to those on land, including aerobic fitness, muscular strength and endurance, flexibility and better balance.</p> <h2>Healthcare providers recommend aquatic exercise because:</h2> <ul> <li>Water's buoyancy supports your weight. When you're submersed up to your neck, the water cancels out about 90% of your body weight, significantly reducing stress on your weight-bearing joints, bones and muscles. Instead of landing on a hard surface with the impact of your full weight, you land with only 10% of your body weight. This reduces risk of injury.</li> <li>When you’re submerged in water, your circulation may increase, improving your cardiovascular health.</li> <li>The pressure of the water on your body can reduce swelling if you have painful injuries.</li> <li>Water offers resistance, which strengthens your muscles as you push against it.</li> <li>Since the effects of gravity diminish in water, you can do stretching exercises that you may not be able to do on land.</li> </ul> <p>You may want to start with <a rel="noopener" href="http://www.mayoclinic.org/healthy-lifestyle/fitness/multimedia/aquatic-exercise/sls-20076730" target="_blank" title="Opens in new window">water walking</a>. In water that's about waist-high, walk across the pool swinging your arms like you do when walking on land. Avoid walking on your tiptoes, and keep your back straight. Tighten your abdominal muscles to avoid leaning too far forward or to the side.</p> <p>To increase resistance as your hands and arms move through the water, wear hand webs or other resistance devices. Water shoes can help you maintain traction on the bottom of the pool.</p> <p>Once you're comfortable walking in waist-high water, try walking in deeper water. As you walk, swing your arms. For a more intense workout, consider jogging in deep water.</p> <p>Water workouts can help you reach your fitness goals without pain or injury. They can add cross-training variety to your existing exercise routine or offer a safe and fun way to start an exercise program. So, jump on in — the water’s fine.</p> <p>If you live with a chronic health condition such as <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/asthma/basics/definition/con-20026992" target="_blank" title="Opens in new window">asthma</a>, <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/diabetes/basics/definition/con-20033091" target="_blank" title="Opens in new window">diabetes</a> or <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/heart-disease/basics/definition/con-20034056" target="_blank" title="Opens in new window">heart disease</a>, talk to your healthcare provider about aquatic exercise.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2015/water-exercise_small.jpg?h=200&iar=0&w=200&sc_lang=en&hash=FBF212C581B66AAA34A5DDDF7D21C174" alt="Water Exercise_Small" width="200" height="200" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Dawn Haller6/3/2020Super glue has a track record of fixing broken things. But what happens when that broken thing is you? Could you use super glue on yourself?Should super glue be in your first-aid kit?<p>Super glue has a long track record of fixing things that are broken. But what happens when that broken thing is you? Could you use super glue on yourself?</p> <p>Perhaps.</p> <p>Do I <em>recommend</em> using household super glue to close a wound instead of seeking proper medical treatment?</p> <p>Not necessarily.</p> <p>Have people been successfully using super glue to close up small cuts? </p> <p>Yes.</p> <p>First and foremost, if you have been injured, it is recommended that you seek proper medical attention.</p> <p>At Mayo Clinic Health System, we try to make a trip to the Emergency Department as pleasant as possible. One way we have been doing this has been by using a form of super glue (skin adhesive) in place of stitches to close a wound.</p> <h4>Here’s why we use skin adhesive instead of stitches:</h4> <ul> <li>It is less painful.</li> <li>There are no needle pokes.</li> <li>It is a faster procedure.</li> <li>Often, it does not require a follow-up visit, saving you another trip to the doctor.</li> <li>It does not require sedation.</li> </ul> <p>If you’re a parent reading this, read the last bullet point <strong><em>one more time.</em></strong></p> <p>I often see parents bring their child to the Emergency Department needing stitches, and the child becomes fearful. Children may need to be kept still, either by their parents or by sedating medications, for procedure. Parents don’t want their child sedated, and I don’t want to sedate him or her. Skin adhesive allows us to keep needles out of the procedure, limit scarring, and get you and your child in and out of the Emergency Department as quickly as possible.</p> <p>Skin adhesive is an alternative that can be as effective as stitches when used on the appropriate wound. Usually, that means a small wound; not very deep or wide; not “dirty” or prone to infection; and not on highly mobile parts, such as joints. If the cut meets these criteria, an option for treatment is to use skin adhesive in order to close the wound. </p> <p>Adhesive use on the face is especially helpful cosmetically. Because the skin on the face isn’t as tight as it is in other places, skin adhesive seals wounds without increased risk of unsightly scarring in the end. </p> <p>Wounds around the mouth, feet and hands are places on the body that are constantly moving. In these areas, sutures work better. </p> <h4>After you’ve had the adhesive applied:</h4> <ul> <li>Do not pick at it!</li> <li>Do not use antibiotic ointments over the skin adhesive, as it will dissolve the glue.</li> </ul> <p>Following these two rules of skin adhesive care will allow the wound to heal and get you or your child active again.</p> <p>Ultimately, the best outcome for you or your child can be assured by visiting a health care provider who can properly treat the wound. Super glue can be a viable option if used under the right circumstances (small and clean cut, not too deep and not infectious). If you choose to use household super glue or even over-the-counter adhesive products, do so with caution and full understanding of the risks, including infection and scarring.</p> <p><em><a href="/providers/paul-horvath-md" target="_self" title="Opens in same window.">Dr. Paul Horvath</a> is a physician in Emergency Medicine in <a href="/locations/barron" target="_self" title="Opens in same window.">Barron</a>, <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/menomonie" target="_self" title="Opens in same window.">Menomonie</a>, Wisconsin.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>University of Wisconsin Medical School-Madison</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Kalamazoo Center for Medical Studies</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Emergency Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Emergency Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Horvath<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/paul-horvath-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=6D9F9FFCF71AD564DF6A3FD125A4F235" alt="Paul Horvath, M.D." width="280" height="280" DisableNVelocity="true" />Paul<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13467174Paul Horvath, M.D.1<img src="/-/media/national-files/images/hometown-health/2020/first-aid-kit.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E737CA286BCCFA3980834346C6F8A52B" alt="First aid kit" width="660" height="370" DisableNVelocity="true" />Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Dawn Haller8/5/2022Did you know headaches generally are classified into two main types? Learn if the pain in your head is a primary or secondary headache and what you can do to prevent them.Common questions about headaches<p>Virtually everyone has experienced at least one headache. It's one of the most common health complaints from patients. They can range from mild everyday headaches to life-threatening symptoms that requires immediate emergency care.</p> <h2>What is a headache?</h2> <p>A headache is pain in any region of the head. It may occur on one or both sides of the head. A headache can be a sharp pain, throbbing sensation or a dull ache. It can last for only a few minutes or for several days.</p> <h2>What causes headaches?</h2> <p>Headaches have many potential causes. Work with your healthcare professional for an accurate diagnosis. Headaches are generally classified into two main types: primary and secondary.</p> <p>Primary headaches are caused by problems with the pain-sensitive structures in your head and aren't a symptom of an underlying disease or condition. Chemical activity in your brain, nerves, blood vessels or muscles of your head and neck may all be a factor in these types of headaches. They can be triggered by lifestyle factors, such as alcohol, foods, sleep patterns, posture and stress. </p> <h3>Examples of primary headaches are:</h3> <ul> <li>Cluster headache</li> <li>Migraine</li> <li>Tension headache</li> <li>Trigeminal autonomic cephalalgia (TAC)</li> <li>Chronic daily headaches</li> <li>Cough headaches</li> <li>Exercise headaches</li> <li>Sex headaches</li> </ul> <p>Secondary headaches are a symptom of a disease. Any number of mild to life-threatening conditions may cause secondary headaches.</p> <h3>Some of the sources of secondary headaches include:</h3> <ul> <li>Acute sinusitis</li> <li>Blood clot in the brain</li> <li>Brain aneurysm</li> <li>Carbon monoxide poisoning</li> <li>Concussion</li> <li>Dehydration</li> <li>Ear infection</li> <li>Encephalitis</li> <li>Glaucoma</li> <li>Hangover</li> <li>Influenza</li> <li>Meningitis</li> <li>Panic attacks</li> <li>Pressure from tight-fitting headwear</li> <li>Stroke</li> </ul> <h2>When should I see my healthcare professional for my headaches?</h2> <p>A headache can be a symptom of a serious condition.</p> <h3>You should go to the Emergency Department or call 911 if you have the worst headache of your life, or a sudden, severe headache accompanied by any or all of these symptoms:</h3> <ul> <li>Confusion or trouble understanding speech</li> <li>Fainting</li> <li>High fever</li> <li>Numbness, weakness or paralysis</li> <li>Trouble seeing, speaking or walking</li> </ul> <h3>You should schedule a visit with your healthcare professional if you experience headaches that:</h3> <ul> <li>Occur more frequently than usual</li> <li>Are more severe than normal</li> <li>Don't improve with use of over-the-counter medication</li> <li>Prevent you from working, sleeping or participating in day-to-day activities</li> <li>Affect your overall quality of life</li> </ul> <h2>How do you treat headaches?</h2> <p>There are several ways to treat headaches. You should work with your healthcare provider to help you manage them.</p> <h3>Common headache treatments are:</h3> <ul> <li>Pain-relieving medication</li> <li>Preventive medication</li> <li>Osteopathic manipulation</li> <li>Acupuncture</li> <li>Botox</li> </ul> <h2>What are some ways to prevent headaches?</h2> <h3>Headaches aren't completely preventable, but you can do a few things to help:</h3> <ul> <li>Avoid your headache triggers, such as foods, caffeine and alcohol.</li> <li>Exercise regularly.</li> <li>Get adequate sleep.</li> <li>Don't use tobacco.</li> <li>Try to control stress in your life.</li> <li>Rest in a dark, quiet room when you feel a headache coming on.</li> <li>Place an ice pack on the back of your neck.</li> </ul> <p>Headaches can have a major effect on your quality of life. Staying positive plays an important role in managing your headaches, along with practicing proper treatment and prevention. Contact your healthcare team if you have questions or concerns about headaches.</p> <h2>In this video, I speak about headache and migraine causes and treatment:</h2> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/qcaUIBmkLRk" title="Headache and migraine causes and treatment" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p><em><a href="/providers/jamie-johannes-do" target="_self" title="Opens in same window.">Jamie Johannes, D.O.</a>, sees patients in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p> <ul> <li>Prenatal care</li> </ul> D.O. <p><strong>Education</strong></p> <ul> <li>Des Moines University College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine Residency Program, University of Minnesota, Mankato</li> </ul> <p><strong>Certifications</strong> </p> <ul> <li>American Board of Osteopathic Medicine</li> <li>Certified medical examiner, Department of Transportation</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Osteopathic Association</li> <li>Family Medicine, American Osteopathic Board of Family Physicians</li> <li>Minnesota Medical Association</li> </ul> <p><strong>Academic Appointments</strong></p> <ul> <li>Instructor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul> Johannes<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jamie-johannes-do2.jpg?h=280&iar=0&w=280&sc_lang=en&hash=3C1C7D29875CA5FD8B7B6E4DBA556B4C" alt="Jamie Johannes, D.O." width="280" height="280" title="Jamie Johannes, D.O." DisableNVelocity="true" /> {B6D6F783-992E-4A89-A6B8-BE4B549C3AC7}Jamie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15124843Jamie Johannes, D.O. 1{B3F96F77-F93E-41A4-AE4E-603045CDB443}<img src="/-/media/national-files/images/hometown-health/2023/backpacking-in-snow.jpg?h=370&iar=0&w=660&sc_lang=en&hash=35D42D1DDB0A509799C192A09071DECC" alt="Backpacking in snow" width="660" height="370" DisableNVelocity="true" />HeadacheHeadache is pain in any region of the head that feels like a sharp pain, throbbing sensation or dull ache. It may develop gradually or suddenly, and last for minutes or days.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller4/8/2022<p>If you've had weight-loss, or bariatric, surgery, learn if you can or need to take vitamins and supplements to get all your nutrients.</p>Should I take vitamins and supplements after weight-loss surgery?<p>Bariatric surgery changes your digestion and limits the amount of nutrients your body receives, even while following a healthy diet. You will need to take vitamin and mineral supplements daily for the rest of your life. Begin taking your supplements when you start the blended food stage of your diet.</p> <h2>Long-term health complications of weight-loss surgery can include:</h2> <ul> <li>Anemia due to a deficiency of iron or B12</li> <li>Neurological complications, such as memory loss or irritability from a lack of B12</li> <li>Bone and kidney disease due to changes in the way your body absorbs calcium and vitamin D</li> </ul> <h3>As a result, these vitamins or minerals are recommended:</h3> <h4>Multivitamin</h4> <p>Vitamins need to be chewable or liquid for the first several months after surgery. Choose a chewable complete multivitamin with iron, and avoid gummy vitamins and vitamin skin patches.</p> <p>If you choose an over-the-counter multivitamin, take one serving in the morning and one serving at bedtime. Several multivitamins are designed for people who've had weight-loss surgery.</p> <p>Not all supplements are equal, even when they are designed specifically for people who've had weight-loss surgery. Also, specific surgeries, such as the duodenal switch, often require more daily supplementation to maintain normal levels of vitamins. Check with your dietitian or bariatrician to determine if your vitamin and mineral routine is meeting your needs.</p> <h4>Calcium</h4> <p>Daily calcium needs are 1,200–1,500 milligrams per day after a sleeve gastrectomy or Roux-en-Y gastric bypass. After a duodenal switch, you need 1,800–2,400 milligrams per day of calcium. The calcium consumed from food counts toward your daily goal. If your diet is high in calcium, you should adjust how much you take in supplemental form.</p> <p>Your body is only able to absorb 500–600 milligrams of calcium at one time. To enhance absorption, take your supplement as three divided doses throughout the day. Calcium citrate is the preferred form of calcium. Take calcium with meals.</p> <h4>Vitamin D3</h4> <p>You will need 3,000 international units or 75 micrograms of vitamin D3 daily. Add the amount of vitamin D in your multivitamin and calcium supplements to determine if you are meeting your vitamin D needs. If you are not, you may need to consider taking an additional vitamin D3 supplement.</p> <h4>Vitamin B12</h4> <p>You can take this supplement by putting it under your tongue (sublingual) or having it injected. Discuss with your health care team which option may work best for you.</p> <p>If taking B12 orally, take 500 micrograms of vitamin B12 daily. If taking B12 by monthly injection, you will need a prescription from your health care professional.</p> <p>It's important to review your vitamin and mineral levels annually. Ideally, your bariatric team should complete this review. If that is not an option, be sure your primary care provider knows you had weight loss surgery and checks your nutrient levels with an annual blood draw.</p> <p><em><a href="/providers/heidi-bednarchuk-cns" target="_self" title="Opens in same window.">Heidi Bednarchuk</a> is a clinical nurse specialist in <a href="/services-and-treatments/bariatric-surgery" target="_self" title="Opens in same window.">Bariatric Surgery</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a> and <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota. <a href="/providers/grace-fjeldberg-rd" target="_self" title="Opens in same window.">Grace Fjeldberg</a> is a registered dietitian nutritionist in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Clinical Nutrition Services</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Weight-loss surgery</li> <li>Weight management</li> </ul>APRN, CNS<p>Weight is a very emotional issue and I like to think of my office as a “no blame, no shame zone.” My goal is to listen and understand my patient’s struggles and work together to develop a plan to address them. </p> <p>I have struggled with weight myself for most of my adult life and have a close family member that had bariatric surgery.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Nursing, Minnesota State University-Mankato</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Adult Health Clinical Nurse Specialist, American Nurses Credentialing Center</li> <li>Certified Bariatric Nurse, American Society for Metabolic and Bariatric Surgery</li> </ul> <p><strong>Membership</strong></p> <ul> <li>President-Elect, American Society for Metabolic and Bariatric Surgery</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Surgery, Mayo Clinic College of Medicine and Science</li> </ul>Bednarchuk<img src="/-/media/shared-files/images/medical-professionals/full/mankato/heidi-bednarchuk-cns.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4FA8ABD1C131281B9AB8444BFA59FB44" alt="Heidi Bednarchuk, C.N.S." width="280" height="280" DisableNVelocity="true" />Heidi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15681548Heidi Bednarchuk, APRN, CNS1{94B2E140-AEF8-44BA-B6A9-4538B77501BC}<ul> <li>Bariatric surgery</li> <li>General nutrition</li> <li>Oncology</li> <li>Pediatric nutrition</li> </ul>RDN, LD <p><strong>Education</strong></p> <ul> <li>Minnesota State University, Mankato</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Mayo Clinic College of Medicine, Minnesota</li> </ul> <p><strong>Certifications</strong> </p> <ul> <li>Commission on Dietetic Registration</li> <li>Minnesota Board of Dietetics and Nutrition Practice</li> </ul> Fjeldberg<img src="/-/media/shared-files/images/medical-professionals/full/mankato/grace-fjeldberg-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=FB99EC499314FA86AE8202C30AB740A2" alt="Grace Fjeldberg RDN" width="280" height="280" DisableNVelocity="true" /> Grace<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15268781Grace Fjeldberg R.D.N. 1<img src="/-/media/national-files/images/hometown-health/2022/reading-supplement-ingredients.jpg?h=370&iar=0&w=660&sc_lang=en&hash=FD4DD37FF4A506FA7D1762912B9FB824" alt="Reading supplement ingredients" width="660" height="370" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller4/21/2022Sea salt has become increasingly popular in recipes. But is it really a reason to put the salt shaker back on the table? Find out if it's healthier, and get other options for other seasonings.Is sea salt healthier than table salt?<p>Sea salt has become increasingly popular. It's seen as a main ingredient in many desserts and snacks, and many recipes call for it by name. Often, terms such as "organic," "natural" and "pure" also accompany products that contain sea salt, alluding that it's a healthy alternative to table salt. But is it really a reason to put the salt shaker back on the table?</p> <h2>Differences and similarities</h2> <p>The main differences between sea salt and table salt are in their tastes, texture and processing. Sea salt comes from evaporated seawater and is minimally processed, so it may retain trace minerals. The minerals sea salt contains depend on the body of water where it's evaporated from. This also may affect taste or color of the salt. In terms of health, the minerals are minor and easily consumed through daily food intake.</p> <p> Regular table salt comes from salt mines and is processed to eliminate minerals. In addition to iodine — an essential nutrient that helps maintain a healthy thyroid — table salt usually contains an additive to prevent clumping.</p> <p>Experts recommend limiting salt of any kind in your diet because this common food topper contains sodium. For some people, sodium can increase blood pressure because it holds excess fluid in the body. The sodium content of sea salt and table salt is identical — 40% when measured by weight. However, some sea salt may have larger crystals than table salt, so the sea salt may have less sodium by volume because fewer crystals will fit in a measuring device such as a spoon.</p> <p>Whether you choose to use sea salt or table salt, remember to use in moderation. Better yet, experiment with herbs and spices to add flavor to your food and keep the salt shaker off the table.</p> <h2>Flavorful alternatives to reduce salt intake</h2> <h3>These seasoning recommendations from the <a rel="noopener noreferrer" href="http://www.heart.org" target="_blank" style="margin-left:0; font-size:20px;font-family:'HelveticaNeueW02-65Medi', arial, 'sans-serif';" title="Opens in new window">American Heart Association</a> add variety to your foods:</h3> <ul> <li><strong>Allspice</strong> — Lean meats, stews, tomatoes, gravies</li> <li><strong>Basil</strong> — Fish, lean meats, stews, salads, soups, sauces, fish cocktails</li> <li><strong>Bay leaves</strong> — Lean meats, stews, poultry, soups, tomatoes</li> <li><strong>Caraway seeds</strong> — Lean meats, stews, soups, salads, breads, cabbage, asparagus, noodles</li> <li><strong>Chives</strong> — Salads, sauces, soups, lean meat dishes, vegetables</li> <li><strong>Cider vinegar</strong> — Salads, vegetables, sauces</li> <li><strong>Curry powder</strong> — Lean meats, lamb, veal, chicken, fish, tomatoes, tomato soup, mayonnaise</li> <li><strong>Dill</strong> — Fish sauces, soups, tomatoes, cabbages, carrots, cauliflower, green beans, cucumbers, potatoes, salads, macaroni, lean beef, chicken, fish</li> <li><strong>Garlic (not garlic salt)</strong> — Lean meats, fish, soups, salads, vegetables, tomatoes, potatoes</li> <li><strong>Ginger</strong> — Chicken, fruits</li> <li><strong>Lemon juice, paprika, parsley</strong> — Lean meats, fish, soups, salads, sauces, vegetables</li> <li><strong>Mustard (dry)</strong> — Lean ground meats, lean meats, chicken, fish, salads, asparagus, broccoli, Brussels sprouts, cabbage, sauces</li> <li><strong>Nutmeg</strong> — Potatoes, chicken, fish, lean meatloaf, toast, veal</li> <li><strong>Onion powder (not onion salt)</strong> — Lean meats, stews, vegetables, salads, soups</li> <li><strong>Rosemary</strong> — Lean meats, poultry, meatloaf, sauces, stuffing, potatoes, peas, lima beans</li> <li><strong>Sage</strong> — Lean meats, stews, biscuits, tomatoes, green beans, fish, lima beans, onions, pork</li> <li><strong>Thyme</strong> — Lean meats, veal, pork, sauces, soups, onions, peas, tomatoes, salads</li> <li><strong>Turmeric</strong> — Lean meats, fish, sauces, rice</li> </ul> <p><em><a href="/providers/allyn-wergin-rdn" target="_self" title="Opens in same window.">Allie Wergin</a> is a dietitian in <a href="/services-and-treatments/diabetes-education" target="_self" title="Opens in same window.">Diabetes Education</a>, and <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition Counseling and Education</a> in <a href="/locations/new-prague">New Prague</a>, Minnesota.</em></p><ul> <li>Bariatric surgery</li> <li>Diabetes management</li> <li>Oncology</li> <li>Weight management</li> </ul>RDN<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, St. Catherine University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration </li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul>Mahowald<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/allyn-wergin-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=74F690ED261F537AA65B66929A3356D1" alt="Allie Mahowald, RDN" width="280" height="280" DisableNVelocity="true" />{9209F8EC-1016-41AA-985F-014D9B877417}Allie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15971546Allyn Mahowald, RDN1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2022/spinkling-salt-on-broccoli.jpg?h=370&iar=0&w=660&sc_lang=en&hash=ACA9DB271B3D0C750F03103C9B5BF327" alt="Sprinkling salt on broccoli next to pan of mac and cheese" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller8/1/2022You may feel the burn after spending too much time in the sun without sunscreen. There's no fast fix to soothe a sunburn, but you can follow these six tips to ease your discomfort.Sunburn treatment: What works?<p>Great summer days are full of relaxation, fun and plenty of sunshine. Unfortunately, spending too much time in the sun can lead to a <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.mayoclinic.org/diseases-conditions/sunburn/basics/definition/con-20031065" target="_blank" title="Opens in a new window.">sunburn</a>. Your skin may be inflamed, painful and feel hot to the touch.</p> <p>Any exposed part of the body, including your lips, earlobes and scalp, can burn. The symptoms of sunburn usually appear a few hours after sun exposure.</p> <p>Unfortunately, there's no fast fix to soothe a sunburn. Once you have sunburn, the damage is done. After a few days, your body will begin to heal by peeling off the damaged skin’s top layer. A bad burn can take several days to heal.</p> <h2>In the meantime, here are a few things you can do to treat sunburn and ease your discomfort:</h2> <h3>Keep skin cool and moist.</h3> <p>Apply cold compresses, such as a towel dampened with cool water, to the affected skin several times a day. Or, take a cool bath with baking soda. Apply aloe vera lotion, moisturizing cream or a nonprescription 1% hydrocortisone cream to the affected skin several times a day. Try cooling the product in the refrigerator before applying for extra soothing comfort. Avoid products containing alcohol, which can further dry out skin.</p> <h3>Avoid products that contain benzocaine.</h3> <p>Beware of sunburn treatment products containing anesthetics, such as <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.mayoclinic.org/drugs-supplements/benzocaine-oral-route-oromucosal-route/description/drg-20072824" target="_blank" title="Opens in a new window.">benzocaine</a>. There's little evidence that these products are effective. In some cases, they can irritate the skin. Benzocaine has been linked to a rare, but serious, and sometimes deadly, condition that decreases the amount of oxygen that the blood can carry. Don't use benzocaine on children younger than age 2 without supervision from a health care professional, as this age group has been most affected. If you're an adult, never use more than the recommended dose of benzocaine, and consider talking with your health care professional.</p> <h3>Leave blisters alone.</h3> <p>If blisters form, don't break them. Doing so only slows the healing process and increases the risk of infection. If needed, lightly cover blisters with gauze.</p> <h3>Take an over-the-counter pain reliever.</h3> <p>If needed, take anti-inflammatory medication, such as aspirin or ibuprofen, according to the label instructions until redness and pain subside. Don't give children or teenagers aspirin. It may cause <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.mayoclinic.org/diseases-conditions/reyes-syndrome/basics/definition/con-20020083" target="_blank" title="Opens in a new window.">Reye's syndrome</a>, a rare, but potentially fatal, disease.</p> <h3>Treat peeling skin gently.</h3> <p>Within a few days, the affected area may begin to peel. This is simply your body's way of getting rid of the top layer of damaged skin. While your skin is peeling, continue to use moisturizing cream.</p> <h3>Drink extra water.</h3> <p>This helps prevent dehydration.</p> <p>Talk with your health care team if your sunburn covers a large portion of your body with blisters, sunburn is accompanied by a high fever or severe pain, or severe sunburn doesn't begin to improve within a few days.</p> <p>To prevent future episodes of sunburn, apply sunscreen frequently and liberally. Select a broad-spectrum product that provides protection against ultraviolet A and ultraviolet B radiation, and has a sun protection factor of at least 15.</p> <p>Be careful in the sun if you take medications that make sunburn more likely. A common example is tetracycline taken orally for acne. Finally, use common sense when outdoors. Cover up and stay in the shade as much as possible.</p> <p><a href="/providers/trent-anderson-do" target="_self" title="Opens in same window."><em>Trent Anderson, D.O.</em></a><em>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/lake-city" target="_self" title="Opens in same window.">Lake City</a> and <a href="/locations/plainview" target="_self" title="Opens in same window.">Plainview</a>, Minnesota.</em> </p><ul> <li>Chronic disease management</li> <li>Colonoscopy</li> <li>Emergency care</li> <li>Obstetrics</li> <li>Preventive care</li> </ul>D.O.<p><strong>Education</strong></p> <ul> <li>Doctor of Osteopathy, Kirksville College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Mid-Minnesota Family Medicine</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Department of Transportation (DOT) exams</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Anderson<img src="/-/media/shared-files/images/medical-professionals/full/lake-city/trent-anderson-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=C7E936A3C6473AEB29FA3D0EEB97AA4E" alt="Trent Anderson DO" width="280" height="280" DisableNVelocity="true" />Trent<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15734765Trent Anderson, D.O.1<img src="/-/media/national-files/images/hometown-health/2022/sunburned-back.jpg?h=370&iar=0&w=660&sc_lang=en&hash=87BB68266C2A83C68A3A8BFEE4D066E3" alt="Sunburned back" width="660" height="370" DisableNVelocity="true" />Skin CancerSkin cancer — the abnormal growth of skin cells — most often develops on skin exposed to the sun. But this common form of cancer can also occur on areas of your skin not ordinarily exposed to sunlight.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Dawn Haller6/30/2015With the Fourth of July approaching and outdoor activities likely taking up much of your summer fun, it's time to consider the importance of protecting your eyes. Eye injuries are largely preventable, but you need to be aware of risks and measures you can take to keep your eyes safe.5 tips for preventing eye injuries<img alt="Safety Glasses_Small" src="/-/media/national-files/images/hometown-health/2015/safety-glasses_small.jpg?h=200&w=200&sc_lang=en&hash=FC8ED443D7092790DC5893BF1CB04BAF" style="width: 200px; height: 200px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>With the Fourth of July approaching and outdoor activities likely taking up much of your summer fun, it's time to consider the importance of protecting your eyes. Eye injuries are largely preventable, but you need to be aware of risks and measures you can take to keep your eyes safe.</p> <h2>Here are five tips to help prevent eye injuries:</h2> <h3>1. Leave fireworks to the pros.</h3> <p>Unfortunately, I've seen many severe eye injuries from fireworks. And most of these injuries resulted in permanent damage or blindness. In fact, a lot of people even lose their eye or eyes from a fireworks accident.</p> <p>The best method of eye injury prevention from fireworks is to leave these exploding wonders to the professionals. July 4 weekend offers many chances to see a well-orchestrated fireworks show from a safe distance. Take advantage of these opportunities rather than trying to conduct your own show.</p> <p>If your family must have fireworks for the holidays, stick to sparklers, wear eye protection and make sure an adult supervises all activity.</p> <h3>2. Wear eye protection when at risk.</h3> <p>Safety glasses go beyond handling fireworks. Whether you're working a construction job, making home improvements or mowing the lawn, always don proper eye protection. Debris can easily get into your eyes and cause problems ranging from irritation to serious damage.</p> <p>Additionally, put on protective eyewear when you're playing certain sports; for example, racquetball and paintball. Always keep the eyewear on until the game is completely finished. Pulling glasses or goggles off early puts you at major risk for injury.</p> <p>You should wear eye protection if you're using bungee cords, which can also be very dangerous. Rope or straps are safer options for tethering items.</p> <h3>3. Use caution with chemicals and cleaners.</h3> <p>Read the labels of cleaning supplies and other chemicals very carefully before using them. Don't mix products, and keep chemicals and sprays out of the reach of children.</p> <h3>4. Be careful when cooking or using hot objects.</h3> <p>Use grease shields to prevent the splattering of hot grease or oil. Keep a safe distance from open flames. Avoid using a curling iron near your eyes.</p> <h3>5. Don't let curiosity get the best of you.</h3> <p>Never look directly at a firework, bottle cork, or other explosive or projectile device if it doesn't go off as expected. Dispose of the object in question in a safe place rather than inspecting it closely or studying it with your face in harm's way. These objects tend to discharge unexpectedly after a delay. Eyes are often damaged in the process.</p> <p>Vision is an important function, and you don't want to compromise your long-term eye health simply because it's inconvenient to follow best practices. Remember to stay aware of your surroundings and risks, wear eye protection, and leave fireworks to qualified professionals. Doing so will help you have a safer, more enjoyable Fourth of July, summer and life.</p> <p><em>By Mayo Clinic Health System staff</em></p>Eye HealthYour eyes are responsible for providing you with vision, perhaps the most important of the senses. However, the eye is a delicate and complicated structure that needs protection. The ugly truth is that eye injuries can happen at any time and place.Dawn Haller6/23/2015When you think of plastic surgery, what comes to mind? Is it high-priced cosmetic procedures in Beverly Hills to make movie stars more glamorous? Learn more about the broad field of plastic surgery.What is plastic surgery?<img alt="Albert Harris MD" src="/-/media/shared-files/images/medical-professionals/full/mankato/albert-harris-md.jpg?h=200&w=200&sc_lang=en&hash=08285E0381E4838967334E83AC6CDE60" style="width: 200px; height: 200px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>When you think of plastic surgery, what comes to mind? Is it high-priced procedures in Beverly Hills to make movie stars more glamorous? Plastic surgery is actually a very broad field that not only includes cosmetic and aesthetic surgery, but also hand and wrist surgery, surgical reconstruction and nonsurgical procedures.</p> <h2>Let's explore some of the basic types of plastic surgery:</h2> <h3>Reconstructive surgery</h3> <p>The simplest way to describe reconstructive surgery is a surgical option to restore form and function of the body. Most often, reconstructive surgery is needed after some type of disease or trauma to the body.</p> <h4>Some of the most common examples include:</h4> <ul> <li><strong>Breast reconstruction</strong><br /> A surgery for women who have had all or part of a breast removed (mastectomy), usually due to breast cancer.</li> <li><strong>Trauma reconstruction</strong><br /> Imagine you've been in a serious accident and suffered a severe injury, such as a major laceration, a severed limb, a severe facial injury or burns — all of these types of trauma can lead to reconstructive surgery by a plastic surgeon.</li> <li><strong>Skin cancer removal</strong><br /> Cancerous growths or lesions of the skin may need to be removed by surgery, which can be done by a plastic surgeon using specialized techniques to preserve your health and appearance.</li> </ul> <h2>Hand and wrist surgery</h2> <p>Did you know that many plastic surgeons have specialized training to help restore function of the fingers, hands and wrist?</p> <h3>Specifically, hand surgery can treat:</h3> <ul> <li><strong>Carpal tunnel syndrome</strong><br /> A condition caused by pressure to the median nerve within the wrist. You might feel pain, tingling, numbness or weakness.</li> <li><strong>Arthritis</strong><br /> Whether due to an inflammatory disease such as rheumatoid arthritis or simple wear and tear, arthritis can have a significant impact on your hands and wrists. Over time, it can deform your fingers and impair movement.</li> <li><strong>Trauma</strong><br /> Plastic surgeons can treat injuries including broken bones, torn ligaments, and cut tendons or nerves</li> </ul> <h2>Cosmetic surgery</h2> <p>Cosmetic surgery is a type of procedure that reshapes your body in order to improve your appearance and self-esteem. Because cosmetic surgery is elective, it is generally not covered by health insurance.</p> <h3>The most common examples include:</h3> <ul> <li><strong>Breast augmentation</strong><br /> A surgery that uses either saline or silicone implants or fat from elsewhere on the body to increase the size of your breasts or restore breast volume after weight reduction or pregnancy.</li> <li><strong>Tummy tuck</strong><br /> Also called an abdominoplasty, the tummy tuck removes excess fat and skin from the abdomen area creating a smoother and firmer profile.</li> <li><strong>Liposuction</strong><br /> A procedure that slims and reshapes parts of the body by removing fat deposits. Most common areas of the body on which this procedure is done are the thighs, hips, buttocks, abdomen and waist.</li> </ul> <h2>Nonsurgical procedures</h2> <p>These types of procedures don't require a trip to the operating room and can be performed by your plastic surgeon to help improve your appearance and fight the effects of aging.</p> <h3>Two of the most common nonsurgical procedures performed by plastic surgeons are:</h3> <ul> <li><strong>Botox injections</strong><br /> Botulinum toxin is an injection that blocks nerve signals to the muscles and temporarily reduces or eliminates frown lines, wrinkles and crow's feet near the eyes and elsewhere on the face. </li> <li><strong>Dermal fillers</strong><br /> These injectable fillers help to diminish facial lines and restore volume and fullness. Some types of fillers include collagen, polylactic acid and polyalkylimide. </li> </ul> <p> Plastic surgery, including cosmetic surgery, has its risks and limitations. Before you proceed with any procedure, make sure your plastic surgeon is board recognized by the American Board of Plastic Surgery. Schedule a consultation and work closely with your plastic surgeon before surgery to establish specific, measurable and achievable goals.</p> <h2>In this video, I talk about more about plastic surgery:</h2> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/_wVVWvsrt1o" title="Plastic surgery" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p><em><a href="/providers/albert-harris-md" target="_self" title="Opens in same window.">Albert Harris, M.D.</a>, is a <a href="/services-and-treatments/plastic-and-reconstructive-surgery" target="_self" title="Opens in same window.">plastic and reconstructive surgeon</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Addressing surgical problems related to arthritis and trauma</li> <li>Breast reconstruction following mastectomy for breast cancer</li> <li>Surgery of the hand and wrist</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Michigan Medical School</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>General Surgery, Rhode Island Hospital</li> <li>Plastic and Reconstructive Surgery, Rhode Island Hospital</li> <li>Hand Surgery, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Hand Surgery, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Plastic Surgery, American Board of Plastic Surgery</li> <li>Hand Surgery, American Board of Surgery</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Hand Surgery</li> <li>American Society for Surgery of the Hand</li> <li>American Society of Plastic Surgeons</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Plastic Surgery, Mayo Clinic College of Medicine and Science</li> </ul>Harris<img src="/-/media/shared-files/images/medical-professionals/full/mankato/albert-harris-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=3A368CABCAAF92FF5578768387BC374A" alt="Albert Harris MD" width="280" height="280" DisableNVelocity="true" />{2BFCE40B-2D0B-437E-B732-37E8DE9BD188}Albert<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14699354Albert Harris, M.D.1{276FDCB2-F341-4C45-B04B-F71FB963B8CB}|{3D1714E2-ECE8-4D0A-98A0-A4318C6DA2C3}Plastic and Reconstructive SurgeryPlastic and reconstructive surgery provides services that not only include cosmetic or aesthetic surgery, but also surgical repair of congenital deformities, laser surgery, postsurgical reconstruction, such as breast, head and neck defects, and microsurgery.SurgeryHaving surgery is a major event in your life. We know this and make every effort to keep you as comfortable as possible, focusing on you as an individual. Our surgeons and staff work as a coordinated team treating a wide variety of illnesses ranging from simple to complex. We offer comprehensive, advanced care and service to every patient.Dawn Haller6/26/2020Few sensations are as frightening as not being able to get enough air. Although healthy people occasionally may experience it, persistent shortness of breath is a sign of a medical problem.Trying to catch your breath? What's normal, when to see your doctor<p>Few sensations are as frightening as not being able to get enough air. Although healthy people occasionally may experience shortness of breath — especially in extreme temperatures, after running up a flight of stairs or when in high altitude — persistent shortness of breath is a sign of a medical problem. </p> <p>Shortness of breath is not a symptom of getting older. People sometimes blame it on age when it actually is due to a medical condition that can be treated. Most cases of shortness of breath are due to heart or lung conditions. Your heart and lungs are involved in transporting oxygen to your tissues and removing carbon dioxide, so problems with either of these organs can impact your breathing. </p> <h4>Speak with your primary care provider if you have worsening or consistent shortness of breath in these situations: </h4> <ul> <li><strong>Walking up a flight of stairs.</strong> Everyone occasionally gets shortness of breath after walking up a flight of stairs. Are you are consistently out of breath, more out of breath that you think you should be or has it progressively gotten worse? </li> <li><strong>Walking a moderate distance.</strong> Do you need to rest after walking around the block or across a large parking lot? Compare this distance to what you could walk six or 12 months ago. </li> <li><strong>Wheezing during exercise.</strong> Wheezing is a high-pitched whistling sound made while you breathe. Regular wheezing during exercise should be discussed with your provider. </li> <li><strong>Persistent coughing</strong>. An ongoing cough that leaves you gasping for breath can be a sign of a medical problem.</li> </ul> <p>There are many things you can do to improve your lung heath, including getting regular exercise, not smoking and getting prescription medication from your primary care provider.</p> <p>Always call 911 if you experience severe shortness of breath that comes on suddenly and affects your ability to function.</p> <p><em>Maureen O'Donnell is a <a href="/services-and-treatments/respiratory-therapy" target="_self" title="Opens in same window.">respiratory therapist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2020/older-man-trying-to-catch-his-breath.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2D8B58CB082C5AB07CC20D45FF0B7C8C" alt="Older man trying to catch his breath" width="660" height="370" DisableNVelocity="true" />BreathingMost cases of shortness of breath are due to heart or lung conditions. Your heart and lungs are involved in transporting oxygen to your tissues and removing carbon dioxide, and problems with either of these processes affect your breathing.Respiratory CareRespiratory care helps people with serious health problems associated with their lungs and ability to breathe. The Respiratory Care team is always ready to respond to a variety of emergency situations, such as an asthma attack. Additional services may include pulmonary rehabilitation and educational programs.PulmonologyTreatment for diseases and conditions affecting lung and airway function.Dawn Haller10/31/2022Feelings of traumatic grief are complex and challenging, with emotional and physical reactions. This Q&A will help you support someone who is grieving, by understanding the nuances of grief.Offering support to the grieving<p>A traumatic event often causes deep-rooted, profound feelings. Depending on the nature of the event, those feelings may be fear, anger, confusion, sadness or a combination of emotions.</p> <p>Feelings of traumatic grief are complex and encompass many challenges and reactions — emotional and physical.</p> <h2>This Q&A can help you effectively support someone who is grieving by first understanding grief's nuances.</h2> <h3>Q. What is traumatic grief?</h3> <p>After a loved one's death, a period with feelings of sorrow, numbness, guilt and anger can result. This is known as traumatic grief. The death may have occurred from illness, accident or violent act, such as domestic abuse or murder. Experiencing numerous deaths of close family or friends or the death of a child — no matter the age or cause — leads many people into a state of traumatic grief.</p> <h3>Q. How is traumatic grief felt?</h3> <p>Traumatic grief can be felt in the body, such as an increase in sensitivity to sight, sound and touch, as well as a decrease in appetite and sleep changes — inability to sleep and nightmares. Emotionally, those grieving may experience increased aggression or irritation in addition to deep feelings of sadness, guilt or self-blame. Their memory may not be working well, so they forget things, are late for appointments or don't remember details for weeks or months after their loved one's death. People frequently describe their grieving period as a blur or being in a fog. Often, people experiencing traumatic grief feel time moving slowly or stopping altogether.</p> <h3>Q. What should I say?</h3> <p>A person experiencing traumatic grief may become isolated because talking to people is too difficult. Many people offer condolences by saying, "They're in a better place," or "Everything happens for a reason," or "Don't feel guilty," or "It's not your fault." The sentiments are intended to help the bereaved person feel better. However, these statements minimize the person's feelings and don't allow for further conversation. Alternatively, <a href="/hometown-health/speaking-of-health/the-space-in-between-grief-and-growth" target="_self" title="Opens in same window.">ask questions and create an environment that fosters dialogue</a>.</p> <h3>Q. How can I support a grieving person?</h3> <h4>Goals for support include:</h4> <ul> <li>Ensure basic needs are met, but don't force the person to eat, sleep or drink. Let them know those options are available when they're ready.</li> <li>Offer a supportive presence, and don't try to fix the situation. Acknowledge their feelings, and avoid telling them not to feel what they're feeling. Prescribing their emotions can result in them no longer being comfortable with sharing. It's OK to feel the feelings.</li> <li>For children, answer questions that are appropriate for the age level. If uncertain, consult with the child's parent — if the child isn't yours — for direction before answering. Just like adults, <a href="/hometown-health/speaking-of-health/do-children-grieve" target="_self" title="Opens in same window.">allow children to share their feelings</a>, acknowledge how feel and simply listen. Don't try to fix everything.</li> <li>Avoid accelerating the grieving period. Grief knows no timeline and can't be rushed. The loss of a loved one will always be part of them, but as time moves forward, grief may feel differently. For some people, grief may not feel different for many years.</li> <li>Allow people to memorialize or remember their loved ones in a manner in which they're comfortable. Funeral rituals, spiritual practices, having a picture in the home, talking about their loved ones, writing a letter to them, lighting a candle in memoriam or scrapbooking are some common practices.</li> <li>Seek out a mental health professional if you or someone else needs or wants a professional to process the situation or if there are concerns for safety.</li> </ul> <p><a href="/providers/jessie-wolf-licsw" target="_self" title="Opens in same window."><em>Jessie Wolf</em></a><em> is a clinical social worker in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Adjustment disorders</li> <li>Adolescent and children’s behavioral health (ages 6-17)</li> <li>Anxiety disorders</li> <li>Attention-deficit/hyperactivity disorder (ADHD) assessment and treatment with adults and children (ages 6-17)</li> <li>Depressive disorders</li> <li>Grief and loss</li> </ul>L.I.C.S.W.<p>I see children six years of age through adulthood.</p><p><strong>Education </strong></p> <ul> <li>Master's degree, Social Work, Minnesota State University-Mankato</li> </ul> <p><strong>Internships</strong></p> <ul> <li>Hospice and Palliative Care, Mayo Clinic Health System-Mankato</li> <li>Nursing Home and Rehab Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>ADHD, Certified Clinical Services Provider </li> <li>Art of Traumatic Grief Counseling, Compassionate Bereavement Care</li> <li>Licensed Independent Clinical Social Worker</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Professional Society of ADHD and Related Disorders</li> <li>National Social Work Association</li> </ul> <p><strong>Academic Rank</strong></p> <ul> <li>Instructor in Social Work, Mayo Clinic College of Medicine and Science</li> </ul>Wolf<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jessie-wolf-licsw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B680201D1A0D763676AD889806D46E00" alt="Jessie Wolf LICSW" width="280" height="280" DisableNVelocity="true" />Jessie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14640821Jessie Wolf LICSW1{2B88C934-922C-4130-B661-197B59D83899}|{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2022/looking-at-sunset-sky.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BA2E1FCD633C5222915982237F4665D8" alt="Looking at sunset sky" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.GriefGrief is the natural reaction to loss. It will be unique to you, depending on your own personality and circumstances.DepressionDepression is a medical illness that causes a persistent feeling of sadness, loss of interest and, sometimes, physical symptoms. It's also called major depression, major depressive disorder and clinical depression.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller2/5/2015The thyroid, a gland at the base of the neck, is a crucial driver of bodily operation. When your thyroid experiences issues, your whole body starts to feel out of sorts — and your quality of life suffers.Thyroid disease diminishes quality of life<p>Much like our vehicles have engines, our bodies have similar parts that help us function. The heart and brain are the big anatomy regulators, but the thyroid is also a crucial driver of bodily operation. And when your thyroid experiences issues, your whole body starts to feel out of sorts — and your quality of life suffers.</p> <p>Knowing how your thyroid works and what signs indicate something is amiss will help you get the care you need and enhance your livelihood.</p> <h4>What is a thyroid?</h4> <p>A thyroid is a gland at the base of the neck. This important part of your body produces hormones that regulate blood pressure, body temperature, heart rate and weight.</p> <h4>What are potential thyroid problems?</h4> <h5>There are four main thyroid afflictions:</h5> <ul> <li><a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/hyperthyroidism/basics/definition/con-20020986" target="_blank" title="Opens in a new window.">Hyperthyroidism</a> is the case of an overactive thyroid.</li> <li><a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/hypothyroidism/basics/definition/con-20021179" target="_blank" title="Opens in a new window.">Hypothyroidism</a> occurs when the thyroid is underactive.</li> <li><a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/thyroid-cancer/basics/definition/con-20043551" target="_blank" title="Opens in a new window.">Thyroid cancer</a> refers to a malignancy in the cells of the thyroid.</li> <li><a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/thyroid-nodules/basics/definition/con-20021546" target="_blank" title="Opens in a new window.">Thyroid nodules</a> are growths on the thyroid.</li> </ul> <p>While all of these conditions can be serious, each has its own symptoms and distinctions.</p> <h4>What are the symptoms of thyroid problems? How are they treated?</h4> <p>As stated before, each thyroid problem has its own nuances.</p> <h5>Here are common symptoms to look for with each condition:</h5> <ul> <li><strong>Hyperthyroidism<br /> </strong>Weight loss, rapid heartbeat, anxiety, fatigue, trouble sleeping, tremors and sweating.</li> <li><strong>Hypothyroidism<br /> </strong>Thinning hair, weight gain, fatigue, muscle weakness, joint pain, depression and impaired memory.</li> <li><strong>Thyroid cancer</strong><br /> A lump on your neck, difficulty swallowing, swollen lymph nodes and changes in your voice.</li> <li><strong>Thyroid nodules</strong><br /> In many cases, nodules don’t produce symptoms. In other cases, nodules become large enough that you can see and/or feel them. Some nodules are cancerous, although most are benign.</li> </ul> <p>Contact your health care team if you experience these symptoms or have other concerns about potential thyroid health.</p> <img alt="Thyroid" src="/-/media/national-files/images/hometown-health/2015/thyroid.jpg?h=200&w=200&sc_lang=en&hash=3B6820497EDD90559AF9BCBADC47AD1D" style="width: 200px; height: 200px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>Treatment options for these conditions include:</p> <ul> <li><strong>Hyperthyroidism. </strong>Multiple treatments are available for hyperthyroidism. Treatments include radioactive iodine, anti-thyroid medications, beta blockers or surgery. It’s important to discuss options with your health care provider to determine what’s best for you.</li> <li><strong>Hypothyroidism. </strong>The most common treatment for hypothyroidism is an oral medication called synthetic thyroid hormone levothyroxine.  After taking this medication, people see improvements with fatigue and even weight management. Finding the right dosage is key, as all patients require different care plans.</li> <li><strong>Thyroid cancer. </strong>Treatment for thyroid cancer is dependent on the type, size and stage of the tumor. Options include surgery — which may consist of partial or complete removal of the thyroid — radioactive iodine, external radiation therapy, chemotherapy or targeted drug therapy.</li> <li><strong>Thyroid nodules.</strong> There are a few options for treating noncancerous nodules. Watch and wait, conduct surgery for large benign nodules or use thyroid suppression therapy.<strong> </strong></li> </ul> <p>The thyroid is so important to your well-being. It’s a gland that regulates vital functions of your body and influences not only your health, but the quality of your life. So if there’s an issue, the faster it’s addressed, the better you’ll feel.</p> <p>Contact your health care team if you have concerns about your thyroid.</p><img src="/-/media/national-files/images/hometown-health/2015/thyroid.jpg?h=200&iar=0&w=200&sc_lang=en&hash=CEC1A3D2C77E98161D6D4C15F809FAFB" alt="Thyroid" width="200" height="200" DisableNVelocity="true" />Thyroid HealthThe thyroid is a gland at the base of your neck. This important part of your body produces hormones that regulate blood pressure, body temperature, heart rate and weight. When your thyroid has problems, many aspects of your well-being can be negatively impacted. Learn more about the thyroid here.Dawn Haller6/1/2015<p>Cravings can quickly sabotage the success of your weight loss surgery, but you can prevent and manage them.</p>Manage your cravings after weight loss surgery<img alt="Sharon Alfuth, R.N." src="/-/media/national-files/images/hometown-health/miscellaneous/sharon-alfuth-rn.jpg?h=200&w=200&sc_lang=en&hash=CB575B602417887A7E047EE40C21DC97" style="width: 200px; height: 200px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>Whether you are preparing for surgery or are focusing on weight loss/maintenance after surgery, food cravings can pose a challenge in your everyday life. Cravings can be the result of stress, boredom, the environment you are in, not following a proper meal schedule or other reasons.</p> <p>Cravings have little to do with nutrients and plenty to do with the brain chemistry of pleasure and reward. Cravings may center on texture (creamy, crunchy) or taste (sweet, salty), but they all have something in common: overindulging can sabotage your weight maintenance efforts.</p> <p>It often seems that the only way to overcome a craving is to give in to it, but that isn’t true. Cravings thrive on your thoughts. The more you think about the item you are craving, the more intense that craving becomes and the harder it becomes to resist.  </p> <p><strong>How do you prevent a potential craving?</strong></p> <ul> <li><strong>Do not skip meals.</strong> If you skip a planned meal or snack, you are putting yourself at risk for experiencing extreme hunger later on. With extreme hunger usually come cravings and unhealthy food choices. Give your body what it needs before you lose control.</li> <li><strong>Plan ahead.</strong> If cravings mainly strike when you're hungry, try eating healthy snacks between meals. Carefully planning your snacks can help you keep hunger and cravings at bay. Portion control is vital. Each snack should be less than 200 calories. Good choices include yogurt with fresh fruit, a hard-boiled egg, a fruit smoothie, or peppers and bean dip.</li> <li><strong>Be sure to stay hydrated.</strong> Drink at least 64 ounces of fluid daily. Dehydration can make you feel hungry and cause cravings.</li> <li><strong>Don’t forget balance.</strong> Although protein remains the priority at your meals, it is important to include some healthy carbohydrates (fruit and whole grains), vegetables and healthy fats (nuts, olive oil, peanut butter, etc.) in your diet. Take into consideration your current dietary stage if you recently had surgery.</li> <li><strong>Resist sweets.</strong> Resisting sweets can be tough. Rather than depriving yourself until you cave, try indulging in a small serving of the desired food.  If it’s chocolate you crave, a small piece of dark chocolate might do the trick. Be careful using sugar-free candy, because it has a lot of calories and is usually high in fat. The fat and sugar alcohols in sugar-free candy also can bring on dumping.</li> <li><strong>Control your hunger.</strong> When you are trying to establish a regular meal pattern, you may need to rely on eating by the clock versus eating according to hunger. Even if you do not feel hungry at mealtime, make sure you eat something anyway. This ensures that you remain in control of your hunger.</li> <li><strong>Control the environment.</strong> You need to get all crave foods out of the house. If it’s out of the house, it’s unlikely you’ll get into the car and drive to the store for it.</li> </ul> <p><strong>When cravings do occur, how do you manage them?</strong></p> <ul style="list-style-type: disc;"> <li><strong>Try drinking water instead.</strong> When craving first strikes, you may actually be thirsty rather than hungry, and this will satisfy the urge.  </li> <li><strong>Think of something else.</strong> Start reading a book, change the channel or call a friend. Occupy your mind so you can stop dwelling on the item you are craving.</li> <li><strong>Distract yourself with activities you plan ahead of time.</strong> Pick activities that are incompatible with eating.  Walk your dog, paint your nails, wash your car, work in the garden or pick up your knitting. Choose activities that are incompatible with eating.  </li> <li><strong>Avoid problem places.</strong> When you have a craving, do your best not to gravitate towards places that will make resisting it more of a challenge. This includes places such as the office vending machine, a fast food line or mall food court.</li> </ul> <p>In our food-rich environment, you will have those times when you are bombarded with choices of healthy and unhealthy foods. Knowing that you have the ability to work through urges gives you the confidence to continue with your weight management efforts. By following a regularly scheduled meal pattern and tuning into your appetite signals, you can prevent and control cravings.</p><img src="/-/media/national-files/images/hometown-health/miscellaneous/sharon-alfuth-rn.jpg?h=200&iar=0&w=200&sc_lang=en&hash=BA432F05BBF506AE03BB6CEF5DD6F02B" alt="Sharon Alfuth, R.N." width="200" height="200" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller8/4/2023<p>Do you experience irregular vaginal bleeding? Find out what's normal, what's not and what course of action to take.</p>Don’t let irregular vaginal bleeding affect your quality of life<p>Do you experience irregular vaginal bleeding and figure it is something you must live with? It's not.</p> <p>For some people, vaginal bleeding is minor and tolerable. For others, it's bothersome and even debilitating. Irregular vaginal bleeding can be an indication of a medical problem. Although some women may choose to live with it, many options are available to treat irregular vaginal bleeding and improve your quality of life.</p> <p>Irregular bleeding is bleeding that occurs outside a regular monthly menstrual period. This type of bleeding may include spotting of small amounts of blood between periods or extremely heavy periods.</p> <p>There are a variety of causes that can lead to irregular bleeding. It can be caused by an issue with your reproductive system, other medical problems or certain medications. It also can be a sign of an underlying medical issue.</p> <h2>What's considered regular menstruation?</h2> <p>Regular menstruation typically occurs every 21 to 35 days and lasts seven or fewer days. There is a large range of what can be considered a regular menstrual cycle. It's usual for there to be some variation from cycle to cycle, and a woman's menstrual cycle often changes over the course of her life.</p> <p>Determining if your vaginal bleeding is typical depends on your age and circumstances.</p> <h3>Vaginal bleeding is common among:</h3> <ul> <li>Newborn girls</li> <li>Teenagers</li> <li>Women starting birth control pills</li> <li>Women nearing menopause</li> </ul> <p>Although bleeding in these situations likely is not unusual, you should speak with your health care team if you're concerned.</p> <h3>Vaginal bleeding isn't common if you're:</h3> <ul> <li>Pregnant</li> <li>Postmenopausal</li> <li>Under age 8 without any other signs of puberty</li> </ul> <p>If you experience vaginal bleeding under these conditions, immediately contact your health care professional.</p> <h2>What can you do about irregular bleeding?</h2> <p>Irregular bleeding should be evaluated if it persists for more than a few months to see if an underlying medical problem needs to be addressed. There are many options to treat irregular bleeding. If an underlying medical problem is causing the bleeding, this will be addressed first.</p> <h3>Common options to treat irregular bleeding include:</h3> <ul> <li>Losing weight if the person is overweight</li> <li>Using hormonal medications, such as birth control, to regulate irregular periods</li> <li>Exploring surgical options if the irregular bleeding persists despite medication</li> </ul> <p>In certain circumstances, irregular bleeding should be treated as soon as possible to prevent other complications later in life. If you're concerned about irregular bleeding, it's important to immediately consult with your health care team.</p> <p><em>By Mayo Clinic Health System staff.</em></p><ul> <li>Pediatrics</li> <li>Skin conditions</li> <li>Women's health</li> </ul>D.O.<p><strong>Education</strong></p> <ul> <li>Doctor of Osteopathic Medicine, A.T. Still University – Kirksville College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Mercy Health System</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Medicine </li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Osteopathic Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Casper<img src="/-/media/shared-files/images/medical-professionals/full/tomah/tiffany-casper-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=1A30A61D9D6C113EA2C621F6A4AD3702" alt="Tiffany Casper DO" width="280" height="280" DisableNVelocity="true" />Tiffany<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15595587Tiffany Casper, D.O.1<img src="/-/media/national-files/images/hometown-health/2023/person-standing-in-pool.jpg?h=370&iar=0&w=660&sc_lang=en&hash=02528C14F16D3A52A5C75AD9CF21EFA7" alt="Person standing in pool" width="660" height="370" DisableNVelocity="true" />Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller5/14/2015<p>Most couples achieve pregnancy within the first six months of trying. Overall, 90% of couples will become pregnant after a year. For any couple wanting to have a baby, the journey to conception can feel like an eternity. Here are a few tips for men and women to improve fertility.</p>Tips to improve fertility<p>Most couples achieve pregnancy within the first six months of trying. Overall, 90% of couples will become pregnant after a year. For any couple wanting to have a baby, the journey to conception can feel like an eternity.  </p> <p>To become pregnant, the complex processes of ovulation and fertilization need to work just right. The best time to try to conceive is several days before through one day after ovulation. Ovulation usually occurs at the middle of the cycle. </p> <h4>Here are some strategies that may increase your chance of becoming pregnant:</h4> <h4>For women:</h4> <ul> <li>Exercise moderately. Regular exercise is important, but if you’re exercising so intensely that your periods are infrequent or absent, your fertility may be impaired.</li> <li>Avoid weight extremes. Being overweight or underweight can affect your hormone production and cause infertility.</li> <li>Quit smoking.</li> <li>Avoid alcohol and illegal drugs. </li> <li>Limit medications that may impact fertility. The use of some prescription and nonprescription drugs can decrease your chance of getting pregnant or keeping a pregnancy. Talk with your doctor about any medications you take regularly. </li> <li>Limit caffeine. Women trying to get pregnant may want to limit caffeine intake. </li> </ul> <h4>For men:</h4> <ul> <li>Avoid drug and tobacco use and excessive alcohol consumption.</li> <li>Avoid high temperatures as this can effect sperm production and motility.</li> <li>Limit medications that may impact fertility.</li> <li>Exercise regularly, eat a balanced diet and maintain a healthy weight. Obesity is directly related to testosterone levels, which is a key hormone responsible for sperm production. Eating a balanced diet provides the necessary nutrients to optimize sperm function.</li> </ul> <p>You may want to consider seeing a board-certified gynecologist to improve your fertility if you’ve been trying to conceive for more than a year. Fortunately, there are many <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infertility/basics/treatment/con-20034770" target="_blank" title="Opens in a new window.">safe and effective therapies</a> to assist with fertility.</p>Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>FertilityFertility issues may be due to a single cause with you or your partner or a combination of factors that may prevent a pregnancy from occurring or continuing. There are multiple safe, effective fertility therapies available.Dawn Haller5/13/2015<p>With the snow gone and the frost out of the ground, farmers are beginning the intensive spring planting season. As seeds are planted, farmers need to use safe farming practices to avoid a visit to the Emergency Department.</p>Plant the seed of safety this spring<img alt="Planting Safety_Small" src="/-/media/national-files/images/hometown-health/2015/planting-safety_small.jpg?h=200&w=200&sc_lang=en&hash=F4BD766E76FFF7A3B2939CACE056F08A" /> <p>With the snow gone and the frost out of the ground, farmers are beginning the intensive spring planting season. It’s a season of hope as seeds are planted and the green tinge of young shoots begins to cover the fields. As those seeds are planted, farmers need to use safe farming practices to avoid a visit to the Emergency Department. </p> <p>We know that spring is a hectic time on the farm. But we don’t want it to be a tragic time as well. Working on a farm can pose risks, but there are things that everyone can do to minimize those risks.</p> <h2>Follow these tips for a safe spring planting:</h2> <ul> <li><strong>Take the time to be sure your equipment is in top working order.</strong><br /> Fix any minor problems now before they become major. Equipment breakdowns pose safety hazards as well as slow down work in the field.</li> <li><strong>Wear your seatbelt when operating equipment, and don't wear loose or baggy clothing.</strong></li> <li><strong>Use proper safety equipment, such as goggles or earplugs.</strong><br /> Anyone working around noisy equipment is at risk for hearing loss.</li> <li><strong>Remember that pesticides and chemicals used on farms can be dangerous.</strong><br /> These materials should be kept locked away in marked containers with warning labels. Use all proper precautions when handling chemicals. If someone is exposed to dangerous chemicals, call the <a href="https://www.aapcc.org/">American Association of Poison Control Centers</a> at 1-800-222-1222.</li> <li><strong>Avoid walking into grain storage areas and silos.</strong><br /> It's possible to become trapped and suffocate under flowing grain. If someone else is trapped in a grain storage area, do not rush in to rescue the person — you could become trapped as well. Call for help immediately.</li> <li><strong>Stay alert and focused.</strong><br /> Get enough rest, take regular breaks, eat healthy meals and drink plenty of water. Avoid alcohol and drug use that can impair your mental and physical abilities.</li> <li><strong>Be prepared for any kind of weather.</strong><br /> Both harsh cold and hot sun are likely in the spring. Wear sunscreen and reapply regularly, even on cloudy days. Dress in layers when the temperature drops.</li> </ul> <h2>Prepare for emergencies</h2> <p>Even with all the right precautions, accidents still happen. One important rule for families who live or work on farms is that family members should always be aware of where everyone is and when they are due to return so they can provide help as soon as possible in an emergency.</p> <p>Be sure that all family members know how to get help in the event of an emergency — by calling 911 or the poison control center if necessary. When calling 911, be prepared to state exactly where you are and what the problem is. And remember to stay on the line until the operator says it's OK to hang up.</p> <p>It's also a good idea to take a CPR class and learn basic first aid, especially for anyone who cares for younger siblings or elderly relatives.</p> <p>Spring is a hopeful season; taking the proper safety precautions can help it stay that way.</p><img src="/-/media/national-files/images/hometown-health/2015/planting-safety_small.jpg?h=200&iar=0&w=200&sc_lang=en&hash=1D49BC5B0A8A1F23F50CDB0F078B1F15" alt="Planting Safety_Small" width="200" height="200" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Dawn Haller7/21/2023Carotid artery disease develops slowly, and the first sign that you have the disease may be a stroke. Learn the risk factors and treatments performed by a vascular medicine specialist.Manage your risk of carotid artery disease<p><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/carotid-artery-disease/basics/definition/con-20030206" target="_blank" title="Opens in a new window.">Carotid artery disease</a> occurs when the blood vessels supplying your brain and head, known as carotid arteries, are damaged or blocked by fatty deposits. These deposits contain cholesterol that organizes as a plaque, which clogs or blocks the carotid arteries. This is similar to coronary artery disease, which reduces blood flow to your heart.</p> <p>This blockage in blood vessels increases your risk of <a href="/hometown-health/speaking-of-health/is-it-a-stroke-how-to-know-and-help" target="_self" title="Opens in same window.">stroke</a> — a medical emergency that occurs when the blood supply to the brain is interrupted or seriously reduced. When a stroke occurs, oxygen can't reach the brain, and brain cells begin to die within minutes.</p> <p>Usually, carotid artery disease develops slowly. The first sign that you have the disease may be a stroke or transient ischemic attack, or TIA, a temporary decrease of blood flow to your brain.</p> <h2>Who is at risk for carotid artery disease?</h2> <p>Your risk of developing carotid artery disease increases if you have a family history of the disease or <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/arteriosclerosis-atherosclerosis/basics/definition/con-20026972" target="_blank" title="Opens in a new window.">atherosclerosis</a>. Age also is a risk factor. As you age, your arteries become less flexible and are more easily damaged.</p> <h3>Other risk factors for carotid artery disease include:</h3> <ul> <li>Diabetes</li> <li>High blood-fat levels </li> <li>High blood pressure</li> <li>Lack of exercise</li> <li>Obesity</li> <li><a href="/-/media/local-files/eau-claire/images/medical-services/pulmonology/upper-airway-stimulation-therapy.jpg" target="_self" title="Opens in same window.">Sleep apnea</a></li> <li>Tobacco use</li> </ul> <h2>What are treatments for carotid artery disease?</h2> <p>Preventing a stroke is the primary goal of treating carotid artery disease. A treatment plan will be based on the degree of blockage in your carotid arteries and could include a combination of lifestyle modifications, medications and surgery. </p> <p>Treatment for mild to moderate blockages may include lifestyle changes to slow the progression of damage to your arteries, including <a href="/hometown-health/speaking-of-health/a-smokers-guide-to-quitting" target="_self" title="Opens in same window.">quitting smoking</a>, losing weight, reducing salt intake and exercising regularly. Medication to control blood pressure, lower cholesterol or prevent blood clots also may be recommended.</p> <p>Your care team may recommend removing the blockage from the artery if it is causing severe narrowing or if you have already had a stroke or TIA.</p> <h3>There are different options to remove the blockage from the carotid artery:</h3> <h4>Carotid endarterectomy</h4> <p>This is the most common treatment for carotid artery disease and involves cutting along the front of the neck to open the carotid artery. The blood flow is temporarily stopped while removing the plaque causing the clog or blockage. At the end of the procedure, the artery is closed with a patch made from a vein, an artificial material or the lining of a cow's heart. </p> <h4>Carotid stenting</h4> <p>There are two types of carotid stenting: transcarotid and transfemoral.</p> <p>Transcarotid artery revascularization, or TCAR, is a minimally invasive procedure that treats carotid artery disease and helps prevent strokes. During the procedure, a small incision is made just above the collarbone to access the carotid artery. A tube or catheter is placed into the artery and connected to a transcarotid neuro-protection system, or NPS. This system diverts blood flow through a filter or basket that catches and prevents loose plaque or debris from entering the brain. After the plaque and debris are collected by the device filter, the blood is returned to a vessel in the leg. Then a wireless mesh tube, called a stent, is inserted to stabilize the blockage site and normal blood flow is resumed. </p> <p>Transfemoral carotid stenting is considered when carotid endarterectomy or transcarotid stenting is not feasible. A tube or catheter is inserted in the groin. A wire and catheter are navigated to the carotid artery's diseased section. A filter or basket placed just beyond the blockage catches plaque or debris that becomes loose during the procedure before entering the brain. A stent is inserted to stabilize the blockage site, and the filter is removed at the end of the procedure. Transfemoral carotid stenting carries a risk of stroke during the procedure that is twice as high as carotid endarterectomy or transcarotid stenting.</p> <h2>Are there ways to reduce the risk of developing carotid artery disease?</h2> <h3>To prevent or slow the progression of carotid artery disease, take these steps to manage your risk factors:</h3> <ul> <li><strong>Control chronic conditions.</strong><br /> Manage any chronic conditions, such as diabetes and high blood pressure.</li> <li><strong>Consider limiting your salt intake.</strong><br /> Reducing sodium can help lower your risk of developing high blood pressure.</li> <li><strong>Eat a variety of fruits and vegetables.</strong><br /> <a href="/hometown-health/speaking-of-health/whats-the-big-deal-about-the-mediterranean-diet" target="_self" title="Opens in same window.">Healthy foods</a> provide valuable nutrients for your body, which may protect you from a stroke.</li> <li><strong>Exercise regularly.</strong><br /> Being physically active can improve the health of your blood vessels and heart.</li> <li><strong>Limit cholesterol and fat intake.</strong><br /> This may help reduce the accumulation of plaque in your arteries.</li> <li><strong>Limit your alcohol intake.</strong><br /> Drinking alcohol in excess increases your risk for carotid artery disease.</li> <li><strong>Maintain a healthy weight.</strong><br /> Maintaining a healthy weight reduces your risk of developing high blood pressure, diabetes and other health risks.</li> <li><strong>Quit smoking or don't start. </strong><br /> After just a few years, a nonsmoker's and a former smoker's risk of stroke are comparable.</li> </ul> <h2>Next steps:</h2> <ul> <li>Request an appointment with a <a href="/services-and-treatments/vascular-medicine" target="_self" title="Opens in same window.">vascular medicine specialist</a>.</li> <li>Learn about <a href="/hometown-health/speaking-of-health/the-other-arterial-disease" target="_self" title="Opens in same window.">peripheral artery disease</a> — another type of arterial disease.</li> <li>Discover how <a href="/hometown-health/speaking-of-health/genetic-testing-and-cardiac-conditions" target="_self" title="Opens in same window.">genetic testing</a> gives insight into cardiac conditions. </li> </ul> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2023/couple-with-kayak.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F160139D505D9C3E2B116B9ECF44F8D8" alt="Couple with kayak" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Stroke AwarenessA stroke occurs when the blood supply to part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and food. A stroke is a medical emergency. Prompt treatment is crucial. Early action can minimize brain damage and potential complications.<br/>Dawn Haller4/7/2015<p>Primary care can seem like a general term. But what does a primary care provider do? Find out about the continuity of care you’ll receive and familiarity you’ll experience to get the care that’s best for you.</p>The importance of a primary care provider<img alt="Nadia Malik MD" src="/-/media/shared-files/images/medical-professionals/full/mankato/nadia-malik-md.jpg?h=200&w=200&sc_lang=en&hash=633B8533C0F7CD8C643A46152DA4CCA5" style="width: 200px; height: 200px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>Primary care can seem like a general, slightly ambiguous term. What does it really mean? What is a primary care provider? Well, primary care is indeed general medical care. In fact, a primary care provider — who may come from family medicine or internal medicine, depending on your needs — is specialized in diagnosing, treating and preventing a wide variety of conditions.</p> <p>But the importance of a primary care provider extends beyond his or her ability to cover myriad issues. Establishing care with a primary care provider affords you consistency and efficiency on a number of levels.</p> <h2 style="margin-top: 6pt; line-height: 150%;">Familiarity</h2> <p style="margin-top: 6pt; line-height: 150%;">Knowing who you are is one thing, but knowing the intricacies of your health and wellness is another. And the latter is something a primary care provider offers you and your family. This knowledge and familiarity helps personalize your care and save time that may have previously been spent explaining medical history, personal caveats and who you are.</p> <p style="margin-top: 6pt; line-height: 150%;">A primary care provider’s goal is to deliver the care that’s right for you — not employ a one-size-fits-all approach. Tailored healthcare is easier when you have a meaningful relationship with your provider.</p> <h2 style="margin-top: 6pt; line-height: 150%;">Prevention and condition management</h2> <p style="margin-top: 6pt; line-height: 150%;">A primary care provider is responsible for screening all major health-related conditions. If you already have a chronic condition, your primary helps manage it and improve your quality of life.</p> <p style="margin-top: 6pt; line-height: 150%;">We screen for many things, including obesity, high blood pressure and diabetes. We also look at immunization records and help with regular immunization refills. Those refills are more difficult if you don’t have a primary care provider.</p> <h2 style="margin-top: 6pt; line-height: 150%;">Emergency Department, Urgent Care and primary care</h2> <p style="margin: 6pt 0in; line-height: 150%;">People often question when the right time to seek care with their primary is. Should they go to <a href="/services-and-treatments/urgent-care" target="_self" title="Opens in same window.">Urgent Care</a> or the <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">Emergency Department</a>? These options aren't interchangeable and should be chosen thoughtfully.</p> <p style="margin: 6pt 0in; line-height: 150%;">An emergency is when a severe condition arises. It’s often a life or death situation. Good examples are heart attack symptoms, stroke or a severe allergic reaction. For emergencies, go to the Emergency Department.</p> <p style="margin-bottom: 6pt; line-height: 150%;">If, from a medical standpoint, you feel like your ailment can’t wait until tomorrow, Urgent Care is the place to go. Urgent Care providers commonly diagnose and treat colds and coughs, ear infections, minor burns and cuts, rashes and other non-life threatening conditions.</p> <p style="margin-bottom: 6pt; line-height: 150%;">Again, seek primary care for nonemergent needs, including checkups, screenings, care for common illnesses and immunizations. Primary care should always be your first stop if possible — but not in an emergency.</p> <h2 style="margin-bottom: 6pt; line-height: 150%;">Caring for you as a team</h2> <p style="margin-bottom: 6pt; line-height: 150%;">Primary care providers are part of an expert team that can meet your exact needs. These teams are commonly comprised of physicians, nurse practitioners, physician assistants, registered nurses, patient access staff and patient care associates. Contributing unique perspectives, the team approach provides you with well-rounded healthcare.</p> <p style="margin-top: 6pt; line-height: 150%;">If you haven’t already, consider doing some research and picking a primary care provider who’s right for you. The continuity of care you’ll receive and familiarity you’ll experience will help you get the care that’s best for you.</p><img src="/-/media/shared-files/images/medical-professionals/full/mankato/nadia-malik-md.jpg?h=200&iar=0&w=200&sc_lang=en&hash=73ECEA64C909C918B756CE3777626B9B" alt="Nadia Malik MD" width="200" height="200" DisableNVelocity="true" />Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller4/6/2015<p>Many people dream of becoming parents, but for some, that dream is difficult because they have trouble achieving pregnancy on their own. At Mayo Clinic Health System, we have the privilege of helping patients try to make that dream a reality.</p>Having difficulty becoming pregnant?<img alt="Riley Rhiannon 2012" src="/-/media/shared-files/images/medical-professionals/full/eau-claire/rhiannon-riley-np.jpg?h=200&w=200&sc_lang=en&hash=79EEA2F94CD6853881E5BCA7AF90FE43" style="height: 200px; width: 200px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>Many people dream of becoming parents, but for some, that dream is difficult because they have trouble achieving pregnancy on their own. At Mayo Clinic Health System, we have the privilege of helping patients try to make that dream a reality.</p> <h2>What's normal? How long should we try?</h2> <p>It can take a healthy couple up to a year to conceive. Couples may begin evaluation after one year of unprotected, appropriately timed intercourse — every day to every other day around expected ovulation — or begin evaluation within six months if there is history to suggest there may be difficulty getting pregnant. History that may contribute to difficulty includes the woman having had irregular menstrual cycles or a tubal pregnancy, or if the man has had history of pelvic injury.</p> <h2>What is an infertility workup?</h2> <p>During a workup, we evaluate a couple to determine the cause of their infertility. This can include lab work and imaging.</p> <h2>What is infertility monitoring?</h2> <p>We monitor a woman through a cycle to see if she is ovulating or to measure the response to treatment. Sometimes, this involves lab work, as well as ultrasound, to look at the ovaries and uterus. We also monitor patients that are undergoing in vitro fertilization at another facility.</p> <h2>How does the process work?</h2> <p>Before the appointment, patients are mailed paperwork that should be completed and brought to the first appointment. The initial appointment is a one-hour visit with a provider to complete a health and reproductive health history, evaluate the circumstances and discuss testing. Both partners are encouraged to attend. By the end of the appointment, the couple receives information regarding the plan for the next steps, which may include lab work, ultrasound, etc.</p><ul> <li>Infertility</li> <li>Lactation</li> <li>Preconception and postpartum care</li> <li>Preventive health</li> <li>Women's health</li> </ul>C.N.P., A.P.N.P., M.S.N.<p><strong>Education</strong></p> <ul> <li>Associate degree, Nursing, Chippewa Valley Technical College</li> <li>Bachelor's degree, Nursing, University of Wisconsin-Eau Claire</li> <li>Master's degree, Nursing, University of Wisconsin-Eau Claire</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Academy of Nurse Practitioners</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Obstetrics and Gynecology</li> </ul>Riley<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/rhiannon-riley-np.jpg?h=200&iar=0&w=200&sc_lang=en&hash=7C9A7935CD1A128D681E86B147158608" alt="Riley Rhiannon 2012" width="200" height="200" DisableNVelocity="true" />{515671C7-83DE-4C0C-8CBD-DC44DBF5E811}Rhiannon<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13985451Rhiannon Riley, C.N.P., A.P.N.P., M.S.N.1{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/rhiannon-riley-np.jpg?h=200&iar=0&w=200&sc_lang=en&hash=7C9A7935CD1A128D681E86B147158608" alt="Riley Rhiannon 2012" width="200" height="200" DisableNVelocity="true" />FertilityFertility issues may be due to a single cause with you or your partner or a combination of factors that may prevent a pregnancy from occurring or continuing. There are multiple safe, effective fertility therapies available.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller7/10/2024<p>Flaxseed may be small, but its health benefits are big. It contains numerous salubrious components, with highlighted nutrients being omega-3 fatty acid ALA (alpha-linolenic acid), fiber and lignans.</p>What makes tiny flaxseed a nutritional powerhouse?<p><a rel="noopener" href="https://www.mayoclinic.org/drugs-supplements-flaxseed-and-flaxseed-oil/art-20366457" target="_blank" title="Opens in a new window.">Flaxseed</a> may be small, but its health benefits are big. This tiny nutritional powerhouse contains numerous good-for-you components while bringing a mild, nutty flavor to your foods.</p> <h2>Key nutrients of flaxseed are:</h2> <ul> <li><strong>Alpha-linolenic acid, an omega-3 fatty acid</strong><br /> <a rel="noopener" href="https://www.mayoclinic.org/drugs-supplements-fish-oil/art-20364810" target="_blank" title="Opens in a new window.">Omega-3 fatty acids</a> are good fats that may lower total cholesterol and low-density lipoprotein (LDL) “bad” cholesterol, reduce inflammation and reduce the risk of certain cancers.</li> <li><strong>Fiber</strong><br /> <a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/fiber/art-20043983" target="_blank" title="Opens in a new window.">Fiber</a> can relieve constipation, control cholesterol levels and keep you feeling full longer.</li> <li><strong>Lignans</strong><br /> Lignans provide <a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/add-antioxidants-to-your-diet/art-20546814" target="_blank" title="Opens in a new window.">antioxidants,</a> which guard against cell damage and inflammation.</li> </ul> <h2>Benefits of ground vs. whole flaxseed</h2> <p>For the most health benefits, flaxseed must be ground or crushed, so the body can access the omega-3-containing oil. Flaxseed is available <a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/flaxseed/faq-20058354" target="_blank" title="Opens in a new window.">whole or ground</a> as flaxseed meal. Whole seeds may be less expensive and can be ground using a coffee grinder or food processor. Store flaxseed meal in the refrigerator in an airtight, opaque container to prevent spoiling.</p> <h2>Adding flaxseed to your diet</h2> <p>While there's no specific portion recommendation for flaxseed, 1–2 tablespoons per day is considered a healthy amount. One tablespoon of ground flaxseed contains 37 calories and 2 grams of polyunsaturated fat, including omega-3 fatty acids, 0.5 grams of monounsaturated fat and 2 grams of dietary fiber.</p> <h3>To include flaxseed in your diet:</h3> <ul> <li>Add to hot or cold cereals.</li> <li>Hide in burritos or lasagna.</li> <li>Mix into chili, sauces or gravies.</li> <li>Sprinkle on top of yogurt or into smoothies.</li> <li>Stir ground flaxseed into baked goods, such as muffins, cookies and quick breads.</li> </ul> <h4>Flaxseed muffins</h4> <p>By Mayo Clinic<br /> Makes 12 servings</p> <p>These muffins give meals a delicious and nutritious boost.</p> <p>1 cup bran cereal<br /> 1 teaspoon vanilla<br /> ⅔ cup skim milk<br /> 2 teaspoon cinnamon<br /> 1 1/4 cups flour<br /> 1/4 teaspoon salt<br /> 1/2 cup ground flaxseed<br /> 1/2 cup packed brown sugar<br /> 1/2 cup finely shredded carrot<br /> 2 eggs (substitute 1/2 cup egg whites)<br /> 3/4 cup chopped apple<br /> 1 tablespoon canola oil<br /> 3 teaspoons baking powder</p> <p>Heat the oven to 375° F. Place a paper baking cup in each well of a pan for 12 regular-size muffins. Spray only the bottoms of baking cups with cooking spray. The muffins will stick if the baking cups aren't sprayed.</p> <p>Place the cereal in a resealable food-storage plastic bag. Seal the bag and crush the cereal with a rolling pin, meat mallet or food processor.</p> <p>In a large bowl, combine crushed cereal and milk. Let the mixture stand for about five minutes until the cereal is softened. Stir in the remaining ingredients. Divide the batter evenly among muffin cups.</p> <p>Bake for 22–25 minutes or until a toothpick inserted in the center comes out clean. Immediately remove the muffins from the pan and place on a cooling rack. Serve warm.</p> <p>To store, wrap tightly and keep in the freezer for two months.</p> <p>Nutrition information per serving: 200 calories, 8 grams total fat, 280 milligrams sodium, 28 grams total carbohydrates, 7 grams fiber, 10 grams sugar, 6 grams protein.</p> <h4>Warm chocolate pudding</h4> <p>By Mayo Clinic<br /> Makes 6 servings</p> <p>Flaxseed takes the place of eggs in this recipe. Make it plant-based by using a milk substitute.</p> <p>1 tablespoon ground flaxseeds (flaxseed meal)<br /> 3 tablespoons brewed espresso<br /> 2 1/4 cups skim milk, divided<br /> 2/3 cup sugar, divided<br /> 1/8 teaspoon salt<br /> 2/3 cup unsweetened cocoa powder<br /> 1 teaspoon vanilla extract<br /> 2 tablespoons cornstarch</p> <p>In a medium bowl, lightly beat ground flaxseeds (flaxseed meal) and warm espresso with a fork. Set aside. In a medium saucepan, combine 1 1/2 cups milk, 1/3 cup sugar and salt. Bring to a simmer over medium heat, stirring occasionally.</p> <p>In a medium bowl, whisk the remaining 1/3 cup sugar, cocoa powder and cornstarch. Then whisk in the remaining 3/4 cup milk until blended. Whisk the simmering milk mixture into the cocoa mixture. Pour the mixture back into the saucepan and bring it to a simmer over medium heat, whisking constantly, until thickened and glossy, about 3 minutes. Remove from heat.</p> <p>Whisk about 1 cup of the hot cocoa mixture into the beaten flaxseeds. Add this mixture to the saucepan and cook over medium-low heat, whisking constantly, until steaming and thickened, about 2 minutes. Do not let the mixture boil. Whisk in vanilla. Serve warm.</p> <p>Nutrition information per 1/2 cup serving: 169 calories, 1 gram total fat, 86 milligrams sodium, 35 grams total carbohydrate, 2 grams fiber, 22 grams sugar, 5 grams protein.</p> <p><a href="/providers/allyn-wergin-rdn" target="_self" title="Opens in same window."><em>Allie Wergin</em></a><em> is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Bariatric surgery</li> <li>Diabetes management</li> <li>Oncology</li> <li>Weight management</li> </ul>RDN<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, St. Catherine University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration </li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul>Mahowald<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/allyn-wergin-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=74F690ED261F537AA65B66929A3356D1" alt="Allie Mahowald, RDN" width="280" height="280" DisableNVelocity="true" />{9209F8EC-1016-41AA-985F-014D9B877417}Allie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15971546Allyn Mahowald, RDN1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2024/oatmeal-with-flaxseed-and-fruit.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8A8E8666A8A88BAE4719931D486F37C9" alt="Oatmeal with flaxseed and fruit" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller4/13/2022If you've ever had chickenpox, you may be susceptible to shingles. This common condition causes a painful, blistered rash. Learn about prevention and treatment.Shingles: Not just a band of blisters<p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/shingles/basics/definition/con-20019574" target="_blank" title="Opens in a new window.">Shingles</a> (herpes zoster) is a common condition caused by the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/chickenpox/basics/definition/con-20019025" target="_blank" title="Opens in a new window.">chickenpox</a> virus (varicella-zoster virus). Not everyone who's had chickenpox will develop shingles. However, after years of lying dormant in nerve tissue near the spinal cord and brain, the virus can reactivate in some people. As it becomes active again, the virus causes pain, tingling and, eventually, a rash of blisters that doesn't last long.</p> <p>The reason for shingles is unclear. But it may be due to lowered immunity to infections as you grow older.</p> <h2>Preventing shingles</h2> <p>Vaccines reduce the risk of developing shingles. The Shingrix vaccine is approved and recommended for people 50 and older, including those who have had shingles or previously received the Zostavax vaccine, which is no longer sold in the U.S. Studies suggest that Shingrix protects against shingles for more than five years. The vaccine is given in two doses with two to six months between doses.</p> <h2>Signs and symptoms of shingles</h2> <h4>Shingles usually affects only a small section on one side of your body and may include:</h4> <ul> <li>Pain, burning, tingling, itching, numbness or extreme sensitivity to touch</li> <li>Red rash with fluid-filled blisters that begins a few days after the pain and lasts two to three weeks before scabbing over and healing</li> <li>Fever</li> <li>Headache</li> <li>Chills</li> <li>Sensitivity to light</li> <li>Malaise — a general feeling of unease and discomfort</li> </ul> <p>Pain usually is the first symptom of shingles. For some, it can be intense. Depending on the location of the pain, sometimes it can be mistaken for a symptom of problems affecting the heart, lungs or kidneys. Some people experience shingles pain without ever developing the rash.</p> <p>The shingles rash commonly occurs on one side of the torso. It often appears as a band of blisters that wraps from the middle of the back to the breastbone, following the path of the nerve where the virus has been dormant. However, the rash can occur around one eye, or on the neck or face.</p> <p>Shingles generally lasts between two and six weeks. Most people get shingles only once, but it's possible to get it two or more times.</p> <h4>See a health care professional as soon as symptoms of shingles appear, especially if:</h4> <ul> <li>The pain and rash occur near an eye. If left untreated, this infection can lead to permanent eye damage.</li> <li>You're 60 or older because age significantly increases the risk of complications.</li> <li>You or someone in your family has a weakened immune system due to cancer, medications, chronic illness or other conditions.</li> <li>The rash is widespread and painful.</li> </ul> <p>When identified early, shingles can be treated with prescription medications to shorten the infection and reduce the risk of complications. Shingles normally isn't serious, although the rash can cause an eye infection. Another complication, called "postherpetic neuralgia," causes the skin to remain painful and sensitive to touch for months or years.</p> <p>A person with shingles can pass the varicella-zoster virus to anyone who isn't immune to chickenpox. This happens through direct contact with the rash's open sores. Once infected, the person will develop chickenpox — not shingles. Chickenpox can be dangerous for some people.</p> <h4>Until the shingles blisters scab over, people are contagious and should avoid physical contact with:</h4> <ul> <li>Anyone with a weak immune system</li> <li>Newborns</li> <li>Women who are pregnant</li> </ul> <p>While shingles can't be cured, getting vaccinated and seeking prompt treatment with antiviral drugs can speed healing and reduce your risk of complications.</p> <p><em><a href="/providers/jeffery-wheeler-md" target="_self" title="Opens in same window.">Jeffery Wheeler, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/cannon-falls" target="_self" title="Opens in same window.">Cannon Falls</a>, Minnesota.</em></p> M.D. <p><strong>Medical School </strong> <br> College of Human Medicine, Michigan State University, East Lansing</p> <p><strong>Residency </strong><br> Mayo Clinic Family Medicine Residency Program, Rochester, Minnesota</p> <p><strong>Certifications and Memberships</strong></p> <ul> <li>American Medical Association</li> <li>Minnesota Medical Society</li> <li>American Academy of Family Physicians</li> <li>Mayo Fellows Association</li> <li>Certified DOT Examiner</li> </ul> Wheeler<img src="/-/media/shared-files/images/medical-professionals/full/cannon-falls/jeffery-wheeler-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=2E50A9EFFC72CD98B90BD690C2F84CAE" alt="Jeffery Wheeler MD" width="280" height="280" DisableNVelocity="true" /> Jeffery<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13826841Jeffery Wheeler MD 1<img src="/-/media/national-files/images/hometown-health/2022/person-with-grey-beard-denim-shirt.jpg?h=370&iar=0&w=660&sc_lang=en&hash=DDA494A4D8CB04EF7CDFC627F55456F7" alt="Person with grey beard, wearing a denim shirt" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Dawn Haller1/19/2015<p>Insulin was discovered in 1921. But until about 35 years ago, people with diabetes still relied on multiple daily insulin injections to manage their blood glucose and avoid life-threatening situations. Improvements in technology are now making lives easier for people with the disease.</p>What is Mayo Clinic’s Diabetes Technology Clinic?<img alt="DrKudva_ClosedLoopSystem" src="/-/media/national-files/images/hometown-health/2015/winter-2015/drkudva_closedloopsystem.jpg?h=220&w=267&sc_lang=en&hash=F5FE34AE8E4AC66246E55734062B867C" style="height: 220px; width: 267px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>Insulin was discovered in 1921. But until about 35 years ago, people with diabetes still relied on multiple daily insulin injections to manage their blood glucose and avoid life-threatening situations. Improvements in technology are now making lives easier for people with the disease.</p> <p>Insulin pumps were developed to deliver insulin subcutaneously using settings prescribed by endocrinologists and implemented by patients, but a new device works with insulin pumps to not only monitor glucose, but control insulin levels. </p> <p>One of the newest technologies used to improve diabetes care is the first-generation Medtronic closed-loop (artificial pancreas) device, which was introduced to patients at Mayo Clinic's Diabetes Technology Clinic in September 2013. The device monitors glucose continuously and can stop the delivery of insulin from the insulin pump when glucose decreases to a preset level.</p> <p>"This closed-loop technology has been the most quickly accepted technology for patients that I have ever seen," says Yogish Kudva, M.B.B.S., director.</p> <p>Continuous glucose monitoring can be used with injections or an insulin pump, on which the closed-loop system shows data. "We have glucose data on a regular basis — every one to five minutes when patients use the closed loop system," says Dr. Kudva. "When glucose decreases to a preprogrammed threshold decided by patient and provider, insulin delivery pauses."</p> <p>More than 40,000 patients have started using this technology since September, which Dr. Kudva calls "fantastic movement." The Diabetes Technology Clinic was instituted 10 years ago and gradually expanded its capacity to see patients who use or have interest in using continuous glucose monitors, pumps or closed loop systems.</p> <img alt="DrKudva_lg" src="/-/media/national-files/images/hometown-health/2015/winter-2015/drkudva_lg.jpg?h=220&w=171&sc_lang=en&hash=CB7140C522A085F2A5EDB25C18811FC6" style="height: 220px; width: 171px; float: right; margin-top: 10px; margin-bottom: 10px; margin-left: 10px;" /> <p>"People with diabetes essentially have two major challenges," says Dr. Kudva. "One is glucose swings with low and high blood sugar. The second is making sure sugar levels and other risk factors are dealt with appropriately."</p> <p>The artificial pancreas has the ability to improve glucose control by reducing occurrences of high sugar levels and ideally eliminating low sugar levels altogether.</p> <p>"The major limiting factor without a closed-loop system is an insulin reaction or low glucose," says Dr. Kudva. Now, with a closed-loop system, the frequency of these reactions is reduced substantially.</p> <p>Dr. Kudva says determining whether artificial devices are a good fit depends on the individual.</p> <p>"We evaluate patients and address their concerns and values," he says. "Are they willing to insert one or two systems under their skin? Are they willing to have devices attached to their body? We've learned in the last 10 years that patients require various amounts of help for particular challenges, but there's no doubt that if the technology is used properly, it offers every diabetes patient the best glucose control."</p> <p>Dr. Kudva is certain that the technology and support available through the Diabetes Technology Clinic have an impact on patients' everyday lives. "We know that improving glucose control lessens complications. Reducing insulin reactions will have an impact on complications. More importantly, the technology allows patients to have less fear and better control."</p><img src="/-/media/national-files/images/hometown-health/2015/winter-2015/drkudva_closedloopsystem.jpg?h=220&iar=0&w=267&sc_lang=en&hash=2CBED3C002D99350AB6F33D977FF59B8" alt="DrKudva_ClosedLoopSystem" width="267" height="220" DisableNVelocity="true" />DiabetesIf you have diabetes, no matter what type, it means you have too much glucose in your blood, although the reasons may differ. Too much glucose can lead to serious health problems.Dawn Haller3/11/2015<p>Do you ever find yourself making two different meals at supper to please picky eaters? The answer is probably "yes." If so, these six tips will help you introduce your kids to new, healthier and possibly strange-looking foods.</p>6 tips for dealing with picky eaters<p>Do you ever find yourself making two different meals at supper? You may prepare a salad piled high with meat and veggies for yourself and something else — slightly unhealthy — for your kids, just hoping they'll eat it. And by the time you're done preparing your plate, the children are finished eating and ready to move on to the next thing.</p> <p>Every once in a while, you may think to yourself, "You should try harder to get them to eat new things. This is silly." Enough is enough.</p> <h2>Here are six tips to get your kids to eat new, healthier and possibly strange-looking foods:</h2> <h3>Understand that new foods take time.</h3> <p>Kids don't always take to new foods immediately. Continue to offer the new food. It may take many tries for a child to enjoy a new food. Don't give up.</p> <h3>Remember that small amounts offer big benefits.</h3> <p>Offer your child a small portion of the healthy foods you enjoy. The more diverse their diet becomes, the easier meal planning becomes.</p> <h3>Serve as a role model.</h3> <p>Try new foods often, describing tastes and textures to your picky eater. They may see you enjoying new cuisine and decide it's OK to try.</p> <h3>Try one new food at a time.</h3> <p>Serving new foods with foods that are well-liked at your house may be helpful. Offering too many new foods at one time can be scary.</p> <h3>Choose the right timing.</h3> <p>It's always helpful to offer new foods at the beginning of the meal, when everyone is most hungry.</p> <h3>Combine foods if necessary.</h3> <p>Some kids may like new foods mixed in with other foods, such as a casserole. Other kids may like new foods separate, and a sectioned plate works best.</p> <p>Dealing with picky eaters may seem like a never-ending, uphill battle, but it will get easier. Keep in mind that you're not alone. Nearly all parents struggle with picky eaters. The key is to keep going and continue offering new foods.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2015/picky-eater_small.jpg?h=200&iar=0&w=200&sc_lang=en&hash=D656F7F6E719DC1C317CB6A64198349F" alt="Picky Eater_Small" width="200" height="200" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller4/5/2022If you feel an achy, heavy or a burning sensation in your legs, you may have varicose veins. They're more than a cosmetic concern. Get information on the minimally invasive treatment options to ease pain.Could your leg pain be varicose veins?<p>If you've been experiencing an achy, heavy feeling or a burning sensation in your legs, it may be symptoms of <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/varicose-veins/basics/definition/con-20043474" target="_blank" title="Opens in a new window.">varicose veins</a>. They are enlarged veins that often develop as people age or even begin when people are younger.</p> <p>It's important to note that for most people, varicose veins simply are a cosmetic concern. But for others, varicose veins may lead to more serious health issues, such as significant life-limiting ulcers or blood clots.</p> <p>Varicose veins usually are dark purple or blue-colored, and they tend to appear twisted or bulge.</p> <h2>Symptoms of varicose veins include:</h2> <ul> <li>Muscle cramping and swelling in your lower legs</li> <li>Worsened pain after sitting or standing for a long time</li> <li>Itching, pain or heat around one or more of your veins</li> <li>Skin ulcers near your ankle </li> </ul> <h2>Self-care options to stop varicose veins from worsening include:</h2> <ul> <li>Exercising</li> <li>Limiting sodium intake by minimizing canned soups and vegetables, snack meats or chips</li> <li>Losing weight</li> <li>Wearing looser clothes</li> <li>Elevating your legs</li> <li>Avoiding sitting or standing for long periods of time</li> </ul> <p>Purchasing compression stockings from your local pharmacy or medical supply store often is the first approach your health care team will suggest before trying other treatment options. Compression stockings are worn during the day and help to improve blood flow in your legs, and reduce swelling and aching.</p> <h2>Alternative treatments for varicose veins</h2> <p>If these self-care options don't ease your pain, your health care team may suggest other options.</p> <h3>These options have minimal pain and provide quick recovery:</h3> <ul> <li><strong>Sclerotherapy</strong><br /> In this procedure, a health care professional injects varicose veins with a solution that scars and closes the veins. This can be done with laser energy without needles.</li> <li><strong>Minimally invasive catheter-assisted procedure</strong><br /> In this procedure using radiofrequency ablation or laser energy, a long, thin tube is placed into the vein and the tip is heated. This destroys larger veins by causing them to collapse and close.</li> <li><strong>Vein stripping</strong><br /> In this procedure, a limited piece of vein is removed through small incisions on the leg. Removing the vein won't keep blood from flowing in the leg because veins deeper in the leg take care of the larger volumes of blood.</li> <li><strong>Ambulatory phlebectomy</strong><br /> This procedure is done in a health care professional's office and is less invasive than vein stripping. Smaller varicose veins are removed through a series of tiny skin punctures. Only the parts of the leg that are being pricked are numbed. It's also performed in the operating room with the help of sedation or other anesthesia for more extensive vein removal.</li> <li><strong>Endoscopic vein surgery</strong><br /> This surgery usually is used for advanced cases where leg ulcers are present.</li> </ul> <p>Sometimes, one or more procedures can be combined for best results. Your health care team would be happy to discuss your options and determine the best approach to relieve your varicose vein symptoms.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/walking-on-rocks-cuffed-jeans.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2A80C842476008192EF77F927AC16556" alt="Walking on rocks cuffed jeans" width="660" height="370" DisableNVelocity="true" />SurgeryHaving surgery is a major event in your life. We know this and make every effort to keep you as comfortable as possible, focusing on you as an individual. Our surgeons and staff work as a coordinated team treating a wide variety of illnesses ranging from simple to complex. We offer comprehensive, advanced care and service to every patient.Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Dawn Haller9/22/2023Dry skin can be temporary, seasonal or a lifelong condition that leaves your skin feeling flaky, rough and itchy. Get tips to keep your skin hydrated and healthy.What to do about dry skin<p>Dry skin can be a temporary condition that people may experience at some point in their lives, especially <a href="/hometown-health/speaking-of-health/winters-dont-have-to-bring-dry-skin" target="_self" title="Opens in same window.">during the winter</a>. For other people, dry skin can be a lifelong condition.</p> <p>Skin may look and feel flaky, itchy, rough or scaly when dry. Although skin often is driest on your hands, arms and lower legs, this varies from person to person. Signs and symptoms of <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/dry-skin/basics/definition/con-20030009" target="_blank" title="Opens in a new window.">dry skin</a> depend on your age, health, where you live, time spent outdoors and cause of the problem.</p> <h2>Dry skin is likely to cause symptoms, including:</h2> <ul> <li>A feeling of skin tightness, especially after showering, bathing or swimming</li> <li>Deep cracks that may bleed</li> <li>Fine lines or cracks</li> <li>Gray, ashy skin in people with dark skin</li> <li>Itching, also known as pruritus</li> <li>Redness</li> <li>Skin that <a href="/hometown-health/speaking-of-health/treating-your-childs-eczema" target="_self" title="Opens in same window.">feels and looks rough</a></li> <li>Slight to severe flaking, scaling or peeling</li> </ul> <h2>Common causes of dry skin</h2> <p>You may hear dry skin called xerosis or xeroderma. It has many causes, including aging, cold or dry weather, sun damage, certain medical treatments, harsh products like soaps or detergents or overbathing. Anyone can develop dry skin, but some people have an increased risk due to their environment, occupation, health history or hobbies.</p> <h3>Take these steps to help your skin retain moisture and decrease dryness:</h3> <ul> <li><strong>Moisturize.</strong><br /> Moisturizers provide a seal over your skin to keep water from escaping. Apply moisturizer several times throughout the day. Thicker moisturizers tend to work best. Use a moisturizer with sunscreen or a broad-spectrum sunscreen with an SPF of at least 30 before going outside. Apply sunscreen generously, even on cloudy days, and reapply every two hours. </li> <li><strong>Use warm water and limit bath time.</strong><br /> Long showers or baths and hot water remove oils from your skin. Limit your bath or shower to five to 10 minutes, and use warm, not hot, water. </li> <li><strong>Avoid harsh, drying soaps.</strong><br /> It's best to use cleansing creams, gentle skin cleansers and bath or shower gels with added moisturizers. Use hypoallergenic soap or fragrance-free soap without alcohol. </li> <li><strong>Apply moisturizers immediately after bathing or washing hands.</strong><br /> Gently pat your skin dry with a towel so some moisture remains. Immediately moisturize your skin with an oil or cream to help trap water in the surface cells.</li> <li><strong>Use a humidifier.</strong><br /> Hot, dry, indoor air can parch sensitive skin and worsen itching and flaking. A portable home humidifier or one attached to your furnace adds moisture to the air inside your home. Be sure to keep your humidifier clean by following the manufacturer's instructions.</li> <li><strong>Choose fabrics that are kind to your skin.</strong><br /> Natural fibers like cotton and silk allow your skin to breathe. Wool sometimes can irritate skin, even though it's also a natural fiber. Wash your clothes with detergents <a href="/hometown-health/speaking-of-health/what-are-natural-personal-care-products" target="_self" title="Opens in same window.">free from dyes</a> or perfumes, which can irritate your skin.</li> </ul> <p>If dry skin causes itching, apply cool compresses to the area. To reduce inflammation, use a nonprescription hydrocortisone cream or ointment containing at least 1% hydrocortisone. </p> <p>If your dry skin still is inflamed, painful, has open sores, or disrupts your sleep and daily activities after lifestyle modifications and <a href="/hometown-health/speaking-of-health/get-radiant-hair-skin-and-nails-naturally" target="_self" title="Opens in same window.">at-home treatment</a>, see your primary care provider or a dermatologist.</p> <p><a href="/providers/megan-johnston-flanders-md" target="_self" title="Opens in same window.">Megan Johnston Flanders, M.D.</a>, is a physician in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> and <a href="/services-and-treatments/hospital-medicine" target="_self" title="Opens in same window.">Hospital Medicine</a> in <a href="/locations/cannon-falls" target="_self" title="Opens in same window.">Cannon Falls</a>, Minnesota.</p><ul> <li>Hospital medicine</li> <li>Obstetrics and gynecology</li> <li>Pediatrics</li> <li>Prenatal care</li> <li>Preventive medicine</li> <li>Sports medicine</li> <li>Women's health</li> </ul> M.D.<p><strong>Education</strong></p> <ul> <li>University of North Dakota School of Medicine and Health Sciences</li> <li>Master's degree, Public Affairs in Health Services Management, Indiana University</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Memorial Hospital of South Bend</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Department of Transportation (DOT) exams</li> </ul>Johnston Flanders<img src="/-/media/shared-files/images/medical-professionals/full/cannon-falls/megan-johnston-flanders-md.jpg?h=280&iar=0&w=280&hash=B59EFF3861B8D93E27D80E0FB138E2A3" alt="Megan Johnston FlandersMD" width="280" height="280" DisableNVelocity="true" />{0BCFDC5F-1673-43A3-8C8C-293116885B4A}Megan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14764181Megan Johnston Flanders, M.D.1<img src="/-/media/national-files/images/hometown-health/2023/hands-spreading-lotion.jpg?h=370&iar=0&w=660&sc_lang=en&hash=FB5A34A8107A6CAAE5A7EA829929F37F" alt="Hands spreading lotion" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Dawn Haller5/26/2022Potions, lotions and supplements to achieve healthy hair, skin and nails can be expensive. Instead, spend that money on groceries. What you eat can give you radiant results naturally.What you eat promotes radiant hair, skin and nails naturally<p>From lotions and moisturizers to conditioners and argan oil to nail-growth polish and supplements, money spent on products to promote shiny hair, supple skin and sturdy nails can add up fast. Instead of spending your hard-earned money on these products, spend it on groceries.</p> <p>Diet is a major factor in the condition of your hair, skin and nails. If you're on point with your nutrition, natural beauty can follow. </p> <p>When you're getting the right amount of vitamins and minerals every day, your body will function better. That means hydrated skin, shiny hair and strong nails.</p> <p>Though you should be getting the right amount of vitamins, minerals and water every day, your body functions at its best. That can lead to hydrated skin, shiny hair and strong nails. Vitamins A, E and D; iron; healthy fats; carbohydrates; and protein are especially important for skin, hair and nail health.</p> <h2>Avoid too much of a good thing</h2> <p>If you're already eating a balanced diet of vegetables, fruits, grains, lean proteins and healthy fats, you shouldn't need pricey supplements. While supplements are necessary for some, they're not for everyone. However, if you're considering a supplement, opt for a multivitamin that provides 100% of <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/documents/mc5129-0709-sp-rpt-pdf/doc-20079085" target="_blank" title="Opens in a new window. ">essential vitamins and minerals</a>.</p> <p><span>One mistake is consuming too much of one vitamin or taking unnecessary supplements. Your body gets rid of excess vitamins and minerals, leading to money wasted on unneeded nutrients. Also, taking too much of one vitamin or mineral may deplete another. </span></p> <p>Zinc and copper are prime examples. <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.ncbi.nlm.nih.gov/pubmed/15762288" target="_blank" title="Opens in a new window.">Research</a> shows those taking extra zinc often leads to a loss of copper, a mineral important in bone health. Too much copper can deplete zinc.</p> <h2>Lock in moisture, support growth</h2> <p>Healthy fats lock moisture into your hair, skin and nails. And since your hair is primarily protein, eating the <a href="/hometown-health/speaking-of-health/are-you-getting-too-much-protein" target="_self" title="Opens in same window.">recommended amount of protein</a> is needed for hair growth.</p> <p>Lacking essential nutrients can not only prevent you from gaining radiant hair, skin and nails, but also can worsen their current condition. Those who consume low-calorie or low-carbohydrate diets sometimes experience thinning and brittle hair strands.</p> <p>The calories from carbohydrates produce energy for vital organs and tissues. When carbs are drastically reduced, the body may not have enough energy to support hair growth. Also, people who greatly restrict their calories may not get enough of the essential nutrients, especially those healthy fats and proteins.</p> <h4>Here's a breakdown of where you should get calories every day:</h4> <ul> <li>20% from protein</li> <li>20%–30% from healthy fats</li> <li>45%–60% from carbohydrates</li> </ul> <h2><span>Choose these foods for hair, skin and nail health</span></h2> <p>Keep a balanced diet by eating a variety of foods to supply the healthy fats, carbs, protein, vitamins and minerals your body needs every day. Your hair, skin and nails will thank you.</p> <h4>Check out this quick guide to sources of nutrients that will help you gain flawless hair, skin and nails:</h4> <p><strong>Healthy fats</strong></p> <ul> <li>Unsaturated fats, such as olive or canola oil</li> <li>Omega 3, which is found in nuts and seeds, such as almonds, chia and flax</li> <li>Plant-based fats from avocados</li> </ul> <p><strong>Protein</strong></p> <ul> <li>Poultry, such as chicken and turkey</li> <li>Lean red meat, 85% lean or higher</li> <li>Seafood, such as shrimp </li> <li>Fish, such as salmon and tuna</li> </ul> <p><strong>Iron</strong></p> <ul> <li>Lean red meat</li> <li>Leafy green vegetables, such as spinach</li> <li>Fortified cereals</li> </ul> <p><strong>Vitamin A</strong></p> <ul> <li>Cooked yellow vegetables, such as sweet potatoes and winter squash</li> <li>Liver or liver oil</li> <li>Cooked leafy greens, such as kale, turnips and collards</li> </ul> <p><strong>Vitamin E</strong></p> <ul> <li>Nuts and seeds, such as almonds and sunflower seeds</li> <li>Fish, such as salmon and rainbow trout</li> </ul> <p><strong>Vitamin D</strong></p> <ul> <li>Eggs, specifically the yolk</li> <li>Fish, such as salmon, herring, sardines and canned tuna</li> </ul> <p><em>Kjersten Nett is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a> and <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2022/close-up-hands-brushing-hair.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3927B6336C25758AB32ED767BB8F15F6" alt="Close-up of hands holding and brushing hair" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller2/14/2022<p>Inflammatory bowel disease, or IBD, can be a frustrating diagnosis. There is no clear evidence that one trigger alone causes problems. Learn about ways you can manage IBD.</p>Lifestyle, diet in inflammatory bowel disease<p><a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/symptoms-causes/syc-20353315" target="_blank" title="Opens in a new window.">Inflammatory bowel disease</a>, also known as IBD, consists of Crohn's disease and ulcerative colitis. No specific food, diet or lifestyle causes, prevents or cures inflammatory bowel disease. And multiple factors can trigger the diagnosis.</p> <p>Your diet does not cause inflammatory bowel disease, or induce a flare. However, modifying your diet can manage symptoms during a flare.</p> <p>While several specialized diets may help certain patients, no plan has been proven to prevent or control inflammatory bowel disease, except for <a rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/home-enteral-nutrition/about/pac-20384955" target="_blank" title="Opens in a new window.">enteral nutrition</a>, which is delivered in a nutrient-rich formula.</p> <p>Keeping a food diary is a great way to manage flare-ups. A dietitian specializing in inflammatory bowel disease may recommend a particular diet based on your symptoms.</p> <h2>These tips may help you manage inflammatory bowel disease:</h2> <ul> <li>Start with a low-fiber or liquid diet until the situation resolves. Avoid identified trigger foods.</li> <li>Eat a low-fiber diet. Limit foods such as seeds, nuts, beans, fruit and bran.</li> <li>Try a low FODMAP diet. FODMAP stands for fermentable, oligo-, di-, monosaccharides and polyols. This type of diet cuts back on a group of sugars that can be poorly absorbed by your gastrointestinal tract. This includes foods containing fructose; lactose; sugar polyols, such as sorbitol and mannitol; fructans, which are found in garlic, leeks, artichokes, and wheat; and galacto-oligosaccharides, which are found in lentils, chickpeas, and green peas.</li> <li>Drink water to stay hydrated.</li> <li>Avoid caffeine and energy drinks.</li> <li>Learn more about inflammatory bowel disease from the <a rel="noopener noreferrer" href="https://www.crohnscolitisfoundation.org/" target="_blank" title="Opens in a new window.">Crohn's & Colitis Foundation</a>.</li> </ul> <p>Be careful with vitamins and mineral supplements. Remember, most of your needed vitamins are obtained by eating a balanced diet. Some over-the-counter supplements can contain lactose, starch and other ingredients that can worsen your symptoms.</p> <p>Besides eating a recommended diet, some supplements may be suggested for patients with inflammatory bowel disease. Talk to your health care professional about healthy levels of calcium, vitamin D, folic acid, vitamin B12, iron and zinc.</p> <h3>As with any health condition, a healthy lifestyle makes it easier to manage your diagnosis:</h3> <ul> <li>Don't smoke or quit smoking.</li> <li>Get regular physical activity to <a href="/hometown-health/speaking-of-health/dont-be-bad-to-the-bone-how-to-preserve-bone-mass" target="_self" title="Opens in same window.">build bone</a> and muscle mass.</li> <li>Eat a sensible diet.</li> <li>Maintain a body mass index of less than 25.</li> </ul> <p>By tuning in to your body, making healthy choices and working closely with your professional, you can enhance your quality of life living with inflammatory bowel disease.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/spooning-yogurt-from-container.jpg?h=370&iar=0&w=660&sc_lang=en&hash=234F4704E7142B1E9B3ED095962483D8" alt="Spooning yogurt from container" width="660" height="370" DisableNVelocity="true" />Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Dawn Haller2/19/2015<p>Young people receive a mixed message about how safe it is for them to use marijuana. So what's the problem?</p>The problem with kids and cannabis<p>Young people receive a mixed message about how safe it is for them to use <a rel="noopener" href="http://www.mayoclinic.org/drugs-supplements/marijuana/background/hrb-20059701" target="_blank" title="Opens in a new window">cannabis, or marijuana</a>. Cannabis has been legalized for medical or recreational purposes in 23 states and the District of Columbia. The federal government has ended its ban on medical marijuana. New Mexico has authorized the use of medical marijuana without age stipulations.</p> <p>So what's the problem with kids using cannabis? Today's marijuana is enhanced genetically and bred for potency. The tetrahydrocannabinol, or THC, content, about 10 milligrams per joint in the 1970s, is five to 15 times more potent today. THC is the active ingredient that gives cannabis its narcotic and psychoactive effects.</p> <p>Thanks to legalization it's easy for practitioners, families and communities to become less concerned, but there are some clear risks associated with the use of cannabis by young people.</p> <p>Early cannabis use negatively impacts the mental abilities and processes related to knowledge, including memory, judgment, evaluation, reasoning, computation, problem-solving and decision-making — and diminishes long-term function while increasing the risk of addiction. The risk of any substance abuse is especially high for young people who start early — age 14 or younger.</p> <p>Cannabis has less potential for addiction and long-term consequences than other substances, including nicotine and alcohol. The number of people who use cannabis and develop a problem is still high. Up to 25% of cannabis users become daily users, and 10% of users will become dependent. In 2011, nearly 4.2 million people age 12 and older had a cannabis abuse or addiction problem.</p> <p>Delaying the use of cannabis until adulthood has a clear positive impact. Be mindful. Pay attention. If you wonder, an assessment is recommended. You shouldn't wait until your child is drug-dependent to do something about it.</p> <h2>Parents can minimize risk by:</h2> <ul> <li>Talking with your children about substances, including cannabis.</li> <li>Getting to know your child's friends and influences.</li> <li>Monitoring your child's activities and affiliations.</li> <li>Setting and enforcing clear rules and consequences.</li> <li>Eating meals and spending time together as a family.</li> <li>Paying attention for changes in your child's mood or behavior.</li> <li>Knowing the <a rel="noopener" href="http://www.mayoclinic.org/healthy-living/tween-and-teen-health/in-depth/teen-drug-abuse/art-20045921?pg=2" target="_blank" title="Opens in a new window">warning signs</a> of drug use in young people.</li> <li>Setting a good example of responsible actions and choices.</li> <li>Teaching communication and problem-solving skills.</li> <li>Providing encouragement, praise, love and acceptance.</li> </ul> <h3>If you suspect your child is abusing drugs, you can:</h3> <ul> <li>Talk with your child about your concerns.</li> <li>Anticipate denial or excuses.</li> <li>Re-establish rules and consequences.</li> <li>Increase monitoring and limits on activities.</li> <li>Consult with teachers, counselors, coaches and other caregivers.</li> <li>Consider drug testing.</li> <li>Have your child evaluated at a primary care or specialty clinic.</li> <li>Call <a href="tel:1-800-662-4357">1-800-662-HELP (4357)</a>, which is the National Drug and Alcohol Treatment Hotline.</li> </ul>Substance AbuseInformation for helping those with alcohol and other drug abuse concerns.Dawn Haller9/28/2023Lupp-dubb. Lupp-dubb. Your heart has a steady regular beat. Sometimes though, an extra heart sound like humming is heard, called a murmur. Find out when a heart murmur is innocent or serious.What's that sound? A heart murmur can be innocent or serious<p>Lubb-dupp. Lubb-dupp. that healthcare professionals often use to mimic the sound of your heartbeat. That steady, regular sound is made by your heart valves opening and closing as blood circulates through your heart.</p> <p>You may have heard the term "heart murmur." A <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/heart-murmurs/basics/definition/con-20028706" target="_blank" title="Opens in a new window.">murmur</a> is an extra heart sound that can be heard by a stethoscope. Sometimes, the murmur sounds like a humming, which can be faint or loud. It might be temporary or persistent. Heart murmurs may be present at birth or develop later in life during pregnancy, phases of rapid growth like adolescence or from a fever or anemia.</p> <p>The murmur may disappear as quickly as it comes if it has a temporary cause. However, a murmur also could be persistent and loud, easily heard and sound like a churning mill wheel or cooing seagull. This might indicate a serious heart problem.</p> <h2>What causes a heart murmur?</h2> <p>Multiple factors can cause a murmur. It could be a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/heart-valve-disease/basics/definition/con-20036065" target="_blank" title="Opens in a new window.">heart valve problem</a> or a hole in the heart.</p> <p>The valves in your heart act as doors between the chambers, or rooms, of the heart. In the case of a murmur, a valve may be tight or leaky. When heart valves are narrow, this is called stenosis. A murmur also could be from a <a href="/hometown-health/speaking-of-health/treating-mitral-valve-regurgitation" target="_self" title="Opens in same window.">leaky valve</a>, called regurgitation.</p> <p>A murmur also may occur from high blood flow in people with a fever or with low red blood cells, called anemia.</p> <p>Some people have a family history of heart murmur and heart disease. Some are born with a <a href="https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/genetic-testing-and-cardiac-conditions">congenital condition</a> causing a murmur. Others have had a recent severe infection or illness that could damage a heart valve and need immediate medical attention.</p> <h2>What are the symptoms of a heart murmur?</h2> <p>Innocent or harmless heart murmurs don't typically cause symptoms, and most heart murmurs aren't serious.</p> <p>Symptoms of a serious or worrisome heart murmur depend on the cause and require evaluation by a healthcare professional.</p> <h3>These heart murmur symptoms may include: </h3> <ul> <li>Blue or gray lips or fingernails</li> <li>Chest pain</li> <li>Fainting </li> <li>Fever </li> <li>Leg swelling </li> <li>Lingering cough</li> <li>Shortness of breath</li> <li>Sudden weight gain</li> <li>Swollen liver or neck veins</li> <li>Worsening fatigue</li> </ul> <h2>How is a heart murmur diagnosed?</h2> <p>It’s common for a heart murmur to be detected during a physical exam being given for another reason. If a healthcare professional hears a murmur, you'll be asked questions about your personal and family history that could indicate a reason for the murmur. </p> <h3>Several criteria are used to determine if a murmur is innocent or worrisome, including: </h3> <ul> <li><strong>Volume<br /> </strong>The loudness of the heart murmur is evaluated on a scale from 1 to 6. The loudest heart murmur is a 6.</li> <li><strong>Location<br /> </strong>The location of the murmur in the heart will be identified, along with whether the sound spreads to the neck or back. </li> <li><strong>Pitch<br /> </strong>The heart murmur may be high-, medium- or low-pitched.</li> <li><strong>Timing<br /> </strong>A heart murmur that occurs when blood leaves the heart is a systolic murmur. A murmur that occurs when the heart fills with blood is called a diastolic murmur. A murmur also may be heard throughout the heartbeat. When the murmur is heard as blood passes through the heart, it may be a sign of a larger heart problem.</li> </ul> <p>You will need to undergo testing to determine the cause of the heart murmur. Your healthcare professional likely will order an ultrasound picture of your heart, called an <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/echocardiogram/basics/definition/prc-20013918" target="_blank" title="Opens in a new window.">echocardiogram</a> or echo, to show detailed images of your heart's valves, chambers, structure and function.</p> <p>Once the cause of a heart murmur has been found, some people will need repeated evaluation over the years. Others may need surgery to treat the cause of the murmur, especially if it's to adjust a tight or leaky valve, or to close a hole in the heart.</p> <p>In some situations, people may need to take antibiotics before going to a dentist to protect the heart valves from potential infection. This infection, called <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/endocarditis/basics/definition/con-20022403" target="_blank" title="Opens in a new window.">endocarditis</a>, can be spread via the bloodstream during dental work. </p> <p>It's important to learn if a heart murmur is innocent or serious so you can get the proper treatment.</p> <h2>Next steps:</h2> <ul> <li><a href="http://https://www.mayoclinichealthsystem.org/providers?service=Cardiology" target="_self" title="Opens in same window.">Find a cardiologist</a> near you.</li> <li>Learn more about <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiology care</a> close to you.</li> <li>Read about a <a href="/hometown-health/speaking-of-health/treating-mitral-valve-regurgitation" target="_self" title="Opens in same window.">minimally invasive surgery to treat a leaky valve</a>.</li> </ul> <p><a href="/providers/michel-barsoum-md" target="_self" title="Opens in same window."><em>Michel Barsoum, M.B., Ch.B.</em></a><em>, is a <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiologist</a> and <a href="/services-and-treatments/vascular-medicine" target="_self" title="Opens in same window.">vascular medicine</a> specialist in <a href="/locations/chippewa-falls" target="_self" title="Opens in same window.">Chippewa Falls</a>, <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/rice-lake" target="_self" title="Opens in same window.">Rice Lake</a>, Wisconsin.</em></p> <ul> <li>Amyloidosis</li> <li>Aneurysms</li> <li>Carotid artery disease</li> <li>Peripheral artery disease</li> <li>Valve and coronary artery diseases</li> <li>Venous disorders, including varicose veins and blood clots</li> </ul> M.B., Ch.B. <p><strong>Education</strong></p> <ul> <li>University of Cairo-Egypt</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Sanford School of Medicine, University of South Dakota</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Vascular Medicine and Cardiology, Mayo Clinic College of Medicine</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Cardiology</li> <li>Internal Medicine</li> <li>Vascular Medicine</li> <li>Vascular Ultrasound</li> </ul> <p><strong>Membership</strong></p> <ul> <li>Fellow, Heart Failure Basic Science Research</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Barsoum<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/michel-barsoum-md.jpg?h=200&iar=0&w=200&sc_lang=en&hash=2D0F65B6CD4883F5C2A81125D313585C" alt="Michel Barsoum, M.D." width="200" height="200" DisableNVelocity="true" /> Michel<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14476029Michel Barsoum, M.B., Ch.B. 1{676428F6-179A-4C9B-9B23-5F1E40032A38}<img src="/-/media/national-files/images/hometown-health/2023/two-people-eating-outdoors.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1A1C786394365E819970AAE450314C28" alt="Two people eating outdoors" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller2/3/2015<p>You've decided to pursue weight-loss surgery. You've found out you're a good candidate and your insurance provides coverage. Now you're told that you have to stop the use of tobacco products before you can have surgery. Learn why it's necessary.</p>Tobacco products and weight-loss surgery<p>You’ve decided to pursue weight-loss surgery. You’ve found out your insurance provides coverage. You’ve attended all your pre- and post-operative appointments. You’ve discovered you are a good candidate surgery. Now you are told that you have to stop the use of tobacco products before you can have surgery. Why is this necessary?</p> <p>If you have had surgery before, you’ve been told that smoking affects your lung function, putting you at greater risk of anesthesia complications during and after surgery. Smoking can increase your risk of developing blood clots in your legs following surgery, which can lead to clots to your lungs, heart and brain. Smoking also decreases blood circulation, affecting the healing process of your incisions. Besides the risks to the heart and lungs, tobacco decreases blood flow to the lining of the stomach, leading to a threefold increased risk of ulcer formation in the surgically altered stomach and small intestine following weight loss-surgery.</p> <p>If you use tobacco products, you know how hard it is to stop. But to continue on this journey, you’ve decided to quit. Where do you begin?</p> <h2>In general, there are four phases to quitting smoking:</h2> <h3>1. Preparing to quit.</h3> <p>Make a list of all the reasons you’ve decided to quit smoking. Identify your smoking triggers (things that make you want to smoke). Learn why you smoke by keeping a journal noting when, where and with whom you smoke. Write down your feelings when you smoke. Are you angry, nervous, bored or depressed?</p> <h3>2. Choosing your quit date.</h3> <p>Whatever method of quitting you choose, your quit date is the day you stop smoking for good. You can prepare to quit by smoking fewer cigarettes, switching to a brand you don’t like, signing up for a smoking cessation program, or speaking with your healthcare provider about using a medication to help you cope or using nicotine replacement therapy.</p> <h3>3. Coping with withdrawal.</h3> <p>Nicotine is an addictive drug. Quitting can bring on temporary withdrawal symptoms, such as strong cravings, headaches, irritability, insomnia and difficulty concentrating. With help and support, you can overcome withdrawal symptoms.</p> <h3>4. Fighting slips and relapse.</h3> <p>This phase involves making changes in your lifestyle that help you stay free from smoking. Plan things to do when you feel the craving for a cigarette, such as going for a walk, chewing sugarless gum, brushing your teeth, or chewing on a celery or carrot stick.</p> <p>Resources that can help you are your primary care provider, Wisconsin Quit Line at 1-800-QUIT-NOW; the American Cancer Society and the American Lung Association.</p> <p><em>By Mayo Clinic Health System staff</em></p>Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Smoking and Tobacco UseSmokers and other tobacco users are more likely to develop disease and die earlier than are people who don't use tobacco. If you smoke, you may worry about what it's doing to your health. You probably worry too about how hard it might be to quit smoking. Nicotine is highly addictive, and to quit smoking — especially without help — can be difficult. In fact, most people don't succeed the first time they try to quit smoking. It may take more than one try, but you can stop smoking.Dawn Haller1/21/2015<p>It’s time we start seeing red. Red — as in the color of heart disease awareness, just as pink is the color we all take notice of in regard to breast cancer</p>Seeing red: Awareness of heart disease in women important<p>It's time we start seeing red.</p> <p>Red — as in the color of <a rel="noopener" href="http://www.mayoclinic.org/diseases-conditions/heart-disease/basics/definition/con-20034056" target="_blank" title="Opens in a new window">heart disease</a> awareness, just as pink is the color we all take notice of in regard to breast cancer. </p> <p>Heart disease is more deadly than all forms of cancer combined. (Yes, you read that right.) According to the <a rel="noopener" href="https://www.heart.org/" target="_blank" title="Opens in a new window.">American Heart Association</a>, while one in 31 American women dies from breast cancer each year, heart disease claims the lives of one in three. That's about one death each minute.</p> <p>So make sure you're as committed to heart disease prevention as you should be to your yearly mammogram. That means: Maintain a healthy weight. Keep your <a rel="noopener" href="http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/definition/con-20019580" target="_blank" title="Opens in a new window">blood pressure</a>, <a rel="noopener" href="http://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/blood-sugar/art-20046628" target="_blank" title="Opens in a new window">blood sugar</a> and <a rel="noopener" href="http://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/basics/definition/con-20020865" target="_blank" title="Opens in a new window">cholesterol</a> at healthy levels. Stop smoking. Or better yet, don't start. Stay physically and mentally active.</p> <p>The more we know about our nation's No. 1 killer of women, the better.</p> <h2>Here's a quick quiz on heart disease and women:</h2> <p><strong></strong></p> <h3>True or false: Heart disease only affects older women.</h3> <p><strong></strong></p> <p><strong>False. </strong>Heart disease affects women of all ages. The combination of birth control pills and smoking boosts heart disease risks by 20 percent in young women, the Heart Association says. Yes, our risk increases as we age. Overeating and leading a sedentary lifestyle are factors that lead to blocked arteries over time. But don't let your age lull you into a false sense of security. I take care of women of all ages in the hospital. Heart disease is an equal opportunity threat.</p> <p><strong></strong></p> <h3>True or false: Heart disease only affects women who don't take care of themselves.</h3> <p><strong></strong></p> <p><strong>False. </strong>Unfortunately, all the salads and yoga in the world can't eliminate your heart disease risk. (If only it were true!) Family history often plays a factor. You easily can be thin and have high cholesterol. </p> <p>Knowing your numbers can help. The American Heart Association recommends you start getting your cholesterol checked at age 20, or earlier, if your family has a history of heart disease. And be sure to have your blood pressure checked regularly.</p> <p><strong></strong></p> <h3>True or false: I feel fine; therefore, I am fine.</h3> <p><strong> </strong></p> <p><strong></strong></p> <p><strong>False. </strong>According to the Heart Association, 64 percent of women who die suddenly of coronary heart disease had no previous symptoms. </p> <p>And when women do experience <a rel="noopener" href="http://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/heart-disease/art-20046167" target="_blank" title="Opens in a new window">symptoms</a>, those signs often are misinterpreted. Women's symptoms often are vague: shortness of breath, nausea/vomiting and back or jaw pain. Other women experience dizziness, lightheadedness, pain in the lower chest or upper abdomen and extreme fatigue.</p> <p>You may be thinking, Ha! I feel back pain and fatigue all the time." I get that. I hope you're talking to your healthcare provider about all your concerns. But if something feels "off," if something feels "not right," don't wait. Trust your gut. Listen to your heart of hearts. Seek medical attention.</p> <p>Start seeing red.</p> <p><em>By Mayo Clinic Health System staff</em></p>Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller1/5/2023Shorter days and cold weather may leave you feeling depressed. If symptoms persist, it may be more than just the winter blues. Learn how to recognize SAD and get easy coping strategies.Seasonal affective disorder: Not just the winter blues<p>For many, the winter season is a joyous time filled with family, friends and great food. However, for others, winter months can be quite the opposite. Shorter days, cold weather and stress from the holidays can be challenging, leading to increased stress, sadness and even depression. </p> <p>While it may seem like "just the winter blues," some people may experience more persistent, pervasive symptoms of depression known as seasonal affective disorder.</p> <h2><strong>Why does seasonal depression increase in the winter?</strong></h2> <p><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651" target="_blank" title="Opens in a new window.">Seasonal affective disorder</a>, or SAD, is a form of major depression that some people commonly suffer from in the late fall and winter months. And more rarely, it may occur in early spring. </p> <p>Research shows that the greater the distance you live north or south of the equator, the greater the incidence of SAD cases. In the U.S., people are more likely to have SAD in the North than in the South. </p> <p>An explanation may be that reduced levels of sunlight disrupt the body's internal clock and may change the levels of serotonin, which affects mood, or melatonin, which plays a role in sleep patterns and mood. </p> <p>People tend to stay indoors more often when it's cold and dark. This can increase isolation and decrease the opportunity to share enjoyable activities with others, further contributing to sadness and depression.</p> <p>In addition, people may be less physically active or not exercise as much during winter, which can impact their sense of well-being. </p> <p>Those most likely to suffer from SAD are females and people with a family or personal history of mood disturbance. SAD is uncommon, although not unheard of, in those younger than 20 and older adults.</p> <h3>Common symptoms of seasonal affective disorder include:</h3> <ul> <li>Depressed mood, such as feeling more sad, down or numb</li> <li>Irritability or mood swings</li> <li>Problems getting along with others</li> <li>Fatigue and oversleeping</li> <li>Appetite changes, such as craving high-carbohydrate foods</li> <li>Weight gain</li> </ul> <h3>In the early spring, symptoms may include:</h3> <ul> <li>Depression</li> <li>Trouble sleeping</li> <li>Anxiety</li> <li>Weight loss</li> </ul> <p>People struggling with SAD are more likely to experience increased appetite, weight gain or hypersomnia (sleeping too much) compared to those with major depressive disorder without a seasonal variation. </p> <p>If you suspect that you or someone you care about may be struggling with SAD, seeking help from a qualified professional is the first step to feeling better.</p> <p>An evaluation by your health care team or a mental health counselor is crucial. SAD can lead to serious complications, such as social withdrawal, school and work problems, substance abuse, and suicidal thoughts or behaviors.</p> <h2>Contributing factors for seasonal affective disorder</h2> <p><strong> </strong></p> <p>SAD is thought to be caused by the seasonal change in exposure to light in the environment that occurs in the fall, winter and spring months. These changes may affect the amount of the hormone melatonin produced by the body in some people, resulting in abnormalities in neurotransmitters in the brain, such as norepinephrine, serotonin and dopamine.</p> <p>Melatonin, produced in the brain's pineal gland and triggered by darkness, influences the sleep/wake cycle. In the cold winter months, when you are more likely to stay indoors and daylight hours are shorter, increased melatonin production in those susceptible can increase the occurrence of SAD.</p> <p>Serotonin, a neurotransmitter in the brain, is believed to have a role in regulating mood. Serotonin levels also may decrease in response to a reduction in daylight hours, resulting in symptoms of depression. Some people experience an increased craving for carbohydrates during low-light months, as carbohydrates help generate serotonin production.</p> <p>Stress during the holidays can contribute to depression. Feeling pressure from others, yourself or your bank account can trigger an emotional roller coaster. These situations are all too common during the holiday season when buying gifts, planning holiday events and spending time with family.</p> <p>The holidays can be trying times for people who are separated from their loved ones by distance or death. Dealing with the absence of loved ones during the holidays – especially if they have passed away – can elicit strong emotions and episodes of depression.</p> <h2>Coping with seasonal affective disorder and lifestyle modifications</h2> <h4>Some of the best ways to prevent or improve a depressed mood are simple, and you can start today:</h4> <ul> <li>Eat a well-balanced diet. If you are not eating a nutritious diet, you are missing out on nutrients that promote a positive state of being. Specifically, consume foods such as fruits, vegetables, whole grains and nuts.</li> <li>Exercise moderately on a regular basis to improve your mood and energy levels.</li> <li>Get enough sleep. When you don't sleep enough, it affects your thoughts, mood and overall cognitive function. Sleep needs vary from person to person, but the National Sleep Foundation recommends between seven and nine hours for adults. Try to keep a consistent sleep schedule.</li> <li>Make time to interact with friends and loved ones. They supply a strong support system, which can help you deal with emotional difficulties. If a friend or family member is exhibiting symptoms of depression, reaching out to them can be helpful.</li> <li>Do something nice for someone else. Volunteering, donating to charity and performing random acts of kindness can be very rewarding. This is an effective way to add a spark back into your life.</li> </ul> <h2>Treatment interventions for seasonal affective disorder</h2> <p>Feeling sad or down now and then is a normal part of life — especially during difficult times or when mourning the loss of someone close to you. However, <a href="/hometown-health/speaking-of-health/seasonal-affective-disorder-more" target="_self" title="Opens in same window.">persistent feelings of sadness</a> or hopelessness may be signs of depression.</p> <p>It's time to contact your health care professional if these feelings interfere with your everyday life, you don't enjoy activities that you once did or you are having thoughts about suicide.</p> <h4>Evaluation and treatment for seasonal affective disorder may involve:</h4> <ul> <li><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/in-depth/seasonal-affective-disorder-treatment/art-20048298" target="_blank" title="Opens in a new window.">Using a light box</a> or bright light therapy may help alleviate SAD symptoms. When using bright light therapy or light box therapy, the light should be 10,000 lux. Light box therapy should be used in the morning, within the first hour of waking, for 30 minutes, such as while getting ready for work or eating breakfast. The light should be placed 1 to 2 feet from the face, making sure not to look directly at the light. </li> <li>Some people choose pharmacologic options to treat symptoms. Speak to your health care team to find out more about starting an antidepressant, such as a selective serotonin reuptake inhibitor (SSRI). Bupropion, an atypical antidepressant medication, is indicated by the Food and Drug Administration for seasonal affective disorder. </li> </ul> <h4>Other treatment interventions include: </h4> <ul> <li>Individual assessment and evaluation for depression/SAD</li> <li>Lifestyle changes to increase exposure to natural light</li> <li>Individual therapy using evidenced-based treatments</li> <li>Support groups and classes</li> </ul> <p>There are many qualified <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">physicians and mental health counselors</a> to assist in finding the help you need.</p> <p><a href="/providers/patrick-bigaouette-md" target="_self" title="Opens in same window."><em>Patrick Bigaouette, M.D.</em></a><em>, is a psychiatrist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Anxiety disorders</li> <li>LGBTQIA+ populations</li> <li>Medical education</li> <li>Mood disorders</li> <li>Peripartum psychiatry</li> <li>Psychopharmacology</li> <li>Trauma- and stressor-related disorders</li> <li>Women's health</li> </ul>M.D.<p>I enjoy working with patients in managing a wide spectrum of psychiatric disorders across psychosocial stages of life. I work in a collaborative, shared decision-making approach based on biologic, psychologic and social factors. My goal is to provide high-quality, evidence-based, patient-centered care to achieve the best possible outcomes in managing psychiatric distress.</p> <p>Outside of my clinical work, I am passionate about medical education and enjoy working with resident physicians and students.</p> <p>In moving back to Minnesota from the East Coast, I enjoy staying active outdoors, going to local theater, and I am always open to book recommendations.</p><p><strong>Education</strong></p> <ul> <li>Georgetown University School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Psychiatry, Mount Sinai-Beth Israel, Icahn School of Medicine at Mount Sinai</li> </ul> <p> <strong>Residency</strong> </p> <ul> <li>Psychiatry, Mount Sinai-Beth Israel, Icahn School of Medicine at Mount Sinai, New York</li> </ul> <p><strong>Certification</strong> </p> <ul> <li>Psychiatry, American Board of Psychiatry and Neurology </li> </ul> <p><strong>Membership</strong> </p> <ul> <li>American Psychiatric Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Psychiatry, Mayo Clinic College of Medicine and Science</li> </ul>Bigaouette<img src="/-/media/shared-files/images/medical-professionals/full/mankato/patrick-bigaouette-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4A09A81BD845D197A88A6FB7DC116F24" alt="Patrick Bigaouette MD" width="280" height="280" DisableNVelocity="true" />Patrick<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30014612Patrick Bigaouette, M.D.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2022/sitting-in-front-of-light-therapy.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1174E431F2A9DDEC029D54B5488548A9" alt="Sitting in front of light therapy" width="660" height="370" DisableNVelocity="true" />DepressionDepression is a medical illness that causes a persistent feeling of sadness, loss of interest and, sometimes, physical symptoms. It's also called major depression, major depressive disorder and clinical depression.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller1/8/2015Contact-sport athletes are at higher risk of acquiring skin infections. Find out which are more common and get prevention tips.Preventing three common skin infections in athletes<p>For many students, participation in athletics is an important part of their formative years. Kids acquire knowledge about teamwork, sportsmanship and much more. However, there are some things kids shouldn't acquire: skin infections.</p> <p>Because many sports like wrestling and basketball involve contact with other players, athletes are at more risk for developing some types of skin infections. Parents, athletes and coaches should be aware of common types of infections to prevent spreading the condition.</p> <p>Skin infections, particularly in athletes, are a serious problem. Statistics show they account for up to 10% of time-loss injuries in some sports and can cause serious illness.</p> <h2>Common types of skin infections</h2> <h3>The three most common infections are:</h3> <ul> <li><strong>Herpes</strong><br /> Herpes is the same virus that causes <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/cold-sore/basics/definition/con-20021310" target="_blank" title="Opens in a new window.">cold sores</a> in the mouth. It typically causes one or more painful blisters with clear fluid surrounded by redness.</li> <li><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/staph-infections/basics/definition/con-20031418" target="_blank" title="Opens in a new window."><strong>Staphylococcus aureus, or staph</strong></a><br /> Staph is a bacterium. It sometimes is resistant to certain types of antibiotics and is called methicillin-resistant staphylococcus aureus, or MRSA. Staph typically causes one or more painful sores with pus surrounded by redness and sometimes is associated with fever.</li> <li><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/ringworm/basics/definition/con-20021104" target="_blank" title="Opens in a new window."><strong>Tinea, or ringworm</strong></a><br /> Tinea is a fungus on the skin that causes itchy, dry, red, circular patches.</li> </ul> <h2>Prevention</h2> <p>Relatively simple measures can prevent skin infections from being passed among athletes. Hand washing and showering after practices or meets are the most important measures. In addition, athletes are advised to make sure they cover sores or wounds with a waterproof bandage, avoid shared personal items like towels or razors, avoid sharing lockers and wash their clothing after each practice or game. It’s also crucial to promptly seek medical attention with any new skin problems so infections can be caught and treated early.</p> <p>Athletes should inform their healthcare provider if they are participating in competitive sports. The provider will recommend whether or not the infection will temporarily prevent the athlete from participating in competitions or practice. It's important to keep yourself and your school environment as healthy as possible.</p> <p><em>By Mayo Clinic Health System staff</em></p>Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller4/1/2022<p>Has your weight loss slowed, or are the numbers on the scale creeping up? Here are 10 tips to help you get back on track.</p>10 tips for getting your weight loss back on track<p>Many people set weight loss goals at the start of a new year. Their dedication and resolve is strong in the beginning but can wane after just a few months. Long-lasting weight loss requires significant lifestyle changes and can be hampered by hormone changes.</p> <h2>If your weight loss slowed or your weight is creeping up, try these 10 tips to help you get back on track:</h2> <h3>1. Avoid skipping meals.</h3> <p> Eating at regular intervals will help manage hunger cues and prevent overeating due to being too hungry. </p> <h3>2. Maintain proper protein intake.</h3> <p>Protein is still necessary. Aim for 60 to 80 grams of protein per day from food sources. Consuming protein shakes may not be needed if you can meet your protein needs from food.</p> <h3>3. Meet carbohydrate needs.</h3> <p>Do so with whole grains and starches, such as quinoa, bulgur, fruit, low-fat dairy, whole-grain bread and legumes.</p> <h3>4. Reduce sweetened beverages.</h3> <p>Limit your sweetened beverage consumption. In addition, keep dairy to three total servings per day — including milk — unless otherwise instructed. Eating your calories rather than drinking them will help you feel full longer.</p> <h3>5. Remember guidelines.</h3> <h4>If you've had bariatric surgery, remember these basic guidelines for eating:</h4> <ul> <li>Eat slowly.</li> <li>Take small bites, and chew thoroughly.</li> <li>If you find you are finishing your meals in less than 20 minutes, try using an eat slower app.</li> <li>Don't drink within 30 minutes of a meal.</li> </ul> <h3>6. Make exercise part of your daily routine.</h3> <p> Regular physical activity is important for both weight loss and weight maintenance. For weight maintenance, the recommendation is a minimum of 150 minutes of moderate physical activity per week.</p> <h3>7. Set SMART goals for yourself.</h3> <p>These goals are Specific, Measurable, Attainable, Realistic and Timely. For example, instead of "I will exercise more," say "I will work up to 15 minutes of strengthening exercises using an exercise band every other day by Feb. 1."</p> <h3>8. Enjoy a wide range of foods.</h3> <p>It's OK to enjoy foods that taste sweet. Make decisions that honor your taste and provide great nutritional value. For example, choose a chocolate mint protein shake, high-protein cookie or protein bar, which allows you a sweet treat and adds protein to your diet.</p> <h3>9. One meal or one day will not make or break a diet.</h3> <p>It's what you do consistently over time.</p> <h3>10. Weigh yourself once a week or less.</h3> <p>True weight loss takes time. A year or more after bariatric surgery, you shouldn't expect to see more than ¼ to 1 pound of weight loss per week.</p> <p><em><a href="/providers/heidi-bednarchuk-cns" target="_self" title="Opens in same window.">Heidi Bednarchuk</a> is a clinical nurse specialist in <a href="/services-and-treatments/bariatric-surgery" target="_self" title="Opens in same window.">Bariatric Surgery</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a> and <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Weight-loss surgery</li> <li>Weight management</li> </ul>APRN, CNS<p>Weight is a very emotional issue and I like to think of my office as a “no blame, no shame zone.” My goal is to listen and understand my patient’s struggles and work together to develop a plan to address them. </p> <p>I have struggled with weight myself for most of my adult life and have a close family member that had bariatric surgery.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Nursing, Minnesota State University-Mankato</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Adult Health Clinical Nurse Specialist, American Nurses Credentialing Center</li> <li>Certified Bariatric Nurse, American Society for Metabolic and Bariatric Surgery</li> </ul> <p><strong>Membership</strong></p> <ul> <li>President-Elect, American Society for Metabolic and Bariatric Surgery</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Surgery, Mayo Clinic College of Medicine and Science</li> </ul>Bednarchuk<img src="/-/media/shared-files/images/medical-professionals/full/mankato/heidi-bednarchuk-cns.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4FA8ABD1C131281B9AB8444BFA59FB44" alt="Heidi Bednarchuk, C.N.S." width="280" height="280" DisableNVelocity="true" />Heidi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15681548Heidi Bednarchuk, APRN, CNS1{94B2E140-AEF8-44BA-B6A9-4538B77501BC}<img src="/-/media/national-files/images/hometown-health/2022/bowl-of-oats-with-fruit-and-yogurt.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BDAAAB46807BDA7E9BA6E65A0AD4FD32" alt="Bowl of oats with fruit and yogurt" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller12/19/2014<p>Are you looking for a way to trim extra calories off your cup of eggnog this holiday season? If not, perhaps you should consider the change. A dietitian shares ways to control holiday drink calories.</p>Healthy alternatives for eggnog<img alt="Romi Londre, R.D.N." style="width: 200px; height: 200px; float: right; margin-bottom: 5px; margin-left: 5px;" src="/-/media/shared-files/images/medical-professionals/full/eau-claire/romi-londre-rdn.jpg?h=200&w=200&sc_lang=en&hash=0B3048593AAC3DF0B3E9C98A9C609827" /> <p>Are you looking for a way to trim extra calories off your cup of eggnog this holiday season? If not, perhaps you should consider the change. On average, a cup of eggnog will cost you anywhere from 280 to about 400 calories. Here are a few ways to control holiday drink calories.</p> <p>When making your own eggnog recipe, cut the amount of sugar you would normally use in half. Instead, you can enhance the sweetness of your drink by adding a touch of nutmeg, cinnamon, vanilla or citrus. The strong flavor of these ingredients means that you don't need to add as much of it to get the taste you desire. </p> <p>If you are really looking to knock out some calories, consider purchasing soy nog or rice nog. These alternatives to regular eggnog contain less fat and nearly half the calories of regular store-bought eggnog.</p> <p>Vanilla chai tea is also a great holiday alternative for those with non-dairy diets. As with most unsweetened black teas, chai tea by itself will have no fat or cholesterol and is a calorie-free drink. A chai tea latte made with chai spices, black tea and skim, soy, or almond milk is a lighter option if you want something creamy. </p> <p>Remember to use pasteurized eggs in your eggnog recipes to prevent the risk of salmonella. There are always risks involved when consuming raw or partially cooked eggs. <a rel="noopener" href="https://www.mayoclinic.org/healthy-living/pregnancy-week-by-week/in-depth/pregnancy-nutrition/art-20043844" target="_blank" title="Opens in a new window.">Pregnant women should not consume eggnog</a> since they are at increased risk of bacterial food poisoning, which is more likely to occur in raw foods. </p> <p>It's important to practice moderation during the holidays. Allow yourself some treats, but make sure you're including fruits, vegetables and lean protein with your meals. You'll be less likely to overdo it on higher calorie foods. Limit treats to one to two per day, and try to balance out your days by eating lighter meals after you've overindulged at a party.</p> <p><a href="/providers/romi-londre-rdn"><em>Romi Londre</em></a><em> is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition Services</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Eating disorders</li> <li>Enteral nutrition or tube feedings</li> <li>Weight management</li> </ul>RDN, CD<p><strong>Education</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Registered Dietitian Nutritionist</li> <li>Certified Nutrition Support Clinician </li> <li>Certificate of Training in Adult Weight Management</li> </ul> <div> </div>Londre<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/romi-londre-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7919B2F8260054ECC4308684471EEEDB" alt="Romi Londre RDN" width="280" height="280" DisableNVelocity="true" />Romi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15183670Romi Londre, RDN, CD1{2BEE5070-65FF-4406-9E59-103E06C5A535}<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/romi-londre-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7919B2F8260054ECC4308684471EEEDB" alt="Romi Londre RDN" width="280" height="280" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller3/9/2022If you need surgery, feeling anxious is normal. Review 6 common Q&A to help you feel more comfortable and prepared.Preparing for surgery? What you need to know<p>It's official. You need surgery.</p> <p>You may have many thoughts and questions running through your head, whether it is a minor, same-day procedure or a complex operation that requires you to stay in the hospital overnight. You may even feel anxious, confused or scared.</p> <p>While these emotions are normal and expected, there are things you can do to feel more comfortable and calm your nerves.</p> <h3>Review the answers to 6 common questions as you prepare for your surgery:</h3> <h4>1. How can I make sure I am healthy and ready for surgery?</h4> <p>As you prepare for surgery, do what you can in the weeks and days before to prepare mentally and physically.</p> <h5>Here are some things you can do to ensure you're ready:</h5> <ul> <li>Attend all appointments and educational seminars as directed by your surgeon.</li> <li>Take your medications as directed.</li> <li>Reduce or quit smoking.</li> <li>Eat healthy foods, such as fruits, vegetables, lean meats and whole grains, and drink enough fluids to stay well-hydrated.</li> <li>Get plenty of rest.</li> <li>Arrange support from family or friends during and after surgery, including transportation to and from the hospital.</li> </ul> <h4>2. Does everyone need a physical exam before surgery?</h4> <p>No. Your surgical team will determine if a physical exam is required before your surgery.</p> <p>Generally, a physical exam is not required for patients who are scheduled for a low-risk surgical procedure; are not taking any prescriptions; and don't have chronic health conditions, like high blood pressure, diabetes, obesity or heart disease.</p> <p>If you don't have a physical exam before surgery, a member of the anesthesia team will meet with you on the day of your surgery to answer questions and gather information about your overall health.</p> <h4>3. Why do some patients need a physical exam before surgery?</h4> <p>A preoperative physical exam helps your surgical team determine if you are healthy enough to undergo anesthesia and surgery. This is sometimes referred to as being optimized for surgery.</p> <p>The exam gives your surgeon and anesthesiology team important information about your health so they are prepared and can tailor your surgical care to your specific medical needs. It also could identify problems or issues that may complicate or delay your planned surgery. In these situations, other health problems could be addressed before proceeding with surgery to ensure you have the safest possible operation.</p> <p>Your primary care provider should complete a preoperative physical exam within 30 days of your scheduled surgery date. A Preoperative Exam Clinic, also called POE, is an option at some Mayo Clinic Health System locations if you do not have a primary care provider or cannot schedule an appointment with your primary care provider during this time frame.</p> <h4>4. What happens during a preoperative exam?</h4> <h5>Your preoperative exam will:</h5> <ul> <li>Measure your height, weight and vital signs.</li> <li>Review your medication list, with recommendations for how to take your medications prior to surgery.</li> <li>Review your medical, surgical and family history.</li> <li>Include a physical exam.</li> <li>If necessary, complete additional preoperative testing following your exam, including blood tests, urine tests, X-rays or an EKG.</li> </ul> <h4>5. What should I bring with me to the hospital?</h4> <p>Just as you would for a weekend getaway, take time to pack necessities and a few comfort items when you have surgery.</p> <h5>These items will make your surgery safe, smooth and comfortable:</h5> <ul> <li>A list of all medications you take or medications in their original bottles.</li> <li>A list of materials or medications that you are allergic to or that have caused adverse reactions, such as latex or iodine.</li> <li>All current insurance cards, pharmacy and drug benefit cards, medical device identification cards, and driver's license or other photo identification card.</li> <li>A copy of your advance directive or living will, if you have one.</li> <li>Information about your pacemaker or internal defibrillator, if you have one.</li> <li>Any special equipment that you use, such as a cane, walker or continuous positive airway pressure machine (CPAP), as well as ostomy or insulin pump supplies.</li> <li>Comfortable, loose-fitting clothing to wear home or during your hospital stay.</li> <li>Slip-on walking shoes or nonskid slippers.</li> <li>Items to help pass the time while you wait, such as a book, music, phone or magazine.</li> </ul> <p>Remove and leave jewelry, including body piercing jewelry, at home. Also, arrange for children or family members who require supervision to stay at home during your surgery.</p> <h4>6. What can I expect on the day of my surgery?</h4> <p>A nurse or care team member will call a few days before your surgery with information about your procedure, what you can eat or drink, visitor guidelines and how to be notified of your arrival time for surgery. You may have received this information at your preoperative physical exam in the POE clinic. Follow all directions carefully.</p> <p>Most patients need to arrive at the hospital at least one hour before the surgery start time. Your surgical team will do their best to avoid long wait times, but please understand delays or changes in the operating room schedule could affect your surgical time.</p> <p>After check-in, you are taken to a preoperative area, where a member of your care team will gather information like your health history and vital signs. They also will be available to answer your questions. You will wait in this area until the operating or procedure room is available.</p> <p>After your surgery, you will be brought to the Post Anesthesia Care Unit, also known as the PACU or the recovery room. Care team members will monitor your vital signs, alertness, pain or discomfort, and the need for medications. How long you stay in the PACU is determined by the anesthetic you received, the time it takes for you to wake up, and room assignment if you are staying overnight in the hospital. If you are going home the same day, you may return to the preoperative area. Most patients stay here for at least two hours after their surgery is complete.</p> <p>After surgery, it's important to follow your surgeon's instructions carefully. This may include information on activity restrictions, medication instructions, dietary restrictions, incision care, follow-up appointment information and more.</p> <p>Remember that recovery is a gradual process. Allow yourself time to recover after your surgery or procedure. Let family and friends help you if you need it and talk with your surgeon if you have questions.</p> <p><em><a href="/providers/elizabeth-cumberland-cnp" target="_self" title="Opens in same window.">Elizabeth Cumberland</a> is a nurse practitioner in <a href="/services-and-treatments/anesthesiology" target="_self" title="Opens in same window.">Anesthesiology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Evaluating health and risk factors prior to surgery</li> <li>Malignant hyperthermia </li> <li>Pre-anesthesia medical examination</li> </ul>APRN, C.N.P.<p>My goal is to help my patients navigate through the steps to a successful surgery. They can expect a comprehensive evaluation with clear preoperative instructions and answers to their questions. I strive to deliver care that meets their individual needs. </p> <p>I grew up in the Mankato area and am grateful to be raising my family in this community. I enjoy exploring everything southwest Minnesota has to offer as well as traveling with my friends and family.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Nursing - Family Nurse Practitioner, King University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Nurse Practitioner, American Nurses Credentialing Center</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Nurses Association</li> <li>American Nurses Credentialing Center</li> <li>Sigma Theta Tau International Honor Society of Nursing</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Anesthesiology, Mayo Clinic College of Medicine and Science</li> </ul>Cumberland<img src="/-/media/shared-files/images/medical-professionals/full/mankato/liz-cumberland-cnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=2E8218DFBB572048D09EAE35DE98B313" alt="Liz Cumberland CNP" width="280" height="280" DisableNVelocity="true" />{F9620CB8-653E-4316-AD51-8C9918498BBE}Liz<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16088638Liz Cumberland, APRN, C.N.P.1<img src="/-/media/national-files/images/hometown-health/2022/person-with-wavy-medium-brown-hair.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3224CABCCAD3C6CFA84E6E9E97DA9519" alt="Person with wavy medium brown hair" width="660" height="370" DisableNVelocity="true" />SurgeryHaving surgery is a major event in your life. We know this and make every effort to keep you as comfortable as possible, focusing on you as an individual. Our surgeons and staff work as a coordinated team treating a wide variety of illnesses ranging from simple to complex. We offer comprehensive, advanced care and service to every patient.Dawn Haller2/23/2024Winter is beautiful, but the cold, ice and snow can be treacherous for many people. Learn how smart decisions can keep you safe — and out of the emergency department — during the winter season.Smart decisions improve your winter health<p>Winter is beautiful, but it can be treacherous. The cold, ice and snow add complexities to our lives — and potentially our health. Many things can happen during the season that cause people to end up in the emergency department. Here is some advice to keep you healthy and safe.</p> <h2>Be prepared in cold weather</h2> <p>Arctic-like temperatures can be dangerous to many, especially the young and the elderly.</p> <h3>Take these precautions to ensure you and your family are safe:</h3> <ul> <li>Avoid lengthy exposure to <a href="/hometown-health/speaking-of-health/tips-for-cold-weather-training" target="_self" title="Opens in same window.">cold weather</a>.</li> <li>Dress in several layers of clothing.</li> <li>Pay special attention to protecting your feet, hands, head, ears and nose from extremely low temperatures.</li> <li>Stay well-hydrated if you're going to spend any length of time in the cold outdoors.</li> <li>Skip tight clothing.</li> </ul> <h2>Watch out for signs of frostbite</h2> <p>Frostbite is a serious condition. The first step in preventing frostbite is to know when you're most at risk. Your risk is higher if you smoke, have a blood vessel disease like diabetes, aren't wearing proper clothing, are dehydrated or tired and if you're at a higher altitude.</p> <h3>Once you understand your risk, take these measures to prevent frostbite:</h3> <ul> <li><strong>Limit your time outdoors in cold, wet or windy weather.</strong><br /> In cold, windy weather, exposed skin can develop frostbite in minutes.</li> <li><strong>Dress in several layers of loose, warm clothing.</strong><br /> Air trapped between the layers of clothing acts as insulation against the cold.</li> <li><strong>Wear a hat or headband that fully covers your ears.</strong><br /> Heavy wool or windproof materials make the best headwear for cold protection.</li> <li><strong>Wear mittens rather than gloves.</strong><br /> Mittens provide better warmth for your fingers.</li> <li><strong>Plan to protect yourself.</strong><br /> When traveling in cold weather, carry emergency supplies and warm clothing in case you become stranded. If you're traveling in remote territory, tell others your route and expected return date.</li> </ul> <h2>Be aware of carbon monoxide poisoning</h2> <p>Carbon monoxide is an odorless, colorless gas produced by burning gasoline, wood, propane, charcoal or other fuel. Carbon monoxide poisoning happens when the gas builds up in your bloodstream. More than 100,000 people go to an emergency department and more than 400 people die due to <a rel="noopener" href="https://www.cdc.gov/carbon-monoxide/about/" target="_blank" title="Opens in a new window.">accidental carbon monoxide poisoning</a> each year, according to the Centers for Disease Control and Prevention (CDC). This occurs more often during the winter because people burn fuel for heat and often are in closed spaces.</p> <h3>Here are some simple things that you can do to prevent carbon monoxide poisoning:</h3> <ul> <li><strong>Install a carbon monoxide detector.</strong><br /> If the alarm sounds, leave your house and call 911 immediately. Don't forget to check the batteries in your carbon monoxide detector every time you check batteries in your smoke detectors ― at least twice a year.</li> <li><strong>Open the garage door before starting your car.</strong><br /> Never leave your car running in the garage because carbon monoxide gas can quickly build to dangerous levels.</li> <li><strong>Keep your furnace and other fuel-burning appliances properly vented and serviced.</strong><br /> This includes water heaters, cooking ranges, fireplaces, space heaters and charcoal grills. Don't bring outdoor fuel-burning heaters or grills inside.</li> <li><strong>If you have a fireplace, keep it in good repair.</strong><br /> Clean your fireplace chimney and flue every year.</li> </ul> <h2>Avoid slips and falls</h2> <p>Fall-related injuries accounted for more than 6.9 million emergency department visits in 2021, according to the <a rel="noopener" href="https://www.nsc.org/work-safety/safety-topics/slips-trips-and-falls" target="_blank" title="Opens in a new window.">National Safety Council</a>.</p> <h3>Here are some tips for preventing slips and falls:</h3> <ul> <li><strong>Wear the right shoes.</strong><br /> Properly fitted shoes increase comfort, reduce fatigue and improve safety.</li> <li><strong>Take your time.</strong><br /> If you notice that the floor or ground doesn't have much traction, walk slowly and be careful with each step.</li> <li><strong>Walk safely.</strong><br /> Move slowly and try <a href="/hometown-health/speaking-of-health/keeping-your-winter-balance" target="_self" title="Opens in same window.">shuffling to prevent slips</a>, trips and falls.</li> <li><strong>Stay aware.</strong><br /> Watch out for uneven ground, protruding structures, holes and debris that can cause slips, trips and falls. Also, be aware of ice- and snow-packed surfaces that increase the risk of falling.</li> <li><strong>Be cautious when exiting your vehicle.</strong><br /> Parking lots are often snow-packed and icy. Hold on to the door while getting out of your vehicle.</li> </ul> <p>Staying healthy is important at all times of the year, and winter is no exception. Keep these tips in mind as you enjoy winter.</p> <h4>In this Mayo Clinic Radio interview video, I share additional tips for avoiding winter hazards:</h4> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/1Nrt7ZIo8zs" title="Avoiding Winter Emergencies" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <h2>Learn more about winter safety:</h2> <ul> <li>Get <a href="/hometown-health/speaking-of-health/tips-for-safe-snow-shoveling" target="_self" title="Opens in same window.">tips for safe snow shoveling</a>.</li> <li>Learn <a href="/hometown-health/speaking-of-health/winter-weather-are-falls-and-slips-avoidable" target="_self" title="Opens in same window.">how to avoid winter slips and falls</a>.</li> <li>Remember <a href="/hometown-health/speaking-of-health/top-10-essentials-to-pack-for-your-outdoor-winter-adventure" target="_self" title="Opens in same window.">10 essentials to pack for your outdoor winter adventure</a>.</li> </ul> <p><a href="/providers/susan-cullinan-md" target="_self" title="Opens in same window."><em>Susan Cullinan, M.D.</em></a><em>, is an <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">Emergency Medicine</a> physician in <a href="/locations/barron" target="_self" title="Opens in same window.">Barron</a>, <a href="/hometown-health/speaking-of-health/smart-decisions-improve-your-winter-health" target="_self" title="Opens in same window.">Bloomer</a>, <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, <a href="/locations/menomonie" target="_self" title="Opens in same window.">Menomonie</a> and <a href="/locations/osseo" target="_self" title="Opens in same window.">Osseo</a>, Wisconsin.</em></p>M.D.<p>In this Mayo Clinic Radio broadcast, Dr. Cullinan shares tips for avoiding winter safety hazards, such as carbon monoxide poisoning, frostbite and falls:</p> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/1Nrt7ZIo8zs" title="Avoiding winter safety hazards" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p><p><strong>Education</strong></p> <ul> <li>University of North Dakota School of Medicine-Grand Forks</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Emergency Medicine, Regions Hospital</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Emergency Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Emergency Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Cullinan<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/susan-cullinan-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=6AB9207BEF59A14D0AFF9305C60F5DAB" alt="Susan Cullinan, M.D." width="280" height="280" DisableNVelocity="true" />Susan <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13892924Susan Cullinan, M.D.1<img src="/-/media/national-files/images/hometown-health/2024/person-wearing-furry-winter-gear.jpg?h=370&iar=0&w=660&sc_lang=en&hash=279096E69C85F4B97E748DBCE0E8CA22" alt="Person wearing furry winter gear" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Dawn Haller11/21/2014<p>Cold and flu season is here. Symptoms of an ordinary common cold are hard not to miss. But could it be worse? Pertussis can mask itself as a cold but can pose serious health risks – especially to unvaccinated babies.</p>What you need to know about pertussis<p>It's that time of year. Cold and flu season is here. Symptoms of an ordinary common cold are hard not to miss. But could it be worse? Pertussis can mask itself as a cold but can pose serious health risks – especially to unvaccinated babies.</p> <p>Pertussis is also commonly known as whooping cough. Children and adults alike can contract whopping cough. Yet, a simple vaccination could have prevented most cases.</p> <p>Whooping cough can take one to three weeks for signs and symptoms to appear. They're usually mild at first and resemble those of a common cold:</p> <ul> <li>Runny nose</li> <li>Nasal congestion</li> <li>Sneezing</li> <li>Red, watery eyes</li> <li>A mild fever</li> <li>Dry cough</li> </ul> <p>After a week or two, signs and symptoms worsen. Thick mucus accumulates inside your airways, causing uncontrollable coughing. Severe and prolonged coughing attacks may:</p> <ul> <li>Provoke vomiting</li> <li>Result in a red or blue face</li> <li>Cause extreme fatigue</li> <li>End with a high-pitched "whoop" sound during the next breath of air</li> </ul> <h2>Why is it so contagious?</h2> <p>Pertussis is a highly contagious respiratory tract infection. It is often marked by a severe hacking cough followed by a high-pitched intake of breath that sounds like "whoop." However, the characteristic "whooping" cough may be absent.</p> <p>Pertussis is caused by bacteria. When an infected person coughs or sneezes, tiny germ-laden droplets are sprayed into the air and breathed into the lungs of anyone who happens to be nearby.</p> <p>It is on the rise because the whooping cough vaccine one receives as a child eventually wears off. This leaves most teenagers and adults susceptible to the infection during an outbreak.</p> <h2>What are the treatment options?</h2> <p>Treatment for older children and adults who have pertussis can usually be managed at home. Antibiotics kill the bacteria causing pertussis and help speed recovery. Family members may be given preventive antibiotics.</p> <p>Stay home from school or work for five days after receiving antibiotic treatment.</p> <h2>How can I make the coughing spells better?</h2> <p>Unfortunately, not much is available to relieve the cough, but these tips can help those who are being treated for pertussis at home:</p> <ul> <li>Get plenty of rest</li> <li>Drink plenty of fluids</li> <li>Eat smaller meals</li> <li>Vaporize the rooms in your house</li> <li>Keep the air clean</li> <li>Prevent transmission by washing your hands regularly throughout the day</li> </ul> <h2>Is pertussis preventable?</h2> <p>The best way to prevent whooping cough is with the pertussis vaccine. Health care providers recommend beginning vaccination during infancy. Although most pertussis vaccinations are given during infancy, there is also a vaccination called the TDaP vaccination that is offered beyond infancy. This is a very important vaccine that is offered at the 11-year-old (pre-adolescent) well child check-up. Revaccination at age 11 is recommended because of the wearing off of the immunization described above.</p> <p>If you suspect you or your child has pertussis, call the <a href="/services-and-treatments/nurse-line" target="_self" title="Opens in same window.">Nurse Line</a> for expert advice. If appropriate, you or your family member may be treated with antibiotics via a pertussis exposure protocol, without an office visit. The nurse line is available 24/7 for Mayo Clinic Health System patients.</p> <p><em>By Mayo Clinic Health System staff</em></p>Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Immunizations<p>Disease prevention is crucial to your health. Getting vaccinated is one of the best ways to maintain good health, and protect you and those you care about against infectious diseases. Vaccinations offer protection against serious diseases by stimulating the immune system to create antibodies against certain bacteria or viruses.</p><br/><p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/vaccine-guidance/art-20536857" target="_blank" title="Opens in a new window.">Get vaccine guidance from Mayo Clinic</a>, including benefits, safety, side effects and what to know about recommended vaccines for babies, children, teens, adults and during pregnancy. For recommended vaccines based on age, refer to the <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/adult" target="_blank" title="Opens in a new window.">adult</a> or <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/child" target="_blank" title="Opens in a new window.">child and adolescent</a> schedules.</p><br/><p>Review the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/coronavirus-covid-19/history-disease-outbreaks-vaccine-timeline" target="_blank" title="Opens in a new window.">history of infectious disease outbreaks and vaccines timeline</a> for information about major disease outbreaks, epidemics and pandemics, and the impact of vaccines and research.</p>Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Dawn Haller11/18/2014<p>It’s that time of year again — family feasts, workplace treats and holiday parties. The holiday season can be quite challenging after bariatric surgery. The good news is that you can still enjoy this time with family and friends. The key is to plan ahead and enjoy in moderation.</p>10 tips to enjoy the holidays after bariatric surgery<img alt="Heidi Bednarchuk C.N.S." src="/-/media/shared-files/images/medical-professionals/full/mankato/heidi-bednarchuk-cns.jpg?h=200&w=200&sc_lang=en&hash=8F92868B9EAEA54E318FE3436D8AEF0E" style="width: 200px; height: 200px; float: right; margin-top: 0px; margin-bottom: 10px; margin-left: 10px;" /> <p>It’s that time of year again — family feasts, workplace treats and holiday parties. The holiday season can be quite challenging after bariatric surgery. The good news is that you can still enjoy this time with family and friends. The key is to plan ahead and enjoy in moderation.</p> <p>Here are 10 tips to help maintain your weight during the holiday season:</p> <h4>1. Don’t save your calories.</h4> <p>Although it may be tempting to skip meals to save your calories for holiday treats, it’s better to stick to your regular eating patterns. You are more likely to overindulge if you arrive at the party hungry.</p> <h4>2. Don’t forget the basics.</h4> <p>Just because it’s the holidays doesn’t mean you can’t maintain the same healthy eating habits. Pay attention to portion sizes, start with protein, eat slowly and track your intake.  Keeping these basic rules in mind will help avoid overeating.</p> <h4>3. Be mindful.</h4> <p> Eating while socializing can easily lead to eating too much. Enjoy the conversation and company. Save eating for a time when you can focus on the food, enjoying the flavor and texture.</p> <h4>4. Steer clear of the buffet table and kitchen.</h4> <p> Standing close to the food may result in mindless nibbling. Carefully select items you truly want to try, and then move away.</p> <h4>5. Go easy on the alcohol.</h4> <p> For starters, alcoholic drinks are full of empty calories. It’s better to eat your calories than drink them. And remember, in addition to adding calories, alcohol actually can dehydrate you. You also should be aware that alcohol can affect you differently after bariatric surgery. You may feel the effects much sooner with less alcohol. You’re also more likely to overindulge at the buffet table after a couple drinks</p> <h4>6. Drink plenty of water.</h4> <p> It’s important to stay hydrated and plan ahead. This ensures you can avoid drinking within 30 minutes of eating and still get in 64 ounces a day.  </p> <h4>7. Exercise.</h4> <p> The holidays can be a busy time, and it’s easy to let exercise routines fall by the wayside. It’s much easier to get out of the habit of exercising than it is to get back into it once the holidays are over. Consider scheduling a time for exercise or organizing family activities that get everyone moving.</p> <h4>8. Bring a dish to share.</h4> <p> That way, you can be certain there is a healthy option at the gathering</p> <h4>9. Choose healthier options.</h4> <p>Give your favorite recipes a healthy makeover or look for alternatives that cut the fat and calories. For example:</p> <ul> <li>Use skim milk instead of whole milk in your mashed potatoes</li> <li>Use fat-free creamed soups in your recipes rather than the full-fat versions</li> <li>Consider substitutes for sugar, such as unsweetened apple sauce or noncaloric sweeteners</li> <li>Add flavor with garlic, spices and herbs rather than fats, such as butter and gravy</li> <li>Combine 1/4 cup Greek yogurt with 1/2 cup butter to replace 1 cup of butter in a recipe</li> <li>When baking your favorite holiday treats, replace each egg with two egg whites, and substitute evaporated skim milk in place of heavy cream</li> </ul> <h4>10. Be kind to yourself.</h4> <p> So you overindulged a bit. Maybe you sampled a few too many goodies. That doesn’t mean all is lost. Forgive yourself, recommit to healthy patterns and move on. And remember, it’s OK to allow yourself an occasional treat.</p> <p><em><a href="/providers/heidi-bednarchuk-cns" target="_self" title="Opens in same window.">Heidi Bednarchuk</a> is a clinical nurse specialist in <a href="/services-and-treatments/bariatric-surgery" target="_self" title="Opens in same window.">Bariatric Surgery</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a> and <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p> <hr /> <h4>HOLIDAY RECIPE IDEAS</h4> <ul> <li>Eggnog: Blend together four bananas, 1 1/2 cups skim milk, 1/ 1/2 cups plain nonfat yogurt and 1/4 teaspoon rum extract. Top with 1/4 teaspoon nutmeg. <em>(Recipe from UCLA Center for Obesity and Metabolic Health)</em></li> <li>Add flavor to protein shakes. Adding vanilla, nutmeg, cinnamon and pumpkin purée is an easy way to make a delicious holiday shake. Around Christmas, try adding sugar-free mint syrup to a chocolate shake.</li> </ul><ul> <li>Weight-loss surgery</li> <li>Weight management</li> </ul>APRN, CNS<p>Weight is a very emotional issue and I like to think of my office as a “no blame, no shame zone.” My goal is to listen and understand my patient’s struggles and work together to develop a plan to address them. </p> <p>I have struggled with weight myself for most of my adult life and have a close family member that had bariatric surgery.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Nursing, Minnesota State University-Mankato</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Adult Health Clinical Nurse Specialist, American Nurses Credentialing Center</li> <li>Certified Bariatric Nurse, American Society for Metabolic and Bariatric Surgery</li> </ul> <p><strong>Membership</strong></p> <ul> <li>President-Elect, American Society for Metabolic and Bariatric Surgery</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Surgery, Mayo Clinic College of Medicine and Science</li> </ul>Bednarchuk<img src="/-/media/shared-files/images/medical-professionals/full/mankato/heidi-bednarchuk-cns.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4FA8ABD1C131281B9AB8444BFA59FB44" alt="Heidi Bednarchuk, C.N.S." width="280" height="280" DisableNVelocity="true" />Heidi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15681548Heidi Bednarchuk, APRN, CNS1{94B2E140-AEF8-44BA-B6A9-4538B77501BC}<img src="/-/media/shared-files/images/medical-professionals/full/mankato/heidi-bednarchuk-cns.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4FA8ABD1C131281B9AB8444BFA59FB44" alt="Heidi Bednarchuk, C.N.S." width="280" height="280" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller12/9/2022For many people, this time of year brings hopes of beautiful moments with family and friends. For some, it also may be the start of the "season of stress." Get tips to set realistic expectations.Coping with holiday stress: Keeping realistic expectations<p>The holiday season is just weeks away. For many, this time of year brings hopes of beautiful moments spent with family, friends and loved ones. Visions of roasting chestnuts on an open fire, a snowy Christmas just like the ones you used to know and rockin' around the Christmas tree.</p> <p>These moments may be among the most cherished in your life. So why can they be the most stressful?</p> <h2>What causes holiday stress?</h2> <p>Whenever something is important, extra attention is paid to it, and you want to become involved to take part. This also means that you carry expectations influenced by your memories, desires and environment. </p> <p>The smell of grandma's home cooking at Thanksgiving, your favorite Christmas cookies, and the sights and sounds of the season in your home or community. This is portrayed in books, movies and the media to become the mental representations by which you measure happiness and satisfaction. </p> <p>You may direct your energy toward creating the perfect experience. Often, events out of your control — finances, travel plans, past and present relationships, health and current events — interfere with your vision of the perfect holiday season. This can lead to stress and unhappiness.</p> <h2>Setting realistic expectations</h2> <p>The key to coping is being realistic about your expectations. Finances may be a cause of stress during the holidays. Take a few moments to write down your anticipated expenses, a budget for gifts, travel and special holiday traditions. </p> <p>People can get caught up in the hunt for the most popular toy or gift and forget the importance of the holiday season. The thought behind the gift is more important than the cost of the gift. Consider baking a treat or offering your talents or time to your loved ones. </p> <p>Set aside funds for those unforeseen expenses and stick to your budget. Remember that overspending now invariably leads to regret and difficulty later.</p> <p>Holiday travel often is complicated. Families today are geographically separated more than ever. You may find yourself <a href="/hometown-health/speaking-of-health/resilience-prepping-for-a-busy-holiday-season" target="_self" title="Opens in same window.">juggling multiple holiday events</a> in a short time frame. Speak with your loved ones about what you and your family can realistically do for your schedule. Allow yourself time for travel, and prioritize events as you are able. The pressure of feeling that you must be in two, or sometimes even three, places at once is enough to take the fun out of any event.</p> <h2>Live in the moment, not in the past</h2> <p>Expectations from past years can lead to feelings of not doing enough in preparation. It's important to clarify what others' expectations are and to state your own. It's also important to prioritize your mental health during the holiday season. This can mean saying "no" or setting boundaries. Give yourself permission to decline things that do not serve you. </p> <p>People change, and, as a result, your holidays change. Sometimes, compromising on having a gathering either just before or after the actual holiday is necessary. Remember that the time spent together is most important, more so than the date on the calendar.</p> <h2>Create a mindset of graciousness</h2> <p>When facing complicated past or present relationships, focus on modeling graciousness. Take responsibility for your feelings and actions. Your friends, family and loved ones also are responsible for their feelings and actions. </p> <p>You don't have control over whether others make the choice you would want. This is where graciousness comes in. You can focus on your best manners and make time to discuss difficult topics another day.</p> <p>Finally, as much as you would like the holidays to be devoid of sadness, anxiety and other negative emotions, the reality is that life is going on around you all the time. You have feelings to inform you about what to pay attention to. </p> <p>Remembering emotions come and go can allow yourself to feel the emotions freely. Avoiding emotions tends to be detrimental in the long term. <a href="/hometown-health/speaking-of-health/discovering-calm-in-the-chaos" target="_self" title="Opens in same window.">Practice healthy coping skills</a>, such as meditation, deep breathing or exercise, to assist your mood. </p> <p>Having a realistic expectation that the holidays won't banish your adverse reactions or emotions can help you cope with the stressors that arise. Allow yourself to set realistic expectations and extend your graciousness to others to have an enjoyable time with those you love.</p> <p><a href="/providers/kayla-wojciechowski-licsw" target="_self" title="Opens in same window."><em>Kayla Wojciechowski</em></a><em> is a clinical social worker in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Adjustment disorders</li> <li>Anxiety disorders</li> <li>Attention-deficit/hyperactivity disorder (ADHD) assessments</li> <li>Cognitive behavioral therapy (CBT) techniques</li> <li>Depressive disorders</li> <li>Grief and loss</li> <li>Mac Initiative support (organization that helps cope with stillborn birth or infant loss)</li> <li>Mindfulness techniques</li> <li>Postpartum mood disorders</li> <li>Psychoeducation</li> <li>Trauma </li> </ul>L.I.C.S.W.<p>I provide short-term therapy for individuals from childhood to adulthood. My approach to therapy is based on many different modalities but primarily focuses on cognitive behavioral therapy and solution-focused therapy.</p> <p>My collaborative approach to therapy will assist you in identifying goals and finding the best solution to meet those goals. By treating you as an expert in your own life, I can further assist you in seeing your strengths.</p> <p>During my free time, I enjoy spending time with my French bulldog, Bentley, as well as my husband, family and friends. I love spending time outdoors, whether it be walking my dog, fishing on the lake or just enjoying the sunshine.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Social Work, Winona State University</li> <li>Master's degree, Clinical Social Work, University of St. Thomas/St. Catherine's University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Mental Health, U.S. Department of Veterans Affairs</li> <li>Skilled Nursing Social Work, Ebenezer Ridges Care Center</li> </ul>Wojciechowski<img src="/-/media/shared-files/images/medical-professionals/full/mankato/kayla-wojciechowski-licsw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=CB02CD9ABAAC1503DD0349B4D48271E3" alt="Kayla Wojciechowski, L.I.C.S.W." width="280" height="280" title="Kayla Scott, L.G.S.W." DisableNVelocity="true" />Kayla<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21158134Kayla Wojciechowski, L.I.C.S.W.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}|{C4130004-0F31-48C4-AC9F-A4350A75AB24}|{F26710D2-A52B-47C8-986C-0B3D1DA0A9D0}<img src="/-/media/national-files/images/hometown-health/2022/child-and-parent-holiday-crafting.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EFA473FAD5F92B051EFD02CBD00B1155" alt="Child and parent holiday crafting" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller11/7/2014<p>Pelvic pain can be caused by multiple conditions. Learn about pelvic pain causes, symptoms and treatment options.</p>Do you suffer from pelvic pain?<img alt="Jessica Alm DO" src="/-/media/shared-files/images/medical-professionals/full/mankato/jessica-alm-do.jpg?h=200&w=200&sc_lang=en&hash=0752715F7C73BE7C2D572007926CA53E" style="width: 200px; height: 200px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <h2>What is pelvic pain?</h2> <p>Pelvic pain in the lowest part of your abdomen, back and pelvis. This can be caused by several different conditions. The first step to finding relief is to realize that you are not alone. Believe it or not, up to 24% of women ages of 15–75 have reported experiencing pelvic pain. And women are not the only ones afflicted by this — men can suffer from pelvic pain as well. If you are one of these people living with pelvic pain or know someone who is, read on.</p> <h2>Symptoms</h2> <p>Depending on the source of the pain, it is often described as dull or sharp; mild, moderate, or severe; constant; or only present with certain activities, such as urination and intercourse. The pain can be located in the pelvic region and/or radiate into the back, hips and groin. Other symptoms that can accompany pelvic dysfunction are urinary leakage or constipation.</p> <h2>Causes</h2> <p>There is a long list of possible causes for pelvic pain. The pain could be referred from reproductive, digestive, or urinary organs. In addition, the pain can be from abnormalities in the muscles, nerves or ligaments of the pelvic floor.</p> <h2>Treatment options</h2> <p>Treatment depends on the source of the pelvic pain. It is important to talk to your healthcare provider so they can identify the cause and direct the appropriate treatment. Depending on the source of the pain, you may need to be referred to a urologist, gynecologist, gastroenterologist or physiatrist. Some of the possible treatment options include physical therapy, medications, injections or surgical procedures.</p> <p><a href="/providers/jessica-alm-do" target="_self" title="Opens in same window."><em>Jessica Alm, D.O.</em></a><em>, is a physiatrist in <a href="/services-and-treatments/physical-medicine-and-rehabilitation" target="_self" title="Opens in same window.">Physical Medicine & Rehabilitation</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Amputee care </li> <li>Botox injections </li> <li>Lumbosacral fluoroscopic injections</li> <li>Musculoskeletal and spine disorders</li> <li>Osteopathic manipulative treatment</li> <li>Pelvic floor disorders</li> <li>Spasticity management </li> <li>Spinal cord injury</li> <li>Traumatic brain injury </li> <li>Trigger point injections </li> <li>Ultrasound-guided injections</li> </ul>D.O.<p>I treat each patient as an individual with their own unique story and tailor treatment recommendations accordingly.</p><p><strong>Medical School</strong></p> <ul> <li>A.T. Still University, Missouri</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Northeast Regional Medical Center, Missouri</li> </ul> <p><strong>Residency</strong></p> <ul> <li>University of Missouri, Columbia</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Undergraduate Osteopathic Manipulative Medicine</li> </ul> <p> <strong>Memberships</strong> </p> <ul> <li>American Academy of Physical Medicine and Rehabilitation</li> <li>American Medical Association</li> <li>International Pelvic Pain Society</li> <li>Spine Intervention Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine and Science, Rochester, Minnesota</li> </ul>Alm<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jessica-alm-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=3FE08780527191B1215C1EFA22C858CE" alt="Jessica Alm DO" width="280" height="280" DisableNVelocity="true" />{82E54506-4EDC-42F0-BB06-9BBBC4A566CE}Jessica<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15387313Jessica Alm, D.O.1{4EA2A40E-3721-48EC-AFC9-E6D0E13BCDEC}<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jessica-alm-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=3FE08780527191B1215C1EFA22C858CE" alt="Jessica Alm DO" width="280" height="280" DisableNVelocity="true" />Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller8/8/2023Everyone needs to take care of their eyes, but when you have diabetes, eye care is especially important. Learn how new AI technology can help detect a common eye issue in people with diabetes.Diabetes and your eyes<p>Diabetes is a prevalent condition worldwide, affecting approximately 10% of the population. It's a condition that happens because of a problem in the way the body regulates and uses sugar as fuel. It is a systemic disease affecting many organs, including the heart, blood vessels, nerves, kidneys and eyes.</p> <p>While eye care and regular eye exams are important for everyone, they're particularly vital for people with diabetes. Let's explore why routine eye care is so important.</p> <h2>Understanding diabetic retinopathy</h2> <p>The eye, a vital part of your vision, contains a sensitive layer called the retina. The blood vessels in the retina can be affected by <a href="/hometown-health/speaking-of-health/how-to-live-well-with-diabetes" target="_self" title="Opens in same window.">diabetes</a>, leading to a condition known as <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/diabetic-retinopathy/symptoms-causes/syc-20371611" target="_blank" title="Opens in a new window.">diabetic retinopathy</a>. This condition gradually damages these blood vessels and can progress through various stages of severity.</p> <p>When diabetic retinopathy develops, eye damage can occur before symptoms develop. There often are no symptoms until the retinopathy has reached a moderate or advanced stage. In the advanced stage, diabetic retinopathy can cause rapid, permanent vision loss.</p> <p>Diabetic retinopathy is the leading cause of vision loss worldwide in people ages 25 to 74. By 2030, an estimated 191 million people globally will have diabetic retinopathy, and 56.3 million people with diabetes will have vision-threatening diabetic retinopathy.</p> <h2>AI-assisted software aids in diabetic retinopathy screening</h2> <p>For people with diabetes, regular eye screening is part of their annual exam with their primary care provider.</p> <p>The Food and Drug Administration (FDA) approved the first autonomous artificial intelligence (AI) system which aids in detecting diabetic retinopathy. The system captures an ocular photograph of the eye's retina to identify early signs of vessel damage. The ocular photograph is quick and designed for your comfort during the process.</p> <p>If the screening detects diabetic retinopathy, your healthcare team will refer you to retinal specialists or an ophthalmology specialist for further evaluation and management of the condition.</p> <h2>Treating diabetic retinopathy</h2> <p>Prevention remains the best approach for diabetic retinopathy. Early detection and diligent management by an ophthalmologist can slow the progression or halt diabetic retinopathy. A prompt diagnosis increases the chances of a favorable outcome.</p> <h3>Even if your annual eye exam showed no issues, it's crucial to report any of these symptoms to your healthcare team right away:</h3> <ul> <li>Blurred vision</li> <li>Double vision</li> <li>Dark or empty spot in the center of your vision </li> <li>Difficulty reading</li> <li>Difficulty seeing well at night</li> <li>Droopy eyelid</li> <li>Eye pain</li> <li>Flashing lights</li> <li>Halos around lights</li> <li>Objects that look larger or smaller than usual</li> <li>Sudden appearance of spots or floaters</li> </ul> <p>These symptoms may indicate you need a change in your eyeglass or contact lens prescription, or signal other more serious diseases, such as diabetic-related ocular complications like diabetic retinopathy.</p> <p>Strict control of your <a href="/hometown-health/speaking-of-health/closing-the-loop-with-insulin-pumps" target="_self" title="Opens in same window.">blood glucose</a> levels reduces your risk of developing vision loss from diabetic retinopathy. In addition, you should control high blood pressure and cholesterol, as they can affect the retinal health of your eyes.</p> <p><a href="/providers/wayne-wu-md" target="_self" title="Opens in same window."><em>Wayne Wu, M.D.</em></a><em>, is a vitreoretinal surgeon and <a href="/services-and-treatments/ophthalmology" target="_self" title="Opens in same window.">ophthalmologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Vitreoretinal</li> </ul>M.D., Ph.D.<p><strong>Medical School</strong></p> <ul> <li>University of Michigan-Ann Arbor</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Transitional, University of Pennsylvania-Philadelphia</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Ophthalmology, University of Pennsylvania-Philadelphia</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Vitreo Retinal Diseases/Surgery, Vanderbilt University </li> </ul> <p><strong>Certification</strong></p> <ul> <li>Ophthalmology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Ophthalmology, Mayo Clinic College of Medicine and Science</li> </ul>Wu<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/wayne-wu-md.jpg?h=200&iar=0&w=200&sc_lang=en&hash=F7E7C316F063DFC063552EF6FCF175C5" alt="Wayne Wu MD" width="200" height="200" DisableNVelocity="true" />Wayne<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15162214Wayne Wu, M.D., Ph.D.1{C5680DDD-C649-4B63-AFCC-B52A244736B7}<img src="/-/media/national-files/images/hometown-health/2023/lifting-eyeglasses-looking-at-phone.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9E8B3F44DB36CD690196EFDF578FFB4D" alt="Lifting eyeglasses looking at phone" width="660" height="370" DisableNVelocity="true" />Eye HealthYour eyes are responsible for providing you with vision, perhaps the most important of the senses. However, the eye is a delicate and complicated structure that needs protection. The ugly truth is that eye injuries can happen at any time and place.DiabetesIf you have diabetes, no matter what type, it means you have too much glucose in your blood, although the reasons may differ. Too much glucose can lead to serious health problems.Transforming HealthcareExpert insight into using innovative technology to identify trends and develop procedures, diagnostics and next-generation care models to advance medicine, and provide healing today and in the future.Dawn Haller11/3/2014<p>The trees aren't the only thing that should be colorful this fall. With summer gone, pumpkins, sweet potatoes and other fall foods are making their debuts in farmers markets and grocery stores, ready to color your plate.</p>Get your fill of fall superfoods<p>By Mayo Clinic staff </p> <p>The trees aren't the only thing that should be colorful this fall. With summer gone, pumpkins, sweet potatoes and other fall foods are making their debuts in farmer’s markets and grocery stores, ready to color up your plate. Find out what the best superfoods are this fall.</p> <h4>POTATOES</h4> <p>Sweet potatoes usually take the cake for being a fall superfood. Sweet potatoes are high in vitamin A, a vitamin linked to decreasing risks of cancer.</p> <img height="120" alt="sweetpotato" width="350" src="/-/media/national-files/images/hometown-health/2014/superfoods-post/sweetpotato.jpg?la=en&sc_lang=en&hash=504438DC9CF039A285E931FA023197AB" class="img-responsive"> <p>What may surprise you is the health benefits of your average, everyday potato.</p> <p>The white potato has a bad reputation, based on the fact that it’s a starch and high in carbohydrates, which our society has wrongly convinced themselves they need to cut. However, the white potato actually holds a lot of nutritional value.</p> <p>In the white potato’s defense, it’s high in vitamin C, which greatly aids beating those fall/cold-weather colds and boosts your immune system.</p> <img height="144" alt="whitepotato" width="386" src="/-/media/national-files/images/hometown-health/2014/superfoods-post/whitepotato.jpg?la=en&sc_lang=en&hash=7CA97C99BD2FEC4C1F670FDC22D5E124" class="img-responsive"> <h4>DARK GREENS</h4> <p>There’s a reason your mom tried to get you to eat spinach. In light of what dark leafy greens have to offer for health, you might want to willingly eat them. The best of the bunch include spinach, kale and collard greens, and here’s why:</p> <p>Any dark green means the vegetable is packed full of vitamin A, an antioxidant that serves as a huge booster to the immune system and healthy cell growth.</p> <img height="380" alt="greens" width="360" src="/-/media/national-files/images/hometown-health/2014/superfoods-post/greens.jpg?la=en&sc_lang=en&hash=8F450AB4F61B28ED24C32897B60C54D4" class="img-responsive"> <h4>WINTER SQUASH/PUMPKIN</h4> <p>Your pumpkin spice latte may be far from healthy, but pumpkins still make the cut for a top superfood. </p> <img height="242" alt="pumpkinsquash" width="442" src="/-/media/national-files/images/hometown-health/2014/superfoods-post/pumpkinsquash.jpg?la=en&sc_lang=en&hash=FD48BC420780BD18362C5775C82F6711" class="img-responsive"> <p>If you have trouble sleeping, consider saving your pumpkin seeds. They are loaded with magnesium. Studies show magnesium aids in sleep and muscle relaxation, so save those pumpkin seeds for a late-night snack if you’re feeling restless.</p> <h4>APPLES</h4> <p>The saying goes, an apple a day keeps the doctor away, and there’s a reason doctors encourage you to eat them. Though they aren't high in many vitamins, nutritionists argue that they serve as a healthy alternative when you’re reaching for the sweet treats. They’re also high in fiber.</p> <img height="123" alt="apples" width="391" src="/-/media/national-files/images/hometown-health/2014/superfoods-post/apples.jpg?la=en&sc_lang=en&hash=4104142163E825F5187E6739471AE89F" class="img-responsive"> <h4>BROCCOLI</h4> <p>Broccoli continues to be on the list of general superfoods, but in fall, it's prime for boosting your immune system with high vitamin C levels. While the fall air is crisp and refreshing, the air we breathe on a day-to-day basis isn't always the most pure. A <a href="http://www.medicalnewstoday.com/articles/278369.php" target="_blank" title="Opens in a new window.">study</a> found that broccoli produces a compound that detoxifies air pollutants in the body.</p> <img height="134" alt="broccoli" width="410" src="/-/media/national-files/images/hometown-health/2014/superfoods-post/broccoli.jpg?la=en&sc_lang=en&hash=354C3933238F27B3BF85BC8EA4D9E4C5" class="img-responsive"> <hr> <p><span style="font-size: 15px; font-weight: bold; color: #131313;">FAST AND FABULOUS FALL RECIPE</span></p> <p>To make the most of fall superfoods, try this 160-calorie, quick-and-easy-to-make snack to get your essential nutrients and still be a part of the fall spirit.</p> <img height="583" alt="pumpkindipi" width="784" src="/-/media/national-files/images/hometown-health/2014/superfoods-post/pumpkindipi.jpg?la=en&sc_lang=en&hash=7FB8E3A5E5D243F7AFEBA61B0B9059DA" class="img-responsive"><img src="/-/media/national-files/images/hometown-health/2014/superfoods-post/superfood_small.jpg?h=75&iar=0&w=75&sc_lang=en&hash=51315F201C88656A376ABCECACE45A6A" alt="superfood_small" width="75" height="75" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller9/16/2014<p>Congratulations! It’s an exciting time for you. Understanding the basics of prenatal care can help prepare you for this 40-week (or so) journey. Here are a few tips to keep in mind as you learn of your pregnancy. </p>Yes, I’m pregnant! Now what? 3 tips to a smooth start<img height="370" alt="Couple with positive pregnancy test" width="660" src="/-/media/national-files/images/hometown-health/2020/couple-with-positive-pregnancy-test.jpg?sc_lang=en&hash=C8C1464BC5A11DC72A57139FBA931DD9" /> <p>Congratulations! It’s an exciting time for you. Understanding the basics of prenatal care can help prepare you for this 40-week (or so) journey.</p> <h4>Here are 3 tips to keep in mind as you learn of your pregnancy:</h4> <h5>1. Take prenatal vitamins and folic acid.</h5> <p>If possible, consider taking prenatal vitamins even before trying to get pregnant. They are available at any drug store and do not require a prescription. Another important nutrient you need daily is folic acid, which helps to prevent birth defects, such as spina bifida. </p> <p>The U.S. Preventive Services Task Force recommends women planning pregnancy consume at least 800 micrograms (mcg) of folic acid daily. Taking an over-the-counter prenatal vitamin that has 800 micrograms folic acid and an extra over-the-counter folic acid pill (400 micrograms) once daily will provide your unborn baby the necessary nutrients for development.</p> <p>In early pregnancy, you may experience morning sickness. This common nausea during pregnancy can affect women any time of day or night. If you find it difficult to swallow a large prenatal vitamin, you also may try two chewable children’s vitamins plus the extra folic acid mentioned above.</p> <h5>2. Schedule a prenatal care visit. </h5> <p>It also is important to schedule an appointment with an obstetrics provider to confirm and discuss your pregnancy. Some important considerations when choosing a provider are availability, personality and experience. This is the time to ask questions about the pregnancy and birth process that concern you. Would you like to see the same provider for all your prenatal care, including the delivery? This type of personal care may be available in your community by family medicine providers who deliver babies at a local hospital. Other options include obstetricians, midwives and nurse-midwives.</p> <p>Your prenatal care will be tailored for you based on your health history and other factors involving your pregnancy. However, a typical timeline for prenatal care visits might look like this:</p> <ul> <li>8–12 weeks: First prenatal care visit, which may involve a pelvic exam, blood tests and an ultrasound</li> <li>20–24 weeks: Ultrasound and blood tests</li> <li>28 weeks (or before): Attend childbirth education classes</li> <li>36 weeks: Weekly visits to check the baby’s position and your cervix for dilation</li> </ul> <h5>3. Involve the baby’s father.</h5> <p> Encourage your baby’s father to come with you to all your appointments. He, too, may ask questions about the process and what is expected when the baby arrives. This will help prepare him for a new responsibility — caring for you and your baby. </p> <p> A healthy start for your baby begins with you. Proactive health choices in the beginning stages of pregnancy will pay off when your new baby is born. </p><img src="/-/media/national-files/images/hometown-health/2020/couple-with-positive-pregnancy-test.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1827747F9E4199A985D3D38EF2BB301A" alt="Couple with positive pregnancy test" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller11/1/2021Flu season is just around the corner. Learn how to put up your best defense and decrease your chances of getting the flu.Facts about flu<p>Flu season is quickly approaching, and it is something everyone should prepare for, especially amid the COVID-19 pandemic. Influenza, or the flu, typically peaks in January and February, and it's associated with illness ranging from the mild to the severe. At times, patients with flu-related complications may need to be hospitalized. The Centers for Disease Control (CDC) estimates that influenza-related deaths annually range in the tens of thousands.</p> <h4>What is the flu?</h4> <p> Flu is a general term for seasonal influenza, which is a viral infection that attacks your respiratory system. Symptoms often come on suddenly and may seem like a cold at first, with a runny nose or congestion, sneezing and sore throat.</p> <h5>These symptoms typically progress and may include symptoms also common with COVID-19, including: </h5> <ul> <li>Fever or feeling feverish (not all will experience fever with the flu)</li> <li>Body aches and muscle stiffness</li> <li>Chills and sweats</li> <li>Headaches</li> <li>Cough</li> <li>Fatigue and weakness</li> <li>Nasal congestion</li> </ul> <p>If you have any of these shared symptoms, contact your care team for guidance. You may need testing for both.</p> <p>It's important to note that seasonal influenza is not the same thing as what many people refer to as the stomach flu, which is a common term for an intestinal infection that causes diarrhea, abdominal cramping, nausea and vomiting.</p> <h4>How does the flu travel?</h4> <p>The influenza virus travels through the air in droplets. You can inhale the droplets when an infected person sneezes, coughs or speaks and aerosolizes the virus. Less likely, you also can pick up the virus by touching objects previously contaminated and then inoculate yourself by touching your eyes, nose or mouth.</p> <h4>How does the flu affect people?</h4> <p>If you are young and healthy, the flu usually is self-limiting, meaning it will resolve with supportive care. However, high-risk people can develop serious complications from the flu — most notably, pneumonia — which can lead to respiratory failure and death.</p> <h5>People in the high-risk category include:</h5> <ul> <li>Young children</li> <li>Adults over age 65</li> <li>Pregnant women</li> <li>People with chronic illnesses, especially chronic lung conditions</li> <li>People with weakened immune systems</li> </ul> <h4>How can chances of getting the flu be decreased?</h4> <h5>There are several simple steps you can take to decrease your chance of getting the flu:</h5> <h5>1. Get an annual vaccination. </h5> <p>The CDC recommends annual flu vaccination for everyone 6 months and older. The flu vaccine is available as an injection or a nasal spray. While the vaccine isn’t 100% effective, it is, by far, your best defense from getting the flu. You cannot get the flu from being vaccinated, as the vaccination contains inactivated, or killed, virus or weakened virus incapable of causing the disease. </p> <h5>2. Wash your hands. </h5> <p>Practicing good hand hygiene not only can keep you from catching the flu, but also prevents other common infections. Scrub your hands vigorously for at least 20 seconds with soap and water. Alcohol-based hand sanitizer also can be effective. Learn how to <a href="/hometown-health/speaking-of-health/clean-up-your-hand-washing-skills" target="_self" title="Opens in same window.">clean up your hand-washing skills</a>, and download a flyer and coloring sheet about hand-washing.</p> <h5>3. Cover your coughs and sneezes. </h5> <p>Whenever you cough or sneeze, you should cover your nose and mouth with a tissue, or use the "vampire" method by pulling your arm up and coughing or sneezing into your sleeve at the elbow. Try not to cough or sneeze into your hands.</p> <h5>4. Social distance during peak flu season. </h5> <p>The influenza virus spreads easily wherever people congregate, including child care centers, schools, office buildings, auditoriums and public transportation. Avoiding larger groups during peak flu season can lower your chances of catching the flu. You also should stay home from work and school when ill to prevent further spread of the virus.</p> <p>Usually, rest and drinking plenty of fluids are the two best treatments for most cases of the flu. Antiviral medications, which can shorten the duration of symptoms, may be appropriate for some people. If symptoms progress and are severe, or if you are at a high risk for influenza-related complications, then seeing your provider early is an important part of protecting your health.</p> <p><em><a href="/providers/jeffrey-green-md" target="_self" title="Opens in same window.">Jeff Green, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> provider in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a>, Minnesota.</em></p><ul> <li>Dermatologic procedures</li> <li>Full-range of family medicine, geriatrics to pediatrics</li> </ul>M.D.<p>I strive to be a good listener and enjoy explaining the miracle that is the human body. I work collaboratively with my patients to ensure its’ proper function — thereby securing the blessing that is good health.</p> <p>I enjoy spending time with my family, especially my wife. I enjoy activities that include gardening, bicycling and caring for all the creatures — great and small — that share our haven of a hobby farm on ten acres in beautiful southern Minnesota. My faith is very important to me and my family, and I enjoy being active in my church.</p><p><strong>Education</strong></p> <ul> <li>University of Utah School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, North Iowa Mercy Health Center</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Medicine, American Board of Family Medicine</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Academy of Family Physicians</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Green<img src="/-/media/shared-files/images/medical-professionals/full/fairmont/jeffrey-green-md.jpg?h=280&iar=0&w=280&hash=96CC72E5F4C4BFDF03F20BA72F0165D0" alt="Jeffrey Green MD" width="280" height="280" DisableNVelocity="true" />{36CF08EC-0806-48AA-8539-2E8B551F7D48}Jeffrey<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13650441Jeffrey Green MD1{B3F96F77-F93E-41A4-AE4E-603045CDB443}<img src="/-/media/national-files/images/hometown-health/2021/working-on-laptop-corded-earbuds.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C12BB52BEDFEE05B2C261E7A74EC3881" alt="Sitting on floor working on laptop and using corded earbuds" width="660" height="370" DisableNVelocity="true" />Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.InfluenzaInfluenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza, commonly called the flu, is not the same as the stomach "flu" viruses that cause diarrhea and vomiting.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Immunizations<p>Disease prevention is crucial to your health. Getting vaccinated is one of the best ways to maintain good health, and protect you and those you care about against infectious diseases. Vaccinations offer protection against serious diseases by stimulating the immune system to create antibodies against certain bacteria or viruses.</p><br/><p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/vaccine-guidance/art-20536857" target="_blank" title="Opens in a new window.">Get vaccine guidance from Mayo Clinic</a>, including benefits, safety, side effects and what to know about recommended vaccines for babies, children, teens, adults and during pregnancy. For recommended vaccines based on age, refer to the <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/adult" target="_blank" title="Opens in a new window.">adult</a> or <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/child" target="_blank" title="Opens in a new window.">child and adolescent</a> schedules.</p><br/><p>Review the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/coronavirus-covid-19/history-disease-outbreaks-vaccine-timeline" target="_blank" title="Opens in a new window.">history of infectious disease outbreaks and vaccines timeline</a> for information about major disease outbreaks, epidemics and pandemics, and the impact of vaccines and research.</p>COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Dawn Haller8/11/2014<p>Children and parents are gearing up for the start of another school year. Preparation for the hallways means shopping for backpacks, clothes and other school supplies. But don't overlook your child's health before the first bell rings.</p>Back-to-school health tips<p>Children and parents are gearing up for the start of another school year. Preparation for the hallways means shopping for backpacks, clothes and other school supplies. While these items are all part of a successful learning experience, making sure your children are healthy in all capacities should be the highest priority. Ensuring the health of your children will help them succeed and help put you at ease.</p> <p>Here are a few back-to-school tips to make your kids' educational experience healthier.</p> <h2>Well-child exams</h2> <p>A well-child exam is a comprehensive health checkup for children of all ages. The exam includes a sports physical for student athletes and looks at many aspects of health for all kids.</p> <p>Preteen and teen patients are able to discuss any health and well-being concerns with their healthcare team. Additionally, providers educate young patients about drinking, drug use, weight issues, the importance of helmet and seat belt use, and sexuality.</p> <p>For young children, providers evaluate where your child ranks based on age-appropriate developmental milestones. For example, at two weeks, an infant's feeding habits and growth are monitored. At five years old, knowledge of the ABCs, basic colors and home address is tested. The healthcare team will also use the time to update immunizations if needed.</p> <h2>Vaccinations</h2> <p>Vaccinations are vital in order to keep children healthy, especially young children. Vaccinations are safe and can be administered in groups if your child is behind schedule. Receiving vaccinations helps keep your child and his or her classmates safe.</p> <h3>Leading healthcare providers and the CDC recommend these vaccinations:</h3> <ul> <li>Diphtheria/tetanus/pertussis</li> <li>Haemophilus influenza B</li> <li>Hepatitis A</li> <li>Hepatitis B</li> <li>Human papilloma virus</li> <li>Influenza</li> <li>Meningococcal</li> <li>MMR</li> <li>Pneumococcal</li> <li>Polio</li> <li>Rotavirus</li> <li>Varicella (chickenpox)</li> </ul> <p>Talk with your healthcare provider about vaccines and any concerns you may have.</p> <h2>Bullying</h2> <p>Unfortunately, bullying occurs far too often in elementary, junior high and high schools across the country. The most important thing for parents to do is to not take bullying lightly.</p> <h3>Teach your children these tactics to address bullies productively:</h3> <ul> <li>Don't fight back.</li> <li>Maintain composure.</li> <li>Say "stop" confidently.</li> <li>Walk away.</li> <li>Use humor or neutral responses.</li> <li>Ask teacher or school officials for help.</li> </ul> <p>If your child is accused of bullying, make sure he or she knows that bullying behavior is unacceptable.</p> <h2>Nutrition</h2> <p>Eating nutritiously is integral to overall health for people of all ages, including children. However, children do need different amounts of nutrients based on age. Check the Dietary Guidelines for Americans to help measure the specific nutrient levels needed for your children.</p> <h3>Nutrient-heavy foods that should be incorporated into your children's diets include:</h3> <ul> <li>Dairy</li> <li>Fruits</li> <li>Grains</li> <li>Protein</li> <li>Vegetables</li> </ul> <p>In the whirlwind that is school preparation, be sure to emphasize health. Don't bypass health checkups, vaccinations, anti-bullying education and nutrition. Use these elements and others to create a plan that will support the improvement and sustainability of your child's well-being.</p> <p><a href="/providers/kimberly-beecher-md" target="_self" title="Opens in same window."><em>Kimberly Beecher, M.D.</em></a><em>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/mankato">Mankato</a>, Minnesota.</em></p><ul> <li>Children's health</li> <li>Women's health</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Rural Family Medicine, University of Minnesota, Waseca</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Medicine, American Board of Family Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>Minnesota Academy of Family Physicians</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Beecher<img src="/-/media/shared-files/images/medical-professionals/full/mankato/kimberlybeechermd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=F07207855B431B37A5BB156D208C3111" alt="Kimberly Beecher, M.D." width="280" height="280" title="Kimberly Beecher, M.D." DisableNVelocity="true" />{B713AB90-4522-4FC1-BBAB-1649682F881A}Kimberly<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14150999Kimberly Beecher, M.D.1{248CBBB9-E59F-4E83-9DF4-2692D1F58514}Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Immunizations<p>Disease prevention is crucial to your health. Getting vaccinated is one of the best ways to maintain good health, and protect you and those you care about against infectious diseases. Vaccinations offer protection against serious diseases by stimulating the immune system to create antibodies against certain bacteria or viruses.</p><br/><p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/vaccine-guidance/art-20536857" target="_blank" title="Opens in a new window.">Get vaccine guidance from Mayo Clinic</a>, including benefits, safety, side effects and what to know about recommended vaccines for babies, children, teens, adults and during pregnancy. For recommended vaccines based on age, refer to the <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/adult" target="_blank" title="Opens in a new window.">adult</a> or <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/child" target="_blank" title="Opens in a new window.">child and adolescent</a> schedules.</p><br/><p>Review the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/coronavirus-covid-19/history-disease-outbreaks-vaccine-timeline" target="_blank" title="Opens in a new window.">history of infectious disease outbreaks and vaccines timeline</a> for information about major disease outbreaks, epidemics and pandemics, and the impact of vaccines and research.</p>Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Childhood ObesityUnderstanding what causes obesity and providing healthy alternatives can help lead your child down a lifelong path of wellness.Dawn Haller9/4/2014<p>Concussions are a hot topic in sports, especially when it comes to the health of our children. What is a concussion? How is it diagnosed? How can it be prevented? Learn all this and more.</p>What is a concussion?<p>A concussion is a traumatic brain injury that alters the way your brain functions. Although concussions usually are caused by a blow to the head, even a "ding," "getting your bell rung," or what seems to be a mild bump or blow to the head can be serious. As many as 3.8 million sports- and recreation-related concussions occur in the U.S. each year.</p> <h2>Signs and symptoms of concussion include:</h2> <ul> <li>Headache or a feeling of pressure in the head</li> <li>Temporary loss of consciousness</li> <li>Confusion or feeling as if in a fog</li> <li>Amnesia surrounding the traumatic event</li> <li>Dizziness or "seeing stars"</li> <li>Ringing in the ears</li> <li>Nausea or vomiting</li> <li>Slurred speech</li> </ul> <h3>Some symptoms of concussions may be immediate or delayed in onset by hours or days after injury:</h3> <ul> <li>Concentration and memory complaints</li> <li>Irritability and other personality changes</li> <li>Sensitivity to light and noise</li> <li>Sleep disturbances</li> <li>Psychological adjustment problems and depression</li> <li>Disorders of taste and smell</li> </ul> <h2>Danger signs for parents</h2> <p>Be alert for symptoms that worsen over time.</p> <h3>Your child or teen should be seen in an Emergency Department right away if they have:</h3> <ul> <li>One pupil (the black part in the middle of the eye) larger than the other</li> <li>Difficult to arouse</li> <li>Severe headache or worsening headache</li> <li>Weakness, numbness, or decreased coordination</li> <li>Repeated vomiting or nausea</li> <li>Slurred speech</li> <li>Convulsions or seizures</li> <li>Difficulty recognizing people or places</li> <li>Increasing confusion, restlessness, or agitation</li> <li>Unusual behavior</li> <li>Loss of consciousness (even a brief loss of consciousness should be taken seriously).</li> </ul> <p><strong><a href="/-/media/national-files/images/hometown-health/2014/concussionflyerweb_blog.jpg?sc_lang=en&hash=896A5E62E5CC1E3B19A9E676F53CF2A2">View and print a flyer about concussions</a>.</strong></p>ConcussionA concussion is a traumatic brain injury that alters the way your brain functions. Although concussions usually are caused by a blow to the head, even a “ding,” “getting your bell rung,” or what seems to be a mild bump or blow to the head can be serious. As many as 3.8 million sports- and recreation-related concussions occur in the U.S. each year.Dawn Haller11/18/2021People considering suicide often don't want to die. Instead, they are seeking relief from emotional and mental pain. Learn how you can help.Suicide isn't always about dying, it may be about perceived relief<p>"I don't want to die. I just don't want to live."</p> <p>This statement represents many conversations between mental health professionals and patients contemplating suicide. As a care provider, loved one, parent or friend, hearing this statement is terrifying. But it could be viewed as a sign of hope. Your loved ones may not want to die. They may just want relief.</p> <p>Many times, people considering suicide view it as a way to end the emotional or physical pain they are experiencing, or resolve stressful life experiences. Keys to help loved ones is to remind them that suicide is a permanent solution to persistent challenges, there are many alternatives to alleviate the suffering they are experiencing and you are there to support them.</p> <p>To understand this feeling, think of a time when you felt overwhelmed by a situation, feeling or sensation. You may not have been able to think, communicate or see clearly, depending on the circumstances. In this way, the symptoms of depression, physical illnesses and devastating life stresses block out the person's ability to experience joy, pleasure or even find steps to end the pain.</p> <h4>Follow these tips to help loved ones who are experiencing a mental health crisis:</h4> <ul> <li><strong>Educate</strong> yourself and others about the many treatments available to reduce and eliminate symptoms that increase risk of suicide. Read about the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/suicide/symptoms-causes/syc-20378048" target="_blank" title="Opens in a new window.">signs and symptoms of suicide</a>.</li> <li><strong>Ask</strong> uncomfortable but direct questions such as, "Are you thinking about suicide" or "Are you thinking about hurting yourself?" Asking about suicidal thoughts or feelings won't push someone into doing something self-destructive. Offering an opportunity to talk about feelings can reduce the risk of acting on suicidal feelings.</li> <li><strong>Persuade</strong> your loved one to let you get help. You cannot demand that he or she get help, but you can ask, "Will you go with me to get help?" If this doesn't work, call the 988 Suicide and Crisis Lifeline at <a href="tel:988">988</a> or chat at <a rel="noopener noreferrer" href="https://988lifeline.org/" target="_blank" title="Opens in a new window.">988lifeline.org</a>.</li> <li><strong>Refer</strong> to the appropriate resources in your area. This could be the National Suicide Prevention Hotline, a local crisis center, a local mental health professional or hospital emergency department. Ideally, you would escort your loved one to the appropriate resource.</li> </ul> <p>If someone says he or she is thinking of suicide or behaves in a way that makes you think the person may be suicidal, don't play it down or ignore the situation. Many people who kill themselves have expressed the intention at some point.</p> <p>You may worry that you're overreacting, but the safety of your friend or loved one is most important. Don't worry about straining your relationship when someone's life is at stake. Call 911 if your loved one is at imminent risk and refusing help.</p> <p>When health care professionals, friends or family know about someone with suicidal thoughts, they can act. If you or someone you know is contemplating suicide, reach out and ask for help. There is hope.</p> <p><a href="/providers/angela-thoreson-licsw" target="_self" title="Opens in same window."><em>Angela Thoreson</em></a><em> is a licensed independent clinical social worker in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</em></p><ul> <li>Acceptance strategies</li> <li> Acceptance and commitment therapy (ACT therapy)</li> <li>Behavioral activation and modification</li> <li>Cognitive behavioral therapy (CBT)</li> <li>Cognitive behavioral therapy for insomnia (CBT-I)</li> <li>Cognitive processing therapy (CPT) for trauma</li> <li>Dialectical behavior therapy (DBT)</li> <li>Individuals with comorbidities, related health or addiction problems</li> <li>Mindfulness intervention</li> <li>Personality disorders</li> <li>Serious and persistent mental illness</li> <li>Stress management</li> </ul>L.I.C.S.W.<p>I provide psychotherapy at Mayo Clinic Health System in Albert Lea and in Austin. Although I work with patients of all ages, my primary focus is with adults. For more than the past decade, I have been involved in varying community-based settings and programs.</p> <p>I use compassion as I provide treatment to adults with serious and persistent mental illness. I believe that practical changes can lead to significant differences in a person’s life and well-being.</p><p><strong>Education</strong></p> <ul> <li>University of St. Thomas</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Licensed Independent Clinical Social Worker</li> </ul>Thoreson<img src="/-/media/shared-files/images/medical-professionals/full/austin/angela-thoreson-licsw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=EEF4CC56A9CE8F5595198A34517FF096" alt="Angela Thoreson, L.I.C.S.W." width="280" height="280" title="Angela Thoreson, L.I.C.S.W." DisableNVelocity="true" />Angela<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20185987Angela Thoreson, L.I.C.S.W.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}|{2B88C934-922C-4130-B661-197B59D83899}<img src="/-/media/national-files/images/hometown-health/2020/hand-on-back-comforting.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B20434C71E81BEB1962D730FC9D525CC" alt="Hand on back comforting" width="660" height="370" DisableNVelocity="true" />Suicide PreventionSuicide is a major concern in the U.S. According to the Centers for Disease Control and Prevention, suicide was among the top nine leading causes of death for people ages 10–64 and the second leading cause of death for people ages 10–14 and 25–34. The positive news is that with the right information and willingness to reach out to someone in need, we all can help prevent suicide.<br /><br /><strong>If you are having suicidal thoughts, call the 988 Suicide and Crisis Lifeline at <a href="tel:988">988</a>, or chat at <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://988lifeline.org/" target="_blank" title="Opens in a new window.">988lifeline.org</a>.</strong>Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller7/18/2014<p>Beau Johnson, physical therapist at Mayo Clinic Health System, is interested in more than just ab training when looking at the core. From your chin to your ankles, he looks at form to increase running performance.<strong></strong></p>Running tips #10: Core workout<p>Beau Johnson, physical therapist at Mayo Clinic Health System, is interested in more than just ab training when looking at the core. From your chin to your ankles, he looks at form to increase running performance.</p> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/tzECMNOfxNs" title="Core workout" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p>Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller7/18/2014<p>If you've been injured, does that mean you stop any form of training? Beau Johnson, physical therapist at Mayo Clinic Health System, discusses the difference between absolute rest and potential drills you can do while healing..<strong></strong></p>Running tips #9: Importance of rest<p>Do you know if you are overtraining? Beau Johnson, physical therapist at Mayo Clinic Health System, discusses resting heart rates and how to identify signs of overtraining your body.</p> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/YnRombaXpvg" title="Importance of rest" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p>Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller7/18/2014<p>Do you know if you are overtraining? Beau Johnson, physical therapist at Mayo Clinic Health System, discusses resting heart rates and how to identify signs of overtraining your body.</p>Running tips #8: Overtraining<p>Do you know if you are overtraining? Beau Johnson, physical therapist at Mayo Clinic Health System, discusses resting heart rates and how to identify signs of overtraining your body.</p> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/6j-7RbAGUdc" title="Overtraining" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p>Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller7/18/2014<p>There are lots of options to keep up your cardiovascular fitness after an injury. Beau Johnson, physical therapist, gives a few recommendations.</p>Running tips #7: Post-injury fitness<p>There are lots of options to keep up your cardiovascular fitness after an injury. Beau Johnson, physical therapist at Mayo Clinic Health System, gives a few recommendations.</p> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/qiuPkI1R1QQ" title="Post-injury fitness" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p>Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller7/18/2014<p>Beau Johnson, physical therapist at Mayo Clinic Health System, identifies what equipment you do or don't need while running.<strong></strong></p>Running tips #5: Running equipment<p>Beau Johnson, physical therapist at Mayo Clinic Health System, identifies what equipment we need or don't need while running.</p> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/GkjKU7dhwPs" title="Running equipment" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p>Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller7/18/2014<p>Running is popular for weight loss, but how long do you need to run to lose weight? Beau Johnson, physical therapist at Mayo Clinic Health System, addresses running and weight loss.</p>Running tips #4: Running to lose weight<p>Running is popular for weight loss but how long do you need to run to lose weight? Beau Johnson, physical therapist at Mayo Clinic Health System, addresses running and weight loss.</p> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/TLkjzgmtMos" title="Running to lose weight" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p>Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller7/18/2014<p>Running form is essential when looking to increase performance. Beau Johnson, physical therapist at Mayo Clinic Health System, provides a few tips to enhance your speed.</p>Running tips #3: Running form<p>Running form is essential when looking to increase performance. Beau Johnson, physical therapist at Mayo Clinic Health System, provides a few tips to enhance your speed.</p> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/RTo30Iaf2Xg" title="Running form" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p>Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller7/18/2014<p>Beau Johnson, physical therapist at Mayo Clinic Health System, says starting your running regimen too quick can lead you off your running goals. Slow and steady wins the race towards better health.</p>Running tips #2: Running goals<p>Beau Johnson, physical therapist at Mayo Clinic Health System, says starting your running regimen too quick can lead you off your running goals. Slow and steady wins the race towards better health.</p> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/_UCbxvjXKbo" title="Running goals" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p>Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller7/18/2014Want to train for a 5K? Beau Johnson, physical therapist, explains the steps you need to take to get the best results.Running tips #1: Running program<p>Want to train for a 5K? Beau Johnson, physical therapist at Mayo Clinic Health System, lets you know the steps you need to take to get the best results.</p> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/OojXCs-lUj4" title="Running program: Getting the best results" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p>Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller7/17/2020<p>Lying, sitting, standing and walking with poor posture can put major strain on your body. These suggestions will help improve your posture.</p>Proper posture is important for good health<p>“Oh, my aching back.”</p> <p>How many of you have said those words about a nagging muscle or ligament problem? While slips on ice, trips over curbs and improper lifting can be the cause of those problems, there’s another culprit. Who or what is this guilty party? Poor posture. Yes, lying, sitting, standing and walking with poor posture can put major strain on your body.</p> <p>According to the American Chiropractic Association, “Several factors contribute to poor posture — most commonly, stress, obesity, pregnancy, weak postural muscles, abnormally tight muscles and high-heeled shoes. In addition, decreased flexibility, a poor work environment, incorrect working posture, and unhealthy sitting and standing habits also can contribute to poor body positioning.”</p> <h4>You can limit wear and tear by taking some of these steps to improve your posture:</h4> <h5>Standing posture:</h5> <ul> <li>Hold your chest high.</li> <li>Relax your shoulders and keep them back.</li> <li>Pull in your abdomen and backside.</li> <li>Don’t lock your knees or tilt your head in any direction.</li> <li>Balance your weight on both feet.</li> <li>Keep your feet parallel.</li> </ul> <h5>Walking posture:</h5> <ul> <li>Hold your head high.</li> <li>Look forward, not down and keep your chin parallel to the ground.</li> <li>Lightly contract your abdominal muscles.</li> <li>Slightly bend your elbows, and freely swing your arms.</li> <li>Move your shoulders naturally.</li> <li>Straighten and avoid arching your back.</li> </ul> <h5>Lying posture:</h5> <ul> <li>Search for a mattress that is right for you.</li> <li>Use a pillow when you sleep.</li> <li>Don’t sleep on your stomach.</li> <li>Put a pillow between your legs if you sleep on your side.</li> <li>Put a pillow under your knees if you sleep on your back.</li> </ul> <h4>Ergonomics at the office</h4> <p>Sitting at a desk all day can contribute to aches and pains.</p> <h5>However, practicing good office ergonomics can help you keep your muscles and ligaments healthy:</h5> <ul> <li>Adjust your chair height. You want your chair to be in a position that allows your feet to sit flat on the ground and your knees to be level with your hips. If need be, place a cushion in the small of your back while sitting in your chair. This helps with lumbar support.</li> <li>Position your go-to items effectively. You’re often reaching for your phone, computer mouse or calculator, so keep these items in easily reachable positions.</li> <li>Take care of your wrists. Keep your wrists straight while typing. Also, use a wrist rest for support.</li> <li>Sit up straight. While in front of your computer or at your desk, sit up straight and position your body in the center of your work station.</li> <li>Use a headset. Wedging your phone between your shoulder and the side of your face while writing isn’t a good thing. Use a headset instead to reduce the strain on your body. </li> </ul> <p>Improving your posture helps improve your overall health. Speak with your health care provider if you have further questions about bettering your posture.</p><img src="/-/media/national-files/images/hometown-health/2020/back-pain-sitting-in-chair.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3D1EE64D456C319925D52182EB8E6352" alt="Back pain sitting in chair" width="660" height="370" DisableNVelocity="true" />Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller6/27/2014<p>Gaining weight while on vacation can be avoided by planning ahead and making smart choices.</p>How to avoid weight gain during your vacation<img style="margin-bottom: 10px; float: right; margin-left: 10px;" alt="Grace Fjeldberg, R.D." src="/-/media/shared-files/images/medical-professionals/full/mankato/grace-fjeldberg-rdn.jpg?sc_lang=en&hash=73BB143039F48ED7AC5447A454AE1A31" /> <p>People often express concern about gaining weight while on vacation as if it’s inevitable. The truth is vacation weight gain can be avoided — and fairly easily.</p> <p>There are many actions you can take to stay healthy while you’re at the cabin, on a road trip or on a cruise. You can enjoy your vacation and stay healthy simultaneously. All you need to do is plan ahead and commit to making smart choices.</p> <p><strong>Tips for shirking extra pounds while on vacation:</strong></p> <ul> <li><strong>Pack a cooler of healthy snacks. </strong>While traveling to your destination or on a vacation where you’re constantly on the move, bring a small cooler with healthy foods along for the ride. Apples, bananas, carrots, dried fruit, low-fat yogurt and nuts are a few ideas.</li> <li><strong>Think twice about fast food. </strong>The drive-thru diet plan may seem like a time-saver, but fast food doesn’t necessarily open up time for more vacation activities. If you have to eat fast food, go with healthy options, such as grilled vs. crispy chicken or salads and sides that aren’t deep fried. Use your healthy snack cooler as a side dish supplier.</li> <li><strong>Find time for exercise. </strong>Cruises and resorts usually offer activities that require some physical exertion. Try those out and get your heart rate going. You may not be able to hit the gym every day, but simply moving around is good for your body. Biking, hiking and swimming are wonderful sources of physical activity, too.</li> <li><strong>Honor your hunger, but be smart. </strong>All-inclusive vacations afford you with constant access to food. Or maybe your family likes to cook colossal cabin dinners. Whatever your situation, be mindful of portion sizes, and never eat to a point where you’re uncomfortable. Fill half of your plate with fruits and vegetables. The other half should be a mix of grains and lean sources of protein.</li> <li><strong>Keep your alcohol consumption under control. </strong>Alcohol can increase your appetite. Additionally, many alcoholic drinks are high in calories. Indulging in an adult beverage is fine as long as you do so in moderation.</li> </ul><ul> <li>Bariatric surgery</li> <li>General nutrition</li> <li>Oncology</li> <li>Pediatric nutrition</li> </ul>RDN, LD <p><strong>Education</strong></p> <ul> <li>Minnesota State University, Mankato</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Mayo Clinic College of Medicine, Minnesota</li> </ul> <p><strong>Certifications</strong> </p> <ul> <li>Commission on Dietetic Registration</li> <li>Minnesota Board of Dietetics and Nutrition Practice</li> </ul> Fjeldberg<img src="/-/media/shared-files/images/medical-professionals/full/mankato/grace-fjeldberg-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=FB99EC499314FA86AE8202C30AB740A2" alt="Grace Fjeldberg RDN" width="280" height="280" DisableNVelocity="true" /> Grace<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15268781Grace Fjeldberg R.D.N. 1<img src="/-/media/shared-files/images/medical-professionals/full/mankato/grace-fjeldberg-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=FB99EC499314FA86AE8202C30AB740A2" alt="Grace Fjeldberg RDN" width="280" height="280" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller7/2/2014<p>Hospice brings a whole team of workers to join the facility staff who all work together to meet the special needs of the patient as they near end of life.</p>Why hospice in the nursing home?<img style="margin-bottom: 10px; float: right; margin-left: 10px;" alt="Ellen Ness" src="/-/media/national-files/images/hometown-health/2014/ness-ellen.jpg?sc_lang=en&hash=9FCA2DD6E2EFF8B4928BDA0F8540DD28" /> <p><strong><em>By Ellen Ness, Home Health & Hospice patient services director</em></strong></p> <p>Hospice has been in the United States since the 1970s. It started as a grass-roots movement by health care workers. Their goal was to care for people in their homes who had a limited life expectancy. There were nurses, social workers and others who volunteered their time to assist people and support them in their end-of-life journey. It soon became apparent this type of support was helping those people stay in their homes. There were greatly reduced trips to the emergency room or to the clinic and fewer hospitalizations to control symptoms. Medicare soon realized what a benefit it was and made hospice a Medicare benefit that could be accessed by anyone who met a couple simple requirements:</p> <ul> <li>The patient’s life is limited to about six months or less </li> <li>The patient has stopped active treatment for his or her disease. </li> </ul> <p>As hospice has expanded over the years, so has its use in the locations the patient calls home, such as group homes, assisted-living facilities and nursing homes.</p> <p>How does hospice care work in a nursing home? Nursing home residents enroll in hospice, but continue to receive the same services from the nursing home, such as bathing, meals, medicines and staff support. When hospice is involved, the resident also receives the support of the hospice team. Much like a resident might receive therapy services in the nursing home, hospice is an additional service that specializes in care at end of life. Hospice brings a whole team of workers to join the facility staff who all work together to meet the special needs of the patient. Hospice and nursing home staff collaborate on a plan that will meet the resident’s and family’s needs. Together, they can provide support to keep the resident comfortable and address symptoms as they arise.</p> <p>Many people ask why they need another nurse when the nursing home provides one. You can compare the support provided by hospice as a specialty service. When you need treatment for cancer, your physician calls an oncologist. When you need assistance at end of life, you call hospice. Hospice does not replace the wonderful staff in the nursing home — they are the extra support for staff, and the resident and his or her family. It’s adding extra people to the care team to assist the resident and his or her family during this special journey.</p><img src="/-/media/national-files/images/hometown-health/2014/ness-ellen.jpg?h=200&iar=0&w=200&sc_lang=en&hash=810906C984AC557359620CAE66783FA9" alt="Ness Ellen" width="200" height="200" DisableNVelocity="true" />HospiceThe Hospice program believes that the highest quality of living is achieved when the family unit and Hospice team together offer hope, opportunity, support, presence, individualized care, comfort and encouragement.<br/><br/>Dawn Haller6/9/2022Up to 10% of people in the U.S. have a communication disorder, from difficulty with speech to vocal cord paralysis. Learn how speech therapy can lead to a more expressive life.Speaking clearly: Help for people with speech and language disorders<p>Speaking and language abilities vary from person to person. Some people can quickly articulate exactly what they are thinking or feeling, while others struggle being understood or finding the right words.</p> <p>These struggles could be due to a speech or language disorder if communication struggles cause ongoing communication challenges and frustrations. Speech and language disorders are common.</p> <p>It's estimated that 5% to 10% of people in the U.S. have a communication disorder. By the first grade, about 5% of U.S. children have a noticeable speech disorder. About 3 million U.S. adults struggle with stuttering and about 1 million U.S. adults have aphasia. These conditions make reading, speaking, writing and comprehending difficult.</p> <p>People with speech and language disorders can find hope in rehabilitation. Speech-language pathologists can evaluate and treat these disorders. This can lead to a happier, healthier and more expressive life.</p> <h2>Types of speech and language disorders</h2> <h4>Speech and language disorders come in many forms, each with its own characteristics:</h4> <ul> <li><strong>Aphasia</strong><br /> People with aphasia have difficulty with reading, writing, speaking or understanding information they've heard. The intelligence of a person with aphasia is not affected.</li> <li><strong>Dysarthria</strong><br /> People with dysarthria demonstrate slurred or imprecise speech patterns that can affect the understanding of speech.</li> <li><strong>Apraxia</strong> <br /> A person with this disorder has difficulty coordinating lip and tongue movements to produce understandable speech.</li> <li><strong>Dysphagia</strong><br /> This condition refers to swallowing difficulties, including food sticking in the throat, coughing or choking while eating or drinking, and other difficulties.</li> <li><strong>Stuttering</strong><br /> This speech disorder involves frequent and significant problems with normal fluency and flow of speech. People who stutter know what they want to say but have difficulty saying it.</li> <li><strong>Articulation disorder</strong><br /> People with this disorder have trouble learning how to make specific sounds. They may substitute sounds, such as saying "fum" instead of "thumb".</li> <li><strong>Phonological disorder</strong><br /> Phonological processes are patterns of errors children use to simplify language as they learn to speak. A phonological disorder may be present if these errors persist beyond the age when most other children stop using them. An example is saying "duh" instead of "duck."</li> <li><strong>Voice</strong><br /> Voice disorders include vocal cord paralysis, vocal abuse and vocal nodules, which could result in vocal hoarseness, changes in vocal volume and vocal fatigue.</li> <li><strong>Cognitive communication impairment</strong> <br /> People with cognitive communication impairment have difficulty with concentration, memory, problem-solving, and completion of tasks for daily and medical needs.</li> </ul> <p>Speech and language disorders are more common in children. It can take time to develop the ability to speak and communicate clearly. Some children struggle with finding the right word or getting their jaws, lips or tongues in the correct positions to make the right sounds.</p> <p>In adults, speech and language disorders often are the result of a medical condition or injury. The most common of these conditions or injuries are a stroke, brain tumor, brain injury, cancer, Parkinson's disease, multiple sclerosis, Lou Gehrig's disease or other underlying health complications.</p> <h2>Treatment options</h2> <p>Speech and language disorders can be concerning, but speech-language pathologists can work with patients to evaluate and treat these conditions. Each treatment plan is specifically tailored to the patient.</p> <h4>Treatment plans can address difficulties with:</h4> <ul> <li>Speech sounds, fluency or voice</li> <li>Understanding language</li> <li>Sharing thoughts, ideas and feelings</li> <li>Organizing thoughts, paying attention, remembering, planning or problem-solving</li> <li>Feeding and swallowing</li> <li>Vocabulary or improper grammar use</li> </ul> <p>Treatment typically includes training to compensate for deficiencies; patient and family education; at-home exercises; or neurological rehabilitation to address impairments due to medical conditions, illnesses or injury.</p> <p>Treatment options are extensive and not limited by age. Children and adults can experience the benefits of treatment.</p> <p>If you or a loved one are struggling with speech and language issues, you are not alone. Millions of people experience similar daily challenges. Better yet, help is available.</p> <p><em><a href="/providers/monica-marzinske-cccslp" target="_self" title="Opens in same window.">Monica Marzinske</a> is a <a href="/services-and-treatments/speech-language-therapy" target="_self" title="Opens in same window.">speech-language pathologist</a> in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Dysphagia</li> <li>Neurogenic communication disorders</li> <li>Pediatric speech and language development</li> </ul>CCC-SLP<p><strong>Education</strong></p> <ul> <li>Master's degree, Communication Disorders, Minnesota State University-Mankato</li> </ul> <p><strong>Certifications</strong></p> <ul> <li><strong></strong>Certificate of Clinical Competence, American Speech-Language-Hearing Association (ASHA)</li> <li>Lee Silverman Voice Training (LSVT)</li> </ul>Marzinske<img src="/-/media/shared-files/images/medical-professionals/full/mankato/monica-marzinske-cccslp.jpg?h=200&iar=0&w=200&sc_lang=en&hash=435C91A04A0B7E67D7B977043F5176BB" alt="Monica Marzinske CCC-SLP" width="200" height="200" DisableNVelocity="true" />Monica<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15858111Monica Marzinske, CCC-SLP1<img src="/-/media/national-files/images/hometown-health/2022/adult-and-child-looking-down.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D73DAEFC47FFC339F9469FFAFB585F23" alt="Adult and child looking down" width="660" height="370" DisableNVelocity="true" />Speech-LanguageThe evaluation and treatment of communication disorders and swallowing disorders.Dawn Haller8/7/2023You protect your community and children when they're vaccinated. Learn about the benefits of vaccines, and get answers to common questions.Why childhood vaccinations matter<p>Protecting your children is one of the most critical responsibilities of parenthood. You protect them with shelter, safety and proper nutrition. But if you've missed their vaccinations, you expose them to potentially dangerous — even deadly — diseases. The most effective way to prevent these diseases is to ensure your child receives the proper vaccination series, typically completed by age 6.</p> <h2>Benefits of vaccinations</h2> <p>Early childhood vaccinations protect children when they're most vulnerable. They protect against 14 different childhood illnesses, many of which can have devastating effects on children. These include HPV, influenza, measles, polio, tetanus and pertussis (whooping cough).</p> <p>Due to the outstanding success of vaccinations, many people in younger generations haven't seen the terrible consequences of these diseases. Nonetheless, certain illnesses resurface as vaccination rates decrease.</p> <p>In addition to keeping your kids safe, regular vaccination of healthy children helps protect those children in the community who cannot receive vaccinations because of health problems or allergies. This concept is called herd immunity. However, vaccination rates usually need to be greater than 95% to effectively protect those who cannot be vaccinated. So, don't forgo vaccinations because you assume others will safeguard you.</p> <h2>Here are answers to common questions about vaccinations:</h2> <h3>Is there a difference between vaccination and immunization?</h3> <p>Yes. A vaccination uses dead or weakened versions of bacteria or viruses to protect people against diseases and conditions. Immunization is the method by which a person develops immunity to these diseases. This happens via vaccination or from infection with that bacteria or virus.</p> <h3>How do vaccines work?</h3> <p><strong> </strong></p> <p>Vaccinations use a weakened or dead antigen, a small piece of the virus or bacteria that helps the body trigger an immune system response. This allows children to develop natural immunity while facing a significantly decreased risk of harm compared to an actual infection.</p> <h3>Are vaccinations really that important?</h3> <p>Yes, vaccinations are important, especially for young children. According to the <a rel="noopener" href="https://www.cdc.gov/" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention</a> (CDC), infants receive some passive immunity from their mothers after birth. However, these immunities wear off during the child's first year and are ineffective against diseases like whooping cough.</p> <p>Without vaccinations, young children's bodies often can't fight diseases. This can lead to severe complications and even death.</p> <h3>Should I space my child's vaccinations out?</h3> <p>No evidence suggests it's more effective for children to receive vaccinations in intervals. Babies can receive multiple vaccinations at once without an issue. Babies are exposed to new antigens every day, and the number of antigens in vaccines is only a fraction of what they're exposed to environmentally.</p> <p>Children can respond to multiple vaccine exposures at the same time without adverse effects. Studies show that vaccinations given in a group are just as effective as individual shots.</p> <h3>Is there a link between vaccinations and autism?</h3> <p>No. There is <a href="/hometown-health/speaking-of-health/autism-vaccine-link-debunked" target="_self" title="Opens in same window.">no link between vaccinations and autism</a>. The study that initially made this claim has been refuted by the journal in which it was originally published and numerous other peer-reviewed scientific journals.</p> <h3><strong>Are vaccines safe?</strong></h3> <p>Yes. Vaccines undergo thorough testing to ensure they are safe and benefit those receiving them. There are minor risks with vaccines, including fever, skin irritation and soreness. These side effects are much less severe than the illnesses they aid in preventing.</p> <h3>What vaccinations are recommended?</h3> <h4>The CDC recommends these vaccinations for children:</h4> <ul> <li><a rel="noopener" href="https://www.mayoclinic.org/drugs-supplements/sars-cov-2-covid-19-vaccine-mrna-lnp-spike-protein-pfizer-intramuscular-route/description/drg-20506420" target="_blank" title="Opens in a new window.">COVID-19</a></li> <li><a rel="noopener" href="https://www.mayoclinic.org/drugs-supplements/diphtheria-tetanus-acellular-pertussis-hepatitis-b-and-polio-vaccine-intramuscular-route/description/drg-20061797" target="_blank" title="Opens in a new window.">Diphtheria, tetanus and acellular pertussis</a></li> <li><a rel="noopener" href="https://www.mayoclinic.org/drugs-supplements/haemophilus-b-conjugate-vaccine-intramuscular-route/description/drg-20069853" target="_blank" title="Opens in a new window.">Haemophilus influenza B</a></li> <li><a rel="noopener" href="https://www.mayoclinic.org/drugs-supplements/hepatitis-a-and-hepatitis-b-vaccine-intramuscular-route/description/drg-20061965" target="_blank" title="Opens in a new window.">Hepatitis A</a></li> <li><a rel="noopener" href="https://www.mayoclinic.org/drugs-supplements/hepatitis-a-and-hepatitis-b-vaccine-intramuscular-route/description/drg-20061965" target="_blank" title="Opens in a new window.">Hepatitis B</a></li> <li><a rel="noopener" href="https://www.mayoclinic.org/drugs-supplements/human-papillomavirus-vaccine-intramuscular-route/precautions/drg-20127679" target="_blank" title="Opens in a new window.">HPV</a></li> <li><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/flu/symptoms-causes/syc-20351719" target="_blank" title="Opens in a new window.">Influenza</a></li> <li><a rel="noopener" href="https://www.mayoclinic.org/drugs-supplements/meningococcal-vaccine-intramuscular-route-subcutaneous-route/description/drg-20064657" target="_blank" title="Opens in a new window.">Meningococcal</a></li> <li><a rel="noopener" href="https://www.mayoclinic.org/drugs-supplements/pneumococcal-vaccine-polyvalent-intramuscular-route-subcutaneous-route/description/drg-20065538" target="_blank" title="Opens in a new window.">Measles, mumps and rubella</a></li> <li><a rel="noopener" href="https://www.mayoclinic.org/drugs-supplements/pneumococcal-vaccine-polyvalent-intramuscular-route-subcutaneous-route/description/drg-20065538" target="_blank" title="Opens in a new window.">Pneumococcal</a></li> <li><a rel="noopener" href="https://www.mayoclinic.org/drugs-supplements/diphtheria-tetanus-acellular-pertussis-polio-vaccine-intramuscular-route/description/drg-20071983" target="_blank" title="Opens in a new window.">Polio</a></li> <li><a rel="noopener" href="https://www.mayoclinic.org/drugs-supplements/rotavirus-vaccine-live-oral-route/description/drg-20071625" target="_blank" title="Opens in a new window.">Rotavirus</a></li> <li><a rel="noopener" href="https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/the-facts-about-vaccinations" target="_blank" title="Opens in a new window.">Varicella (chickenpox)</a></li> </ul> <p>Many vaccinations can be administered in groups, and catch-up schedules are available. Certain people shouldn't receive vaccines, like those who recently had a blood transfusion; have severe, life-threatening allergic reactions to the vaccine ingredients; or are immunocompromised or have a weakened immune system because of medical conditions or treatments for diseases.</p> <p>When considering your child's health, make sure you factor in the necessity of proper childhood vaccinations. You protect your child and your community when they are fully vaccinated. Talk with your child's healthcare team if you have questions.</p> <p><a href="/providers/jessica-sheehy-pac" target="_self" title="Opens in same window."><em>Jessica Sheehy</em></a><em> is a physician assistant in <a href="/services-and-treatments/infectious-diseases" target="_self" title="Opens in same window.">Infectious Diseases</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Antimicrobial stewardship</li> <li>Infectious disease</li> <li>Travel medicine</li> </ul>P.A.-C.<p>My goal is to help my patients understand what is happening in regard to their infection, and how it impacts them. When my patients are informed, they can fully participate in the development of a plan that will treat their infection.</p> <p>I have always had an interest in microbiology, and have a college minor in microbiology. Therefore, infectious diseases was a natural fit for my professional career. </p> <p>I love to travel and visit my friends and family in Montana as often as I can.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Physician Assistant Studies, Arcadia University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>National Commission on Certification of Physician Assistants</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Sheehy<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jessica-sheehy-pac.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4E5429A03BCFC322B550B0EC92C132BF" alt="Jessica Sheehy, P.A.-C., P.A." width="280" height="280" DisableNVelocity="true" />{645A5342-C9AE-4AD4-9114-2A0634580FC2}Jessica<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15739287Jessica Sheehy PAC1{C8A905E8-82D3-45FC-9669-A5F09F2EF6CA}<img src="/-/media/national-files/images/hometown-health/2023/child-with-bandage-on-arm.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7AA71594D95E1799D90DB3FE5FB94503" alt="Child with bandage on arm" width="660" height="370" DisableNVelocity="true" />Immunizations<p>Disease prevention is crucial to your health. Getting vaccinated is one of the best ways to maintain good health, and protect you and those you care about against infectious diseases. Vaccinations offer protection against serious diseases by stimulating the immune system to create antibodies against certain bacteria or viruses.</p><br/><p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/vaccine-guidance/art-20536857" target="_blank" title="Opens in a new window.">Get vaccine guidance from Mayo Clinic</a>, including benefits, safety, side effects and what to know about recommended vaccines for babies, children, teens, adults and during pregnancy. For recommended vaccines based on age, refer to the <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/adult" target="_blank" title="Opens in a new window.">adult</a> or <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/child" target="_blank" title="Opens in a new window.">child and adolescent</a> schedules.</p><br/><p>Review the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/coronavirus-covid-19/history-disease-outbreaks-vaccine-timeline" target="_blank" title="Opens in a new window.">history of infectious disease outbreaks and vaccines timeline</a> for information about major disease outbreaks, epidemics and pandemics, and the impact of vaccines and research.</p>Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller5/29/2014<p>Knowledge of work-related injuries with actions to prevent them will keep you healthy and avoid missed work days.</p>Avoiding and recovering from work-related injuries<img alt="Occupational Medicine" src="/-/media/local-files/eau-claire/images/medical-services/occupational-health/occ-med-hard-hat.jpg?h=284&w=300&sc_lang=en&hash=42F9286AFF14FC321AE289293D756A05" style="height: 284px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /> <p>Time away from work can be a wonderful thing, as long as it's planned. Missed days of work because of injury are not in the same category as vacation or paid time off. Unfortunately, work-related injuries are the reason behind more than 1.1 million missed work days, according to the Bureau of Labor Statistics.</p> <p>That's why occupational medicine providers are around — to help prevent work-related injuries and rehabilitate those who do suffer injuries. Let's look at what occupational medicine really is and some common questions occupational medicine providers face.</p> <h2>What is occupational medicine?</h2> <p>Occupational medicine provides a full spectrum of services aimed at keeping employees of regional companies healthy and safe at work. Occupational medicine providers offer physical examinations, health recommendations and other wellness programs to prevent illness and injury at work. Additionally, we help people who have been injured on the job to get back to work.</p> <h2>I hurt my back at work. Should I take time off to rest?</h2> <p>The first step would be to see a physician to determine what is causing the pain. We see a lot of back injuries in occupational medicine as these are common in many workplaces. If there is not concern for a fracture or herniated disc, the best treatment is anti-inflammatory medication, stretching and modified work activities to keep as active as able. Bed rest has been shown to prolong healing time for back injuries. So, keep moving as much as possible.</p> <h2>How do I prevent back pain and injuries at work?</h2> <h3>Here are some basic tactics you can employ to keep your back healthy at work:</h3> <ul> <li>Maintain a healthy weight.</li> <li>Strive for 30 minutes of exercise each day.</li> <li>Use good posture — keep weight balanced on your feet, avoid slouching, and use a pillow or rolled towel on your chair, if needed, to support your back.</li> <li>Lift heavy objects using your legs, not your back.</li> <li>Pay attention to your body — if you're aching, take a break or ask for help.</li> <li>Try to break up repetitive tasks.</li> </ul> <h2>What should I do about pain and numbness in my hand?</h2> <p>See a physician as soon as you have concern about hand pain as it is easier to resolve when treated quickly. If you think the pain is caused by your work activities, an occupational medicine provider will want to learn more about your job, your symptoms and how the injury occurred.</p> <p>Most hand pain can be reversed quickly with temporary work modifications, decreasing inflammation and bracing. If the pain was caused by ergonomic issues at your workstation, we may come to your work site to do an evaluation of the workstation and recommend modifications to improve the pain and prevent it from recurring.</p> <h2>Are there new guidelines for DOT exams for commercial drivers?</h2> <p>Yes. On May 21, 2014, the U.S. Department of Transportation (DOT) began requiring commercial motor vehicle drivers to be examined by a healthcare professional listed on the <a rel="noopener" href="https://nationalregistry.fmcsa.dot.gov/NRPublicUI/home.seam" title="Opens in a new window." target="_blank">National Registry of Certified Medical Examiners</a>. The DOT only will accept physical examinations and CMV medical certificates from certified providers.</p> <p>Mayo Clinic Health System has providers certified to perform physical examinations on drivers seeking commercial motor vehicle licenses. Our goal in occupational medicine is to keep drivers healthy so they can be safe on the road. We follow DOT recommendations and regulations for certifying drivers and will work closely with drivers to help make sure they get evaluation and treatment of any conditions that could limit their ability to drive. We value the importance of drivers and the transportation industry to our country and economy. We want to keep drivers on the road if possible.</p> <p>Occupational medicine is available to help you and your co-workers stay healthy and able to do your jobs — no matter what industry you work in. Coupling knowledge of work-related injuries with actions to prevent them will keep you healthy and at work.</p><img src="/-/media/local-files/eau-claire/images/medical-services/occupational-health/occ-med-hard-hat.jpg?h=284&iar=0&w=300&sc_lang=en&hash=EBF39816DFF138AD7290264CF42F3676" alt="Occupational Medicine" width="300" height="284" DisableNVelocity="true" />Occupational MedicineBusiness success depends upon the productivity of the workforce. Occupational medicine helps businesses and organizations prevent and manage occupational and environmental injuries, illnesses and disabilities.Dawn Haller4/25/2014<p>So your loved one has decided to have bariatric surgery to improve their health. They'll need your love and support as they go through this life-changing process. Here is some advice on how to be the best support system you can be.</p>Tips to help you support a loved one who has chosen bariatric surgery<p><img src="/-/media/shared-files/images/medical-professionals/full/mankato/heidi-bednarchuk-cns.jpg?sc_lang=en&hash=4396297DED700190C18AE591368ED484" alt="Heidi Bednarchuk C.N.S." style="float: right; margin-bottom: 10px; margin-left: 10px;" />So, your loved one has decided to have bariatric surgery to improve her health. Your loved one will need your love and support as she goes through this life-changing process.</p> <h2>Here is some advice on how to be the best support system you can be:</h2> <ul> <li><strong>Educate yourself.</strong><br /> Learn about the bariatric surgery for weight-loss program.</li> <li><strong>Eliminate temptation.</strong><br /> Keep nutritious foods on hand, and do not bring foods that your loved one should not eat or drink into the house.</li> <li><strong>Be aware that your loved one must eat slower after surgery.</strong><br /> Be patient and allow more time for meals.</li> <li><strong>Encourage regular physical activity.</strong><br /> Offer to go for walks or bike rides with them.</li> <li><strong>Offer to help.</strong><br /> Find out what your loved one needs. What are they struggling with? What would make things easier?</li> <li><strong>Take care of yourself.</strong><br /> Share your feelings, and talk about how you can make changes together.</li> <li><strong>Focus on the positive.</strong><br /> There are going to be good days and bad days. It can be difficult to change lifelong habits. Acknowledge the changes that your loved one has already made and support them as they continue to work toward better health.</li> </ul> <p><em><a href="/providers/heidi-bednarchuk-cns" target="_self" title="Opens in same window.">Heather Bednarchuk</a> is a clinical nurse specialist in <a href="/services-and-treatments/bariatric-surgery" target="_self" title="Opens in same window.">Bariatric Surgery</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a> and <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Weight-loss surgery</li> <li>Weight management</li> </ul>APRN, CNS<p>Weight is a very emotional issue and I like to think of my office as a “no blame, no shame zone.” My goal is to listen and understand my patient’s struggles and work together to develop a plan to address them. </p> <p>I have struggled with weight myself for most of my adult life and have a close family member that had bariatric surgery.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Nursing, Minnesota State University-Mankato</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Adult Health Clinical Nurse Specialist, American Nurses Credentialing Center</li> <li>Certified Bariatric Nurse, American Society for Metabolic and Bariatric Surgery</li> </ul> <p><strong>Membership</strong></p> <ul> <li>President-Elect, American Society for Metabolic and Bariatric Surgery</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Surgery, Mayo Clinic College of Medicine and Science</li> </ul>Bednarchuk<img src="/-/media/shared-files/images/medical-professionals/full/mankato/heidi-bednarchuk-cns.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4FA8ABD1C131281B9AB8444BFA59FB44" alt="Heidi Bednarchuk, C.N.S." width="280" height="280" DisableNVelocity="true" />Heidi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15681548Heidi Bednarchuk, APRN, CNS1{94B2E140-AEF8-44BA-B6A9-4538B77501BC}<img src="/-/media/shared-files/images/medical-professionals/full/mankato/heidi-bednarchuk-cns.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4FA8ABD1C131281B9AB8444BFA59FB44" alt="Heidi Bednarchuk, C.N.S." width="280" height="280" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller4/25/2014<p>If you're not getting some physical activity most days, now is the time to start. Here's some information to help you get started with a plan that works for you. </p>Physical activity: Benefits and simple steps<img src="/-/media/shared-files/images/medical-professionals/full/mankato/heidi-bednarchuk-cns.jpg?sc_lang=en&hash=4396297DED700190C18AE591368ED484" alt="Heidi Bednarchuk C.N.S." style="float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>If you're not getting some physical activity most days, now's the time to start. Here’s some information to help you get started with a plan that works for you.</p> <h2>Benefits of physical activity</h2> <p>Physical activity can improve or prevent other health conditions, including: </p> <ul> <li>High blood pressure</li> <li>High cholesterol or triglycerides</li> <li>Diabetes</li> <li>Depression</li> <li>Heart disease</li> </ul> <p>When you exercise, your body releases chemicals that can help boost your mood and help you feel more relaxed.</p> <p>Exercise can help you build muscle and increase your endurance and can help your heart and lungs work better so you have more energy to do the things you want to do.</p> <p>Regular exercise can help you fall asleep faster and stay asleep longer.</p> <h3>Simple steps you can take to increase physical activity include:</h3> <ul> <li>Start with 10 minutes at a time and work your way up. You don't have to do it all at once.</li> <li>Take the stairs instead of the elevator or escalator.</li> <li>Park further back in the parking lot.</li> <li>Buy a pedometer or activity monitor. Set daily goals and increase your target as you become more active.</li> </ul> <p> Using more calories than you take in will encourage weight loss and weight maintenance. Take this information and put it to use so that you can improve your health and well-being. </p> <p><em><a href="/providers/heidi-bednarchuk-cns" target="_self" title="Opens in same window.">Heidi Bednarchuk</a> is a clinical nurse specialist in <a href="/services-and-treatments/bariatric-surgery" target="_self" title="Opens in same window.">Bariatric Surgery</a> in <a href="/locations/fairmont">Fairmont</a> and <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Weight-loss surgery</li> <li>Weight management</li> </ul>APRN, CNS<p>Weight is a very emotional issue and I like to think of my office as a “no blame, no shame zone.” My goal is to listen and understand my patient’s struggles and work together to develop a plan to address them. </p> <p>I have struggled with weight myself for most of my adult life and have a close family member that had bariatric surgery.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Nursing, Minnesota State University-Mankato</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Adult Health Clinical Nurse Specialist, American Nurses Credentialing Center</li> <li>Certified Bariatric Nurse, American Society for Metabolic and Bariatric Surgery</li> </ul> <p><strong>Membership</strong></p> <ul> <li>President-Elect, American Society for Metabolic and Bariatric Surgery</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Surgery, Mayo Clinic College of Medicine and Science</li> </ul>Bednarchuk<img src="/-/media/shared-files/images/medical-professionals/full/mankato/heidi-bednarchuk-cns.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4FA8ABD1C131281B9AB8444BFA59FB44" alt="Heidi Bednarchuk, C.N.S." width="280" height="280" DisableNVelocity="true" />Heidi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15681548Heidi Bednarchuk, APRN, CNS1{94B2E140-AEF8-44BA-B6A9-4538B77501BC}<img src="/-/media/shared-files/images/medical-professionals/full/mankato/heidi-bednarchuk-cns.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4FA8ABD1C131281B9AB8444BFA59FB44" alt="Heidi Bednarchuk, C.N.S." width="280" height="280" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Dawn Haller4/25/2014<p>After bariatric surgery, most patients lose weight rapidly no matter how they eat or how much physical activity they get. Learn why the commitment to a healthy lifestyle needs to be life-long. </p>Important steps to take before bariatric surgery<p><img src="/-/media/shared-files/images/medical-professionals/full/mankato/heidi-bednarchuk-cns.jpg?sc_lang=en&hash=4396297DED700190C18AE591368ED484" alt="Heidi Bednarchuk C.N.S." style="float: right; margin-bottom: 10px; margin-left: 10px;" />After bariatric surgery, most patients lose weight rapidly no matter how they eat or how much physical activity they get. However, after the first 12 to 18 months, you may start regaining the weight you lost if you are not eating right and exercising regularly. The commitment to a healthy lifestyle needs to be life-long.</p> <p>Here are some things you can do to help prepare for surgery. Your team at Mayo Clinic Health System will provide the support and education you need to make these changes part of your new lifestyle.</p> <ul> <li>Go through your house and get rid of unhealthy, potentially tempting foods.  </li> <li>Start reducing the amount of carbonated beverages and caffeine you drink. You need to give these up before you have surgery.</li> <li>Practice eating slowly and chewing food thoroughly. Eating a normal meal should take 30 minutes.</li> <li>Buy a blender or food processor if you don’t already have one. You will also need measuring cups and a food scale.</li> <li>Talk with your registered dietitian about your post-surgery diet, and start planning now. Have appropriate foods ready when you come home from your surgery.</li> <li>Make sure that you have protein supplements on hand. You will need to eat plenty of protein after surgery. If you are not currently taking a multivitamin and calcium supplement, now is the time to start.</li> </ul> <p> Exercise as tolerated. If you are not currently active, start with short walks and build your distance. Every step counts! </p><ul> <li>Weight-loss surgery</li> <li>Weight management</li> </ul>APRN, CNS<p>Weight is a very emotional issue and I like to think of my office as a “no blame, no shame zone.” My goal is to listen and understand my patient’s struggles and work together to develop a plan to address them. </p> <p>I have struggled with weight myself for most of my adult life and have a close family member that had bariatric surgery.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Nursing, Minnesota State University-Mankato</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Adult Health Clinical Nurse Specialist, American Nurses Credentialing Center</li> <li>Certified Bariatric Nurse, American Society for Metabolic and Bariatric Surgery</li> </ul> <p><strong>Membership</strong></p> <ul> <li>President-Elect, American Society for Metabolic and Bariatric Surgery</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Surgery, Mayo Clinic College of Medicine and Science</li> </ul>Bednarchuk<img src="/-/media/shared-files/images/medical-professionals/full/mankato/heidi-bednarchuk-cns.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4FA8ABD1C131281B9AB8444BFA59FB44" alt="Heidi Bednarchuk, C.N.S." width="280" height="280" DisableNVelocity="true" />Heidi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15681548Heidi Bednarchuk, APRN, CNS1{94B2E140-AEF8-44BA-B6A9-4538B77501BC}<img src="/-/media/shared-files/images/medical-professionals/full/mankato/heidi-bednarchuk-cns.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4FA8ABD1C131281B9AB8444BFA59FB44" alt="Heidi Bednarchuk, C.N.S." width="280" height="280" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller4/25/2014Are you considering bariatric surgery, but wondering how it works or what you might expect during the process? Check out these frequently asked questions and answers.Frequently asked questions about bariatric surgery<p><img src="/-/media/shared-files/images/medical-professionals/full/mankato/heidi-bednarchuk-cns.jpg?sc_lang=en&hash=4396297DED700190C18AE591368ED484" alt="Heidi Bednarchuk C.N.S." style="float: right; margin-bottom: 10px; margin-left: 10px;" /></p> <h2>How long will my surgery take?</h2> <p>This depends on the <a rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/bariatric-surgery/in-depth/weight-loss-surgery/art-20045334?pg=2" target="_blank" title="Opens in a new window.">type of bariatric surgery</a> you are having. If you are having a Roux-en-Y gastric bypass, surgery will typically take 2 1/2 to three hours. If you are having a sleeve gastrectomy, you can expect surgery to take 1 1/2 to two hours. Each case is individual, and these times are only rough estimates.</p> <h2>What are possible complications associated with bariatric surgery?</h2> <p>At your pre-op visit, your doctor will thoroughly review risks and potential complications with you. You will work together to complete a checklist of potential complications to be sure that you understand each one.</p> <p>Although rare, complications may include bleeding, blood clots, breathing problems, infections, and death. You will receive antibiotics to prevent infection and medicine to prevent blood clots.  We will get you up and moving after your surgery and will have you wear special compression boots when in bed, which also helps prevent blood clots.</p> <p>Occasionally, your doctor will not be able to complete <a rel="noopener noreferrer" href="http://www.medicinenet.com/laparoscopy/article.htm" target="_blank" title="Opens in a new window">laparoscopic</a> surgery and will have to switch to an open surgery. If this happens, you may need to stay in the hospital longer and will need to allow more time before returning to work. You will have time to talk to your doctor about any concerns or questions you have about risks before your surgery.</p> <h2>What kind of anesthesia will I have?</h2> <p>The anesthesiologist will meet with you before surgery to talk about your anesthesia. All patients having bariatric surgery will have general anesthesia. This means that you will be completely asleep during your surgery. The anesthesiologist will insert a tube through your mouth to help you breath. Your condition will be monitored closely by the anesthesiologist throughout your surgery.</p> <h2>Will I need a blood transfusion after my surgery?</h2> <p>Although uncommon, some patients may need to receive blood following surgery. A lab technician will come in to your room each morning to collect blood so we can monitor your condition closely. If you do need blood, our nurses will provide you with information on blood transfusions.</p> <h2>How long will I have to stay in the hospital?</h2> <p>Most patients will spend two nights in the hospital. For example, if you have surgery on a Monday, you can expect to go home after lunch on Wednesday.</p> <h2>How long before I can return to work?</h2> <p>Some people are able to go back to work two weeks after surgery. You may have to take more time off if you have other health concerns or if your job requires heavy lifting.</p> <h2>When can I eat regular foods?</h2> <p>If you have the gastric sleeve procedure, you will have full liquids, such as creamed soup and cream of wheat, for three weeks. If you have Roux-en-Y gastric bypass, you will need to eat a blended, or pureed, diet for several weeks. These foods do not have to be bland. You will work closely with our registered dietician to find soft foods that you like but that also provide the amount of protein you need. Gradually you’ll go back to eating a regular diet of healthy foods. It is important to know that there may be some foods that your system may not tolerate after surgery, such as red meat, certain breads and starchy foods. </p> <h2>Will I need cosmetic surgery?</h2> <p>Most patients do not choose to have cosmetic surgery. Patients are encouraged to exercise and maintain a healthy diet to minimize the need for cosmetic surgery. However, if you choose to have this type of surgery, we can refer you to a skilled plastic surgeon. Most insurance companies will not pay for cosmetic surgery unless it is medically necessary.</p> <h2>How much weight can I expect to lose?</h2> <p>The average patient loses about two- thirds of their excess bodyweight in the first 12 to 18 months after surgery. Your excess body weight is the difference between what you weigh now and what your ideal body weight is. For example, if you currently weigh 300 pounds and your ideal body weight is 150 pounds, you have 150 pounds of excess body weight. You could expect to lose approximately two-thirds of that weight, or 100 pounds. Most bariatric surgery patients do not actually get to their "ideal" weight.</p> <p> In the year following surgery, you will tend to lose weight no matter how you eat or how active you are. To keep the weight off, you will need to eat a healthy diet and get plenty of exercise. </p><ul> <li>Weight-loss surgery</li> <li>Weight management</li> </ul>APRN, CNS<p>Weight is a very emotional issue and I like to think of my office as a “no blame, no shame zone.” My goal is to listen and understand my patient’s struggles and work together to develop a plan to address them. </p> <p>I have struggled with weight myself for most of my adult life and have a close family member that had bariatric surgery.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Nursing, Minnesota State University-Mankato</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Adult Health Clinical Nurse Specialist, American Nurses Credentialing Center</li> <li>Certified Bariatric Nurse, American Society for Metabolic and Bariatric Surgery</li> </ul> <p><strong>Membership</strong></p> <ul> <li>President-Elect, American Society for Metabolic and Bariatric Surgery</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Surgery, Mayo Clinic College of Medicine and Science</li> </ul>Bednarchuk<img src="/-/media/shared-files/images/medical-professionals/full/mankato/heidi-bednarchuk-cns.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4FA8ABD1C131281B9AB8444BFA59FB44" alt="Heidi Bednarchuk, C.N.S." width="280" height="280" DisableNVelocity="true" />Heidi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15681548Heidi Bednarchuk, APRN, CNS1{94B2E140-AEF8-44BA-B6A9-4538B77501BC}<img src="/-/media/shared-files/images/medical-professionals/full/mankato/heidi-bednarchuk-cns.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4FA8ABD1C131281B9AB8444BFA59FB44" alt="Heidi Bednarchuk, C.N.S." width="280" height="280" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller6/29/2022Life at the dinner table looks different for people with food allergies, which often is confused with food intolerance. Understand the differences to help manage your meal planning.All about food allergies<p>What if you had to carefully read the ingredients of every food you ate to avoid an allergic reaction? For thousands of people in the U.S., this is the reality of living with a food allergy.</p> <p> Life at the dinner table is different for those with food allergies. Recent studies show that approximately 5% of children under age of 5 and 3% of adults have food allergies.</p> <p><a href="/hometown-health/speaking-of-health/food-intolerance-or-food-allergy" target="_self" title="Opens in same window.">Food allergies and intolerances</a> often are confused for one another. The symptoms can be similar.</p> <h2>What is a food allergy?</h2> <p>If you have a food allergy, your body is overreacting to a specific food as if it were a threat. This can occur when you ingest even the smallest amount of the food. For some people, the allergy may be triggered by smelling or coming into contact with the food.</p> <p>When you come into contact with the food, your immune system releases an antibody called immunoglobulin E to neutralize the food allergen.</p> <h3>The immunoglobulin antibodies tell your immune system to release a chemical called histamine, which causes many allergic symptoms:</h3> <ul> <li>Itching</li> <li>Swelling</li> <li>Hives</li> <li>Difficulty breathing</li> <li>Vomiting</li> <li>Diarrhea</li> <li>Abdominal cramps</li> <li>Anaphylaxis, which is a severe, life-threatening reaction</li> </ul> <h3>The top eight most common food allergens are:</h3> <ol> <li>Eggs</li> <li>Milk</li> <li>Peanuts</li> <li>Shellfish</li> <li>Tree nuts</li> <li>Soy</li> <li>Fish</li> <li>Wheat</li> </ol> <h2>What is food intolerance?</h2> <p>Unlike an allergic reaction, the symptoms of food intolerance are typically gastrointestinal. An intolerance means that your body does not have the correct mechanisms to digest certain foods properly. </p> <p>A common food intolerance is to lactose — the main sugar in milk products. If you have a <a href="/hometown-health/speaking-of-health/a-closer-look-at-lactose-intolerance" target="_self" title="Opens in same window.">lactose intolerance</a>, your body has difficulty digesting lactose, causing symptoms of bloating, abdominal pain and sometimes diarrhea.</p> <h3>Other intolerances that are sometimes confused with food allergy include:</h3> <ul> <li>Irritable bowel syndrome — a condition causing frequent diarrhea, constipation, bloating and other gastrointestinal symptoms when excess short-chain carbohydrates are consumed</li> <li>Celiac disease — a condition where the body sustains damage at a microscopic level from <a href="/hometown-health/speaking-of-health/gluten-free-what-does-that-mean" target="_self" title="Opens in same window.">ingesting gluten</a>, which is found in wheat, barley or rye products</li> <li>Food poisoning causes by bacteria that contaminate food</li> </ul> <h2>How a food allergy is diagnosed</h2> <p>An allergist is the best qualified professional to diagnose a food allergy. Your allergist will begin by taking a detailed medical history to find out whether your symptoms are an allergic reaction, an intolerance or another health problem.</p> <h3>Other food allergy tests include:</h3> <ul> <li><strong>Skin test<br> </strong>A skin test may determine which foods, if any, trigger your allergic symptoms. In skin testing, a small extract of the food is placed on your forearm or back by a tiny pin prick just below the skin. If you're allergic to the substance, you'll develop a small bump.</li> <li><strong>Blood test<br> </strong>Your allergist may also take a blood sample to measure the levels of food-specific immunoglobulin E. Positive blood tests do not necessarily mean that you have a food allergy, but they can help put together the pieces to the puzzle.</li> <li><strong>Food diary</strong><br> You may be asked to keep a food diary of what you eat and whether you have a reaction.</li> <li><strong>Elimination diet</strong><br> A limited elimination diet is removing the suspected food allergen from your diet under the direction of your health care professional for a few weeks. You then add the food item back into your diet to see if symptoms return.</li> <li><strong>Oral food challenge</strong><br> During this test, conducted in your allergist's office, you are given small, but increasing amounts of the suspect food. Your health care professional watches you to see whether a reaction occurs. A reaction only to suspected foods confirms the diagnosis of a food allergy. If you don't have a reaction, you may be able to include that food in your diet again.</li> </ul> <p>Unfortunately, those with food allergies cannot be cured. You can only prevent the symptoms by avoiding the foods that cause a reaction. If you come into contact with a food that causes a minor allergic reaction, you can often use an antihistamine to reduce the symptoms.</p> <p>For severe reactions, you may need an emergency epinephrine injection or a trip to the emergency department. You should always wear a medical alert bracelet or necklace. Seek medical care if you suspect you are having an allergic reaction.</p> <p><em>Kjersten Nett is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Clinical Nutrition</a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a> and <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2022/herbed-shrimp.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1F8A2DBC9C7C8E54BD5044312EEE217E" alt="Herbed shrimp" width="660" height="370" DisableNVelocity="true" />Allergy and AsthmaOur allergists provide care for your allergies, asthma and conditions that affect the immune system's ability to defend the body against foreign or abnormal cells. The main treatment goal is your satisfaction when your condition is under control and quality of life is improved.Celiac DiseaseCeliac disease is a digestive condition triggered by consumption of the protein gluten, which primarily is found in bread, pasta, cookies, pizza crust and many other foods containing wheat, barley or rye.Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller3/15/2022Does it sometimes sound like a warm summer night in your head? If you're hearing crickets and other noises, you may have tinnitus. Learn more about this condition.Are you hearing crickets?<p>Crickets, crickets, crickets.</p> <p>I hear them all the time, even in the winter. I hear them more in one ear than the other. Sometimes they don't sound like crickets, but a ringing, hissing and even chirping. At times, they're loud — really loud. I have tinnitus.</p> <p>I'm not alone. Nearly 45 million people suffer from tinnitus or head noises. The sound, or sounds, may be intermittent or annoyingly continuous in one or both ears.</p> <p>Mine is intermittent, catching me off guard when I least expect it. It's especially bothersome when I'm trying to have a conversation or fall asleep.</p> <p>So what causes tinnitus? Experts believe it comes from damage to the hair cells in the inner ear. The health of these hair cells is important for sending signals to the auditory nerve and ultimately the brain. Injury to them brings on hearing loss and often tinnitus. In most cases, the tinnitus or noises will start years before any identifiable hearing loss.</p> <p>There's no specific cure for tinnitus, but it's important that if you start experiencing these noises to be checked by an audiologist. The audiologist may refer you to an ear, nose and throat specialist. These health care professionals can rule out any worrisome problems and provide management options so the sounds no longer interfere with daily living.</p> <p>Tinnitus can be made worse by external factors, such as stress, anxiety, poor sleep hygiene, caffeine or sodium intake, and even nicotine use or exposure. I've noticed how much worse my sounds are when I'm stressed from a busy workday or when I stayed up too late the night before.</p> <p>I find a few moments of mindfulness or meditation help on those extra stressful days. I also try to get seven to eight hours of sleep each night and keep my caffeine consumption with reasonable limits. Technically, that’s 400 mg of caffeine or about four cups of brewed coffee, 10 cans of cola or two "energy shot" drinks.</p> <p>Others use sound, like a fan or a sound machine playing ocean waves or music, when falling asleep. Some who wear hearing aids to treat hearing loss notice less tinnitus while wearing their devices.</p> <p>Treatment for managing tinnitus isn't a one-size-fits-all approach. Meeting with your health care team, especially an audiologist, can identify tools that are right for you and calm those annoying crickets.</p> <p><em><a href="/providers/katie-dease-aud" target="_self" title="Opens in same window.">Katie Kendhammer, Au.D</a>., is an <a href="/services-and-treatments/audiology">audiologist</a> in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em></p><ul> <li>Amplification/hearing aids</li> <li>Audiometry</li> <li>Pediatrics</li> <li>Tinnitus</li> </ul>Au.D.<p><strong>Education</strong></p> <ul> <li>Doctor of Audiology, University of Wisconsin-Stevens Point</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Audiology</li> <li>Certificate of Clinical Competence, American Speech-Language-Hearing Association</li> <li>Hearing Instrument Dispenser</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Speech-Language-Hearing Association</li> </ul>Dease<img src="/-/media/shared-files/images/medical-professionals/full/mankato/katie-dease-aud.jpg?h=280&iar=0&w=280&hash=2A9E758AE48ADAA463D9362B7EE868C8" alt="Katie Dease, Au.D." width="280" height="280" DisableNVelocity="true" />{A4D89010-062B-42B7-830A-2F6D0A2BD079}Katie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15263924Katie Dease, Au.D.1{18E5E65E-45C8-4C48-BD32-A914794E2AA4}<img src="/-/media/national-files/images/hometown-health/2022/knit-sweater-long-blonde-hair.jpg?h=370&iar=0&w=660&sc_lang=en&hash=83943F020645B8078C8AD87ABD288647" alt="Person with long blonde hair wearing knit sweater" width="660" height="370" DisableNVelocity="true" />Ear HealthAn audiologist specializes in evaluating and treating people of all ages with hearing loss, dizziness and balance disorders. Specialty audiology consultation is available for assessment and treatment of hearing loss, tinnitus, dizziness and balance disorders.Dawn Haller2/22/2022<p>Emotional overeating can lead to unhealthy eating patterns. Learn the difference between emotional and physical hunger, and how to break the cycle.</p>Feeding your feelings<p>Many people have experienced emotional eating at some point in their lives. You don't always eat to support what your physical body needs — you feed your emotions. Eating when feeling certain emotions can replace the emotional void and create a false sense "fullness." The core area of concern is not feeling powerless over emotional eating, it's feeling powerless over your emotions.</p> <p>Emotional hunger never can be satisfied with food. Emotional overeating can make you feel good, but afterwards, you're left with feelings of guilt, shame and powerlessness. Often the guilt may lead to circular dieting. Diets don't fail because you have lack of willpower or control, they fail because your emotional needs are not being met. When you ignore these emotions, they continue many times with an unhealthy eating pattern.</p> <h4>The differences between emotional hunger and physical hunger are:</h4> <table> <tbody> <tr> <td rowspan="1" colspan="1"><strong>Emotional hunger</strong> <ul> <li>Comes on suddenly</li> <li>Crave certain foods</li> <li>Not satisfied with fullness</li> <li>Feel guilt or shame </li> </ul> </td> <td rowspan="1" colspan="1"><strong>Physical hunger</strong> <ul> <li>Comes on gradually</li> <li>Open to eating any food</li> <li>Feel full and can stop eating</li> <li>Don't feel bad </li> </ul> </td> </tr> </tbody> </table> <br /> <h4>There is hope</h4> <p>The answers are within you if you dig deep to learn what triggers your emotional eating for comfort. Ask yourself, "Am I feeling stressed or anxious? Is this a habit steaming back from childhood? Is my social environment affecting my choices? Am I feeling bored or empty inside?" Numbing yourself with food can feel as if it helps avoid emotions that may be uncomfortable to feel and acknowledge.</p> <p>Acknowledging what you're feeling and taking action steps will break the cycle that no longer is serving you. Acknowledging your feeling and taking steps to healing can give you a healthy feeling of empowerment and confidence. You deserve to feel great — emotionally and physically. When your body is nurtured and supported, you're better prepared for life's inevitable curveballs. Exercise, sleep and healthy nutrition can help get you through times of stress, leaving less trips to the fridge.</p> <h4>How to support yourself</h4> <ul> <li>Finding a coach, mentor or counselor can help you discover your emotional eating patterns and root cause.</li> <li>Surround yourself with encouraging friends who share your values, leaving you feeling uplifted and supported.</li> <li>Show yourself love by doing activities you enjoy.</li> <li>Make time for yourself to decompress, journal and relax every day, even if its just five to 10 minutes.</li> </ul> <p><strong>Feel your feelings</strong></p> <p>Feeling your feelings is more effective than feeding them. Notice when you have the trigger to eat when you're not hungry. Take a few moments to pause and notice what emotion is coming up for you. Name the feeling without judgment. Is it boredom, anxiousness or loneliness? When you're able to name what your feeling is, you're able to work through it. </p> <p>Your feelings are a beautiful transparent window into your interior world. They shouldn't be buried with food or other fillers. Feelings help you to uncover fears, explore desires, understand frustrations and define what makes you happy. Find your happiness within.</p> <p><em><a href="/providers/amanda-bassett-swanson-licsw" target="_self" title="Opens in same window.">Amanda Bassett-Swanson</a> is a licensed clinical social worker in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Adjustment disorders</li> <li>Community social services resources </li> <li>Grief and loss</li> <li>Mac Initiative support</li> <li>Mental health care of obstetrics and postpartum women</li> <li>Mental health support for miscarriage, stillbirth and infant/child death</li> <li>Postpartum mood disorders</li> </ul>L.I.C.S.W., PMH-C<p>The primary areas of focus in my practice are strength-based care for woman during their pregnancy, postpartum transition and cognitive behavior therapy.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Social Work, Arizona State University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Department of Economic Security, State of Arizona </li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Licensed Independent Clinical Social Worker</li> <li>Perinatal Mental Health Certification</li> </ul>Bassett-Swanson<img src="/-/media/shared-files/images/medical-professionals/full/mankato/amanda-bassett-swanson-licsw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=327AE41DB5E463CA600EE443DB999285" alt="Amanda Bassett Swanson, L.I.C.S.W., PMH-C" width="280" height="280" DisableNVelocity="true" />Amanda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15136272Amanda Bassett-Swanson LICSW1{F26710D2-A52B-47C8-986C-0B3D1DA0A9D0}<img src="/-/media/national-files/images/hometown-health/2022/writing-in-journal.jpg?h=370&iar=0&w=660&sc_lang=en&hash=72B292E5FEBE2E9A4C103A126C5B0C24" alt="Writing in journal" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Life CoachingThe life coach works with the whole person, taking the time to listen to concerns and asking powerful questions to help motivate you in your desire to make and sustain changes. Through coaching, you are empowered to reach your highest level of physical, emotional and spiritual health.Dawn Haller5/10/2023Viral infections are as common as they are frustrating, but your body is designed to fight them. Learn the difference between bacteria and viruses, and why antibiotics may not be necessary.Why antibiotics aren't always the answer for an illness<p>Have you ever left your healthcare professional's office feeling frustrated that you didn't get an antibiotic for a sinus infection, sore throat or ear infection? If you answered yes, you aren't alone. Millions of people visit their healthcare team each year looking for antibiotics to cure infections. The reality is that if you have a virus that cause illnesses like bronchitis, sinus infection and the common cold, you don't need antibiotics to get better. </p> <h2>Bacteria or virus: What's the difference?</h2> <p>Though both bacteria and viruses are germs too small to see with the naked eye and are spread in a similar way, the similarities end there. Bacteria are cells capable of surviving on their own. Viruses are not cells — they are even smaller particles that require a host, such as your healthy sinus or lung cells, to survive and multiply. This key difference is why antibiotics aren't effective against viruses.</p> <h2>How is it determined if a bacteria or a virus is causing an illness?</h2> <p>Determining whether bacteria or a virus has caused an infection can be difficult. Your healthcare team may run blood tests, collect a urine sample or perform a throat swab to help answer this question. The type of infection often is a clue.</p> <p>For example, scientists know viruses cause bronchitis, so healthcare professionals no longer use antibiotics to treat it. Likewise, over 90% of sinus infections are caused by viruses. Antibiotics typically are not used to treat a sinus infection unless it lasts longer than 10 days without improvement. Your healthcare professional will evaluate, test and review your symptoms to be confident your infection is caused by a bacteria before prescribing an antibiotic.</p> <h2>Why aren't antibiotics used to help a person recover quicker?</h2> <p>The body needs time to fight an infection, whether bacteria or a virus causes that infection. After the infection is gone, the body needs additional time to recover.</p> <p>If an illness does not improve with an antibiotic, this is an indication that the infection causing the illness is viral. Unless an illness becomes severe, additional antibiotics are not needed.</p> <h3>This may have you wondering why healthcare professionals don't prescribe antibiotics to help people recover quicker. The answer is trifold:</h3> <h4>1. Antibiotics don't work for viruses.</h4> <p>Antibiotics work by destroying bacterial cell membranes and bacterial replication. Since viruses are not cells, they do not have cell membranes, so antibiotics are ineffective against them.</p> <h4>2. Antibiotics have side effects.</h4> <p>If you take antibiotics for a viral infection, you are putting yourself at risk for side effects. All antibiotics can cause diarrhea and nausea. Some antibiotics are hard on your kidneys, liver or other body parts. In certain instances, side effects can be life-threatening, such as an allergic reaction. Every antibiotic can have side effects.</p> <h4>3. Using antibiotics to treat viruses causes superbugs.</h4> <p>Superbugs are bacteria that become resistant to antibiotics. This happens when antibiotics are inappropriately used to treat viral infections. When a person gets an infection caused by a superbug, antibiotics don't work. Thousands of people die from these infections every year. Infants, young children and older adults are at greatest risk. These deaths are preventable — but only if antibiotics are used correctly.</p> <p>Viral infections are as common as they are frustrating. Your body is designed to fight these infections. You can help your body heal and strengthen your immune system by getting plenty of rest, staying hydrated and eating healthy.</p> <p>The next time you see your healthcare team for an infection, you have an opportunity to be a good steward of antibiotics. If your healthcare team determines that you don't need antibiotics, you can contribute to the greater good by avoiding unnecessary use of these medications for viral illnesses.</p> <p><em><a href="/providers/carrie-kern-do" target="_self" title="Opens in same window.">Carrie Kern, D.O.</a></em><em>, is a </em><em><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">family medicine</a></em><em> physician in <a href="/locations/ellsworth" target="_self" title="Opens in same window.">Ellsworth</a>, Wisconsin, and <a href="/locations/red-wing" target="_self" title="Opens in same window.">Red Wing</a>, Minnesota. </em></p><ul> <li>Adolescent health</li> <li>Preventive medicine</li> <li>Women’s health</li> </ul>D.O.<p><strong>Education</strong></p> <ul> <li>Des Moines University College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>University of Minnesota – St. Joseph’s Hospital</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Medicine</li> </ul>Kern<img src="/-/media/shared-files/images/medical-professionals/full/red-wing/carrie-kern-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4E10714922F39E081ADC081ADB26D057" alt="Carrie Kern DO" width="280" height="280" DisableNVelocity="true" />{AAA82E74-D2AA-47E2-91F3-5B95772E1677}Carrie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15372782Carrie Kern DO1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}<img src="/-/media/national-files/images/hometown-health/2023/young-child-with-hand-over-ear.jpg?h=370&iar=0&w=660&sc_lang=en&hash=19DC8586B5F39F44C3A1F97D59246144" alt="Young child with hand over ear" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller12/8/2022Winter is beautiful, but it does come with risks. Take steps to prevent falls, hypothermia, frostbite and more so you can remain in good health and enjoy the splendor of the season.Watch out for winter mishaps<p>Winter is a beautiful season enjoyed by many people. Outdoor activities in winter can be enjoyable and exhilarating. Yet, there are some risks.</p> <p>Snow, ice and the arctic-chilled air can add a layer of difficulty and potential danger to life. There are major health concerns that are more common during winter. Watch out for these throughout the season.</p> <h2>Slips and falls</h2> <p>Nearly 7 million U.S. adults are treated in Emergency Departments for fall-related injuries each year. The risk of slipping or falling increases significantly in winter due to snow and ice-covered sidewalks. Most slips and falls occur at building entrances, on lawns, in parking lots and garages, and inside walkways.</p> <p>Watch out for uneven ground, protruding structures, holes and debris that can cause slips, trips and falls.</p> <h3>Follow these tips for preventing slips and falls:</h3> <ul> <li><strong>Wear the right shoes.</strong><br /> Properly fitted shoes increase comfort, reduce fatigue and improve safety. Look for shoes with good support and traction. You also can purchase snow grips for the bottoms of your shoes or boots.</li> <li><strong>Take your time.</strong><br /> If you notice that the floor or ground doesn't have much traction, walk slowly and be careful with each step. Don't hurry when walking outside.</li> <li><strong>Walk like a penguin.</strong><br /> Walk with your feet slightly pointed forward and try the "shuffle step" to prevent slips, trips and falls. Taking small steps and waddling like a penguin helps you maintain your center of gravity.</li> <li><strong>Use assistance.</strong><br /> Always use handrails, a walking stick or a cane when out in winter weather.</li> </ul> <h2>Hypothermia prevention</h2> <p>Hypothermia is a serious medical emergency that occurs when your body loses heat faster than it can produce it. Symptoms may include shivering, lack of coordination, confusion, drowsiness and slow, shallow breathing. It occurs when a person's body temperature drops below 95 F (35 C).</p> <h3>Give hypothermia the cold shoulder by remembering the acronym COLD:</h3> <ul> <li><strong>Cover </strong><br /> Wear weather-appropriate clothing, including a hat and scarf to cover your head, face and neck. Cover your hands with mittens, not gloves, to keep your fingers warm.</li> <li><strong>Overexertion<br /> </strong>Be cautious of any winter activities that would cause you to sweat excessively. This can cause you to lose body heat more quickly. </li> <li><strong>Layer<br /> </strong>Wear loose-fitting, layered clothing. Outer clothing made of tightly woven, water-repellent material is best for wind protection. Wool or silk inner layers hold body heat better than cotton does. </li> <li><strong>Dry<br /> </strong>Keep yourself dry. Wet clothing and cold weather can cause a quick drop in body temperature. Remove wet clothing as quickly as possible. </li> </ul> <p>When traveling, keep your vehicle stocked with emergency supplies in case bad weather causes you to get stranded. A charged cellphone, blankets, candles, matches, winter attire and a first aid kit would be helpful in an emergency. If you're traveling during bad weather, alert someone where you are going, the planned route and expected arrival time.</p> <p>Seek immediate medical attention if you are experiencing symptoms of hypothermia. As you wait for medical assistance, relocate to a warmer location, remove any wet clothing and cover yourself with blankets or coats.</p> <h2>Frostbite</h2> <p>Having cold extremities is one thing, but frostbite is a whole different condition. And it's a serious one. Frostbite is an injury caused by the freezing of the skin and underlying tissues. </p> <p>At first, the skin feels cold and has a prickling feeling. This is followed by numbness and swollen or discolored skin. Eventually, the skin may become hard or waxy-looking. Frostbite requires medical care because it can permanently damage skin, muscles, nerves and other tissues. <br /> <br /> The first step to preventing frostbite is to know when you're most at risk. Your risk is elevated if you smoke, have a blood vessel disease like diabetes, aren't wearing proper clothing, are dehydrated or fatigued, and if you're at a higher altitude.</p> <h3>Take these measures to prevent frostbite:</h3> <ul> <li>Cover your ears, face, head and nose.</li> <li>Wear proper boots or shoes — no sandals or open-toed shoes.</li> <li>Wear mittens or gloves — mittens provide better protection.</li> <li>Put on two pairs of socks on extremely cold days.</li> <li>Pack your car with winter survival gear in case of emergency.</li> <li>Travel with another person whenever possible.</li> </ul> <h2>Illnesses</h2> <p>Winter is a season where colds and flu are more prevalent than any other time of the year.</p> <h3>There are some things you can do today to help prevent winter illness:</h3> <ul> <li><strong>Get your flu shot and COVID-19 booster.</strong><br /> The most effective way to stop the spread of flu and COVID-19 is to receive recommended vaccinations. Flu and COVID-19 vaccines are recommended for people 6 months and older.</li> <li><strong>Practice proper hand-washing.</strong><br /> Wash your hands thoroughly and frequently with water and soap or alcohol-based hand sanitizer. This is particularly important before leaving the bathroom, eating or touching your face.</li> <li><strong>Don't smoke.</strong><br /> In general, smoking makes you more susceptible to illness.</li> <li><strong>Eat a clean diet and exercise.</strong><br /> A <a href="/hometown-health/speaking-of-health/clean-eating-what-does-that-mean" target="_self" title="Opens in same window.">clean diet</a> and regular physical activity, plus a daily multivitamin with vitamin D, will keep you healthy and boost your immune system.</li> </ul> <p>Cold weather poses many challenges for people of all ages. Using these tips will aid you in your attempt to combat winter health mishaps and maintain good health.</p> <p><em>By Mayo Clinic Health System staff</em> </p><img src="/-/media/national-files/images/hometown-health/2022/untying-shoe-in-winter.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7325E98C7AA1DF1ACCFC8AD1BF33E6B7" alt="Untying shoe in winter" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.InfluenzaInfluenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza, commonly called the flu, is not the same as the stomach "flu" viruses that cause diarrhea and vomiting.Immunizations<p>Disease prevention is crucial to your health. Getting vaccinated is one of the best ways to maintain good health, and protect you and those you care about against infectious diseases. Vaccinations offer protection against serious diseases by stimulating the immune system to create antibodies against certain bacteria or viruses.</p><br/><p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/vaccine-guidance/art-20536857" target="_blank" title="Opens in a new window.">Get vaccine guidance from Mayo Clinic</a>, including benefits, safety, side effects and what to know about recommended vaccines for babies, children, teens, adults and during pregnancy. For recommended vaccines based on age, refer to the <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/adult" target="_blank" title="Opens in a new window.">adult</a> or <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/child" target="_blank" title="Opens in a new window.">child and adolescent</a> schedules.</p><br/><p>Review the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/coronavirus-covid-19/history-disease-outbreaks-vaccine-timeline" target="_blank" title="Opens in a new window.">history of infectious disease outbreaks and vaccines timeline</a> for information about major disease outbreaks, epidemics and pandemics, and the impact of vaccines and research.</p>Dawn Haller9/30/2020October is breast cancer awareness month. Each year, about 250,000 in the U.S. are diagnosed. Arm yourself with information to better understand and reduce the risk of breast cancer.Breast cancer awareness saves lives<p>About 250,000 women in the U.S. are diagnosed with breast cancer each year, with nearly 40,000 women dying from the disease annually. On average, a woman who lives to be 90 or older has between a 10% and 15% chance of developing breast cancer.</p> <p>Although prognosis and detection have improved in recent years, awareness, healthy lifestyle choices and screenings are still vital to reducing the impact of breast cancer.</p> <h2>Consider this information to help you better understand breast cancer:</h2> <h3>There are lifestyle changes you can make to help reduce the risk of breast cancer, such as:</h3> <ul> <li><strong>Maintain a healthy weight.</strong><br> If you are at a healthy weight, continue to eat healthy and exercise to maintain it. If you looking to drop extra pounds, get regular exercise and eat a diet rich in fruits, vegetables, whole grains and lean protein. Avoid foods high in saturated fat and sugar.</li> <li><strong>Adopt a physically active lifestyle</strong>.<br> Aim for 150 minutes of moderate exercise each week. Get creative and make your workouts fun. A casual sporting activity or working in your garden are perfectly acceptable forms of exercise. </li> <li><strong>Consume alcohol in moderation.</strong><br> Don't have more than one drink per day.</li> <li><strong>Avoid or limit the duration of postmenopausal hormone therapy.</strong><br> This type of combination hormone therapy may make women more susceptible to breast cancer.</li> </ul> <h3>Breast cancer warning signs</h3> <p>Breast cancer is the most commonly diagnosed cancer and the fifth leading cause of death among women according to the Centers for Disease Control and Prevention (CDC).</p> <h4>General warning signs of breast cancer include:</h4> <ul> <li>General breast pain</li> <li>A new lump in the breast</li> <li>Breast thickening or swelling</li> <li>Shift in the breast shape or size</li> <li>Changes in the nipple, including bloody discharge</li> </ul> <p>If you notice any of these symptoms, contact your health care provider as soon as possible.</p> <h3>Breast cancer screenings</h3> <p>Detecting breast cancer early is key to the best possible outcomes. Undiagnosed breast cancer can lead to serious complications and even death.</p> <p>Women should become familiar with their breasts and conduct regular self-exams to ensure there are no lumps or other red flags.</p> <p>A mammogram, or X-ray of the breast, is a proven method of determining if you have any breast abnormalities. Although mammograms don't reduce the risk of developing breast cancer, screening does allow your doctor to detect breast cancer in its early stages, which is important for effective diagnosis and treatment. </p> <p>Start having yearly mammograms at age 40. If you have family history of breast cancer, start your exams 10 years prior to your family member's diagnosis. For example, begin yearly mammograms at 37 if your mother was diagnosed at 47.</p> <p>In addition, a yearly physical exam is a good way to review your risk for breast cancer and discuss an appropriate screening schedule. And, as always, your health care provider is the best resource for any questions or concerns about your health.</p> <p>This October, be breast-conscious and help raise awareness for breast cancer prevention.</p> <p><em>Paula Gill, M.D., is an <a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">oncologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2020/breast-cancer-awareness-pink-ribbon.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0C463AE558EB5E035BC697F75B36EC21" alt="Breast cancer awareness pink ribbon" width="660" height="370" DisableNVelocity="true" />Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller1/2/2014Winter can be a challenging time for people who enjoy exercising outside, considering it's dark and cold. But you can endure this time of year without letting your fitness goals go into hibernation.Warm up to the idea of winter exercise<p>Winter can be a challenging time for people who enjoy exercising outside. Dark mornings are followed by even darker evenings. And then there's the cold, cold, cold.</p> <h2>But here are some ways to endure this time of year without letting your fitness goals go into hibernation:</h2> <h3>Schedule around it. </h3> <p>If dealing with the dark and cold seem like too much, try scheduling around it. If there's flexibility with your work schedule, spend the darker hours of the day in the office, then take a midday exercise break to enjoy some daylight and slightly warmer temperatures.</p> <h3>Brace for it.</h3> <p>Winter is cold. There's no getting around it. Sometimes just accepting that fact and dressing accordingly is all it takes to push through that mental barrier. Also, focus on the warmth you know you'll feel once you get moving.</p> <p>You can add extra heat with hand and toe warmers. Because they're air activated, you can reuse warmers by putting them in a plastic baggie when you're done.</p> <h3>Embrace it.</h3> <p>Some recreational activities can only be performed on snow and ice. Use this time of year to take advantage of skiing, snowshoeing and ice skating opportunities. Many races and events occur all winter long to give you a goal to work toward.</p> <h3>Make a scene.</h3> <p>If you have to exercise in the dark, stay safe by being visible. Wear light-colored clothing or a reflective vest. Lightweight headlamps and flashlights also help you to see and be seen.</p> <h3>Exercise with others.</h3> <p>Knowing a buddy is waiting for you outside or planning on taking an exercise class with you holds you accountable. Getting out of bed on these dark and cold mornings is easier when someone is counting on you.</p> <h3>Fresh air is good.</h3> <p>People tend to be inside so much in the colder months that they forget how good it is to go outside for a short time each day. Kids in a school playground are good role models, as outside recess rarely is canceled. They play in all conditions, and so should everyone.</p> <p>It can seem like forever before the cold weather finally abates and the ease of warm weather exercise resumes. Until then, keep reminding yourself, "Spring is just around the corner."</p> <p><em>Karen Myhre, M.D.</em><em>, is a <a href="/services-and-treatments/hospital-medicine" target="_self" title="Opens in same window.">hospitalist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2014/winterexercise1.jpg?h=351&iar=0&w=250&sc_lang=en&hash=6CE42D8C2DE971B24CBB5F283CB27A32" alt="Jogger running in winter" width="250" height="351" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Dawn Haller12/26/2013<p>Patients requiring left ventricular assist devices, or LVADs, now have more options in their care.</p>Shared care offers new options for patients with LVADs<p>Patients with severe congestive heart failure may benefit from a ventricular assist device, a mechanical device that helps pump blood from the lower chambers of the heart, or ventricles, to the body, enhancing the heart's function. Left ventricular assist devices, or LVADs, are the most common form of this therapy. Originally used for patients awaiting heart transplant or recovering from surgery, LVADs increasingly are a long-term solution that provides a good quality of life. </p> <img alt="lvad graphic" src="/-/media/national-files/images/hometown-health/miscellaneous/lvad-graphic.jpg?sc_lang=en&hash=449F7F3FC8BB0E15E66C008F2C991DFF" /> <p>"Sometimes when an LVAD is implanted as a bridge to transplant, the patient feels they do reasonably well with it and opts not to have the transplant. Patients who don't respond to medical therapy go through an in-depth evaluation to determine if they are good candidates for LVADs. Most benefit from dramatically improved symptoms and survival rates for heart failure," says <a href="/providers/daniel-kincaid-md" target="_self" title="Opens in same window.">Daniel T. Kincaid, M.D.</a>, a <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>. "They often can live a nearly normal life. Some even golf."</p> <p>The LVADs are implanted at Mayo Clinic in Rochester. "At Mayo, 19 circulatory failure specialists see patients with heart failure who may receive or have received transplants or ventricular assist devices," says Margaret M. Redfield, M.D., a cardiologist in Rochester. "We also see patients with pulmonary hypertension, which destroys blood vessels in the lungs."</p> <p>Patients generally stay in the hospital in Rochester for two to four weeks following LVAD implant surgery and return for follow-up care every month, initially, and then every two to four months. Four LVAD coordinators see patients in Rochester for their regularly scheduled appointments. They share appointment notes with the patients' primary care providers and cardiologists, who may contact the LVAD coordinators with questions during their own appointments with these patients.</p> <h2>Eau Claire named shared care center</h2> <p>Mayo Clinic Health System in Eau Claire recently was designated a LVAD shared care center by a LVAD manufacturer, which will allow the facility to provide care for both Mayo and non-Mayo patients with LVADs. </p> <p>"Patients won't need to travel to Rochester as often for follow-up care," says Dr. Kincaid. "More importantly, the designation means that there will be a medical facility and well-qualified staff to work with these complicated, sophisticated medical devices in our area."</p><img src="/-/media/national-files/images/hometown-health/miscellaneous/lvad-device.jpg?h=75&iar=0&w=75&sc_lang=en&hash=DF780FDF3AF9B699B33AAC5F64CC8412" alt="lvad device" width="75" height="75" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller6/19/2023Aphasia creates communication obstacles for the affected person and their family. Raising awareness about aphasia, and its underlying causes and treatment options can help ease the effects on many lives.Understanding aphasia and its causes<p>"It's on the tip of my tongue" is a phrase people say time and time again. Sometimes it's hard to find that word you're looking for — whether it's someone's name, an everyday object, a favorite restaurant menu item, your address or something else. But for people with a disorder called aphasia, it's as if their brain's word cabinet has fallen over and mixed their words around, resulting in varying levels and forms of impairment with language comprehension and expression.</p> <h2>Causes of aphasia</h2> <p>A stroke and its subsequent brain damage is the most common cause of aphasia. A stroke results from the bursting or blockage of blood vessels supplying the brain. This reduces blood flow to the brain, depriving the brain of essential nutrients and oxygen needed to support brain cell life. When a <a href="/hometown-health/speaking-of-health/women-and-stroke-what-you-need-to-know" target="_self" title="Opens in same window.">stroke occurs</a>, the brain's language centers can be affected if they don't receive essential components like blood and oxygen.</p> <p>Aphasia also can develop due to a brain tumor, infection or degenerative disease. There always is an underlying cause of aphasia, which determines the severity of the person's language difficulties.</p> <p>Temporary aphasia can appear during a migraine. It can occur from a seizure or transient ischemic attack, or TIA, sometimes called a mini-stroke. Anyone who experiences a TIA is at an elevated risk for a full-blown stroke in the future.</p> <h2>Symptoms of aphasia</h2> <h3>A person who is affected by aphasia may:</h3> <ul> <li>Experience difficulty understanding conversations</li> <li>Have trouble writing coherent sentences</li> <li>Speak in brief or incomplete sentences</li> <li>Use words or sentences that don't make sense</li> </ul> <p>Seek medical help immediately if you or a loved one experiences these symptoms. A form of aphasia can be the <a href="/hometown-health/speaking-of-health/is-it-a-stroke-how-to-know-and-help" target="_self" title="Opens in same window.">first sign of stroke</a>.</p> <h2>Types of aphasia</h2> <h3>Aphasia presents itself in three different ways. Your health care team may classify aphasia as:</h3> <ul> <li><strong>Broca's (non-fluent) aphasia</strong><br /> Non-fluent aphasia is identified as decreased language output, difficulty identifying words and incomplete or short sentences. People with non-fluent aphasia are aware of their communication difficulties as their cognition and comprehension are most commonly still intact.</li> <li><strong>Wernicke (fluent) aphasia</strong><br /> Fluent aphasia is identified as language output that is incoherent composure of words, word combination errors, grammar mistakes and incorrect word choices. People with fluent aphasia also may have difficulties with cognition and comprehension.</li> <li><strong>Global aphasia</strong><br /> Global aphasia results from a major stroke that affects the brain more extensively causing cognition, comprehension and language difficulties.</li> </ul> <h2>Testing for aphasia</h2> <p>A common initial test from your health care team to determine the cause of aphasia is a CT or MRI.</p> <h3>Aside from that, testing for aphasia usually involves exercises and observations to gauge your ability to:</h3> <ul> <li>Explain a situation depicted on paper</li> <li>Follow directions</li> <li>Have a conversation</li> <li>Read and write</li> <li>Repeat words and sentences</li> </ul> <h2>Treatment and coping with aphasia</h2> <p>Speech-language therapy is the most common form of treatment for aphasia. <a href="/hometown-health/speaking-of-health/help-is-available-for-speech-and-language-disorders" target="_self" title="Opens in same window.">Early intervention and timely treatment</a> are imperative for achieving maximum results.</p> <p>A speech-language pathologist works with patients with aphasia to regain as many previous language skills as possible or, with certain diseases and conditions, to maintain their current communication ability. Treatment exercises often incorporate meaningful activities relevant to the patient to increase motivation and participation. Exercises may include functional tasks, such as ordering food from a menu, writing on a greeting card, or stating your address or birthdate.</p> <p>In terms of coping, family and friends can adjust by simplifying conversations to ensure comprehension. This allows for active participation for people with aphasia and eases their apprehension about communication. Those with aphasia also may choose to use images and gestures to help them communicate.</p> <p>Stroke and aphasia support groups also can aid <a href="/hometown-health/speaking-of-health/recharge-with-planned-mental-health-day" target="_self" title="Opens in same window.">healing and coping</a> for patients and family members.</p> <p>Aphasia is a challenging communication disorder that creates communication obstacles for patients and their families. Fortunately, raising awareness about the condition, and its underlying causes and treatment options can help reduce the effects of aphasia on many lives.</p> <p><a href="/providers/delaney-collins-ccc-slp" target="_self" title="Opens in same window."><em>Delaney Collin</em></a><em>s is a <a href="/services-and-treatments/speech-language-therapy" target="_self" title="Opens in same window.">speech-language therapist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Aphasia</li> <li>Apraxia of speech</li> <li>Cognitive-linguistic disorders</li> <li>Developmental delay</li> <li>Dysarthria</li> <li>Dysphagia</li> <li>Pediatric feeding disorders</li> <li>Speech sound disorders</li> <li>Voice disorders</li> </ul>CCC-SLP<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Communication Sciences and Disorders, University of Wisconsin-Milwaukee</li> <li>Master's degree, Speech Pathology, Fontbonne University</li> </ul> <p><strong>Certification</strong></p> <ul> <li> Clinical Competence, American Speech-Language Hearing Association</li> <li>Lee Silverman Voice Therapy</li> <li>McNeil Dysphagia Therapy Program</li> </ul>Collins<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/delaney-collins-ccc-slp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=419CABE41113583BA9F3FC872D28636F" alt="Delaney Collins, CCC-SLP" width="280" height="280" DisableNVelocity="true" />Delaney<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30232211Delaney Collins, CCC-SLP1{161AC8C4-5C35-4A06-8AFF-4311067526AF}<img src="/-/media/national-files/images/hometown-health/2022/middle-aged-person-thoughtful-gaze.jpg?h=370&iar=0&w=660&sc_lang=en&hash=602A037FACB3FD1CF0054C63708719E5" alt="Middle-aged person looking to side with a thoughtful gaze" width="660" height="370" DisableNVelocity="true" />Speech-LanguageThe evaluation and treatment of communication disorders and swallowing disorders.Dawn Haller6/10/2024A brain injury, such as a stroke, can cause aphasia, which may affect the person's ability to speak, read, write and more. These tips can help you reconnect with your loved one through language.How to improve communication with a loved one who has aphasia<p>Imagine being dropped off in a country where you aren't fluent in the local language Even when the native speakers speak slowly, you may understand only portions of what's being said. This is similar to how someone with <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/aphasia/symptoms-causes/syc-20369518" target="_blank" title="Opens in a new window.">aphasia</a> may feel every day.</p> <p>Aphasia is an <a href="/hometown-health/speaking-of-health/aphasia-putting-the-disorder-into-words" target="_self" title="Opens in same window.">impairment of language</a> that may affect ability a person's ability to speak, understand spoken language, read, write, use numbers, perform calculations or use nonverbal gestures. It happens after an injury to the brain, most commonly a stroke. However, it also can be caused by a traumatic brain injury, brain tumor or other incident affecting the brain. </p> <h2>What are the symptoms of aphasia?</h2> <p>Aphasia symptoms can range from mild to severe, with each person experiencing their own set of communication weaknesses. Mild forms of aphasia may include only occasional difficulties finding words. But those with severe aphasia can suffer a complete loss of ability to speak or understand spoken and written words.</p> <p>One of the most common questions about aphasia is, "When will this be better?" Research suggests that most recovery happens during the first four to six months following the injury. However, improvements in communication can continue for years.</p> <h2>How can you treat aphasia?</h2> <p>A speech-language pathologist, or SLP, trained in treating aphasia and related disorders can help with recovery. According to the <a rel="noopener" href="https://www.asha.org/" target="_blank" title="Opens in a new window.">American Speech-Language Hearing Association (ASHA)</a>, clinical evidence declaring shows that people who receive services from qualified SLPs benefit in quality and quantity of their language recovery.</p> <p><a href="/services-and-treatments/speech-language-therapy" target="_self" title="Opens in same window.">Therapy</a> may focus on regaining abilities, strategies to compensate for communication loss or a combination of both. Either way, the main goal of <a href="/services-and-treatments/neurology" target="_self" title="Opens in same window.">treatment</a> is to improve the quality and efficiency of communication.</p> <h2>10 tips for communication success</h2> <p>An aphasia diagnosis affects not only the person, but also their family and friends. When communicating with a loved one who has aphasia, setting them up for success is essential.</p> <h3>Here are 10 tips for improving communication with someone who has aphasia:</h3> <ol> <li>Continue to treat the person with aphasia as a mature adult.</li> <li>Reduce background noises, such as the radio, TV and other conversations.</li> <li>Reduce visual distractions, including the TV and people moving around the area.</li> <li>Be sure you have the person's attention before speaking to them.</li> <li>Keep messages short and simple. Speak slowly but naturally. Speaking louder doesn't increase understanding.</li> <li>Use gestures, facial cues and voice intonation to help the person understand the message, even if they don't understand the words.</li> <li>Don't assume they understand what you're saying. Your loved one may respond with head nods and sounds of agreement but still not understand what's being said.</li> <li>Encourage communication and be patient.</li> <li>Give your loved one plenty of time to respond, and try not to answer for them.</li> <li>Include the person when they're present. Don't talk about them as if they aren't there. Just as you shouldn't assume comprehension, don't assume lack of comprehension.</li> </ol> <p>Recovering speech and language after an aphasia diagnosis can take time and practice, so give your loved one support, and remain calm and focused on <a href="/locations/eau-claire/services-and-treatments/neurology/aphasia-camp" target="_self" title="Opens in same window.">improving communication together</a>.</p> <p><a href="/providers/jody-englert-slp" target="_self" title="Opens in same window."><em>Jody Englert</em></a><em> is a <a href="/services-and-treatments/speech-language-therapy" target="_self" title="Opens in same window.">speech-language therapist</a> in <a href="/locations/red-wing" target="_self" title="Opens in same window.">Red Wing</a>, Minnesota.</em></p><ul> <li>Pediatric speech and language</li> <li>Rehabilitation of adults with communication, voice and swallowing disorders</li> </ul>CCC-SLP<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Communication Science Disorders, James Madison University</li> <li>Master's degree, Speech-Language Pathology, James Madison University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Clinical Competence, American Speech-Language-Hearing Association</li> <li>Lee Silverman Voice Treatment-LOUD</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Speech-Language-Hearing Association</li> </ul>Englert<img src="/-/media/shared-files/images/medical-professionals/full/red-wing/rehab-services/jody-englert-slp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=90B1A9580E9DD433F8897005FEF66BBC" alt="Jody Englert SLP" width="280" height="280" DisableNVelocity="true" />Jody<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15885291Jody Englert, CCC-SLP1{161AC8C4-5C35-4A06-8AFF-4311067526AF}<img src="/-/media/national-files/images/hometown-health/2024/elderly-person-sitting-with-younger.jpg?h=370&iar=0&w=660&sc_lang=en&hash=962186A7750D6E6B630FCD55CC00F4BB" alt="Elderly person sitting on sofa with younger person" width="660" height="370" DisableNVelocity="true" />Speech-LanguageThe evaluation and treatment of communication disorders and swallowing disorders.Dawn Haller1/13/2023MRI exams are used to help diagnose a wide range of conditions. However, it isn't an easy option for larger patients or patients with claustrophobia. Learn how a wide-bore MRI can help.Wide-bore MRI improves patient comfort<p>Health care teams use MRI exams to help diagnose a wide range of conditions, from sports-related injuries to all types of cancers. It uses a magnetic field and computer-generated radio waves to create detailed images of organs and tissues in the body. It produces 3D images that can be viewed from different angles.</p> <p>Most MRI machines are large, tube-shaped magnets, and the patient lies inside the machine. The magnetic field temporarily realigns water molecules in the body, and radio waves cause the aligned atoms to produce faint signals that are used to create cross-sectional images.</p> <p>Patients cannot feel the magnetic field during the scan. The machine will produce repetitive tapping or thumping noises. Earplugs can help block out the noises. An MRI scan can last 60 minutes or longer, and the patient needs to remain still so images are clear.</p> <p>While the scan is painless, the enclosed space of an MRI machine is a challenge for some patients, especially larger patients or patients with claustrophobia. Some MRIs are called "wide-bore," which means the machine has a wider tunnel-like opening than other MRI systems. This creates more headroom and space around the patient.</p> <p>A wide-bore MRI system offers a more comfortable exam for people with wide shoulders or who weigh up to 550 pounds. The exam table height is lower, so it is easier to get onto the MRI table without using a step stool. The wider bore design can help reduce anxiety during the test because your head can remain outside the bore for many MRI exams. This helps make the MRI machine feel more open and helps lessen feelings of claustrophobia.</p> <p>Another benefit of a wide-bore MRI is that it produces high-quality images to help your health care team make quicker, more accurate diagnoses.</p> <p>A wide-bore MRI is available at many Mayo Clinic Health System locations. Talk with your health care team about your questions before an MRI exam, and ask if a wide-bore option is right for you.</p> <p><a href="/providers/christopher-lindsay-md" target="_self" title="Opens in same window."><em>Christopher Lindsay, M.D.</em></a><em>, is a <a href="/services-and-treatments/radiology-and-imaging">radiologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>University of Minnesota</li> </ul> <p><strong>Internship</strong></p> <ul> <li>General Surgery, Mayo Clinic</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>Radiology, Mayo Clinic</li> <li>Urology, Mayo Clinic</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Neuroradiology, Mayo Clinic</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Diagnostic radiology</li> <li>Neuroradiology</li> </ul> <p><strong>Academic Rank</strong></p> <ul> <li>Instructor in Radiology, Mayo Clinic College of Medicine and Science</li> </ul>Lindsay<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/christopher-lindsay-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=F3AEC7DEBEFDAED2B49CF3E79ACBB76B" alt="Christopher Lindsay, M.D." width="280" height="280" DisableNVelocity="true" />Christopher<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13041011Christopher Lindsay, M.D.1<img src="/-/media/national-files/images/hometown-health/2022/wide-bore-mri.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EE633A198EC1EA6490721F14C7605F55" alt="Wide bore MRI" width="660" height="370" DisableNVelocity="true" />Dawn Haller6/5/2023No parent wants to think about the possibility of having a premature baby. It’s important to talk with your health care team and family about what you’ll do if a premature birth occurs.Beware of risks, signs of premature birth<p>It may be scary to think about the possibility of having your baby before its due date. A birth is considered premature if the baby is born before 37 weeks of pregnancy, which is about a month before the due date. Although you may feel uncomfortable, <a href="/hometown-health/speaking-of-health/the-importance-of-a-birth-plan" target="_self" title="Opens in same window.">talk with your health care team</a> and family about what to do if early labor or premature birth occurs. </p> <p>About 1 in 10 babies in the U.S. is born prematurely. Preterm birth is identified by the number of completed weeks of pregnancy: </p> <ul> <li><strong>Late preterm</strong> — Baby born between 34 and 36 weeks</li> <li><strong>Moderately preterm</strong> — Baby born between 32 and 34 weeks</li> <li><strong>Very preterm</strong> — Baby born between 28 and 32 weeks</li> <li><strong>Extremely preterm</strong> — Baby born before 28 weeks</li> </ul> <p>Complications of preterm birth include underdeveloped brain and lungs, digestive and liver problems, and infections. Premature birth also can affect the baby long term. Some of the most common long-term effects include <a href="/hometown-health/speaking-of-health/5-steps-to-help-avoid-birth-defects" target="_self" title="Opens in same window.">neurological problems</a>, such as cerebral palsy, or chronic medical problems, such as lung disease.</p> <h2>Survival rate for premature babies increasing</h2> <p>With today's technology, the survival rate of babies born as early as 25 weeks ranges from 70% to 90%. Although this is good news, it's still important to be cautious throughout your pregnancy and know the risk factors that increase the likelihood of preterm labor.</p> <h3>Risk factors for preterm birth include:</h3> <ul> <li>Previous premature births</li> <li>Pregnancy with twins, triplets or other multiples</li> <li>Smoking or illicit drug use</li> <li>Having high blood pressure</li> <li>Having gestational diabetes</li> <li>Experiencing chronic stress</li> <li>Pregnancies spaced less than six months apart</li> <li>Structural or functional problems with the uterus, cervix or placenta</li> <li>Uterine or kidney infection</li> <li>Being overweight or underweight</li> </ul> <p>Complex social or economic factors also are associated with preterm delivery. Health care disparities may present barriers to receiving care during pregnancy, which can lead to preterm delivery. Black and American Indian <a href="/hometown-health/speaking-of-health/maternal-fetal-health" target="_self" title="Opens in same window.">women</a> are about 50% more likely to have preterm deliveries than other demographic groups. But premature birth can happen to anyone, and many preterm births have no known risk factors. </p> <h2>Monitoring your health and your baby's</h2> <p>Your health care team may decide to induce your labor before the due date when it's necessary for the safety of you or your baby. Your care team will carefully monitor you and your baby during your <a href="/hometown-health/speaking-of-health/is-virtual-prenatal-care-right-for-you" target="_self" title="Opens in same window.">prenatal visits</a> to track your health and the baby's health.</p> <h3>Precautions to take during pregnancy to avoid premature birth include: </h3> <ul> <li><a href="/hometown-health/speaking-of-health/eating-twice-as-well-during-pregnancy" target="_self" title="Opens in same window.">Healthy eating</a></li> <li>Getting plenty of rest</li> <li>Following weight-gain guidelines</li> <li>Avoiding alcohol and smoking</li> </ul> <p>Following these steps, along with other guidance from your health care team, helps ensure the best outcome for you and your baby.</p> <p>Identifying risk factors that can be modified through lifestyle changes can reduce the chances of preterm birth. Knowing the signs of premature labor is crucial to beginning the appropriate care as soon as possible.</p> <h3>Signs of preterm labor include:</h3> <ul> <li>Contractions — the intermittent <a href="/hometown-health/speaking-of-health/5-common-questions-about-braxton-hicks-contractions" target="_self" title="Opens in same window.">tightening of your abdomen</a> — which aren't relieved with rest or drinking water</li> <li>Vaginal bleeding</li> <li>Cramping, a feeling similar to menstrual cramps</li> <li>Increase or change in vaginal discharge</li> <li>Pelvic pressure, or the feeling that the baby is pushing down</li> <li><a href="/hometown-health/speaking-of-health/pregnancy-back-pain-relief" target="_self" title="Opens in same window.">Backache</a></li> </ul> <p> Contact your health care team if you have questions about your risk of preterm birth or are experiencing symptoms of premature labor.</p> <p><a href="/providers/erica-berven-md" target="_self" title="Opens in same window."><em>Erica Berven, M.D.</em></a><em>, is an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em></p><ul> <li>Abnormal pap management (HPV, colposcopy, LEEP) </li> <li>Birth control</li> <li>Menstruation issues</li> <li>Prenatal care and delivery</li> </ul>M.D.<p>My practice goal is to promote inclusive health of diverse obstetric and gynecologic patients. I hope to provide compassionate and sensitive care guided by the strongest evidence. I try to be pragmatic rather than dogmatic in determining a care plan. One size does not fit all in many cases, and I will use shared decision-making and advocacy to work toward healthy outcomes.</p> <p>I love working in my yard and garden with the assistance of my husband and our four rescue cats.</p><p><strong>Medical School</strong></p> <ul> <li>Mayo Clinic College of Medicine and Science</li> </ul> <p><strong>Residency</strong></p> <ul> <li>OB-GYN, Mayo Clinic College of Medicine and Science</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Obstetrics and Gynecology (ABOG)</li> <li>Fellow of the American Congress of Obstetricians and Gynecologists (FACOG)</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Obstetricians and Gynecologists (ACOG) </li> <li> American Society for Colposcopy and Cervical Pathology (ASCCP) </li> </ul>Berven<img src="/-/media/shared-files/images/medical-professionals/full/owatonna/erica-berven-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B76B6CE28F6B68FCDB4935DC5BD42C00" alt="Erica Berven MD" width="280" height="280" DisableNVelocity="true" />Erica<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12585394Erica Berven, M.D.1<img src="/-/media/national-files/images/hometown-health/2022/hands-on-folded-baby-clothes.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CA09976C5BFDD019C167C45912A60B33" alt="Hands on folded baby clothes" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller8/29/2022<p>Almost every day, your lungs are affected by chemical exposure, secondhand smoke and smoking. Breathe easy by finding out how much you know about keeping them healthy.</p>Lung health: Know the fallacies and facts<p>Healthy lungs are fundamental to your health and well-being. Yet, almost every day, these essential organs are affected by smoking, secondhand smoke and chemical exposure.</p> <h2>Know these facts and fallacies so you can keep breathing easy:</h2> <h3>1. Family history factors into the likelihood of developing a respiratory illness.</h3> <p><strong>True. </strong>Respiratory illnesses such as asthma, lung cancer and chronic obstructive pulmonary disease can be genetic. If any of these conditions run in your family history, preventive care and careful monitoring of unusual or recurring health symptoms are important.</p> <h3>2. Acid reflux could be the cause of chronic cough.</h3> <p><strong>True. </strong>Many cases of chronic cough stem from gastrointestinal issues such as acid reflux. A cough is the initial symptom, leading to heartburn as the condition worsens. Asthma, postnasal drip and tobacco use also cause chronic cough.</p> <p>You shouldn't ignore a chronic cough. It can interrupt sleep patterns. In more severe cases, it can cause vomiting, lightheadedness and even broken ribs.</p> <h3>3. Radon and respiratory illness are linked.</h3> <p><strong>True. </strong>Radon is the leading cause of lung cancer in nonsmokers and the No. 2 cause of lung cancer overall, according to the Environmental Protection Agency. It causes roughly 21,000 deaths each year. About 2,900 of these deaths are in people who never smoked.</p> <p>The first step is to have your basement tested for unhealthy radon levels. If indicated, contact a qualified radon service professional to properly ventilate your home.</p> <h3>4. Smoking won't kill me or anyone else.</h3> <p><strong>False.</strong> The Surgeon General's report states that 1 out of every 3 cancer deaths in the U.S. would not occur if no one smoked. Almost 90% of men who died from lung cancer smoked.</p> <p>The effects on nonsmokers also are significant, with secondhand smoke exposure related to approximately 3,000 adult deaths per year. Nonsmokers have a 20%–30% higher risk of developing lung cancer if exposed to secondhand smoke, according to the U.S. Department of Health and Human Services.</p> <p>Pregnant women should be aware that smoking has been linked to premature birth and low birth weight, as well as increased chance of sudden infant death syndrome.</p> <p><strong></strong></p> <h3>5. The symptoms of lung cancer are obvious.</h3> <p><strong>False. </strong>Lung cancer tends to act silently. The tissue that lung cancer affects is on the inside of the lung. Because you only feel pain on the outer part of your lungs, detection can be difficult.</p> <p>If you experience a chronic cough, persistent chest pain during deep breathing or unexplained weight loss, alert your health care professional about these warning signs.</p> <p>Approximately 235,000 people in the U.S. will be diagnosed with lung cancer this year. Lung cancer is the leading cause of cancer death in the U.S. However only about 29% of Americans know this. Survival rates are improving, but it's important to be aware of the risks and symptoms, and discuss concerns with your health care team.</p> <h3>6. You can take action today to improve your lung health.</h3> <p><strong>True.</strong> The best way to fight respiratory illness is by not smoking or quitting smoking immediately. Regular aerobic exercise also can counter breathing issues and make your lungs and breathing muscles stronger. In addition, eating a diet rich in fruits, vegetables, whole grains and lean sources of protein helps fight all types of illness.</p> <h2>Don't ignore symptoms</h2> <p>If you have concerns about respiratory illness, consult with your health care team.</p> <h3>Watch this video explaining lung cancer:</h3> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/UViC-yNkN98?" title="Speaking of Health: Lung cancer" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe> </p> <p class="video-container"><em><a href="/providers/jamil-taji-md" target="_self" title="Opens in same window.">Jamil Taji, M.D.</a>, is a <a href="/services-and-treatments/pulmonology" target="_self" title="Opens in same window.">pulmonologist</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a> and <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Lung cancer</li> <li>Pulmonary artery hypertension</li> </ul>M.D.<p><strong>Medical School</strong></p> <ul> <li>University of <span class="RadEWrongWord" id="RadESpellError_0">Szeged</span> Medical School, Hungary</li> </ul> <p><strong>Residency</strong></p> <ul> <li>University of Toledo Medical School, Ohio</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>University of Toledo Medical School, Ohio</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Internal Medicine </li> <li>Pulmonology and critical care</li> </ul> <p> </p>Taji<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jamil-taji-md.jpg?h=200&iar=0&w=200&sc_lang=en&hash=56CAAF52CF62D9FF8B802873FF147F31" alt="Jamil Taji MD" width="200" height="200" DisableNVelocity="true" />Jamil<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13999001Jamil Taji MD1<img src="/-/media/national-files/images/hometown-health/2022/hand-spread-over-chest-area.jpg?h=370&iar=0&w=660&sc_lang=en&hash=65DFDDD070E700004B6D1E65DA2C54B7" alt="Hand spread over chest area" width="660" height="370" DisableNVelocity="true" />Lung CancerLung cancer is a type of cancer that begins in the lungs. It is the leading cause of cancer deaths in the U.S., among both men and women. Lung cancer claims more lives each year than do colon, prostate, ovarian and breast cancers combined. <br/><br/>Dawn Haller8/24/2022Infertility can cause stress, affecting relationships with partners, friends and family, and create financial difficulty. Read about ways to deal with this stress.Infertility and stress<p>Infertility can have far-reaching effects. It can affect a person's relationship with family and friends, create financial difficulty, affect the relationship between partners and negatively affect the couple's sexual relationship.</p> <p>In a nutshell, <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infertility/symptoms-causes/syc-20354317" target="_blank" title="Opens in a new window.">infertility</a> can cause stress.</p> <p>Research has shown that women with infertility have the same anxiety and depression levels as women with cancer, heart disease and HIV. Many societies do not understand that infertility is a disease, so couples are blamed for their condition.</p> <h2>Does stress cause infertility?</h2> <p>While it's unlikely that stress alone can cause infertility, stress interferes with a woman's ability to get pregnant. Research has shown that women with a history of depression are twice as likely to experience infertility. <a href="/hometown-health/speaking-of-health/tips-to-help-ease-anxiety" target="_self" title="Opens in same window.">Anxiety</a> also can prolong the time needed to achieve pregnancy. </p> <p>Studies on women undergoing in vitro fertilization showed that stress decreases the pregnancy rate.</p> <h2>How can you deal with the stress of infertility?</h2> <h3>To deal with the stress of infertility:</h3> <ul> <li><strong>Learn.</strong><br /> Educate yourself about the normal responses to infertility. Talk to other people going through infertility. Understand your medical condition and ask about treatment options.</li> <li><strong>Communicate.</strong><br /> Talk to your partner about your feelings and needs, and allow your partner to feel and cope differently. Talk about your differences and avoid conflict. Keep communicating with family and friends to avoid isolating yourself. Understand that you can talk about your situation without going into details and tell others how they can support you.</li> <li><strong>Practice relaxation techniques.</strong><br /> The human body has two types of responses: fight-or-flight and relaxation. The fight-or-flight response is what happens to your body when you feel danger. This is the same response you experience during psychological stress. The relaxation response is when your body is in deep rest. <a href="/hometown-health/speaking-of-health/massage-for-depression-anxiety-and-stress" target="_self" title="Opens in same window.">Relaxation techniques</a>, such as progressive muscle relaxation, deep breathing, meditation and imagery, can help you transition to a relaxation response state. These techniques can help you deal with any stress, including stress related to infertility.</li> <li><strong>Take care of your health.</strong><br /> Make sure you get your well-adult exam every year. Eat healthy, <a href="/hometown-health/speaking-of-health/fit-a-workout-into-any-schedule" target="_self" title="Opens in same window.">exercise regularly</a>, get <a href="/hometown-health/speaking-of-health/5-ways-to-get-better-sleep" target="_self" title="Opens in same window.">adequate sleep</a> and allow time for recreation.</li> <li><strong>Deal with sexual stress.</strong> <br /> Sexual stress is common among couples with infertility, mostly because couples feel that this is an obligation or a duty rather than a fun activity. Couples can deal with this in several ways, including taking a break from baby-making, distinguishing between work and fun sex, and learning sensual contact that doesn't lead to pregnancy.</li> </ul> <h2>Does managing stress improve fertility?</h2> <p>In brief, managing stress may improve fertility. However, the effect of managing stress on the rate of fertility has not been well-studied. </p> <p>Most available research suggests that there is a positive effect. Mind-body infertility programs have been shown to improve the pregnancy rates in women with infertility. </p> <p>One study showed that 55% of women involved in a mind-body program could get pregnant, compared to 20% of women who were not in such a program. These programs teach relaxation techniques, stress management, coping skills and group support. Programs range from five to 10 sessions, and most include male partners in the sessions.</p> <p><a href="/providers/fadi-yahya-md" target="_self" title="Opens in same window."><em>Fadi Yahya, M.D.</em></a><em>, is an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN </a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a> and <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</em></p><ul> <li>Incontinence</li> <li>Infertility evaluation and treatment</li> <li>Menstrual disorders</li> <li>Pelvic pain and endometriosis</li> <li>Prolapse of pelvic organs, including uterus, bladder, rectum and bowel</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>American University of Beirut</li> <li>Master of Healthcare Administration, University of Southern California</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Obstetrics and Gynecology, American University of Beirut</li> <li>Riverside Regional Medical Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Obstetrics and Gynecology, American Board of Obstetrics & Gynecology</li> <li>Minimally Invasive Gynecologic Surgery Focused Practice Designation, American Board of Obstetrics & Gynecology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Obstetrics and Gynecology, Mayo Clinic College of Medicine and Science</li> </ul>Yahya<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/fadi-yahya-md.jpg?h=280&iar=0&w=280&hash=E736BD0910ABE8C3992BE5C3A07ABB0C" alt="Fadi Yahya, M.D." width="280" height="280" DisableNVelocity="true" />{668BC882-2740-41A2-AD6E-97954A90F269}Fadi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15562000Fadi Yahya, M.D.1<img src="/-/media/national-files/images/hometown-health/2022/closeup-of-hands-with-wedding-rings.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8D96F3BB44EFA5A98925C0EF60EA0F28" alt="Close-up of hands with wedding rings" width="660" height="370" DisableNVelocity="true" />FertilityFertility issues may be due to a single cause with you or your partner or a combination of factors that may prevent a pregnancy from occurring or continuing. There are multiple safe, effective fertility therapies available.Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller8/31/2023When life gets challenging, the rates of depression, feelings of hopelessness and thoughts of suicide can increase. Here are five things you can do to help teens overcome suicidal thoughts.5 ways to help teens overcome suicidal thoughts<p>Navigating adolescence can be challenging for anyone. It's a time of facing significant milestones and experiencing confusing physical and hormonal changes. The COVID-19 pandemic escalated some challenges and created new issues. Loneliness and psychological distress rates increased exponentially during and following the height of the pandemic.</p> <p>Regardless of age, life's challenges can affect anyone's ability to cope. When hard times lead to depression or hopelessness, some people contemplate suicide as their only way out. But there is hope and suicide can be preventable. Awareness of risk factors and <a href="/hometown-health/speaking-of-health/addressing-your-mental-health-by-identifying-the-signs-of-anxiety-and-depression" target="_self" title="Opens in same window.">warning signs</a>, along with knowledge of what to do to help, can make a difference in the lives of others.</p> <h2>Risk factors for suicide include:</h2> <ul> <li>Conflict with others</li> <li>Family conflict and <a href="/hometown-health/speaking-of-health/teen-dating-violence" target="_self" title="Opens in same window.">poor relationships</a> in general</li> <li>Feelings of worthlessness, helplessness, or hopelessness</li> <li>History of or current experience(s) of bullying</li> <li>History of suicidal thoughts or <a href="/hometown-health/speaking-of-health/help-i-think-my-teenager-is-cutting" target="_self" title="Opens in same window.">self-injury</a></li> <li>Loss of close friend(s) by suicide</li> </ul> <h2>Warning signs among those at risk for suicide include:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/college-students-and-depression" target="_self" title="Opens in same window.">Decreases in academic</a> or job performance</li> <li>Direct or indirect verbal threats of suicide</li> <li>Giving away prized possessions</li> <li>Irritability or anger</li> <li>Loss of interest in usual activities or social and emotional withdrawal</li> <li>Sudden or dramatic changes in mood</li> </ul> <p>Helping teens find hope while understanding their emotional struggles is essential to starting their journey to healing.</p> <h2>Here are five things you can do to help prevent suicide:</h2> <h3>1. Acknowledge negative feelings and provide support.</h3> <p>If your teen is going through a rough time, provide support. Listen to their concerns and let your teen know you are there to help. Also, look for ways to provide spiritual, emotional and personal support and offer problem-solving and coping techniques that could improve the situation.</p> <h3>2. Be honest.</h3> <p>Talk to your teen. Ask how they are doing and about some of the emotions they may be experiencing. Review past experiences that were challenging and talk about how your teen overcame them. Validate their concerns while gently reminding them about the temporary nature of problems and that moving forward through adversity is possible by using resilience tools developed in the past.</p> <h3>3. Promote social connectivity.</h3> <p>Identify ways to connect more as a family and provide opportunities to connect with peers and other adult caregivers. These social connections can help override a teen's feelings of loneliness and helplessness and allow them to transition to a <a href="/hometown-health/speaking-of-health/is-having-a-sense-of-belonging-important" target="_self" title="Opens in same window.">sense of belonging</a> and importance.</p> <h3>4. Ask questions and have conversations.</h3> <p>Noticing changes in your teen can be unsettling. Be proactive and ask what's wrong. If you're worried your teen may have suicidal thoughts, be direct and ask, "Are you thinking about hurting yourself?" Asking about suicidal thoughts doesn't cause harm and often helps. If your teen answers yes, don't downplay the situation. Ask how you can help, <a href="/hometown-health/speaking-of-health/awareness-and-intervention-help-with-suicide-prevention" target="_self" title="Opens in same window.">express your concerns</a> about his or her feelings and seek professional help.</p> <h3>5. Seek professional help.</h3> <p>There are many treatment options for people contemplating taking their own life. More than 90% of people who commit suicide have one or more treatable mental illnesses. Even if the root cause isn't a mental illness, <a href="/hometown-health/speaking-of-health/suicide-crisis-develop-safety-plan" target="_self" title="Opens in same window.">coping techniques</a> and emotional support are proven methods to aid those in need.</p> <p>Suicide is a significant concern in the U.S. and was the 11th leading <a rel="noopener noreferrer" href="https://www.cdc.gov/nchs/fastats/suicide.htm" target="_blank" title="Opens in a new window.">cause of death</a> for people ages 10 and over in 2021, according to the Centers for Disease Control and Prevention. A 40-year study by the American Foundation for Suicide Prevention revealed that approximately 100,000 teens ages 15–19 died by suicide between 1975 and 2015. You can find specific programs for students and parents in the <a rel="noopener noreferrer" href="https://afsp.org/more-than-sad/" target="_blank" title="Opens in a new window.">More Than Sad</a> section of the organization's website.</p> <p>The positive news is that with the proper information and willingness to reach out to someone in need, everyone can help prevent suicide.</p> <h2>Next steps:</h2> <ul> <li>In case of emergency, call <a href="tel:911">911</a> or the <a href="tel:988">988</a> Suicide and Crisis Lifeline.</li> <li>Get additional information from the <a rel="noopener noreferrer" href="https://www.nimh.nih.gov/health/topics/suicide-prevention" title="Opens in a new window." target="_blank">National Institute of Mental Health Suicide Prevention</a>.</li> <li>Find resources for developing a <a rel="noopener noreferrer" href="https://www.samhsa.gov/find-help/988/partner-toolkit" target="_blank" title="Opens in a new window.">safety plan</a> from the Substance Abuse and Mental Health Services Administration.</li> <li>Get <a rel="noopener noreferrer" href="https://www.yourlifeyourvoice.org/pages/13-reasons-why-not.aspx" target="_blank" title="Opens in a new window.">tips for preventing suicide</a> based on the Netflix series "13 Reasons Why."</li> </ul> <p><em><a href="/providers/lisa-hardesty-phd-lp" target="_self" title="Opens in same window.">Lisa Hardesty, Ph.D.</a>, is a clinical psychologist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Co-morbid medical and behavioral health conditions</li> <li>Integrated behavioral health</li> <li>Optimizing health and well-being</li> <li>Weight management</li> </ul>Ph.D., L.P.<p><strong>Education</strong></p> <ul> <li>Master's degree, Health and Clinical Psychology, Minnesota State University-Mankato</li> <li>Doctor of Philosophy degree, Western Michigan University-Kalamazoo</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Post Doctoral Fellowship, Health Psychology, Henry Ford Hospital</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Clinical Health Psychology, American Board of Professional Psychology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Psychology, Mayo Clinic College of Medicine and Science</li> </ul>Hardesty<img src="/-/media/shared-files/images/medical-professionals/full/mankato/lisa-hardesty-phdlp.jpg?h=280&iar=0&w=280&hash=0F1D1C9CA069ED45487CBB5A40FD588A" alt="Lisa Hardesty, Ph.D., L.P." width="280" height="280" DisableNVelocity="true" />{A9A6221E-C37E-4EAE-B151-BFE624FC511D}Lisa<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>11683651Lisa Hardesty, Ph.D., L.P.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}|{94B2E140-AEF8-44BA-B6A9-4538B77501BC}<img src="/-/media/national-files/images/hometown-health/2023/group-of-teens.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D8BAEAE4406DC5910ACD6B563AC8C661" alt="Group of teens" width="660" height="370" DisableNVelocity="true" />Suicide PreventionSuicide is a major concern in the U.S. According to the Centers for Disease Control and Prevention, suicide was among the top nine leading causes of death for people ages 10–64 and the second leading cause of death for people ages 10–14 and 25–34. The positive news is that with the right information and willingness to reach out to someone in need, we all can help prevent suicide.<br /><br /><strong>If you are having suicidal thoughts, call the 988 Suicide and Crisis Lifeline at <a href="tel:988">988</a>, or chat at <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://988lifeline.org/" target="_blank" title="Opens in a new window.">988lifeline.org</a>.</strong>Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Dawn Haller9/3/2013Training for any sporting event takes dedication and focus. But to achieve the best results, it's important to remember proper nutrition.Nutrition is important to your training routine<img style="margin-top: 0px; margin-bottom: 5px; float: right; margin-left: 5px;" alt="Grace Fjeldberg RD" src="/-/media/shared-files/images/medical-professionals/full/mankato/grace-fjeldberg-rdn.jpg" /> <p>Training for any sporting event takes dedication and focus. You must prepare your body for exertion and intense physical activity. Part of your training undoubtedly involves lifting and running. But to achieve the best results, it's important to remember proper nutrition too.</p> <p>Nutrition is important to your preparation because it provides you with the fuel needed to achieve optimal performance.</p> <h2>Here are some nutrition tips to keep in mind while you're getting ready for a running race:</h2> <h3>To meet nutrition goals on a daily basis:</h3> <ul> <li>Eat at least three kinds of food at each meal, preferably consisting of fruit, lean protein, vegetables and whole grains.</li> <li>Eat every three to five hours, and avoid crescendo eating, which is eating a small breakfast and consuming progressively larger portions by the end of the day.</li> <li>Stay well hydrated with the goal of drinking eight to 10 8-ounce glasses of fluid per day.</li> </ul> <h3>During training sessions and on race day, focus on these tips:</h3> <ul> <li>Learn how much pre-exercise food you can eat and still exercise comfortably.</li> <li>On long runs, remember to drink every 15 to 20 minutes to maintain hydration.</li> <li>If running longer than 60 to 90 consecutive minutes, you need to replace fluid and carbohydrates.</li> <li>Don't let yourself get too thirsty — it's a sign of dehydration. Also, don't let yourself drink too much as a full stomach impairs performance. Too much fluid may also lead to a condition called hyponatremia, so consider using a drinking schedule of 4 to 8 ounces every 15 to 20 minutes.</li> <li>When running longer than one hour, the body needs adequate carbohydrate to function at maximum capacity. On average, runners need 30 to 60 grams of carbohydrate an hour after the start of their run and with each additional hour of activity. Consider these popular snacks and beverages for long distance running: <ul> <li>Dried fruit, bagels, pretzels, bananas, sugar cookies, honey sticks, diluted juice, candy, sports drinks, sweetened ice tea, iced coffee with sugar and squeeze-pack yogurt.</li> <li>Aim to eat within 15 to 30 minutes after exercise for recovery. Focus on foods that provide carbohydrate and some protein, such as cereal, yogurt, fruit or fruits smoothies, peanut butter and crackers, chocolate milk, low-fat cottage cheese and fruit, and small sandwiches or wraps.</li> </ul> </li> </ul> <p>Remember that everybody is different and has different needs. Be sure to seek individual nutrition counseling if you're experiencing difficulty meeting your goals.</p> <p>As you get ready to challenge your body and mind with a running race, be sure to factor in proper nutrition. Healthy eating and proper refueling will help give you the edge you need to perform at your highest level.</p><ul> <li>Bariatric surgery</li> <li>General nutrition</li> <li>Oncology</li> <li>Pediatric nutrition</li> </ul>RDN, LD <p><strong>Education</strong></p> <ul> <li>Minnesota State University, Mankato</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Mayo Clinic College of Medicine, Minnesota</li> </ul> <p><strong>Certifications</strong> </p> <ul> <li>Commission on Dietetic Registration</li> <li>Minnesota Board of Dietetics and Nutrition Practice</li> </ul> Fjeldberg<img src="/-/media/shared-files/images/medical-professionals/full/mankato/grace-fjeldberg-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=FB99EC499314FA86AE8202C30AB740A2" alt="Grace Fjeldberg RDN" width="280" height="280" DisableNVelocity="true" /> Grace<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15268781Grace Fjeldberg R.D.N. 1<img src="/-/media/shared-files/images/medical-professionals/full/mankato/grace-fjeldberg-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=FB99EC499314FA86AE8202C30AB740A2" alt="Grace Fjeldberg RDN" width="280" height="280" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Dawn Haller4/23/2025Heading back to school for many students includes a bagged lunch tucked into their backpack. Follow these tips for packing healthy lunches kids will like and help improve their ability to learn.Beat the 'back-to-school blues' with healthy lunches<p>Healthy eating is important at every age, but especially in growing children. Research has shown there's a close link between nutrition and learning. A healthy diet improves children's ability to focus, memory, brain function, behaviors and moods.</p> <p>The basics of a healthy diet include a variety of fruits, vegetables, grains, proteins and dairy or fortified soy alternatives. Beverages should be nutrient-rich and have little to no added sugars.</p> <p>If creating a healthy, balanced family meal plan feels overwhelming, start with the U.S. Department of Agriculture's <a rel="noopener" href="https://www.myplate.gov/" target="_blank" title="Opens in a new window.">MyPlate</a> guidelines. These guidelines call for half of the plate to be fruits and vegetables and the other half split between grains and protein, with a serving of dairy on the side.</p> <h2>Packing a healthy grab-and-go lunch</h2> <p>While many children eat a prepared lunch at school, others bring their lunches from home. If you pack a school lunch for your children, you can help beat the back-to-school blues by giving them something that not only satisfies their hunger but also boosts their attention and energy for a day of learning.</p> <h3>When packing lunches that can help your child succeed in school, include these foods:</h3> <h4>Grains</h4> <p>At least half — 3 ounces — of the grains eaten daily should be whole grains, which are packed with fiber. When you check a product's ingredient list, the first ingredient should be a whole grain, such as whole wheat, brown rice or whole oats.</p> <p>Sandwiches are an easy way to include whole grains at lunch. Make them with whole-grain bread, bagels, pitas or tortillas. Or pack a whole-grain side dish featuring quinoa, brown rice or a snack bag of whole-grain crackers.</p> <h4>Proteins</h4> <p>Choose lean cuts of meat, poultry and fish prepared without additional fat or oil. Baking, broiling and grilling are healthy ways to cook proteins. Nuts, beans and lentils also are packed with protein.</p> <p>Foods with protein help children feel full longer. A sandwich of peanut butter, almond butter or lean meat and sliced cheese is a lunch-bag staple. Or make a wrap by spreading a tortilla with hummus and rolling it up with shredded lettuce, sliced tomatoes and shredded chicken. On frosty days, fill an insulated container with chili. To add protein on the side, pack string cheese, a yogurt cup or a handful of nuts.</p> <h4>Fruits and vegetables</h4> <p>Aim for 1½ to 2 cups of fruits and at least 1½ cups of vegetables daily. Keep in mind that 1 cup of 100% fruit juice is equal to 1 cup of fruit. Fresh fruits and vegetables get their colorful appearance from the essential vitamins and minerals they contain. Add a variety of fresh vegetables and fresh, dried or canned fruits to your children's lunchboxes.</p> <p>Some ideas for lunch-friendly veggies include cucumber slices, celery, carrot or jicama sticks dunked into a low-fat dip or hummus, or a small container of cherry tomatoes or sugar snap peas. Whole, fresh fruits like oranges, bananas, grapes, apples and pears are perfect for lunches. Or pack a snack bag of raisins, apricots or dried banana chips.</p> <p><strong>Healthy beverages</strong></p> <p>The best way to keep children hydrated is to have them drink water or milk. Milk is a great source of calcium, which helps build strong bones. Avoid juice, soda or energy drinks, which are high in sugar.</p> <p>For the most part, no foods are off limits when it comes to building a healthy, balanced meal. But some foods should be limited because they lack nutritional value, including:</p> <ul> <li>High-fat foods that contain more than 30% of daily calories. You can find this information on the nutrition label. </li> <li>Foods that cause dental cavities, such as soda, gum, candy and sugar-sweetened beverages. Too much sugar has been shown to have a negative effect on academic performance.</li> <li>Caffeinated drinks, which can cause restlessness and dehydration.</li> </ul> <h2>Pack what kids like</h2> <p>Even the best-packed lunch won't be any good if it goes uneaten.</p> <h3>Here are a few tips for packing lunches your children will eat.</h3> <ul> <li><strong>Get them involved.</strong><br> The best way to find out what your child wants is to ask. This conversation will be a chance to talk about making healthy food choices and help keep lunches from going to waste.</li> <li><strong>Pack familiar foods.</strong><br> Familiar foods usually aren't boring to children. They're foods they enjoy and will eat.</li> <li><strong>Give them options.</strong><br> Pack a variety of items so your children can choose what to eat. Even if they don't eat everything at lunch, they can snack on leftovers later.</li> </ul> <p><em>Lizzie Bertrand</em><em> is a </em><em>registered dietitian</em><em> in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in </em><em><a href="/locations/st-james" target="_self" title="Opens in same window.">St. James</a></em><em>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2023/healthy-school-lunch.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5D4B434F102289D295283C3742D70AA9" alt="Healthy school lunch" width="660" height="370" DisableNVelocity="true" />Childhood ObesityUnderstanding what causes obesity and providing healthy alternatives can help lead your child down a lifelong path of wellness.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller5/26/2023No matter the season, before you venture outdoors, you should apply sunscreen. But myths abound about sunscreens and how to use them. Here's what you need to know about these sun blockers.Top 10 myths about sunscreens<p>Sunscreen is essential for protecting your skin from early aging and skin cancer<s>s</s>, which often are a direct result of the sun's ultraviolet, or UV, radiation.</p> <p>Even with increased awareness of dangers from the sun, more people in the U.S. are diagnosed with <a href="/topics/skin-cancer" target="_self" title="Opens in same window.">skin cancer</a> each year than all other cancers combined. By age 70, at least 1 in 5 people in the U.S. will develop skin cancer.</p> <p>It's more difficult to treat wrinkles, sunspots and leathery skin once the damage is done, so prevention is key.</p> <h2>Check out the top 10 myths about sunscreen before you venture outdoors:</h2> <h3>Myth #1: It doesn't matter what time of day I go out in the sun.</h3> <p>Fact. In North America, the sun is at its peak between 10 a.m. and 4 p.m. That's when UV rays are strongest and your risk of skin damage is the greatest. However, this doesn't mean early mornings and late afternoons are without risk. You need skin protection from sunrise to sunset.</p> <h3>Myth #2: I can't get sunburned or suffer skin damage when it's cloudy, rainy or during the winter.</h3> <p>Fact. If the sun is up and you're outdoors, you're exposing your skin to UV radiation. Even on cloudy days, up to 90% of the sun's rays still can penetrate your skin. Water, sand and snow can reflect the sun, which exposes your skin to indirect UV rays. No matter the weather or the season, applying sunscreen every day is a must.</p> <h3>Myth #3: I tan but don't burn, so I don't need sunscreen.</h3> <p>Fact. There is no such thing as a safe tan. Tanning is your body's response to UV damage and a sign that your skin has been injured. Even getting just a "glow" damages your skin's DNA, and increases aging and your risk of skin cancers. A tan will not protect your skin from sunburn or other sun damage.</p> <h3>Myth #4: I don't need sunscreen because I have dark-colored skin.</h3> <p>Fact. Dark-colored skin does not burn as quickly, although it still is susceptible to sun damage, including dark spots, wrinkles and sunburn. Regardless of your skin tone, do not skip the sunscreen.</p> <h3>Myth #5: My makeup has sunscreen. That's all I need.</h3> <p>Fact. Foundation with a sun protection factor, or SPF, of at least 30 provides some sun protection, but is less protection than traditional sunscreen. Also, most people typically apply makeup to just the face, and not the throat, back of the neck or other sun-sensitive areas. Be sure to apply a layer of traditional sunscreen under your foundation, as well as any areas that will be exposed to the sun.</p> <h3>Myth #6: I won't get enough Vitamin D if I wear sunscreen.</h3> <p>Fact. Even well-applied sunscreen lets 2% to 3% of the sun's ultraviolet B rays reach your skin, and your body needs only a little to produce vitamin D. Rather than risk skin cancer, it's better to seek your vitamin D needs through a healthy diet or supplement.</p> <h3>Myth #7: Any kind of clothing protects my skin from getting too much sun.</h3> <p>Fact. Darker, heavier fabrics with tighter weaves offer more protection than lightweight and light-colored clothing. You also can get high-tech protection and breathability from many new fabrics. Look for the ultraviolet protection factor, or UPF, designation on apparel. A UPF of 30 to 49 offers good protection, while a UPF of 50 or more rates as excellent. The more skin you cover, the better. Don't forget to accessorize your outfit with a wide-brimmed hat and UV-filtering sunglasses.</p> <h3>Myth #8: A higher SPF gives significantly more protection.</h3> <p>Fact. No sunscreen blocks 100% of the sun. Sunscreen with an SPF of 100 blocks only 1% to 2% more of the sun's rays than one with an SPF of 30, which already blocks 97% of rays. Also, SPF does not affect how long you will be protected. Protection typically lasts two hours or less for all sunscreens. Look for a broad-spectrum — blocks UVA and UVB rays — water-resistant sunscreen with an SPF of at least 30. Reapply it frequently, especially after being in the water or sweating.</p> <h3>Myth #9: All sunscreens are created equal.</h3> <p>Fact. Not necessarily. There are two primary types of sunscreen: physical and chemical. Both options have pros and cons.</p> <p>Physical sunscreens, also called mineral sunscreens, work like a shield and sit on the surface of your skin to deflect the sun's rays. They contain the active ingredients zinc oxide or titanium dioxide. Mineral sunscreens are considered safer for you and the environment. They also are best for people with sensitive skin, children and those with pigment concerns, such as melasma. While traditional mineral sunscreens left a white residue on your skin, tinted and less-visible mineral sunscreens now are available.</p> <p>Chemical sunscreens work like a sponge. They absorb the sun's rays into the skin and convert the UV light into heat, which then dissipates. In the U.S., these sunscreens contain one or more of these active ingredients: oxybenzone, avobenzone, octisalate, octocrylene, homosalate and octinoxate. Chemical sunscreens are easier to apply and don't leave a white residue on the skin. However, they can irritate the eyes and cause allergic reactions on some people's skin.</p> <p>If possible, avoid sunscreens with oxybenzone because this chemical may disrupt hormones and cause allergic skin reactions. Also, pass on spray sunscreens, which are not nearly as effective as those applied by hand.</p> <p>Also avoid so-called sunscreens, such as cocoa butter, safflower, olive, jojoba, baby or coconut oil that provide no sun protection.</p> <h3>Myth #10: Sunscreen never goes bad.</h3> <p>Fact. The Food and Drug Administration requires that all sunscreens retain their original strength for at least three years. Check the bottle for an expiration date. If your sunscreen has expired or been exposed to extreme heat or cold, toss it. If you're using sunscreen every day when outside, a bottle should not last long.</p> <p><a href="/providers/melanie-dixon-md"><em>Melanie Dixon, M.D.</em></a><em>, practices <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">family medicine</a>, with a special interest in dermatology, in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Acne</li> <li>Skin cancer screening exams </li> </ul>M.D.<p>As a family medicine physician with a special interest in dermatology, my goal is to provide thorough and compassionate care for my patients. I enjoy treating a wide variety of dermatologic conditions for patients of all ages.</p> <p>I am a mom of three teenage boys who keep me busy! In my spare time, I love playing and singing music with my husband, gardening, and exploring the outdoors — with sunscreen of course!</p><p> <strong>Education</strong></p> <ul> <li>University of Minnesota</li> </ul> <p><strong>Residency</strong></p> <ul> <li>United Family Medicine Residency Program</li> </ul> <p><strong>Certification </strong></p> <ul> <li><strong></strong>American Board of Family Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Alpha Omega Alpha (AOA) Honor Medical Society </li> <li>Minnesota Medical Associations</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Dixon<img src="/-/media/shared-files/images/medical-professionals/full/mankato/melanie-dixon-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=24994F681CF9EF3BD60B386BA7BB1D57" alt="Melanie Dixon MD" width="280" height="280" DisableNVelocity="true" />Melanie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15868524Melanie Dixon, M.D.1<img src="/-/media/national-files/images/hometown-health/2023/person-wearing-hat-and-sunglasses.jpg?h=370&iar=0&w=660&sc_lang=en&hash=75D249A1BDD83A1A7FA6A7BD80442080" alt="Person wearing hat and sunglasses" width="660" height="370" DisableNVelocity="true" />Skin CancerSkin cancer — the abnormal growth of skin cells — most often develops on skin exposed to the sun. But this common form of cancer can also occur on areas of your skin not ordinarily exposed to sunlight.Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Dawn Haller4/3/2024Preparing for race day requires logging lots of miles, but cross-training can help reduce injuries, build strength and enhance your performance. Learn how to work it into your training program.Maximize your running potential with cross-training<p>When preparing to run a race, it's essential to train correctly to reduce injury, increase your running efficiency and improve your endurance. One of the best things you can do to prepare for race day is cross-train.</p> <p>Cross-training uses a variety of exercises to enhance your overall performance and resilience against <a href="/hometown-health/speaking-of-health/offseason-sports-training-tips" target="_self" title="Opens in same window.">injury</a>. The goal is to <a href="/hometown-health/speaking-of-health/progressive-overload-get-stronger-in-a-healthy-way" target="_self" title="Opens in same window.">build up your entire body by stressing it</a> in multiple ways.</p> <h2>Here are a few techniques that, when part of a cross-training routine, will help you prepare for your race:</h2> <h3>Long, slow distance training</h3> <p>One to two times a week, go for a long run at a slow speed based on time and for a long distance based on miles. This training helps your body adapt to the stress of the race. Long, slow distance training strengthens bones, ligaments and tendons, which will support your body while running. In addition, long, slow distance training promotes endurance and increases your body's ability to transport oxygen more efficiently. The key to successful training is finding the right balance of mileage and duration for your body.</p> <h3>Pace running</h3> <p>Commit several of your weekly training days to run at the pace you plan for race day. This may change as your overall pace increases. Pace running is essential to your training regimen because it mimics what you'll be doing on race day.</p> <h3>Interval training</h3> <p><a href="/hometown-health/speaking-of-health/interval-training-for-heart-health" target="_self" title="Opens in same window.">Interval training</a> focuses on short bursts of vigorous exercise. During a 30-minute run, sprint for one to two minutes every five minutes. Do this about three to five times during the run. This method contributes to improving blood vessel flexibility, as well as increasing your aerobic threshold and <a rel="noopener" href="https://www.mayoclinic.org/medical-professionals/physical-medicine-rehabilitation/news/sprint-rest-repeat-exploring-the-benefits-of-high-intensity-interval-training/mac-20431116" target="_blank" title="Opens in a new window.">VO2 max</a>, which is the maximum volume of oxygen your body can absorb and use during exercise. You also can use interval training with other forms of cardio that don't focus on your legs but give you the same benefits.</p> <h3>Other forms of cardio</h3> <p>Running is a high-impact exercise, which means that your legs and body are taking a beating when you regularly run on hard surfaces. Try switching up your routine by using bikes, elliptical machines and swimming pools for additional cardio training.</p> <p>These other forms of exercise help improve strength and endurance while reducing the high-impact stress on your body. You can use long, steady-state cardio for aerobic development, as well as interval training to build up your system. Choose your favorite form of cardio or try several types. Reducing repetitive impact on your legs can help cut your injury risk and get you to race day.</p> <h3>Strength training</h3> <p>Although cross-training for running mostly is an aerobic activity, strength training also is a valuable component. Building lower-body muscles can help you run on inclines, declines and over rough terrain. Upper body strength enables you to maintain good running form, especially toward the end of a long run when your stamina is low. Exercises such as hex bar deadlifts, squats or leg presses also improve bone health by stressing them without the impact.</p> <p>Incorporate cross-training into your plans and you'll notice positive results, from reducing injury risk to boosting your performance. If you have questions about your training regimen or potential injuries, consult an athletic trainer or sports medicine specialist.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2024/mountain-biking.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B6C55332E3BBA488CB78D1E79B9ECBF4" alt="Mountain biking" width="660" height="370" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller3/12/2013<p>Dr. William David Farrar, a gastroenterologist from Mayo Clinic Health System in Red Wing, gets personal about a subject many of us would rather ignore — colonoscopies. His experience can resonate for everyone.</p>My colonoscopy: Gastroenterologist gets own medicine<img style="margin-bottom: 5px; float: right; margin-left: 5px;" alt="Dr. Farrar and his father" src="/-/media/national-files/images/hometown-health/miscellaneous/dr-farrar-and-his-fatherweb.jpg" class="img-responsive"> <p>Dr. William David Farrar, a gastroenterologist from Mayo Clinic Health System in Red Wing, gets personal about a subject many of us would rather ignore: colonoscopies.</p> <h4>A CALL FROM MY FATHER</h4> <p>I knew something wasn’t quite right listening to the message on our answering machine early last October. It was my dad. "David, give me a call. I’ve got to talk to you about something." Calling back, somehow I wasn’t that surprised when he told me almost immediately, “I had my colonoscopy last week, and they found an early cancer. So you know what that means.”</p> <p>I knew exactly what he meant: I needed a colonoscopy. My dad, also a gastroenterologist, knows the recommendations for colon cancer screenings as well as I do. If a person has a first-degree relative (a parent, sibling or child) who had colon cancer, it is recommended for that person to have a colonoscopy either at age 40 or 10 years before the age when the first-degree relative was diagnosed with cancer, whichever comes first. Guess what? I was 40. Rather than waiting until the magic age of 50, I get to have my colonoscopy 10 years earlier than expected. </p> <p>My dad didn’t seem nervous at all. I think he was more nervous for me. Fortunately, everything went fine for him. The cancer was completely removed by surgery, and because it was an early cancer, he didn’t need chemotherapy.</p> <p>I, on the other hand, had some work to do. I scheduled my colonoscopy for 8:45 a.m. on Nov. 6, 2012, which happened to be Election Day. To be honest, I was looking forward to getting it done. After performing colonoscopies on patients for almost 10 years, I was somewhat intrigued to experience it from the other side. </p> <h4>PREPPING FOR MY APPOINTMENT</h4> <p>I picked up my prep (Miralax) and read through the instructions on Nov. 4, since the prep would start the next day. Reading through my choices of what I could eat for breakfast and lunch actually made me even hungrier. The next morning, I chose the option of yogurt and a banana. It’s important to drink plenty of clear liquids, so I was gulping down apple juice and a diet soda most of the day. At 11:45 a.m., I had my chicken sandwich, but I wished it was bigger. I finished up work a bit early and was home by 5:15 p.m.</p> <p>I mixed half of the Miralax bottle in a pitcher with two orange Gatorade bottles. The Miralax acts to flush the system. I drank it down in 20 minutes without any difficulty. Miralax has no taste. I can’t say I loved the Gatorade taste, but it really wasn’t that bad. I took the four bisacodyl pills by 6 p.m., which help the colon to contract and begin to move things through.</p> <p>It didn’t take long. At 6:48 p.m., I had my first trip to the bathroom. My family had dinner at 7 p.m. I wasn’t too hungry, but only having water while everyone else is eating a nice meal was tough. By 11 p.m., I had six more trips to the bathroom. I have heard several complaints from my patients about cramping pain or nausea from the prep. I really didn’t have either, though I can still sympathize. I felt fine, other than being a bit hungry. I went to bed at 11:05 p.m.</p> <p>I did wake up once to go again, and then I intentionally woke up at 3:45 a.m. to start the second half of the prep. I downed the second half of the Miralax in two more Gatorade bottles (lemon-lime this time) by 4 a.m. I had to go just four more times all morning. There was truly nothing left in my colon.</p> <p>At 8 a.m., my wife, Janie, drove me to Mayo Clinic Health System in Red Wing, which is where I work. The receptionist thought I was joking, but she checked me in quickly. My nurse, Glenda, brought me back to my room and got me ready. I wasn’t really that nervous — probably because I knew what was going to happen, and trusted my friend and colleague, Jaswin Sawhney, M.D. It was a bit strange having a friend do the procedure, but it was probably stranger for him than me. I knew I would be asleep. I was tired but ready to get it done.</p> <h4>THE COLONOSCOPY</h4> <p>When it was time to walk to the procedure room, I tried to give my nurses and Dr. Sawhney a hard time to lighten the mood. These are all my friends looking at me on the table when I am usually the one performing the test. It was just an odd feeling. Once I got the medications for sedation though, I was out.</p> <p>My next memory was Dr. Sawhney asking, “Hey, Dave. What would you do with this? Would you tattoo it?” Uh-oh. Tattooing means either he found cancer or a big polyp. This is done to mark the location of the polyp. I rose up my head and first saw Melissa, my GI technician, looking far more wide-eyed than usual. Then I looked at the TV screen and, fortunately, it was only a polyp. It was a big polyp, but it looked fairly easy to take out through the scope. All I could think was, “Wow. I’m really glad I had this colonoscopy.” </p> <p>Looking at it more closely, it would be the type that would turn into cancer in the long run. I replied to him that I wouldn’t tattoo the polyp because we knew the location and it looked resectable (removable). My last memory of my colonoscopy was Dr. Sawhney saying, “OK, we’re tattooing it, and give him two more milligrams of midazolam.” Midazolam is used to induce drowsiness. Apparently, he didn’t need any more of my opinions.</p> <p>The rest of the morning was a blur. I have brief memories of meeting people and then periods of time with no memory. I have a vague memory of calling my parents while Janie was driving me home, telling them I had a big polyp removed. </p> <p>Overall, I had five polyps, but it was the one big one that scared me. That bigger polyp very likely would have turned into a cancer before I would have had a colonoscopy at the normal age of 50. In a way, I’m strangely thankful my dad was diagnosed with cancer when he was, because otherwise I never would have had the colonoscopy that early in life.  </p> <p>Not everyone has an easy time with their colonoscopy, but for me, it was painless. Prepping wasn’t fun, but it really wasn’t that bad. I get to do it all over again in three years thanks to my bigger polyp, but it’s worth it. According to the studies, a person’s risk of colon cancer is 5 percent if you don’t have a screening — that’s one out of 20 people. I probably would have been one of them. I encourage you, if you are due, to get screened.</p><ul> <li>Gastrointestinal endoscopy</li> <li>Inflammatory bowel disease</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Colorado School of Medicine</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>Internal Medicine, University of Minnesota Hospital</li> <li>Internal Medicine, VA Medical Center</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Gastroenterology, Hepatology and Nutrition, University of Minnesota</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Gastroenterology, American Board of Internal Medicine</li> <li>Internal Medicine, American Board of Internal Medicine</li> </ul> <p><strong>Academic Appointments</strong></p> <ul> <li>Assistant Professor of Medicine, Mayo Clinic College of Medicine and Science</li> <li>Instructor in Nutrition, Mayo Clinic College of Medicine and Science</li> </ul>Farrar<img src="/-/media/shared-files/images/medical-professionals/full/red-wing/david-w-farrar.jpg?h=280&iar=0&w=280&sc_lang=en&hash=82E7CA01D2044A8E3E1ADD06367F97AF" alt="David W Farrar" width="280" height="280" DisableNVelocity="true" />W. David<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13723715W. David Farrar, M.D.1<img src="/-/media/shared-files/images/medical-professionals/full/red-wing/david-w-farrar.jpg?h=280&iar=0&w=280&sc_lang=en&hash=82E7CA01D2044A8E3E1ADD06367F97AF" alt="David W Farrar" width="280" height="280" DisableNVelocity="true" />Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Colorectal HealthGet screening and treatment for colorectal cancer symptoms, and learn about risk factors and prevention strategies.Dawn Haller12/21/2021Many New Year’s resolutions are health related. Turn your resolution into action by going beyond a simple promise. Find out how to set SMART goals to start the journey to live a healthier life.Making New Year's resolutions that stick<p>It's the time of year again when people make New Year's resolutions, many of which are health related. <a href="/hometown-health/speaking-of-health/are-you-ready-to-change-habits-to-lose-weight" target="_self" title="Opens in same window.">Losing weight</a>, eating healthier, exercising and quitting smoking are popular choices. Losing weight usually leads the group, but also is the most difficult to accomplish.</p> <p>By the time the new year rolls around, many people are well-versed with the classic promise: "I will start my diet on Monday." In fact, by the end of December, many people have made that promise to themselves 52 times.</p> <h4>Discover the secret to success</h4> <p>New Year's resolutions are easy to make, but not so easy to achieve. To make the resolution into an actual solution, you need to spend time preparing and planning. There is no magic button for keeping a resolution. The first step toward success is developing a structured health plan.</p> <h5>Your health plan should include:</h5> <ul> <li>Where you’re headed</li> <li>Why you want to get there</li> <li>What challenges you may face along the way</li> <li>How you plan to work through the challenges</li> </ul> <h4>Create a health vision</h4> <p>The second step is to visualize your goals. Think about a what a healthy future might look like to you. Convert those thoughts into a short, clear statement: your health vision.</p> <p>While there are many ways to write a health vision, one popular format is: "I want to ______, so ________."</p> <h5>Examples of a health vision may be:</h5> <ul> <li>"I want to lose weight, so I have more energy to enjoy life."</li> <li>"I want to be physically fit, so I am no longer out of breath playing with my grandkids."</li> <li>"I want to have better balance between my work and personal life, so I have more quality time for myself and my family."</li> </ul> <h4>Set SMART goals</h4> <p>Goals help keep you focused after you record your health vision. Achieving identified goals produces a feeling of accomplishment and much-needed motivation to fuel your health journey.</p> <h5>When setting your goals, remember the SMART acronym:</h5> <ul> <li><strong>Specific — What am I going to do?</strong><br /> You need to have a specific plan in place to start. Take the time to design and research.</li> <li><strong>Measurable — How will I track my progress?</strong><br /> You may say, "I would like to lose some weight." But it would be better if you said, "I want to lose 50 pounds in four months."</li> <li><strong>Achievable — What steps will I take to make this happen?</strong><br /> Set a realistic goal. With the right weight-loss program, 50 pounds may be realistic. Ask the program you're considering what the average weight loss among participants is after one year. Depending on the program and its weight loss approach, you may need to set a smaller, more attainable goal.</li> <li><strong>Relevant — Is this important enough to me to want to do it?</strong><br /> Think positively. Behavior only changes from the positive. Remember there are programs to help you accomplish your goal.</li> <li><strong>Time-framed — When will I do this?</strong><br /> Set a specific target date. There is nothing magical about Jan. 1 as a start date. It is better to pick a date when you have a plan in place.</li> </ul> <p>Your SMART goals should consist of long-term and short-term goals. Establish your long-term goal first. An example of a long-term goal is: "I will walk briskly for 30 minutes each day at least five days a week."</p> <p>However, if you haven't been exercising on a regular basis, there often is a need for intermediary, short-term goals. For example: "I will walk 15 minutes during my lunch hour at least three days each week for the next month." After reaching your short-term goal, extend your efforts gradually, until you ultimately accomplish your long-term goal.</p> <h4>Accept challenges, and don’t give up</h4> <p>Nearly everyone will face challenges during their health journey. Perhaps it's a busy family life, work, school, medical issues or peer pressure to continue bad habits. It’s important to identify potential challenges and envision strategies to address them as part of an effective health plan.</p> <p>A network of family and friends can encourage and partner with you. Consider keeping a health journal to record your activities and achievements, adding to your motivation and accountability.</p> <h5>Here are a few other tips for success:</h5> <ul> <li><strong>Confront your temptations.</strong><br /> You will need to change your environment to help with your weight goals. Get rid of food that won't help you realize your goal — this should be part of your planning.</li> <li><strong>Tell your friends.</strong><br /> Changing your habits for good may affect your inner circle of friends. Let them know what you're trying to do and enlist their support in helping you achieve your goal.</li> <li><strong>Remember the reward.</strong><br /> Make a list of the reasons you want to lose weight. When you lack reasons to change, it is easy to fall back into old habits.</li> <li><strong>Be prepared for a setback.</strong><br /> Give yourself another chance. Most people slip up at some point. The people who are successful are the ones who get back on track. Look at how many days you still have left in the calendar year and see what you can accomplish before the year is up. Don't give up.</li> <li><strong>Commit yourself.</strong><br /> You can't take lifestyle changes lightly. Make your health a priority.</li> </ul> <p>Embracing a healthy lifestyle is an ongoing, dynamic process. Use the new year as an opportunity to start the journey to living a healthier life.</p> <p><em><a href="/providers/gabriel-berendes-md" target="_self" title="Opens in same window.">Gabriel Berendes, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>University of Wisconsin School of Medicine and Public Health</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul>Berendes<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/gabriel-berendes-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=AF078455AD7D8531BBC094B793351761" alt="Gabriel Berendes MD" width="280" height="280" DisableNVelocity="true" />Gabriel<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13393723Gabriel Berendes, M.D.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{61776FD2-05E8-47E9-AB55-EE465BD29A19}|{FFD57D6A-3E3A-4808-8F93-B38864FDF469}<img src="/-/media/national-files/images/hometown-health/2021/chopping-vegetables-wood-board.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7B9B0036190D9D5923A1DDD5217FEF27" alt="Chopping vegetables wood board" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller4/26/2023Menopause is a natural part of the aging process but can be challenging for some women. Get answers to common questions for a greater understanding of symptoms and treatments to smooth the transition.Menopause: A natural part of aging<p>The average age for menopause in the U.S. is 51. For some women, menopause can be challenging, but a greater understanding of the symptoms and treatments can help smooth this natural transition. </p> <h2>Here are answers to common questions women have about menopause: </h2> <h3>How do I know if what I'm experiencing is menopause?</h3> <p>Menopause is defined as the permanent cessation of menstrual periods. It's triggered by a natural decline in female hormones released by the ovaries, surgical removal of the ovaries, lack of sufficient reproductive hormones, or sometimes by chemotherapy and radiation therapy. A woman has officially entered menopause after she hasn't had her menstrual period for 12 consecutive months.</p> <p>Some women confuse perimenopause with <a href="/hometown-health/speaking-of-health/menopause-change-of-life-q-and-a" target="_self" title="Opens in same window.">menopause</a>. Perimenopause generally begins years before women reach menopause and can include irregular menstrual periods and other common menopause symptoms.</p> <h3>What are the symptoms of menopause?</h3> <h4>Aside from the end of menstruation, some women have no additional symptoms. For others, symptoms may include:</h4> <ul> <li><a href="/hometown-health/speaking-of-health/lets-talk-low-libido" target="_self" title="Opens in same window.">Decreased libido</a></li> <li>Hot flashes</li> <li>Irregular or missed menstrual periods</li> <li>Mood swings or changes</li> <li>Night sweats</li> <li>Painful sex</li> <li>Sleep disturbances</li> <li>Thinning hair</li> <li>Weight gain</li> </ul> <h3>Do all women have hot flashes during menopause?</h3> <p>Not all women undergoing menopause suffer through hot flashes.</p> <h4>These factors have been associated with increased incidence of hot flashes:</h4> <ul> <li>Ethnicity — more African American women report hot flashes than those of European or Asian descent</li> <li>Lack of exercise</li> <li>Obesity</li> <li>Smoking</li> </ul> <h4>Not all women experience hot flashes with menopause, but for some women, the hot flashes can be severe. Jennifer Bantz, M.D. explains why hormone replacement therapy can help manage symptoms:</h4> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/5TxfmKv03so" title="Ask Mayo Clinic Health System: Menopause & Hormone Replacement Therapy (HRT)" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <h3>Are there any health risks associated with menopause?</h3> <h4> A woman's risk for these chronic medical conditions can increase after menopause:</h4> <ul> <li><strong>Cardiovascular disease</strong><br /> The decline in estrogen increases the risk of <a href="/hometown-health/speaking-of-health/heart-disease-in-women-symptoms-and-risk-factors" target="_self" title="Opens in same window.">heart attack</a> and stroke.</li> <li><strong>Osteoporosis</strong><br /> During the first few years after menopause, women may rapidly lose bone density, leading to an enhanced risk for bone fractures.</li> <li><strong>Genitourinary syndrome of menopause</strong><br /> As vaginal tissues lose elasticity, and becomes thin and dry, women may struggle with pain during intercourse. The urethra also becomes dry and irritated, which may increase the risk of infection. Some women may need to urinate more often and may experience leakage, also known as <a href="/hometown-health/speaking-of-health/is-urine-incontinence-normal-for-women" target="_self" title="Opens in same window.">urinary incontinence</a>.</li> <li><strong>Weight gain</strong><br /> Because of the decrease in basal metabolic rate after menopause, women may need to decrease caloric intake and increase exercise to maintain their weight.</li> </ul> <h3>Are there treatments for menopause?</h3> <p>Contemporary treatments focus on relieving any symptoms of menopause that may be disruptive and assessing current or potential chronic medical conditions. Women should speak with their health care team about risks and benefits related to treatment options, which may include hormone replacement therapy or nonhormonal remedies.</p> <p>Some women notice pelvic floor issues during menopause, such as an <a href="/hometown-health/speaking-of-health/what-can-you-do-for-an-overactive-bladder" target="_self" title="Opens in same window.">overactive bladder</a> or urinary incontinence. Others may experience vaginal dryness or irritation. Many options are available for treating these bothersome and sometimes embarrassing problems.</p> <p>For some women, lifestyle changes can manage bladder problems, such as limiting the amount of caffeine they drink or scheduling regular trips to the bathroom. For other women, physical therapy or biofeedback is effective. Some women may benefit from topical vaginal lubricants or moisturizers. </p> <h3>What lifestyle modifications can I make to ease the transition of menopause?</h3> <h4>Women may also find relief through lifestyle changes, such as:</h4> <ul> <li>Eating a balanced diet that limits saturated fats, oils and sugars. For some women, hot flashes may be triggered by hot beverages, spicy foods or alcohol.</li> <li>Exercising a minimum of 30 minutes per day at a moderate intensity level.</li> <li>Incorporating relaxation techniques, such as deep breathing, guided imagery, progressive muscle relaxation and yoga.</li> <li>Layering clothing to accommodate body temperature changes. </li> <li>Optimizing sleep by avoiding caffeine and exercising earlier in the day. Aim for getting seven to nine hours of sleep each night. </li> <li>Quitting smoking.</li> </ul> <p><a href="/hometown-health/speaking-of-health/too-embarrassed-to-ask-part-3" target="_self" title="Opens in same window.">Menopause</a> is a normal life change and a natural part of the aging process. Treatment should be individualized and based on a woman's symptoms. Women should discuss the risks and benefits of treatment options with their health care team. </p> <p><a href="/providers/katie-casper-md" target="_self" title="Opens in same window."><em>Katie Casper, M.D.</em></a><em>, and <a href="/providers/tarek-khalife-md" target="_self" title="Opens in same window.">Tarek Khalife, M.D.</a>, are <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYNs</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Advocacy</li> <li>Contraception</li> <li>Evaluation and management of pelvic pain</li> <li>High-risk pregnancy</li> <li>International health care of underserved communities</li> <li>Laparoscopic surgery and other minimally invasive surgical techniques</li> <li>Preventive health care</li> <li>Treatment of abnormal uterine bleeding</li> </ul>M.D.<p>I believe the best patient care happens through listening and education. Health care is always evolving, and I believe it is critical for providers to pursue excellence through continued education and innovation.</p> <p>I will strive to empower you with knowledge so we can work together to create your individualized management plan. I look forward to getting to know you and want to optimize your health care throughout your lifespan.</p> <p>I enjoy many hobbies and actives in my spare time. After work, I generally partake in some sort of physical activity – kickboxing, strength training or hiking. I enjoy spending time at home with my husband and puppy dog. I am an avid golfer and like being outside any chance I get! I also enjoy creating healthy and delicious plant-based meals for my family.</p><p><strong>Education</strong></p> <ul> <li>Doctor of Medicine, University of Minnesota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Obstetrics and Gynecology, Creighton University School of Medicine-Phoenix</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Certified Holistic Nutritionist, American Fitness Professionals & Associates </li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Gynecologic Laparoscopists</li> <li>American College of Obstetrics & Gynecology </li> </ul>Casper<img src="/-/media/shared-files/images/medical-professionals/full/mankato/katie-casper-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=70DE9576AA96A312C2C550A790093017" alt="Katie Casper, M.D." width="280" height="280" DisableNVelocity="true" />Katie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30122594 Katie Casper, M.D.1{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}|{54693F31-87AF-4B21-91DB-1DEC1E21F878}<ul> <li>Adenomyosis</li> <li>Endometriosis</li> <li>Female sexual dysfunction, pain and vulvar disease, such as lichen sclerosus and lichen planus</li> <li>Fibroid treatment</li> <li>Heavy or irregular menstrual bleeding</li> <li>In-office treatment, including LEEP procedures, colposcopy and hysteroscopy</li> <li>Minimally invasive surgery for treatment of gynecologic disorders, such as laparoscopy and hysteroscopy</li> <li>Obstetric and advanced gynecologic 3D ultrasound</li> <li>Pelvic pain</li> <li>Robotic surgery</li> <li>Urine incontinence</li> <li>Uterovaginal prolapse</li> <li>Vaginal natural orifice transluminal endoscopic surgery (VNOTES)</li> </ul>M.D.<p>Every patient will have ample time to explain her condition and shed light on what matters to her most, as we navigate her treatment options. It is very imperative that the patient understands our partnership in managing her condition and identifies us as her support team to focus on her treatment and recovery.</p> <p>The most rewarding aspect of my time with the patient is when I get to educate them about their body and how disease affects its balance. It is my goal to allow my patient to graduate from her care with enough knowledge that she would use to teach and advocate for herself and to other women in her community. This way touches the patient’s life and the communities' lives at large.</p> <p>Outside of work, I do enjoy biking, swimming and camping. I am also a remote-control plane hobbyist, and I love grilling and cooking Lebanese cuisine.</p><p><strong>Education</strong></p> <ul> <li>Beirut Arab University</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>Obstetrics and Gynecology, Henry Ford Health System-Wayne State University</li> <li>Obstetrics and Gynecology, American University of Beirut Medical Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Minimally Invasive Gynecologic Surgery, American Board of Obstetrics and Gynecology</li> <li>Fellow, American College of Obstetrics and Gynecology</li> </ul> <p><strong> Memberships</strong></p> <ul> <li>American Association of Gynecologic Laparoscopists</li> <li>American College of Obstetrics and Gynecology</li> <li>International Society for the Study of Women's Sexual Health</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Obstetrics and Gynecology, Mayo Clinic College of Medicine and Science</li> </ul>Khalife<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/tarek-khalife-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A39C3DF2BF499DCA00FE29E1F7699D5D" alt="Tarek Khalife MD" width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/36088274/" target="_blank" title="Opens in new window">Retroperitoneal causes of genitourinary pain syndromes: Systemic approach to evaluation and management</a>, October 2022.</li> <li><a rel="noopener" href="https://www.sciencedirect.com/science/article/pii/S0002937821006074?via%3Dihub" target="_blank" title="Opens in new window">Pregnancy with IUD in place</a>, May 2021.</li> <li><a rel="noopener" href="https://www.liebertpub.com/doi/abs/10.1089/gyn.2021.0041" target="_blank" title="Opens in a new window">Intraoperative genitourinary injuries during a hysterectomy: Risks, management, and mitigation strategies</a>, May 2021.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/30398979" target="_blank" title="Opens in new window. ">The endogenous opioid system: Role and dysfunction caused by opioid therapy</a>, March 2019.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/28118169" target="_blank" title="Opens in new window. ">The K-technique: A novel technique for laparoscopic apical suspension using barbed sutures</a>, April 2017.</li> </ul>{CA02D1B4-DD8D-4C67-B975-FFCAEB25CAEF}Tarek<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20407092Tarek Khalife, M.D.1{83EB2AA2-1436-4DDC-B7BB-51F8E6A87FC9}|{54693F31-87AF-4B21-91DB-1DEC1E21F878}<img src="/-/media/national-files/images/hometown-health/2023/toweling-face-after-workout.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0F34C7475AACFB4B52CEB4D62671A57E" alt="Toweling face after workout" width="660" height="370" DisableNVelocity="true" />MenopauseMenopause is the permanent end of menstruation and fertility, defined as occurring 12 months after your last menstrual period.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller7/22/2022Bite into a luscious blueberry, and you're biting into a powerhouse of nutrients. Versatile, delicious blueberries provide body-wide benefits — from heart health to weight control to memory.The power of blueberries<p>Often labeled a "superfood," the blueberry is bursting with nutrients, many of which are classified as <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/multimedia/antioxidants/sls-20076428" target="_blank" title="Opens in new window.">antioxidants</a> and phytochemicals.</p> <p>Much of the power of blueberries lies in their colors. The deep-blue hue comes from anthocyanin, a phytochemical whose abilities may help protect the body from heart disease and Type 2 diabetes, offering cancer-fighting benefits, promote gut health and reduce inflammation. Research also suggests regularly eating blueberries may improve memory and delay age-related cognitive decline. </p> <p>A one-cup serving of blueberries contains 25% of the recommended daily value for vitamin C and 4 grams of dietary fiber, but only 80 calories. Plus, blueberries are juicy fruits, which means they contain mostly water. That high water content makes them great for weight loss or maintenance because they fill you up quickly without a lot of calories. </p> <p>Whether you're eating blueberries for the health benefits, because you like the taste or both, blueberries are a versatile option for every day. Eat them plain, sprinkle them on hot or cold cereal or yogurt, or stir them into baked goods for added sweetness and nutrition. You can easily substitute frozen berries for fresh.</p> <p>During summer months, take advantage of blueberries when they're plentiful and on sale by purchasing in large quantities and freezing them. Store fresh blueberries in the refrigerator and wash before serving. To freeze, wash and dry the berries, lay them on a pan and freeze until they're solid. Pack the berries in freezer-safe storage bags.</p> <h2>This easy cobbler makes the most of fresh blueberries when they're in season, but frozen berries will give you the taste of summer throughout the winter:</h2> <h4>Apple-blueberry Cobbler</h4> <p>Servings: 8</p> <p><strong>Cobbler</strong><br /> 2 large apples, peeled, cored and thinly sliced<br /> 1 tablespoon lemon juice<br /> 2 tablespoons sugar<br /> 2 tablespoons cornstarch<br /> 1 teaspoon ground cinnamon<br /> 12 ounces fresh or frozen blueberries</p> <p><strong>Topping</strong><br /> 3/4 cup all-purpose flour<br /> 3/4 cup whole-wheat flour<br /> 2 tablespoons sugar<br /> 1 1/2 teaspoons baking powder<br /> 1/4 teaspoon salt<br /> 4 tablespoons cold margarine, cut into pieces<br /> 1/2 cup fat-free milk<br /> 1 teaspoon vanilla extract</p> <p>Heat the oven to 400 F. Lightly coat a 9-inch square baking dish with cooking spray. In a large bowl, sprinkle the apples with lemon juice. In a small bowl, combine the sugar, cornstarch and cinnamon. Add the mixture to the apples and toss gently to mix. Stir in the blueberries. Spread the apple-blueberry mixture evenly in the baking dish. Set aside.</p> <p>In another large bowl, combine the flours, sugar, baking powder and salt. Using a fork, cut the cold margarine into the dry ingredients until the mixture resembles coarse crumbs. Add the milk and vanilla. Stir just until a moist dough forms. Turn the dough onto a generously floured work surface and, with floured hands, knead gently six to eight times until the dough is smooth and manageable. Using a rolling pin, roll the dough into a rectangle 1/2-inch thick. Use a cookie cutter or knife to cut out shapes. Gather the scraps and roll out to make more shapes.</p> <p>Place the dough shapes over the apple-blueberry mixture until the top is covered. Bake until the apples are tender and the topping is golden, about 30 minutes. Serve warm.</p> <p>Nutrition per 1/8 of cobbler: Calories, 222; total fat, 6 grams; saturated fat,1 gram; monosaturated fat, 2 grams; cholesterol, trace; sodium, 202 milligrams; total carbohydrates, 38 grams; dietary fiber, 4 grams; added sugars, 6 grams; protein, 4 grams.</p> <p><em><a href="/providers/allyn-wergin-rdn" target="_self" title="Opens in same window.">Allie Wergin</a> is a registered <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">dietitian nutritionist</a> in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Bariatric surgery</li> <li>Diabetes management</li> <li>Oncology</li> <li>Weight management</li> </ul>RDN<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, St. Catherine University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration </li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul>Mahowald<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/allyn-wergin-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=74F690ED261F537AA65B66929A3356D1" alt="Allie Mahowald, RDN" width="280" height="280" DisableNVelocity="true" />{9209F8EC-1016-41AA-985F-014D9B877417}Allie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15971546Allyn Mahowald, RDN1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2022/blueberries-on-bush.jpg?h=370&iar=0&w=660&sc_lang=en&hash=34C7A18238A3E377F0957CEAAE3241F0" alt="Blueberries on bush" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller8/5/2020Warm weather is a perfect motivator to get outside and move around. But when summer goes from warm to hot, exercising could be risky — unless you’re prepared with these tips.Keep your cool while exercising in the heat<p>The warm weather is a perfect motivator to get outside, go for a walk, and get off the couch and move around. For many people, exercising outdoors certainly feels better than being stuck inside due to the bitter cold. But when summer goes from warm to hot, exercising could be risky — unless you’re prepared.</p> <p>Staying active, even exercising in hot weather, can be done safely, but you really have to pay attention to the environment and your body to make sure a good thing doesn’t go bad.</p> <h3>Here are a few tips for exercising in the heat:</h3> <h4>Know the weather.</h4> <p>If you haven’t been exercising in hot weather already this summer, don’t choose a hot day to start. Your body needs to acclimate to the heat, so start with shorter periods of exercise and gradually extend the duration of your workout. High humidity prevents sweat from readily evaporating from this skin, which puts added stress on your body.  And pay attention to the forecast — and the sky. Severe weather can develop rather quickly, and there are no extra points for trying to outrun a thunderstorm or tornado.</p> <h4>Stay hydrated.</h4> <p>Your body cools itself by sweating, and if you stay hydrated, the body is pretty good at cooling itself. When you become dehydrated, your body starts to store heat inside. Your core temperature begins to increase, and that can put your organs and nervous system at risk. Drink water before, during and after you exercise. Additionally, make sure you have food throughout the day.</p> <h4>Slow down.</h4> <p>Don’t try to keep up your normal pace and intensity in hot weather. Get comfortable knowing you’ll have to take things a bit easier when the mercury rises. Save your goal of setting a personal best for another, cooler day. Don’t think you have to keep up with your running or workout buddies — at least until the temperature cools off a bit.</p> <h4>Dress smart.</h4> <p>Clothing for exercise or working out in hot weather should permit evaporation of sweat from your skin. Wear light-colored, lightweight and loose-fitting items. Clothing also can help protect your skin from the sun, along with plenty of sunscreen.</p> <h4>Listen to your body.</h4> <p>The old adage “no pain, no gain” is false. You should slow down or stop exercising at the first sign of discomfort. Other warning signs of heat exhaustion include heavy sweating, muscle cramps, fatigue, weakness and dizziness. Heat stroke, which is more serious, may be indicated by a rapid, weak pulse, confusion and loss of consciousness. If you experience any of these warning signs of heat stroke, call 911 immediately, or alert someone to make the call on your behalf.</p> <p>Summer fun can include outdoor exercise and workouts. The trick is to be smart about it. By following some simple tips, you’ll get more out of your time outdoors and reduce the risks associated with hot weather.</p> <p><em><a href="/providers/chaun-cox-md" target="_self" title="Opens in same window.">Chaun Cox, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> provider in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota, and an avid runner.</em></p><ul> <li>Obstetrics care</li> <li>Preventive care</li> <li>Sports medicine</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of North Dakota School of Medicine and Health Sciences</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Family Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Cox<img src="/-/media/shared-files/images/medical-professionals/full/mankato/chaun-cox-md.jpg?h=280&iar=0&w=280&hash=12088C5D39DB7B0A98EE17EC6A4B3DFE" alt="Chaun Cox MD" width="280" height="280" DisableNVelocity="true" />{026CC400-B31B-4412-A625-1FCAFF3B3D19}Chaun<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13518801Chaun Cox, M.D.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}<img src="/-/media/national-files/images/hometown-health/2020/older-man-running-in-the-park.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9B51D88C04A81D621F88D4C31EFC6703" alt="Older man running in the park" width="660" height="370" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Dawn Haller6/30/2016<p>Grief is a normal process of adapting that everyone moves through differently. There's no right or wrong way to do it. Know what's normal and when to get help.</p>What is normal when I'm grieving?<img alt="Blog_grief" src="/-/media/national-files/images/hometown-health/2016/2016-general/blog_grief.jpg?h=199&w=299&sc_lang=en&hash=7FDA65800DAA08CEE8B303482B552022" style="height: 199px; width: 299px; float: right; margin-bottom: 10px; margin-left: 10px;"> <p>Changing seasons can trigger feelings of grief. Because the shift can be subtle, I think we often minimize the effect it can have on us, making us wonder what normal is.</p> <p>The word grief comes from the old French <em>grever</em>, meaning afflict or burden. Our grief can feel like a heavy burden, but it is a natural and normal reaction to loss. It is a complex response that includes not only your emotions, but also thoughts, behaviors, relationships and physical well-being. </p> <p>There is not a right or wrong way to move through the grief process — everyone is different. There is no timetable indicating that at a certain point we will be over our loss. Just as the seasons blend from one to the next, so do our experiences of grief. Within each of these seasons, there are certain characteristics. </p> <p>In the summer, our mood can change from a beautiful sunny sky to storm clouds rolling in, bringing thunder, lightning and downpours within minutes. Then the sun comes out again. Sometimes, the seasons seem to be mixed up. You can have a cool day in August that actually feels as though it were October. There may be a snowstorm in May and warm temperatures in January. That, too, reflects the contradictory nature of grief. </p> <p>It can be a series of what feels like ups and downs or two steps forward, three steps back. Remember, grief does not move us in a linear pattern, but movement and processing is key. I have come to believe that each of us has a built-in monitor that allows feelings to surface as they need to. If we can honor that within ourselves that will be our guide and help understand why everyone is so different.</p> <p>It can be difficult to make sense of the intense and fluctuating emotions when we grieve. Because grief is a normal response to loss, though, it can actually serve an adaptive purpose, creating a new normal.</p> <p>Sometimes, grief reactions can become disruptive or don’t lessen over time, and that might be an indicator that additional help is needed, such as speaking with a counselor or attending a grief support group. Remember, reaching out for assistance is not a sign of weakness, but one of strength.</p> <p>We grieve because we have loved and have been loved. And we will continue to love. That is ours to hold onto and cherish.</p> <p><em>Lisa De Sieno is the Bereavement Services director in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2016/2016-general/blog_grief.jpg?h=335&iar=0&w=504&sc_lang=en&hash=8C946500BBE765220953FA660F733A36" alt="Blog_grief" width="504" height="335" DisableNVelocity="true" />GriefGrief is the natural reaction to loss. It will be unique to you, depending on your own personality and circumstances.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller6/30/2016<p>Healthcare has changed dramatically over the past 100 years. There are new treatments, tests and cures. Yet for the most part, the way healthcare is delivered has stayed the same. But that’s starting to change as well. And Mayo Clinic Health System is on the leading edge of the transformation.</p>New care model improving care for patients<img alt="SpeakingofHealth_DrRadke" src="/-/media/national-files/images/hometown-health/2016/spring-2016/speakingofhealth_drradke.jpg?h=222&w=207&sc_lang=en&hash=6ED4CAE175D579F008046435102E5FDB" style="height: 222px; width: 207px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>Healthcare has changed dramatically over the past 100 years. There are new treatments, tests and cures. Yet for the most part, the way healthcare is delivered has stayed the same.</p> <p>But that’s starting to change as well. And Mayo Clinic Health System is on the leading edge of the transformation.</p> <p>“We’re working to make care more effective, convenient and accessible,” says <a href="/providers/jennifer-radtke-md" target="_self" title="Opens in same window.">Jennifer Radtke, M.D.</a>, an internal medicine specialist in Red Wing who is helping to spearhead the effort. The goal is to provide patients with the right care at the right time and from the right provider.</p> <p>“People don’t have the same needs every time they call for an appointment,” says Dr. Radtke. “We’ve put together teams of providers who work together to meet patients’ various needs.”</p> <p>Those teams include nurses, nurse practitioners, physician assistants, pharmacists, behavioral health providers and primary care providers. Dr. Radtke says that by working together, she and her colleagues are better able to meet patients’ needs quickly.</p> <p>How does the new model work? Say you have a simple concern, such as a sore throat or pink eye. That’s something that can be diagnosed and treated by a nurse, nurse practitioner or physician assistant. But when something more complicated comes up — such as a cough that lingers or a new complication related to a chronic condition – your primary care provider is a better fit for your needs.</p> <img alt="MCHS_CareModel_SP16" src="/-/media/national-files/images/hometown-health/2016/spring-2016/mchs_caremodel_sp16.jpg?h=512&w=400&sc_lang=en&hash=EE150355A1AD78B900434A7022E246E9" style="height: 512px; width: 400px;" /> <p>Dr. Radtke says the teams work together closely to ensure patients are getting the care they need. And the teams have daily meetings, called “huddles,” to discuss patients and determine follow-up plans.</p> <p>“We’re making a big effort to get patients in to see a provider as quickly<br /> as possible,” says Dr. Radtke. “Having more team members available to care for patients means we’re able to do that more often.”</p> <p>Dr. Radtke compares the old model of healthcare — where a single provider is in charge of all of a patient’s healthcare needs — to a single baseball player trying to play every position on the field.</p> <p>“You do much better with a full team,” she says.</p><img src="/-/media/national-files/images/hometown-health/2016/spring-2016/drradke_sm.jpg?h=76&iar=0&w=76&sc_lang=en&hash=9480B6A0061831B93C57F23EF9410A7D" alt="DrRadke_sm" width="76" height="76" DisableNVelocity="true" />Transforming HealthcareExpert insight into using innovative technology to identify trends and develop procedures, diagnostics and next-generation care models to advance medicine, and provide healing today and in the future.Dawn Haller6/30/2016Five centimeters. Less than 3 inches. That's the window to the heart I use when I perform a minimally invasive heart valve surgery on a patient.Window to the heart<img alt="Blog_cardiac1" src="/-/media/national-files/images/hometown-health/2016/2016-general/blog_cardiac1.jpg?h=266&w=400&sc_lang=en&hash=F90861F9CC51ED132C99DC71B5C14F85" style="height: 266px; width: 400px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>Five centimeters. Less than 3 inches. That's the window to the heart I use when I perform a minimally invasive heart valve surgery on a patient.</p> <p>The small incision in the patient's right chest wall allows me to avoid dividing the patient's sternum or breast bone. </p> <p>My colleague, Dr. Robert Wiechmann, and myself are cardiovascular surgeons that have performed more than 400 minimally invasive valve procedures over the past nine years at Mayo Clinic Health System in Eau Claire. We are among a small number of hospitals nationwide doing minimally invasive valve surgeries.</p> <p>I hear from many of my patients after recovery about how grateful they are for being able to have their surgery done close to home. They also really appreciate the shorter recovery time, less risk of infection and a more cosmetic result from a smaller incision.</p> <p>Minimally invasive surgical techniques are not appropriate for every patient. If you have been told that you need to have heart surgery, your surgeon will review your diagnostic tests to determine if you are a candidate. The surgical team will carefully discuss with you the advantages and disadvantages of minimally invasive techniques versus traditional surgery.</p><ul> <li>Biopsies and surgical treatment of lung cancer</li> <li>Carotid endarterectomy</li> <li>Endoscopic vein and radial artery removal</li> <li>Endovascular and surgical repair of aortic aneurysm</li> <li>Maze surgery for atrial fibrillation</li> <li>Minimally invasive valve surgery, including mitral valve repair/replacement and aortic valve replacement</li> <li>Off-pump (beating heart) coronary artery bypass</li> <li>Traditional coronary artery bypass</li> <li>Transmyocardial laser revascularization</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Creighton University School of Medicine</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>Michigan State University at Butterworth Hospital in Grand Rapids</li> <li>Department of Surgery, SUNY, Syracuse</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Michigan State University at Butterworth Hospital in Grand Rapids</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Surgical critical care</li> <li>Thoracic surgery</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American College of Chest Physicians</li> <li>American College of Surgeons</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor of Surgery, Mayo Clinic College of Medicine and Science</li> </ul>Carmody<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/thomas-carmody-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A77C1D57B819650D664AFBDD3832CA76" alt="Thomas Carmody MD" width="280" height="280" DisableNVelocity="true" />{66ABF025-EC0C-4CA2-99BE-D242A86DD033}Thomas<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14290561Thomas Carmody, M.D.1{676428F6-179A-4C9B-9B23-5F1E40032A38}<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/thomas-carmody-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A77C1D57B819650D664AFBDD3832CA76" alt="Thomas Carmody MD" width="280" height="280" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller6/16/2023Many people underestimate how common eye injuries are and believe that regular glasses can protect them. Learn how safety glasses are made to withstand projectiles and can save your sight.Why do I need safety glasses?<p>Many workers underestimate the importance of eye safety, especially when working eight hours a day, five days a week. Yet each day, about 2,000 workers in the U.S. experience a job-related eye injury that requires medical treatment, and more than 100 lose one or more days of work due to their injuries. </p> <p>These eye injuries often are due to exposure to a harmful substance, getting a foreign object stuck in the eye or being struck in the eye by an object. Fortunately, you can avoid most eye injuries by wearing a pair of high-quality safety glasses that have impact-resistant lenses.</p> <h2>Preventing job-related eye injuries</h2> <p>Hazards exist in every workplace, but some have a higher risk of eye injuries. Safety glasses are recommended for people who work in or around potentially dangerous conditions. This includes work in manufacturing, construction, landscaping, auto repair, plumbing, woodworking, agriculture, mining, metal fabrication and health care. </p> <p>Wearing safety glasses on the job is more than just a good idea — it's your right. The <a rel="noopener noreferrer" href="https://www.osha.gov/" target="_blank" title="Opens in a new window.">Occupational Safety and Health Administration</a>, or OSHA, requires employers to provide eye and face protection for employees whenever they may be exposed to potential eye injuries during their work, if work practices or engineering controls do not eliminate the risk of injury.</p> <p>I also recommend that people wear safety glasses when working on household tasks like lawn mowing, chopping wood or using strong cleaning products. </p> <h2>Safety glasses benefits</h2> <p>Safety glasses are not regular glasses, and regular glasses are not a replacement for safety glasses. A major difference is the material used in the lenses. Some safety lenses are made with the same material that is used for airplane windshields, which is tested to withstand high-impact projectiles. The risk of this material shattering is negligible. Most conventional eyeglass lenses, while sturdy and built for everyday wear, are made of a plastic called acetate. That is not heavy-duty enough to protect your eyes in work situations.</p> <p>Another difference is the wide coverage provided by safety glasses. In addition to protecting the eyes from objects in the front, safety glasses have side shields to protect the peripheral and temple areas. Regular glasses are meant for comfort, not protection, with no additional coverage.</p> <h2>Prescription safety glasses</h2> <p>Some people who need prescription lenses for clear vision opt for safety goggles that can be worn over their regular glasses. This isn't the safest option. Regular glasses under safety goggles can interfere with how the goggles sit on the face or, in some cases, seal to the face. The safest, most comfortable option is to order prescription safety glasses. Safety glasses can be customized with prescriptions that give wearers the best vision possible while maintaining safety for their eyes. </p> <p>Prescription safety glasses must meet requirements established by OSHA and the <a rel="noopener noreferrer" href="https://www.ansi.org/" target="_blank" title="Opens in a new window.">American National Standards Institute</a> to be classified as protective eyewear. There are many frame options that meet national requirements. Some have the appearance of regular eyewear with detachable side shields. Talk with your optometrist about the best option for you. </p> <p><a href="/providers/logan-kiekhafer-od" target="_self" title="Opens in same window."><em>Logan Kiekhafer, O.D.</em></a><em>, is an optometrist in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Contact lenses, such as RGP, scleral hybrid, prosthetic and soft</li> <li>Corneal disease and glaucoma management</li> <li>Ocular disease</li> <li>Myopia management</li> </ul>O.D.<p>Getting to know my patients and their lifestyles allows me to tailor their care to achieve their visual goals. I believe in treating every patient like they are a member of my family.</p> <p> In my spare time, I enjoy hunting, fishing, playing golf, watching sports and spending time with my family.</p><p><strong>Education</strong></p> <ul> <li>Illinois College of Optometry</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Diplomat, American Board of Optometry</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Optometric Association</li> <li>Wisconsin Optometric Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Ophthalmology, Mayo Clinic College of Medicine and Science</li> </ul>Kiekhafer<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/logan-kiekhafer-od.jpg?h=280&iar=0&w=280&sc_lang=en&hash=FC9EDBE943CC4A44E5DC136AFA419A52" alt="Logan Kiekhafer, O.D." width="280" height="280" DisableNVelocity="true" />Logan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14956039Logan Kiekhafer, O.D.1{C5680DDD-C649-4B63-AFCC-B52A244736B7}<img src="/-/media/national-files/images/hometown-health/2023/wearing-safety-glasses.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7F2F7F15E54571F967DDC3198DFB9682" alt="Wearing safety glasses" width="660" height="370" DisableNVelocity="true" />Eye HealthYour eyes are responsible for providing you with vision, perhaps the most important of the senses. However, the eye is a delicate and complicated structure that needs protection. The ugly truth is that eye injuries can happen at any time and place.Dawn Haller8/15/2022Coloring is a new craze, especially for adults. Learn about the therapeutic effects that take place when you sit down with some colored pencils and paper.Coloring is good for your health<p>What used to be known as a simple, fun activity for kids now is a tool for practicing good mental health. Coloring has increased in popularity recently, especially for adults.</p> <p>While children's coloring books feature cartoon characters and simple designs, adult coloring books have intricate patterns of flowers, artwork, mandalas or animals. Books are available for purchase, and you can print free coloring pages online. For people who prefer a digital version, many coloring apps are available for mobile devices.</p> <p>But what makes adult coloring so popular?</p> <h2>Coloring can improve your health by:</h2> <h3>Promoting mindfulness</h3> <p>Coloring can help you be more mindful. <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/mindfulness-exercises/art-20046356" target="_blank" title="Opens in a new window.">Mindfulness</a> is the ability to focus and stay in the moment.</p> <p>For example, because you're focusing on color choice and staying inside the lines, you're only thinking about the present moment. You can shut off the noise around you, and give your mind the gift of focusing on the movements, sensations and emotions of your present moment.</p> <p>Practice being nonjudgmental as you go through the task with no expectations — just being in the moment. If your mind wanders, which is normal, gently return to what you are experiencing right now. While coloring, you use the parts of your brain that enhance focus and concentration. It gives you the opportunity to disconnect from stressful thoughts.</p> <h3>Relieving stress</h3> <p>Coloring is a healthy way to relieve stress. It calms the brain and helps your body relax. This can improve sleep and fatigue while decreasing body aches, heart rate, respiration, and feelings of depression and anxiety.</p> <p>Although coloring isn't the ultimate cure for stress and anxiety, sitting down for a long coloring session holds great value. As you color, pay attention to your breathing rhythm, ensuring steady, full breaths from your diaphragm, and tune into your heart rate periodically if you can.</p> <h3>Embracing the imperfect</h3> <p>There's no right or wrong way to color. Coloring is a noncompetitive activity, so there isn't pressure to "level up," win a prize or beat the clock. You can color for as long or as little time as you want. You don't need to finish a picture in one sitting.</p> <p>Try to let go of judgments or expectations and enjoy the simple beauty of coloring. It doesn't matter if your picture is neat or messy. The only thing that matters is if you found enjoyment and relaxation while coloring.</p> <h2>Other ways to relieve stress</h2> <p>Some people don't find coloring to be relaxing or enjoyable, especially those who didn't like to color as a child. That's OK.</p> <h3>Other fun ways to relieve stress include:</h3> <ul> <li><strong>Spend time with a four-legged friend.</strong> <br /> It's no secret that pets make us happy. Their love is unconditional, they are always happy to see us, and they're adorable. Spend some quality time with a pet, or volunteer at an animal shelter if you don't have pets of your own.</li> <li><strong>Crack open a book.</strong> <br /> Reading is a great way to wind down. Like coloring, it helps you lose yourself in the moment and forget about your work or other stressors.</li> <li><strong>Massage your earlobes.</strong> <br /> Massaging the pressure points in your earlobes brings on a calming, relaxing sensation over your body. Do this for a few minutes, and you may start to feel some relief.</li> <li><strong>Bust a move.</strong> <br /> Breaking out your best dance moves along with your favorite song can be therapeutic for many people. If you're dancing throughout most of the song, you also can say you snuck in some exercise.</li> <li><strong>Take a deep breath.</strong> <br /> <a href="/hometown-health/speaking-of-health/mindfulness-meditation-improve-your-quality-of-life" target="_self" title="Opens in same window.">Deep breathing</a> is a great way to reduce your body's response to perceived threats. Breathe in through your nose for five seconds and hold for two seconds. Then release your breath through your mouth for five seconds.</li> </ul> <p><em><a href="/providers/joel-bobby-licsw" target="_self" title="Opens in same window.">Joel Bobby</a> is a licensed independent clinical social worker in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</em></p><ul> <li>Anxiety</li> <li>Child/adolescent behavioral and adjustment issues</li> <li>Cognitive behavioral therapy</li> <li>Depression</li> <li>Mindfulness practices</li> </ul>L.I.C.S.W.<p>I have been providing psychotherapy care for children, adolescents and adults in Albert Lea and Austin since 2005. I enjoy partnering with my patients by using the skills they already possess and teaching them new skills to enhance functioning every day.</p><p><strong>Education</strong></p> <ul> <li>Boise State University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Licensed Independent Clinical Social Worker</li> </ul>Bobby<img src="/-/media/shared-files/images/medical-professionals/full/austin/joel-bobby-licsw.JPG?h=280&iar=0&w=280&hash=EA5AB7DD957135F1235C9B2792CD9468" alt="Joel Bobby LICSW" width="280" height="280" DisableNVelocity="true" />Joel<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14509571Joel Bobby LICSW{2B88C934-922C-4130-B661-197B59D83899}|{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}|{C4130004-0F31-48C4-AC9F-A4350A75AB24}<img src="/-/media/national-files/images/hometown-health/2022/adult-using-colored-pencils.jpg?h=370&iar=0&w=660&sc_lang=en&hash=43E11FB0782448894FA714AD9AB45DDA" alt="Adult using colored pencils" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller8/12/2016<p>I have spoken to many cardiac valve patients that have said they are afraid of having an open surgical sternotomy. They say it is a powerful reason to put off surgery when they are told about the many months of a painful recovery, respiratory compromise and the possibility of an infected large wound. But now, there are options.</p>Performing more than 400 minimally invasive heart valve repair surgeries<p><img alt="Blog_cardiac3" src="/-/media/national-files/images/hometown-health/2016/2016-general/blog_cardiac3.jpg?h=266&w=400&sc_lang=en&hash=F9B220F9A61877A582D29B73DBF1D9B0" style="height: 266px; width: 400px; float: right; margin-bottom: 10px; margin-left: 10px;" />I have spoken to many cardiac valve patients that have said they are afraid of having an open surgical sternotomy. They say it is a powerful reason to put off surgery when they are told about the many months of a painful recovery, respiratory compromise and the possibility of an infected large wound.</p> <p>But for select patients, there's an alternative: minimally invasive valve surgery through a 5-centimeter incision instead of a 25-centimeter incision needed to divide the sternum. </p> <p>Since 2007, our cardiovascular surgery team at Mayo Clinic Health System in Eau Claire has had one of the few high-volume practices (over 400 cases) in the U.S. We have helped many patients, specializing in the minimally invasive approach for aortic valve replacements, mitral valve repair or replacement and tricuspid procedures. </p> <p>I sought training in the minimally invasive procedure over a decade ago in response to so many of my patients' apprehension over sternotomy. I was hearing them say, "I just don't want my sternum cracked or split open." It seemed to me that if you could keep the sternum intact and still do the procedure, then the patient was better off. The typical minimal approach recovery is several weeks, as opposed to several months, long.</p> <h2>The main differences of the minimally invasive approach are:</h2> <ul> <li>Specialized surgical tools with longer handles, pincer grip and modified motions for manipulation, stitching and tying knots</li> <li>Smaller access, afforded by 5-centimeter surgical opening.</li> <li>New visualization methods in which only the surgeon sees the operative field; the team watches multiple wall screens broadcasting video recorded through the surgeon's camera</li> </ul> <p>Our team continues to learn more about new approaches and look at patients who can benefit from a less-invasive procedure. Although not all patients qualify for this procedure, if you have been told that you have a heart condition and will need surgery, speak to your provider about the option of having a minimally invasive procedure done.</p> <p>You can also hear more in this video on <a rel="noopener noreferrer" href="https://www.youtube.com/watch?v=iPAxbcsMAAg" target="_blank" title="Opens in a new window">minimally invasive aortic valve replacement</a>.</p> <p><a href="/providers/robert-wiechmann-md" target="_self" title="Opens in same window."><em>Robert Wiechmann, M.D.</em></a><em>, is a <a href="/services-and-treatments/cardiac-surgery" target="_self" title="Opens in same window.">cardiothoracic surgeon</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Biopsies and surgical treatment of lung cancer</li> <li>Carotid endarterectomy</li> <li>Endoscopic vein and radial artery removal</li> <li>Endovascular and surgical repair of aortic aneurysm</li> <li>Maze surgery for atrial fibrillation</li> <li>Minimally invasive acid reflux/esophageal surgeries</li> <li>Minimally invasive valve surgery, including mitral valve repair/replacement and aortic valve replacement</li> <li>Off-pump (beating heart) coronary artery bypass</li> <li>Traditional coronary artery bypass</li> <li>Transmyocardial laser revascularization</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Minnesota School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>General Surgery, University of Utah School of Medicine</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Cardiac Transplantation and Heart Failure, University of Utah School of Medicine</li> <li>Thoracic Surgery, University of Michigan</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Surgery, American Board of Surgery</li> <li>Thoracic Surgery, American Board of Thoracic Surgery</li> <li>Mayo Clinic Quality Fellow, Bronze Level</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Surgeons</li> <li>Doctors Mayo Society</li> <li>International Society for Heart and Lung Transplantation</li> <li>Society for Advanced Gastrointestinal Endoscopic Surgery</li> <li>Wisconsin Medical Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Surgery, Mayo Clinic College of Medicine and Science</li> </ul>Wiechmann<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/robert-wiechmann-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=48692ADA7AAE05EC2044CCA80B2428F7" alt="Robert Wiechmann MD" width="280" height="280" DisableNVelocity="true" />{D487F93A-BC20-4A5F-BBFE-2916B48C430A}Robert<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13790218Robert Wiechmann, M.D.1{676428F6-179A-4C9B-9B23-5F1E40032A38}<img src="/-/media/national-files/images/hometown-health/2016/2016-general/blog_cardiac3.jpg?h=335&iar=0&w=504&sc_lang=en&hash=D73AF72088EDCE3E6BF90804938FDA2B" alt="Blog_cardiac3" width="504" height="335" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller8/9/2016<p>Smoothies can be a nutritious treat, but remember — just because it's called a smoothie doesn't mean it's healthy. Here are some tips for nutritious and filling smoothies.</p>3 simple tips for healthier smoothies<p>Smoothies can be a nutritious treat, but remember — just because it’s called a “smoothie” doesn’t mean it’s healthy.</p> <h2>Watch this video for tips for nutritious, filling smoothies:</h2> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/CNwCfP8va-A" title="Nutritious, filling smoothies" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p><strong>Slow down</strong></p> <ul> <li>Watch your consumption. When you drink liquids, like a smoothie, you tend to consume calories quickly and can end up feeling hungry.</li> <li>Take your time. By drinking smoothies slowly, there’s an increased chance you’ll feel full and consume fewer unnecessary calories.</li> <li>Enjoy...then wait. The brain can take 20 to 40 minutes to release satiety (feeling full) hormones, so wait before eating or drinking more — maybe you won’t be hungry.</li> </ul> <p><strong>Skip the fruit juice</strong></p> <ul> <li>Avoid added sugars. Stay away from sugars in your smoothie, including fruit juice.</li> <li>Use water or milk as your base. Skim milk, unsweetened almond milk, unsweetened soy milk or water are all good options for the liquid base of your smoothie.</li> <li>Add a protein source. Include milk, plain yogurt or plain kefir to your smoothie to help increase satiety or feeling full.</li> </ul> <p><strong>Keep the veggies visible</strong></p> <ul> <li>Include vegetables. Adding kale, spinach, carrots and beets are all great ways to increase vegetable consumption for children.</li> <li>Keep the fruits and vegetables visible. Children need to be exposed to fruits and vegetables in their whole, natural form to know they’re part of a nutritious diet. Including vegetables is recommended, but hiding them in smoothies and other dishes should not be the sole source of exposure.</li> <li>Give taste buds time. Kids need to be exposed to new foods 10 to 15 times before the food is considered as disliked.</li> </ul> <p>Try these delicious smoothie recipes:</p> <p><strong><span style="text-decoration: underline;">Fruity smoothie</span></strong></p> <p>1 cup frozen, unsweetened strawberries</p> <p>1 cup frozen, unsweetened peaches</p> <p>3/4 cup frozen, unsweetened blueberries</p> <p>1 large, ripe banana</p> <p>1 cup fat-free, low-calorie peach or strawberry yogurt</p> <p>1 cup skim milk</p> <p>Put all the ingredients in the blender and process until the mixture is smooth. Stop the blender and scrape the sides so everything gets mixed well. Pour the smoothie into serving glasses.</p> <p>Serves 4</p> <p><strong><span style="text-decoration: underline;">Green smoothie</span></strong></p> <p>1 banana</p> <p>1/2 cup strawberries</p> <p>Juice of 1 lemon (about 4 tablespoons)</p> <p>1/2 cup other berries, such as blackberries or blueberries</p> <p>2 ounces fresh, raw baby spinach (about 2 cups)</p> <p>1 tablespoon fresh mint or to taste</p> <p>1 cup cold water or ice</p> <p>Place all ingredients in a blender or juicer and puree.</p> <p>Serves 4</p> <p style="margin-bottom: 12px;"><em>Kelly Tasky is a registered dietitian nutritionist at <a href="/locations/mankato">Mayo Clinic Health System in Mankato.</a></em></p><img src="/-/media/national-files/images/hometown-health/2016/2016-general/smoothies-400x400.jpg?h=400&iar=0&w=400&sc_lang=en&hash=27706C68A0E8AE7296F7D95182D8025E" alt="Smoothies 400x400" width="400" height="400" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller8/1/2016<p>Does this sound familiar? "Yikes! I’ve lost 20 pounds, which is great, but the past two weeks my weight loss has plateaued, and I still need to lose 50 more pounds. What am I doing wrong?"</p>Why has my weight plateaued when I have 50 more pounds to lose?<p><img alt="blog_WeightLossPlateau_216" src="/-/media/national-files/images/hometown-health/2016/2016-general/blog_weightlossplateau_216.jpg?h=266&w=400&sc_lang=en&hash=7F82D69125464FCF544F2374673FDC33" style="height: 266px; width: 400px; float: right; margin-bottom: 10px; margin-left: 10px;" />There are many challenges and questions that arise when losing weight. Here's one our educators in <a href="/services-and-treatments/weight-management">Weight Management Services</a> hear regularly:</p> <p>Yikes! I've lost 20 pounds, which is great, but the past two weeks my weight loss has plateaued, and I still need to lose 50 more pounds. What am I doing wrong? I am following a 1,200-calorie-per-day plan.</p> <p>You may not be doing anything wrong. During the first two to three weeks of losing weight, a rapid weight loss is normal. You are using your glycogen stores found in muscle and the liver. Because glycogen is made partly of water and when it's used for energy it releases the water, weight loss is mostly water. Then, your body turns to using its fat stores for energy, and you lose body fat. Body fat is lost in the form of ketones, which, upon excretion, also pulls out some water. </p> <p>You need 10 calories per pound of current weight plus your exercise calories to maintain weight.</p> <h2>Here's how to calculate that based on a weight of 180 pounds:</h2> <ul> <li>Your weight times 10 calories per pound is 1,800 calories.</li> <li>If you burn off 300 physical activity calories per day, that's a total of 2,100 calories per day to maintain your weight.</li> <li>Your total calories of 2,100 minus 1,200 calories equals 900 calories per day deficit.</li> <li>Multiply 900 by seven days a week, and you get 6,300 weekly deficit calories.</li> <li>Your weekly deficit calories of 6,300 divided by 3,500 calories in one pound body fat equals 1.8 pounds body fat lost per week.</li> </ul> <p>If you are following the 1,200-calorie-per-day plan and burn off 300 physical activity calories per day, could your body retain 1.8 pounds of water and cover up the 1.8 pounds of body fat lost? Yes. You lost the 1.8 pounds of body fat even though the scale did not change.</p> <p>About 65% of your weight on the scale is water weight. Your body can easily let go of water weight as well as hold water weight.</p> <h2>Other factors that can cause you to hold water weight include:</h2> <ol> <li>If you increase exercise, especially if muscles are sore; as your body forms its own hot tub and bathes sore muscles in water</li> <li>If you're on your period</li> <li>If you're taking medications, such as ibuprofen and other NSAIDS and cortisol products</li> <li>If you have extra sodium (salt) in your diet</li> </ol> <p>So, here's the bottom line. This work takes a lot of tolerating of the scale. Don't get discouraged. By understanding what causes a weight plateau, you can decide to respond positively and avoid backsliding on your new healthy habits. </p> <p>Whatever you do, do not give up and revert back to your old eating and exercise habits, because you will gain all the weight back.</p> <p>Good luck on your journey. You can do this.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2016/2016-general/blog_weightlossplateau_216.jpg?h=335&iar=0&w=504&sc_lang=en&hash=A8CF47EAEC08BC1EE4E19A1AAB5B8F92" alt="blog_WeightLossPlateau_216" width="504" height="335" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller7/26/2016<p>Packing up the kids for a road trip can be difficult. If car sickness, a common type of motion sickness, is thrown into the equation, road trips can be even more of a struggle.</p>Tips to prevent your kids from getting car sick<img alt="Car Sickness 400x300" src="/-/media/national-files/images/hometown-health/2016/2016-general/car-sickness-400x300.jpg?h=300&w=400&sc_lang=en&hash=72CFBE2AFBBFFE9AF2FE82E988EAA127" style="width: 400px; height: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>Packing up the kids for a road trip can be difficult. Making sure they are stocked with things to do to keep them occupied can be a tough battle on its own. If car sickness, a common type of motion sickness, is thrown into the equation, road trips can be even more of a struggle.</p> <p>Car sickness occurs when the brain receives mismatching information from the ears, eyes and nerves in the extremities. The results of this sensation are upset stomach, fatigue and, of course, vomiting. This experience is fairly common for children ages 2 to 12.</p> <p>Although the reasons children are so prone to car sickness are still unexplained, here are some suggestions that may help you keep your child from getting car sick on your next trip:</p> <ul style="list-style-type: disc;"> <li><strong>Cut down on sensory input.</strong> <br /> Loading up your kids with movies and books during a road trip may not be the best thing for them, especially if they are easily car sick. Encourage them to focus on things outside the vehicle instead.</li> <li><strong>Offer distractions.</strong> <br /> Talking, listening to music and singing songs with your child could serve as a good distraction during a car trip.</li> <li><strong>Provide adequate air ventilation.</strong> <br /> Make sure the car is free of odors and there is a decent amount of ventilation.</li> <li><strong>Be careful with snacks.</strong> <br /> Greasy and spicy foods are not going to be good for your child before a car trip. If the trip is going to be long, feed your child a small, bland snack before you leave.</li> <li><strong>Try medication.</strong> <br /> If your child is age 2 or older, ask your child’s healthcare provider about over-the-counter medications available for car sickness. Dimenhydrinate is available for children ages 2 and older, and diphenhydramine is available for children ages 6 and older. Drowsiness is a common side effect of these drugs.</li> </ul> <p>If you follow these suggestions and your child is still experiencing car sickness, ask your child’s healthcare provider about other options. Identifying car sickness triggers can aid in making difficult car trips a thing of the past.</p> <p><em><a href="/providers/jodi-breska-md">Jodi Breska, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/arcadia">Arcadia</a>, Wisconsin.</em></p>M.D.<p>In my junior year of college, my friends and I decided to go to medical school together. They decided to become a physician assistant and dentist during our senior year. I didn't know what else to do, so I stayed the course. During a summer internship after my first year of medical school, I knew I was where I belonged. I feel honored to be a part of peoples lives in this capacity.</p> <p>I came to Mayo Clinic Health System because the people are friendly, and there are many similarities to my hometown of Lancaster. The staff is compassionate and dedicated.</p> <p>My No. 1 piece of wellness advice to patients is "all things in moderation."</p> <p>I want to run a marathon or at least a half marathon again. In my spare time, I enjoy reading, cooking, baking, hiking, biking, fishing, and visiting with family and friends.</p><p><strong>Education</strong></p> <ul> <li>University of Wisconsin Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Practice, Sioux Falls Family Practice Residency</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Medicine, American Board of Family Practice</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>Wisconsin Medical Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Breska<img src="/-/media/shared-files/images/medical-professionals/full/arcadia/jodi-breska-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7E08684C5C6341E508CFEF8820F5D762" alt="Jodi Breska MD" width="280" height="280" DisableNVelocity="true" />Jodi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13886088Jodi Breska, M.D.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}<img src="/-/media/national-files/images/hometown-health/2016/2016-general/car-sickness-200x200.jpg?h=200&iar=0&w=200&sc_lang=en&hash=054EBFBAD9B63B14D67F25BEE1881428" alt="Car Sickness 200x200" width="200" height="200" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Dawn Haller9/6/2016<p>Have you recently sustained a running injury, started experiencing new onset of pain with running or struggled with recurrent running injuries? Are you looking to improve your running form and performance? Then you may be the perfect candidate for a running evaluation. </p>Pain-free running? Yes, it's possible<img alt="Pain Free Running Large" src="/-/media/national-files/images/hometown-health/2016/2016-general/pain-free-running-large.jpg?h=350&w=350&sc_lang=en&hash=278CE33BD15DD5F3B600960C44EA1B81" style="width: 350px; height: 350px; float: right; margin-bottom: 10px; margin-left: 10px;"> <p>Have you recently sustained a running injury, started experiencing new onset of pain with running or struggled with recurrent running injuries? Are you looking to improve your running form and performance? Then you may be the perfect candidate for a running evaluation. </p> <p>Running continues to be one of the most popular activities for individuals to maintain fitness. However, increased mileage or errors in training often result in overuse injuries due to the repetitive nature of running. This can be very frustrating for both recreational and competitive runners who want to continue training.</p> <p><strong>Running evaluation</strong></p> <p>A running evaluation is beneficial for any individual of any age or training level interested in improving running performance or who is currently dealing with an injury with a goal of returning to pain-free running. <span>A video running gait analysis is used to break down the running cycle frame by frame in various planes to make a detailed assessment of the runner’s form in order to identify mechanical faults. A physical evaluation is also performed to identify potential strength or flexibility deficits that may be contributing to pain with running. Runners commonly have weak core muscles and hip abductors that often lead to back, hip or knee pain.<p> <p>These deficits can be found through the gait analysis and physical assessment. This evaluation is performed by a physical therapist who has advanced training and knowledge in identifying and correcting running form, strength or flexibility deficits. The therapist will instruct you in a personalized exercise program, including corrective drills and individualized rehabilitative exercises for strength, flexibility and neuromuscular control.</p> <p>As a longtime runner myself, I understand the frustration that comes with a running injury and the desire to return to training as soon as possible. My goal is to return patients to pain-free running as quickly as possible and help prevent future injuries to keep patients on their training schedules.</p> <p><strong>Success Story</strong></p> <p><a href="/providers/carrie-kern-do">Carrie Kern, D.O.</a>, a family medicine physician at Mayo Clinic Health System, shares her personal experience: “I was having severe knee pain that was really limiting the length of my runs. At first, it was just being unable to complete half marathon, then difficult to do five to six mile, then down to two to three miles. I also tried to start skate skiing, but my knees hurt too much. It hadn’t even crossed my mind that the problem was weakness in my hips. Kimberly (Helmus) did a running evaluation and instructed me in gait training and hip strengthening exercises. Now I am able to run several miles comfortably and feel great when skiing.”</p> <p><em>Kimberly Helmus is a <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapist</a> in <a href="/locations/red-wing" target="_self" title="Opens in same window.">Red Wing</a>, Minnesota.</em></p></span><img src="/-/media/national-files/images/hometown-health/2016/2016-general/pain-free-running.jpg?h=200&iar=0&w=200&sc_lang=en&hash=4773588F2524F19F82484CC1865269EF" alt="Pain Free Running" width="200" height="200" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Dawn Haller3/3/2023The importance of sleep can be underestimated when juggling schedules filled with activities and tasks. Learn why prioritizing sleep is essential for children, and get tips for better sleep.Sleep: An essential element of success for children<p>Busy lifestyles can make it difficult to maintain schedules and routines. This may cause regular bedtime routines to shift and children to stay awake later than usual. Insufficient sleep can affect a variety of behavioral and cognitive functions. If you notice your children struggling with tasks or activities, you might evaluate how much sleep your children need.</p> <p>Often, the importance of sleep and children's sleep requirements are underestimated. The connection between behavioral challenges, impaired cognition and overall health with insufficient sleep is frequently overlooked.</p> <p>When children, teens and their families have concerns about behavior, mood and school performance issues, parents may have many theories about what's causing the problem. However, sleep may not be considered a potential contributing factor.</p> <h2>A thorough evaluation should include an assessment of children's sleep habits, including:</h2> <ul> <li>Amount of time it takes children to fall asleep</li> <li>Bedtime routine</li> <li>Consistency of sleep and wake schedule</li> <li>Environmental factors that could interfere with sleep</li> <li>Nighttime awakenings</li> <li>Sleep patterns</li> </ul> <h2>Prioritizing sleep</h2> <p>Sleep deprivation is an overlooked cause of many performance and behavioral concerns in children. In American culture, putting in long hours for work and study is highly valued and touted as essential for children to achieve success. As children are encouraged and expected to learn more and faster, they may participate in multiple academic and extracurricular activities. </p> <p>Children's schedules have become so full that they scarcely have time for sleep, and the <a href="/hometown-health/speaking-of-health/stressed-out-kids" target="_self" title="Opens in same window.">pressures of success</a> interfere with restful sleep. With a spirit of seizing the day, sleep may be perceived as wasting time.</p> <h3>Symptoms of sleep deprivation in children may include:</h3> <ul> <li>Absenteeism from school</li> <li>Being accident prone</li> <li>Challenges with impulse control</li> <li>Decrease in attention span, mental alertness, and ability to learn and reason</li> <li>Decreased motivation</li> <li>Defiance or noncompliance</li> <li>Depression or anxiety</li> <li>Difficulty falling asleep</li> <li>Difficulty in waking</li> <li>Hyperactivity and silliness or giddiness</li> <li>Impairment in decision-making, problem-solving and judgment</li> <li>Increase in appetite and sugar cravings</li> <li>Overemotional</li> <li>Poor concentration</li> <li>Poor school performance</li> <li>Signs of cognitive, memory impairment and forgetting daily tasks</li> <li>Tantrums, irritability or aggressive behavior</li> </ul> <p>Sleep is a crucial biological function. Loss of sleep is hypothesized to play a significant role in restoring and recovering the body systems, learning, memory consolidation and healthy brain development. Sleep deprivation can lead to physical and behavioral symptoms that can be misdiagnosed as more severe mental and behavioral disorders.</p> <p>Children who don't get a sufficient amount of sleep may not appear to be sleepy. Instead, they may struggle with attentiveness, hyperactivity, aggression or disruptive behavior.</p> <p>For example, a child with tantrums may be diagnosed with oppositional defiant disorder; or a child who is hyperactive and has a poor attention span might be thought to have <a href="/hometown-health/speaking-of-health/what-is-adhd" target="_self" title="Opens in same window.">attention-deficit/hyperactivity disorder</a>.</p> <p> Sleep deprivation reduces the immune system's ability to defend against colds and the flu. It can place adults at risk for chronic conditions like cardiovascular problems, obesity and diabetes.</p> <h2>Recommended length of sleep for children and adults</h2> <h3>The National Sleep Institute recommends these hours of sleep:</h3> <ul> <li>12–17 for newborns and infants</li> <li>11–14 for ages 1–2</li> <li>10–13 for ages 3–5</li> <li>9–11 for ages 6–13</li> <li>8–10 for ages 14–17</li> <li>7–9 for adults</li> </ul> <h2>Better sleep is possible</h2> <h3>Tips for good sleep habits for children and families include:</h3> <ul> <li><strong>Make sleep a respected priority.</strong><br /> Establish a consistent, relaxing bedtime routine.</li> <li><strong>Consistency is key for regular daytime and bedtime routines for sleep.</strong><br /> Attempt to maintain a regular sleep and wake schedule, including on weekends. </li> <li><strong>Provide children with positive attention before bedtime.</strong><br /> This may reduce conflict or resistance to bedtime routines.</li> <li><strong>Keep bedrooms dark, cool and quiet.</strong><br /> Do not have a TV, computer or cellphone in the room.</li> <li><strong>Use the bed only for sleep.</strong><br /> Avoid reading or doing homework in bed. Remove activities from the sleep environment that may be stimulating, such as <a href="/hometown-health/speaking-of-health/are-video-games-and-screens-another-addiction" target="_self" title="Opens in same window.">devices with screens</a> and video games.</li> <li><strong>Avoid caffeine in the late afternoon and evening, or for a minimum of three hours before bed.</strong> </li> <li><strong>Encourage children to sleep in their beds.</strong><br /> It helps them learn to fall asleep independently. Parents also need uninterrupted sleep.</li> </ul> <p> If you suspect your child or teen may be struggling with sleep deprivation, consulting a health care or mental health professional can help you determine a path toward restoring good sleep habits and ensuring a successful future.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2023/preteen-sleeping-arms-crossed-on-pillow.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A553AE1590B34E22CCAC7A2BC6119E62" alt="Preteen sleeping arms crossed on pillow" width="660" height="370" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.SleepSleep is essential to good health. It's one of the body's basic needs. But, what do you do when you have troubles sleeping, or getting enough hours of sleep? Dawn Haller8/23/2016<p>A good percentage of Americans love football, but ACL injuries and concussions commonly occur. Learn the symptoms to be aware of and how to prevent them.</p>Identifying and preventing ACL injuries, concussions<img alt="Identifying and preventing ACL injuries and concussions" src="/-/media/national-files/images/hometown-health/2016/2016-general/football-players-400x306.jpg?h=306&w=400&sc_lang=en&hash=48974EDD46B079ADD6A365A5709BF028" /> <p>A good percentage of Americans love football for the fast-paced, hard-hitting product displayed on the field. And spectators enjoy the game at all levels — grade school, high school, college and the pros. Because the nature of football is highly intense and physical, injuries are prevalent. In particular, <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/acl-injury/home/ovc-20167375" target="_blank" title="Opens in new window.">ACL injuries</a> and <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/concussion/basics/definition/con-20019272" target="_blank" title="Opens in new window.">concussions</a> commonly surface in athletes of all age levels. And these injuries aren't limited to just football — many other sports pose risks.</p> <p>But what are ACL injuries and concussions? What symptoms should you be aware of? How can you prevent them? Let’s examine both injuries in more detail to find those answers.<strong></strong></p> <h2>ACL injuries</h2> <p>The ACL is one of the primary ligaments that connects your femur, or thighbone, to your tibia, or shinbone, helping stabilize your knee joint. With an ACL injury, the ligament tissue is often partially or fully torn. In less severe instances, the ACL can be sprained but left intact.</p> <h3>Symptoms of an ACL injury include:</h3> <ul> <li>A popping noise in the knee at the time of the injury</li> <li>Extreme knee pain that inhibits continuing the activity</li> <li>Swelling around the knee that starts within a few hours of an injury</li> <li>Decrease in knee mobility</li> <li>Feeling unstable when bearing weight on the knee</li> </ul> <p>If you notice symptoms of ACL damage, seek medical care immediately. A timely diagnosis is essential to ensure your knee is treated effectively. One potential complication related to ACL injuries is knee instability, which, when left untreated, can lead to premature <a rel="noopener" href="http://www.mayoclinic.org/diseases-conditions/osteoarthritis/home/ovc-20198248" target="_blank" title="Opens in new window">degenerative changes in the joint (arthritis)</a>.</p> <h4>To prevent ACL problems, athletes should train properly by:</h4> <ul> <li>Working out the hamstrings to balance leg muscle strength</li> <li>Strengthening the core muscles</li> <li>Using proper jumping and landing techniques (Knees over toes is the correct position!)</li> <li>Improving pivoting and cutting techniques by working on balance and coordination drills</li> </ul> <h2>Concussion</h2> <p><strong></strong></p> <p>While ACL injuries are serious, concussions are an even bigger concern with football and other contact sports. A concussion is a mild traumatic brain injury that alters the functional capacity of the brain, leading to temporary concentration, memory, balance and coordination problems.  Kids have been shown to be more likely to sustain a concussion from contact than adults. Long-term effects of concussions can be severe and life-altering.</p> <h3>Symptoms of concussion may include:</h3> <ul> <li>Headache or head pressure</li> <li>Temporary loss of consciousness</li> <li>Confusion or mental fog</li> <li>Dizziness</li> <li>Ringing in the ears</li> <li>Nausea</li> <li>Vomiting</li> <li>Slurred speech</li> <li>Delayed response to questions</li> </ul> <h4>Sometimes concussion symptoms appear hours or days later. These signs can present as:</h4> <ul> <li>Concentration and memory complaints</li> <li>Changes in personality, such as irritability</li> <li>Sleep problems</li> <li>Depression</li> <li>Sensitivity to light and noise</li> </ul> <p>To ensure proper management of a concussion, see a physician within one to two days of any head injury, even if it’s not an emergency. In addition, never return to sports or physical activity with concussion symptoms, always have a professional evaluate a head injury and be sure to wear necessary protective equipment during sports.</p> <p>If you’re concerned about sports injuries, such as with the knees and head, speak to your healthcare team or consider an activity with little to no physical contact.</p> <p><em><a href="/providers/joshua-berndt-pt-ocs" target="_self" title="Opens in same window.">Josh Berndt</a> is a <a href="/services-and-treatments/physical-therapy">physical therapist</a> in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><ul> <li>Concussions</li> <li>Evidence-based medicine</li> <li>High school sports team support</li> <li>Orthopedics</li> <li>Spine</li> <li>Sports Medicine</li> <li>Wound care</li> </ul>P.T., MPT, D.P.T.<p>My treatment philosophy starts with understanding my patients and what led them to see me. My patients can expect a thorough assessment and education regarding their condition or surgery. They will leave with tools and confidence to manage their condition and a roadmap to recovery. I will walk with them through this process and mange any bumps along the way. If I am unable to meet their needs, I will advocate for them and refer on to the appropriate providers.</p> <p>My interests outside of work include the outdoors, fishing, hunting, golf, basketball and music. I enjoy volunteering in the community and am on many community boards.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Physical Therapy, Mayo Clinic Alix School of Medicine</li> <li>Doctor of Physical Therapy, The College of Saint Scholastica</li> </ul> <p><strong>Internships</strong></p> <ul> <li>Sports Medicine, Hand Clinic, Acute Neurologic Rehabilitation, Acute Care Rehabilitation, Outpatient Spine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Orthopedic Certified Specialist, American Board of Physical Therapy Specialties</li> </ul>Berndt<img src="/-/media/shared-files/images/medical-professionals/full/mankato/joshuaberndtpt.jpg?h=280&iar=0&w=280&sc_lang=en&hash=FA087465E8096D11849386C89C23154B" alt="Josh Berndt, P.T." width="280" height="280" title="Josh Berndt, P.T." DisableNVelocity="true" />{9C43DFB8-2B63-4AFE-A742-AA44F7B055FD}Josh<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13839667Josh Berndt, P.T.1{7746ADF8-715B-4593-8AAB-55D7F0467848}|{2951D78A-CC76-4C49-B556-549282DF4345}<img src="/-/media/national-files/images/hometown-health/2016/2016-general/football-players-200x200.jpg?h=200&iar=0&w=200&sc_lang=en&hash=5AD96B02413B3641C2565BDAAD362C35" alt="Identifying and preventing ACL injuries and concussions" width="200" height="200" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller9/28/2016<p>Time can be hard to measure. We often measure our lives in the tasks and accomplishments of everyday life — a pace of business, providing us with momentum and a feeling of control. In between the noise of the day, quiet moments remind us of those we love and what we have lost.</p>Art to heal the human heart<p><img alt="Art therapy" src="/-/media/national-files/images/hometown-health/2016/2016-general/blog_artther.jpg?h=335&w=504&sc_lang=en&hash=9D57317F885768562C348714BFDE3EA0" style="height: 335px; width: 504px; float: right; margin-bottom: 5px; margin-left: 5px;" />Time can be hard to measure. We often measure our lives in the tasks and accomplishments of everyday life — a pace of business, providing us with momentum and a feeling of control. In between the noise of the day, quiet moments remind us of those we love and what we have lost. In grief, life can all at once stand still. It is in this stillness of sorrow we are presented with mixed emotions and the challenge of change</p> <p>As children, we all are gifted with resilient spirits to overcome, thrive and change. Engaging in creative play, we all have dared to go where words alone cannot; we transformed our sorrows into stories. Through our human senses, we transform sound into music and movement into dance. We use objects and tools to sculpt and draw our story. The creative arts fulfill our lifelong journey of honoring what is meaningful and mysterious. It is in honoring the stories of our lives that we build the compassionate awareness that we all are interconnected.</p> <p>During the 2016 Dragon Boat Festival, a competitive team rowing event held in Eau Claire, Bereavement Services provided a community weaving project. As individuals chose different colored fibers and wove them into a loom, something uniquely beautiful began to form. Stepping back to gaze at this tapestry, it seemed to hold the metaphor of a greater story — a story that brings people together, both young and old, to share in a quiet moment and to honor the strength in the collective calm. The finished art piece serves as a symbol of healing, hope and community.</p> <p>As an art therapist, I seek to companion, guide and witness stories yet untold. Without judgment or restraint, the child within us is free to sculpt, draw and dance a story that heals. I hope you will continue to nurture your creative outlet with gratitude and joy.</p> <p><em>Trisha Lundin is an art therapist and bereavement counselor in Bereavement Services in <a href="/locations/eau-claire">Eau Claire, Wisconsin</a>.</em></p><img src="/-/media/national-files/images/hometown-health/2016/2016-general/blog_artther.jpg?h=335&iar=0&w=504&sc_lang=en&hash=4198D37C186A5CCBFA1135811403A66D" alt="Child and adult doing art therapy on window" width="504" height="335" DisableNVelocity="true" />GriefGrief is the natural reaction to loss. It will be unique to you, depending on your own personality and circumstances.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.HospiceThe Hospice program believes that the highest quality of living is achieved when the family unit and Hospice team together offer hope, opportunity, support, presence, individualized care, comfort and encouragement.<br/><br/>Palliative CarePalliative care offers pain and symptom management, and emotional and spiritual support when you face a chronic, debilitating or life-threatening illness.Dawn Haller2/7/2022For most women, taking nine months off to rest while pregnant is not a possibility. To stay healthy and productive on the job, it's helpful to understand how to alleviate common pregnancy discomforts.Work more comfortably while pregnant<p><em>By Mayo Clinic Health System staff</em></p> <p>For most women, taking nine months off to rest while pregnant is not a possibility. Women often plan to work until their due date in order to get the most time possible with their baby during maternity leave. But <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy/art-20047441" target="_blank" title="Opens in new window.">working during pregnancy</a> isn't always easy. </p> <h3>To stay healthy and productive on the job, it's helpful to understand how to alleviate common pregnancy discomforts:</h3> <h4>Nausea</h4> <p>Feeling nauseous at work is a common pregnancy discomfort. While commonly called morning sickness, queasiness can occur any time of the day. To keep nausea at bay, avoid things that trigger a sick feeling in your stomach and snack often. Keep a stash of crackers or another bland food at your desk.</p> <h4>Fatigue</h4> <p>You might feel tired as your body works overtime to support your pregnancy, and resting during the workday may not be possible. </p> <h5><strong>To improve energy, try these tips:</strong></h5> <ul> <li><strong>Eat foods rich in iron and protein.</strong><br /> Try red meat, poultry, leafy green vegetables, iron-fortified whole-grain cereal and beans.</li> <li><strong>Take short, frequent breaks.</strong><br /> Getting up and moving around for a few minutes can reinvigorate you.</li> <li><strong>Drink plenty of fluids.</strong><br /> Keep a water bottle in your work area so you can sip throughout the day. </li> <li><strong>Cut back on activities.</strong><br /> Scaling back can help you get more rest after the workday ends. </li> <li><strong>Keep up your fitness routine.</strong><br /> Physical activity can help boost your energy level. Try a prenatal fitness class or take a walk after work, as long as it's OK with your health care professional.</li> <li><strong>Go to bed early.</strong><br /> Try to get seven to nine hours of sleep every night. Resting on your left side will maximize blood flow to your baby and ease swelling. Pillows between your legs and under your belly can add comfort. </li> </ul> <h4>Movement and stress</h4> <p>As your pregnancy progresses, everyday activities, such as sitting and standing, can become uncomfortable. Moving around every few hours can ease muscle tension and help prevent fluid buildup in your legs and feet.</p> <p>It's also important to limit the amount of stress at work during your pregnancy. Job stress can sap the energy you need to care for yourself and your baby. To reduce the amount of stress at work, share your frustrations with a supportive co-worker, make daily to-do lists and prioritize your tasks, and practice relaxation techniques.</p> <p>Working during pregnancy is not always easy. If you have concerns about your work duties affecting your pregnancy, talk with your health care professional.</p><img src="/-/media/national-files/images/hometown-health/2022/hand-over-pregnancy-keyboard.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1CFF7C6BB0387A2EEF88A6A8FFBBAE0C" alt="Pregnant woman with hand over belly, sitting and looking at computer screen with keyboard on desk" width="660" height="370" title="Pregnant woman with hand over belly, sitting and looking at computer screen with keyboard on desk" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Prenatal CareOB-GYN and Family Medicine providers offer exactly the care you need for starting or growing your family, including pregnancy planning and prenatal care.Dawn Haller7/1/2024Intense rainfall and flooding lead to many areas playing host to standing water. When water accumulates, it can pose significant health and safety risks. Read six tips to help you stay safe.6 tips for flood water safety<p>Recent weather has produced intense rainfalls and flooding in the Midwest. Subsequently, these rainfalls have resulted in many facilities and basements playing host to standing flood water. Though most flood water eventually evaporates or is removed, these water accumulations can pose significant health and safety risks.</p> <p>Standing flood water can be a breeding ground for mosquitoes, which carry diseases like <a href="/hometown-health/speaking-of-health/west-nile-virus" target="_self" title="Opens in same window.">West Nile virus</a> and several viruses that cause <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/encephalitis/basics/definition/con-20021917" target="_blank" title="Opens in new window.">encephalitis</a>. Flood water and standing pools also may contain sewage and hazardous substances from chemicals and agricultural runoff.</p> <h2>You should avoid standing flood water whenever possible. Here are practical safety tips:</h2> <ul> <li><strong>Avoid flooded areas.<br /> </strong>Flood waters can be fast-moving and sweep away people and vehicles. Do not drive, walk or swim through flood waters. Don't allow children to play in or near flood waters. It can be difficult to judge the depth of the water, and unknown dangers may be hidden by it.</li> <li><strong>Clean and disinfect items that have touched flood water.<br /> </strong>Taking a twofold approach to cleaning up after a flood is crucial. Cleaners remove dirt and grime, and disinfectants stop the growth of bacteria carried in floodwater. Wear proper safety gear like gloves and eye protection while cleaning. If you are cleaning areas that have mold growing, it's also recommended to wear a N95 mask.</li> <li><strong>Don't eat foods that may have come into contact with flood water.<br /> </strong>Even if the food is packaged, it could have been exposed to bacteria from the floodwater. If there are power outages, dispose of food that has warmed or thawed in fridges and freezers.</li> <li><strong>Ensure drinking water is safe.<br /> </strong>Contaminated water can contain bacteria and cause serious infections. Follow water safety advisories to boil water before drinking or use bottled water. If needed, bring water to a rolling boil for one full minute to kill water-borne bacteria.</li> <li><strong>Never expose an open wound to flood water.</strong><br /> During flood cleanup, there's a risk of developing cuts, open wounds or blisters, which could increase the risk of infection. Clean wounds with soap and clean water. Apply an antibiotic ointment and cover it with a waterproof bandage.</li> <li><strong>Wash your hands often and thoroughly.<br /> </strong>If you've come into contact with flood water or objects that have touched flood water, it's crucial to <a href="/hometown-health/speaking-of-health/5-ws-of-healthy-hands" target="_self" title="Opens in same window.">clean your hands</a> with soap and water or alcohol-based hand sanitizer.</li> </ul> <p>Consider having an emergency kit stocked with water, nonperishable food, a first-aid kit, flashlights and extra batteries. Stay informed of your local flood warnings, particularly if you live in an area prone to flooding.</p> <p>If you've been in contact with flood water, watch for <a href="/hometown-health/speaking-of-health/steps-to-prevent-norovirus" target="_self" title="Opens in same window.">symptoms like diarrhea</a>, vomiting and fever. Seek care with your healthcare team if you develop symptoms and feel unwell.</p> <p>To learn more about protecting yourself against the dangers of flood water, visit the <a rel="noopener" href="https://www.cdc.gov/floods/about/" target="_blank" title="Opens in new window">Centers for Disease Control and Prevention's website</a>.</p> <p><em><a href="/providers/jessica-sheehy-pac" target="_self" title="Opens in same window.">Jessica Sheehy</a> is physician assistant in <a href="/services-and-treatments/infectious-diseases" target="_self" title="Opens in same window.">Infectious Diseases</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota</em></p><ul> <li>Antimicrobial stewardship</li> <li>Infectious disease</li> <li>Travel medicine</li> </ul>P.A.-C.<p>My goal is to help my patients understand what is happening in regard to their infection, and how it impacts them. When my patients are informed, they can fully participate in the development of a plan that will treat their infection.</p> <p>I have always had an interest in microbiology, and have a college minor in microbiology. Therefore, infectious diseases was a natural fit for my professional career. </p> <p>I love to travel and visit my friends and family in Montana as often as I can.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Physician Assistant Studies, Arcadia University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>National Commission on Certification of Physician Assistants</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Sheehy<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jessica-sheehy-pac.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4E5429A03BCFC322B550B0EC92C132BF" alt="Jessica Sheehy, P.A.-C., P.A." width="280" height="280" DisableNVelocity="true" />{645A5342-C9AE-4AD4-9114-2A0634580FC2}Jessica<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15739287Jessica Sheehy PAC1{C8A905E8-82D3-45FC-9669-A5F09F2EF6CA}<img src="/-/media/national-files/images/hometown-health/2024/flooded-road-and-sign.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D43C8E6F6F530BEB9311075B9CB41822" alt="Flooded road and sign" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Dawn Haller9/6/2022The backpack is as much as a part of school life as homework and recess. Get tips for picking out your child's backpack, and how to wear it to avoid neck and back problems.Are backpacks hurting your kids' backs?<p>The backpack is as much a part of school life as homework, pencils and recess. Kids use backpacks to carry everything they need during the day and make a fashion statement. Unfortunately, the excess weight of supplies stuffed into an improperly worn backpack may lead to sore joints and muscles.</p> <h2>As a new school year begins, follow these tips to help kids take a load off to keep their backs healthy:</h2> <h3>Limit backpack weight.</h3> <p>Students of all ages seem to carry heavier loads in their backpacks. They are often toting a day's worth of textbooks and a change of clothing for after-school activities, plus school projects and lunch. As a result, many parents have heard their school-age children complaining of <a rel="noopener" href="http://www.mayoclinic.org/diseases-conditions/back-pain/basics/definition/con-20020797" target="_blank" title="Opens in a new window.">back pain</a>.</p> <p>Overall, adults and children should not carry more than 15% of their body weight in a backpack. For example, the backpack for a 60-pound child should weigh less than nine pounds.</p> <p>Even when worn properly, your student may need to lean forward to compensate for extra backpack weight. This can affect the natural curve in the lower back. Extra weight also can cause a rounding of the shoulders and an increased curve in the upper back. As a result, children may experience back, shoulder and neck pain.</p> <h3>Adjust the backpack properly.</h3> <p>When worn properly, backpacks are the best way to carry things, especially for long periods of time.</p> <p>Backpacks should be worn using both straps. Slinging a backpack over one shoulder can cause a person to lean to one side to compensate for the uneven weight. This can curve the spine. Over time, this can cause lower and upper back pain, strained shoulders and neck, and even functional <a rel="noopener" href="http://www.mayoclinic.org/diseases-conditions/scoliosis/home/ovc-20193685" target="_blank" title="Opens in a new window.">scoliosis</a> (curvature of the spine). Teenage girls are especially susceptible to scoliosis.</p> <p>Tighten the straps so the pack sits high on your child's back with the top of the pack about even with the shoulder blades. It also should be snug, so it doesn't sway side to side while walking.</p> <p>When properly worn, the back and abdominal muscles support a backpack. These are the strongest muscles in the body, and stabilize the trunk and hold the body in proper postural alignment. Improper backpack use presents some dangers to young, still-growing joints and muscles.</p> <h3>Look for key pack features.</h3> <p>Urge your children to look past the color or design when selecting a backpack.</p> <h4>These features can make a significant difference in how they feel while wearing the pack at school:</h4> <ul> <li><strong>Wide straps</strong><br /> Wide, padded straps won't dig into the shoulders, and they are more comfortable. Narrow straps can hinder circulation, causing numbness or tingling in the arms, which may cause weakness in the hands over time.</li> <li><strong>Multiple sections</strong><br /> Select a backpack with many pockets and sections to keep children organized. This also helps distribute the weight more evenly across the pack.</li> <li><strong>Waist belt</strong><br /> Tightening the waist belt helps distribute the weight of the backpack more evenly and support children's abdominal muscles.</li> <li><strong>Lightweight when empty</strong><br /> It's also wise to consider the weight of the backpack when empty so your children don't have additional weight beyond books and supplies. For example, a canvas backpack will be lighter than leather.</li> <li><strong>Reflective material</strong><br /> If your children walk or bike to school, look for a backpack that has reflective strips that make them more noticeable to drivers.</li> </ul> <p>Overall, you should encourage your children to wear their backpacks properly and keep them light. Have them use both straps and make frequent stops at their lockers throughout the day to avoid carrying all their books at once. And leave nonessentials at home.</p> <p>Talk with your children's primary care providers if they are in pain or have discomfort before a problem becomes serious.</p> <p><em><a href="/providers/michelle-rein-md" target="_self" title="Opens in same window.">Michelle Rein, M.D.</a>, is a physician in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/la-crosse">La Crosse</a>, Wisconsin.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Board of Family Practice</li> <li>Wisconsin Academy of Family Physicians</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Rein<img src="/-/media/shared-files/images/medical-professionals/full/caledonia/michelle-rein-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=72797BFBA691DFD62F212FD9F838474A" alt="Michelle Rein MD" width="280" height="280" DisableNVelocity="true" />Michelle<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12734438Michelle Rein, M.D.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}<img src="/-/media/national-files/images/hometown-health/2022/student-putting-notebook-in-backpack.jpg?h=370&iar=0&w=660&sc_lang=en&hash=281CE0D650F5085E7E22EAD4E775A50D" alt="Student putting notebook in backpack" width="660" height="370" DisableNVelocity="true" />ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.Dawn Haller5/19/2023Stroke is the fifth leading cause of death for women. Learn why women have a greater risk than men and how to spot a stroke quickly.Women and stroke: What you need to know<p>Ladies: The statistics are not in our favor. We need to take the risk of stroke seriously.</p> <p>Many women underestimate their risks for stroke and believe that it mainly affects men. In reality, stroke is the fifth leading cause of death for women. According to the <a rel="noopener" href="https://www.cdc.gov/stroke/about/women-and-stroke.html" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention</a>, about 1 in 5 women between the ages of 55 and 75 will have a stroke.</p> <p>Each year, stroke kills nearly twice as many women as breast cancer. About 60% of stroke deaths occur in women.</p> <h2>Women's risk factors for stroke</h2> <p>There are a few reasons why women have a higher risk for stroke. High blood pressure is a major risk for stroke, and nearly 40% of women have elevated blood pressure or are taking medication to keep their blood pressure under control.</p> <p>Women also have a higher risk of stroke than men because of factors related to reproduction. Specifically, oral contraceptives, pregnancy and post-menopausal hormone therapy all can increase women's stroke risk. Women who develop <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/preeclampsia/basics/definition/con-20031644" target="_blank" title="Opens in new window.">preeclampsia, eclampsia</a> or gestational diabetes while pregnant also have a higher risk of stroke.</p> <p>Finally, women live longer than men on average. Because risk of a stroke increases with age, women have greater risk for stroke over their lifetimes.</p> <p>Other factors that increase a person's risk for stroke include heart disease, including abnormal heart rhythms like atrial fibrillation, smoking or tobacco use, and physical inactivity.</p> <h2>Know the warning signs</h2> <p>It's important to learn the many warning signs of a stroke and seek emergency medical care immediately after the first symptoms appear.</p> <p>Stroke symptoms appear suddenly.</p> <h3>"Think FAST:" This saying and acronym makes recognizing and acting on these symptoms easy:</h3> <ul> <li><strong>Face</strong> — Ask the person to smile. Does one side of their face droop?</li> <li><strong>Arms</strong> — Ask the person to lift up both arms. Does one arm drift downward, or is one arm unable to rise?</li> <li><strong>Speech</strong> — Ask the person to repeat a simple or common phrase. Is their speech slurred or strange sounding?</li> <li><strong>Time</strong> — If you notice any of these signs, call 911 immediately. Some treatment options need to be used in the first 4 ½ hours after a stroke, so it's essential to get help quickly.</li> </ul> <p>You may be tempted to downplay symptoms and not want to go to the hospital. This feeling may be normal but is ill-advised. When care is delayed for someone having a stroke, the person's brain is deprived of blood, oxygen and nutrients. Within minutes, brain cells start to die. Emergency medical care by experts trained in the diagnosis and treatment of stroke is necessary to preserve brain cells and, in the most serious cases, prevent death.. </p> <p>Time is critical with a stroke, so it's usually best to call 911. Don't try to drive yourself to the emergency department.</p> <h2>Stroke treatment</h2> <p>More treatment options are available if you get to the emergency department quickly. Sometimes, medications can be administered through an IV to break up blood clots. The sooner the medications are given, the better. The medications only are effective if delivered within 4 ½ hours from the start of symptoms. This time frame may be only 3 hours for specific patient populations, so it's critical to seek medical evaluation as soon as symptoms start.</p> <p>If a blood clot causes a stroke in a large artery, endovascular therapy may be necessary to remove the clot with a stent retriever. This intervention also is time sensitive. </p> <p>Talk with your healthcare team about your personal risk for stroke. Also, learn how to spot a stroke using <a href="/hometown-health/speaking-of-health/with-stroke-time-is-survival" target="_self" title="Opens in same window.">FAST</a>, and encourage people in your life to do so as well.</p> <p><a href="/providers/bayan-moustafa-do" target="_self" title="Opens in same window."><em>Bayan Moustafa, D.O.</em></a><em>, is a <a href="/services-and-treatments/neurology" target="_self" title="Opens in same window.">neurologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Cerebrovascular disease</li> <li>Stroke</li> </ul>D.O.<p><strong>Education</strong></p> <ul> <li>Des Moines University</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Neurology, University of Illinois at Chicago</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Vascular Neurology, University of Illinois at Chicago</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Neurology</li> <li>American Heart Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Neurology, Mayo Clinic College of Medicine and Science</li> </ul>Moustafa<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/bayan-moustafa-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=D35319C009C763BE753D3DBC5FD28BE7" alt="Bayan Moustafa, D.O." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/39571921/" target="_blank" title="Opens in a new window.">Neuro-ophthalmic outcomes after carotid intervention for ocular symptoms</a>, November 2024.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/38574808/" target="_blank" title="Opens in a new window.">Ocular ischemic syndrome and the role of carotid artery revascularization</a>, August 2024.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/38336118/" target="_blank" title="Opens in a new window.">Efficacy and safety of PCSK9 inhibitors for stroke prevention: Systematic review and meta-analysis</a>, April 2024.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/36227497/" target="_blank" title="Opens in a new window.">Navigating antiplatelet treatment options for stroke: Evidence-based and pragmatic strategies</a>, November 2022.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/35834250/" target="_blank" title="Opens in a new window.">Association of Mediterranean diet with cognitive decline among diverse Hispanic or Latino adults from the Hispanic Community Health Study/Study of Latinos</a>, July 2022.</li> </ul>Bayan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30071426Bayan Moustafa, D.O.1{954F8C76-231B-4BB6-AB03-24CD0E4834AC}|{D68138A4-E93F-4DDA-BA2A-9B9545F14DD3}<img src="/-/media/national-files/images/hometown-health/2023/two-people-side-hugging.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D28EE8659101A069A9B745FE50B5BC26" alt="Two people side hugging" width="660" height="370" DisableNVelocity="true" />StrokeAs one of the leading causes of death in the U.S., stroke will affect 80% of families during their lifetimes, according to the National Stroke Association. And the faster care you receive for stroke, the better. Learn more about stroke prevention, symptoms and treatments here.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Stroke AwarenessA stroke occurs when the blood supply to part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and food. A stroke is a medical emergency. Prompt treatment is crucial. Early action can minimize brain damage and potential complications.<br/>Dawn Haller10/13/2016<p>Your gear might be prepared for hunting season, but have you stopped to ask yourself if your heart is ready?</p>Hunting and heart attacks<img alt="hearthunting" src="/-/media/national-files/images/hometown-health/2016/2016-general/hearthunting.jpg?h=297&w=400&sc_lang=en&hash=7716E9BC85796401C56EC435B263BA56" style="height: 297px; width: 400px;" /> <p>It' still dark outside. The weather is bitter and cold. It's the perfect day to get together with good friends, reflect on life, walk the countryside and bring home that trophy buck or prize pheasant. You're fully prepared this year. Your scope is right on, you've scouted out the perfect spot for your stand and you've been punching paper targets for months. But is your heart ready?</p> <p>Like any sport, hunting requires participants to train, focus, and be mentally and physically fit for the activity required. When hunters aren't in shape, their trips sometimes can end in tragedy. Hunting may be the most demanding physical exertion some hunters experience all year.</p> <p>Dragging a heavy deer through the snow or brush can be exceptionally stressful on the heart. Studies show that excitement of sighting a deer can send a hunter's heart rate soaring. This excitement, combined with strenuous hunting activity, can put a physically unfit hunter at risk of a heart attack.</p> <h2>Know the warning signs</h2> <p>Knowing the warning signs of a <a rel="noopener" rel="noopener " href="https://www.mayoclinic.org/diseases-conditions/heart-attack/symptoms-causes/syc-20373106" target="_blank" title="Opens in a new window.">heart attack</a> can help alleviate the severity of the attack. Many people fail to recognize a heart attack because the symptoms can be vague and easy to pass off as a less serious problem. Knowing the signs allows you to act fast.</p> <p>A heart attack does not always produce a giant, immobilizing pain or a sharp stabbing pain. The body sends signals that the heart is starving for oxygen by these warning signals:</p> <ul> <li>An uncomfortable pressure, fullness, squeezing or pain in the center of the chest for more than two minutes.</li> <li>Chest pain that spreads to the shoulders, neck, or arms.</li> <li>Dizziness, fainting, sweating, nausea and shortness of breath may also occur.</li> </ul> <p>Sometimes these signals may subside only to return later, possibly with greater discomfort and danger. The <a rel="noopener" href="https://www.heart.org/en/" target="_blank" title="Opens in a new window.">American Heart Association</a> recommends that anyone experiencing chest pain and discomfort for two minutes or more should call 911 or go to a hospital immediately. Expect the person to deny the possibility of having a heart attack, but insist on prompt action. Do not ignore any warning signal — act immediately.</p> <p>Before your trip, find out which hospitals provide 24-hour service in the area you will be hunting. Select the nearest facility in advance so there will be no delay in finding a hospital. Inform your family and friends so they know where to go in case of an emergency. Don't worry about a false alarm — just get to the hospital. Reacting quickly could save your life as you have only a couple of hours to save that heart muscle.</p> <p>Smoking, family history of heart disease, <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444" target="_blank" title="Opens in a new window.">diabetes</a>, <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/obesity/symptoms-causes/syc-20375742" target="_blank" title="Opens in a new window.">obesity</a>, and <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/symptoms-causes/syc-20350800" target="_blank" title="Opens in a new window.">high cholesterol</a> all could be causes of a heart attack. Now is the best time to get a checkup from your doctor so you know if you're ready and what you can do to prepare. In addition to giving you a heart risk assessment, physicians also can give advice on exercise programs to get you ready for dragging out that buck or for those long prairie walks seeking the elusive pheasant.</p> <h2>Learn more about your heart:</h2> <ul> <li>Read more about <a href="https://mayoclinichealthsystem.org/hometown-health?topic=Heart%20Health" target="_self" title="Opens in same window.">heart health</a>.</li> <li>Discover unique signs and risks for <a href="/hometown-health/speaking-of-health/women-and-heart-disease" target="_self" title="Opens in same window.">women and heart disease</a>.</li> <li>Get the facts. Download an <a href="/-/media/national-files/documents/hometown-health/2019/get-the-facts-high-blood-pressure.pdf?sc_lang=en&hash=938229F6EA80675E1B647E093FB1D162" target="_blank" title="Opens in a new window.">infographic about high blood pressure</a>.</li> <li>Do you know your risk of developing diabetes? Take the <a rel="noopener" href="https://donations.diabetes.org/site/SPageServer/?pagename=Diabetes_Risk_Test&source=dorg&cate=link&loca=alert-day" target="_blank" title="Opens in a new window.">American Diabetes Association's 60-second test</a> to find out.</li> </ul> <p><em><a href="/providers/anthony-furlano-do" target="_self" title="Opens in same window.">Anthony Furlano, D.O.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Hospital medicine</li> <li>Maternity care</li> <li>Medical education</li> <li>Musculoskeletal and sports medicine</li> <li>Osteopathic manipulative treatment</li> <li>Pediatrics</li> </ul>D.O.I decided to move to Eau Claire because of the great community atmosphere. I look forward to providing quality, full-spectrum family medical care for my patients.</p> <p>In my free time, I enjoy woodworking, biking, snowboarding, reading, playing board games, and spending time with my wife and two daughters.</p> <p><strong>Education</strong></p> <ul> <li>Rocky Vista University College of Osteopathic Medicine</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Osteopathic Manipulative Medicine, Rocky Vista University College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo Clinic Family Medicine Residency Program in La Crosse</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Medicine, American Board of Family Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American College of Osteopathic Family Physicians</li> </ul>Furlano<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/anthony-furlano-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=445C00E8B6EAF07A6675F6187EA2D53A" alt="Anthony Furlano, D.O." width="280" height="280" DisableNVelocity="true" />{B6150DAF-1ADF-4506-B787-B8035589A498}Anthony<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14973111Anthony Furlano, D.O.1<img src="/-/media/national-files/images/hometown-health/2016/2016-general/hearthunting.jpg?h=297&iar=0&w=400&sc_lang=en&hash=67235D40DCD2FA16FA8AC4AD7C4FA2D1" alt="Is your heart ready for hunting?" width="400" height="297" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Micah Dorfner12/27/2016<p>The vulva is made up of mucous membranes, several glands, and highly innervated and sensitive skin and hair follicles. This makes it one of the most anatomically and physiologically intricate body parts. Vulvar health is dependent on many aspects of a woman's health.</p>Vulvar health: Pay attention, speak up<img alt="Women Standing Together" src="/-/media/national-files/images/hometown-health/2016/2016-general/women-standing-together.jpg?h=300&w=300&sc_lang=en&hash=2676C501AD4110D7D05105DF8F8B9EF9" style="width: 300px; height: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive"> <p>The <a href="http://www.mayoclinic.org/vulva/img-20005974" target="_blank" title="Opens in new window">vulva</a>, quite often erroneously referred to as “vagina” or many other names, is the external part of the female genitalia. This complex organ is comprised of the mons pubis, labia majora, labia minora, clitoris, vestibule of the vagina, bulb of the vestibule and the Bartholin glands. The vulva is made up of mucous membranes, several glands, and highly innervated and sensitive skin and hair follicles. This makes it one of the most anatomically and physiologically intricate body parts.</p> <p>Vulvar health is dependent on many aspects of a woman's health, including:</p> <ul> <li>The presence of urine or fecal incontinence</li> <li>Menopause and its changes</li> <li>Menstrual abnormalities</li> <li>Systemic or local dermatologic conditions</li> </ul> <p>All of these can have a negative impact on the vulva. Vulvar disorders are usually reported to or noted by providers from various disciplines (e.g., dermatologists, gynecologists, urologists, primary care physicians, nurse practitioners and physician assistants). Unfortunately, many providers overlook the vulva, which often is seen as a conduit to the cervix, where the routine <a href="http://www.mayoclinic.org/tests-procedures/pap-smear/basics/definition/prc-20013038" target="_blank" title="Opens in new window,">pap smear</a> is performed upon.</p> <p>As a society, we still seem uncomfortable using the term vulva when referring to the female anatomy. In fact, most women are embarrassed to report their own vulvar problems and instead go to the pharmacy to find self-treatments that often cause more harm than good.</p> <p><strong>Why stigma can lead to vulvar issues</strong></p> <p>Patients often are embarrassed to report issues related to their vulva. Something as simple and annoying as a longstanding itch may not be discussed with a provider. This leads to potential oversight of an underlying skin condition or lesion that might otherwise have been treated.</p> <p>As women’s health providers, we encourage all women to speak freely about their vulva and recommend every woman routinely check her vulva. You can do this using a mirror. If skin changes occur, you will be the first to notice.</p> <p>Every vulva is unique and different. There is no ideal or perfect vulva. Therefore, it’s so important to pay attention to your vulva, as no one will know it better than you.</p> <p><strong>Listen to your body</strong></p> <p>Vulvar itching is one of many symptoms of vulvar disease. Also, burning, pain, a sense of fullness and sexual discomfort might all be caused by vulvar conditions that need medical attention. Some of these conditions can be potentially serious and require immediate treatment.</p> <p>Below is what you should know and do when you’re experiencing more than the occasional itch. Keep in mind that some itching from time to time is normal.</p> <ul> <li><strong>Not every itch is yeast-related. </strong>In many cases, yeast may be the culprit. However, irritation from sweat, feces, soap, urine or any other irritant also may cause itching by triggering irritant dermatitis. Itching also can be caused by conditions such as eczema, psoriasis and lichen sclerosus. Even more unfortunate is that your itching may be the result of a secondary allergic reaction to a topical agent like Benzocaine, which is present in many over-the-counter medications that are advertised to treat itching.</li> <li><strong>Avoid topical applications. </strong>Unless prescribed by a physician, stop any topical applications to your vulva. Keep it simple by washing with water only, and make sure to not wash too much or often. You can apply a thin film of petroleum jelly for protection from irritants.</li> <li><strong>Don’t scratch. </strong>Do your best to avoid scratching, as this might make itching worse. Wear cotton-only undergarments, and avoid tight clothing that might keep the area hot and moist.</li> <li><strong>Consider bedtime routines. </strong>Try sleeping without underwear at night, especially during evenings when the weather is warm or hot.</li> <li><strong>Call for help. </strong>Lastly, if the itch still is not improving, make sure to contact your provider as soon as possible, and take pictures of any skin changes you notice prior to your visit. A picture is worth a thousand words.</li> </ul> <p>Annual preventive visits with your <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">women's health provider</a> are good opportunities to address any feminine hygiene concerns you have and to check the vulva for any changes that may need treatment.</p> <p><em><a href="/providers/tarek-khalife-md" target="_self" title="Opens in same window.">Tarek Khalife, M.D.</a>, <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a>, and Becky DeLuca, OB-GYN nurse practitioner, see patients in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Adenomyosis</li> <li>Endometriosis</li> <li>Female sexual dysfunction, pain and vulvar disease, such as lichen sclerosus and lichen planus</li> <li>Fibroid treatment</li> <li>Heavy or irregular menstrual bleeding</li> <li>In-office treatment, including LEEP procedures, colposcopy and hysteroscopy</li> <li>Minimally invasive surgery for treatment of gynecologic disorders, such as laparoscopy and hysteroscopy</li> <li>Obstetric and advanced gynecologic 3D ultrasound</li> <li>Pelvic pain</li> <li>Robotic surgery</li> <li>Urine incontinence</li> <li>Uterovaginal prolapse</li> <li>Vaginal natural orifice transluminal endoscopic surgery (VNOTES)</li> </ul>M.D.<p>Every patient will have ample time to explain her condition and shed light on what matters to her most, as we navigate her treatment options. It is very imperative that the patient understands our partnership in managing her condition and identifies us as her support team to focus on her treatment and recovery.</p> <p>The most rewarding aspect of my time with the patient is when I get to educate them about their body and how disease affects its balance. It is my goal to allow my patient to graduate from her care with enough knowledge that she would use to teach and advocate for herself and to other women in her community. This way touches the patient’s life and the communities' lives at large.</p> <p>Outside of work, I do enjoy biking, swimming and camping. I am also a remote-control plane hobbyist, and I love grilling and cooking Lebanese cuisine.</p><p><strong>Education</strong></p> <ul> <li>Beirut Arab University</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>Obstetrics and Gynecology, Henry Ford Health System-Wayne State University</li> <li>Obstetrics and Gynecology, American University of Beirut Medical Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Minimally Invasive Gynecologic Surgery, American Board of Obstetrics and Gynecology</li> <li>Fellow, American College of Obstetrics and Gynecology</li> </ul> <p><strong> Memberships</strong></p> <ul> <li>American Association of Gynecologic Laparoscopists</li> <li>American College of Obstetrics and Gynecology</li> <li>International Society for the Study of Women's Sexual Health</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Obstetrics and Gynecology, Mayo Clinic College of Medicine and Science</li> </ul>Khalife<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/tarek-khalife-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A39C3DF2BF499DCA00FE29E1F7699D5D" alt="Tarek Khalife MD" width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/36088274/" target="_blank" title="Opens in new window">Retroperitoneal causes of genitourinary pain syndromes: Systemic approach to evaluation and management</a>, October 2022.</li> <li><a rel="noopener" href="https://www.sciencedirect.com/science/article/pii/S0002937821006074?via%3Dihub" target="_blank" title="Opens in new window">Pregnancy with IUD in place</a>, May 2021.</li> <li><a rel="noopener" href="https://www.liebertpub.com/doi/abs/10.1089/gyn.2021.0041" target="_blank" title="Opens in a new window">Intraoperative genitourinary injuries during a hysterectomy: Risks, management, and mitigation strategies</a>, May 2021.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/30398979" target="_blank" title="Opens in new window. ">The endogenous opioid system: Role and dysfunction caused by opioid therapy</a>, March 2019.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/28118169" target="_blank" title="Opens in new window. ">The K-technique: A novel technique for laparoscopic apical suspension using barbed sutures</a>, April 2017.</li> </ul>{CA02D1B4-DD8D-4C67-B975-FFCAEB25CAEF}Tarek<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20407092Tarek Khalife, M.D.1{83EB2AA2-1436-4DDC-B7BB-51F8E6A87FC9}|{54693F31-87AF-4B21-91DB-1DEC1E21F878}<img src="/-/media/national-files/images/hometown-health/2016/2016-general/women-standing-together.jpg?h=300&iar=0&w=300&sc_lang=en&hash=3225B2AB1AA0461D46C6FAD5786C67AD" alt="Women standing together" width="300" height="300" DisableNVelocity="true" />Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller12/22/2016The holidays can be a difficult time for many, especially if you are dealing with unacknowledged grief.When grief goes unacknowledged<img alt="Blog_grief_16" src="/-/media/national-files/images/hometown-health/2016/2016-general/pine-bough-and-cookies.jpg?h=335&w=504&sc_lang=en&hash=F6D63B95A7B52C781105C8175D978A98" style="height: 335px; width: 504px;" /> <p>The holiday season brings a time of traditions, family, friends, thankfulness, love, goodwill and joy. As the days of autumn turn darker and colder, our senses begin to absorb sights, sounds and smells that may trigger memories of the past. For those that are grieving the death of a loved one, it is understandable that many feel the pull to draw inward to block out the season. Some may be experiencing these feelings complicated by the fact that their loss goes unacknowledged.</p> <p>Losses, such as a miscarriage; the death of a friend, ex-spouse, co-worker or same-sex partner; a death by suicide; or the loss of beloved companion animal, can often be overlooked. Even widely recognized forms of grief can become disenfranchised when well-meaning friends and family attempt to set a time limit on a bereaved person's right to grieve.</p> <p>When a person is grieving, it is easy to feel as if nobody understands and even more so when a significant loss is not acknowledged or recognized by society. Societal expectations can create pressure to grieve a certain way, for a certain length of time or even of who is entitled to grieve. As a result, a person may keep his or her feelings bottled up inside, which can lead to deep resentment. That, in turn, is stressful on a body and can make a person more prone to illness.</p> <p>Grief at the holidays for anyone who is experiencing the impact of a significant loss needs to have a voice. This time of year inherently represents hope and also can be a time of healing. It's never too late to mourn or celebrate the relationships of those we have loved and lost.</p> <h2>Here are some ideas that may be helpful:</h2> <ul> <li><strong>Recognize that your feelings are valid.</strong><br /> Be honest about how you feel, and give yourself time to express your emotions.</li> <li><strong>Create your own ritual to commemorate the person.</strong><br /> Donate to a favorite charity in their memory, light a candle, read a poem or prayer in their honor, or visit a meaningful place.</li> <li><strong>Assess your support system, and find people who understand.</strong><br /> Search for a bereavement support group, or reach out to someone who might have experienced a similar loss.</li> <li><strong>If some traditions are not helpful, it might feel better to try something new, even if just for this year.</strong></li> <li><strong>Recognize that there is no right or wrong way to feel.</strong><br /> Don't try to live up to others' expectations of how you should feel. It's OK if you feel happy and enjoy some aspect of the season; it's also OK if you don't.</li> <li><strong>Remember to maintain healthy habits during the holidays.</strong><br /> Exercise and activity can help alleviate stress.</li> <li><strong>Be flexible.</strong><br /> It is OK to change plans or leave early from an event if you are having a difficult time. It's hard to predict the intensity of emotions on any given day.</li> <li><strong>Simplify.</strong><br /> Grief takes a lot of energy. Get enough rest, and listen to your body.</li> </ul> <p>The holidays can present challenges to all those who are grieving. By being aware of your emotions and taking special care in planning, you will get through the difficult moments. As you honor the memories, you might even find new ones to give you added strength.</p> <p><em>Lisa De Sieno is director of Bereavement Services in Eau Claire, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2016/2016-general/pine-bough-and-cookies.jpg?h=335&iar=0&w=504&sc_lang=en&hash=5ED4337578119D19F92074A3799BC3EF" alt="Pine bough and cookies" width="504" height="335" DisableNVelocity="true" />GriefGrief is the natural reaction to loss. It will be unique to you, depending on your own personality and circumstances.DepressionDepression is a medical illness that causes a persistent feeling of sadness, loss of interest and, sometimes, physical symptoms. It's also called major depression, major depressive disorder and clinical depression.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller9/29/2022<p>Tightness in your chest, pain in your jaw and shortness of breath. Are these signs you're having a heart attack? Learn why recognizing the symptoms and calling 911 are vital during a heart attack.</p>What should I do if I might be having a heart attack?<p>A heart attack is a frightening experience. Fortunately, health care professionals are highly trained to provide critical care to assist heart attack patients during their time of need. However, it’s equally important for people everywhere to better recognize the symptoms of a heart attack and to react quickly. Together, we all have the power to play a vital role during a heart attack. The more we understand, the more we can help.</p> <h2>What is a heart attack?</h2> <p>Each year in the U.S., approximately 250,000 people have a specific type of severe heart attack known as a STEMI, or ST-segment elevation myocardial infarction. A STEMI is caused by a complete blockage of blood flow to the heart, which requires timely treatment.</p> <p>To minimize damage to the heart and potentially prevent death, it's critical to immediately restore blood flow in the heart artery by mechanically opening the blocked vessel or administering clot-busting medication.</p> <h2>Heart attack symptoms vary</h2> <p>Remember, not all people who have heart attacks have the same symptoms or severity of symptoms. Most heart attacks involve central chest pain, but symptoms can include pain or discomfort in one or both arms, the back, the jaw, the neck or upper stomach. Some people have mild pain, others have more severe pain, some people have no symptoms and, for certain people, the first sign may be sudden cardiac arrest.</p> <p><a href="/hometown-health/speaking-of-health/women-and-heart-disease" target="_self" title="Opens in same window.">Women are more likely than men to present with atypical symptoms</a>, such as shortness of breath, nausea and vomiting. Therefore, it's important for everyone to pay attention to all symptoms, not just chest pain.</p> <h2>When to call 911</h2> <p>If you or someone else is experiencing warning signs, call 911 right away.</p> <h3>Common heart attack signs and symptoms include:</h3> <ul> <li>Pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back</li> <li>Nausea, indigestion, heartburn or abdominal pain</li> <li>Shortness of breath</li> <li>Cold sweat</li> <li>Fatigue</li> <li>Lightheadedness or sudden dizziness</li> </ul> <h2>Am I at risk?</h2> <p>Certain factors contribute to the unwanted buildup of fatty deposits (atherosclerosis) that narrows arteries throughout your body. You can modify or eliminate many of these <a href="/hometown-health/speaking-of-health/know-your-heart-health-numbers" target="_self" title="Opens in same window.">risk factors</a> to reduce your chances of having a first or subsequent heart attack.</p> <h3>Heart attack risk factors include:</h3> <ul> <li><strong>Age</strong><br /> Men 45 and older and women 55 and older are more likely to have a heart attack than younger men and women.</li> <li><strong>High blood pressure</strong><br /> Over time, <a href="/hometown-health/speaking-of-health/know-your-numbers-blood-pressure" target="_self" title="Opens in same window.">high blood pressure</a> can damage arteries that feed your heart by accelerating atherosclerosis.</li> <li><strong>High blood cholesterol or triglyceride levels</strong><br /> A high level of low-density lipoprotein (LDL) cholesterol can contribute to narrowing of arteries. LDL is referred to as the "bad" cholesterol. A high level of triglycerides, a type of blood fat related to your diet, also is associated with increased cardiovascular risk. Conversely, a low level of high-density lipoprotein (HDL) cholesterol is associated with an increased risk of heart attack. HDL is referred to as the "good" cholesterol.</li> <li><strong>Diabetes</strong><br /> Having diabetes — not producing enough insulin or not responding to insulin properly — causes your body's blood sugar levels to rise. Diabetes, especially when uncontrolled, increases your risk of heart attack.</li> <li><strong>Family history of heart attack</strong><br /> If your siblings, parents or grandparents have had early heart attacks, you may be at increased risk. Early heart attacks are considered before 55 for male relatives and before 65 for female relatives.</li> <li><strong>Lifestyle</strong><br /> Tobacco use, lack of physical activity, obesity and <a href="/hometown-health/speaking-of-health/tips-to-keep-stress-from-hurting-your-heart" target="_self" title="Opens in same window.">stress</a> are all additional contributing risk factors that can be modified by adopting healthy habits into your daily life.</li> </ul> <p>Remember, treatment for a heart attack begins by calling 911 to receive help from professionals who are trained to handle these situations. At Mayo Clinic Health System, we are committed to meeting and exceeding our goals of providing the highest level of care to our heart patients. Yet for all we do, recognizing the signs and reacting quickly to a heart attack begins with you.</p> <p><em><a href="/providers/john-haley-md" target="_self" title="Opens in same window.">John Haley, M.D.</a>, is a <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiologist</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Adult echocardiography</li> <li>Cardiac computed tomography (CT)</li> <li>Noninvasive cardiac imaging</li> <li>Nuclear cardiology</li> </ul>M.D.<p><strong>Medical School</strong></p> <ul> <li>University of Minnesota Medical School, Twin Cities</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Mayo Clinic College of Medicine & Science, Minnesota</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Cardiovascular Diseases, Mayo Clinic College of Medicine & Science, Minnesota</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Adult Comp Echocardiography, National Board of Echocardiography</li> <li>Cardiovascular Diseases, American Board of Internal Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Society of Echocardiography</li> <li>Fellow, American College of Cardiology</li> <li>Minnesota Chapter of the American College of Cardiology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Haley<img src="/-/media/shared-files/images/medical-professionals/full/mankato/john-haley-md.jpg?h=280&iar=0&w=280&hash=BB6C422979379FC61C86BBA3FABA5629" alt="John Haley MD" width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.ncbi.nlm.nih.gov/pubmed/16236554" target="_blank" title="Opens in new window. ">Dynamic left ventricular outflow tract obstruction in senile cardiac amyloidosis</a>, December 2006</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.ncbi.nlm.nih.gov/pubmed/14736448" target="_blank" title="Opens in new window. ">Transient constrictive pericarditis: causes and natural history</a>, January 2004</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.ncbi.nlm.nih.gov/pubmed/11571257" target="_blank" title="Opens in new window. ">Myocardial ischemia on thallium scintigraphy in hypertrophic cardiomyopathy: predictor of sudden cardiac death</a>, September 2001</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.ncbi.nlm.nih.gov/pubmed/10961976" target="_blank" title="Opens in new window. ">Images in cardiovascular Medicine. Wide-complex tachycardia</a>, August 2009</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.ncbi.nlm.nih.gov/pubmed/10488794" target="_blank" title="Opens in new window. ">Dynamic left ventricular outflow tract obstruction in acute coronary syndromes: an important cause of new systolic murmur and cardiogenic shock</a>, September 1999</li> </ul>John<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>11945028John Haley, M.D.1{676428F6-179A-4C9B-9B23-5F1E40032A38}<img src="/-/media/national-files/images/hometown-health/2022/person-with-dark-hair-looking-right.jpg?h=370&iar=0&w=660&sc_lang=en&hash=84BF8E38F2569D837A2670F724229916" alt="Person with dark hair looking right" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller3/13/2024Anyone can be infected with the highly contagious illness norovirus. Follow these tips to decrease your risk of getting the viruses that cause gastroenteritis, often referred to as the stomach flu.Steps to prevent norovirus<p>Norovirus tends to spread during the fall and winter months, but it can make people ill any time of the year. Often referred to as the stomach flu, <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/norovirus/basics/definition/con-20029968" target="_blank" title="Opens in new window">norovirus</a> causes people to experience cramping, stomach pain, nausea, vomiting and diarrhea. Noroviruses are a group of related viruses that can cause <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/viral-gastroenteritis/basics/definition/con-20019350" target="_blank" title="Opens in new window">gastroenteritis</a>, which is an inflammation of the stomach and intestines.</p> <p>People with norovirus illness are highly contagious from when they begin feeling sick until a few days after they recover. With no vaccine to prevent norovirus and no medication to treat it, prevention is up to you.</p> <h2>Who is infected with norovirus?</h2> <p>Anyone can be infected with norovirus and become sick. It's also possible to be infected with the virus many times in your life. </p> <p>Each year, norovirus causes approximately 20 million illnesses, resulting in tens of thousands of hospitalizations and hundreds of deaths. If you're infected with norovirus, you can feel ill and throw up or have diarrhea many times a day. This can lead to dehydration, especially in young children, older adults and people with other illnesses. Norovirus is the leading cause of foodborne illness outbreaks in Minnesota.</p> <p>Most people will recover within a few days, but people with weakened immune systems may experience more prolonged symptoms. Norovirus can spread quickly in shared spaces like day care centers, school classrooms, nursing homes and cruise ships.</p> <h2>Tips for prevention</h2> <h3>Consider these tips to prevent norovirus infection:</h3> <ul> <li><strong>Stay home if you're sick.</strong><br /> This means staying home from school and work. Food service workers are legally required to stay home if they are sick.</li> <li><strong>Practice proper hand hygiene.</strong><br /> Wash your hands carefully with soap and water, especially after using the restroom, changing diapers and before preparing food or eating. Wash your hands more often when someone in your household is sick.</li> <li><strong>Don't rely on alcohol-based hand sanitizer.</strong><br /> Hand sanitizer shouldn't be used as a substitute for hand-washing. You can use hand sanitizer in addition to washing your hands, but hand-washing is the best method to prevent norovirus.</li> <li><strong>Be smart in the kitchen.</strong><br /> Don't prepare food while you are sick with norovirus or are experiencing norovirus symptoms for at least three days after you recover. Carefully rinse fruits and vegetables, and thoroughly cook oysters and other shellfish before serving.</li> <li><strong>Clean and disinfect contaminated surfaces.</strong><br /> Use a household bleach solution, up to 1 ½ cups of bleach in one gallon of water, to clean surfaces after vomiting or diarrhea accidents. Leave the solution on a bleach-safe hard surface for at least five minutes, and then wash the area with soap and hot water. Wear rubber gloves while cleaning, and dispose of paper towels in a plastic bag. </li> <li><strong>Avoid potluck meals.</strong><br /> Stay away from potluck meals or homemade items to reduce exposure to potentially contaminated food during norovirus outbreaks.</li> </ul> <p>Following these tips can decrease your risk of becoming infected with norovirus. Prevention of norovirus infection is your best option to stay healthy.</p> <p><em><a href="/providers/timothy-slama-do" target="_self" title="Opens in same window.">Timothy Slama, D.O.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a>, Minnesota.</em></p><ul> <li>Dermatology</li> <li>Pediatrics</li> <li>Sports medicine</li> </ul>D.O.<p>I grew up 30 minutes from Fairmont. I'm married with three kids and coach tennis at the Fairmont High School. I'm also a medical consultant for public health in Martin and Faribault counties.</p><p><strong>Education</strong></p> <ul> <li>Des Moines University College of Osteopathic Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Iowa Lutheran Hospital, University of Iowa</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Iowa Lutheran Hospital</li> </ul> <p><strong>Certifications</strong> </p> <ul> <li>Family Medicine, American Board of Family Medicine</li> <li>Certified Medical Examiner, Department of Transportation</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Medical Association </li> <li>Minnesota Academy of Family Physicians</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Slama<img src="/-/media/shared-files/images/medical-professionals/full/fairmont/timothy-slama-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=FCCFA79564EA50EAAA4C53E2DE19802C" alt="Timothy Slama, D.O." width="280" height="280" DisableNVelocity="true" />{F6F9D4D2-2155-4F19-885A-FEFABCBBB330}Timothy <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15345599Timothy Slama DO1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}<img src="/-/media/national-files/images/hometown-health/2024/preparing-shrimp-meal-in-bowl.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6330243F7FA28C291D8753D55DD1479E" alt="Preparing shrimp meal in bowl" width="660" height="370" DisableNVelocity="true" />Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller11/29/2016<p>Chronic obstructive pulmonary disease, or COPD, is a collection of serious lung diseases that obstructs airflow from the lungs and causes breathing issues. According to the American Lung Association, more than 11 million people in the U.S. have been diagnosed with COPD, which is the third leading cause of death. Understanding the risks, symptoms and effective prevention methods of COPD can help your long-term health.</p>COPD: Risks, symptoms and prevention<a href="http://www.mayoclinic.org/diseases-conditions/copd/home/ovc-20204882" target="_blank" title="Opens in new window"><img alt="COPD" src="/-/media/national-files/images/hometown-health/2016/2016-general/copd.jpg?h=249&w=300&sc_lang=en&hash=97E723B5BA913DE464297138147ECFA6" style="width: 300px; height: 249px; float: right; margin-bottom: 10px; margin-left: 10px;" /> </a> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/copd/symptoms-causes/syc-20353679" target="_blank" title="Opens in new window">Chronic obstructive pulmonary disease</a>, or COPD, is a collection of serious lung diseases that obstructs airflow from the lungs and causes breathing issues. Emphysema and chronic bronchitis are the conditions that most commonly contribute to COPD. According to the <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.lung.org/" target="_blank" title="Opens in new window">American Lung Association</a>, more than 11 million people in the U.S. have been diagnosed with COPD, which is the third leading cause of death. Understanding the risks, symptoms and effective prevention methods of COPD can help your long-term health.</p> <p>The greatest risk for developing COPD is smoking cigarettes. Any long-term exposure to irritant gases increases chances of COPD, but cigarette use is by far the most common, especially if you’re a smoker who also has asthma.</p> <p>Symptoms typically don’t appear until extensive lung damage has occurred. However, warning signs may include:</p> <ul> <li>Daily cough and mucus production</li> <li>Shortness of breath, especially during physical exertion</li> <li>Wheezing</li> <li>Tightness in the chest</li> <li>Blue-colored lips or fingernails</li> <li>Regular respiratory infections</li> <li>Poor energy levels</li> <li>Unexplained weight loss</li> <li>Swelling of ankles, feet or legs</li> </ul> <p>COPD patients commonly experience what are known as exacerbations, which are periods where symptoms are worse than normal for several days.</p> <p>Notable risk factors outside of smoking are exposure to chemical fumes, dusts and vapors, which commonly occur in workplace settings,  as well as exposure to fumes from burning fuel, older age and genetics.</p> <p>In order to prevent COPD and associated issues, individuals need to protect their lungs. Don’t smoke. Avoid coming into contact with chemical fumes and pollutants. And protect yourself from respiratory illnesses by making healthy lifestyle choices. The earlier COPD is detected, the better the potential outcome. So, be sure to talk with your health care team if you have signs, symptoms or concerns.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2016/2016-general/copd.jpg?h=249&iar=0&w=300&sc_lang=en&hash=FA814D9978F2A60DE0ED593BD8A9A455" alt="COPD" width="300" height="249" DisableNVelocity="true" />PulmonologyTreatment for diseases and conditions affecting lung and airway function.Dawn Haller11/27/2024Most people in the U.S. exceed their protein needs. But those on restricted diets or weight-loss medications may need more. Learn what's the right amount of protein for you.Are you getting enough protein?<p>Are you getting too much protein, not enough or just the right amount? The answer? It depends. Your gender, age, activities, use of weight-loss medication or supplements and other factors can affect your protein needs.</p> <h2>Here are some answers to your questions about protein needs:</h2> <h3>Are you getting too much protein?</h3> <p>Contrary to all the hype that everyone needs more protein, most people in the U.S. meet or exceed their needs. This is especially true for males ages 19-59. The <a rel="noopener" href="https://www.dietaryguidelines.gov/resources/2020-2025-dietary-guidelines-online-materials" target="_blank" title="Opens in a new window.">Dietary Guidelines for Americans, 2020–2025</a> indicates that men in that age range exceed their protein recommendations, especially from meat, poultry and eggs.</p> <p>Even <a href="/hometown-health/speaking-of-health/assessing-protein-needs-for-performance" target="_self" title="Opens in same window">athletes often get more protein</a> than they need without <a href="/hometown-health/speaking-of-health/multivitamins-and-supplements-to-take-or-not-to-take" target="_self" title="Opens in same window">supplements</a> because their calorie requirements are higher. With more food comes more protein.</p> <h3>Are you getting enough protein?</h3> <p>Concerns about not getting enough protein arise when you're undereating or taking a <a href="/hometown-health/speaking-of-health/whats-the-skinny-on-weight-loss-drugs" target="_self" title="Opens in same window">weight-loss medication</a>. People on a restrictive diet, diagnosed with an eating disorder or taking a weight-loss drug tend to skip meals. That starts a cascade of effects including not getting enough protein and greater loss of muscle mass, which isn't the type of weight you want to lose.</p> <p>If you're trying to <a href="/services-and-treatments/weight-management" target="_self" title="Opens in same window">lose weight,</a> it's essential that you don't skip meals. Eat a good source of protein three times a day to meet your body's needs.</p> <h3>Does a bigger steak equal bigger muscles?</h3> <p>Although adequate protein throughout the day is necessary, extra strength training is what leads to muscle growth — not extra protein intake. You can't build muscle without the exercise to go with it.</p> <p>The body can't store protein, so once its needs are met, any extra protein is used for energy or stored as fat. Excess calories from any source will be stored as fat in the body.</p> <p>Extra protein intake can also lead to elevated blood lipids and heart disease since many high-protein foods are high in total and saturated fat. Because it can <a href="/hometown-health/speaking-of-health/5-nutrition-tips-for-chronic-kidney-disease" target="_self" title="Opens in same window">tax the kidneys</a>, extra protein intake poses an additional risk to people predisposed to kidney disease.</p> <h3>How much protein do you need?</h3> <p>Protein should account for 10% to 35% of your calories. So, if your daily needs are 2,000 calories, that's 200-700 calories from protein or 50-175 grams.</p> <p><strong>If you're an average adult.</strong><br /> The recommended dietary allowance to prevent deficiency for an average sedentary adult is 0.8 grams per kilogram of body weight. For example, a person who weighs 165 pounds, or 75 kilograms, should consume 60 grams of protein per day.</p> <p><strong>If you're over age 40-50.</strong><br /> Once you're between the ages of 40 and 50, sarcopenia — losing muscle mass as you age — begins to set in. To prevent this and to maintain independence and quality of life, your protein needs increase to about 1-1.2 grams per kilogram or 75-90 grams per day for a 165-pound person.</p> <p><strong>If you exercise regularly.</strong><br /> People who exercise regularly also have higher needs, about 1.1-1.5 grams per kilogram. People who regularly lift weights or are training for a running or cycling event need 1.2-1.7 grams per kilogram. Excessive protein intake would be more than 2 grams per kilogram of body weight each day.</p> <p><strong>If you're overweight.</strong><br /> If you are overweight, your weight should be adjusted before calculating your protein needs to avoid overestimating. A <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window">dietitian</a> can help with this calculation and develop a personalized plan. Consulting with a dietitian is also a good idea if you're underweight or on weight-loss medications.</p> <h2>Where does protein come from?</h2> <p>The healthiest protein options include:</p> <ul> <li><a href="/hometown-health/speaking-of-health/is-it-healthy-to-eat-eggs-every-day" target="_self" title="Opens in same window">Egg whites</a></li> <li>Fish or seafood</li> <li>Lean meats, such as skinless, white-meat chicken or turkey</li> <li>Low-fat dairy</li> <li><a href="/hometown-health/speaking-of-health/tips-for-eating-more-plant-proteins" target="_self" title="Opens in same window">Plant sources</a>, such as soy, nuts, seeds, beans and lentils</li> </ul> <p>In general, you should try to meet your dietary protein needs with these whole foods instead of supplements, as long as your energy intake is adequate for building lean mass. Manufactured foods don't contain everything you need from food, and manufacturers don't know everything that should be in food.</p> <h2>When is the best time to consume protein?</h2> <p>It's better to spread out your protein consumption evenly throughout the day. On average, people get most of their protein from evening meals and the least from breakfast.</p> <p>Some newer studies show that moving some protein from supper to breakfast can help with weight management by decreasing hunger and cravings throughout the day. More research is needed before these claims are verified.</p> <p>General recommendations are to consume 15-30 grams of protein at each meal. Studies show that higher intakes in one sitting — more than 40 grams — are no more beneficial than consuming the recommended 15-30 grams at one time. Don't waste your money on more protein than you need.</p> <h2>What if you do want to use a protein supplement?</h2> <p>If you want to use a protein supplement, here's what to look for per portion:</p> <ul> <li>2 grams or less of saturated fat</li> <li>5 grams of sugar or fewer</li> <li>About 200 or fewer calories</li> <li>No transfat or partially hydrogenated oils</li> </ul> <h2>What does 15-30 grams of protein from whole foods look like?</h2> <p>For example, an average-sized banana, Greek yogurt and a hard-boiled egg have 19 grams of protein. A 3-ounce chicken breast with a half-cup of rice and a half-cup of vegetables amounts to 25 grams of protein. An egg and bean burrito with a glass of milk is about 28 grams of protein.</p> <p>As you can see, getting the recommended 15-30 grams per meal is easy. Most people — even athletes — can meet their protein needs by including a serving of dairy at each meal and a piece of meat the size of a deck of cards at lunch and supper.</p> <p>Protein should accompany <a href="/hometown-health/speaking-of-health/eat-the-rainbow-for-good-health" target="_self" title="Opens in same window">fruits, vegetables</a> and whole grains, not make up your entire meal. If you feel you need more protein, consider adding more beans, lentils, soy or seafood rather than processed supplements.</p> <p><em><a href="/providers/kristi-wempen-rdn" target="_self" title="Opens in same window.">Kristi Wempen</a> is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition Counseling and Education</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Chronic kidney disease</li> <li>General health and wellness</li> <li>Weight management</li> </ul>RDN, LD<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Minnesota State University-Mankato</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Iowa State University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration</li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul> <p><strong>Membership</strong></p> <ul> <li>Academy of Nutrition and Dietetics</li> </ul>Wempen<img src="/-/media/shared-files/images/medical-professionals/full/mankato/kristi-wempen-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=BB7EFDC16603EA67B00B7CD0DBD528E1" alt="Kristi Wempen RDN" width="280" height="280" DisableNVelocity="true" />Kristi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14834341Kristi Wempen, R.D.N.1{2BEE5070-65FF-4406-9E59-103E06C5A535}<img src="/-/media/national-files/images/hometown-health/2022/handful-of-nuts.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B67C0C267C7AFBE2393EBEDA4FA3A1D4" alt="Handful of nuts" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller7/1/2022In our digital world, most of us own electronic devices with screens. Can screen time or video games become an addiction? Learn how to spot the signs and what you can do.Are video games, screens another addiction?<p>In an increasingly digital world, most people own multiple electronic devices with screens. However, many parents worry about the effects of screen use on themselves and their children.</p> <p>With screens virtually everywhere, controlling a child's screen time can be challenging. How can you manage your children's screen time? How will you know if you or your children are addicted to screens or video games?</p> <h2>Is screen time damaging?</h2> <p>It's difficult to avoid screens completely, especially with their importance at work and school. However, excessive screen time can affect a persons mental, social and physical health.</p> <h3>Too much screen time has been linked to:</h3> <ul> <li>Obesity</li> <li>Poor sleep or insomnia</li> <li>Behavioral problems, including impulsive actions</li> <li>Loss of social skills</li> <li>Violence</li> <li>Less time for play</li> <li>Eye strain</li> <li>Neck and back problems</li> <li>Anxiety</li> <li>Depression</li> <li>Difficulties with work or school</li> </ul> <p>Screen time can be engaging for people of all ages. This is because their brains process and react to the sensory input as if it were happening to them. For example, many people have cried, laughed or been startled while watching a movie. This same type of engagement is possible when a person plays a video game.</p> <p>While playing a video game, the person's brain processes the scenario as if it were real. If the game depicts a dangerous or violent situation, the gamer's body reacts accordingly. This "fight-or-flight response" to that perceived danger is triggered by exposure to intense stimulation and violence in the game. Excessive video game use can lead to the brain being revved up in a constant state of hyperarousal.</p> <p>Hyperarousal looks different for each person. It can include difficulties with paying attention, managing emotions, controlling impulses, following directions and tolerating frustration. Some adults or children struggle with expressing compassion and creativity, and have a decreased interest in learning. This can lead to a lack of empathy for others, which can lead to violence. Also, kids who rely on screens and social media to interact with others typically feel lonelier than kids who interact in person.</p> <p>Chronic hyperarousal can have physical symptoms, as well, such as decreased immune function, irritability, jittery feelings, depression and unstable blood sugar levels. In children, some can develop cravings for sweets while playing video games. Combined with the sedentary nature of gaming, children's diet and weight can be negatively affected, as well. Sometimes children will even avoid stopping the game to go to the restroom, which can lead to hygiene issues.</p> <h2>How can gaming become an addiction?</h2> <p>An addiction is defined as a person's inability to control use of a substance or behavior, despite negative consequences. Some people who are engrossed in screen time or video games while ignoring other normal activities could be close to meeting this definition.</p> <p>So why does this happen? The reward center in the brain releases dopamine in response to a pleasurable experience or hyperarousal. If a person experiences hyperarousal while playing video games, the brain associates the activity with dopamine. The person develops a strong drive to seek out that same pleasure again and again.</p> <p>Dopamine is a powerful neurotransmitter in the brain. It helps sustain people's interest and attention, which is why it can hard for people to tear themselves away from a situation or behavior. It's also self-reinforcing. The more times people experience the behavior, the more dopamine is released, and the more driven they are to return to the behavior.</p> <h2>Symptoms of screen time or video game addiction</h2> <p>Similar to tobacco, alcohol or drugs, screen time or video games can become an addiction if it damages your health and relationships, and you are unable to control it.</p> <h3>Some symptoms could include:</h3> <ul> <li>Having intense urges for screen time or to play video games, and these urges block out other thoughts</li> <li>Spending money on video games or screens, even though you can't afford it</li> <li>Cutting back on social or recreational activities because of preference for screen time or video games</li> <li>Continuing to play video games or participate in screen time, even though you know it's causing problems in your life, such as poor performance at school or work, or letting household responsibilities go</li> <li>Displaying signs of irritability, anxiety or anger when forced to stop playing, even for brief periods of time</li> <li>Lying to others about the extent of your use</li> <li>Needing more screen time over time to get the same level of enjoyment</li> <li>Neglecting your appearance, including lack of interest in grooming or clothing</li> </ul> <p>Continued excessive use of screens can result in long-term or permanent changes in the brain that require extensive behavioral and medical treatment to reverse.</p> <h2>What can you do?</h2> <p>As your child grows, a one-size-fits-all approach doesn't work as well. Not all kids are the same when it comes to screens and technology. Some children can self-regulate and might even put the screens down to go outside without you prompting them. Other kids become noticeably more anxious and quicker to lose their tempers when they spend a lot of time on screens. You'll need to decide how much media to let your child use each day and what's appropriate.</p> <p>Consider applying the same rules to your child's real and virtual environments. In both, play with your child, teach kindness, be involved, and know who your child's friends and what your child does with them. Also, keep in mind that the quality of the media your child is exposed to is more important than the type of technology or amount of time spent. Encourage active screen time over passive screen time.</p> <p>Active screen time is when you are interacting with other people that you know or when you are cognitively or physically engaged. For example, play educational games, or games that require players to build something together. Other options are fitness-type games that require movement while playing. Passive screen time includes watching screens with minimal cognitive engagement, such as scrolling through social media, watching online videos or playing simple games.</p> <p>Set reasonable limits for your child's screen time and video game types, especially if your child's use of screens hinders involvement in other activities.</p> <h3>Consider these tips:</h3> <ul> <li>Follow guidelines for screen time, such as those suggested by the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.apa.org/monitor/2020/04/cover-kids-screens" target="_blank" title="Opens in a new window.">American Academy of Pediatrics</a>.</li> <li>Model healthy use of screens and video games. Consider unplugging when you first get home from work, at dinner and when driving. Model other methods of relaxation and entertainment, such as taking a walk, playing a game, having a dance party or reading a book.</li> <li><a href="/wellness/slim-your-screen-time" target="_self" title="Opens in same window.">Encourage a balance between screen time and activities</a> that require in-person social interactions, such as family activities or extracurricular activities.</li> <li>Create structured, screen-free times, such as during mealtimes, in the mornings and before bedtime.</li> <li>Consider using apps that control the length of time your child can use a device.</li> <li>Keep screens out of bedrooms.</li> <li>Require that all devices be charged outside of bedrooms at night.</li> <li>Learn about the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.esrb.org/" target="_blank" title="Opens in a new window.">game rating categories</a> and only allow your children to play video games suitable for their ages.</li> </ul> <p>If you're concerned about a child or loved one's use of screen time, consulting a behavioral or addictions specialist can help determine treatment options.</p> <p><em><a href="/providers/edward-luker-lpc" target="_self" title="Opens in same window.">Edward Luker</a> is a counselor in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Addictions and co-occurring disorders</li> <li>Families and couples</li> </ul>L.P.C.<p><strong>Education</strong></p> <ul> <li>Adler Graduate School</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Licensed Clinical Substance Abuse Counselor (Wisconsin)</li> <li>Licensed Clinical Alcohol and Drug Counselor (New Jersey)</li> </ul>Luker<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/edward-luker-lpc.jpg?h=280&iar=0&w=280&sc_lang=en&hash=70C096A12BF826962D887D0756F13A3F" alt="Edward Luker LPC" width="280" height="280" DisableNVelocity="true" />Edward<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15985032Edward Luker, L.P.C.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2020/hand-controller-and-video-game-on-screen.jpg?h=370&iar=0&w=660&sc_lang=en&hash=57E4FF1232FB684902562EFB164B033B" alt="Hand controller and video game on screen" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Karen Sperl11/22/2023<p>Making a few changes to your favorite holiday meals and spending your calories wisely can help you celebrate in a healthier way. Get healthy recipe makeovers with loads of flavor and fewer calories.</p>Healthy changes that will make you thankful<p>This is the time of year when many people struggle to maintain a healthy weight. The holidays are full of <a href="/hometown-health/speaking-of-health/coping-with-holiday-stress-keeping-our-expectations-realistic">challenges</a> that encourage you to overindulge and make it harder to fit in physical activity. The numerous advertisements for processed foods, plentiful amounts of holiday treats and your <a href="/hometown-health/speaking-of-health/resilience-prepping-for-a-busy-holiday-season">family traditions</a> involving high-fat, high-calorie recipes can make it difficult to avoid overeating. Additionally, colder weather and shorter daylight hours can lead to a decrease in exercise. </p> <h2>Why do calories matter?</h2> <p>A 150-pound woman needs about 1,500 calories daily to maintain weight without exercise. A 225-pound man needs about 2,475 calories each day to maintain his weight. With 3,500 calories in a pound of body fat, eating excess calories during the holidays can easily be a source of additional weight — added weight can cause issues with your health. </p> <p>Keep in mind, that the average meal consumed on Thanksgiving can contain 4,000 - 6,000 calories. If you eat an indulgent holiday meal, look for ways to offset the high caloric intake. Even as little as one hour of <a href="/hometown-health/speaking-of-health/5-tips-for-walking-your-way-to-better-health">walking each day</a> can burn 300 to 450 calories.</p> <p>Making a few changes to your holiday traditions and spending your calories wisely can help you celebrate in a healthier way.</p> <p>Consider these holiday recipe makeovers with the recipes below:</p> <ul> <li>Instead of dark turkey meat at 65 calories per ounce, try white meat, which has 50 calories per ounce.</li> <li>Skip canned cranberry sauce, at 400 calories per cup, and make your own fresh version using gelatin, at 44 calories per cup.</li> <li>Instead of making the stuffing in the turkey at approximately 500 calories per cup, make a low-calorie, tasty version with a wild rice base at approximately 90 calories per half cup.</li> <li>Instead of traditional gravy, which can have as many as 800 calories per cup, try low-fat turkey gravy with about 30 calories per half cup.</li> <li>Replace the traditional green bean casserole, which can pack between 300 to 400 calories per cup, with this creamy green bean and mushroom casserole for a lower-calorie, tasty alternative for a mere 100 calories per cup. </li> <li>Pumpkin pie with the crust contains 80 calories per ounce with an average slice weighing 5 ounces or 400 calories. Instead, try this delicious crustless pumpkin pie recipe with only 24 calories per ounce or 120 calories in a 5-ounce piece.</li> </ul> <p>It's vital to remember the reason for the season is to get together and celebrate with your family and friends. Use the food you share to nourish your body, not abuse it.</p> <h2>Fresh Cranberry Sauce</h2> <p>3 cups water<br /> 12-ounce bag of cranberries<br /> 1 large box of sugar-free cherry gelatin</p> <p>Boil water and add cranberries. Gently boil for another 10 minutes. Add gelatin, stir to dissolve and then cool.<br /> <br /> 1 cup equals 44 calories. </p> <h2>Creamy Green Beans and Mushrooms </h2> <p>3 ½ cups green beans, washed and trimmed<br /> 1 ¼ cups fresh mushrooms, washed and sliced thin <br /> 1/3 cup low-fat cream of mushroom soup <br /> 1/3 cup skim milk <br /> 2 tablespoons green onion, minced fine </p> <p>Steam green beans in steamer until crisp, but tender (3 to 5 minutes). Place mushrooms, soup, skim milk and green onion in a medium saucepan and bring to a boil. Reduce heat to simmer and cook briefly for 2 to 3 minutes or until mushrooms are tender. Stir frequently to prevent burning. Add green beans and heat thoroughly. </p> <p>1 cup is approximately 100 calories. </p> <h2>Crustless Pumpkin Pie </h2> <p>1 15-ounce can pumpkin <br /> 1 12-ounce can evaporated skim milk <br /> 1–2 eggs or ¾ cup egg substitute <br /> ½ teaspoon salt <br /> 1–2 tablespoons pumpkin pie spice <br /> 1 teaspoon cinnamon <br /> 1 teaspoon vanilla <br /> 2/3 cup of a sugar substitute appropriate for baking </p> <p>Combine all ingredients and beat until smooth. Pour into a 9-inch pie pan sprayed with cooking spray. Bake at 400 degrees for 15 minutes; reduce the temperature to 325 and bake for an additional 45 minutes. The pie is done when the knife comes out clean. </p> <p>Each 5-ounce piece of pie (or 1/8 of the pie) is 90 calories. Add 2 tablespoons of whipped topping for an additional 50 calories if desired.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2023/pumpkin-dessert.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C1FD19F5C9483917F548BC5959631225" alt="Pumpkin dessert" width="660" height="370" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller11/2/2016<p>Have you every walked down the feminine hygiene aisle at a drugstore and wondered if all those so-called cleansing products are really necessary? They're not. A woman only needs to clean her vagina with warm water. Yes, warm water.</p>You don't need fancy products for good feminine hygiene<img alt="Smiling MiddleAged Woman" src="/-/media/national-files/images/hometown-health/2016/2016-general/smiling-middleaged-woman.jpg?h=267&w=400&sc_lang=en&hash=EEB3A13D30A56661D5630DAA0EB38741" style="width: 400px; height: 267px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /> <p>Have you every walked down the feminine hygiene aisle at a drugstore and wondered if all those so-called cleansing products are really necessary? They're not.</p> <p>Vaginal cleansing products are not like hair products, although they are just as expensive. More is not better. A woman only needs to clean her vagina with warm water. Yes, warm water. Many women may not realize that the vagina has an acidic environment, which naturally protects against bacteria. Adding chemicals, including anti-bacterial soaps, alters the normal eco-system and can allow growth of bacteria and yeast.</p> <h2>To practicing good feminine hygiene, you should:</h2> <ul> <li><strong>Avoid perfumes, deodorants and powder in the vagina.</strong><br /> A majority of odor is not from the vagina at all, however, it may be from the inner thighs and folds.</li> <li><strong>Maintain a healthy weight, especially in the inner thighs</strong><br /> This can help eliminate vaginal odor. Consider starting an exercise routine or meeting with a personal trainer to concentrate on thigh exercises.</li> <li><strong>Avoid fashionable panties, thongs and tight-fitting nightwear.</strong><br /> Consider wearing no underwear to bed and adding loose fitting pants and skirts to part of your wardrobe. White cotton panties are the healthiest option.</li> <li><strong>Wash panties with mild detergent.</strong><br /> Separate them from other clothing.</li> <li><strong>Consider switching to a <a href="/hometown-health/speaking-of-health/menstrual-cups-vs-tampons-things-you-might-not-know-about-the-cup" target="_blank" title="Opens in new window.">menstrual cup</a> or tampons during your period.</strong><br /> Limit the duration of each and change frequently to avoid leakage.</li> <li><strong>Avoid pantyhose, girdles and panties that are too tight.</strong></li> </ul> <h2>Feminine hygiene and sex</h2> <p>Media and major marketing campaigns tend to induce insecurity around vaginal hygiene before and after sex. If you are concerned about vaginal hygiene before sex, consider a shower with warm water. After sex, it is important to urinate and avoid douching. Also, consider a condom if you experience vaginal irritation or concerns for abnormal discharge. Although not all vaginal discharge is abnormal, if you have concerns regarding your symptoms, you should <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">make an appointment with your healthcare provider</a>.</p> <p>Remember, less is more when it comes to practicing good feminine hygiene. So, skip the trip to the drugstore and feel clean by practicing these healthy feminine hygiene tips.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2016/2016-general/smiling-middleaged-woman.jpg?h=267&iar=0&w=400&sc_lang=en&hash=CAA1FC91CBD19590D138E959BC57F47B" alt="Smiling MiddleAged Woman" width="400" height="267" DisableNVelocity="true" />Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Dawn Haller10/21/2022Goblins and ghosts and candy, oh my! Halloween fun starts with a great costume. Follow five simple safety tips to avoid a costume catastrophe.5 sneaky Halloween costume health concerns<p>Halloween fun starts with a great costume. However, parents often make a few common mistakes when choosing their child's costume.</p> <p>Parents can help their children stay safe and avoid a hospital visit by following a few simple rules when choosing costumes.</p> <h2>Here are five top costume health concerns and how to avoid them:</h2> <h3>Beware of borrowed costumes.</h3> <p>Wearing an unwashed costume from last year or one that's been borrowed can cause skin infections from leftover bacteria. Wash any costume before use.</p> <h3>Avoid costume mask hazards.</h3> <p>Wearing a full-face mask as part of a costume can result in difficulty seeing, headaches, acne or a skin infection if it doesn't fit properly. Make sure to try on the mask for a few minutes before buying it, and have your children and teenagers wash their faces after the Halloween fun is over.</p> <h3>Mitigate makeup mistakes.</h3> <p>Some makeup can contain dyes and other components that can cause skin irritations and rashes. A few days before Halloween night, test the makeup on a small patch of skin on the arm or stomach to make sure your child isn't allergic.</p> <h3>Ditch colored contacts.</h3> <p><a href="/hometown-health/speaking-of-health/halloween-safety-decorative-lenses-can-be-dangerous" target="_blank" title="Opens in new window">Wearing nonprescription colored contacts can cause scratches, infection or blindness</a>. These eye accessories aren't made to fit each individual's eye. Avoid the contacts, and opt for eye makeup or fun glasses instead.</p> <h3>Choose flame-resistant items.</h3> <p>According to the American Academy of Pediatrics, one of the most common reasons kids visit the hospital on Halloween is for burns from flammable costumes. Purchase costumes with "flame-resistant" on the tag.</p> <h2>Bonus safety tip</h2> <h3>Increase visibility of costumes.</h3> <p>Traffic safety is extra important on Halloween because of low visibility. Remind your children to watch for cars. As an added safety measure, have your children decorate their costume with reflective tape or stickers, and carry glow sticks or flashlights to help them see and be seen by drivers.</p> <h2>Read more about Halloween:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/treat-yourself-to-the-best-this-halloween">Treat yourself to the best this Halloween</a></li> <li><a href="/hometown-health/speaking-of-health/tips-to-keep-your-halloween-safe" target="_self" title="Opens in same window.">Tips to keep your Halloween safe</a></li> </ul> <p><em><a href="/providers/jessica-sosso-md" target="_self" title="Opens in same window.">Jessica Sosso, M.D.</a>, is a physician in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/sparta" target="_self" title="Opens in same window.">Sparta</a>, Wisconsin.</em></p><ul> <li>Chronic disease management, including diabetes, hypertension and heart disease</li> <li>Fertility care medical consultant, including use of natural, noncontraceptive methods to treat women's health issues</li> <li>Natural family planning and fertility awareness-based methods</li> <li>Preventive health</li> </ul>M.D., M.P.H.<p>I value relationships with patients and their families. As a Family Medicine physician, I see children and adults of all ages and complexity. I seek to educate and collaborate with my patients to together make healthcare decisions consistent with their values.</p> <p>Family time with my husband and children is a priority for me, and I strive to find balance between my work and home life. I enjoy gardening, hiking, biking and quiet time spent in prayer or reading an engaging book.</p><p><strong>Education</strong></p> <ul> <li>University of Wisconsin School of Medicine and Public Health</li> <li>Master of Public Health, Portland State University</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine/Preventive Medicine, Oregon Health and Sciences University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Family Medicine, American Board of Family Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>Catholic Medicine Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Sosso<img src="/-/media/shared-files/images/medical-professionals/full/sparta/jessica-sosso-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=CB5FB5273358EABA7C138C22C38C77FA" alt="Jessica Sosso, M.D." width="280" height="280" title="Jessica Sosso, M.D." DisableNVelocity="true" />Jessica<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15588416Jessica Sosso, M.D., M.P.H.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{4CCEC5BD-06A3-471A-8B8D-4C52837DAA4E}<img src="/-/media/national-files/images/hometown-health/2022/child-in-halloween-costume.jpg?h=370&iar=0&w=660&sc_lang=en&hash=32B3F67B8B8A9FA7AC0BC488A4B43419" alt="Child in Hallowen costume" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller2/23/2022Urinary incontinence is common among men and women. Follow these tips to lessen the burden of managing your condition and improve symptoms.6 helpful tips for managing urinary incontinence<p><a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.mayoclinic.org/diseases-conditions/urinary-incontinence/basics/definition/con-20037883" target="_blank" title="Opens in new window">Urinary incontinence</a> is a common, often embarrassing, condition. Although not life-threatening, it can significantly affect every aspect of a person's life — from social and family relationships, work, finances, psychological health and sexual health.</p> <p>Urinary incontinence is the loss of bladder control. This condition can affect both men and women and can occur at all ages, although the risk does increase with age. About 25% to 45% of adults experience incontinence at some point in their lives.</p> <p>Managing involuntary leakage of urine can be frustrating and time-consuming.</p> <h2>These tips can reduce the burden of symptoms and help your bladder train for better behavior moving forward:</h2> <h3>1. Follow a fluid schedule.</h3> <p>Try to keep your fluid intake on a schedule to help retrain your bladder when to fill and when to empty. Also, limit fluid intake after 6 p.m. to reduce night-time voiding and incontinence. Target total fluid intake to 40–60 ounces per day. Consuming too little fluid during the day can concentrate the urine and irritate the lining of the bladder, whereas too much fluid can increase frequency, leakage and night-time trips.</p> <h3>2. Limit common bladder irritants.</h3> <p>Some fluids are more difficult for your bladder to process than others. We call these bladder irritants. Caffeine, alcohol and high-citrus content can make symptoms worse. Many people can reduce or even eliminate symptoms by avoiding common irritants most days. Tobacco is also very irritating to the bladder lining, in addition to increasing bladder cancer risk.</p> <h3>3. Plan a toileting schedule.</h3> <p>Plan toileting attempts at least every two to three hours during the day. Normal bladder behavior is to urinate six to eight times per day, along with emptying your bladder before changing activities, leaving home or going to bed. A schedule helps prevent your bladder from becoming too full, resulting in a rush to find a restroom.</p> <h3>4. Do pelvic floor exercises.</h3> <p>Strengthening the muscles of the pelvic floor can reduce urinary incontinence by as much as 90%. <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/kegel-exercises/art-20045283" target="_blank" title="Opens in a new window.">Kegel exercises</a> can help.</p> <h3>5. Manage constipation.</h3> <p>Infrequent or difficult-to-pass stools will increase pressure in the pelvis and the bladder. Eat a diet rich in fiber, drink adequate amounts of water and maintain a healthy elimination pattern to help the bladder fill and empty more effectively.</p> <h3>6. Keep a bladder diary.</h3> <p>Record your fluid intake and toileting pattern over the course of three to seven days in a bladder diary. Important components to the diary include the time of day, amount of fluid intake, how many times you went to the bathroom, how many times you leaked urine throughout the day, if you felt an urge to urinate before leaking and what type of activity you were engaged in at the time. Bring the diary with you to appointments with your health care provider.</p> <p>Some people may have urinary retention, which is the inability to fully empty the bladder with each trip to the restroom. This can cause overflow incontinence episodes. Urinary retention is a less common cause of leakage, but it can be a sign of a neurological problem and, in sudden or severe cases, cause bladder injury.</p> <p>It's important to have a conversation with your health care professional about new or persistent urinary changes you are noticing Incontinence treatments are available and can be explored by your health care team.</p> <h4>Watch this video to learn more about urinary incontinence treatments including sacral neuromodulation therapy:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/HNIMJx5I-Ys" title="Urinary incontinence treatments" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p><em>Becky DeLuca is an <a href="/services-and-treatments/obstetrics-and-gynecology">OB-GYN</a> nurse practitioner in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2022/mustard-sweater-wind-blowing-hair.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2AA3A2BBE38E24E5D49D36829EA968DB" alt="Wearing mustard sweater, wind blowing hair" width="660" height="370" DisableNVelocity="true" />Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Urinary IncontinenceThe loss of bladder control is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that's so sudden and strong you don't get to a toilet in time. For most people, simple lifestyle changes or medical treatment can ease discomfort or stop urinary incontinence.Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller5/17/2023You ran your best race, but you're not finished yet. Now it's time to focus on recovery divided into three phases with each having its own purpose. Give this approach a try.Post-race recovery tips for runners<p>Congratulations! You've just finished a marathon or other running event.</p> <h2>Now recovery begins. Try this three-phase approach for best results:</h2> <h3>Phase one: Immediately after you finish</h3> <p>Once you've crossed the finish line, it's imperative to focus on recovery.</p> <h4>You can start swapping stories as soon as you've taken a few basic steps:</h4> <ol> <li>When you stop running, your body immediately enters recovery mode. Even on a warm day, you can feel yourself getting cold and clammy. Avoid this by wrapping up in a foil blanket or other covering, then changing into warm, soft clothes — including footwear — as soon as possible. Injuries aside, another pair of shoes is helpful to keep your feet from swelling and give them much-needed support.</li> <li>Start the rehydration process as quickly as you can. Ideally, you should drink 16–20 ounces of fluid for every pound you lost. When you can, weigh yourself to help plan your fluid intake.</li> <li>Find a way to lie down and put your feet up. After several hours of hard work, your body needs help recovering. Besides, this is just plain relaxing. Try keeping your feet elevated for 15–25 minutes. It's recommended you do this several more times during the day.</li> <li>You'll need a recovery meal containing protein, preferably in liquid form. Avoid processed fruit juices or other sugary substitutes. Instead, consume something you enjoy that's easy on your stomach. Use what has worked in training, but make sure you have something to eat within the first 30 minutes after your event.</li> <li>If you've sustained an injury, such as a blister or <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/sprains-and-strains/basics/definition/con-20020958" target="_blank" title="Opens in a new window.">muscle strain</a>, now you can begin assessing the extent of the damage and seek help. Your brain will be much clearer, and if you need to go somewhere or wait in line, at least your basic needs will have been met.</li> </ol> <h3>Phase two: 12–24 hours post-race</h3> <p>By now, you've found your friends and family. Maybe you're even home or at your hotel and are thinking about your next meal.</p> <h4>Here are some key things you can do:</h4> <ul> <li><strong>Take a shower or bath to rejuvenate your body and help identify any issues.</strong><br /> If possible, consider a cool or cold bath to help promote recovery. You also can add some light, static stretching that should be easy and comfortable on your muscles, and they should feel better when done.</li> <li><strong>Focus on a proper meal.</strong><br /> As you choose your foods, try to keep them reasonably healthy, and drink lots of water.</li> <li><strong>You've earned the right to celebrate, but don't overdo it.</strong><br /> Your body is still recovering. Limit the amount of alcohol you consume and how long you stand on your feet.</li> <li><strong>Get some well-deserved sleep.</strong><br /> You'll likely be so tired that falling asleep won't be an issue. The problem is you'll probably be so sore that staying asleep could be harder than you think. Put plenty of fluids — and maybe even a snack — on your bedside table, and keep your feet elevated.</li> </ul> <h3>Phase three: Two–three days post-race</h3> <p>After 72 hours, you'll be through the toughest part of your recovery process. But some of the greatest need for recovery takes place during this period. Once the adrenaline wears off, the fatigue and soreness will be all that's left.</p> <h4>These tips can help you weather this last phase:</h4> <ul> <li><strong>Do your best to avoid being stationary, other than sleeping.</strong><br /> Light walking, an easy dip in the pool, or a short spin on an exercise bike will help your muscles flush out toxins and aftereffects of the race. Frequent rest will be needed, but total rest is your enemy here.</li> <li><strong>Continue to <a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/basics/nutrition-basics/hlv-20049477" target="_blank" title="Opens in a new window.">eat healthy</a>.</strong> <br /> Focus on proteins and quality carbohydrates, such as fruits and vegetables, especially when your body is vulnerable. A treat or two is all right, but try to save the serious snack attacks until you can savor the food.</li> <li><strong>Lightly working on your calves, feet, hamstrings, glutes and quads is another great way to stay loose and promote recovery.</strong><br /> Whether you use your hands or a tool, taking the time to focus on your trouble areas will be beneficial. Keep it light; it should feel good, not hurt. Going too deep or hard with this work can make you sorer.</li> </ul> <h2>Wrapping up recovery</h2> <p>Once you've made it through the first three days of recovery, your work isn't done. Your body is still a long way from being where it was before the race. You'll want to continue staying active by walking or including some cross-training into your post-race training regimen. You should wait at least one to two weeks before returning to running if you haven't competed in many races before.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2023/runner-wrapped-in-foil-warming-blanket.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8C47C3704A3E344FB9C7140D602CAF98" alt="Runner wrapped in foil warming blanket" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller10/11/2016<p>Compelling evidence shows that generous amounts of fruits and veggies as part of a healthy diet may lower the risk of chronic diseases like diabetes, heart disease and certain types of cancer. Eating a healthy diet and adopting healthy habits have so much power in decreasing the possibility of developing breast and colorectal cancers.</p>Healthy food, lifestyle can help prevent cancer<img alt="Woman Lifting Weights by Healthy Food" src="/-/media/national-files/images/hometown-health/2016/2016-general/woman-lifting-weights-by-healthy-food.jpg?h=286&w=400&sc_lang=en&hash=8BEE41DF38A743E424334EEE20CF59B3" style="width: 400px; height: 286px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive"> <p>Compelling evidence shows that generous amounts of fruits and veggies as part of a healthy diet may lower the risk of chronic diseases like <a href="http://www.mayoclinic.org/diseases-conditions/diabetes/basics/definition/con-20033091" target="_blank" title="Opens in new window">diabetes</a>, <a href="http://www.mayoclinic.org/diseases-conditions/heart-disease/basics/definition/con-20034056" target="_blank" title="Opens in new window">heart disease</a> and certain types of cancer. Eating a healthy diet and adopting healthy habits have so much power in decreasing the possibility of developing <a href="http://www.mayoclinic.org/diseases-conditions/breast-cancer/home/ovc-20207913" target="_blank" title="Opens in new window">breast</a> and <a href="http://www.mayoclinic.org/diseases-conditions/colon-cancer/home/ovc-20188216" target="_blank" title="Opens in new window">colorectal</a> cancers in particular.</p> <h4>Risks</h4> <p>Research shows diets high in red and processed meats, such as beef, pork, lamb, liver, hot dogs and deli meat, can raise your colorectal cancer risk. Additionally, cooking meats to very high temperatures or charring meat can create harmful chemicals that may also raise colorectal cancer risk. Alcohol use is also linked to colorectal cancer and increases the risk of developing breast cancer. Women who have two to five drinks daily have about one-and-a-half times the risk of breast cancer compared to women who don’t drink alcohol. <a href="http://www.cancer.org/" target="_blank" title="Opens in new window">The American Cancer Society</a> recommends that women have no more than one alcoholic drink a day. A drink is defined as 12 ounces of regular beer, 5 ounces of wine or 1.5 ounces of 80-proof distilled spirits.</p> <h4>Diet and nutrition</h4> <p>Focus on eating a diet rich in fruits and veggies, legumes, nuts and seeds, lean meats, low-fat dairy products and whole grains. Most of these foods have functional components, such as <a href="http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/multimedia/antioxidants/sls-20076428" target="_blank" title="Opens in new window">antioxidants</a>, <a href="http://www.mayoclinic.org/drugs-supplements/omega-3-fatty-acids-fish-oil-alpha-linolenic-acid/background/hrb-20059372" target="_blank" title="Opens in new window">omega-3 fatty acids</a> and polyphenols. Functional foods, also known as super foods, work to decrease damage caused by inflammation and oxidation. Oxidation is a natural process that leads to cell and tissue damage and may contribute to some diseases.</p> <p>Over the years, research has revealed the true power of plant-based nutrition and has linked specific foods to decreasing risk of certain types of cancer. For example, garlic has wonderful anti-inflammatory properties and can pack a cancer-protective punch, especially to colorectal cancer. Garlic is also found to be more beneficial when crushed prior to use.</p> <h4>Exercise</h4> <p>On top of eating a healthy diet, increase physical activity to assist in cancer prevention. Prevalent research shows regular exercise can reduce cancer risk. One study revealed one hour and 15 minutes to two-and-a-half hours per week of brisk walking reduced a woman’s breast cancer risk by 18 percent, and walking 10 hours a week or more may further reduce risk.</p> <p>The American Cancer Society recommends adults perform moderate intensity physical activity 150 minutes each week or 75 minutes of vigorous intensity each week (or a combination), preferably spread throughout the week.</p> <p>More investigation of foods and their functional components is bound to reveal all that a plant-based diet has to offer. Until then, eating a variety of fruits and veggies prepared in numerous ways will improve your odds for preventing cancer. And don’t forget to pair proper nutrition with plenty of exercise.</p> <p><em><a href="/providers/grace-fjeldberg-rd">Grace Fjeldberg</a> is a registered dietitian-nutritionist in <a href="/locations/mankato">Mankato</a>, Minnesota.</em></p><ul> <li>Bariatric surgery</li> <li>General nutrition</li> <li>Oncology</li> <li>Pediatric nutrition</li> </ul>RDN, LD <p><strong>Education</strong></p> <ul> <li>Minnesota State University, Mankato</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Mayo Clinic College of Medicine, Minnesota</li> </ul> <p><strong>Certifications</strong> </p> <ul> <li>Commission on Dietetic Registration</li> <li>Minnesota Board of Dietetics and Nutrition Practice</li> </ul> Fjeldberg<img src="/-/media/shared-files/images/medical-professionals/full/mankato/grace-fjeldberg-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=FB99EC499314FA86AE8202C30AB740A2" alt="Grace Fjeldberg RDN" width="280" height="280" DisableNVelocity="true" /> Grace<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15268781Grace Fjeldberg R.D.N. 1<img src="/-/media/national-files/images/hometown-health/2016/2016-general/woman-lifting-weights-by-healthy-food.jpg?h=286&iar=0&w=400&sc_lang=en&hash=EEDF80180B796E265F8C3558D692BEF1" alt="Woman Lifting Weights by Healthy Food" width="400" height="286" DisableNVelocity="true" />CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Michele Halterman1/4/2022Dry eye disease leads to burning, stinging, watery or red eyes, and can affect your daily life. Here's what you need to know if you experience dry eyes.Relief for dry eyes a welcome sight<p>You may have heard the adage "A picture is worth a thousand words." That is used to say that it is easier to show something than describe it. This is because our sense of sight is responsible for most of the information that we absorb from the world around us. How people move through their days and interact with others and their environment is impacted by their vision. If you can see well, the odds are that you rarely think about your eyes and may even take your eye health for granted.</p> <p>However, for many people, dry eye disease is an uncomfortable condition that affects their daily lives. People with dry eyes produce poor quality tears, not enough tears or both. This leads to chronic inflammation of the eye surface and a stinging or burning sensation. Other symptoms include eye redness, difficulty wearing contact lenses, watery eyes, blurred vision, sensitivity to light or eye fatigue. Some people experience dry eyes in specific situations, such as on an airplane, while looking at a computer screen or during periods of low humidity like during the winter. Here's what you need to know if you suffer from dry eyes.</p> <h4>I have dry eyes, but my eyes are watery all the time. How can that be?</h4> <h5>Your eyes produce three kinds of tearing:</h5> <ul> <li><strong>Basal (basic)</strong>, which produces continual lubrication to your eye</li> <li><strong>Emotional</strong>, which occurs when a person is upset or moved by a sensitive situation</li> <li><strong>Reflex</strong>, which occurs when trying to flush a foreign object from the eye</li> </ul> <p>With dry eye disease, basal tears are of poor quality and quantity. With emotional tearing and reflex tearing, there are plenty of tears but they're typically poor quality.</p> <p>When your eyes get dry enough, they act as if there is something in them and try to flush it out, which leads to watery eyes. Watery eyes is the No. 1 complaint of dry eye sufferers.</p> <h4>What causes dry eye?</h4> <p>Dry eyes can occur when you're unable to produce enough tears. The medical term for this condition is keratoconjunctivitis sicca.</p> <h5>Common causes of decreased tear production include:</h5> <ul> <li><strong>Age</strong><br /> Normal aging changes your eyes, and they don't function as well as when you're younger.</li> <li><strong>Hormones</strong><br /> Changes in hormone levels associated with age, menopause, pregnancy or birth control pills affect the eyes.</li> <li><strong>Specific medial conditions</strong><br /> People who have acne rosacea, diabetes, thyroid disease, autoimmune diseases and inflammatory diseases that include <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/home/ovc-20197388" target="_blank" title="Opens in a new window.">rheumatoid arthritis</a>, lupus and <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.mayoclinic.org/diseases-conditions/sjogrens-syndrome/basics/definition/con-20020275" target="_blank" title="Opens in a new window.">Sjogren's syndrome</a> are more likely to develop dry eyes. About 50% of people with acne rosacea have dry eyes. In addition, dry eye disease is often the first presenting symptom of rheumatoid arthritis.</li> <li><strong>Medications</strong><br /> Oral medications, including antihistamines, antidepressants and birth control pills, can increase the likelihood of dry eyes. Preservatives found in medicated eye drops that are used chronically, including glaucoma drops and over-the-counter artificial tears, also can worsen dry eye symptoms. Avoid drops that claim to get the red out. These can lead to rebound red eyes, which cause eyes to be even redder and more irritated than before.</li> <li><strong>Smoking</strong><br /> Irritation from secondary smoke, as well as the internal effects of smoking may lead to dry eyes.</li> <li><strong>High-fat diet</strong><br /> Diets high in omega-6 fatty acids and low in omega-3 fatty acids can cause inflammation, a key component to dry eye disease. A heart-smart diet is an eye-smart diet, such as the Mediterranean diet.</li> <li><strong>Overall eye health</strong><br /> The health of your eyelid margins and eyelashes is important. Eye conditions can contribute to dry eye disease, such as blepharitis (dandruff-like debris called scurf), Meibomian gland dysfunction, ocular rosacea, irregular eye lid margins and mites living in eyelash follicles.</li> <li><strong>Contacts</strong><br /> Wearing contacts disrupts the tear film, leading to dry eye symptoms and decreased contact comfort and wearing time. Existing dry eye disease can lead to poor successful contact lens wear.</li> <li><strong>Environment</strong><br /> Dry, windy, dusty and smoky conditions can all be problematic. So is polluted air quality, including second-hand smoke and seasonal air quality. Winter can be especially challenging with dry air and forced air heaters in vehicles or other enclosed environments.</li> <li><strong>Blinking rate</strong><br /> A poor blinking rate can affect your eyes. A normal rate is 15 blinks per minute. A poor blinking rate would be as low as 4-5 blinks per minute. Incomplete blinking, which is often 60% to 70% when working on digital devices, also can lead to dry eyes.</li> <li><strong>Vitamin D deficiency</strong><br /> Many people are vitamin D deficient. This contributes to dry eyes, along with many other health issues.</li> </ul> <h4>Is there anything I can do to improve my dry eye disease?</h4> <p>Yes, but it takes time. Your dry eye disease didn't occur overnight. It took many months or years to develop, and it's not going to go away immediately. The first step is to visit your eye doctor and discuss your symptoms. Many people fail to mention these issues to their eye doctor because they don't see them as important.</p> <h4>How your eye doctor can help</h4> <p>Your doctor will work to evaluate your symptoms and the quality and quantity of your tears. The doctor will ask about your symptoms, including when, where, how often and what you're doing when they occur. Then, ask about your general health and the medications you're taking.</p> <p>Finally, the doctor will perform a thorough quality evaluation of your eyelashes, eyelid margins, Meibomian glands and the surface of the eyeball (the conjunctiva and cornea).</p> <p>Once an evaluation is complete, your doctor will design a treatment plan to improve the environment for your eyes and your dry eye disease. There's no magic wand to make dry eye disease instantly better. However, if a treatment plan is followed and you learn and use new habits, your dry eye disease can be improved.</p> <h5>Treatment options may include:</h5> <ul> <li>Reduce eyelash and eyelid inflammation with hygiene, supplements and prescription drops.</li> <li>Improve quality and quantity of the Meibomain gland oil using supplements, hot compresses and other treatments.</li> <li>Quiet eye surface inflammation with artificial tears, supplements and prescription drops.</li> <li>Increase quantity of tears using artificial tears, prescription drops and tear duct (punctal) plugs.</li> <li>Control your environment with a humidifier and eliminating forced air across the face.</li> <li>Improve diet with supplements and meal planning.</li> </ul> <p><em><a href="/providers/robert-friese-od" target="_self" title="Opens in same window">Robert Friese, O.D.</a>, is an optometrist in <a href="/locations/fairmont" target="_self" title="Opens in same window">Fairmont</a>, Minnesota.</em></p><ul> <li>Comprehensive eye exams</li> <li>Contact lens fitting</li> <li>Diabetes</li> <li>Diagnoses and treatment of eye diseases</li> <li>Dry eye disease</li> <li>Glaucoma</li> <li>Macular degeneration</li> </ul>O.D.<p>I provide comprehensive eye exams, diagnoses and treatment of eye disease, dry eye disease and contact lens fitting. </p> <p>I have lived in Fairmont for 30 years. </p><p><strong>Education</strong></p> <ul> <li>Doctor of Optometry, University of California - Berkeley School of Optometry</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Diplomate, American Board of Optometry</li> </ul>Friese<img src="/-/media/shared-files/images/medical-professionals/full/fairmont/robert-friese-od.jpg?h=280&iar=0&w=280&hash=28DC7F4D3B18AA7644C9CBBA5B19C874" alt="Robert Friese OD" width="280" height="280" DisableNVelocity="true" />{D85012E4-9C42-474E-AFB0-A40376EC9035}Robert<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14474077Robert Friese, O.D.1{C5680DDD-C649-4B63-AFCC-B52A244736B7}<img src="/-/media/national-files/images/hometown-health/2022/winter-trail-walking-knit-hat.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EAA0F70DB51F09885981F1131729B966" alt="Person walking on winter trail, wearing knit hat" width="660" height="370" DisableNVelocity="true" />Eye HealthYour eyes are responsible for providing you with vision, perhaps the most important of the senses. However, the eye is a delicate and complicated structure that needs protection. The ugly truth is that eye injuries can happen at any time and place.Michele Halterman2/10/2023While it has an intimidating name, dry needling is a commonly offered treatment for muscle, ligament or tendon pain. Learn how it can release muscle trigger points and ease pain.On pins and needles: Just what is dry needling?<p>You may have heard of a treatment called dry needling and wondered what it is or if it's right for you. While the name of the procedure may sound intimidating, dry needling is an accessible and commonly offered therapy for people with muscle, ligament or tendon pain.</p> <h2>Dry needling basics</h2> <p>During a dry needling treatment, one or more thin, monofilament needles are inserted into a muscle trigger point. A trigger point is a local band of tight, irritable and dysfunctional muscle tissue. This often emerges because of injury, overuse or poor movement patterns.</p> <p>Trigger points can disrupt your muscle function, restrict your range of motion or cause pain and tenderness. Physical therapists or licensed acupuncturists perform an in-depth evaluation to determine if dry needling is appropriate. Then they discuss your symptoms while assessing mobility and muscle function to determine if trigger points are contributing to symptoms.</p> <p>When dry needling is applied to an affected muscle or trigger point, it can decrease muscle tightness, increase blood flow and reduce pain. Patients often report immediate relief after treatment. The needles remain in your muscle for a short period of time — between 10 seconds and 20 minutes — during treatment. This depends on the treatment location, number of needles used and treatment goals.</p> <p>Dry needling usually is paired with exercise and other physical therapy techniques to prevent trigger points from reoccurring.</p> <p>The needles used are solid and don’t inject liquid into your body. It's the reason this treatment is referred to as "dry." All forms of acupuncture use dry needles as well.</p> <p>Dry needling is a safe technique for treating many musculoskeletal conditions, including shoulder pain, rotator cuff pain, biceps tendinitis, iliotibial band syndrome, Achilles tendinitis, low back pain, tennis elbow, whiplash or neck pain, headaches, muscle strains, hip pain and temporomandibular pain, also called TMJ.</p> <p>Dry needling is performed by physical therapists and licensed acupuncturists trained in the procedure. Certification requirements vary by state. Most people report minor or no discomfort during treatment.</p> <h2>Dry needling and acupuncture</h2> <p>There are some similarities between dry needling and acupuncture. Both use thin needles inserted at various depths to treat symptoms. The health care professional also may gently move or manipulate the needles after placement. Both acupuncture and dry needling are safe treatments, and usually are part of a larger treatment plan. The treatments are widely embraced by many, including those who practice conventional or Western medicine.</p> <p>However, there are significant differences between acupuncture and dry needling. Acupuncture has been used for about 3,000 years as a key component of traditional Chinese medicine. Its effectiveness has been studied rigorously.</p> <p>Acupuncture is a technique for balancing the flow of energy or life force — known as chi or qi — believed to flow through pathways in your body called meridians. By inserting needles into specific points along these pathways, licensed acupuncturists help rebalance your energy and promote healing. Most of the time, multiple needles are used during treatment. Acupuncture treats a wide range of conditions, including pain, fatigue, infertility, headache, insomnia, anxiety and depression.</p> <p>Dry needling is a newer treatment and evolved in the last few decades. It focuses exclusively on treating musculoskeletal and neuromuscular pain by releasing trigger points. Acupuncture restores energy flow, while dry needling targets dysfunctional muscle trigger points.</p> <p>Fewer needles are used during dry needling treatment. It's often paired with electrical stimulation to enhance the effects of the treatment. This combination causes a gentle contraction and relaxation of the irritable muscle, which helps the muscle relax further.</p> <p>Talk with your primary care provider if you are experiencing muscle, tendon or ligament pain. Working together, you and your health care team will determine if dry needling is right for you. Like all medical treatments, dry needling should be considered carefully before proceeding.</p> <p> Before your appointment, check your health insurance plan for coverage information for dry needling treatments.</p> <p><em>Kara Johnson and <a href="/providers/bryce-jenson-pt-dpt" target="_self" title="Opens in same window.">Bryce Jenson</a> are <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapists</a> who see patients in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin, respectively.</em></p><ul> <li>Functional dry needling</li> <li>Knee injuries</li> <li>Low back pain</li> <li>Neck pain</li> <li>Post-surgical rehabilitation</li> </ul>P.T., D.P.T.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Exercise and Sport Science, University of Wisconsin-La Crosse</li> <li>Doctor of Physical Therapy, University of Wisconsin-La Crosse</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Functional Dry Needling-Level 1, Evidence in Motion</li> </ul>Jenson<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/bryce-jenson-pt-dpt.jpg?h=280&iar=0&w=280&sc_lang=en&hash=CB9618D43F5FA3B0D85B0600BED23707" alt="Bryce Jenson, P.T., D.P.T." width="280" height="280" DisableNVelocity="true" />Bryce<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30037128Bryce Jenson, P.T., D.P.T. 1<img src="/-/media/national-files/images/hometown-health/2023/two-people-on-sofa-holding-cups.jpg?h=370&iar=0&w=660&sc_lang=en&hash=79DBEB61DD1FFDC3C2D83DD7946B6881" alt="Two people on sofa holding cups" width="660" height="370" DisableNVelocity="true" />Integrative MedicineUnderstanding total health, not just of the body, but of the mind and the spirit, enhances the natural healing process allowing you to feel more empowered, have more energy and experience tranquility.HeadacheHeadache is pain in any region of the head that feels like a sharp pain, throbbing sensation or dull ache. It may develop gradually or suddenly, and last for minutes or days.Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.Dawn Haller11/5/2021By age 30, your bones may have already started to lose mass — one of the first signs of osteoporosis. Learn who's at greatest risk and what you can do to maintain bone mass.Don’t be bad to the bone: How to preserve bone mass<p>When working with patients who have problems with their bones, I often think of the phrase, "out of sight, out of mind." When it comes to taking care of our bodies, so often we forget about taking care of the things we can't see, such as our bones. Did you know that our bones start to gradually lose their mass by age 30? This is one of the first signs of osteoporosis.</p> <h4>What is osteoporosis and can it affect me?</h4> <p><a rel="noopener noreferrer" href="http://www.mayoclinic.org/diseases-conditions/osteoporosis/home/ovc-20207808" target="_blank" title="Opens in a new window.">Osteoporosis</a> is a silent condition that is characterized by decreased bone mineral density and structural bone changes that may cause the bones to weaken and become brittle. Because of these changes, people with osteoporosis or osteopenia — a condition of slightly decreased bone mineral density seen as a precursor to osteoporosis — are at increased risk of fracture. The lower your bone density, the more susceptible you are at risk for a fracture.</p> <p>The most common areas of fracture that affect people living with osteoporosis are the spine, hip and wrist. These fractures can have serious consequences that cause back pain or disfigured posture, and impair the ability to walk and live independently.</p> <p>Osteoporosis does not discriminate against gender or race; however, women are more commonly affected, especially those of Asian or European descent. Women entering menopause or who are in their postmenopausal years are also vulnerable to this disease, as decreased estrogen levels affect bone density.</p> <h5>These and other conditions increase the risk for developing osteoporosis:</h5> <ul> <li>Certain medical conditions that affect the kidneys, lungs, heart, stomach, intestines, liver or thyroid</li> <li>Certain medications, such as prolonged steroid use to treat asthma or arthritis, anticonvulsants, aluminum-containing antacids and cancer treatments</li> <li>Eating disorders</li> <li>Excessive soft drink intake</li> <li>Low body mass index</li> <li>Low calcium and vitamin D consumption</li> <li>Long periods of bed rest during serious illness</li> <li>Low testosterone levels in males</li> <li>Malnutrition</li> <li>Menopause</li> <li>Sedentary lifestyle</li> <li>Small stature, small bone structure</li> <li>Thin or transparent skin</li> <li>Tobacco use</li> </ul> <h4>What can I do to maintain my bone mass?</h4> <p>Being aware of the risk factors associated with osteoporosis and talking with your health care provider are powerful first steps in preventing osteopenia, osteoporosis and fractures.</p> <h5>It's also important to maintain a healthy lifestyle to keep your bones healthy throughout your life, including these important factors:</h5> <ul> <li><strong>Protein</strong><br /> Protein is one of the building blocks of bone. Talk to your health care provider about the right amount of protein for you with your medical history.</li> <li><strong>Calcium</strong> <br /> Calcium helps build and maintain strong bones. The daily intake for men and women 18 to 50 should be 1,000 milligrams. This daily amount should increase to 1,200 milligrams when women turn 50 and men turn 70. Good sources of calcium include dairy products; dark-green, leafy vegetables; canned salmon or sardines with bones; soy products; calcium-fortified cereals; and orange juice.</li> <li><strong>Vitamin D</strong> <br /> This essential vitamin improves your body's ability to absorb calcium and improves bone health in other ways. You can get some vitamin D from sunlight. Most adults need to get 600 to 800 international units (IU) a day, through food or supplements. Up to 4,000 IU of vitamin D a day is safe for most people.</li> <li><strong>Exercise</strong> <br /> Exercise can help you build strong bones and slow bone loss. Activities that put weight through your spine are most beneficial and may include walking, running, dancing, skiing, jumping rope, tennis or other racquet sports. Adding resistance exercise, such as weightlifting, resistance bands, yoga or push-ups, just twice a week to your routine also can stress your bones in a good way to help keep their density. Exercise also helps improve your balance, which may prevent falls.</li> </ul> <h4>How can physical therapy help treat osteoporosis and prevent injury?</h4> <p>Physical therapists are a great resource for education on proper body mechanics necessary for everyday activities to minimize the risk for future fractures. Physical therapists are able to help people with osteoporosis avoid the devastating effects of a fracture and enjoy their maximum level of function and independence throughout their lives.</p> <p>If you have already sustained a fracture, physical therapy can play a key role in the rehabilitation of your mobility, strength and function, and assist with managing your pain.</p> <p>Talk to your health care provider if you have questions about your bone health and ask if physical therapy is recommended.</p> <p><a href="/providers/carol-gardner-pt" target="_self" title="Opens in same window.">Carol Gardner</a> is a <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapist</a> in <a href="/locations/red-wing" target="_self" title="Opens in same window.">Red Wing</a>, Minnesota.</p> <ul> <li>Pelvic health for women and men</li> <li>Women's health issues</li> </ul> P.T. <p>I strive to assist people to get back to what matters most to them. I see patients with pelvic and spine issues, back pain, pre- and postpartum clients and osteoporosis issues. I believe in educating my patients in self symptom management.</p> <p>I have completed advanced certifications to deepen my expertise in areas related to pelvic health.</p> <p> I enjoy gardening, walking, traveling and activities with family and friends.</p> <p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Physical Therapy, University of Wisconsin-La Crosse</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Clinical Specialist, Women's Health Physical Therapy</li> <li>Pelvic Muscle Dysfunction Biofeedback, Biofeedback Certification International Alliance</li> </ul> Gardner<img src="/-/media/shared-files/images/medical-professionals/full/red-wing/rehab-services/carol-gardner-pt.jpg?h=280&iar=0&w=280&sc_lang=en&hash=70644BE0CC9078268D1F702C9DD70AC0" alt="Carol Gardner PT" width="280" height="280" DisableNVelocity="true" /> {6CE3A6BA-43F7-4D2E-A3D9-4805E50C1F4F}Carol<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15835073Carol Gardner, P.T. 1{986C767E-E5DE-43F5-957F-B4212DB8E384}|{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}<img src="/-/media/national-files/images/hometown-health/2021/stretching-to-reach-toes.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F7A981822C6D55D1213E8A4D9B0DF318" alt="Stretching to reach toes" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.AgingLife expectancy is 75 for males and 80 for females according to the National Center for Health Statistics. We'll help you keep you informed about potential issues with aging, and steps you can take to maintain your health and keep active.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Michele Halterman1/25/2017HPV (human papilloma virus) is a common virus among young adults. According to the Centers for Disease Control, almost 80 million Americans currently have the virus, and an additional 14 million will contract it each year.What you may not know about HPV<p><img alt="HPV_blog_FB_504x504" src="/-/media/national-files/images/hometown-health/2017/hpv_blog_fb_504x504.jpg?h=300&w=300&sc_lang=en&hash=98199AC1AECE0C2F958EDAB3EA7E62BB" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;">HPV (human papilloma virus) is a common virus among young adults. According to the Centers for Disease Control, almost 80 million Americans currently have the virus, and an additional 14 million will contract it each year. It is transmitted sexually, and if you have not been vaccinated against the virus, it is likely you will contract it at some point in your life.</p> <p>Most often, there are no signs or symptoms with the infection, so people do not know they have it. Like the common cold, the body can fight off the virus. However, if it does not, it can lead to cancer or genital warts in men and women. Sometimes, the cancer does not show up for years or even decades later. Common cancers include cervical, vaginal, penial, anal, throat and neck. It also can lead to genital warts. More than a quarter of a million men and women are affected by genital warts annually, and more than 11,000 women are diagnosed with cervical cancer each year. </p> <p><strong>Why is the vaccine recommended at so young an age? </strong></p> <p>The reason the vaccine is recommended for your preteen or teenager is because it only works to prevent these illnesses, and we want to protect your child before they become sexually active. Since the vaccine’s introduction, cervical cancer has been reduced by two-thirds in teenage girls. </p> <p><strong>When should your child receive the vaccine?</strong></p> <p>The vaccine is approved and recommended by the Centers for Disease Control just like other childhood vaccines, starting as early as age 9. It routinely is given with their 11 to 12-year-old vaccines of Tdap and meningitis. Traditionally, three doses were recommended for all adolescents; however, the Advisory Committee on Immunization Practices and the CDC now recommend only two doses, which are separated by six months for those 14 and under. If the series is started later, between 15 to 26 years old, three doses are required, as studies have proven that older teens have less of an immune response toward the vaccine.</p> <p><strong>Is the vaccine safe?</strong></p> <p>Yes, the vaccine is safe. In fact, it has undergone some of the most in-depth testing and largest studies to date. The CDC has carefully studied and continues to monitor the risks and benefits of all vaccines, including HPV. The benefits of cancer prevention far outweigh risks and possible side effects. Just like any medication, there are potential side effects. The most common side effects are pain, redness or swelling at the injection site, fever, nausea and headache or fatigue. Some have reported fainting after injection; however, fainting can happen after any medical procedure, especially with teens. To help prevent this, it is recommended that they remain seated for 15 minutes after injection.</p> <p>If you have questions or concerns about the HPV vaccine for you child, please talk to your primary care provider.</p> <p><em>Jennifer LeGare is a nurse practitioner in <a href="/locations/eau-claire/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">Pediatrics & Adolescent Medicine</a> in Eau Claire, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2017/hpv_blog_fb_504x504.jpg?h=504&iar=0&w=504&sc_lang=en&hash=0BA10E6B6E2F008C3E3B7D3190CD4704" alt="What you may not know about HPV" width="504" height="504" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller11/8/2022Do you know what to do if someone is having a seizure? Injury can be reduced if you know these simple interventions.How to help someone having a seizure<p>Although quite common, seizures are not something people typically are used to seeing in person. Many people don't know how to react when observing somebody having a seizure.</p> <p>Fundamentally, seizures result from abnormal electrical discharges in a small region or broadly distributed throughout the brain, almost like an abnormal surge of electrical activity. This activity's clinical manifestation depends on which part of the brain is involved.</p> <p>There are multiple types of seizures. The most common is a grand mal seizure, which features violent muscle contractions and loss of consciousness. Other types of seizures are less apparent and may include lip smacking, staring, loss of awareness, unusual finger motions, or repetitive chewing or swallowing.</p> <h2>These simple interventions can significantly reduce the possibility of injury from a seizure:</h2> <h3>Ensure safety:</h3> <ul> <li>Gently lower the person to the ground. </li> <li>Turn the person on the side to keep the mouth and airway open. </li> <li>Move away any easily mobile objects that the person could strike or fall on them.</li> <li>Do not try to restrain the person in any way, as this can cause more injury. It is essential to keep in mind your safety as well. Often, violent convulsions or falls lead to injuries in people trying to assist. </li> <li>Do not put any objects in the person's mouth, as this may lead to oral injury or injury to you.</li> <li>Remain calm and by the person's side until the seizure has stopped.</li> </ul> <p>Most seizures are self-limiting and will stop on their own. After the seizure has stopped, provide reassurance that the person is in a safe place.</p> <h3>Seek medical attention:</h3> <ul> <li>Record what time the seizure started and how long it lasted. Relay this information to a medical first responder or the person after the episode stops.</li> <li>Look for a medical bracelet on their arms, as many people with epilepsy have one as part of their rescue plan. The bracelet should state whom you can contact in an emergency and if the person is carrying medication that can stop the seizure.</li> <li>Call 911 if it's the first time your loved one has had a seizure.</li> </ul> <p>Seizures can be frightening, but remembering these tips will help you provide the right care for your loved one. More detailed information and resources about seizure first aid can be found through the <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.epilepsy.com/start-here/seizure-first-aid" target="_blank" title="Opens in a new window">Epilepsy Foundation</a>.</p> <p><em><a href="/providers/scott-spritzer-do" target="_self" title="Opens in same window.">Scott Spritzer, D.O.</a>, is a <a href="/services-and-treatments/neurology" target="_self" title="Opens in same window.">neurologist </a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Epilepsy and other neurological conditions</li> </ul>D.O.<p>In my spare time, I enjoy spending time with family and outdoor activities.</p><p><strong>Education</strong></p> <ul> <li>Doctor of Osteopathic Medicine, Midwestern University/Arizona College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Neurology, Mayo School of Graduate Medical Education, Mayo Clinic College of Medicine</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Epilepsy, Mayo School of Graduate Medical Education, Mayo Clinic College of Medicine</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Neurology, American Board of Psychiatry and Neurology</li> <li>Clinical Neurophysiology, American Board of Psychiatry and neurology</li> <li>Mayo Clinic Quality Fellow, Bronze Level</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Neurology</li> <li>American Epilepsy Society</li> <li>American Medical Association</li> <li>Wisconsin Medical Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Neurology, Mayo Clinic College of Medicine and Science</li> </ul>Spritzer<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/scott-spritzer-do.jpg?h=200&iar=0&w=200&sc_lang=en&hash=485562F16077B3B2D8830FB2B867D242" alt="Scott Spritzer, D.O." width="200" height="200" DisableNVelocity="true" />{612AFFD2-050B-4F69-BC9B-93F0A7051756}Scott<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15260917Scott Spritzer, D.O.1<img src="/-/media/national-files/images/hometown-health/2020/contemplative-woman-hands-under-face.jpg?h=370&iar=0&w=660&sc_lang=en&hash=582563B62E061EB5E9738962341D1303" alt="Contemplative woman hands under face" width="660" height="370" DisableNVelocity="true" />EpilepsyEpilepsy is a central nervous system disorder (neurological disorder) in which nerve cell activity in the brain becomes disrupted, causing seizures or periods of unusual behavior, sensations and sometimes loss of consciousness.Dawn Haller1/19/2017Keep your cholesterol and triglycerides at normal levels to lower your risk of heart disease and stroke.Love your lipids<img alt="Lipids_FB504x504" src="/-/media/national-files/images/hometown-health/2017/lipids_fb504x504.jpg?h=300&w=300&sc_lang=en&hash=3130A11E445A92FE9BA411C855909F03" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>Dyslipidemia. (Dis-lip-eh-dee-mee-ah.) It's one of those big, need-your-dictionary words. But it's linked to something many of us are familiar with: heart disease and stroke, the No. 1 and No. 3 killers in the U.S.</p> <p>Dyslipidemia means abnormal cholesterol and triglyceride levels. While these fat substances are necessary for your body to function normally, too much of the bad kind or not enough of the good kind increases your risk of heart disease, stroke or narrowed arteries in your arms or legs.</p> <p>The first step is getting a cholesterol test, also called a lipid panel or lipid profile.</p> <h2>According to mayoclinic.com, this blood test measures four types of fats in your blood:</h2> <ul> <li><strong>Total cholesterol</strong><br /> A sum of your blood's cholesterol content. </li> <li><strong>High-density lipoprotein (HDL) cholesterol</strong><br /> Sometimes called "good" cholesterol, it helps carry away LDL cholesterol. It keeps arteries open and your blood flowing more freely. </li> <li><strong>Low-density lipoprotein (LDL) cholesterol</strong><br /> Sometimes called "bad" cholesterol, too much of it in your blood causes the buildup of fatty deposits, or plaques, in your arteries, or atherosclerosis, which reduces blood flow. These plaques sometimes rupture and can lead to a heart attack or stroke. </li> <li><strong>Triglycerides</strong><br /> When you eat, your body converts any calories it doesn't need to use right away into triglycerides, which are stored in fat cells. High levels are also seen in overweight people, in those consuming too many sweets or too much alcohol, and in people with diabetes who have elevated blood sugar levels. High levels can cause a problem with the pancreas.</li> </ul> <h3>Based on your results and your family history, your healthcare provider will work with you to help modify any of your risk factors, such as:</h3> <ul> <li>High cholesterol</li> <li>High blood pressure</li> <li>Diabetes</li> <li>Overweight</li> <li>Sedentary lifestyle</li> <li>Tobacco use</li> </ul> <p>Your care plan might include referral to resources such as smoking-cessation classes, a weight-loss program or diabetes education. Medication also may be used to lower lipid levels.</p> <p>Together, these efforts actually may prevent heart disease, stroke and peripheral artery disease. </p> <p><a href="/providers/andrew-calvin-md" target="_self" title="Opens in same window."><em>Andrew Calvin, M.D.</em></a><em>, is a <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li><a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/echocardiogram/basics/what-you-can-expect/prc-20013918" target="_blank" title="Opens in a new window.">Echocardiography</a></li> <li><a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/echocardiogram/basics/what-you-can-expect/prc-20013918" target="_blank" title="Opens in a new window."> </a><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/definition/con-20019580" target="_blank" title="Opens in a new window.">Hypertension</a></li> <li><a rel="noopener" href="http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/definition/con-20019580" target="_blank" title="Opens in a new window."> </a><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/basics/definition/con-20020865" target="_blank" title="Opens in a new window.">Lipid disorders</a></li> <li>Medical education</li> <li> Preventive cardiology</li> <li> <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/stress-test/about/pac-20385234" target="_blank" title="Opens in a new window.">Stress testing</a></li> <li>Valve disorders</li> </ul>M.D., M.P.H.<p>I'm a specialist in cardiovascular medicine with a passion for prevention of cardiovascular disease, cardiovascular physiology and noninvasive testing. I seek to match the best available treatments to my patients’ preferences and values through shared decision-making.</p> <p>In addition to practicing clinical cardiology, I have the privilege of serving as Chair of Education for Mayo Clinic Health System. I love working with medical students, residents, and trainees, as it helps improve our practice. I am also passionate about ongoing professional education, with leadership roles as an Associate Dean in the Mayo Clinic School of Continuous Professional Development, a member of the Cardiovascular Disease Approval Committee of the American Board of Internal Medicine, and a member of the board of directors of the Wisconsin Medical Society.</p><p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> <li>Master of Public Health, University of Minnesota School of Public Health</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Internal Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Cardiovascular Disease, Mayo Clinic School of Graduate Medical Education</li> <li>Echocardiography, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Cardiovascular Disease, American Board of Internal Medicine</li> <li>Internal Medicine, American Board of Internal Medicine</li> <li>Adult Comprehensive Echocardiography, National Board of Echocardiography</li> <li>Special Qualification in Preventive Cardiology, Mayo Clinic </li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Cardiology</li> <li>American College of Physicians</li> <li>American Heart Association</li> <li>American Medical Association</li> <li>American Society of Echocardiography</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Associate Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Calvin<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/andrew-calvin-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=950E112EFF943E2362105E122B66405C" alt="Andrew Calvin, M.D." width="280" height="280" DisableNVelocity="true" />{9552C266-D741-4612-8CB3-21B67C81B413}Andrew<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14765101Andrew Calvin, M.D.1{676428F6-179A-4C9B-9B23-5F1E40032A38}<img src="/-/media/national-files/images/hometown-health/2017/lipids_fb504x504.jpg?h=504&iar=0&w=504&sc_lang=en&hash=57E2C1F8C24513B75C939C1C2436EAA4" alt="Lipid values in a lab report along with tube of blood" width="504" height="504" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Micah Dorfner1/17/2017You just received a letter from your doctor's office informing you that you're due for your Pap smear. Learn why you should get screened for cervical cancer and get prevention tips.Cervical cancer: Pap smears and prevention<img alt="Cervical Cancer" src="/-/media/national-files/images/hometown-health/2017/cervical-cancer.jpg?h=225&w=400&sc_lang=en&hash=1FBA6677FD75E89B19CD4156D8AE6C01" style="width: 400px; height: 225px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>You just received a letter from your doctor’s office informing you that you’re due for your <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/pap-smear/basics/definition/prc-20013038" target="_blank" title="Opens in new window">Pap smear</a>. You dutifully call and schedule an appointment, but have you ever taken a moment and really asked yourself what is a Pap? Why are you getting screened for cervical cancer, and can you do anything to prevent it?</p> <p>Cervical cancer is the third most common type of gynecological cancer behind uterine and ovarian cancer, with around 12,000 new cases of invasive cervical cancer diagnosed this year, according to the <a rel="noopener" href="https://www.cancer.org/" target="_blank" title="Opens in new window">American Cancer Society</a>. It’s also the third leading cause of death from gynecological cancer. It should be noted, however, that we have come a long way as cervical cancer was once a leading cause of cancer in women. Due to screening and prevention, this has drastically changed. It’s usually slow-growing, and often, there are no symptoms until it spreads to other organs, such as the bladder, uterus or bowels. Some early signs may include new pain during sex or abnormal vaginal bleeding or discharge.</p> <h2>What causes cervical cancer?</h2> <p>Why and where does cervical cancer occur? The cervix is located at the very back of the vagina and is the entrance to the uterus. Here is where the “transformation zone” is located — an incredible area where cells reproduce and are rapidly broken down. What increases the risk of these rapidly growing and dying cells to become abnormal and pre-cancerous is the <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/hpv-infection/home/ovc-20199062" target="_blank" title="Opens in new window">human papillomavirus (HPV)</a>. HPV is a sexually transmitted virus that many people don't even know they're carrying. There are subtypes of this virus that are particularly high risk and increase your risk of developing cervical cancer.</p> <h2>The Pap test explained</h2> <p>The Pap test, or Papanikolaou test, was invented by and named after Dr. Georgios Papanikolaou. It's performed with use of a speculum exam so the cervix can be visualized. An instrument is used to gently brush the surface of the cervix and collect a sample of the cell in that transformation zone mentioned earlier. This sample is then prepared and viewed by a pathologist to look for any abnormal cells. The sample can also be tested for the high-risk HPV subgroups that can lead to cervical cancer.</p> <h2>When and how often do I need to have a Pap smear?</h2> <h3>These are the Pap screening recommendations in women with no previous history of cervical cancer and normal immune systems:</h3> <ul style="list-style-type: disc;"> <li>Women should have a Pap every three years starting at age 21 until age 65.</li> <li>At age 30, a woman may opt to get tested with a Pap, as well as high-risk HPV. This is called co-testing. If both are negative, she may choose to be co-tested every five years until age 65. Otherwise, she may continue a Pap schedule of every three years.</li> <li>Women who have had a total hysterectomy including the cervix with no previous history of cervical or vaginal cancer don't need to have a Pap.</li> <li>Women with HIV or on immunosuppressive medication for conditions, such as organ transplant, cancer or autoimmune disease, may need more frequent screening and should have a conversation with their healthcare provider.</li> </ul> <h2>How can I protect against cervical cancer?</h2> <p>First and foremost, always use protection, such as a condom or abstinence.</p> <p>Additionally, what if I told you there is a vaccine that would protect you from getting a certain type of cancer? Would you believe me? Well, there is. The <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/cancer/expert-blog/hpv-vaccine-cervical-cancer/bgp-20056326" target="_blank" title="Opens in new window">HPV vaccine</a> is one such vaccination that we recommend every female and male get starting as early as age nine in girls and age 12 in boys, and can be given until the age of 26 in both sexes. It's administered in a series of three vaccinations and provides protection against the most common high-risk subtypes of HPV that lead to cervical and penile cancer.</p> <h2>What if my Pap smear is abnormal?</h2> <p>Should a Pap result come back abnormal, you'll meet with your healthcare provider to construct a plan together. Often for younger patients, the body will clear the abnormal cells on its own. In such cases, repeat surveillance every six months or yearly could be the plan. In some cases, your healthcare provider may have to perform an interventional procedure, which they will discuss with you in detail.</p> <p>The important message is immunization against HPV leads to prevention, and regular screening promotes early detection, which leads to early treatment and, in most cases, easily treats the disease that will most likely never return. So, when you get that notice in the mail and you schedule your Pap, know that you're doing the best job of proactively taking care of your health.</p> <em><a href="/providers/graham-king-md" target="_self" title="Opens in same window.">Graham King, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em><ul> <li>Community fitness outreach programs</li> </ul>M.D.<p>I enjoy caring for the health needs of families from prenatal care and pediatrics to adult medicine, and specialize in women's health and reproductive health. I focus on listening and hearing my patients, and forming partnerships with them in delivering their care.</p> <p>I am married to an elementary school teacher with four energetic boys who are active in community, school and sports. I enjoy playing guitar and piano, writing educational blogs and practicing healthful living. </p> <p>I am an 80s rock superfan and love going to concerts with my family and friends. I also enjoy Vikings, Twins, Wild and Maverick sports.</p><p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Mercy Hospital</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Sutter Health Family Medicine Residency Program</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Family Medicine</li> <li>Mayo Clinic Quality Fellow, Bronze Level</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Medical Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>King<img src="/-/media/shared-files/images/medical-professionals/full/mankato/graham-king-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=78048D61A3A60EF1DF00C06F2F6CCBEE" alt="Graham King MD" width="280" height="280" DisableNVelocity="true" />{46521252-3F34-48F2-80D2-338AA6DD4C22}Graham<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14899019Graham King, M.D.1<img src="/-/media/national-files/images/hometown-health/2017/cervical-cancer.jpg?h=225&iar=0&w=400&sc_lang=en&hash=A140591F2E4024655A2351305A0D4484" alt="Cervical Cancer" width="400" height="225" DisableNVelocity="true" />Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Micah Dorfner4/12/2022Although a cold usually is minor, it can make you feel miserable. The best thing you can do is take care of yourself. Try these seven at-home remedies to ease your symptoms.7 ways to combat coughs, colds<p>The next time you see your health care team for an upper respiratory illness, such as a common cold or cough, antibiotics may not be part of the treatment plan. Antibiotics are used to treat bacterial infections, such as <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/pneumonia/symptoms-causes/syc-20354204" target="_blank" title="Opens in a new window.">pneumonia</a>, and won't help viral illnesses like colds, flu and most sore throats.</p> <p>So what can you do to combat a viral illness?</p> <p>Some at-home remedies can ease your symptoms. With the common cold, you can expect to experience symptoms for one to two weeks.</p> <h2>To make yourself as comfortable as possible when you have a cough or cold, try to:</h2> <ul> <li><strong>Drink plenty of fluids.</strong><br /> Stay hydrated with water, juice, clear broth or warm lemon water with honey. Avoid caffeine and alcohol, which can dehydrate you.</li> <li><strong>Eat chicken soup.</strong><br /> Chicken soup and other warm fluids, such as warm apple juice or tea, can be soothing and loosen congestion.</li> <li><strong>Rest.</strong><br /> Stay home from work or school if you have a fever or bad cough, or are drowsy after taking medications. This will give you a chance to rest and reduce the chances you'll infect others.</li> <li><strong>Adjust your room's temperature and humidity.</strong><br /> Keep your room warm but not overheated. If the air is dry, a cool-mist humidifier or vaporizer can moisten the air and ease congestion and coughing. Keep the humidifier clean to prevent the growth of bacteria and molds.</li> <li><strong>Soothe your throat.</strong><br /> Ice chips, throat sprays, lozenges or sugar-free hard candy can help keep your throat from feeling dry and scratchy. A saltwater gargle can temporarily relive a sore throat. Dissolve one-quarter to one-half teaspoon of salt in a 4- to 8-ounce glass of warm water. This can relieve a sore or scratchy throat temporarily. Lozenges, hard candy and saltwater gargle are not recommended for children younger than 6.</li> <li><strong>Use saline nasal drops.</strong><br /> To relieve nasal congestion, try saline nasal drops. You can buy these drops over the counter, and they can help relieve symptoms ― even in infants and children.</li> <li><strong>Take over-the-counter cold and cough medications.</strong><br /> For adults and children older than 5, over-the-counter decongestants, antihistamines and pain relievers might offer some symptom relief. However, they won't prevent a cold or shorten its duration, and most have some side effects. Take medications only as directed on the label. Some medications include multiple ingredients, so read labels carefully to understand what ingredients are in the medication. Experts agree you shouldn't give these medications to younger children. Overuse and misuse of cold and cough medications can cause serious damage. Talk with your child's health care team before giving medications.</li> </ul> <p>Although colds are usually minor, they can make you feel miserable. It's tempting to try the latest remedy, but the best thing you can do is take care of yourself. Rest, drink fluids and keep the air around you moist. Also, remember to wash your hands frequently.</p> <p><em><a href="/providers/timothy-slama-do" target="_self" title="Opens in same window.">Timothy Slama, D.O</a>., is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a>, Minnesota.</em></p><ul> <li>Dermatology</li> <li>Pediatrics</li> <li>Sports medicine</li> </ul>D.O.<p>I grew up 30 minutes from Fairmont. I'm married with three kids and coach tennis at the Fairmont High School. I'm also a medical consultant for public health in Martin and Faribault counties.</p><p><strong>Education</strong></p> <ul> <li>Des Moines University College of Osteopathic Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Iowa Lutheran Hospital, University of Iowa</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Iowa Lutheran Hospital</li> </ul> <p><strong>Certifications</strong> </p> <ul> <li>Family Medicine, American Board of Family Medicine</li> <li>Certified Medical Examiner, Department of Transportation</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Medical Association </li> <li>Minnesota Academy of Family Physicians</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Slama<img src="/-/media/shared-files/images/medical-professionals/full/fairmont/timothy-slama-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=FCCFA79564EA50EAAA4C53E2DE19802C" alt="Timothy Slama, D.O." width="280" height="280" DisableNVelocity="true" />{F6F9D4D2-2155-4F19-885A-FEFABCBBB330}Timothy <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15345599Timothy Slama DO1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}<img src="/-/media/national-files/images/hometown-health/2022/overhead-view-drinking-tea.jpg?h=370&iar=0&w=660&sc_lang=en&hash=96687ADCA6B5DD66FDDB2126A2C7D58C" alt="Overhead view drinking tea" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller7/8/2024An ankle injury or arthritis can sideline you from sports and daily activities. Wearing a brace provides support and can get you back on your game. Read about the benefits.Brace for it: When to use an ankle brace<p>In the early 1990s, ankle braces began appearing more often on sports courts and playing fields due to their improved designs. They also cost less than repeatedly taping an athlete's ankle.</p> <p>Now, ankle braces are available in various designs, including sport-specific options. But the goal is the same — to provide extra support after an injury or prevent an ankle sprain from occurring in the first place.</p> <p>Coaches, parents and athletes often ask if wearing an ankle brace is worthwhile. Research shows that high school-age athletes who use ankle braces experience fewer ankle injuries. However, ankle braces don't reduce the severity of ankle, knee or other lower-extremity injuries.</p> <h2>How bracing works</h2> <p>Bones, muscles and a network of ligaments and tendons form internal supports that keep your ankle stable, flexible and strong. Ligaments are tough bands of tissue that stabilize joints and help prevent excessive movement.</p> <h3>Three main bones make up the ankle joint:</h3> <ul> <li><strong>Tibia</strong> — the long shin bone in your lower leg that provides the main weight-bearing surface at the roof of the ankle joint</li> <li><strong>Fibula</strong> — the bone on the outside of the ankle that provides lateral and rotational stability</li> <li><strong>Talus</strong> — the bone that provides the lower cartilage in the ankle and connects the ankle to the foot, functioning like a hinge to flex your foot</li> </ul> <p>These internal supports link your foot all the way up to your hip. Ideally, they function as a unit.</p> <img alt="Ankle anatomy illustration" style="width:351px; height:221px;" src="/-/media/national-files/images/hometown-health/2024/ankle-anatomy-illustration.jpg?h=221&w=351&sc_lang=en&hash=17A944BE528D36938F88810B87269918" /> <p>Ankle braces serve as external supports to limit certain motions, such as plantar flexion/inversion, which is the movement at the ankle joint that points the foot downward away from the leg and turns the foot inward.</p> <p>Braces also provide awareness of where your ankle joint is in space. For maximum effectiveness, ankle braces should fit comfortably in the shoes you wear during an activity, which also makes it more likely you'll wear the braces.</p> <h2>Rehabilitation plays a key role in recovery</h2> <p>If you do experience an ankle injury, weakness or instability, rehabilitation is a key component of your treatment plan. Often, when athletes still have ankle pain or aren't back to full function, it's because they haven't allowed enough time to heal properly. Rehabilitation providers specialize in balance, range of motion, strength and endurance, which are key therapy and training factors for recovery.</p> <p>Performing exercises as directed helps ensure a safe return to activity and lessens the likelihood of reinjury.</p> <h2>Deciding if a brace is right for you</h2> <p>Keep in mind that wearing an ankle brace isn't a 100% cure-all or guarantee against injuries. Your healthcare team can help you make an educated decision about whether an ankle brace is right for you.</p> <h2>Next steps:</h2> <ul> <li>Check out this <a href="/hometown-health/speaking-of-health/top-5-sports-medicine-faqs" target="_self" title="Opens in same window.">Sports Medicine consultation FAQ</a>.</li> <li>Find out what <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">Sports Medicine</a> has to offer.</li> <li>Learn about <a href="/hometown-health/speaking-of-health/is-your-injury-a-sprain-or-break" target="_self" title="Opens in same window.">ankle sprains and breaks</a>.</li> <li>Learn if you could benefit from an <a href="/hometown-health/speaking-of-health/athletic-or-personal-trainer-best-fit" target="_self" title="Opens in same window.">athletic trainer</a>.</li> <li>Read more about <a href="/hometown-health/speaking-of-health/to-brace-or-not-to-brace" target="_self" title="Opens in same window.">bracing</a>.</li> </ul> <p><em><a href="/providers/kurt-jacobson-lat" target="_self" title="Opens in same window.">Kurt Jacobson</a></em><em> is a licensed athletic trainer in <a href="/services-and-treatments/sports-medicine">Sports Medicine</a> in <a href="/locations/eau-claire">Eau Claire</a>, Wisconsin.</em></p><p>Prevention of injuries in the multiple sport athlete <br /> Archery and the shoulder <br /> Golf conditioning <br /> Balance training</p>L.A.T.<p><strong>Education</strong> <br /> Bachelor of Arts, Saint Olaf College, Northfield, MN<br /> Master of Science, Indiana University, Bloomington, IN</p> <p><strong>Certification</strong> <br /> National Athletic Trainers Association </p>Jacobson<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/kurt-jacobson-lat.JPG?h=280&iar=0&w=280&sc_lang=en&hash=5DFC0EB3931E9B249A2483173B0AEB44" alt="Kurt Jacobson, L.A.T." width="280" height="280" DisableNVelocity="true" />Kurt<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12696820Kurt Jacobson, L.A.T.1{2951D78A-CC76-4C49-B556-549282DF4345}|{7746ADF8-715B-4593-8AAB-55D7F0467848}|{DEF55970-853F-4E96-9A4D-3413874FF059}<img src="/-/media/national-files/images/hometown-health/2024/people-playing-basketball.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8ADA0BD29AEA3FD7A4D03738D93F463E" alt="People playing basketball" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Michele Halterman7/25/2024Are you trying to make healthier food choices? When shopping, look for minimally processed foods rather than ultra-processed foods. Learn how reading nutrition labels can help you choose.What you should know about processed, ultra-processed foods<p>Processed, and especially ultra-processed, foods have been blamed for the national rise in obesity, high blood pressure and diabetes. But what exactly are these foods, and are they really all that bad for you?</p> <h2>Defining processed foods</h2> <p>According to the <a rel="noopener" href="https://www.usda.gov/wps/portal/usda/usdahome" target="_blank" title="Opens in new window">Department of Agriculture</a>, processed foods are any raw agricultural commodities altered from their original state. This includes washing, cleaning, milling, cutting, chopping, heating, pasteurizing, blanching, cooking, canning, freezing, drying, dehydrating, mixing or packaging.</p> <p>While processing includes basic steps like washing, foods cross into ultra-processed territory when they contain preservatives, flavorings and other food additives, or substances approved for use in food products, such as salt, <a href="/hometown-health/speaking-of-health/are-you-consuming-too-much-sugar" target="_self" title="Opens in same window.">sugars</a> and <a href="/hometown-health/speaking-of-health/fast-facts-on-fats-and-heart-health" target="_self" title="Opens in same window.">fats</a> used to enhance flavor and increase shelf life.</p> <h2>Ranking foods from minimally to ultra-processed</h2> <p>Here's how the <a rel="noopener" href="https://www.eatright.org/" target="_blank" title="Opens in new window.">Academy of Nutrition and Dietetics</a> ranks processed foods from minimally to mostly or ultra-processed:</p> <ul> <li>Minimally processed foods, such as fresh blueberries, cut vegetables and roasted nuts, prepped for convenience.</li> <li>Foods processed at their peak to lock in nutritional quality and freshness including canned tomatoes, tuna, frozen fruit or vegetables.</li> <li>Foods with ingredients added for flavor and texture, such as sweeteners, spices, oils, colors and preservatives, include jarred pasta sauce, salad dressing, yogurt and cake mixes.</li> <li>Ready-to-eat foods like crackers, chips and deli meat, which are more heavily processed.</li> <li>The most heavily or ultra-processed foods include sweetened breakfast cereals, soda, energy drinks, artificially flavored crackers and potato chips, chicken nuggets and hot dogs.</li> </ul> <p>Minimally processed foods have a place in healthy diets. For example, low-fat milk, whole-grain or wheat bread, precut vegetables and fresh-cut greens are considered processed foods. Dairy- and plant-based milks and juices may be fortified with vitamin D and calcium, while breakfast cereals may have added fiber. Canned fruits packed in water or natural fruit juice can be part of a healthy diet when fresh fruit isn't readily available.</p> <h2>Reading the labels</h2> <p>When choosing foods, do some investigative work by examining ingredient lists and analyzing the nutrition facts labels:</p> <ul> <li>Avoid foods that contain additives and preservatives, such as high fructose corn syrup, hydrogenated oils, food dyes, monosodium glutamate, sodium nitrates, sodium nitrites and sulfites such as sulfur dioxide, sodium bisulfite or sodium sulfite.</li> <li>Cut back on ultra-processed foods and purchase more unprocessed or minimally processed foods.</li> <li>Look for more natural ingredients.</li> </ul> <p>When reading the nutrition facts labels, watch for hidden sugars, fats and salt, especially those added during processing.</p> <p>Most labels now include <a href="/hometown-health/speaking-of-health/the-not-so-sweet-truth-of-added-sugars" target="_self" title="Opens in same window.">added sugars</a>. The <a rel="noopener" href="https://www.dietaryguidelines.gov/" target="_blank" title="Opens in a new window.">Dietary Guidelines for Americans</a> recommends that people older than 2 get less than 10% of total calories from added sugars, or about 200 calories in a 2,000-calorie diet. Children younger than 2 shouldn't have any added sugars in their diets. Learn to spot words like maltose, brown sugar, corn syrup, honey and fruit juice concentrate.</p> <p>When it comes to <a href="/hometown-health/speaking-of-health/kids-and-sodium-serious-risks-and-alarming-realities" target="_self" title="Opens in same window.">sodium</a>, people often comment that they salt their food. As it turns out, you don't need to because manufacturers have already added salt for you, and it's often too much. The Dietary Guidelines also recommends adults consume less than 2,300 milligrams of sodium per day. Look for low- or reduced-sodium foods. Also try rinsing canned vegetables with water to remove some of the salt.</p> <p>When checking fat content on labels, scan for saturated fats and <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/trans-fat/art-20046114" target="_blank" title="Opens in a new window.">trans fats</a>. Choose foods lower in saturated fats. Trans fats are considered one of the worst types of fat because they can raise your low-density lipoprotein (LDL or "bad") cholesterol and lower your high-density lipoprotein (HDL or "good") cholesterol.</p> <h2>Taking baby steps toward healthier eating</h2> <p>Take baby steps by making one dietary change at a time. Consider healthy swaps, such as whole-grain cereal with no added sugar instead of highly processed, sugary cereals. Choose whole-grain, high-fiber breads over white bread products. When looking for a healthy snack, reach for fresh fruit or vegetables instead of crackers, potato chips or processed cookies.</p> <p> The key to healthy eating starts with you. Educate yourself on what to look for and talk with your healthcare professional or nutrition expert to discuss a food plan that works best for you.</p> <em>Anne Harguth is a <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">registered dietitian</a> in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em><img src="/-/media/national-files/images/hometown-health/2024/instant-soup-with-noodles.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F14329C05FB31223307D4D1BA95A382F" alt="Instant soup with noodles" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Michele Halterman9/21/2022If your kids are picky eaters, eat the same foods or only want to snack all day, you're not alone. Find out if kids really do need to clean their plate, and get nine tips to raise healthy eaters.Raising healthy eaters: Should kids clean their plate?<p>As parents, it can be tempting to control the types and amounts of food children eat. Still, these well-intentioned actions can sometimes create feeding problems, such as overeating, rebellious eating and secrecy eating.</p> <p>Raising kids who are healthy eaters starts by becoming familiar with some typical eating behaviors of children. Picky eating, eating the same food every meal and changes in portions from meal to meal are all normal.</p> <h2>Introducing new foods</h2> <p>It takes 12 to 17 times to introduce a food to children before they're even interested in trying it.</p> <p>Children's appetites will change based on how fast they're growing. At times, it may seem like children are never full, and other times they won't eat more than one bite.</p> <p>It's best not to trick, bribe, or force a child to try new foods. Describe the food's taste, texture and temperature to help children become more comfortable with new food.</p> <h2>'One bite' tactic</h2> <p>Pushing children to eat all the food on their plate or enforcing the "one bite" rule isn't recommended. Instead, parents should let children learn to eat in their own way.</p> <p>Keeping mealtime tactics consistent is also important. For example, if parents push children to eat when they aren't hungry, it could teach them to overeat by sending the message that they need to eat even when they aren't hungry. If parents limit how much food children eat during a meal, it can give children mixed messages and ultimately doesn't allow them to listen to their bodies.</p> <h2>Monitoring meal portions</h2> <p>Many parents are concerned about what and how much their kids eat. Remember, it's normal for kids to choose not to eat meat at one meal and only eat bread at another. Pushing kids to eat food they don't want could make them rebellious and decide not to eat it at all.</p> <p>When children are forced to eat veggies, they often cry and may even gag. This experience may teach children that veggies are not pleasant and may limit their desire to try them in the future.</p> <h2>Snack time habits</h2> <p>For toddlers, offer three meals and two to three snacks daily. At age 2, milk intake should not exceed two cups per day, and milk should be offered at meals.</p> <p>Offering milk or snacks in between meals will make a child less hungry at meal times and likely less interested in trying new foods.</p> <h2>To raise healthy eaters, consider these tips:</h2> <ul> <li>Offer at least three food groups at each meal and snack: fruits, veggies, whole grains, low-fat dairy, lean protein or legumes.</li> <li>Ensure one food is offered with each meal your child will eat while not catering to likes and dislikes.</li> <li>Give your child the responsibility to choose how much and whether to eat at mealtime.</li> <li>Create an environment that allows your child to explore, touch and experience different foods and textures at his or her own pace.</li> <li>Minimize mealtime distractions, such as the TV or having toys at the table. Enjoy conversation with family instead.</li> <li>Don't be fooled by "distracted eating." Children will often say they're done eating to play, though they may not be done eating. Encourage your child to sit with the rest of the family, even if they say they are finished eating.</li> <li>Take charge of eating by providing consistent meals and snack times.</li> <li>Choose the healthy foods your child should eat. Young children don't know what is healthy for them, so given a choice, they may not choose what is best for them.</li> <li>Model healthy eating behaviors in front of your children. They best learn from you.</li> </ul> <p>While most children have normal eating behaviors, if they start to gain or lose too much weight, a meeting with their primary care provider or <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">dietitian</a> can help determine possible reasons for the change and support appropriate growth.</p> <p>Over a day, week or even a month, children will likely rotate through various food groups to meet their growing needs. Remember that most children will gradually learn to eat what their parents eat.</p> <em><a href="/providers/grace-fjeldberg-rd" target="_self" title="Opens in same window.">Grace Fjeldberg</a> is a dietitian in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em><ul> <li>Bariatric surgery</li> <li>General nutrition</li> <li>Oncology</li> <li>Pediatric nutrition</li> </ul>RDN, LD <p><strong>Education</strong></p> <ul> <li>Minnesota State University, Mankato</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Mayo Clinic College of Medicine, Minnesota</li> </ul> <p><strong>Certifications</strong> </p> <ul> <li>Commission on Dietetic Registration</li> <li>Minnesota Board of Dietetics and Nutrition Practice</li> </ul> Fjeldberg<img src="/-/media/shared-files/images/medical-professionals/full/mankato/grace-fjeldberg-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=FB99EC499314FA86AE8202C30AB740A2" alt="Grace Fjeldberg RDN" width="280" height="280" DisableNVelocity="true" /> Grace<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15268781Grace Fjeldberg R.D.N. 1<img src="/-/media/national-files/images/hometown-health/2022/child-with-berries-on-fingertips.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C77FBE24BFD79C15DE7FF7B2C5347D7F" alt="Child with berries on fingertips" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Michele Halterman2/24/2017As you’re burning up the miles, you’re giving your body the fuel it needs to go the distance. One important thing to remember as your body works to recover between runs and workouts is to make sure you’re giving it enough carbohydrates.Monday Run Day 6: Assessing your carbohydrate needs<img alt="MRD_carbs_504x504" src="/-/media/national-files/images/hometown-health/2017/mrd_carbs_504x504.jpg?h=300&w=300&sc_lang=en&hash=9BBED8038663B779F8DE2F48F1B5B32D" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p><em>By Mayo Clinic Health System staff</em></p> <p>Now that we’ve had a taste of spring-like weather, it seems the end of our long, cold, dark winter is in sight. We just have to be patient and keep trucking. Even though we’re likely to see more snow, it’s nice to be over the hump.</p> <p>The same may be said for your training right about now. Are you tired and sore? Are people sick of you talking about training for this marathon yet? Nobody said this would be easy, but each passing week brings you closer to your goal. Just make sure that, as you’re burning up the miles, you’re giving your body the fuel it needs to go the distance. One important thing to remember as your body works to recover between runs and workouts is to make sure you’re giving it enough carbohydrates.</p> <p>Carbohydrates are good choices for fueling muscles and promoting adequate muscle recovery after a workout. A carbohydrate-rich diet that includes whole grains, fruits and vegetables should be the foundation for every type of athlete, along with adequate protein and healthy fats.</p> <p>When planning your daily diet, you should include 3 to 5 grams of carbohydrate per pound of body weight. That will keep your muscles supplied with glycogen and allow you to train at your best and compete at your peak potential.</p> <p>So, fuel up, forge ahead and remember the end is in sight. You’ll get there!</p><img src="/-/media/national-files/images/hometown-health/2017/mrd_carbs_504x504.jpg?h=504&iar=0&w=504&sc_lang=en&hash=E07C446A2F711AD99EDBE87E748E636C" alt="Carbohydrates for runners" width="504" height="504" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Dawn Haller8/12/2025We understand that in the world of obstetrics and gynecology, there are many topics which women may wonder about, but are uncertain how to address. This series is designed to help you to feel less squeamish about discussing those topics.Too Embarrassed to Ask: Part I<p>We understand that in the world of obstetrics and gynecology, there are many topics which women may wonder about, but are uncertain how to address. In fact, you may feel downright embarrassed to even ask, so you keep it to yourself. As women’s health experts, we encourage you to engage in those difficult conversations with your health care provider, as we are here to assist you with maintaining or initiating healthy lifestyle choices, to reassure when things are normal and to offer solutions when they are not. This series is designed to help you to feel less squeamish about discussing women’s health topics.</p> <p><strong>Too Embarrassed to Ask: When should I have my first exam with an OB-GYN?</strong></p> <p>As we kick off the series, we are starting with the topic of “When should I have my first exam with an OB-GYN?” First, we would like to focus on our adolescent population with this question. As a young female, your body is going through a number of changes, some of which may be exciting, but many of which are strange and confusing. Puberty typically begins for girls at age 11, but may start years before that. The first sign of puberty typically is breast development, followed by pubic hair growth, a growth spurt and then around two years after breast development starts, girls will have their first period. Menses can be irregular in frequency, volume and duration for several years after menarche (the first period). Even though it may be normal, this unpredictability can be bothersome to some young women. We can help. If you have questions about development or management of your menses, the office of your local gynecologist is a great place to start.</p> <p>We generally consider the age of 13–15 to be an excellent time to schedule your first health maintenance exam with a gynecologist. At this visit, we can review your immunization history, assist with questions regarding puberty and development, and discuss healthy and safe recommendations for your future. Development of the human papilloma virus, or HPV, vaccine specifically is for boys and girls from the ages of 9–26 to prevent cervical cancer, genital warts and penile cancer. This is a three-shot series. Some discussion during this visit may focus on education of female anatomy and prevention of unplanned pregnancy and sexually transmitted infections. This visit does not have to include a speculum exam.</p> <p>If you are already sexually active and have concerns regarding possible exposure to sexually transmitted infections, we can assist with testing and treatment. For women trying to avoid pregnancy, we have a variety of birth control options, from the oral contraceptive pill to an intrauterine device and many other options. If you are pregnant or believe you may be pregnant, our clinical team can assist with testing and establishing prenatal care so you and your baby are safe and cared for during your pregnancy.</p> <p>Remember, as embarrassing as it may seem to you, we, as women’s health experts, want to hear from you when you have questions about your body. We’ll help answer your questions and guide you as you grow and mature.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2017/too-embarrassed-first-exam.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1A72DDEE15D43B2C661DA0F3887DDAB4" alt="Too Embarrassed First Exam 660x370" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Michele Halterman2/22/2017While not harmful, a double chin can make people appear older than they are, and few people want that. Surgery is an option, but there now is an option that is not as costly and is less invasive.Chin up — This disappearing act can be your secret<img alt="blogFB_chin_504x504" src="/-/media/national-files/images/hometown-health/2017/cryolipolysis-chin-treatment.jpg?h=300&w=300&sc_lang=en&hash=3B921C61344E1BD86511AC26C3023D3C" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /> <p>Providers hear time and again from patients that despite working hard to slim and tone their bodies with diet and exercise, their double chins just won't go away. It can be frustrating for them to not like what they see in the mirror. While not harmful, a double chin can make people appear older than they are, and few people want that. Surgery is an option, but there now is an option available that is not as costly and is less invasive.</p> <p>Cryolipolysis, also known as CoolSculpting, is a noninvasive cosmetic procedure using controlled cooling to eliminate fat cells underneath the skin that are resistant to diet and exercise. There now is a cooling application specifically designed to treat that frequent trouble spot — the double chin.</p> <p>So how does it work? In the <a href="/services-and-treatments/plastic-and-reconstructive-surgery" target="_self" title="Opens in same window">Plastic & Reconstructive Surgery Department</a>, we attach an applicator to your chin and neck area. You may initially feel slight discomfort, because the machine produces a vacuum suction sensation and intense coolness. However, after five to seven minutes, the feeling dissipates.</p> <p>Each treatment lasts one hour, so it can be completed over your lunch. Many people read, play on their phones or even take a nap. You can go back to work after the procedure, because no downtime is needed for recovery.</p> <p>Most people require one to two 45-minute treatments. You will begin to see gradual results about three to six weeks later and full results by three months. Because the results are not instantaneous like some other cosmetic procedures, no one needs to know about it, unless you tell them. While some patients like to tell everyone about their experience, others prefer to keep it their "little secret."</p> <p>Cryolipolysis is a procedure for men and women. In fact, more and more men are choosing to have this procedure to tighten up problem areas, including chin and side flanks. So the next time you notice something a little different about the person next to you, but aren't sure exactly what it is, perhaps it's because of their little secret.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2017/cryolipolysis-chin-treatment.jpg?h=504&iar=0&w=504&sc_lang=en&hash=F022A16AF21EDFA2B33532D23A896349" alt="Cryolipolysis at Mayo Clinic Health System can help make your double chin disappear." width="504" height="504" DisableNVelocity="true" />Plastic and Reconstructive SurgeryPlastic and reconstructive surgery provides services that not only include cosmetic or aesthetic surgery, but also surgical repair of congenital deformities, laser surgery, postsurgical reconstruction, such as breast, head and neck defects, and microsurgery.Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller5/9/2022Falls can happen to anyone of any age at any time. But for older people, falls can have long-term effects on health and independence. Learn about falls and how they can be prevented.Q&A: Falls and fall prevention<p>Falls can happen to people of all ages and for a variety of reasons. However, the older we get, the more brittle our bones can become, so even a simple fall can cause a possibly life-changing injury.</p> <h2>Here are a few common questions about falls and fall prevention:</h2> <h3> Q. Is everyone at risk for falls?</h3> <p>A. Falls can happen at any age, but older adults are at higher risk of injury from falls. The <a rel="noopener" href="https://www.cdc.gov/falls/data-research/facts-stats/" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention</a> reports that falls are the leading cause of fatal and nonfatal injuries in patients older than 65. Falls in older patients result in more than 3 million emergency room visits and almost 300,000 hip fractures a year.</p> <h3>Q. What orthopedic injuries are most common?</h3> <p>A. Bone health directly affects injury from falls. An estimated 10 million people in the U.S. have <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-20351968" target="_blank" title="Opens in a new window.">osteoporosis</a>. Due to our aging population, 1 in 2 Americans over age 50 has or is at risk of developing osteoporosis of the hip. Women are more affected than men. Common locations for osteoporosis-related fractures, also known as fragility fractures, are the spine, hip and wrist. More than 400,000 fragility fractures occur each year.</p> <p>The risk of future fracture is increased five-fold after the first fragility fracture, yet only 1 in 5 fracture patients receive screening to prevent future fractures. Of repeat fractures, 50% can be avoided. Fracture patients are less likely to seek follow-up after their injury has healed because they don't think it's needed. An orthopedic health care professional can identify at-risk patients and ensure they get preventive and appropriate post-fracture care.</p> <h3>Q: What are the effects of falls?</h3> <p>Falls can have long-term ramifications. Fractures can make the simplest activities challenging, leading to loss of independence and increased need for support. For older patients, this could mean staying at a temporary rehabilitation center or permanently moving to a family member's home or an assisted living facility for help with daily activities. Younger patients also may need help as their fractures heal.</p> <h3>Q. What are the main causes of falls and how can they be prevented?</h3> <p>Fall prevention and fall-risk awareness are everyone's responsibility. Lifestyle and home modifications can help avoid fractures, and keep us all safer and out of the hospital. Fall risks can be categorized as either patient-specific or environmental.</p> <h4>Patient-specific risk factors and prevention:</h4> <ul> <li><strong>Osteopenia and osteoporosis</strong><br /> Good bone health. can decrease the severity of injuries after a fall. Make sure you're getting enough vitamin D and calcium. Also, consider bone mineral density testing, especially after a fragility fracture (spine, hip or wrist). Depending on the results, your health care professional may recommend treatment.</li> <li><strong>Impaired gait</strong><br /> How you walk can affect your risk for falls. Talk with your health care professional about an exercise program to improve your strength and balance. Assistive devices, such as a cane or walker, may reduce risk, too. Gait also can be affected by diseases, such as Parkinson's and inner ear disorders.</li> <li><strong>General health</strong><br /> An annual exam evaluates your overall health and can detect heart and blood pressure problems that may cause unexpected falls.</li> <li><strong>Medications</strong><br /> Be aware of medication side effects, such as making you sleepy or impairing your balance. Make sure medications are clearly labeled and take them according to the instructions.</li> <li><strong>Dementia</strong><br /> Patients with dementia who live at home and alone are at higher risk for injury. Family members with memory issues may need redirecting or reminders to use assistive devices.</li> <li><strong>Vision and hearing</strong><br /> Get annual eye and hearing exams.</li> <li><strong>Nicotine and alcohol</strong><br /> Nicotine in any form decreases bone health. Alcohol can impair coordination and judgment.</li> </ul> <h4>Environmental risk factors and prevention:</h4> <ul> <li><strong>Lighting</strong><br /> Make sure stairs and hallways are well lit. Install night lights to light the path from your bed to the bathroom. Keep flashlights at the bedside in case of power outages.</li> <li><strong>Floors</strong><br /> Avoid wet floors and use nonskid floor wax.</li> <li><strong>Carpets</strong><br /> Secure area rugs with double-sided, slip-resistant backing, and consider carpeting concrete, ceramic or marble floors to cushion falls.</li> <li><strong>Stairs</strong><br /> Stairs should have sturdy handrails on both sides. Add nonslip treads to hardwood stairs. Avoid using patterned or thick carpets on stairs since these make the edges of the steps harder to see and easier to trip on. Repair loose carpets and floorboards.</li> <li><strong>Bathrooms</strong><br /> Install grab bars near toilets and showers, replace glass shower enclosures with shatterproof material, and place slip-resistant rugs near the shower for safety. Consider using shower chairs and raised toilet seats.</li> <li><strong>Living space</strong><br /> Remove clutter, low coffee tables, footrests and electric cords that may cause you to trip. Remove any shaky or damaged furniture.</li> <li><strong>Bedroom</strong><br /> Make your bed easy to get in and out of, keep a phone near your bed, and remove any clutter from around the bed.</li> <li><strong>Cabinets</strong><br /> Use easy-to-reach and low cabinets. Don't stand on chairs or boxes to reach higher cabinets or shelves. Instead, use a sturdy step stool with handrails for balance.</li> <li><strong>Chairs</strong><br /> Avoid chairs that are too low to get up from easily. Remove unstable chairs.</li> <li><strong>Shoes</strong><br /> Wear supportive, nonskid shoes that are weather-appropriate and fit properly. Make sure your shoelaces are well-tied. House slippers also should fit well and have good traction. During the winter, watch for icy spots, and salt or request that your snow removers frequently salt areas in your walkway that tend to get icy as snow melts and refreezes.</li> <li><strong>Pets</strong><br /> Beware of tripping over pets or getting tangled in long leashes.</li> </ul> <p>Fall prevention is key for maintaining health and independent living. Talk with an orthopedic professional about osteoporosis, bone health and post-fracture care and concerns about potential fracture risk.</p> <p><a href="/providers/jacqueline-corona-md" target="_self" title="Opens in same window."><em>Jacqueline Corona, M.D.</em></a><em>, is an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgeon</a> and hand surgery specialist in <a href="/locations/mankato">Mankato</a>, Minnesota.</em></p><ul> <li>Addressing surgical problems related to hand and wrist arthritis and trauma</li> <li>Orthopedic trauma</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Icahn School of Medicine at Mount Sinai</li> </ul> <p><strong>Research Fellowship</strong></p> <ul> <li>Pediatric Orthopedics, Columbia University College of Physicians and Surgeons</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, Southern Illinois University School of Medicine</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Hand Surgery, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Orthopaedic Surgery</li> <li>Subspecialty Certification in Surgery of the Hand, American Board of Orthopaedic Surgery </li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Society for Surgery of the Hand</li> <li>Fellow, American Academy of Orthopaedic Surgeons</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Orthopedics, Mayo Clinic College of Medicine and Science</li> </ul>Corona<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jacqueline-corona-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=AF17ABA7DF98C91AD0D6D0116D6DB604" alt="Jacqueline Corona MD" width="280" height="280" DisableNVelocity="true" /><p><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/33084381/" target="_blank" rel="noopener noreferrer" data-auth="NotApplicable" data-linkindex="0" title="Opens in a new window">Outcomes of Surgical Management of Intraosseous Ganglia of the Carpal Bones: A Case Series</a>, October 2020</p> <p> </p>{D9F2AE61-8625-4CB7-B111-16546A7FCA08}Jacqueline<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16214391Jacqueline Corona, M.D.1<img src="/-/media/national-files/images/hometown-health/2022/senior-with-cane-on-staircase.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B9D824E56186DF0B30297F1627E6B695" alt="Senior with cane on staircase" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Michele Halterman9/3/2019For anyone who has epilepsy or a seizure disorder, life can be a challenging and uncertain journey. Every person with epilepsy has a unique life situation, and the cause for their seizures may or may not be known.Option for seizure answers closer to home<p>For anyone who has epilepsy or a seizure disorder, life can be a challenging and uncertain journey. Every person with epilepsy has a unique life situation, and the cause for their seizures may or may not be known, which is scary and frustrating.</p> <p>Treatment options vary from person to person, and it is vital to find the best advice and course of care just for that individual. Learning more about what area of their brain is being impacted and what triggers they may have is so important in controlling their seizures.</p> <p>Epilepsy can appear and look different for everyone, with different behaviors, sensations and emotions. It is a complex disorder and can’t be evaluated or treated with a cookie-cutter approach. Each person who has epilepsy deserves answers to their questions, and the ability to define seizure control and success for a better quality of life.</p> <p>One way to get answers is a short hospital stay in an epilepsy monitoring unit or EMU. These are special hospital units that help doctors evaluate, diagnose and treat seizures. During the stay, the patient is monitored around the clock with a video camera and small electrodes attached to their scalp, so during a seizure, the doctor and team can monitor brain activity and body movement. The EMU provides a safe and comfortable place where changes to medications and plan of care can be specifically determined for that patient.</p> <p>Until recently, western Wisconsin residents have had to travel 90 miles or more for an EMU stay. This not only is expensive, but also can be emotionally difficult and inconvenient to be away from family and loved ones during this time. The best news is that long-distance travel isn’t required anymore. Mayo Clinic Health System opened an amazing four-bed EMU in their Eau Claire hospital.</p> <p>We are extremely excited and optimistic that there now is the wonderful opportunity for people with epilepsy to get the answers to that help their seizures so much closer to their home. This local EMU will help so many who deal with the challenges of having seizures, so they are able to learn the answers they need to live active and full lives.</p> <h4>Learn more about seizures and epilepsy:</h4> <ul> <li>Not many people know how to react when observing somebody having a seizure. Read <a href="/hometown-health/speaking-of-health/how-to-help-someone-having-a-seizure" target="_self" title="Opens in same window.">how to help someone having a seizure</a>.</li> <li>Approximately 70% of people with epilepsy are able to find seizure control using a single medication or a combination of two or more. Read about <a href="/hometown-health/speaking-of-health/vagus-nerve-stimulation-treatment-for-seizures" target="_self" title="Opens in same window.">how a vagus nerve stimulator can help people with epilepsy</a>.</li> <li>Jake Weiss felt like he was dying when his panic attack symptoms set in. Read his story of getting back behind the wheel after an epilepsy diagnosis.</li> </ul> <p><em>Lou Kelsey is director emeritus for the Epilepsy Foundation of Western Wisconsin.</em></p> <p><em>Th </em><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://epilepsywisconsin.org/" target="_blank" title="Opens in a new window."><em>Epilepsy Foundation of Wisconsin</em></a><em> has lead the fight to overcome the challenges of living with epilepsy and to accelerate therapies to stop seizures, find cures and save lives. The organization works with over 14,000 people with epilepsy and their families across 22 counties in Wisconsin. Mayo Clinic Health System is a proud sponsor of the foundation’s programming and special events.</em></p><img src="/-/media/national-files/images/hometown-health/2017/epilepsy-monitoring-unit.jpg?h=504&iar=0&w=504&sc_lang=en&hash=CD34E623E54567FBBC99C838644E0EC6" alt="Seizure control is possible with the Epilepsy Monitoring Unit at Mayo Clinic Health System." width="504" height="504" DisableNVelocity="true" />EpilepsyEpilepsy is a central nervous system disorder (neurological disorder) in which nerve cell activity in the brain becomes disrupted, causing seizures or periods of unusual behavior, sensations and sometimes loss of consciousness.Michele Halterman2/17/2017Are you finding times when you look at the long road ahead and wonder how you’ll maintain this pace until you reach the finish line? A slight shift in perspective might help.Monday Run Day 5: Staying motivated<img alt="Monday Run Day_motiv_504x504" src="/-/media/national-files/images/hometown-health/2017/monday-run-day_motiv_504x504.jpg?h=300&w=300&sc_lang=en&hash=5A27AB5CA542EBA4E89042A471B13BAB" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>You’ve put a lot of miles on by now. Congratulate yourself for staying committed to your goal. See? You’re already a winner! Are you finding times when you look at the long road ahead and wonder how you’ll maintain this pace until you reach the finish line? A slight shift in perspective might help.</p> <p><a href="/providers/dawn-mihalovic-bayer-pac" target="_self" title="Opens in same window.">Dawn Mihalovic-Bayer</a>, a physician assistant at Mayo Clinic Health System – Northland in Barron, went from being inactive and out of shape nine years ago, to running more than a dozen marathons. Looking back has helped her to move forward, through everything from her first 5K to her first Ironman Triathlon last fall.</p> <p>“I tell myself and other people, ‘You need to look at how far you’ve come and not how far you have to go’” Mihalovic-Bayer says. “Think of what you’ve conquered to get where you are. When I’m running, I don’t think, ‘I’ve got 16 miles to go.’ I think, ‘Look, I’ve done 10 miles. That’s pretty amazing.’”</p> <p>She also reminds herself why she starting working so hard in the first place. For Mihalovic-Bayer, her motivation was being able to keep up with her two kids.</p> <p>“When I had my first baby, I was overweight and out of shape,” Mihalovic-Bayer says. “I wanted to be able to do everything they wanted to do.”</p> <p>These days, Mihalovic-Bayer is always training for her next event. To keep the constant training from getting monotonous, she varies her routine, including running, swimming, biking and strength training. She also says that continually studying ways to improve her technique and performance helps keep her interested.</p> <p>Don’t forget to celebrate your milestones — big or small. The satisfaction you gain from achieving your goals can help inspire you to move on to the next.</p> <p>“There’s so much you learn about yourself,” Mihalovic-Bayer says. “You think, ‘I did this; now, I know I can do that.’”</p> <p>In case you get hung up on thinking you’re not as young as you used to be, Mihalovic-Bayer says she draws inspiration from Ironman competitors who are still going strong in their 60s.</p> <p>“You’re never too old,” she says. “I became an Ironman at age 47. Anything is possible. If you put the time and work into it, it will happen.”</p> <p>So what motivated you to start this journey in the first place? Keep that goal front and center as you put more miles behind you. Look how far you’ve come already!</p> <p>Let us know why you’re training for the Eau Claire Marathon. Have a story to share? We’d love to hear it. <strong>Join the discussion below.</strong></p><img src="/-/media/national-files/images/hometown-health/2017/monday-run-day_motiv_504x504.jpg?h=504&iar=0&w=504&sc_lang=en&hash=1EAF84FE539043BC6ABC86BAF488559C" alt="Monday Run Day_motiv_504x504" width="504" height="504" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Michele Halterman2/16/2017Weight loss surgery is not the best option for every person, but incorporating healthful habits is good for everyone. We have some tips to get you started living more healthfully.Healthy habits before and after bariatric surgery<p><img alt="Blog_habits" src="/-/media/national-files/images/hometown-health/2017/modify-your-habits.jpg?h=199&w=299&sc_lang=en&hash=AC18425FA035955025E38AD53195A9D3" style="height: 199px; width: 299px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive"></p> <p>Considering bariatric surgery for weight loss is a big decision. It is more than just having a surgery, because patients need to commit to a lifetime of healthy eating and regular exercise to have long-lasting results. Weight loss surgery is not the best option for every person, but incorporating healthful habits is good for all. Here are some tips to get you started living more healthful if you are unsure of how to start:</p> <ul> <li><strong>Use a <a href="https://www.mayoclinic.org/healthy-lifestyle/weight-loss/in-depth/calorie-calculator/itt-20402304?_ga=2.121368653.473319243.1553688748-328039268.1553688748" target="_blank" title="Opens in a new window.">calorie calculator</a></strong> to determine the correct amount of calories you should be taking in each day. Many people assume that they should consume 2,000 each day, but their numbers could be higher or lower based on their activity levels.</li> <li><strong>Reduce the amount of sweetened beverages</strong> you drink so you don’t fill up your calorie allotment with liquids. Replace drink calories with nutritious snacks, such as vegetables and fruits.</li> <li><strong>Slow down when you are eating</strong> by taking smaller bites. This gives your brain time to send out fullness signals and helps you enjoy your meal more fully.</li> <li><strong>Get moving</strong>. Regular exercise is important to every aspect of your health. Many people use a fitness app on their mobile devices or a wearable fitness tracker to keep track of their activities each day. Another simple and free tracking option is a paper diary. Sometimes, getting more activity into your day could be parking your vehicle farther away than usual, walking to the store or using the stairs instead of an elevator. These little actions can add up.</li> <li>Remember, there always is a <strong>healthier food option</strong>. Even during those days when you have no other option than to eat on the go, a quick web search of a restaurant menu can lead you to the nutrition information and help you make a healthier choice.</li> <li><strong>Drink plenty of water</strong>. Every system in your body depends on water. Water helps flush toxins out of vital organs, carries nutrients to your cells and provides a moist environment for your cells. Try to drink eight 8-ounce glasses of water each day.</li> <li><strong>One meal will not ruin your work or diet</strong>. If you make healthful choices on a regular basis, a single slip will not undo your hard work. Try not to get discouraged, and focus on the next meal or day.</li> <li><strong>Make it fun</strong>. Habits are much more likely to stick if you have fun doing them. Make it a race or challenge with your family, friends or co-workers. Try a new food or exercise. Visit a new park or walking trail. There is so much to discover when you make healthful decisions and feel good.</li> </ul> <p><a href="/providers/wendy-payson-rn" target="_self" title="Opens in same window."><em>Wendy Payson</em></a><em> is a registered nurse in <a href="/services-and-treatments/bariatric-surgery" target="_self" title="Opens in same window.">Bariatric Surgery</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Bariatric surgery</li> </ul>R.N.<p><strong>Education</strong></p> <ul> <li>Bachelor’s degree, Nursing, Viterbo University</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Society for Metabolic and Bariatric Surgery</li> </ul>Payson<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/wendy-payson-rn.JPG?h=280&iar=0&w=280&sc_lang=en&hash=145BB27D742C8127BD511ABBE43A5F35" alt="Wendy Payson, R.N." width="280" height="280" DisableNVelocity="true" />Wendy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13785401Wendy Payson, R.N.1{94B2E140-AEF8-44BA-B6A9-4538B77501BC}<img src="/-/media/national-files/images/hometown-health/2017/modify-your-habits.jpg?h=335&iar=0&w=504&sc_lang=en&hash=4F9D937EBE0DCF8E319775173FC8D618" alt="Modify your habits and transform your life." width="504" height="335" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Michele Halterman2/15/2017Increasing numbers of expectant moms are requesting nitrous oxide for pain relief during childbirth. Answers to some common questions may help you decide if this comfort measure is right for you.Easing labor pain with inhaled nitrous oxide<img alt="birth_504x504" src="/-/media/national-files/images/hometown-health/2017/birth-baby.jpg?h=300&w=300&sc_lang=en&hash=8B9E9BD516E4F65AA416A18BE2688FE8" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>Increasing numbers of expectant moms are requesting nitrous oxide for pain relief during childbirth. The answers to these common questions may help you decide if this comfort measure is right for you.</p> <p><strong>What is nitrous oxide?</strong></p> <p>Nitrous oxide is an odorless, tasteless gas. It sometimes is referred to as laughing gas, because you can feel a little lightheaded or silly while you are using it. <br /> <br /> <strong>How does nitrous oxide work to relieve pain during labor?</strong></p> <p>Nitrous oxide is mixed with oxygen and inhaled through a hand-held face mask. Its effects are felt within a minute. You hold the mask so you can decide when to use it and how much you need to ease pain during contractions.</p> <p><strong>How much does nitrous oxide help with labor pain?</strong></p> <p>Nitrous oxide relaxes the central nervous system to dull the perception of pain, but does not completely block it. Some women describe it as “taking the edge off.” It can help you relax and lessen your anxiety. Nitrous can be a good alternative for women who are looking for a less-invasive alternative to an epidural.</p> <p><strong>Does nitrous oxide have any lasting effects?</strong></p> <p>Nitrous oxide is safe for mom and baby, and will not cause any lasting effects. As soon as you pull the mask away, the effect of breathing the gas is gone within a few breaths.</p> <p><strong>Do I have to choose between using nitrous oxide or having an epidural?</strong></p> <p>No. You may choose to use nitrous oxide first and then move to a different type of pain relief, such as an epidural, later in labor.</p> <p>If you are interested in using nitrous oxide for pain management during labor, talk with your obstetric provider.</p> <p><em><a href="/providers/jennifer-meyers-cnm" target="_self" title="Opens in same window.">Jennifer Meyers</a> is a certified nurse-midwife in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Adolescent and college-aged healthcare</li> <li>LGBTQ+ concerns</li> <li>Perinatal mental health</li> <li>Sexuality</li> </ul>C.N.M.<p>I have been a midwife since 2007. My favorite part of my practice is building meaningful relationships with patients and families.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degrees, Nursing and Psychology, Concordia College</li> <li>Master's degree, Nursing, Frontier School of Nursing</li> <li>Master's degree, Psychology, University of Nebraska</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Midwifery Certification Board</li> <li>Perinatal Mental Health Certification</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Obstetrics and Gynecology, Mayo Clinic College of Medicine and Science</li> </ul>Meyers<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/jennifer-meyers-cnm-apnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=00390B580B9B33A73E716B235CA9F994" alt="Jennifer Meyers, CNM, A.P.N.P." width="280" height="280" title="Jennifer Meyers, CNM, A.P.N.P." DisableNVelocity="true" />Jennifer<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14585910Jennifer Meyers, C.N.M.1{54693F31-87AF-4B21-91DB-1DEC1E21F878}<img src="/-/media/national-files/images/hometown-health/2017/birth-baby.jpg?h=504&iar=0&w=504&sc_lang=en&hash=E69B8A32BBFAC5018BBB3E2666522E0B" alt="Mother with newborn" width="504" height="504" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Michele Halterman2/27/2023Women all of ages should take heart disease seriously. The more you know about the nation's No. 1 killer of women, the better. Test your knowledge about heart disease in women.Heart disease in women: Symptoms, risk factors<p>Sweating, nausea, dizziness and unusual fatigue may not sound like typical heart attack symptoms. However, they are common for women and may occur more often when resting or asleep.</p> <p>Pain, pressure or discomfort in the chest is not always severe or even the most prominent heart attack symptom, particularly in women. That’s why women need to understand their unique symptoms and work to reduce their risk of heart disease.</p> <p>Certain factors play a more significant role in the development of heart disease in women than the traditional risks of high cholesterol, high blood pressure and obesity.</p> <h2>Women should control these risk factors to help prevent heart disease:</h2> <ul> <li>Diabetes</li> <li><a href="/hometown-health/speaking-of-health/tips-to-keep-stress-from-hurting-your-heart" target="_self" title="Opens in same window.">Mental stress</a> and depression</li> <li>Smoking</li> <li>Sedentary lifestyle</li> </ul> <p>Certain conditions, including menopause, broken heart syndrome and pregnancy complications, also may increase a woman's risk for heart disease.</p> <p>Women all of ages should take heart disease seriously. Women tend to seek care in emergency rooms after heart damage has already occurred, because their symptoms are not those usually associated with a <a href="/hometown-health/speaking-of-health/what-should-i-do-if-i-might-be-having-a-heart-attack" target="_self" title="Opens in same window.">heart attack</a>, and they tend to downplay their symptoms.</p> <p>If you experience these symptoms or think you're having a heart attack, call for emergency medical help immediately.</p> <h2>Test your knowledge about heart disease and women</h2> <p>The more you know about the nation's No. 1 killer of women, the better. Here's a quiz to test your knowledge about heart disease and women.</p> <h3>True or False: Heart disease only affects older women.</h3> <p><strong>False: </strong>Heart disease affects women of all ages. The combination of birth control pills and smoking boosts heart disease risks by 20% in young women, according to the American Heart Association. And risk increases as women age. Overeating and leading a sedentary lifestyle are factors that lead to blocked arteries over time. Don't let your age lull you into a false sense of security. </p> <h3>True or False: Heart disease only affects women who don't take care of themselves.</h3> <p><strong>False: </strong>Unfortunately, all the salads and yoga in the world can't eliminate your heart disease risk. Family history often plays a factor.</p> <p>Knowing your heart health numbers can help. The American Heart Association recommends you start getting your cholesterol checked at age 20, or earlier if your family has a history of heart disease. And be sure to have your blood pressure checked regularly.</p> <h3>True or False: I feel fine; therefore, I am fine.</h3> <p><strong>False: </strong>According to the American Heart Association, 64% of women who die suddenly of coronary heart disease had no previous symptoms.</p> <p>And when women experience <a rel="noopener noreferrer" href="http://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/heart-disease/art-20046167" target="_blank" title="Opens in a new window.">symptoms</a>, those signs often are misinterpreted. Women's symptoms often are vague — shortness of breath, nausea/vomiting, and back or jaw pain. Other women experience dizziness, lightheadedness, pain in the lower chest or upper abdomen, and extreme fatigue. If something feels off or not right, don't wait to seek medical attention.</p> <p><a href="/providers/stacy-blackburn-do" target="_self" title="Opens in same window."><em>Stacy Blackburn, D.O.</em></a><em>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/prairie-du-chien" target="_self" title="Opens in same window.">Prairie du Chien</a>, Wisconsin.</em></p><ul> <li>Maternity care</li> <li>Osteopathic manipulation therapy</li> <li>Pediatric care</li> </ul>D.O.<p><strong>Education</strong></p> <ul> <li>Des Moines University Osteopathic Medical Center</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Mayo Clinic Family Medicine Residency Program</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Academy of Family Physicians</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Blackburn<img src="/-/media/shared-files/images/medical-professionals/full/prairie-du-chien/stacy-blackburn-do.jpg?h=325&iar=0&w=280&sc_lang=en&hash=CCF5A94F2B050B1C94515D2E2D81AB13" alt="Stacy Blackburn DO" width="280" height="325" DisableNVelocity="true" />Stacy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14786133Stacy Blackburn, D.O.1<img src="/-/media/national-files/images/hometown-health/2023/women-arm-in-arm.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3063DFDF79BB913B85F509E58103ABD3" alt="Women arm in arm" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Michele Halterman2/10/2017Another week of training is behind you. Good work! You’re getting closer to your goal, and you can do it. Make sure you’re giving your body the nutrients it needs to recover between workouts.Monday Run Day 4: Recipe for recovery<img alt="MRD_smooth_504x504" src="/-/media/national-files/images/hometown-health/2017/monday-run-day-smoothie-504x504.jpg?h=300&w=300&sc_lang=en&hash=89364CA8C60B2CD8EC15C9B9A627ECC6" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>Another week of training is behind you. Good work! You’re getting closer to your goal, and you can do it. Trust us, we’re here cheering you on and celebrating with you. So, how are you holding up? If you’re like other, normal human beings and not a superhero, you likely may find as you push yourself harder, your body is going through some changes to meet the challenge. Make sure you’re giving your body the nutrients it needs to recover between workouts.</p> <p>“After a run, your body is begging you to replenish used carbohydrates, electrolytes and sugar,” says Katie Johnson, a health educator at Mayo Clinic Health System. “Having a quick smoothie already made up to drink within 30 minutes post-run can help you to replenish the lost nutrients.”</p> <p>Johnson says you can make smoothies any way you like and change up recipes for variety — the combinations are virtually endless. Think about adding in some fresh fruit for quick sugar and fiber, Greek yogurt or nuts for protein, and maybe some oats for extra carbohydrates and calories. Your body will thank you, and your taste buds likely will not complain, either.</p> <p>For starters, try this post-run recovery recipe:</p> <p><strong>Fresh Fruit Smoothie</strong><br /> Serves 4</p> <p>Ingredients</p> <ul> <li>1 cup fresh pineapple</li> <li>1/2 cup cantaloupe or other melon</li> <li>1 cup fresh strawberries</li> <li>Juice of 2 oranges</li> <li>1 cup water</li> <li>1 tablespoon honey</li> </ul> <p>Remove rind from pineapple and melon. Cut into chunks. Remove stems from strawberries. You may want to refrigerate ingredients now to save until later. When you're ready to serve, place all ingredients in blender and puree until smooth. Serve cold.</p> <p><em>Created by the chefs at Mayo Clinic's Dan Abraham Healthy Living Center</em></p><img src="/-/media/national-files/images/hometown-health/2017/monday-run-day-smoothie-504x504.jpg?h=504&iar=0&w=504&sc_lang=en&hash=E7AA7C0D698B809EB40F9499CD5C4996" alt="MRD_smooth_504x504" width="504" height="504" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Michele Halterman2/13/2023Valentine's Day may sabotage your healthy weight plans. Learn what you can do to navigate this day full of indulgences so you can still enjoy it.Valentine's Day survival guide<p>The holidays are behind you and the new year has begun. Like many, you may be focusing on the goal of improving your health. Then comes Valentine's Day — a day that's full of indulgences which may sabotage your plans for health improvement.</p> <p>Even if you don't have a romantic partner, treats are all around on Valentine's Day. Usually, if the treats are there, it's hard not to eat them. So what can you do? Have faith, all is not lost.</p> <p>Many Valentine's Day gifts center around sweet treats. This year, express interest in a gift that doesn't include food, such as flowers or balloons.</p> <h2>Here are some additional tips that may help you achieve your health goals and enjoy Valentine's Day:</h2> <h3>Skip eating out:</h3> <ul> <li>Avoid 2,000-calorie entrees by preparing a leaner version of your favorite meal at home, including large portions of fruits and vegetables.</li> <li>Make a healthier, delicious dessert. Try this <a href="#Bavarian">Bavarian cream dessert recipe.</a></li> <li>Prepare the meal with someone you enjoy and have fun while you cook.</li> <li>Set the table with nice dishes and include candles and music for a beautiful presentation.</li> <li>Eat one or two dark chocolates, but decline a full box.</li> </ul> <h3>Start a food-free Valentine's Day tradition:</h3> <ul> <li>Try a new physical activity, like bowling, cross-country skiing, skating, snowshoeing or just going for a walk.</li> <li>Head to the gym or yoga studio with your significant other.</li> <li>Write a love letter.</li> <li>Plan a scavenger hunt.</li> <li>Host a dance party in the kitchen.</li> </ul> <h3>Satisfy your sweet tooth in a healthy way:</h3> <ul> <li>Grill fruit, such as bananas, peaches and pineapple. These fruits are delicious grilled and can be served with a dollop of fat-free whipped topping.</li> <li>Make a fresh fruit salad.</li> <li>Drizzle dark chocolate over fresh strawberries.</li> <li>Serve yogurt with fruit.</li> <li>Try a fruit that you've never tried before.</li> </ul> <h4 id="Bavarian">Try this Bavarian cream dessert:</h4> <ul> <li>1 cup skim milk (may use 1 cup of water and vanilla shake powder)</li> <li>1 1.4 ounce sugar-free vanilla instant pudding mix</li> <li>1 cup vanilla sugar-free, low-fat yogurt</li> <li>1 cup fat-free sour cream</li> <li>1 can light cherry pie filling</li> <li>Fat-free or light whipped topping</li> </ul> <p>Mix milk and pudding together. Add yogurt and sour cream. Add cherry pie filling, and top with whipped topping.</p> <p>Nutrition information: 160 calories per cup</p> <h3>Celebrate American Heart Month or Black History Month instead</h3> <ul> <li>Attend a special lecture, museum exhibit or film screening.</li> <li>Support Black-owned businesses.</li> <li>Participate in an organized heart walk or a monthly step challenge.</li> <li>Go to health demonstrations, presentations, and cholesterol and blood pressure screenings to understand your individual risk for heart disease.</li> </ul> <p>Get additional resources for <a href="/topics/eat-well" target="_self" title="Opens in same window.">eating well</a>, <a href="/services-and-treatments/weight-management" target="_self" title="Opens in same window.">managing weight</a> and <a href="/topics/move-more">moving more</a>.</p> <p>Last, but not least: Don't forget the card.</p> <p><em>By Mayo Clinic Health System staff. </em></p><img src="/-/media/national-files/images/hometown-health/2023/flower-bouquet-in-paper-wrap.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5E63EC655D89E1B3F6050478F854283D" alt="Flower bouquet in paper wrap" width="660" height="370" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Michele Halterman4/18/2023Fever in an infant under 3 months old is cause for concern. Recognizing the signs that your infant is sick and then accurately checking their temperature can help determine how to respond to a fever.Recognizing and responding to infant fevers<p>Fever in an infant under 3 months old is cause for concern. Fever in this age group can be a sign of a serious bacterial infection that requires urgent medical treatment.</p> <p>While you don't have to check the temperature of a healthy-looking infant, it's vital to check your child's temperature if there are <a href="/hometown-health/speaking-of-health/do-ear-infections-always-need-to-be-treated-with-antibiotics" target="_self" title="Opens in same window.">signs of illness</a>, or if you believe your child may have a fever.</p> <h2>How to tell if your infant is sick</h2> <h3>Determining if an infant is ill can be difficult, but signs can include:</h3> <ul> <li>Appearing to have pale or yellow skin</li> <li><a href="/hometown-health/featured-topic/what-parents-should-know-about-rsv" target="_self" title="Opens in same window.">Breathing quicker</a> or harder than usual</li> <li>Crying and fussing even after efforts to comfort them</li> <li>Developing a new skin rash</li> <li>Seeming weaker and more tired than usual or hard to awaken</li> <li>Having a cough</li> <li>Feeding poorly</li> <li>Feeling warm to the touch</li> <li>Vomiting beyond the normal spitting up</li> </ul> <h2>What is a fever?</h2> <p>A fever is a single temperature reading of 100.4 degrees Fahrenheit or greater. However, not all methods of taking an infant's temperature are accurate.</p> <p>Oral and temporal, or forehead, thermometers aren't recommended for infants under 3 months old. Tympanic, or ear, thermometers aren't recommended until infants are 6 months old.</p> <h2>How do I check a rectal temperature?</h2> <p>A rectal temperature is a quick, easy and accurate way to measure an infant’s temperature. To take a rectal temperature, you need a digital multiuse thermometer, cool water and some lubricant, such as petroleum jelly. </p> <p>Start by cleaning the end of the thermometer with cool water. Never use warm water because it may affect the reading. Next, place a small amount of lubricant on the end of the thermometer. Place your child on his or her stomach with your hand just above the child's bottom, or on the child's back and raise the legs to the chest. Place the thermometer end 1/2 to 1 inch into the anal opening, and hold it loosely with two fingers. Keep the thermometer in place until it beeps, then remove it. Your child has a fever if the thermometer reads 100.4 degrees Fahrenheit or greater.</p> <h2>My child has a fever. What do I do next?</h2> <p>If your child has a fever, the next step is to take your infant to the nearest <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">emergency department</a>. If there's a serious illness causing your child's fever, quick diagnosis and treatment will help your child recover sooner.</p> <p>In the emergency department, the medical team will perform a physical exam and run a series of tests to identify the cause of your child's fevers. Some causes can be serious.</p> <h3>Tests may include:</h3> <ul> <li>Blood tests to look for blood infections and signs of infection elsewhere</li> <li>Chest X-ray to look for lung infections</li> <li>Lumbar puncture to look for <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/meningitis/home/ovc-20169520" target="_blank" title="Opens in new window.">meningitis</a></li> <li>Urine tests to look for urine or kidney infections</li> </ul> <p> An infant 1 month old or younger who has a fever likely will have to spend some time in the hospital until the cause of the fever is known and properly managed. Remember, fevers in infants 3 months old and younger are a big deal. Make sure you're checking a rectal temperature. If the temperature is 100.4 degrees Fahrenheit or greater, your child needs to be seen as soon as possible.</p> <p><em><a href="/providers/seth-gregory-md" target="_self" title="Opens in same window.">Seth Gregory, M.D.</a>, is a <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">pediatrician</a> in <a href="/locations/red-wing" target="_self" title="Opens in same window.">Red Wing</a>, Minnesota.</em></p><ul> <li>Infectious diseases</li> <li>Newborn care </li> <li>Sports medicine </li> </ul>M.D.<p>I have an interest in resident and medical student education, as well as, improving health measures in rural Minnesota.</p><p><strong>Education</strong></p> <ul> <li>Mercer University School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Pediatrics, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Neonatal resuscitation program</li> <li>Pediatric fundamental critical care support</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Pediatrics, Mayo Clinic College of Medicine and Science</li> </ul>Gregory<img src="/-/media/shared-files/images/medical-professionals/full/red-wing/seth-gregory-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=2CB958EE1B82415483DF428540DF3960" alt="Seth Gregory MD" width="280" height="280" DisableNVelocity="true" />Seth<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15933300Seth Gregory, M.D.1{02421E57-1F9C-4F00-BF77-56DA854DCF27}|{7746ADF8-715B-4593-8AAB-55D7F0467848}|{C8A905E8-82D3-45FC-9669-A5F09F2EF6CA}|{1299CFB6-B378-46AD-824F-16E1674179A6}<img src="/-/media/national-files/images/hometown-health/2023/newborn-infant-in-pink.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A45B60068AF3D5F142EBF55FB7C45FF3" alt="Newborn infant in pink" width="660" height="370" DisableNVelocity="true" />Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Michele Halterman3/31/2017Do you sometimes run out of steam partway through a run? When you are really pushing yourself, such as training for a marathon, you may need to fuel up during your workout.Monday Run Day 11: Fuel during and after exercise<img alt="MRD_energy_504x504" src="/-/media/national-files/images/hometown-health/2017/mrd_energy_504x504.jpg?h=300&w=300&sc_lang=en&hash=D9B5BE2D8D2655452D6A8638ADA9B84D" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p><em>By Mayo Clinic Health System staff</em></p> <p>Your runs likely are getting longer and your workouts more intense. Do you occasionally run out of steam partway through, even when you started out with a healthy breakfast and fueled up beforehand? When you are really pushing yourself, such as training for a marathon, you may need to fuel up during your workout, as well.</p> <p>If you are a recreational exerciser, working out three to four times a week for 45 to 60 minutes, you do not need to add additional food to supply energy for your workout. However, if you work out more than 90 minutes a day or more than once a day, it would be beneficial to add additional carbohydrates during a workout to maintain your energy.</p> <p>You may need an additional 30 to 60 grams of carbohydrates depending on the intensity of your workout. Examples include a 32-ounce sports drink (60 grams), banana (30 grams) or four fig cookies (45 grams).</p> <p>Meals post-workout should include carbohydrates to help replenish muscles with energy, but that doesn’t mean you need to carb load. Your muscles will become saturated when you’re taking in 3 to 5 grams of carb per pound of body weight.</p> <p>Your goal is to balance your intake of carbohydrates into your diet while replenishing your muscle stores. You are trying to promote good energy in your workout while keeping your weight in check. You also should incorporate protein into the meal for muscle repair. Try to avoid high-fat and fried foods post-workout.</p> <p>Finally, don’t forget the importance of hydration.</p> <p>Athletes should drink two to four cups of water two hours before a workout. During a workout, athletes should drink between one to one and a half cups every 15 minutes. After a workout, two to three cups of water per pound of weight lost should be replaced.</p> <p>Water is the best fluid to consume before and during an exercise. After exercise, a beverage with carbohydrates and electrolytes is recommended. It also is encouraged to eat a slightly saltier food for a snack, such as pretzels.</p> <p>You’ve invested a lot of time and energy already. Don’t let anything slow you down now. Give your body the fuel it needs to stay strong to the end, and you’ll come out a winner.</p> <p>Try this <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.mayoclinic.org/healthy-lifestyle/recipes/apple-cinnamon-muffins/rcp-20197656" target="_blank" title="Opens in a new window.">apple cinnamon muffin recipe</a> along with a 16-ounce glass of skim, 1% or soy milk for a post-run recovery snack.</p><img src="/-/media/national-files/images/hometown-health/2017/mrd_energy_504x504.jpg?h=504&iar=0&w=504&sc_lang=en&hash=935375024E0A3487449851346B136F5E" alt="MRD_energy_504x504" width="504" height="504" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Michele Halterman7/12/2019Medications and other treatments, such as a vagus nerve stimulator, can help people with epilepsy find seizure control.Vagus nerve stimulation treatment for seizures<p>In a patient with newly diagnosed recurrent seizures, or <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.mayoclinic.org/diseases-conditions/epilepsy/home/ovc-20117206" target="_blank" title="Opens in a new window."><span>epilepsy</span></a><span>, medications typically are the first line of treatment. Approximately 70 percent of people with epilepsy are able to find seizure control using a single medication or a combination of two or more. For other people with epilepsy, other treatment options are used, including a <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.mayoclinic.org/tests-procedures/vagus-nerve-stimulation/details/why-its-done/icc-20167758" target="_blank" title="Opens in a new window.">vagus nerve stimulator</a>.</span></p> <p>There is one vagus nerve on each side of your body, running from your brainstem through your neck to your chest and abdomen. <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.mayoclinic.org/tests-procedures/vagus-nerve-stimulation/details/what-you-can-expect/rec-20167767" target="_blank" title="Opens in a new window.">Vagus nerve stimulation</a> is a system in which a device is implanted, typically by an ear, nose and throat physician, in your chest wall. This is similar to a pacemaker. Then, the device is connected to a wire that is wrapped around your left vagus nerve. The procedure uses a small incision, and most patients can go home the same day.</p> <p>After a two-week healing time, a neurologist turns on the device to a low setting during a clinic visit. Small electrical signals are sent to this nerve on a scheduled basis. It can be programmed to deliver electric impulses at various times, frequencies and currents. Each week, the device is monitored and adjusted until you reach a peak tolerance or find seizure control.</p> <p>Vagus nerve stimulation has effectively treated seizures for approximately 20 years, especially in patients who have partial seizures, which are a result of abnormal, uncontrolled electrical activity that starts in one small part of the brain. Studies found that patients found a significant reduction, up to 50 percent, in the frequency and intensity of seizures. Overall, this treatment is well-tolerated.</p> <h4>Learn more about seizures and epilepsy:</h4> <ul> <li>Not many people know how to react when observing somebody having a seizure. Read <a href="/hometown-health/speaking-of-health/how-to-help-someone-having-a-seizure" target="_self" title="Opens in same window.">how to help someone having a seizure</a>.</li> <li>For anyone who has epilepsy or a seizure disorder, life can be a challenging and uncertain journey. Read about a <a href="/hometown-health/speaking-of-health/new-option-for-seizure-answers-closer-to-home" target="_self" title="Opens in same window.">new option for seizure answers closer to home</a>.</li> <li>Jake Weiss felt like he was dying when his panic attack symptoms set in. Read his story of getting back behind the wheel after an epilepsy diagnosis.</li> </ul> <p><a href="/providers/scott-spritzer-do" target="_self" title="Opens in same window."><em>Scott Spritzer, D.O.</em></a><em>, is a <a href="/services-and-treatments/neurology" target="_self" title="Opens in same window.">neurologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Epilepsy and other neurological conditions</li> </ul>D.O.<p>In my spare time, I enjoy spending time with family and outdoor activities.</p><p><strong>Education</strong></p> <ul> <li>Doctor of Osteopathic Medicine, Midwestern University/Arizona College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Neurology, Mayo School of Graduate Medical Education, Mayo Clinic College of Medicine</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Epilepsy, Mayo School of Graduate Medical Education, Mayo Clinic College of Medicine</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Neurology, American Board of Psychiatry and Neurology</li> <li>Clinical Neurophysiology, American Board of Psychiatry and neurology</li> <li>Mayo Clinic Quality Fellow, Bronze Level</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Neurology</li> <li>American Epilepsy Society</li> <li>American Medical Association</li> <li>Wisconsin Medical Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Neurology, Mayo Clinic College of Medicine and Science</li> </ul>Spritzer<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/scott-spritzer-do.jpg?h=200&iar=0&w=200&sc_lang=en&hash=485562F16077B3B2D8830FB2B867D242" alt="Scott Spritzer, D.O." width="200" height="200" DisableNVelocity="true" />{612AFFD2-050B-4F69-BC9B-93F0A7051756}Scott<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15260917Scott Spritzer, D.O.1<img src="/-/media/national-files/images/hometown-health/2017/vsn_504x504.jpg?h=504&iar=0&w=504&sc_lang=en&hash=728CCA1BF6B636D7144DEC07AF7803B6" alt="Vagus nerve stimulation: Brain illustration" width="504" height="504" DisableNVelocity="true" />EpilepsyEpilepsy is a central nervous system disorder (neurological disorder) in which nerve cell activity in the brain becomes disrupted, causing seizures or periods of unusual behavior, sensations and sometimes loss of consciousness.Dawn Haller3/24/2017Are you starting to feel like the “The Little Engine that Could?” As you continue to push yourself, remember that nutrition is an incredibly important piece of the puzzle.Monday Run Day 10: Fuel before exercise<img alt="MRD_fuel_504x504" src="/-/media/national-files/images/hometown-health/2017/mrd_fuel_504x504.jpg?h=300&w=300&sc_lang=en&hash=161FECCA74BD3E8D82FB451A29BC249C" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>Are you starting to feel like the “The Little Engine that Could?” At this point in your training prep, you may find yourself saying, “I think I can, I think I can” almost on autopilot; but, perhaps your body is fighting back and saying, “Stop!” How is your energy holding up during workouts? As you continue to push yourself, remember that nutrition is an incredibly important piece of the puzzle. Be sure you are starting each run by properly fueling your body before you hit the road.</p> <p>Whether you’re an athlete or an everyday exerciser, it is important to fuel yourself before you exercise. Eat a snack or a light meal before your workout to increase your energy potential.</p> <p>Fueling before a workout can offer other benefits, such as preventing hypoglycemia. A light snack helps manage hunger, settles your stomach and fuels muscles with glycogen to enhance your exercise performance. </p> <p>What you eat before you exercise is up to you. The choices can vary from person to person and sport to sport. Many athletes use trial and error to determine what agrees with them for their type of exercise. Remember, it is important to try to incorporate a carbohydrate along with a small amount of protein and fat.</p> <p>So, fuel up for peak performance and hit the road. Your hard work is paying off, and we know you can do it.<span style="color: #131313; font-family: 'Open Sans', Arial, sans-serif;"> </span></p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2017/mrd_fuel_504x504.jpg?h=504&iar=0&w=504&sc_lang=en&hash=AA90A0B5129E0E0D54A6910697870EB9" alt="MRD_fuel_504x504" width="504" height="504" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Michele Halterman4/3/2023Tinnitus, or ringing in the ears, can be more than just annoying. It can negatively affect your quality of life. Learn about strategies to help manage your symptoms.Is tinnitus making you miserable? <p>Tinnitus is a frequently reported symptom for audiology patients. It's commonly referred to as ringing in the ears, but it can be different sounds like buzzing, roaring, clicking, hissing or humming.</p> <p>Tinnitus is the sensation or perception of sounds that other people can't hear, and it doesn't have an external source. It lasts longer than five minutes and occurs more than once per week.</p> <p>According to the <a rel="noopener noreferrer" href="https://www.nidcd.nih.gov/health/statistics/quick-statistics-hearing" target="_blank" title="Opens in a new window.">National Institute on Deafness and Other Communication Disorders</a>, about 10%, or about 25 million, U.S. adults, have experienced tinnitus lasting at least five minutes in the past year.</p> <h2>Tinnitus causes</h2> <p>Usually, tinnitus is caused by an underlying condition. This could be age-related hearing loss, an ear injury, ear infection, ear canal blockage, medications or a problem with the circulatory system. Most of the time, tinnitus will improve when the underlying condition is addressed or with treatments that reduce the perception of the noise.</p> <p>For some people, tinnitus can be exceedingly bothersome and may even cause negative effects on their quality of life. Some say it makes their lives miserable. It can disrupt their sleep and cause communication issues, anxiety, irritability, concentration difficulties or depression. In extreme cases, some people with tinnitus have had suicidal thoughts or actions.</p> <h2>Treating tinnitus</h2> <p>Most people with tinnitus aren't severely affected; yet, discussing it with your health care team is important. They can focus on improving quality of life thanks to advancements in treatments and management strategies.</p> <p>Unfortunately, tinnitus can't be cured for some people. In these situations, management strategies can make symptoms less noticeable. Researchers and clinicians continually seek new and practical strategies to help patients manage their symptoms.</p> <h3>Not all strategies are appropriate for all patients, so patients and audiologists work together to create an individualized intervention plan, which could include:</h3> <ul> <li>Hearing aids</li> <li>Earwax removal</li> <li>Treating a circulatory condition</li> <li>Masking devices or white noise machines</li> <li>Relaxation therapies</li> <li>Medication adjustments</li> <li>Diet and lifestyle adjustments</li> </ul> <p>In addition, intensive behavioral therapies can help decrease a person's perception of tinnitus. These can help people learn coping techniques to make tinnitus symptoms less bothersome and help with other problems linked to tinnitus, such as anxiety and depression.</p> <p>Talk with your primary care provider or an audiologist if tinnitus interferes with your daily life or if you’re experiencing dizziness or hearing loss.</p> <p><a href="/providers/trista-williams-aud" target="_self" title="Opens in same window."><em>Trista Williams</em></a><em> is an <a href="/services-and-treatments/audiology" target="_self" title="Opens in same window.">audiologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Adult and pediatric diagnostics and treatment</li> <li>Assistive hearing devices</li> <li>Audiological evaluations</li> <li>Aural rehabilitation </li> <li>Bone conduction implants</li> <li>Custom earplugs for musicians</li> <li>Dizziness</li> <li>Earmolds and ear impressions</li> <li>Hearing aids for adults and children</li> <li>Hearing aid repairs</li> <li>Hearing conservation and noise-induced hearing loss</li> <li>Hearing loss</li> <li>Hearing protection</li> <li>Tinnitus</li> </ul>Au.D.<p><strong>Education</strong></p> <ul> <li>Doctor of Audiology, University of Wisconsin-Madison</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Medical College of Wisconsin</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Speech-Language and Hearing Association</li> <li>Fellow, American Academy of Audiology</li> <li>Wisconsin Speech, Language, and Hearing Association</li> </ul>Williams<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/trista-williams-aud.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B66BFEFAF424A92F66C7A90E7E4378F6" alt="Trista Williams, Au.D." width="280" height="280" DisableNVelocity="true" />Trista<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20678525Trista Williams, Au.D.1{18E5E65E-45C8-4C48-BD32-A914794E2AA4}<img src="/-/media/national-files/images/hometown-health/2023/provider-giving-hearing-test-to-patient.jpg?h=370&iar=0&w=660&sc_lang=en&hash=152528874D0DE3D8AD1E22D2E872FA78" alt="Provider giving hearing test to patient" width="660" height="370" DisableNVelocity="true" />Ear HealthAn audiologist specializes in evaluating and treating people of all ages with hearing loss, dizziness and balance disorders. Specialty audiology consultation is available for assessment and treatment of hearing loss, tinnitus, dizziness and balance disorders.Michele Halterman3/30/2019A Mayo Clinic study asking participants 70 and older how their memory now compared with their memory of the past indicated that 4 in 5 had trouble remembering people’s names.Memory loss<a href="/-/media/national-files/images/hometown-health/2017/alzheimers-quick-facts-975x1241.jpg?sc_lang=en&hash=2E31F284EFFA5AE6474FB94EE8A55051" target="_blank" title="Opens in a new window."><img alt="Alzheimer Quick Facts" src="/-/media/national-files/images/hometown-health/2017/alzheimers-quick-facts-497x517.jpg?h=312&w=300&sc_lang=en&hash=7DB945DDAD95F0147E11906865FB173E" style="height: 312px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /></a> <p>A Mayo Clinic study asking participants 70 and older how their memory now compared with their memory of the past indicated that 4 in 5 had trouble remembering people’s names.</p> <p>The fairest thing to say about memory loss is that the most significant risk factor is aging. Most people will certainly experience some loss of memory in their 70s and 80s, but some start to notice it as early as their 50s.</p> <p>A mild degree of memory loss is quite common. But memory loss can be a symptom of dementia, which I define as the inability to think as well as you used to. Although Alzheimer’s disease — a progressive, degenerative brain cell disease that affects memory and mental function — is the most common form of dementia, the condition doesn’t necessarily include memory loss. It refers to degradation in thinking, caused by old age, that can affect your daily function.</p> <p>The best thing you can do to keep memory loss at bay and sustain mental function for longer is to maintain physical fitness, be intellectually engaged, make heart-healthy food choices and stay socially connected.</p> <p>When it gets beyond "Where are my car keys?" and "Where are my reading glasses?" — when you start to forget important information and, most importantly, those around you start to notice your forgetfulness — it doesn’t mean you have Alzheimer’s or dementia. But, it probably merits a look by your physician to examine what might be going on.</p> <h2>Brain games to help prevent dementia</h2> <p>Crossword puzzles, Sudoku, word searches, mazes: You might have heard that activities such as these can be effective brain games to stay sharp. Some of these claims are based on real science, and if you engage in these activities, you may keep yourself mentally fresher and sharper for a longer period of time. The big challenge is determining whether or not this transfers into any real-life activity. We think so, but we don’t know for sure.</p> <p><a href="/hometown-health/speaking-of-health/5-tips-to-keep-your-brain-healthy" target="_self" title="Opens in same window.">Keeping active mentally, physically and socially</a> might play a role in keeping your memory healthier for longer. There is increasing evidence now that lifestyle modifications can affect your cognitive function going forward. That doesn’t mean that lifestyle modifications will necessarily prevent Alzheimer’s disease.</p> <p>However, physical activity is healthy for your body, and playing games is just plain fun. So, why not take the gamble and enjoy life as fully as possible while you’re at it?</p> <p><em><a rel="noopener" href="http://www.mayoclinic.org/biographies/petersen-ronald-c-m-d-ph-d/bio-20054548" target="_blank" title="Opens in a new window.">Ronald Petersen, M.D., Ph.D.</a>, is a neurologist at Mayo Clinic and director of the <a rel="noopener" href="https://www.mayo.edu/research/centers-programs/alzheimers-disease-research-center" target="_blank" title="Opens in a new window.">Mayo Clinic Alzheimer’s Disease Research Center</a> in Rochester, Minnesota</em></p><img src="/-/media/national-files/images/hometown-health/2017/alzheimers-quick-facts-497x517.jpg?h=517&iar=0&w=497&sc_lang=en&hash=236238DC2FF5F418B7DAD0528A4522A7" alt="Get quick facts about Alzheimer's disease from Mayo Clinic Health System." width="497" height="517" DisableNVelocity="true" />Dementia/Alzheimer's DiseaseDementia isn't a specific disease. Instead, dementia describes a group of symptoms affecting thinking and social abilities severely enough to interfere with daily functioning. Many causes of dementia symptoms exist. Alzheimer's disease is the most common cause of a progressive dementia. AgingLife expectancy is 75 for males and 80 for females according to the National Center for Health Statistics. We'll help you keep you informed about potential issues with aging, and steps you can take to maintain your health and keep active.Michele Halterman8/2/2023Stroke symptoms come on suddenly. And women are more like to have a stroke than men. There’s an acronym to make it easy to recognize and act on these symptoms: Think FAST.With stroke, time is survival<p>What happened to my arm? Why can't I walk right? What's wrong with my mom's face? It's drooping on one side, and her words don't make sense.</p> <p><a href="/hometown-health/speaking-of-health/who-is-most-at-risk-for-a-stroke" target="_self" title="Opens in same window.">Stroke affects someone</a> about every 40 seconds in the U.S. Suddenly, life is changed.</p> <p><a href="/hometown-health/speaking-of-health/stroke-what-it-is-and-the-different-types" target="_self" title="Opens in same window.">Stroke</a> occurs when your brain isn't getting enough blood flow, which deprives brain cells of oxygen. That decreased blood flow can be from bleeding in the brain or blockage of the arteries supply blood to your brain. Without oxygen, brain cells lose function. If the situation isn't quickly corrected, it can cause cell death and permanent disability. </p> <p> That's why it's essential to know the common warning signs of a stroke. If you see the signs, it's time to call 911.</p> <h2>Stroke symptoms come on suddenly, and there's an acronym to make it easy to recognize and act on these symptoms. Think FAST:</h2> <ul> <li><strong>Face</strong> — Ask the person to smile. Does one side of the face droop?</li> <li><strong>Arms</strong> — Ask the person to lift both arms. Does one arm drift downward, or is the person unable to raise one arm?</li> <li><strong>Speech</strong> — Ask the person to repeat a simple or common phrase. Is the person's speech slurred or strange-sounding?</li> <li><strong>Time</strong> — If you notice any of these signs, call 911, because after 4½ hours, treatment options quickly evaporate.</li> </ul> <h2>Women and stroke</h2> <p>Women of all ages should pay more attention to the risk of stroke than men. In the U.S., about 55,000 more women than men have a stroke each year. While stroke is the fifth-leading cause of death for men, it is the third-leading cause of death for women. As the population ages, these trends are likely to continue to rise.</p> <p>Men and women share many of the same risk factors for stroke, but women have sex-specific risk factors, including pregnancy, use of oral contraceptives and hormonal therapy. About 3 out of 10,000 pregnant women will have a stroke during pregnancy, compared to 2 out of 10,000 women who are not pregnant. Women on oral contraceptives who also have high blood pressure double their risk for stroke. Preeclampsia, which is elevated blood pressure during pregnancy, doubles the risk of stroke later in life, even once blood pressure returns to normal after delivery.</p> <h2>Stroke risk factors</h2> <h3>Factors that increase the risk of stroke include:</h3> <ul> <li>A personal or family history of stroke or heart attack</li> <li>Being over age 55</li> <li>Being overweight or obese</li> <li>Certain <a href="/hometown-health/speaking-of-health/racing-heart-beat-heart-arrhythmia-101" target="_self" title="Opens in same window.">irregular heart rhythms</a></li> <li>Diabetes</li> <li><a href="/-/media/national-files/images/hometown-health/2021/know-your-numbers-blood-pressure.jpg" target="_self" title="Opens in same window.">High blood pressure</a></li> <li>High cholesterol</li> <li>Physical inactivity</li> <li>Smoking</li> </ul> <h4>In addition, some risk factors for stroke are more common in women than they are in men, including:</h4> <ul> <li>Migraines with aura — a type of headache accompanied by distortions in vision and hearing</li> <li>Cerebral vein thrombosis — blood clot formations in the brain</li> <li>Atrial fibrillation — an irregular and often rapid heart rate</li> </ul> <h3>The signs of stroke are the same for women and men, including:</h3> <ul> <li>Sudden numbness or weakness of the face, arm or leg, especially on one side of the body</li> <li>Sudden confusion, trouble speaking or understanding</li> <li>Sudden trouble seeing or blurred vision in one or both eyes</li> <li>Sudden trouble walking, dizziness, loss of balance or coordination</li> <li>Sudden severe <a href="/hometown-health/speaking-of-health/common-questions-about-headaches" target="_self" title="Opens in same window.">headache</a> with no known cause</li> </ul> <h2>Stroke treatment</h2> <p>It's worth repeating: If you have the symptoms of a stroke — think FAST — call 911 and get to a hospital emergency department immediately. Some treatment options are available only if you quickly get medical attention. Treatment will depend on time of symptom onset, whether you take blood thinners, and whether your stroke is from brain bleeding, or narrowed or blocked arteries. If your stroke results from bleeding in your brain, neurosurgical procedures may be done to help improve your recovery.</p> <p>If the stroke is the result of a narrowed or blocked artery, you may receive clot-busting medications or undergo a procedure to remove the blood clot.</p> <h2>Beyond the obvious</h2> <p>The onset of depression is triggered in more than half of people who experience a stroke. In addition to changing family dynamics, a stroke also can cause less obvious changes. Get physical and emotional care if you or someone you know has had a stroke, and speak to a health care professional about any questions or concerns.</p> <p>For yourself, your family and everyone else you care about, take time to know the symptoms of a stroke — think FAST. Encourage others to become aware, and learn about your personal risk factors. That way, if or when we meet, it's less likely to be in the Emergency Department.</p> <p><a href="/providers/felix-chukwudelunzu-md" target="_self" title="Opens in same window."><em>Felix Chukwudelunzu, M.D.</em></a><em>, is a <a href="/services-and-treatments/neurology" target="_self" title="Opens in same window.">neurologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Cerebrovascular disease</li> <li>Peripheral arterial disease</li> <li>Stroke</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Wayne State University School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Department of Neurology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Cerebrovascular Diseases, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Neurology </li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Diplomate, American Board of Psychiatry and Neurology</li> <li>Fellow, American Academy of Neurology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Neurology, Mayo Clinic College of Medicine and Science</li> </ul>Chukwudelunzu<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/felix-chukwudelunzu-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A7D0C727535C22801FA05BD51CB6AADF" alt="Felix Chukwudelunzu, M.D." width="280" height="280" title="Felix Chukwudelunzu, M.D." DisableNVelocity="true" />{38371586-2A4A-4B53-A65E-1B9DBFBC7ABF}Felix<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12003727Felix Chukwudelunzu, M.D.1{954F8C76-231B-4BB6-AB03-24CD0E4834AC}|{D68138A4-E93F-4DDA-BA2A-9B9545F14DD3}<img src="/-/media/national-files/images/hometown-health/2022/bearded-person-white-shirt-blue-stripes.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CC4956CCE42E91859049A62B1B95D2DE" alt="Bearded person wearing white shirt with blue stripes" width="660" height="370" DisableNVelocity="true" />StrokeAs one of the leading causes of death in the U.S., stroke will affect 80% of families during their lifetimes, according to the National Stroke Association. And the faster care you receive for stroke, the better. Learn more about stroke prevention, symptoms and treatments here.Stroke AwarenessA stroke occurs when the blood supply to part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and food. A stroke is a medical emergency. Prompt treatment is crucial. Early action can minimize brain damage and potential complications.<br/>Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Dawn Haller8/21/2025Women with urinary incontinence often think it’s untreatable and something they have to learn to live with. Thankfully, this is not the case, and there are many options to treating urinary incontinence, including surgery.Too Embarrassed to Ask: Is urinary incontinence in women treatable?<p>Women experiencing urinary incontinence often think it's untreatable and something they have to learn to live with. Thankfully, this is not the case, and there are many options to treating urinary incontinence, including surgery.</p> <p>The first step in determining what treatment option is right for you is to understand what type of urinary incontinence you are suffering from. There are four main types of urinary incontinence, including stress, urgency, mixed and overflow.</p> <p>If your leakage happens mostly with physical activity, such as coughing, sneezing, laughing or jogging, then you likely have stress incontinence or stress predominant mixed incontinence. On the other hand, if the leakage is mostly when you have a strong urge to urinate, then you likely have urgency incontinence or urge predominant mixed incontinence. </p> <h2>How do you know if surgery is the next step? Have you:</h2> <ul> <li>Tried simple treatments, such as a lifestyle modification, pelvic muscle exercises and bladder training?</li> <li>Consulted with your healthcare provider about medications and/or nonsurgical options?</li> <li>Decided you will not be getting pregnant in the future?</li> </ul> <p>If you have done all of these and still feel incontinence is interfering with your daily routine, your next step may be surgery.</p> <h3>If your urine leakage is associated with any of these symptoms, you should see your OB-GYN provider immediately:</h3> <ul> <li>Blood in the urine</li> <li>Painful urination</li> <li>Abdominal pain</li> <li>Pelvic pain</li> <li>Pelvic surgery or trauma</li> <li>Other pelvic problems, such as prolapse</li> <li>Neurologic symptoms, such as sudden numbness in the genitals or weakness in the legs</li> </ul> <h2>How do you determine what type of surgery is most likely to help with your symptoms?</h2> <p>The two most common types of surgery are midurethral sling surgery and bladder botox injections. If you're being treated for stress incontinence or stress predominant mixed incontinence, your provider may recommend the midurethral sling surgery. If you have urgency incontinence or urge predominant incontinence, your provider may suggest bladder botox injections.</p> <h2>What results should you expect from surgery?</h2> <p>Midurethral sling surgery typically is performed on those suffering from stress urinary incontinence. Studies show that over 77% of women with stress urinary incontinence are cured or have significant improvements lasting up to 11 years after surgery.</p> <p>Complications from sling surgery may include urgency symptoms, difficulty passing urine, urinary infection, difficulty with intercourse or groin and thigh pain. Note that many of these complications are temporary. Bladder botox injections are for patients with urgency incontinence. The effectiveness of the injection lasts on an average six months and provides an average cure rate for urgency incontinence of 58%.</p> <p>Women may experience difficulty passing urine and get a urinary infection. Other less common side effects include constipation, flu-like symptoms, dry mouth and malaise. </p> <p>Although urinary incontinence may not be glamorous to discuss with your provider, it's quite common among women. Our OB-GYN staff are highly trained to help you find the treatment option that best fits your lifestyle. </p> <p><a href="/providers/fadi-yahya-md" target="_self" title="Opens in same window."><em>Fadi Yahya, M.D.</em></a><em>, is an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a>, Minnesota.</em></p><ul> <li>Incontinence</li> <li>Infertility evaluation and treatment</li> <li>Menstrual disorders</li> <li>Pelvic pain and endometriosis</li> <li>Prolapse of pelvic organs, including uterus, bladder, rectum and bowel</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>American University of Beirut</li> <li>Master of Healthcare Administration, University of Southern California</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Obstetrics and Gynecology, American University of Beirut</li> <li>Riverside Regional Medical Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Obstetrics and Gynecology, American Board of Obstetrics & Gynecology</li> <li>Minimally Invasive Gynecologic Surgery Focused Practice Designation, American Board of Obstetrics & Gynecology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Obstetrics and Gynecology, Mayo Clinic College of Medicine and Science</li> </ul>Yahya<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/fadi-yahya-md.jpg?h=280&iar=0&w=280&hash=E736BD0910ABE8C3992BE5C3A07ABB0C" alt="Fadi Yahya, M.D." width="280" height="280" DisableNVelocity="true" />{668BC882-2740-41A2-AD6E-97954A90F269}Fadi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15562000Fadi Yahya, M.D.1<img src="/-/media/national-files/images/hometown-health/2017/urinary-incontinence.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4606A247C0BCA969AC72EEB4688A3007" alt="Too Embarrassed Urinary Incontinence blog image" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Urinary IncontinenceThe loss of bladder control is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that's so sudden and strong you don't get to a toilet in time. For most people, simple lifestyle changes or medical treatment can ease discomfort or stop urinary incontinence.Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Michele Halterman3/17/2017Cryolipolysis, also known as CoolSculpting, is a noninvasive cosmetic procedure that uses controlled cooling to eliminate fat cells underneath the skin that are resistant to diet and exercise. Here are 10 things you can do during your procedure.10 things you can do during a cryolipolysis procedure<img alt="cool_sculpting_504x504" src="/-/media/national-files/images/hometown-health/2017/use-your-time-wisely.jpg?h=300&w=300&sc_lang=en&hash=86BE777464B918F0E56B082603025E7A" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>Cryolipolysis, also known as CoolSculpting, is a noninvasive cosmetic procedure that uses controlled cooling to eliminate fat cells underneath the skin that are resistant to diet and exercise. It is easy, painless and effective.</p> <p>To help you use your time wisely, here are <a href="/-/media/national-files/documents/10-things-coolsculpting.pdf?sc_lang=en&hash=2FC45055C68BDCE53201C7565555F4E4" target="_blank" title="Opens in a new window.">10 things</a> you can do during your procedure:</p> <ol> <li><strong>Read.</strong> Lose yourself in an epic mystery novel, or get tips from a magazine. Either way, the hour will fly by.</li> <li><strong>Call your mom.</strong> You know she wants to hear from you. Now is the time to reconnect, ask how her day is going and get her famous casserole recipe.</li> <li><strong>Post on social media.</strong> Go ahead and tweet your experience, or post a photo or two on Facebook or Instagram. We have free Wi-Fi just for you.</li> <li><strong>Take a nap.</strong> We can turn down the lights to let you enjoy a few minutes of peace and quiet while you check your eyelids for holes.</li> <li><strong>Knit or crochet.</strong> Feeling crafty? This would be the perfect time to finish that scarf you have been putting off. Stitch two, purl one.</li> <li><strong>Shop for gifts.</strong> Experience the thrill of the hunt as you find and purchase that perfect gift for someone special using our free Wi-Fi.</li> <li><strong>Exercise your brain.</strong> Why not give your brain a workout? Crossword puzzles, Sudoku and other games will give you multitasking bragging rights for days.</li> <li><strong>Catch up on emails.</strong> If your email inbox is overflowing, now is the time to read and purge those messages that are weighing you down.</li> <li><strong>Set your fantasy lineup.</strong> Being a good GM for your fantasy sports team means you need to put in some time. So, research players, make a few trades and position your team to win the league championship.</li> <li> <strong>Meditate.</strong> Focusing on your breathing, and only your breathing, can make your mind calm and peaceful. What a good use of your time.</li> </ol> <p>In the weeks and months following your procedure, your body naturally processes the fat and eliminates these dead cells. Once the treated fat cells are gone, they're gone for good.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2017/use-your-time-wisely.jpg?h=504&iar=0&w=504&sc_lang=en&hash=8CC9C051EFBBED6A2A2E55B9D4956205" alt="Use your time wisely graphic" width="504" height="504" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Michele Halterman3/17/2017By now, you likely have put in hour after hour, day after day and week after week of training for this race. Have you found yourself begging family and friends for forgiveness while dedicating so much time to achieving your goal?Monday Run Day 9: Balancing training and family<img alt="MRD_time_504x504" src="/-/media/national-files/images/hometown-health/2017/mrd_time_504x504.jpg?h=300&w=300&sc_lang=en&hash=F3634CA27179DB9BC132FFCC0C02F974" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>By now, you likely have put in hour after hour, day after day and week after week of training for this race. That’s impressive! All that training time had to come from somewhere. Have you found yourself begging family and friends for forgiveness while dedicating so much time to achieving your goal?</p> <p><a href="/providers/dawn-mihalovic-bayer-pac" target="_self" title="Opens in same window.">Dawn Mihalovic-Bayer</a>, a physician assistant at <a href="/locations/barron" target="_self" title="Opens in same window.">Mayo Clinic Health System – Northland in Barron</a>, knows what it’s like to balance intense training with family obligations. As a mom of two girls, ages 10 and 13, Dawn and her husband, a teacher, have plenty to keep them occupied.</p> <p>“We have a pretty busy life for an average family,” Dawn says. “It helps that we have a couple of grandparents in the area.”</p> <p>It was being able to keep up with her girls when they were little that inspired Dawn to get active and into better shape, and that continues to motivate her. She says she’s always training for a marathon or triathlon but does not want her family to feel neglected.</p> <p>“It means getting up at dawn and being out at first light on the bike or in the pool when it’s dark, trying to get as much training as I can while my kids are still sleeping,” Dawn says. She also has managed to make training a family activity.</p> <p>“If I can incorporate them when I’m training, I do,” Dawn says. “I’ll take them to the pool or biking. Sometimes they run on the treadmill while I’m riding my bike inside on a trainer.” Both of her daughters are runners and triathletes, though her husband has yet to catch the bug.</p> <p>So, how does a busy mom who also works outside the home fit all that she needs to into a 24-hour day? Dawn says she has learned to make some adjustments, such as working a bit less during peak training for the Ironman Triathlon and cutting herself some slack.</p> <p>“I do cook all of our meals — I’m pretty big on nutrition — but my house isn’t as clean as it could be,” she says. </p> <p>You can do the same things Dawn does:</p> <ul style="list-style-type: disc;"> <li>Make priorities, and cut yourself some slack along the way to achieve balance.</li> <li>If they’re interested and able, consider getting your family involved in your training to have a positive impact on their health and fitness level, while also creating family memories.</li> <li>When you think about the long term, maybe a few chores can wait while you work through the toughest parts of this challenge. There will always be more dust, dirty dishes and laundry.</li> </ul> <p>This time is for you, and you’re worth the time and investment. When you cross the finish line, it all will be worth it.</p><img src="/-/media/national-files/images/hometown-health/2017/mrd_time_504x504.jpg?h=504&iar=0&w=504&sc_lang=en&hash=682DC472541A6904B599D3F4A29BA671" alt="MRD_time_504x504" width="504" height="504" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Dawn Haller4/23/2025 Eating and exercise are closely connected. Proper nutrition is essential for building strength and fueling activity. These five tips will get you started training for an athletic event. 5 nutrition tips to maximize your workouts <p>Are you looking for ways to maximize your workout or training plan, but are unsure where to start? An excellent starting point is nutrition. Eating and exercise are closely connected; proper nutrition is essential for building strength and fueling activity. Try these five nutrition tips to help boost the benefits of your exercise routine.</p> <h2>1. Eat a balanced diet of carbs, protein and fats.</h2> <h3>Carbohydrates</h3> <p>Eating a variety of carbohydrate sources, such as whole grains, fruits and vegetables, is key to optimizing sports performance, especially for high-intensity and long-duration exercise programs. Consuming carbs<strong> </strong>creates energy for the central nervous system and muscles, while also supporting digestion, microbiome health and immune function. Plan to eat carbohydrates throughout the day for meals and snacks. It's recommended that carbs make up 45%–65% of your total daily calories.</p> <h3>Protein</h3> <p>Protein supports energy metabolism, immune system function and hormone production. During a workout, it helps sustain your energy level, and afterward, it's essential for muscle recovery. Ideal protein intake is .6–.9 grams per pound of body weight per day. For example, if you weigh 150 pounds, you should be eating 90–135 grams of protein per day.</p> <p>For maximum benefit, spread your protein intake throughout the day. Aim for .12–.19 grams per pound in one sitting. If you weigh 150 pounds, plan to eat about 18 grams of protein per snack and 29 grams per meal.</p> <h3>Fats</h3> <p>Fats provide energy when your body is at rest, but they're also ideal fuel for low-intensity and long-duration activity. They play an important role in brain function, heart health, mental health, joint mobility and post-workout recovery. However, they also can trigger inflammatory responses.</p> <p>The type of fat does matter. Choose plant-based fats from avocados, olive oil, canola oil, almonds, pistachios, walnuts, and fatty fish like salmon, tuna and cod.</p> <p>Portion control also is a factor when it comes to fats, especially if you want to lose weight as you increase activity. Regardless of the type of fat, this macronutrient contains 9 calories per gram, which can add up. Total fats should account for no more than 20%–35% of daily calories.</p> <h2>2. Set pre-workout goals.</h2> <h3>When it comes to nutrition, consider these nutritional goals:</h3> <ul> <li>Consume enough calories from carbohydrates through foods and beverages high in carbs.</li> <li>Eat enough to prevent hunger. Concentrate on easily digested, high-quality carbohydrates such as bananas, grapes, watermelon, dates and peaches, and foods with low-to-moderate protein content, fiber and fat to prevent digestive issues.</li> <li>Drink adequate fluids and electrolytes.</li> </ul> <h3>Snacks can fuel a strong workout. Try these pre-workout snacks based on your exercise time frame:</h3> <ul> <li><strong>One or more hours before an activity</strong><br> 1/2 cup dry oatmeal with nuts and fruit</li> <li><strong>Up to one hour before an activity</strong><br> Banana and 1 tablespoon of natural peanut butter or energy bites</li> <li><strong>Five to 15 minutes before an activity</strong><br> Small handful of raisins or other dried fruit, 1 tablespoon of honey and an electrolyte drink</li> </ul> <h2>3. Set post-workout goals.</h2> <p>It's important to refuel as soon as possible after exercise. Aim to eat 30 minutes to two hours after your workout. Waiting longer than two hours may reduce your body's ability to replenish the nutrients it used through exercise by 50%.</p> <p>Take in enough carbohydrates to maintain blood glucose levels and restore glycogen, your body's store of glucose. By consuming 15–30 grams of protein, you maximize your synthesis of muscle protein.</p> <h3>Post-workout snacks can be heartier to begin replenishing your energy stores. These are good choices:</h3> <ul> <li>Veggie egg bake with whole-wheat toast.</li> <li>Protein drink or protein powder fruit smoothie.</li> <li>Roasted red pepper, chicken and hummus wrap with veggies and fresh cherries.</li> </ul> <h2>4. Know how to hydrate.</h2> <p>Losing just 2% of your body's fluid may decrease energy metabolism and lower cognitive function by 5%. To calculate the hydration you need, divide your weight by two for the total ounces per day. For example, if you weigh 150 pounds, you should take in a minimum of 75 ounces of fluid per day.</p> <p>If you're well-hydrated, you generally won't be thirsty. Thirst is a sign you're not taking in enough fluids. Be aware of the color of your urine — the lighter yellow it is, the more hydrated you are.</p> <p>Water, seltzer, juices, sports nutrition drinks, 6–12 ounces of coffee or tea and high-fluid fruits and veggies are good hydration sources.</p> <p>Other factors affect hydration when working out. Ensure you're eating enough<strong> </strong>carbs and sodium. Keep in mind that carbohydrate and sodium needs can vary dramatically by person.</p> <h2>5. Don't forget micronutrients, phytochemicals, functional ingredients and rest</h2> <h3>Micronutrients</h3> <p>Iron deficiency is most common among women and those with high-intensity exercise routines. Iron absorption may be best in the morning and after exercise. Be sure to pair iron-rich foods such as dark greens and leafy green vegetables with vitamin C to maximize absorption.</p> <p>Another nutrient to focus on is vitamin D, which benefits muscle function, bone health, immunity and hormone health. Omega-3 fatty acids from walnuts, salmon and cod are good for muscle recovery, heart health, and brain and immune function.</p> <h3>Antioxidant phytochemicals</h3> <p>One reason to <a href="/hometown-health/speaking-of-health/eat-the-rainbow-for-good-health" target="_self" title="Opens in same window.">"eat the rainbow"</a> is to gain the benefits of antioxidant phytochemicals found in a variety of whole plant foods. Eating these foods will boost performance, contribute to recovery and help maintain your overall health.</p> <h3>Functional ingredients</h3> <p>Functional food ingredients are substances thought to provide health benefits beyond basic nutrition.</p> <h4>Here are some that may affect your workout in a variety of ways:</h4> <ul> <li>Caffeine may improve cognition, concentration, muscular strength and power. The effects of caffeine peak about one hour after consuming it. However, before a race, competition or other type of event, consider avoiding caffeine for five days to two weeks to optimize your performance.</li> <li>Creatine may support muscular power, endurance, recovery, mental health and cognition.</li> <li>Collagen may benefit joint health.</li> </ul> <h3>Rest</h3> <p>Don't underestimate the power of rest, which is restorative for the body in various ways. Take time for rest days and strive for at least seven hours of <a href="/hometown-health/speaking-of-health/5-ways-to-get-better-sleep" target="_self" title="Opens in same window.">good sleep</a> each night.</p> <p>Whether you're training for a 5K, triathlon or endurance bike race, you'll perform your best with an optimal balance of nutrition, hydration, rest days and adequate sleep.</p> <p><em><a href="/providers/corrinna-lenort-rdn" target="_self" title="Opens in same window.">Corrinna Lenort</a> is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a>, Minnesota.</em></p> <ul> <li>Diabetes</li> <li>Weight management</li> </ul>RDN, LD<p>Patients can expect feeling seen and heard during appointments. I strongly believe in individualized nutrition care based on a patient's main concerns and health goals they want to focus on. My nutrition philosophy is small, sustainable changes for long-term success.</p> <p>I enjoy spending time with my family and friends. My hobbies include nice evening walks, being outside and squeezing in short exercises when a busy life schedule allows the opportunity. I aim to meet needs of people I encounter in my day. I enjoy cooking and trying new recipes; quick and easy are most realistic for me.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Dietetics, South Dakota State University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Dietetic Program, University of South Dakota Center for Disabilities</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetics Registration</li> <li>Minnesota Board of Dietetics and Nutrition Practice</li> </ul>Lenort<img src="/-/media/shared-files/images/medical-professionals/full/fairmont/corrinna-lenort-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=19F275E4907F391664940C0314CB187E" alt="Corrinna Lenort, R.D.N." width="280" height="280" DisableNVelocity="true" />Corrinna<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30259811Corrinna Lenort RDN1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2023/nutrition-for-workouts.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BDC36A28387890C48DB654070F0119E6" alt="Nutrition for workouts" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Michele Halterman3/15/2024The thrill of making a wager on the outcome of a big game can be exhilarating. But sports betting can spiral out of control if it becomes an addiction. Learn how to spot the signs of a problem.Don't bet on it: How to know when sports betting is more than entertainment<p>Sports betting has grown in recent years as more states allow online gambling. Throughout history, people have found that applying a wager on a contest makes the outcome more interesting and the online options make that type of betting more accessible than ever.</p> <p>Making a small wager on a game is fun and harmless for many people. The problem with gambling is the subtle way it can take over your behavior and sensibility. This change can happen slowly or quite rapidly depending on a number of variables. However, the outcomes tend to be the same: <a href="/hometown-health/speaking-of-health/7-anger-management-tips-to-prevent-relationship-damage" target="_self" title="Opens in same window.">damage to your relationships</a>, bank accounts, credit rating, and overall mental and physical health.</p> <h2>Gambling beliefs</h2> <p>Simple rules can help you manage your gambling, as well as give you warning signs that you may have a problem with gambling.</p> <p>The first thing to check is your attitude or belief about gambling. Your beliefs will affect the way you conduct yourself when making a wager. The act of gambling itself can strongly contribute to the formation of these beliefs. They may include the idea that gambling is an easy way to earn money or that gamblers are smart enough to beat the odds.</p> <p>You also may think that the more money spent gambling, the more you'll win. That belief is like the advertising "buy now and save" phrase seen in advertising. It sounds believable until you realize how illogical it is. Buying and saving are opposites; one doesn't lead to the other.</p> <h2>Gambling's effect on your brain</h2> <p>The act of gambling has a powerful effect on the human mind. Wagering can create a compulsive dynamic, affecting your mental, emotional and physical health. If your gambling <a href="/hometown-health/speaking-of-health/do-you-have-addictive-personality-traits-video" target="_self" title="Opens in same window.">tips over to addiction</a>, it changes the way the brain operates, leading to a real need for help.</p> <p>According to the Diagnostic and Statistical Manual of the American Psychiatric Association, the criteria for a gambling disorder is persistent, recurrent problematic gambling behavior leading to clinically significant impairment or distress.</p> <h3>A person exhibiting four or more of the following signs in a one-year period meets the criteria for a gambling disorder:</h3> <ul> <li>Being preoccupied with gambling, including having persistent thoughts of reliving past gambling experiences, handicapping or planning the next venture, and thinking of ways to get money to gamble more.</li> <li>Being restless or irritable when attempting to cut down or stop gambling.</li> <li>Chasing your losses after losing money gambling by trying to gamble more to get back to even.</li> <li>Gambling when feeling distressed, helpless, guilty, <a href="/hometown-health/speaking-of-health/addressing-your-mental-health-by-identifying-the-signs-of-anxiety-and-depression" target="_self" title="Opens in same window.">anxious or depressed</a>.</li> <li>Jeopardizing or losing a significant relationship, job, or educational or career opportunity because of gambling.</li> <li>Lying to conceal the extent of your gambling.</li> <li>Making repeated unsuccessful efforts to control, cut back or stop gambling.</li> <li>Needing to gamble with increasing amounts of money to achieve the desired excitement.</li> <li>Relying on others to provide money to relieve desperate financial situations caused by gambling.</li> </ul> <p>If any of this sounds familiar, it might be an indication that you need to reconsider your gambling habits. If your attempts to control gambling fail, consider seeking help from an addiction professional.</p> <h3>Once you accept that gambling is for entertainment only, follow these simple guidelines to manage it:</h3> <ul> <li>Avoid ATM machines or using lines of credit.</li> <li>Don't gamble while <a href="/hometown-health/speaking-of-health/does-drinking-alcohol-kill-brain-cells" target="_self" title="Opens in same window.">drinking alcohol</a>.</li> <li>Don't play a game you don't understand.</li> <li>Limit the time you spend gambling.</li> <li>Money for placing a wager should come only from your entertainment budget.</li> <li>Never borrow money while gambling.</li> <li>Never lie about your wins or losses.</li> <li>Only bet what you can afford to lose.</li> <li>Remember the principle of gravity: What goes up must come down.</li> </ul> <p>The No. 1 rule for gambling is don't chase your losses. Ultimately, you will lose money gambling. It's entertainment, not income. Otherwise, providers of that entertainment — casinos and online apps — would quickly be out of business.</p> <p> If you look forward to the annual activity of selecting your brackets or trying to pick the champion of the big game, just remember that gambling and wagering can be a slippery slope.</p> <h4>Watch this video about how to deal with addictions, including gambling:</h4> <p><iframe width="560" height="315" src="https://www.youtube.com/embed/RzX4DiPr_oQ" title="Dealing with addictions" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p><em><a href="/providers/brien-gleeson-lpc-csac" target="_self" title="Opens in same window.">Brien Gleeson</a> is licensed professional counselor in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p> <ul> <li>Adult children of alcoholics and co-dependency</li> <li>Families impacted by addiction</li> </ul> L.P.C., CSAC <p>I specialize in patients ages 10 and older.</p> <p><strong>Education</strong></p> <ul> <li>Social Work, University of Wisconsin-Eau Claire</li> <li>Guidance & Counseling - Alcohol and Other Drug Abuse, University of Wisconsin-Stout</li> </ul> <p><strong>Internships</strong></p> <ul> <li>Alcohol and Other Drug Abuse, Lutheran Social Services-Fahrman Center</li> <li>Social Work, Child & Family Services</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Clinical Substance Abuse Counselor</li> <li>Licensed Professional Counselor</li> </ul>Gleeson<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/brien-gleeson-lpc-csac.jpg?h=200&iar=0&w=200&sc_lang=en&hash=9897E606B8D6CE708B01D434A2CF31E6" alt="Brien Gleeson, L.P.C., CSAC" width="200" height="200" DisableNVelocity="true" /> {0AFC5615-156D-4364-B866-752114EC92E2}Brien<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14604442Brien Gleeson, L.P.C. 1{67744200-E25F-439A-8B70-572A5A091172}|{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2020/guy-group-excited-gestures.jpg?h=370&iar=0&w=660&sc_lang=en&hash=908FB1CA45350C2EFE2D89EFFD176EE3" alt="Guy group excited gestures" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Micah Dorfner3/8/2017Did you know your posture can contribute to shoulder pain? A common shoulder condition seen in the physical therapy clinic is referred to as shoulder impingement. Learn how improved posture can mean less pain and greater range of motion.Poor posture can cause shoulder pain<img alt="Shoulder Pain 2" src="/-/media/national-files/images/hometown-health/2017/shoulder-pain-2.jpg?h=225&w=400&sc_lang=en&hash=F78BB0D95380447C1B842A253B679137" style="width: 400px; height: 225px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /> <p>Did you know your posture can contribute to shoulder pain? A common shoulder condition seen in the <a href="/services-and-treatments/physical-therapy" target="_blank" title="Opens in new window">physical therapy clinic</a> is referred to as shoulder impingement. Often, rotator cuff tendons press on the coracoacromial arch of the shoulder, which causes pain with reaching movements, lying on the involved side and changes in the motion of the shoulder.</p> <p>Although some compression of this joint is good and considered normal, these forces are causing too much contact during shoulder motions in the impinged shoulder. Common causes of impingement include:</p> <ul style="list-style-type: disc;"> <li>Repetitive overhead movement</li> <li>Compression to the shoulder with a fall or other trauma</li> <li>Osteoarthritis</li> <li>Weakness</li> <li>Poor posture</li> </ul> <p>It’s important to know there are many different causes and types of impingement. Getting an evaluation to determine the cause for your symptoms is key. Essential components of managing this condition include improving the balance of strength and motion of the shoulder and changing posture.</p> <p><strong>Sources of shoulder strength</strong></p> <p>Most of us think of the rotator cuff when considering the strength of the shoulder, because the job of these smaller muscles is to give stability to the shoulder joint during movement. The larger muscles of the shoulder and back must support these smaller muscles in order to function efficiently.</p> <p>Shoulder and back muscles affect the position of the spine, shoulder blades and neck. All too often, they are weaker than the muscles in the front of our body due to prolonged sitting, sedentary lifestyles, and frequent and extended use of phones and computers. This change in balance to the shoulder and the resulting effect on posture keeps the rotator cuff from working well.</p> <p><strong>Posture and shoulder motion</strong></p> <p>Why does posture matter with shoulder pain?<strong> </strong>When you are resting, it may not. Unfortunately, changes in posture also can change the way we move and use our body. Our posture can impact: </p> <ul style="list-style-type: disc;"> <li>Positioning of the shoulder blade</li> <li>How efficient the muscles of the shoulder are</li> <li>How well the muscles work together</li> <li>Space available at the shoulder for movement</li> <li>Positioning of the arm as it raises</li> </ul> <p>Here’s an easy way to see how your posture changes the available motion of your shoulder. Sitting with slouched posture, raise your arm as high as you can manage. Do you feel tightness and pinching with this motion? Now, sit with your best posture and complete the same motion. Does your motion improve? Does your pain change?</p> <p><strong>How to improve posture</strong></p> <p>Basic posture changes to improve shoulder motion include rolling shoulders up and back, then letting them relax down, tucking chin down lightly, and sitting up from the hips. Sometimes standing against a wall and making contact with your hips, upper back and head can help gain this position. Keep your shoulder blades down and back to “pinch” the shoulders together lightly. </p> <p>Changing posture frequently and having greater awareness of positioning are vital to changing your habits. If you’re having difficulties with proper posture, you may want to consider getting professional help to gain motion, strength and knowledge to change your habits.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2017/shoulder-pain-2.jpg?h=225&iar=0&w=400&sc_lang=en&hash=443398D937489D76241DE576EDFB7CC3" alt="Shoulder Pain 2" width="400" height="225" DisableNVelocity="true" />Pain ReliefApproximately 50 million people in the U.S. live with chronic pain. If you experience chronic pain, you're not alone. Learn about the ways to deal with painful disorders, from at-home solutions to drug treatments, injectable or implantable therapies to surgery.Rehabilitation TherapyRestoring movement and function to people injured or impaired by disease or injury.Michele Halterman6/15/2020We’ve all been there. Your toddler is having a meltdown in the middle of the grocery store aisle. What do you do now? These 4 tips may offer some techniques you haven’t tried yet.4 tips for temper tantrums<p>We’ve all been there. Your toddler is having a meltdown in the middle of the grocery store aisle. What do you do now? Temper tantrums are an immature way of expressing negative feelings.</p> <h3>These 4 tips may offer some techniques to help your child channel their feelings in a positive way:</h3> <h4>1. Encourage your child to talk about their feelings.</h4> <p>Give your child an emotional vocabulary by giving the feelings names. You could say, "I know you wanted that cereal. I understand that you're angry. Instead of screaming say: 'I'm mad.'"</p> <h4>2. Stay calm.</h4> <p>If you reward tantrums with something your child wants, the tantrums are likely to continue. Try redirecting your child to a different activity, or leave the room until they regain control.</p> <h4>3. Keep the child safe while not giving too much attention.</h4> <p>When your child quiets down, you might say, "Tantrums won't get my attention. If you want to tell me something, you have to use your words."</p> <h4>4. Try to keep your child on schedule with regular meals/snacks and sleep routine.</h4> <p>Children may have more tantrums when they are hungry or tired. Once your child is over their tantrum, come back together lovingly. To do this, you need to validate their feelings, help them process the situation and offer unconditional love. Try saying, "You were so angry. It looked like you felt…" and "I am here, and I always love you, even when you are screaming and upset."</p> <p>As your child’s self-control improves, tantrums should become less common. Most children begin having fewer tantrums by age 3 1/2. If you're having concerns about your child's tantrums, talk with a health care provider.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2020/toddler-pouting.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C067BF4A820B50A57C4732832B09F64B" alt="Toddler pouting" width="660" height="370" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Child DevelopmentWe all want our children to grow up happy and healthy. The reality is most all of them do — but at vastly different rates. Experts across Mayo Clinic Health System see thousands of children each year, and have the experience and resources to know what is normal and what may be cause for closer observation. This includes not only physical and motor skills development, but psychological and social skill advancement.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Back to SchoolMichele Halterman3/20/2023Spring has sprung. And with warmer weather comes time outdoors after a long winter. Remember these safety tips as you resume yardwork and clear clutter with spring cleaning.Make this spring a safe one<p>Spring has sprung. Well, at least it's trying. Spring in the Midwest is lovely, but it's important to keep safety in mind as the weather warms and outdoor activities resume.</p> <h2>Nothing can ruin a beautiful spring day like an accident, so remember these tips as you head out:</h2> <h3>Stinging insects</h3> <p>The bugs are back, and a sting can cause an allergic reaction. If you're stung, remove the stinger with a quick scrape of a fingernail or credit card edge. Treat reactions, such as redness, swelling, itching or discomfort near the site of the sting, with cold compresses and antihistamines.</p> <p>Seek immediate medical attention if you have tightness in your chest, difficulty breathing, swelling of your tongue, a hoarse voice, dizziness, nausea or a loss of consciousness.</p> <h3>Yardwork</h3> <p>Spring is the perfect time to clear your yard and landscaping of winter debris. Remember to wear gloves, goggles, sturdy shoes and long pants, especially around machinery.</p> <p>Use hearing protection when operating machinery. If you have to raise your voice to talk to someone an arm’s length away, the equipment noise can harm your hearing.</p> <h3>Sun safety</h3> <p>The sun's rays in the spring can be surprisingly intense, especially if you've been indoors for most of the winter. When outside, remember to wear a hat, sunglasses and sunscreen, which should be SPF 30 or higher.</p> <p>With the warmer weather, sun and outdoor activities, also comes the risk of dehydration leading to heat exhaustion or <a href="/hometown-health/speaking-of-health/when-temps-rise-remember-these-heatstroke-prevention-tips" target="_self" title="Opens in same window.">heatstroke</a>. So drink plenty of water and find shade on those warm days.</p> <h3>Smoke detectors</h3> <p>The start of daylight saving time is a good reminder to change the batteries in your home's smoke detectors. You should have a detector in each bedroom, outside each sleeping area and on each floor of the house, including the basement. Swap out the batteries and test your smoke detectors when you move your clocks ahead one hour.</p> <h3>Spring cleaning</h3> <p>You may feel motivated to clear some clutter or look for ways to make your house safer to navigate.</p> <h4>Keep these strategies in mind when cleaning to help avoid slips and falls:</h4> <ul> <li><strong>Remove clutter.</strong><br /> Extra boxes, cords and rugs should be stored in a safe place. All of these and more are fall hazards. Keep your house — inside and out — well-lit. Dark rooms and areas pose greater risks than spaces with adequate lighting.</li> <li><strong>Use support as needed.</strong><br /> If you walk with a cane or walker, make sure you use it. Also use hand railings, seating and nonslip treads throughout your home. Don't forget to include your bathroom and shower area.</li> </ul> <h4>Household chemicals on shelves, benches and countertops are another common, overlooked danger in the home. Be sure to: </h4> <ul> <li>Store chemicals in original containers. If that's not an option, clearly label the bottle or can.</li> <li>Keep cleaners and other toxins out of the reach of children.</li> <li>Read warning labels.</li> <li>Follow safety instructions.</li> <li>Have the Poison Control Centers phone number available: <a href="tel:1-800-222-1222">1-800-222-1222</a>.</li> <li>Properly dispose of expired, leaking or contaminated chemicals.</li> <li>Don't combine chemicals.</li> <li>Be diligent about hand-washing after using cleaners and other chemicals.</li> </ul> <h3>Medication safety</h3> <p>It's a good time to evaluate medications in your home. Always keep your medications in their original containers, except for those you place in a daily pill box. Use a pill box to help you take your medications as directed, and always store medication in a safe place. </p> <p>Never take another person's medication, share yours, or take more or less of a medication than directed. Appropriately dispose of unused or unneeded controlled substances and all old medications.</p> <p><a href="/providers/sandy-dahl-pac" target="_self" title="Opens in same window."><em>Sandy Dahl</em></a><em> is a physician assistant in the <a href="/services-and-treatments/emergency-medicine">Emergency Department</a> in <a href="/locations/osseo" target="_self" title="Opens in same window.">Osseo, Wisconsin</a>.</em></p>P.A.-C.<p><strong>Education</strong></p> <ul> <li>Master's degree, Physician Assistant Studies, Pacific University</li> </ul>Dahl<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/sandy-dahl-pa.jpg?h=200&iar=0&w=200&sc_lang=en&hash=E2094E51D233DD0189C7104A974A248F" alt="Sandy Dahl, P.A." width="200" height="200" DisableNVelocity="true" />Sandy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13746197Sandy Dahl, P.A.-C.1<img src="/-/media/national-files/images/hometown-health/2023/weedeating-wearing-rubber-boots.jpg?h=370&iar=0&w=660&sc_lang=en&hash=70EB58C74400D9B8AD9A107EAD9B317E" alt="Weedeating wearing rubber boots" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Michele Halterman11/10/2022About half of adults regularly have headaches. The pain be a dull ache or intense, impacting daily life. Follow these tips to find relief.6 tips for headache relief<p>It's common for adults to <span style="color: #333333;">occasionally </span>experience the tight, aching pain of a tension headache. According to the <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.who.int/mediacentre/factsheets/fs277/en/" target="_blank" title="Opens in a new window.">World Health Organization</a>, about 50% of adults worldwide have had headaches in the last year and about 30% have migraines.</p> <p>Headache pain can slow you down or even stop you in your tracks. It can be intense or a dull ache that lasts for a few days. Regardless of the exact symptoms, you want relief. </p> <h2>Here are six things you can do to help lessen headache intensity or frequency:</h2> <h3>1. Exercise regularly.</h3> <p>Exercise is good for your body, but it also is good for your brain. Exercise is the most effective lifestyle change to significantly reduce headaches.</p> <p>It's a natural stress reliever that lowers the tension that can trigger headaches and releases feel-good endorphins that block pain signals to the brain. Aim for 30 minutes of moderate exercise at least five days a week or 150 total minutes per week to experience the full benefit.</p> <h3>2. Limit caffeine.</h3> <p>Some over-the-counter headache medications include caffeine, and a small amount can help stop your headache. However, heavy caffeine use could be causing your headaches. Too much raises your blood pressure and can trigger a headache.</p> <p>Overall, up to 400 milligrams of caffeine per day is considered safe for most adults. Soda and energy drinks can be particularly high in caffeine, so closely monitor your intake. Any reduction can help, so aim for no more than one cup of coffee or tea a day.</p> <h3>3. Eat a healthy diet.</h3> <p>Some people with chronic headaches or migraines have found relief by changing their diets to eliminate specific foods. For some, a specific food may trigger a headache. For others, certain chemicals in foods can create a trigger load that can reduce the threshold for developing a headache. Check seasoning ingredients, too, as many contain gluten, sugar, salt, preservatives, and artificial colors and flavors.</p> <p>After eliminating potential trigger foods for some time, you can slowly reintroduce them one at a time. Some common foods to eliminate include highly processed foods, caffeine, chocolate, aged cheeses, processed meats high in nitrates, high-sugar foods, gluten and alcohol.</p> <p>Some people find that moving their diet away from processed foods to whole, made-from-scratch foods has made a big difference in their headaches. In addition, you may find that a daily multivitamin and supplements of riboflavin and magnesium help with headaches.</p> <h3>4. Avoid substances.</h3> <p>It's no secret that alcohol, tobacco and illegal drugs affect your brain. Many people who have chronic headaches or migraines are sensitive to alcohol. Limit your alcohol intake to one drink a day if you're a women or two drinks a day if you're a man. If you smoke, quit.</p> <h3>5. Get enough sleep.</h3> <p>Sleep is essential to our well-being, and getting an adequate amount can help reduce headaches. You may find you don't need the recommended full eight hours per night, but it's important you get enough to feel like you're functioning well.</p> <p>Avoid over- or under-sleeping, as this can trigger migraines. If you've been told you snore, talk to your health care provider about sleep apnea, which also can trigger headaches.</p> <h3>6. Relax and recharge.</h3> <p>Stress can make your head hurt, so find something you enjoy doing that reduces stress and gets your creative juices going. Headaches are more likely to occur when you're stressed, so do what you can to keep your stress level under control.</p> <p>Make time to take care of yourself, whether going to an activity or staying home. If you aren't recharged by hanging out with others, then have something at home that helps you get in sync with yourself again.</p> <p>As a bonus, these tips also help other health conditions, including heart disease, depression, Type 2 diabetes and high blood pressure.</p> <p>Talk with your primary care provider if you have headaches occurring a few times per week, are debilitating, last more than one day, or interfere with your daily activities, such as missing work or life activities.</p> <p><a href="/providers/kerri-crank-np" target="_self" title="Opens in same window."><em>Kerri Crank</em></a><em> is a nurse practitioner in <a href="/services-and-treatments/neurology" target="_self" title="Opens in same window.">Neurology</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Migraine treatment</li> <li>Sleep disorders</li> </ul>A.P.N.P.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Nursing, University of Wisconsin-Eau Claire</li> <li>Master's degree, Nursing, University of Wisconsin-Eau Claire</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Nurse Practitioner, American Nurses Credentialing Center</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Neurology, Mayo Clinic College of Medicine and Science</li> </ul>Crank<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/kerri-crank-np.JPG?h=280&iar=0&w=280&sc_lang=en&hash=797D346060D81751E1AC88BB09391349" alt="Kerri Crank, N.P." width="280" height="280" DisableNVelocity="true" />{83B8E8A5-0725-4297-AAF0-81658DABE125}Kerri <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13497669Kerri Crank, A.P.N.P.1{B98A8ABA-9382-4804-A585-EA5B53B1D179}|{1903C77E-B711-48A8-9BB1-1CB5B9B8DD8E}<img src="/-/media/national-files/images/hometown-health/2022/two-young-adults-backpacks.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6CA6442A12614345885CD9CC2BE0FEEF" alt="Two young adults wearing coats and backpacks" width="660" height="370" DisableNVelocity="true" />HeadacheHeadache is pain in any region of the head that feels like a sharp pain, throbbing sensation or dull ache. It may develop gradually or suddenly, and last for minutes or days.Michele Halterman11/30/2021Menopause can be a blessing and a curse. Learn how to tell if you're in menopause, what to expect and how to manage symptoms.Pausing to learn more about menopause<p>Menopause can be a blessing for those with a history of heavy periods and pelvic pain, but it also can be a curse for others with new-onset frequent hot flashes, drenching sweats, sleepless nights, mood swings, vaginal dryness and urinary disturbances.</p> <p><a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397" target="_blank" title="Opens in a new window.">Menopause</a> is defined as the cessation of the menses, and it is recognized to have occurred after one year of no menses. In the U.S., an estimated 6,000 women daily and more than 2 million women yearly reach menopause. With an average life expectancy of 81, women are spending greater than one-third of their lives in menopause.</p> <h2>Are you in menopause?</h2> <p>If you have not had a period in the last consecutive 12 months without an obvious cause for it, such as hormonal medications, thyroid problems, pregnancy or a prolactin disorder, you might be in menopause. Elevated levels of follicle-stimulating hormone can suggest menopause or perimenopause in a blood test. This blood test is not necessary to diagnose menopause, however.</p> <h3>Symptoms associated with menopause include:</h3> <ul> <li><strong>Hot flashes</strong> <br /> This is the most common symptom, and it is present in up to 80% of women.</li> <li><strong>Vaginal dryness</strong> <br /> This symptom is present in up to 47% of women.</li> <li><strong>Sleep disturbances</strong><br /> This symptom is present in up to 46% of women.</li> <li><strong>Sexual dysfunction</strong><br /> Apart from vaginal dryness, this symptom could include pain with intercourse and decreased desire.</li> <li><strong>Urinary symptoms</strong><br /> Menopause increases frequency of urination and increases the potential for infections.</li> <li><strong>New-onset depression</strong><br /> Women in menopause are 2½ times more likely to be depressed.</li> </ul> <p>These symptoms can begin before menopause, including the final menstrual period, during a phase called menopause transition. Hot flashes typically peak during the first two years after your last period, lasting on average for three to five years. In some women, hot flashes can last for 10 years of more.</p> <p>Perimenopause includes the menopause transition phase, and it lasts up to one year after menopause.</p> <h2>When and why does menopause happen?</h2> <p>Natural menopause happens when the ovaries permanently stop releasing an egg every month. The median age of natural menopause is 51. At birth, the ovaries contain about 1 to 2 million eggs contained in follicles. A significant proportion of these eggs undergo death through a process called atresia, leaving only 400,000 eggs at the time menstruation begins.</p> <p>With each menstrual cycle, roughly 1,000 follicles are recruited, but only one of these matures to become the dominant egg that gets released into the fallopian tubes in preparation for a potential pregnancy through a process called ovulation. Follicles produce estrogen.</p> <p>On average, a woman ovulates about 400 eggs in a lifetime. Once the ovaries run out of follicles, the estrogen levels drop and natural menopause occurs. This natural drop in estrogen, particularly a form of estrogen called estradiol, usually is gradual and leads to the symptoms associated with menopause and perimenopause. After menopause occurs, the body continues to produce a weaker form of estrogen called estriol that helps mitigate the symptoms.</p> <p>When menopause happens before 40, it is called premature ovarian failure. This can be caused by autoimmune disease, a history of ovarian surgery, chemotherapy, radiation, Turner syndrome and fragile X syndrome. Surgical menopause happens after the surgical removal of ovaries. Induced menopause is menopause caused by surgical removal and by medications, such as Lupron, which is used to treat gynecological problems, including pelvic pain and heavy bleeding.</p> <h2>What are long-term health risks associated with menopause?</h2> <h3>The lack of estrogen affects various systems in the body:</h3> <ul> <li><strong>Bone</strong><br /> A rapid loss of bone density occurs during the immediate years following menopause due to a lack of estrogen. This can lead to weakening of bones and an increased risk of fracture from trivial injury, especially fractures of the hip, wrist or spine. A balanced diet and routine exercise can help maintain bone integrity.</li> <li><strong>Heart and blood vessels</strong><br /> The estrogen produced before menopause protects against heart attacks and stroke. The decline in estrogen, along with other risks factors, such as high cholesterol, high blood pressure and a sedentary lifestyle, leads to an increased risk of heart attacks and stroke. Thus, it is important to eat healthy and maintain a normal diet.</li> <li><strong>Bladder and vaginal tissue</strong><br /> With decreasing estrogen, the lining of the vaginal canal becomes thinner, dryer and less elastic. This can lead to pain during sexual intercourse and an increased susceptibility to vaginal infections. This same lack of estrogen can lead to the urethra becoming inflamed and irritated, leading to more frequent urination and urinary infections. Lubricants and vaginal estrogen can help with these symptoms.</li> </ul> <h2>What is hormone replacement therapy? Am I eligible for it? Is it safe?</h2> <p>Hormone replacement therapy involves replacement of the estrogen hormones to help alleviate distressing menopause-related symptoms. If you have a uterus, you also will require progesterone to prevent excessive thickening of the uterine lining that can lead to precancer or cancer of the uterus.</p> <h3>Currently, hormone replacement is approved and considered safe for use in these ways:</h3> <ul> <li>Relief from moderate to severe hot flashes and night sweats</li> <li>Relief from moderate to severe genitourinary symptoms including urgency, frequency and vaginal dryness</li> <li>In the prevention of osteoporosis and for women who have had their ovaries surgically removed or have undergone menopause early</li> </ul> <p>In these cases, it's recommended to start hormone replacement within the first 10 years of menopause. New studies suggest potential benefits for mood, sleep and joint aches. Surgical removal of ovaries leads to a more abrupt drop in estrogen levels and more drastic symptoms, and this is often benefited by hormone replacement.</p> <p>Vaginal estrogen in the form of a cream or ring can be used in women who are more bothered by the genitourinary symptoms of vaginal dryness, urgency and increased frequency of urination. Low-dose topical formulations of testosterone, along with estrogen replacement, have been shown to improve sexual satisfaction in women who are past menopause.</p> <p>Testosterone therapy has not yet been approved by the Food and Drug Administration (FDA) for use in women, and it can be associated with theoretical risks of abnormal lipid panels, clitoral enlargement, abnormal hair growth and acne.</p> <p>Hormone replacement therapy should be used with caution in women with a history of stroke, heart attack, increased risk of blood clots, history of clots in the lungs of legs, breast cancer, estrogen-dependent cancers, allergy to estrogen, liver dysfunction and/or unexplained vaginal bleeding.</p> <h2>Are there any nonhormonal medications useful in managing menopausal symptoms?</h2> <p>The FDA has approved paroxetine, an antidepressant, for hot flashes associated with menopause. It can be used in women who have contraindications to traditional hormone replacement or who do not want to use hormonal medications. Other nonhormonal medications, such as gabapentin, pregabalin and clonidine, also have been used to manage hot flashes.</p> <h2>Do natural remedies help with menopausal symptoms?</h2> <p>Phytoestrogens, such as soybeans, herbal remedies, including St. John's wort, black cohosh, ginseng and vitamins, have been proposed to help with menopausal symptoms. In the U.S., none of these complementary medicines have been approved by the FDA for the use in menopause. Most studies have not shown that these have had much benefit over placebo in helping with menopausal symptoms.</p> <h2>Can lifestyle modifications help my hot flashes?</h2> <p>Exercise, avoidance of caffeine and alcohol, a well-balanced diet, dressing in layers, maintaining a low temperature in your surroundings and consuming cool drinks can reduce the severity of your symptoms.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2021/using-tablet-outdoors-smiling.jpg?h=370&iar=0&w=660&sc_lang=en&hash=09ACBC20552481AC0FF5F7F2FBFC1FD9" alt="Person using tablet outdoors and smiling" width="660" height="370" DisableNVelocity="true" />MenopauseMenopause is the permanent end of menstruation and fertility, defined as occurring 12 months after your last menstrual period.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Micah Dorfner4/25/2017Sleep apnea is a serious condition in which you repeatedly stop breathing or have shallow breaths while you sleep. When this happens, you may snore loudly or making choking noises as you try to breathe.Do I have sleep apnea?<img alt="Sleep Apnea" src="/-/media/national-files/images/hometown-health/2017/sleep-apnea.jpg?h=266&w=400&sc_lang=en&hash=79A4E1CF419307148A7D605A9C058643" style="width: 400px; height: 266px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /> <p><a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/sleep-apnea/basics/definition/con-20020286" target="_blank" title="Opens in new window.">Sleep apnea</a> is a serious condition in which <span>you repeatedly stop breathing or have shallow breaths while you sleep. </span>When this happens, you may snore loudly or making choking noises as you try to breathe. Your brain and body become oxygen-deprived, and you may wake up. This may happen a few times a night, or in more severe cases, hundreds of times during the night.</p> <p>More than 18 million American adults have sleep apnea, and many cases are undiagnosed. </p> <h2>Main types of sleep apnea</h2> <h3>Obstructive sleep apnea</h3> <p>This is the more common form, which occurs when throat muscles relax. When the muscles relax, your airway narrows or closes as you breathe in, and you can't get an adequate breath. This may lower the level of oxygen in your blood.</p> <p>Your brain senses this inability to breathe and briefly awakens you from sleep so that you can reopen your airway. This awakening is usually so brief that you don't remember it.</p> <p>You may make a snorting, choking or gasping sound. This pattern can repeat itself five to 30 times or more each hour, all night long. These disruptions impair your ability to reach the desired deep, restful phases of sleep, and you'll probably feel sleepy during your waking hours.</p> <h3>Central sleep apnea</h3> <p>This form is much less common than obstructive sleep apnea and occurs when your brain doesn't send proper signals to the muscles that control breathing. This means you make no effort to breathe for a short period of time. You may awaken with shortness of breath or have a difficult time getting to sleep or staying asleep.</p> <h3>Complex sleep apnea syndrome</h3> <p>Also known as treatment-emergent central sleep apnea, complex sleep apnea syndrome occurs when someone has both obstructive sleep apnea and central sleep apnea.</p> <h2><strong>Sleep apnea signs and symptoms</strong></h2> <h3>The most common signs and symptoms of obstructive and central sleep apneas include:</h3> <ul style="list-style-type: disc;"> <li>Loud snoring, which is usually more prominent in obstructive sleep apnea</li> <li>Episodes of breathing cessation during sleep witnessed by another person</li> <li>Abrupt awakenings accompanied by shortness of breath, which more likely indicates central sleep apnea</li> <li>Awakening with a dry mouth or sore throat</li> <li>Morning headache</li> <li>Difficulty staying asleep (insomnia)</li> <li>Excessive daytime sleepiness (hypersomnia)</li> <li>Attention problems</li> <li>Irritability</li> </ul> <h2>Sleep apnea risk factors</h2> <h3>Risk factors for obstructive sleep apnea include:</h3> <ul style="list-style-type: disc;"> <li>Excess weight</li> <li>Increased Neck circumference</li> <li>A narrowed airway</li> <li>Being male</li> <li>Being older</li> <li>Family history</li> <li>Use of alcohol, sedatives or tranquilizers</li> <li>Smoking</li> <li>Nasal congestion</li> </ul> <h3>Risk factors for central sleep apnea include:</h3> <ul style="list-style-type: disc;"> <li>Being older</li> <li>Heart disorders</li> <li>Using narcotic pain medications</li> <li>Stroke</li> </ul> <h3>Untreated sleep apnea can:</h3> <ul style="list-style-type: disc;"> <li>Increase the risk of high blood pressure, heart attack, stroke, obesity and diabetes</li> <li>Increase the risk of developing, or worsen heart failure</li> <li>Make arrhythmias ( irregular heartbeats) more likely</li> <li>Increase the chance of having work-related or driving accidents</li> <li>Increase the risk of complications with certain medications and surgery</li> </ul> <h2>Sleep studies</h2> <p><a href="/services-and-treatments/neurodiagnostics" target="_self" title="Opens in same window.">Sleep studies</a> are tests that measure how well you sleep and how your body responds to sleep problems. These tests can help your doctor find out if you have a sleep disorder and how severe it is. Sleep studies are the most accurate tests for diagnosing sleep apnea.</p> <h2>Treatment for sleep apnea</h2> <p>Sleep apnea is treated with lifestyle changes, mouthpieces, breathing devices and surgery. Medicines typically aren't used to treat the condition.</p> <p>The goals of treating sleep apnea are to restore regular breathing during sleep and to relieve symptoms, such as loud snoring and daytime sleepiness.</p> <p>Treatment may improve other medical problems linked to sleep apnea, such as high blood pressure. Treatment also can reduce your risk for heart disease, stroke and diabetes.</p> <h3>For milder cases of obstructive sleep apnea, your doctor may recommend lifestyle changes, such as:</h3> <ul style="list-style-type: disc;"> <li>Losing weight if you're overweight</li> <li>Exercising regularly</li> <li>Drinking alcohol moderately, if at all, and not drinking several hours before bedtime</li> <li>Using a nasal decongestant or allergy medications.</li> <li>Avoiding sleeping on your back</li> </ul> <p>If these measures don't improve your sleep or if your apnea is moderate to severe, then your doctor may recommend other treatments. Certain devices can help open up a blocked airway. In other cases, surgery may be necessary.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2017/sleep-apnea.jpg?h=266&iar=0&w=400&sc_lang=en&hash=D060AA8F27ADE1D4E1227D82B71B79DC" alt="Person wearing CPAP mask for sleep apnea" width="400" height="266" DisableNVelocity="true" />SleepSleep is essential to good health. It's one of the body's basic needs. But, what do you do when you have troubles sleeping, or getting enough hours of sleep? Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Michele Halterman4/24/2017It can be a shock to be diagnosed with a long-term illness. You likely will deal with many different feelings following your initial diagnosis, and it’s important to learn how to effectively cope with the daily stresses of living with your illness.3 Tips for living well with chronic conditions<img alt="blog_504x504_chronicCond2017" src="/-/media/national-files/images/hometown-health/2017/chronic-conditions.jpg?h=300&w=300&sc_lang=en&hash=FD26A016CF511A07E9FCF308BE5062FE" style="height: 300px; width: 300px;" /> <p>It can be a shock to be diagnosed with a long-term illness. You likely will deal with many different feelings following your initial diagnosis, and it's important to learn how to effectively cope with the daily stresses of living with your illness.</p> <h2>Here are three tips on how to live well with a chronic condition:</h2> <h3>1. Understand your condition.</h3> <p>Living with a long-term illness can be difficult, but knowing more about your disease can help you manage it and work toward acceptance. Here are some things you can do to be informed:</p> <ul> <li>Speak to your health care provider. Ask him or her for trustworthy websites, as not all online information is reliable. He or she also may be able to provide you with information for living with your condition.</li> <li>Reach out to others with similar conditions. Join a support group, national organization or find a social network.</li> <li>The more you learn, the more ordinary and in control you will begin to feel. This will help you to not let your disease control you. </li> </ul> <h2>2. Deal with new emotions.</h2> <p>As you begin to learn more about your disease, your feelings may change. The initial stress you may have felt may develop into sadness, confusion, anger or depression.</p> <h3>Fortunately, all of these feelings can be managed in a variety of ways:</h3> <ul> <li>Assess your feelings daily.</li> <li>Try <a href="/hometown-health/speaking-of-health/mindfulness-meditation-improve-your-quality-of-life" target="_self" title="Opens in same window.">meditation</a>.</li> <li>Write day-to-day events in a personal diary.</li> <li>Play an instrument or listen to music.</li> <li>Read a book or watch a movie.</li> <li>Get outside and <a href="/hometown-health/speaking-of-health/physical-activity-benefits-and-simple-steps" target="_self" title="Opens in same window.">exercise</a>.</li> <li>Spend time with loved ones.</li> <li>Speak with a therapist about your feelings.</li> </ul> <h2>3. Use your illness as a catalyst for personal growth.</h2> <p>One of the biggest mistakes some people make after a chronic illness diagnosis is dealing with it in an ineffective way. While some people choose to feel resentful about their disease, there are better alternatives.</p> <h3>Instead of focusing on what you cannot do, look for opportunities to better yourself:</h3> <ul> <li>Accept the new limitations of your illness.</li> <li><a href="/wellness/gratitude" target="_self" title="Opens in same window.">Practice gratitude</a> and positive thinking.</li> <li><a href="/hometown-health/speaking-of-health/3-health-benefits-of-volunteering" target="_self" title="Opens in same window.">Give back to others</a>, perhaps by donating your time or talents.</li> <li>Learn to play an instrument you have always wanted to try.</li> <li>Join a softball league or take an art class.</li> </ul> <p>Although living with a chronic condition often is difficult, it can be managed. Your health care team can help you answer questions and ensure you receive the care you need.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2017/chronic-conditions.jpg?h=504&iar=0&w=504&sc_lang=en&hash=C45C3D950166CFD494BA18AF20AD7E92" alt="Chronic conditions" width="504" height="504" DisableNVelocity="true" />Stress ManagementGuidance to help you reduce and manage daily stress.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Michele Halterman11/3/2022High consumption of sodium can increase adult risk of hypertension and stroke. Find out if it poses the same risk for children and how to reduce your family's sodium intake.Kids and sodium: Serious risks, alarming realities<p>When it comes to sodium intake among adults, the general consensus is that high consumption will increase risk of hypertension and stroke. According to the 2020–2025 Dietary Guideline for Americans, 45% of people 18 and older are living with hypertension. Hypertension is a preventable risk factor for cardiovascular disease and stroke. </p> <p> Does a high sodium intake pose the same risks for children and adolescents as it does for adults?</p> <p>Children and adolescents, ages 2–18, develop dietary patterns that tend to carry on through adulthood. According to the Centers for Disease Control and Prevention (CDC), about 9 in 10 children consume more sodium than recommended. The main source of excess sodium is processed foods.</p> <p>Roughly 1 in 6 children have high blood pressure during childhood, which remains a major risk factor for heart disease and stroke.</p> <h2>Americans consume too much salt</h2> <p>Table salt, or sodium chloride, consists of roughly 40% sodium and 60% chloride. In the U.S., approximately 90% of sodium consumption comes from sodium chloride.</p> <h3> Within the U.S. diet, the average person consumes salt:</h3> <ul> <li>From processed and prepared foods — 77%</li> <li>From natural sources — 12%</li> <li>Adding while eating — 6%</li> <li>Adding during cooking — 5%</li> </ul> <p>One teaspoon of salt equals 2,300 milligrams of sodium.</p> <h3>Daily recommended sodium intake guidelines for children and adolescents are:</h3> <ul> <li>Ages 1–3 — Less than 1,200 milligrams</li> <li>Ages 4–8 — Less than 1,500 milligrams</li> <li>Ages 9–13 — Less than 1,800 milligrams</li> <li>Ages 14–18 — 2,300 milligrams</li> </ul> <p>One fast food kid's meal can easily exceed 1,500 milligrams of sodium.</p> <h2>Concerning statistics</h2> <h3>According to the 2015-2016 National Health and Nutrition Examination Survey:</h3> <ul> <li>Of surveyed children and adolescents, 90% exceeded the recommended sodium level for their age.</li> <li>The average sodium intake was 3,393 milligrams per day, with a range of 2,000–5,000 milligrams per day.</li> <li>High school-aged students consumed roughly 400–800 milligrams more than younger school-aged kids.</li> <li>50% of sodium intake came from pizza, Mexican dishes, sandwiches — including burgers — cold cuts, soups, snacks and cheese.</li> <li>Girls consumed significantly less sodium than boys.</li> <li>Of total daily sodium consumption, 58% came from store-bought foods, 16% from fast food/restaurants and 10% from school cafeterias.</li> </ul> <h2>Sodium reduction is a must</h2> <p>The statistics are alarming, making reducing sodium intake among children and teens crucial. Children and adolescents' dietary habits often resemble those of their household and their environment. Taste preferences formed during childhood often carry into adulthood.</p> <p>Because much of the sodium intake comes from processed foods and restaurant foods, lowering sodium content across the food supply would contribute to significantly less sodium intake among children, teens and adults.</p> <p>Cooking meals at home also can significantly reduce sodium intake, specifically with the use of spices and herbs to replace sodium and enhance flavor. Reading nutrition facts labels of boxed, bagged and canned foods is important. Look for products that contain less than 140–200 milligrams of sodium per serving. At each meal, try to have only one product that comes from a bag, box or can.</p> <p>Lastly, grocery shopping, cooking and eating together with children gives parents and guardians the opportunity to model healthy dietary choices to create lifelong habits.</p> <p><em>Anne Harguth is a registered dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/waseca">Waseca</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2022/handing-bowl-of-salad-to-child.jpg?h=370&iar=0&w=660&sc_lang=en&hash=09107E057FB96246505C5FC1F7CB4441" alt="Handing bowl of salad to child" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Michele Halterman3/1/2023You've got a training plan and gear for your distance run, but don't forget about staying safe. Here's how to keep visible, prevent injury and summon help if you need it.Staying safe while on a run<p>Training for a distance race means logging a lot of miles — sometimes in cold, rainy or hot weather, sometimes in the early morning or in the evening, sometimes on streets or country roads. No matter the weather, time of day or route, make sure you're safe during all your training runs.</p> <p>Several things to think about when it comes to staying safe are being visible to drivers and bicyclists on the road or trail, preventing injury, and being able to summon help if you need it.</p> <p> You can address these concerns by developing and practicing safe running habits. Having the proper basic gear — down to your socks and shoes — is essential. Also, take advantage of high-tech gadgets designed for runners, such as LED-enhanced gear for running at night and phone apps to track your progress and help motivate you.</p> <h2>Here's a safe running checklist to get you started:</h2> <h3>Preparing to run</h3> <ul> <li>Dress for the weather, and be aware of the forecast.</li> <li>Be visible. Wear bright colors. In poor light conditions, consider reflective and/or LED-lighted gear.</li> <li>Wear well-fitting shoes and low-friction socks.</li> <li>Apply anti-chafing agents to those "tender" areas.</li> <li>Let someone know your route and what time you expect to return.</li> <li>Consider running in a group for safety, training camaraderie and motivation.</li> </ul> <h3>Helpful gadgets</h3> <ul> <li>Carry pepper spray if running in isolated areas or if there are aggressive dogs along your route.</li> <li>Take a fully charged phone with you. Not only is the phone for your safety, but it can help your motivation and pace if paired with music, podcasts or any of the myriad training apps available to runners.</li> <li>Use wearable identification with name, address, phone number, emergency contacts and medical information. In case of a medical emergency, if you can't speak for yourself, first responders will be able to immediately contact family members and communicate medical conditions or allergy information to medical staff.</li> </ul> <h3>While running</h3> <ul> <li>Be alert and aware of your surroundings.</li> <li>Keep earbud volume low so you can hear sounds around you.</li> <li>When running along roads, follow all traffic rules. Run against the traffic and not with the traffic, and be prepared to take evasive action.</li> <li>Look both ways at intersections. Make eye contact with drivers stopped at intersections before crossing.</li> <li>On multiuse trails, follow the rules of the road. If you alter your direction, look over your shoulder before crossing the path to avoid colliding with a passing runner or cyclist.</li> <li>Announce your approach when overtaking and passing other runners.</li> <li>Avoid unlit areas, especially at night, and run clear of bushes or parked cars.</li> <li>Ignore verbal harassment; keep your distance and keep moving.</li> <li>Trust your intuition about an individual or an area.</li> </ul> <p>Check out this <a href="/hometown-health/speaking-of-health/the-5-elements-of-fitness" target="_self" title="Opens in same window.">advice to avoid injuries while running</a>. Be safe and enjoy your training runs.</p> <p><em>Karla Marley is a <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapy</a> assistant in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2023/runner-wearing-headlamp.jpg?h=370&iar=0&w=660&sc_lang=en&hash=ED98AD7D8858FDFFA4E391FB9B558EA8" alt="Runner wearing headlamp" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Micah Dorfner4/11/2017Leaking urine from your bladder isn’t a normal part of being a woman. However, you may be lulled into thinking leaking is simply something you need to deal with. The best news is you can do something about it.Strengthening pelvic floor muscles can help prevent bladder leakage<img alt="Pelvicfloormuscles" src="/-/media/national-files/images/hometown-health/2017/pelvicfloormuscles.jpg?h=294&w=432&sc_lang=en&hash=460E7128EDD21C00F9006757FC3A4491" style="width: 432px; height: 294px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>Therapist: “Do you have any issues with your bladder?”</p> <p><span>Patient: “No. Well, I only leak with normal stuff like coughing and sneezing. But otherwise, I’m fine.”</span></p> <p><span>Leaking urine from your bladder isn’t a normal part of being a woman. However, you may be lulled into thinking leaking is simply something you need to deal with. Women may have increased risk factors for leaking, such as vaginal child birth, pelvic anatomy and menopause, but, again, it’s not normal. The best news is you can do something about it.</span></p> <p><strong><span>Pelvic floor muscles                                                                                                 </span></strong></p> <p><span><a href="http://www.mayoclinic.org/healthy-lifestyle/womens-health/multimedia/female-pelvic-floor-muscles/img-20006566" target="_blank" title="Opens in new window">Pelvic floor muscles</a> are a group of muscles that make up the bottom of the pelvic region. They have an important role in continence, supporting the pelvic organs, stabilizing the pelvis and in sexual activity. They are essentially like any other muscle in the body — they can be weak, stretched out, strong and tight. Generally, pelvic floor weakness and tension leads to pelvic muscle dysfunction. Weakness is a common cause for incontinence, and tension often leads to pelvic pain.</span></p> <p><span>Exercising these muscles can be important to prevent leaking, help with support and decrease pain. A big problem is that you can’t see these muscles like other muscles in your body. So, you may not realize they’re weak until one day you wet your pants or feel a bulge in your vagina. And you may not realize how tense your pelvic floor muscles can be until you experience pain with an activity like sexual intercourse.</span></p> <p><strong><span>Next steps</span></strong></p> <p><span>If you’ve identified potential pelvic floor muscle concerns, you’re likely wondering what to do next. Making an appointment with a pelvic floor physical therapist is a great start. The therapist can guide you in a program that’s right for you. If you have weakness, you can try <a href="http://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/kegel-exercises/art-20045283" target="_blank" title="Opens in new window">Kegel exercises</a>, which help you strengthen pelvic floor muscles.</span></p> <p><span>Improving pelvic floor function takes time and effort, but in the end, your muscles can work well for you again.</span></p> <em><a href="/providers/kelly-feddema-pt">Kelly Feddema</a> is a physical therapist at <a href="/locations/mankato">Mayo Clinic Health System in Mankato</a>.</em><ul> <li>Pelvic floor rehabilitation for men's and women's health</li> <li>Pelvic pain</li> </ul>P.T.<p>I am a physical therapist specializing in pelvic floor rehabilitation. I enjoy working with all aspects of pelvic health servicing men, women and children with issues such as urinary/fecal incontinence, constipation, pelvic pain and pre- and post-natal care.</p> <p>I have been practicing with a pelvic health focus for 20 years. I enjoy working on an individualized care plan with my patients to help as best as I am able to achieve the patient's therapy goals.</p> <p>In my spare time, I enjoy being with my family, Minnesota sports and the great outdoors!</p><p><strong>Education</strong></p> <ul> <li>Bachelor's Degree, Physical Therapy, The College of St. Scholastica</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Pelvic Rehab Practitioner, Herman & Wallace Pelvic Rehabilitation Institute</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Physical Therapy Association</li> </ul>Feddema<img src="/-/media/shared-files/images/medical-professionals/full/mankato/kelly-feddema-pt.jpg?h=280&iar=0&w=280&sc_lang=en&hash=3714117D30428F62D66D42CC9315D17F" alt="Kelly Feddema PT" width="280" height="280" DisableNVelocity="true" />{F89DC859-1DFF-48D7-96A7-39A5F991BB4C}Kelly<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12707899Kelly Feddema, P.T.1{7F12DA7A-1D3B-4F43-96BB-0B69DBAD2F9D}<img src="/-/media/national-files/images/hometown-health/2017/pelvicfloormuscles.jpg?h=294&iar=0&w=432&sc_lang=en&hash=89ECB0C299F73BCE457C3D4057681565" alt="Pelvicfloormuscles" width="432" height="294" DisableNVelocity="true" />Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Michele Halterman4/7/2017As you push yourself through training, do you reward yourself with a refreshing treat at the end of your workout? Selecting the right treat can ensure your body gets the proper nutrients needed to repair itself.Monday Run Day 12: Recovery recipe 2<img alt="MRD_chocMilk_504x504" src="/-/media/national-files/images/hometown-health/2017/mrd_chocmilk_504x504.jpg?h=300&w=300&sc_lang=en&hash=789001402703501154FF37931BB103A4" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>As you push yourself through training, do you reward yourself with a refreshing treat at the end of your workout? Selecting the right treat can not only be a great pick-me-up, it also can ensure your body gets the proper nutrients needed to repair itself. This allows you to progress toward your goal of having that shiny marathon medal around your neck.</p> <p>“Consuming adequate fluids, carbohydrates and protein after a long or intense run can help you recover more quickly,” says <a href="/providers/laura-knudsen-rdn-cd" target="_self" title="Opens in same window.">Laura Knudsen</a>, a registered dietitian at Mayo Clinic Health System – Red Cedar in Menomonie. “This can be especially helpful if you are running or working out twice in one day to get your extra mileage in, or perhaps you are working out in the evening and planning to get up early the next morning to go for another run.”</p> <p>Laura says after a long run you need fluids to replace what you lost in your sweat, plus 50 grams of carbohydrate and 15 grams of protein to help replenish your glycogen and repair your muscles. One quick and easy way to meet those criteria is to drink 16 ounces of chocolate milk within 30 minutes of completing your run. You’ll also feel like a kid again, which always is an added bonus.</p> <p>For a little more substantial treat after a long run, this fruit and yogurt smoothie recipe will fit the bill:</p> <p><strong>Fruit and yogurt smoothie</strong> (makes about 24 ounces)</p> <ul> <li>1 cup skim milk</li> <li>1 medium banana</li> <li>1 cup strawberries, fresh or frozen</li> </ul> <p>Place ingredients in a blender, and puree until smooth.</p> <p>One serving equals 366 calories, 74 grams carbohydrate, 21 grams protein, 1 gram fat and 155 milligrams sodium.</p> <p>You’ll want a few different options for variety. Check out this <a href="http://www.mayoclinic.org/healthy-lifestyle/recipes/fresh-fruit-smoothie/rcp-20049983" target="_blank" title="Opens in a new window.">fresh fruit smoothie recipe</a>.</p> <p>You’re doing great! Don’t forget that with all that hard work you’re putting in to train, you also need to reward yourself. You, and your body, deserve it.</p><img src="/-/media/national-files/images/hometown-health/2017/mrd_chocmilk_504x504.jpg?h=504&iar=0&w=504&sc_lang=en&hash=59A8043EC2B920F9E0489639E1A1D39B" alt="MRD_chocMilk_504x504" width="504" height="504" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Micah Dorfner4/5/2017Sleep provides the foundation for all our daily habits and decisions. A lack of quality sleep can negatively impact our mood as well as our ability to focus on daily tasks. To maximize your sleep health, here are some tips you can follow.Sleep is the foundation for healthy habits<img alt="mansleepinginbed" src="/-/media/national-files/images/hometown-health/2017/mansleepinginbed.jpg?h=267&w=400&sc_lang=en&hash=19F3301C3DFF68A1AAC3B47E65B9556B" style="width: 400px; height: 267px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive"> <p>Adequate, <a href="http://www.mayoclinic.org/diseases-conditions/insomnia/expert-answers/lack-of-sleep/faq-20057757" target="_blank" title="Opens in new window">quality rest each night is essential for good health</a>. Sleep provides the foundation for all our daily habits and decisions. A lack of quality sleep can negatively impact our mood as well as our ability to focus on daily tasks. To maximize your sleep health, here are some tips you can follow:</p> <ul style="list-style-type: disc;"> <li><span style="letter-spacing: -0.15pt;">Even moderate exercise, such as walking, can help you sleep better. Aim for at least 30 minutes of moderate exercise three times a week or more.</span><span> Just make sure you don’t work out within three hours of bedtime.</span>  </li> <li><span>Alcohol and caffeine (found in coffee, tea, chocolate and some pain relievers) can interfere with sleep. If you have trouble sleeping, avoid caffeine eight hours before bedtime. Smokers should also avoid tobacco too close to bedtime.</span> </li> <li><span>Dimming the lights in your bedroom and turning off all electronics about 30 minutes to an hour before bedtime can be very helpful to increase the release of <a href="http://www.mayoclinic.org/drugs-supplements/melatonin/background/hrb-20059770" target="_blank" title="Opens in new window">melatonin</a>. Melatonin is a hormone that helps regulate your body's internal circadian clock. It increases in the evening as it becomes dark, which helps induce sleep, and shuts down when it's light outside, which can then increase wakefulness and alertness.</span> </li> <li><span>Indigestion from spicy or fatty food or having too much food in your stomach can cause insomnia. For a better night's sleep, eat light, simple foods at least three hours before bed.</span>  </li> <li><span>Stress and overstimulation can make it hard to fall asleep. Try to avoid intense television programs or movies before bed. Relax with a soothing, warm bath and curl up with a book instead.</span>  </li> <li><span>Create a comfortable sleep environment: t<span style="letter-spacing: -0.15pt;">ry sleep shades, earplugs, a white-noise machine or all three. Also, make sure the room is not too warm; temperatures between 60 and 70 degrees are considered the most comfortable. </span>Evaluate your mattress and pillows for proper comfort and support.</span>  </li> <li><span style="letter-spacing: -0.15pt;">If you can't fall asleep or you wake up and can't get your mind to shut down, avoid watching the clock, which can create more anxiety. If you have been awake more than 20 minutes, get up, go to another room and do something relaxing to help you get drowsy. Keep the lights low, have some warm milk, read a book or write about whatever may be on your mind until your eyelids get heavy.</span>  </li> <li><span>Snoring, especially when accompanied by daytime fatigue, can be a sign of <a href="http://www.mayoclinic.org/diseases-conditions/sleep-apnea/basics/definition/con-20020286" target="_blank" title="Opens in new window">sleep apnea</a>, a common disorder in which breathing repeatedly stops and starts as you sleep due to obstruction of your airway. Sleep apnea can leave you feeling exhausted during the day, can affect your mood and can even be dangerous to your health. If you are worried about sleep apnea, ask your primary care provider to refer you to a sleep specialist.</span></li> </ul> <p><span>By making sleep health a priority, you will begin seeing positive effects almost right away.</span></p> <span><em>By Mayo Clinic staff</em></span><img src="/-/media/national-files/images/hometown-health/2017/mansleepinginbed.jpg?h=267&iar=0&w=400&sc_lang=en&hash=C877EDC28D2276A90E41405444EEE55D" alt="Man sleeping in bed" width="400" height="267" DisableNVelocity="true" />SleepSleep is essential to good health. It's one of the body's basic needs. But, what do you do when you have troubles sleeping, or getting enough hours of sleep? Michele Halterman5/31/2017<span>Using a spiralizer is not only a great way to cut down or control carb intake, but it also is great for getting more of those nutrient-rich vegetables needed in your diet.</span>Get more veggies with a spiralizer<img alt="blog_504x504_spiralize" src="/-/media/national-files/images/hometown-health/2017/spiralizer.jpg?h=300&w=300&sc_lang=en&hash=A2CDC8F3FE0B3E762E77B9D6AA323745" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;"> <p>Have you been thinking about trying a spiralizer? A spiralizer cuts vegetables into a noodle shape.</p> <p>Using a spiralizer is not only a great way to cut down on or control carb intake, but it also is great for getting more of those nutrient-rich vegetables needed in your diet. Of course, these noodles do not taste like pasta; but, when prepared in dishes similar to those using pasta, they taste great.</p> <p>You can find spiralizers at most retail stores in many shapes and forms, from small hand-held models to countertop models in various sizes. They can be inexpensive depending on the size and model you choose.</p> <p>One of my favorite recipes is zucchini spaghetti. I was not sure I would like zucchini prepared this way or use a spiralizer on a regular basis, so I invested in an inexpensive hand-held model.</p> <p>The recipe I use is quick to prepare. I usually vary the recipe each time I make it, depending on what other vegetables I happen to have on hand. Adding any of the optional ingredients will increase your vegetable intake, as well. The best thing is that it turns out great each time. I also like to make a large amount of it so there are left overs, which makes for an even faster meal the next time. Here is the recipe:</p> <p><strong>Zucchini spaghetti</strong></p> <ul> <li>3-4 zucchini</li> <li>1 jar of spaghetti sauce or 1 can of tomato sauce and 1 can of tomato paste</li> <li>1 pound of lean ground beef, turkey or venison</li> <li>1 onion, chopped</li> <li>Garlic to taste, powdered, minced or fresh</li> <li>Salt and pepper, to taste; use your favorite pepper seasoning if you like spicier food</li> <li>Olive or coconut oil</li> <li>Parmesan cheese, low-fat cottage cheese or a light sprinkling of mozzarella (optional)</li> </ul> <p><strong>Directions:</strong><br> Wash zucchini, leaving the skin on, and cut off each end before spiralizing. After spiralizing the zucchini and while preparing the rest, you may prefer to place the zucchini in a strainer above a bowl, and sprinkle it lightly with a small amount of salt to help pull the water out. Rinse and blot off water with paper toweling. I prefer to sauté and drain. Be creative with the recipe. Consider adding carrots, broccoli, mushrooms, peppers, green beans, cauliflower or other vegetables you like. Wash and spiralize other vegetables, as desired. Using a large pan with a small amount of oil in the bottom, sauté all raw vegetables until tender (except zucchini). Remove vegetables from the pan, and transfer to a large pot or wok. Cook the meat using the same pan. Drain fat from meat, and add meat to the sautéed vegetables. Add spaghetti sauce to the mixture (adjust amount to your preference), place on low heat and stir occasionally. Sauté the zucchini until tender, drain and combine with the rest of the vegetables and meat. Sprinkle a little cheese on top prior to serving, if desired.</p> <p>Here’s an easy summer dessert or snack to go with it:</p> <p><strong>Blueberry Jicama Fruit salad</strong></p> <ul> <li>1 package blueberries</li> <li>1 cup seedless watermelon, cubed</li> <li>1 cup honeydew melon, cubed</li> <li>1 cup jicama, cubed</li> </ul> <p>Combine, and enjoy. Jicama is a root vegetable. Other common names for it are yam bean, Mexican water chestnut or Mexican turnip. It has a crisp, slightly starchy texture, sort of like a potato. Its flavor is slightly sweet and has been described as a cross between a water chestnut and an apple.</p> <p>Check out more healthy <a href="/locations/eau-claire/services-and-treatments/weight-management/recipes" target="_blank" title="Opens in a new window.">recipes</a> and additional weight management <a href="/locations/eau-claire/services-and-treatments/weight-management/resources" target="_blank" title="Opens in a new window.">resources</a>.</p> <p><em>Arlene Hrdlicka</em><em> is a registered nurse in <a href="/services-and-treatments/weight-management" target="_blank" title="Opens in a new window.">Weight Management</a> Services in <a href="/locations/eau-claire" target="_blank" title="Opens in a new window.">Eau Claire</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2017/spiralizer.jpg?h=504&iar=0&w=504&sc_lang=en&hash=623A29913D600A1669BD7E7892601F4F" alt="Get more veggies with a spiralizer" width="504" height="504" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Micah Dorfner5/30/2017<p>Are you finding yourself stuck in the same old eating patterns? One of the best ways to spice up your daily meals is to try something new that will benefit your health today.</p>Looking to try something new? Start with what you eat<img alt="Farmers Market" src="/-/media/national-files/images/hometown-health/2017/farmers-market.jpg?h=267&w=400&sc_lang=en&hash=A790F4B711C478E66024B950487168F0" style="width: 400px; height: 267px;" /> <p>Are you finding yourself stuck in the same old eating patterns? One of the best ways to spice up your daily meals is to try something new that will benefit your health today. Here are a few delicious and healthy food options to help you get started:</p> <ul style="list-style-type: disc;"> <li><strong>Nuts and seeds</strong><br /> Try chia seeds in your oatmeal, yogurt or smoothie, or a few walnuts on a salad or as a snack. Both will give you a boost of omega-3 fatty acids, which may reduce inflammation and improve cardiovascular health.</li> <li><strong>Proteins</strong><br /> Try a new recipe with salmon or tuna to increase your omega-3 fatty acid intake. Look to substitute beans or tofu for meat in a recipe. Many studies show health benefits of following a more plant-based diet, such as reducing risk of heart disease, Type 2 diabetes and some types of cancer. </li> <li><strong>Whole grains</strong><br /> Try quinoa, which is a complete protein source that is also high in fiber, vitamins and minerals.</li> <li><strong>Dairy</strong><br /> Try kefir for its probiotics, which may improve digestive and immune health. Just be sure to find a variety with less added sugar.</li> <li><strong>Fruits and veggies</strong><br /> They are full of vitamins, minerals and disease-fighting antioxidants. The more colorful, the better. Eat a rainbow of colors, and try them in a new way. You might not like some vegetables raw, but give them a chance steamed or roasted to bring out new flavors. You can even try grilled fruit, such as a grilled peach — it tastes like dessert! Try tart cherries for their anti-inflammatory effects or pomegranate seeds and kale, which are powerhouses for vitamins, minerals and antioxidants. </li> <li><strong>Tea</strong><br /> Try black, green or oolong tea for a flavored beverage that is also a major source of disease-fighting antioxidants.</li> </ul> <p>Variety really is the spice of life. Look up a new recipe, or try a new cooking class to incorporate new foods into your repertoire.</p> <p><em><a href="/providers/kristi-wempen-rdn">Kristi Wempen</a> is a clinical dietician in <a href="/locations/mankato">Mankato</a>, Minnesota.</em></p><ul> <li>Chronic kidney disease</li> <li>General health and wellness</li> <li>Weight management</li> </ul>RDN, LD<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Minnesota State University-Mankato</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Iowa State University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration</li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul> <p><strong>Membership</strong></p> <ul> <li>Academy of Nutrition and Dietetics</li> </ul>Wempen<img src="/-/media/shared-files/images/medical-professionals/full/mankato/kristi-wempen-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=BB7EFDC16603EA67B00B7CD0DBD528E1" alt="Kristi Wempen RDN" width="280" height="280" DisableNVelocity="true" />Kristi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14834341Kristi Wempen, R.D.N.1{2BEE5070-65FF-4406-9E59-103E06C5A535}<img src="/-/media/national-files/images/hometown-health/2017/farmers-market.jpg?h=267&iar=0&w=400&sc_lang=en&hash=81209CF22F0AB6A91E2F10493E5B41C6" alt="Farmers Market" width="400" height="267" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Michele Halterman9/23/2022<p>OB-GYN and Family Medicine can complete preventive health exams for women. So when do you see an OB-GYN and when should you see a family medicine professional?</p>When should a female start seeing a gynecologist?<p>With several choices in health care professionals and specialties, determining whom to see and when can be confusing. As an OB-GYN, one of the most common questions I hear from patients is, “What are the differences between the services offered by an OB-GYN and Family Medicine?” The second most common question is, “When should my daughter start seeing an OB-GYN versus her pediatrician or family medicine professional?” Both are excellent questions. However, the answers are not as straightforward as one might hope.</p> <h2>OB-GYN or Family Medicine?</h2> <p>OB-GYN and Family Medicine can complete preventive health exams for women. Both departments can screen for health diseases. So when do you see a gynecology professional and when should you see a family medicine professional? </p> <h3>Family Medicine is best suited if:</h3> <ul> <li>You have a chronic medical condition that requires medication or regular lab work, such as diabetes, high blood pressure or cholesterol, or chronic pain. </li> <li>You have an acute condition that might require antibiotics, such as ear infections, strep throat, <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.mayoclinic.org/diseases-conditions/cellulitis/basics/definition/con-20023471" target="_blank" title="Opens in new window">cellulitis</a> or upper respiratory symptoms. </li> <li>You have any new onset of pain or recent injury. </li> </ul> <h3>OB-GYN is best suited if:</h3> <ul> <li>You have questions or concerns regarding the female reproductive system, including breasts, uterus, ovaries and vulva. It also can include some urological or gastrointestinal symptoms.</li> <li>You have menstrual, pregnancy, fertility or contraception questions or issues.</li> <li>You have sexual health concerns, such as libido, pain or abuse. </li> </ul> <p>Some services provided by Family Medicine and OB-GYN overlap, such as birth control, thyroid disorder and mood changes. In these cases, it’s best to start with whomever you feel most comfortable with, and they can guide you further if your concerns cannot be addressed fully. </p> <h2>At what age should a female see an OB-GYN professional?</h2> <h3>A female could see an OB-GYN beginning at age 11 if she has concerns with:</h3> <ul> <li>Delayed puberty (no breast tissue changes before age 14) or delayed menarche (no menstrual cycles before age 16) </li> <li>Painful menstrual cycles, especially if missing school or activities due to symptoms</li> <li>Unable to wear a tampon or questions about genital anatomy</li> <li>Any sexual health questions or contraceptive needs</li> </ul> <p>For other young females, family medicine or pediatric professionals can address most other health needs, including general questions about puberty. Sports exams and immunization reviews are best in those departments.</p> <h2>When to begin Pap smears</h2> <p>It’s important to understand Pap smear screening recommendations continue to change over time as more is learned about HPV. As a result, many parents remain uncertain about when their daughter should begin this screening. The recommendation is to begin Pap smear screenings at age 21, regardless of sexual activity or birth control needs. </p> <p>At times, a pelvic exam or evaluation of the genitalia might be warranted. But this is not for Pap smear screening purposes. Also, HPV vaccination is recommended during the early teenage years — before sexual activity — to help prevent cervical cancer. Your health care team can give you more information regarding HPV vaccination at your appointment.</p> <em>Becky DeLuca is an OB-GYN nurse practitioner in <a href="/locations/new-prague">New Prague</a>, Minnesota.</em><img src="/-/media/national-files/images/hometown-health/2022/holding-towel-against-neck.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E50269B063C25DD123218180C6C31749" alt="Holding towel against neck" width="660" height="370" DisableNVelocity="true" />Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Michele Halterman9/14/2020Staring at digital screens often leads to tired eyes, blurred vision and headaches, but also can cause eye damage. Knowing the risks and how to safeguard your eyes from harmful blue light is important. <p> </p>Protect your eyes from harmful light<p> Staring at digital screens often leads to tired eyes, blurred vision and headaches, but also can cause eye damage.</p> <h3>Knowing the risks and how to safeguard your eyes from harmful blue light is important:</h3> <h4>Blue light</h4> <p>Not all blue light is bad. For example, sunlight is the main source of blue light. Being outdoors during daylight is where most people get the majority of their exposure. However, the world largely has become reliant on smartphones, tablets and laptops — technologies with displays that often produce large amounts of blue light. The long-term effects may be harmful. Blue light or blue-violet light can be damaging to delicate retinal cells deep in the eye. Additionally, studies have shown blue light is a risk factor for the onset of age-related macular degeneration, which is a progressive condition that can lead to vision loss over time.</p> <h4>Specialized lenses can help</h4> <p>One of the ways you can protect your eyes is to selectively filter the blue light around you so your eyes receive good light, while at the same time reducing your exposure to bad blue light. Some lenses can include a specialized filter to help reduce exposure to harmful blue light. These premium lenses can be specifically <span style="color: #333333;">made</span> to meet your needs.</p> <h4>Benefits of no-glare lenses</h4> <p>During nighttime, color recognition, peripheral vision and depth perception all are negatively affected.</p> <p>However, no-glare lenses can make driving at night safer and more comfortable. They increase clarity, protect your eyes from distracting reflections and provide relief from eye fatigue. Plus, today’s no-glare lenses are designed to not peel or break down like older versions of no-glare and anti-reflective lenses.</p> <h4>No-glare lenses are important for kids</h4> <p>Clear vision is vital to improving child development and growth. Bright reflections and glare can cause irritation, eye strain and overall discomfort to the eyes.</p> <p>Keeping our eyes protected is important for people of all ages. Eye protection means healthy eyes for years to come. Talk to your optometrist and eye care team about the benefits of a specialized lens for your eyes.</p> <p><em>Brooke Pierce and Denise True are opticians in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2020/dark-brown-eyes.jpg?h=370&iar=0&w=660&sc_lang=en&hash=06BCA235B672B0CE1DB3F2F8E471CE5B" alt="Dark brown eyes" width="660" height="370" DisableNVelocity="true" />Eye HealthYour eyes are responsible for providing you with vision, perhaps the most important of the senses. However, the eye is a delicate and complicated structure that needs protection. The ugly truth is that eye injuries can happen at any time and place.Michele Halterman11/9/2021If diagnosed early, learn how this wrist injury can be treated with a variety of nonsurgical options and alternative medicine therapies.Can carpal tunnel syndrome be treated without surgery?<p>Patients with <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/symptoms-causes/syc-20355603" target="_blank" title="Opens in a new window.">carpal tunnel syndrome</a> symptoms often ask, "Can it be treated without surgery?" The answer is, "yes," as long as the condition is diagnosed early and symptoms aren't severe.</p> <p>A compressed nerve in the carpal tunnel — a narrow passageway on the palm side of the wrist — causes carpal tunnel syndrome. This compression causes swelling, which leads to pain, weakness, numbness, and tingling in the thumb, fingers, wrist and arm.</p> <h4>Nonsurgical options and treatment include:</h4> <ul> <li>Improving and avoiding positions that overextend the wrist.</li> <li>Wearing a wrist splint to hold the hand in a neutral position at bedtime.</li> <li>Taking medication to reduce inflammation. In some cases, steroid injections might be prescribed.</li> <li>Treating other underlying health conditions that contribute to the swelling in the carpal tunnel, such as gout or rheumatoid arthritis.</li> </ul> <h4>Other strategies and alternative medicine therapies can be incorporated into a treatment plan for coping with symptoms, such as:</h4> <ul> <li><strong>Ergonomics</strong><br> Improve your work environment by using armrests, choosing ergonomic keyboards and other computer hardware, and ensuring chairs and work surfaces are at the proper height.</li> <li><strong>Yoga</strong><br> Yoga poses that stretch and lengthen the upper limbs and joints can reduce pain and improve grip strength.</li> <li><strong>Hand therapy</strong><br> Wrist exercises recommended by a hand therapist can reduce pain and symptoms.</li> </ul> <p>It's important to inform health care providers about carpal tunnel symptoms when they appear, so providers can discuss the nonsurgical treatments and complementary or alternative medicine therapy options. These symptoms also are similar to those for spinal cord and nerve compression, which is why a clinical assessment is essential.</p> <p><em>Manish Sharma, M.B.B.S., is a <a href="/services-and-treatments/neurosurgery" target="_self" title="Opens in same window.">spine and neurological surgeon</a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a>, <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a> and <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2021/resistance-band-training.jpg?h=370&iar=0&w=660&sc_lang=en&hash=46B6F471890D5AEB0808CAB467DFF62C" alt="Resistance band training" width="660" height="370" DisableNVelocity="true" />NeurosurgeryNeurosurgery treats disorders that impact any part of the nervous system, which may include the brain, spine or peripheral nerves. Conditions treated range from life-threatening brain tumors, to disorders impacting quality of life, such as back pain and carpel tunnel syndrome.Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Michele Halterman4/23/2025 It’s hardly news that fruits and vegetables are good for you. The real news is why. Try some new fruits and veggies this summer<p>It’s hardly news that fruits and vegetables are good for you. The real news is why. More and is being learned about how fresh produce, beyond its rich stores of vitamins and minerals, can supply us with substances that help ward off many illnesses.</p> <p>To enjoy a full mix of foods that help fight disease, pick a variety of colors from the produce bin. It's easy to get into a rut and eat the same favorites every day. Break out of your comfort zone and try some less familiar produce, if available in your local grocery store or farmers market, this growing season.</p> <img alt="fbBlog_HTH_freshFV_504x504" src="/-/media/national-files/images/hometown-health/2017/fbblog_hth_freshfv_504x504.jpg?h=300&w=300&sc_lang=en&hash=D2AE43E031024C68682148DB74734F1F" class="img-responsive" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <div> <h3>Some less familiar fruits and veggies to enjoy:</h3> <ul> <li>Beets</li> <li>Bok choy</li> <li>Celery root</li> <li>Collard greens</li> <li>Dandelion greens</li> <li>Eggplant</li> <li>Figs</li> <li>Kohlrabi</li> <li>Leeks</li> <li>Morel mushrooms</li> <li>Pluots and apriums (hybrids of an apricot and plum) </li> <li>Rhubarb</li> <li>Persimmon</li> <li>Swiss Chard</li> <li>Turnip</li> </ul> <p>This recipe featuring figs makes a light, summery end to any meal:</p> <h4>Fresh figs with walnuts and mascarpone</h4> <p>Serves 6</p> <p>¼ cup chopped walnuts<br /> 12 ripe figs<br /> 2 tablespoons mascarpone cheese or whipped cream cheese<br /> Pinch of ground nutmeg<br /> ¼ cup honey</p> <p>Put the walnuts in a small, dry frying pan over medium-low heat. Cook, stirring often, until lightly toasted, 3 to 5 minutes. Transfer immediately to a plate to cool. Slice the stems off the figs. Cut an X in the top of each fig, cutting down into the fruit about 1 inch. Carefully squeeze each fig from the bottom to open it slightly. Spoon ½ teaspoon of the cheese into the opening of each fig and sprinkle with nutmeg. To serve, divide the figs among individual plates. Sprinkle with toasted walnuts and drizzle each serving with 2 teaspoons of honey.</p> <p><em>By Mayo Clinic Health System staff</em></p> </div><img src="/-/media/national-files/images/hometown-health/2022/fresh-fruit-on-wood-skewers.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E97C710EE290D972F8D1C64FC9948443" alt="Fresh fruit on wood skewers" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Michele Halterman5/16/2022Everyone worries sometimes. But people with anxiety disorders have excessive worry they can't control. Learn about the types of anxiety disorders and treatments that can help.Overwhelmed by anxiety?<p>Stress and feeling anxious are common and normal. Your body naturally produces these reactions to situations that could lead you to harm's way.</p> <p>Stress is a normal psychological and physical reaction to the demands of life. It's normal to feel anxious from time to time, especially during times of stress. This can be helpful, as it can help you remain focused and make better decisions.</p> <p>However, people with anxiety disorders have frequent, sustained and excessive worry that they can't control. They also may feel fear, terror and panic in everyday situations.</p> <h2>There are many types of anxiety. Here are explanations of each, including symptoms and common treatments:</h2> <h3>Generalized anxiety disorder</h3> <p>This type of anxiety involves persistent and excessive worry. If you have generalized anxiety disorder, you may have an uneasy feeling about most everything. This worry feels difficult to control and interferes with your daily life. You may overthink plans and solutions to worst-case scenarios. Or you may anticipate disaster and be overly concerned about money, health, family, work and other life events.</p> <p>Generalized anxiety disorder can lead to worrying more than what seems warranted about situations or expect the worst even then there's no apparent reason to do so. You may feel an inability to relax or enjoy quiet time. You may feel tense all the time and have body aches.</p> <p>You avoid stressful situations and may have difficulty concentrating. You may find it hard to tolerate uncertainty and may feel a sense of dread or impending doom. This disorder can cause you to struggle with intrusive thoughts about the worst that could happen.</p> <p>Generalized anxiety disorder can cause you to not sleep well, or feel jumpy or restless. You may have an upset stomach or heart palpitations, shakiness, sweating, a dry mouth, difficulty breathing or a lump in your throat. You could feel dizzy; have cold chills, hot flashes, or numbness and tingling; or may have persistent irritability.</p> <p>Ongoing generalized anxiety disorder may manifest physically through chronic neck and back pain, headache, irritable bowel syndrome, or stomach and abdominal pain.</p> <p>There is evidence that biological factors, stressful life experiences, lack of personal security and lack of positive role-modeling of anxious behaviors can lead to generalized anxiety disorder.</p> <p>Generalized anxiety disorder is treatable, but it takes persistence. A person can find significant relief with psychotherapy, relaxation and mindfulness techniques, or medication. Support groups also help.</p> <p>Practicing helpful ways of thinking and stress coping skills can lessen the amount of worry. Seek healthy connections with others and a lower-stress lifestyle to find greater freedom from your anxiety. Set healthy boundaries in your life. Use humor and practice to manage your negative anxious tendencies. Exercise can help by relieving the built-up stress and tension.</p> <p>One of the most important principles of overcoming anxiety is facing your fears. Therapy can help develop a plan, and little by little, you'll grow in self-confidence to manage and cope with anxiety.</p> <h3>Social anxiety</h3> <p>If you struggle with social anxiety, everyday interactions cause significant anxiety, self-consciousness and embarrassment. It is related to the fear of being scrutinized or judged negatively by others. It is intense and affects your work or social life.</p> <p>You may worry about blushing, trembling, or fear you may look foolish or unintelligent to other people. You may have generalized anxiety disorder symptoms that are mainly associated with social situations. You may fear meeting new people, talking to others at work or school, or speaking in public. Some people with social anxiety fear using a public restroom, being seen eating or drinking in public, or having to perform in front of others.</p> <p>You may experience feelings of panic or panic attacks, and feel self-conscious or awkward in front of others. You may have difficulty speaking and may avoid situations you feel may trigger anxiety.</p> <p>Your body may feel rigid and tense while your voice may be soft during social interactions. You may have difficulty making eye contact with others and be sensitive to criticism. You may feel a low self-worth and have a lot of negative self-talk.</p> <p>Sometimes people with social anxiety may not seek treatment because they feel this uncomfortable way of being is just a part of their personality. However, without treatment for this disorder, these people cannot achieve their potential at school, work or in their personal life.</p> <p>Social anxiety is treated using the same methods as generalized anxiety disorder.</p> <h3>Panic disorder</h3> <p>A panic attack causes a sudden intense fear or discomfort that peaks within minutes. Other symptoms may include a rapid heart rate, sweating, shakiness, shortness of breath and hot flashes. A person may feel lightheaded, have a sense of impending doom, chills, nausea, abdominal or chest pain, headaches, and numbness or tingling.</p> <p>Many people feel something is physically wrong when they have a panic attack and that they may be having a heart attack or stroke.</p> <p>Expected panic attacks occur when there is an obvious cue or trigger, such as with generalized anxiety disorder or a specific phobia. Panic disorder is when a person has frequent, unexpected panic attacks. These panic attacks seem to come out of the blue without a trigger or apparent explanation. If you have panic disorder, you may not be able to stand the thought of experiencing the physical discomfort that has happened when you have panicked before and may always be on guard for another one potentially happening.</p> <p>Treatment for panic disorder is similar to that of generalized anxiety disorder and social anxiety. Persistence and practice of healthy thinking and coping tools will help develop a better level of confidence in your ability to cope with stress, as well as with the strong feelings of anxiety or panic.</p> <h3>Phobias</h3> <p>Phobias are an overwhelming and unreasonable fear of objects or situations that pose little real danger but provoke anxiety and avoidance. Fear and phobia are different. Fear is a temporary emotion; whereas, a phobia is longstanding. Phobias can create fear that is so strong it becomes debilitating. When this occurs, a phobic fear has become an anxiety disorder.</p> <p>Your sense of danger or fear is designed to protect you from danger. It can trigger your flight-or-fight instinct so you're ready to take action to protect yourself. A phobia overestimates the threat of a particular situation and triggers intense anxiety leading you to avoid that situation in the future. Avoidance worsens the phobia because it reinforces the brain's exaggerated association between the situation and its threat level.</p> <p>There are various phobias, including a phobia of animals, insects or spiders; a phobia of natural phenomena like storms or water; and a phobia of blood or injury, blood tests or needles.</p> <p>Social anxiety can lead to a phobia. Often this comes with agoraphobia, which is a phobia of any place or situation that you fear you can't escape or get help easily. You might avoid travel on public transportation, being in a crowded area or being alone in public. It's rooted in the fear of having intense anxiety or a panic attack in certain places rather than a fear of the place itself.</p> <p>Health care professionals do not clearly understand why people develop phobias. Often, they begin in childhood — similar to panic disorders.</p> <p>If you struggle with a phobia, you may notice a racing heart rate, difficulty breathing, trembling, sweating, nausea, dry mouth, and chest pain or tightness. You may feel an overwhelming anxiety or fear. You know your fear is irrational, but you feel powerless to overcome it. You may fear losing control and feel an intense need to escape.</p> <p>According to research, cognitive therapy and exposure therapy tend to be the best treatment for phobias. Social skills training, mindfulness and medication may help, as well.</p> <h3>Obsessive-compulsive disorder</h3> <p>Obsessive-compulsive disorder, also known as OCD, is a pattern of unwanted thoughts and fears, or obsessions, that lead a person to do repetitive behaviors, or compulsions. The typical onset of OCD is before age 20.</p> <p>OCD often develops related to a theme. For example, being fearful of germs — an obsession — leads to excessive hand-washing — a compulsion — to reduce the thoughts and fears. If you don't have control over your thoughts, you wash your hands more. This becomes a vicious circle that worsens, and it can become a debilitating lifestyle if not addressed.</p> <p>Other types of OCD may be needing to have things in perfect symmetrical order; having taboo or other unwanted thoughts; having aggressive thoughts toward yourself or others; and fear of causing harm or danger to self or others by not turning off the stove or not locking the door, so you check and recheck.</p> <p>Compulsions are the direct result of the obsessive thoughts that lead to repetitive behaviors. These are done in the hope of reducing the anxiety and preventing something bad from happening. Sometimes, actions bring temporary relief but no pleasure. Common compulsions include counting, checking, washing or cleaning; strict routines; orderliness; and a need for reassurance. Symptoms may come and go over time and seem to worsen when a person is under stress.</p> <p>While adults may recognize their irrational fears and behavior, children may not. Usually, medication and psychotherapy are recommended and can help alleviate many OCD symptoms.</p> <h3>Post-traumatic stress disorder</h3> <p>If you suffer from post-traumatic stress disorder, you have significant anxiety and uncontrolled thoughts triggered by a terrifying or life-threatening event. This could be a terrible accident, a tornado, domestic violence, war, the sudden death of a loved one, critical illness, a near-death experience, kidnapping, terrorist attacks, an assault or a direct threat to your life, or witnessing someone else being attacked.</p> <p>Some people work through these experiences and learn to cope and adjust with time. Occasionally, people find themselves reliving it, and this affects their ability to function. You may struggle with post-traumatic stress disorder if you get stuck in a state of fear and your symptoms don't improve or worsen.</p> <p>Symptoms may include avoidance, intrusive memories, changes in emotional reactions, negative changes in thinking and mood, flashbacks, jumpiness and emotional detachment. You may struggle with an overwhelming sense of guilt or shame, sleep disturbances, difficulty concentrating, always being on guard for danger, irritability, angry outbursts, aggressive behavior, and self-destructive behavior. You may feel negative about yourself, have a lack of interest in activities you used to enjoy or have difficulty maintaining your relationships. You could experience memory problems, feelings of hopelessness about the future, and feeling emotionally numb or unable to experience positive emotions.</p> <p>Having post-traumatic stress disorder increases your risk for depression, anxiety, eating disorders and substance use disorders. It is important to seek treatment if you struggle with intrusive memories, avoid thinking or talking about the trauma, have negative changes to your thinking and mood, and have changes in your physical and emotional reactions to life and others. Treatment may include psychotherapy, exposure therapy called EMDR, medication and other therapies.</p> <h2>For more information, watch this video for ways to combat stress and anxiety:</h2> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/B_kSmOsNujQ" title="Combat stress and anxiety" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <h2>Learn more about anxiety:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/tips-to-help-ease-anxiety" target="_self" title="Opens in same window.">5, 4, 3, 2, 1: Countdown to take control of anxiety</a></li> <li><a href="/hometown-health/speaking-of-health/9-ways-to-tame-anxiety-during-the-covid-19-pandemic" target="_self" title="Opens in same window.">9 ways to tame anxiety during the COVID-19 pandemic</a></li> <li><a href="/hometown-health/speaking-of-health/11-tips-for-coping-with-an-anxiety-disorder" target="_self" title="Opens in same window.">11 tips for coping with an anxiety disorder</a></li> <li><a href="/hometown-health/speaking-of-health/addressing-your-mental-health-by-identifying-the-signs-of-anxiety-and-depression" target="_self" title="Opens in same window.">Identifying signs of anxiety and depression</a></li> </ul> <p><em>Linda Hubbard</em><em> is a psychotherapist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2022/stone-stacking-near-body-of-water.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CAED1CDE75ECA31E87DBE8CDF2F868E7" alt="Stone stacking near body of water" width="660" height="370" DisableNVelocity="true" />AnxietyFeelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. Symptoms may start during childhood or the teen years and continue into adulthood. We have the experts who can help diagnose and treat anxiety concerns.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Micah Dorfner5/10/2017Steve Brock thought he had slept on his arm wrong, causing it to go numb. He didn’t learn until a few days later that he was having a stroke.Stroke survivor advises others to seek help quickly when symptoms appear<img alt="Steven Brock" src="/-/media/national-files/images/hometown-health/2017/steven-brock.jpg?h=274&w=400&sc_lang=en&hash=714272BE5E257E25D5B102AC21340E8D" style="width: 400px; height: 274px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /> <p>Steve Brock thought he had slept on his arm wrong, causing it to go numb. He didn’t learn until a few days later that he was having a stroke.</p> <p>“It felt like my arm was asleep, says Steve, 36, of Cameron, Wisconsin. “I really didn’t think anything of it. I went back to sleep.”</p> <p>That was around 2 a.m. on a Saturday in February 2017. Steve felt sick throughout the weekend, but thought he had the flu and a nasty headache. It wasn’t until Monday morning that Steve realized he had a bigger problem.</p> <p>“I got up to go to work, and I could hardly see anything,” Steve says. “That’s when I knew I had to go to the emergency room.”</p> <p>Nathan Smithberg, M.D., saw Steve when he arrived at the Emergency Department at <a href="/locations/barron" target="_self" title="Opens in same window.">Mayo Clinic Health System – Northland in Barron</a>. After a CAT scan and an MRI, Dr. Smithberg told Steve that he had experienced a stroke and would be transferred to <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Mayo Clinic Health System in Eau Claire</a> for additional care. </p> <p><a href="/providers/leonardo-fugoso-md" target="_self" title="Opens in same window.">Leonardo Fugoso, M.D.</a>, the neurologist who treated Steve in Eau Claire, says it is common for people to put off seeing a doctor, hoping their symptoms will go away.</p> <p>“That is a huge mistake,” Dr. Fugoso says. “It is crucial for people to get emergency medical care immediately. The clot-busting medication is more effective given as early as possible but can, in certain instances, be given up to four and a half hours of having a stroke. Prompt medical attention also can help to determine if the clot from the stroke can be removed.” A stroke can be caused by a clot that becomes lodged in an artery, blocking the blood flow, or by a narrowing or closing of an artery. Medication given early after symptoms begin can help prevent damage.</p> <p>Steve says he thought he was too young to have a stroke. But Dr. Fugoso points out that a recent study published in the Journal of the American Medical Association Neurology found rising stroke hospitalization rates among men and women between age 35 and 44. That was associated with a doubling of stroke risk factors, such as high blood pressure, diabetes, high cholesterol and smoking.</p> <p>Steve says he wishes he would have taken better care of himself before his stroke. On the advice of Dr. Fugoso, he has made some changes.</p> <p>“I used to eat as many as three meals a day from a drive-through,” Steve says. “I’m eating better now, I’m losing weight, I quit smoking and I try to get more sleep.”</p> <p>After receiving physical therapy, Steve is back at work as a maintenance warehouse supervisor, though he had to cut back on his hours because he tires quickly. He says poor short-term memory is another lingering effect of his stroke, and he doesn’t remember much from the three days he spent in the hospital. He still suffers from tunnel vision, which was constant at first, but now comes and goes. Despite his ongoing challenges, Steve knows it could have been worse.</p> <p>“Really, ultimately, I could have died,” Steve says. </p> <p>Dr. Fugoso advises people to be familiar with the <a rel="noopener" href="https://www.strokeassociation.org/" target="_blank" title="Opens in new window.">American Stroke Association’s</a> guide for identifying stroke symptoms, using the acronym of FAST:</p> <p><strong>F</strong>: Face drooping or numb on one side<br /> <strong>A</strong>: Arm is weak or numb<br /> <strong>S</strong>: Speech difficulty, slurred speech<br /> <strong>T</strong>: Time to call 911</p> <p>As for Steve, he now tries to warn others so they can avoid the trouble he has had.</p> <p>“I tell people, ‘There’s no flashing light saying you’re having a stroke,’” Steve says. “If you experience something like one side of your body goes numb and there’s no explanation for it, go to the doctor right away.”</p><img src="/-/media/national-files/images/hometown-health/2017/steven-brock.jpg?h=274&iar=0&w=400&sc_lang=en&hash=44FF7A5011BCB3ED0B50BCA43378ABF8" alt="Steven Brock" width="400" height="274" DisableNVelocity="true" />StrokeAs one of the leading causes of death in the U.S., stroke will affect 80% of families during their lifetimes, according to the National Stroke Association. And the faster care you receive for stroke, the better. Learn more about stroke prevention, symptoms and treatments here.Michele Halterman5/5/2017People who suffer from chronic migraines know the debilitating pain. There are many different treatment options, including medications and Botox injections.Botox as a treatment for chronic migraines<img alt="migraine_504x504" src="/-/media/national-files/images/hometown-health/2017/migraine_504x504.jpg?h=300&w=300&sc_lang=en&hash=F191D0A2C5D423513E26BA020A0ACB27" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>People who suffer from chronic <a href="http://www.mayoclinic.org/diseases-conditions/migraine-headache/home/ovc-20202432" target="_blank" title="Opens in a new window."><span>migraines</span></a><span> know the debilitating pain. These headaches cause severe pain that can last for hours, or even days, and cause sensitivity to light and noise, nausea and vomiting, blurred vision and lightheadedness. They can interrupt your relationships and hobbies and cause you to miss work. There are many different treatment options, including medications and Botox injections.</span></p> <p>Long known as an elective cosmetic treatment for helping smooth out wrinkles, <a href="http://www.mayoclinic.org/tests-procedures/botox/home/ovc-20196291?_ga=1.221115416.1032801696.1452548906" target="_blank" title="Opens in a new window.">Botox</a>, or onabotulinum toxin A, has been approved by the U.S. Food and Drug Administration as a treatment for chronic migraines. We don’t fully understand why Botox helps migraine suffers. The belief is that it blocks a nerve’s ability to activate a muscle; however, the migraine prevention effect likely goes beyond this, even potentially modifying how the brain perceives pain.</p> <p>Botox injections are appropriate for people who are 18 or older and have headaches 15 days or more per month, eight of which meet diagnostic criteria for migraine headache.</p> <p>The treatment involves a series of several small injections targeting muscles in your face, head and neck once every three months. The amount injected, as well as injection locations, is adjusted based on your reported pain.</p> <p>It is common for patients to report they tolerate Botox injections better than other oral migraine prevention medications. Many patients note an improvement in the quality of their lives, more time with their families and a reduction in time missed from work. Over time, some people are able to reduce or stop taking other daily migraine medications, as well.</p> <p>Botox injections for migraines are covered by most insurance plans; however, you may need to try other treatment options first.</p> <p>If you think you may benefit from Botox for your migraines, the first step is to keep a headache diary to track of your headache frequency, what appears to trigger them and which treatment is most effective. Then, you can discuss this with your primary care provider or a neurologist. A referral to a neurologist is not required.</p> <p>Please call 715-838-1900 if you would like a free headache diary.</p> <p><a href="/providers/scott-spritzer-do" target="_self" title="Opens in same window."><em>Scott Spritzer, D.O.</em></a><em>, is a neurologist in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire, Wisconsin</a>.</em></p><ul> <li>Epilepsy and other neurological conditions</li> </ul>D.O.<p>In my spare time, I enjoy spending time with family and outdoor activities.</p><p><strong>Education</strong></p> <ul> <li>Doctor of Osteopathic Medicine, Midwestern University/Arizona College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Neurology, Mayo School of Graduate Medical Education, Mayo Clinic College of Medicine</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Epilepsy, Mayo School of Graduate Medical Education, Mayo Clinic College of Medicine</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Neurology, American Board of Psychiatry and Neurology</li> <li>Clinical Neurophysiology, American Board of Psychiatry and neurology</li> <li>Mayo Clinic Quality Fellow, Bronze Level</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Neurology</li> <li>American Epilepsy Society</li> <li>American Medical Association</li> <li>Wisconsin Medical Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Neurology, Mayo Clinic College of Medicine and Science</li> </ul>Spritzer<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/scott-spritzer-do.jpg?h=200&iar=0&w=200&sc_lang=en&hash=485562F16077B3B2D8830FB2B867D242" alt="Scott Spritzer, D.O." width="200" height="200" DisableNVelocity="true" />{612AFFD2-050B-4F69-BC9B-93F0A7051756}Scott<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15260917Scott Spritzer, D.O.1<img src="/-/media/national-files/images/hometown-health/2017/migraine_504x504.jpg?h=504&iar=0&w=504&sc_lang=en&hash=6806DEF84897419D1D6F779F75DAF5EF" alt="Person with migraine with hands on temples " width="504" height="504" DisableNVelocity="true" />HeadacheHeadache is pain in any region of the head that feels like a sharp pain, throbbing sensation or dull ache. It may develop gradually or suddenly, and last for minutes or days.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Michele Halterman9/12/2023With over 100 varieties, HPV has a low or high risk based on the potential to cause cancer in infected tissues. Read about screening methods and the recommended age for getting the HPV vaccine.Protecting yourself against HPV<p>HPV is a viral infection that commonly causes abnormal growth of skin or other tissues in your body. There are more than 100 varieties of the virus. </p> <p>HPV infections are categorized as low or high risk depending on the potential to cause cancer in the infected tissues. Infection from low-risk strains can cause genital warts, which may be problematic but generally aren't life-threatening. Low-risk HPV infections don't lead to cancer and may disappear without treatment. </p> <p>Infection from high-risk HPV strains can <a href="/hometown-health/speaking-of-health/hpv-infection-and-mouth-throat-cancer" target="_self" title="Opens in same window.">lead to cancer</a> in many areas of the body. Cancers of the anus, penis, vagina, cervix and back of the throat ― known as oropharyngeal cancer ― have been linked to high-risk HPV infections.</p> <p>These infections often are transmitted through intimate skin-to-skin contact. The virus can enter the body through a cut, abrasion or small tears in affected issues.</p> <p>HPV infections are common, with more than 42 million U.S. men and women infected. In most cases, the body's immune system suppresses HPV infection before it creates symptoms, so it is easy to have HPV and not realize it.</p> <h2>HPV prevention tips</h2> <p>You can reduce your and your children's risk of developing warts and other HPV-related illnesses by getting the HPV vaccine when eligible.</p> <p>The <a rel="noopener noreferrer" href="http://www.mayoclinic.org/diseases-conditions/hpv-infection/in-depth/hpv-vaccine/art-20047292" target="_blank" title="Opens in a new window.">HPV vaccine</a> is highly effective and safe. It significantly reduces the incidence of genital warts and cervical cancer, especially if given before age 15. </p> <p>The Centers for Disease Control and Prevention recommends that all 11- and 12-year-olds receive two doses of HPV vaccine at least six months apart. This is the best age to receive the vaccine to protect against the virus, before a person is exposed through sexual activity. Children as young as 9 can receive the <a href="/hometown-health/speaking-of-health/the-facts-about-vaccinations" target="_self" title="Opens in same window.">vaccine</a> as well. Research has shown that the two-dose schedule is effective for children under 15.</p> <p>Teens and young adults who begin the vaccine series later ― ages 15 to 26 ― should receive three doses. </p> <p>Some people outside these age groups may benefit from the vaccine. Adults ages 27 to 45 may decide to receive the vaccine after discussing it with their healthcare teams. For example, people who have been celibate and are returning to intimate activities may be candidates for the vaccine. </p> <h3>For sexually active people, additional preventive measures include:</h3> <p><strong> </strong></p> <ul> <li>Being in a mutually monogamous sexual relationship</li> <li>Reducing the number of sexual partners</li> <li>Using a latex condom or dental dam consistently</li> </ul> <h2>Screening for HPV</h2> <p>HPV causes nearly all cases of cervical cancer. Screening can help prevent cervix precancer or cancer through different types of tests. A Pap test looks at cells in the cervix, and an HPV test looks for evidence of infection on DNA. </p> <p>With <a href="/hometown-health/speaking-of-health/cervical-cancer-awareness" target="_self" title="Opens in same window.">regular screening</a>, abnormal cells are detected early, and they can be monitored or treated to prevent progression to cancer.</p> <p>Guidelines recommend starting <a href="/hometown-health/speaking-of-health/too-embarrassed-to-ask-an-update-on-pap-tests" target="_self" title="Opens in same window.">Pap test</a> screening at 21 and continuing until age 65 for most women. Many women only need a Pap test every three to five years if they have an adequate history of normal tests. </p> <p>Routine HPV screening for males is not recommended, although it is an area of scientific discussion and research. Your healthcare professional may be able to diagnose HPV infection by visual inspection or using a vinegar solution test to identify difficult-to-see lesions.</p> <p> People who are immunosuppressed due to a history of organ transplant, chronic systemic steroid use or HIV should be screened earlier and more frequently than those with an unaffected immune system.</p> <p><a href="/providers/erica-berven-md" target="_self" title="Opens in same window."><em>Erica Berven, M.D.</em></a><em>, is an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em></p><ul> <li>Abnormal pap management (HPV, colposcopy, LEEP) </li> <li>Birth control</li> <li>Menstruation issues</li> <li>Prenatal care and delivery</li> </ul>M.D.<p>My practice goal is to promote inclusive health of diverse obstetric and gynecologic patients. I hope to provide compassionate and sensitive care guided by the strongest evidence. I try to be pragmatic rather than dogmatic in determining a care plan. One size does not fit all in many cases, and I will use shared decision-making and advocacy to work toward healthy outcomes.</p> <p>I love working in my yard and garden with the assistance of my husband and our four rescue cats.</p><p><strong>Medical School</strong></p> <ul> <li>Mayo Clinic College of Medicine and Science</li> </ul> <p><strong>Residency</strong></p> <ul> <li>OB-GYN, Mayo Clinic College of Medicine and Science</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Obstetrics and Gynecology (ABOG)</li> <li>Fellow of the American Congress of Obstetricians and Gynecologists (FACOG)</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Obstetricians and Gynecologists (ACOG) </li> <li> American Society for Colposcopy and Cervical Pathology (ASCCP) </li> </ul>Berven<img src="/-/media/shared-files/images/medical-professionals/full/owatonna/erica-berven-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B76B6CE28F6B68FCDB4935DC5BD42C00" alt="Erica Berven MD" width="280" height="280" DisableNVelocity="true" />Erica<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12585394Erica Berven, M.D.1<img src="/-/media/national-files/images/hometown-health/2020/young-child-smiling.jpg?h=370&iar=0&w=660&sc_lang=en&hash=AA5D5845EECDED2C90F7A5E6F94F4255" alt="Young child smiling" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Michele Halterman9/18/2023Have you ever wondered how a passion could turn into a problem with gaming, drinking, gambling, shopping or something else? Learn about the signs of addiction and why some people are more prone to it.Do you have addictive personality traits?<p>Some people appear to overindulge more than others or seem incapable of saying "no" or "enough already." You may have heard the term "addictive personality" to describe people who believe that too much of a good thing is never enough. But is this an actual diagnosis, and do some personality traits increase a person's addiction risk?</p> <p>Here's a closer look at addictive personality traits and their effect on the likelihood of addiction.</p> <h2>Types of addiction</h2> <p>Addiction is a disease that affects a person's brain, their behaviors and results in the compulsive need either for a substance or to participate in a specific behavior despite adverse consequences. There are many causes or factors leading to addiction.</p> <p>Generally, addictions fall into two categories ― misusing or overusing substances and excessively engaging in behaviors regardless of the costs.</p> <p>A substance use disorder, sometimes called a drug or alcohol addiction, is the inability for a person to control their use of a legal or illegal drug or medicine.</p> <p>People also can develop an addiction to activities or behaviors like shopping, screen time including video games, gambling, sex, pornography or food.</p> <p>Individually, repeated use of drugs or alcohol or just engaging in these behaviors are not addictions. It's unlikely that you have an addiction if you often enjoy a glass of wine with dinner or occasionally buy a lottery ticket. Addiction is distinguished by a person's inability to control the behavior, difficulty going without it, intense cravings for it and continued action despite negative consequences.</p> <p>Addiction is often isolating. For some, it can be a self-medicated solution to underlying problems or trauma.</p> <h2>Personality characteristics</h2> <p>An addictive personality is not a diagnosable disease or condition. There isn't one single trait that leads to addiction. Instead, this term is used to informally describe a collection of characteristics, environmental factors and health conditions that make a person more prone to developing an addiction.</p> <h3>Common characteristics or factors include:</h3> <ul> <li>Adventurous or thrill-seeking</li> <li>Attention deficit disorder diagnosis</li> <li>Comfort with secrets or lying</li> <li>Desire for immediate gratification</li> <li>Difficulty in accepting responsibility</li> <li>Difficulty with self-regulation</li> <li>Ease with risk-taking behaviors</li> <li>Early childhood trauma</li> <li>Exposure to drugs and alcohol</li> <li>Family history of addiction</li> <li>Impulsivity</li> <li>Mental health conditions like anxiety and depression</li> <li>Neuroticism or high levels of sensitivity or nervousness</li> <li>Obsessive and compulsive behaviors</li> </ul> <p>Not everyone with these traits will develop an addiction. Having some or all of these does not foretell a person's fate. Personal decisions, support networks and other genetic and environmental factors affect the likelihood of addictive behaviors emerging.</p> <h2>Signs of addiction</h2> <p><strong> </strong></p> <p>Some addictions develop quickly and are immediately apparent to the person and loved ones. Others progress over time, making it a challenge to identify when a passion has become unhealthy.</p> <p>Let's look at the example of shopping. Every person needs to purchase items to live in our society. But if you get an extreme high or euphoria when you go shopping, there is the potential that this behavior could become addictive. Other signs could be that you need to keep buying things to keep your mood high or that your shopping habits are jeopardizing your career, budget or personal relationships.</p> <h3>Watch for these signs of addiction: </h3> <ul> <li><strong>Always wanting more</strong><br /> Feeling that you must use the substance or engage in the behavior regularly ― daily or even several times a day. </li> <li><strong>Financial problems</strong><br /> Spending a significant amount of money on an addictive substance or behavior, even though you can't afford it. </li> <li><strong>Inability to stop</strong><br /> Failed attempts to stop, even when you want to, or not being able to follow rules that you have set for yourself. </li> <li><strong>Increased tolerance</strong> <br /> Needing more of the drug or behavior to get the same effect. </li> <li><strong>Intense cravings</strong> <br /> Having strong urges that block out other thoughts. </li> <li><strong>Loss of control</strong><br /> Difficulty in controlling use or behavior, even though you know it's causing problems in your life or causing you physical or psychological harm. </li> <li><strong>Loss of interest in hobbies or other people</strong><br /> Former interests, activities or relationships don't hold the same appeal, and addiction takes precedence.</li> <li><strong>Neglecting responsibilities</strong><br /> Not meeting obligations and work responsibilities or cutting back on social or recreational activities because of behavior or substance.</li> <li><strong>Preoccupation</strong><br /> Spending considerable time thinking about, obtaining or recovering from the behavior or substance.</li> <li><strong>Risk-taking</strong><br /> Driving or doing other risky activities like stealing when you're under the influence.</li> <li><strong>Secrecy<br /> </strong>Hiding substance use from others and being deceptive about activities.</li> </ul> <p>People with an addiction often are the last to recognize that they have a problem or have lost control. These problems can severely affect their health, relationships, careers and other aspects of their lives.</p> <h4>Watch this video to learn if your behavior is OK or something to be concerned about:</h4> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/RzX4DiPr_oQ" title="Addictive personality traits" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <p>Help is available. Addiction and its related problems can be treated successfully, but no single treatment works for addictions. Recovery is an ongoing process requiring time and patience.</p> <p>Unfortunately, there continues to be a stigma surrounding addiction that can prevent people from seeking necessary help. It's important to be honest and transparent with your healthcare team if you or someone you know is struggling with an addiction. </p> <p><em><a href="/providers/brien-gleeson-lpc-csac" target="_self" title="Opens in same window.">Brien Gleeson</a> is a clinical substance abuse counselor in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p> <ul> <li>Adult children of alcoholics and co-dependency</li> <li>Families impacted by addiction</li> </ul> L.P.C., CSAC <p>I specialize in patients ages 10 and older.</p> <p><strong>Education</strong></p> <ul> <li>Social Work, University of Wisconsin-Eau Claire</li> <li>Guidance & Counseling - Alcohol and Other Drug Abuse, University of Wisconsin-Stout</li> </ul> <p><strong>Internships</strong></p> <ul> <li>Alcohol and Other Drug Abuse, Lutheran Social Services-Fahrman Center</li> <li>Social Work, Child & Family Services</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Clinical Substance Abuse Counselor</li> <li>Licensed Professional Counselor</li> </ul>Gleeson<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/brien-gleeson-lpc-csac.jpg?h=200&iar=0&w=200&sc_lang=en&hash=9897E606B8D6CE708B01D434A2CF31E6" alt="Brien Gleeson, L.P.C., CSAC" width="200" height="200" DisableNVelocity="true" /> {0AFC5615-156D-4364-B866-752114EC92E2}Brien<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14604442Brien Gleeson, L.P.C. 1{67744200-E25F-439A-8B70-572A5A091172}|{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2023/playing-video-game.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A60F3DA6668716FB2123067388E7E980" alt="Playing video game" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Michele Halterman8/22/2023Menstrual cycle irregularities are not unusual, although the causes of abnormal bleeding may vary by age. Learn about the three most common bleeding patterns women experience.Why are my periods so irregular, heavy and painful?<p>Menstrual cycle irregularities are not unusual, although the causes of abnormal bleeding may vary by age. For example, cancers are more likely to trigger irregular bleeding in postmenopausal women than in younger women, while pregnancy-related bleeding is more common among reproductive-age women.</p> <p>After age 50, postmenopausal bleeding may occur and should be evaluated by a healthcare professional. For women ages 15–49, there are three abnormal bleeding patterns, and each has specific causes. Be sure to exclude pregnancy before considering other reasons.</p> <h2>The three most common bleeding patterns are:</h2> <h3>Heavy menstrual bleeding</h3> <p>This is when the cycles are regular but the bleeding is heavy or prolonged. Bleeding is considered heavy if you have to change a pad or tampon every one to two or hours because it’s completely soaked or you're passing large clots. Bleeding is considered prolonged if it lasts more than eight days. </p> <h4>The most common causes of heavy menstrual bleeding are:</h4> <ul> <li><strong><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/home/ovc-20212509" target="_blank" title="Opens in new window">Fibroids</a></strong><br /> A fibroid is an abnormal growth of the muscles of the uterus. Fibroids are common, with some studies showing that approximately 80% of women will have fibroids during their lifetime, although not all will experience symptoms.</li> <li><strong><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/adenomyosis/basics/definition/con-20024740" target="_blank" title="Opens in new window">Adenomyosis</a></strong><br /> This condition occurs when the cells that line the inner walls of the uterus begin invading the muscles of the uterus. This condition often causes heavy and painful periods.</li> <li><strong>Bleeding disorder</strong><br /> This condition affects the way the blood clots. A bleeding disorder is likely if heavy or prolonged menses began at menarche, or first menstruation; there is a family history of bleeding issues;  there are signs of a bleeding problem, such as easy bruising; or if taking medications that can prevent usual clotting.</li> </ul> <h3>Intermenstrual bleeding</h3> <p>This refers to vaginal bleeding at any time during the menstrual cycle other than during normal menstruation.</p> <h4>The most common causes of intermenstrual bleeding include:</h4> <ul> <li><strong>Cancer or pre-cancer</strong><br /> Cancer or pre-cancer growth on the uterus or cervix can cause intermenstrual bleeding. This is more likely if a woman has had previous abnormal Pap smears or if there are other risk factors, such as obesity, family history of uterine cancer or bleeding that has been going on for a long time without evaluation.</li> <li><strong>Cesarean scar defect</strong><br /> Two-thirds of women who had a C-section may have a cesarean scar defect. Approximately one-third of women with this condition experience bleeding that starts just after the end of their regular menstruation.</li> <li><strong>Contraceptive methods</strong><br /> Many contraceptive methods can cause intermenstrual and irregular bleeding, especially in the first few months after starting the method.</li> <li><strong>Pelvic infections</strong><br /> Intermenstrual bleeding can be a sign of an infection in the uterus or on the cervix. This usually causes <a href="/hometown-health/speaking-of-health/addressing-pelvic-health-disorders" target="_self" title="Opens in same window.">pelvic pain</a> or increased vaginal discharge in addition to bleeding. Pelvic infections are more common in women who have been exposed to <a href="/hometown-health/speaking-of-health/current-sexually-transmitted-infection-trends" target="_self" title="Opens in same window.">sexually transmitted infections</a>, recently gave birth or had surgery on their uterus or cervix.</li> <li><strong>Polyps</strong><br /> A polyp is an overgrowth of cells around a small blood vessel inside the uterus or on the cervix.</li> </ul> <h2>Irregular bleeding</h2> <p>This is when a woman goes through phases of no bleeding that may last two or more months and other phases with either spotting or episodes of heavy bleeding. Irregular bleeding most often is related to abnormal ovulation or what's known as polycystic ovarian syndrome.</p> <p>All women with menstrual irregularities should see a healthcare professional for an evaluation to uncover the cause of their problem. The evaluation considers a woman's bleeding pattern and medical history, and includes a physical and pelvic exam. Additional testing based on the evaluation could include a urine pregnancy test, hormonal testing, an ultrasound, a biopsy called endometrial biopsy and a Pap smear. Once the cause of the bleeding is determined, a treatment plan can be developed to manage the problematic bleeding pattern.</p> <p>For women experiencing menstrual cycle irregularities, help is available so you don’t have to suffer through another painful period.</p> <em><a href="/providers/fadi-yahya-md">Fadi Yahya, M.D.</a>, is an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/mankato">Albert Lea</a>, Minnesota.</em><ul> <li>Incontinence</li> <li>Infertility evaluation and treatment</li> <li>Menstrual disorders</li> <li>Pelvic pain and endometriosis</li> <li>Prolapse of pelvic organs, including uterus, bladder, rectum and bowel</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>American University of Beirut</li> <li>Master of Healthcare Administration, University of Southern California</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Obstetrics and Gynecology, American University of Beirut</li> <li>Riverside Regional Medical Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Obstetrics and Gynecology, American Board of Obstetrics & Gynecology</li> <li>Minimally Invasive Gynecologic Surgery Focused Practice Designation, American Board of Obstetrics & Gynecology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Obstetrics and Gynecology, Mayo Clinic College of Medicine and Science</li> </ul>Yahya<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/fadi-yahya-md.jpg?h=280&iar=0&w=280&hash=E736BD0910ABE8C3992BE5C3A07ABB0C" alt="Fadi Yahya, M.D." width="280" height="280" DisableNVelocity="true" />{668BC882-2740-41A2-AD6E-97954A90F269}Fadi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15562000Fadi Yahya, M.D.1<img src="/-/media/national-files/images/hometown-health/2023/loading-bicycle-on-car-rack.jpg?h=370&iar=0&w=660&sc_lang=en&hash=84072632C45F0257077A2E5DC25635CA" alt="Loading bicycle on car rack" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Micah Dorfner6/17/2020With summer in full swing and seemingly unlimited opportunities for kids to play, it’s a good time to remember that play isn’t just fun — it’s the foundation for healthy growth.Play! It's good for your family's health<p>With summer in full swing and seemingly unlimited opportunities for kids to play, it’s a good time to remember that play isn’t just fun — it’s the foundation for healthy growth.</p> <p>Play strengthens bones, muscles, lungs and the heart, and can help reduce obesity, diabetes and high cholesterol.</p> <p>In addition to the positive physical benefits of play, play also is important for emotional and mental development. Play helps build confidence — think of the boost kids get when they go down the big slide or learn to pump on a swing — and can teach them how to problem solve.</p> <p>Children learn how to work in a community through play. It teaches them to explore the relationships they see adults modeling, helps them become aware of their surroundings and offers them the opportunity to control their environment.</p> <p>Play also is a great way for kids to release energy — something most parents already know. It's a great way for kids to work through their emotions. Getting that energy out also allows them to focus on other tasks and sleep better.</p> <h4>Tips for encouraging play</h4> <p>Play doesn’t have to be structured, complicated or require expensive equipment. Providing ideas can be helpful, but kids should direct their own play when possible. Parents should join in, because children are more likely to be playful when they see their parents participating.</p> <h3>Low-cost, simple play ideas</h3> <h4>Try some of these outdoor play ideas:</h4> <ul> <li>Teach kids games from your childhood, such as hopscotch, Mother May I or Simon Says.</li> <li>At a playground, pretend the ground is lava with the goal to move across the playground without touching the ground.</li> <li>Ride bikes.</li> <li>Run around the block or down the street as fast as you can.</li> <li>Make dirt soup.</li> <li>Create a nature collection.</li> <li>Go on a color or shape walk by choosing a color or shape and trying to find it along the walking path.</li> </ul> <h4>Try some of these indoor play ideas:</h4> <ul> <li>Use pillows or cushions to create an obstacle course.</li> <li>Have an indoor snowball fight with soft balled socks.</li> <li>Secure colored paper to the floor and race from color to color.</li> <li>Have a treasure hunt in your home by hiding small objects and giving your child directions to find them.</li> <li>Check out indoor play areas that encourage play, as well as large-muscle activity.</li> </ul> <p>Parents: No matter where play happens, it’s important for children, as well as grown-ups. Play can lower stress hormones and provide many of the same physical benefits for you as it does for kids. So, play along with the kids — it’s good for you.</p> <em><a href="/providers/hilary-kent-dpt" target="_self" title="Opens in same window.">Hilary Kent</a>, D.P.T., is a <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapist</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em><ul> <li>Parkinson's Disease</li> <li>Pediatrics</li> <li>Spinal cord injury</li> <li>Stroke</li> </ul>D.P.T. I have a deep interest in working with patients who are experiencing any neurological symptoms to reach their personal best.<p><strong>Education</strong></p> <ul> <li>Doctor of Physical Therapy, Creighton University, Nebraska</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Board Certified Neurologic Clinical Specialist, ABPTS </li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Physical Therapy Association</li> </ul>Kent<img src="/-/media/shared-files/images/medical-professionals/full/mankato/hilary-kent-dpt.jpg?h=200&iar=0&w=200&sc_lang=en&hash=7AEFA1CD9B9815F007B6C9930191089F" alt="Hilary Kent, DPT" width="200" height="200" DisableNVelocity="true" />{192687D0-2043-40D8-BB1A-030665A7C5CC}Hilary<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15896536Hilary Kent, D.P.T.1<img src="/-/media/national-files/images/hometown-health/2020/family-playing-board-game.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5475D768EF7BA9F03084343593E3EC2A" alt="Family playing board game" width="660" height="370" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Back to SchoolMichele Halterman6/22/2017<p>Sometimes, finding time to exercise can seem like a bigger challenge than your workout itself. But with a little planning, you can fit fitness into your schedule. Here are a few tips to help you get on the right track.</p>5 tips for fitting in fitness<img alt="fbBlog_HTH_fitness_504x504" src="/-/media/national-files/images/hometown-health/2017/fbblog_hth_fitness_504x504.jpg?h=300&w=300&sc_lang=en&hash=3241BDBD8C1C3D22A992D0B22CBF7733" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>Sometimes, finding time to exercise can seem like a bigger challenge than your workout itself. </p> <p>“Even though most people believe it’s important, exercise is often one of the first things to drop off the to-do list when life gets hectic,” says <a href="/providers/jacob-erickson-do" target="_self" title="Opens in same window.">Jacob Erickson, D.O.</a>, a family medicine physician at Mayo Clinic Health System in Onalaska, Wisconsin.</p> <p>But with a little planning, you can fit fitness into your schedule. Here are five tips to help you get on the right track:</p> <ol> <li><strong>Schedule a time to work out.</strong> Write it on your calendar, and treat your workout as you would any other appointment. </li> <li><strong>Be an early bird.</strong> Exercising first thing in the morning gives you a sense of accomplishment that can last the whole day. And, you’re less likely to cancel your workout because something else seems more important. </li> <li><strong>Find ways to fit exercise into your daily routine.</strong> Take the stairs. Park at the back of the parking lot. Do squats while you’re on a conference call. Plan walk-and-talks instead of sit-down meetings with colleagues. </li> <li><strong>Redefine happy hour.</strong> Meet a friend for a workout rather than a drink. </li> <li><strong>Use TV to your advantage.</strong> Make a deal with yourself that you can only tune in to your favorite show if you do burpees, planks and other exercises while you watch. </li> </ol> <p>“Even squeezing in 10 minutes of movement, three times a day has benefits,” says Dr. Erickson. Among those, he says, are improved mood, more energy and a healthier heart.</p><img src="/-/media/national-files/images/hometown-health/2017/fbblog_hth_fitness_504x504.jpg?h=504&iar=0&w=504&sc_lang=en&hash=C1ECFD1B6B1F78879F09A9A0CA5CAED8" alt="fbBlog_HTH_fitness_504x504" width="504" height="504" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Michele Halterman5/30/2023What you eat may play a role in maximizing your memory. Learning how to diversify your plant-based food portfolio and incorporate healthier fats in your diet can work wonders for your memory.Maximize memory function with a nutrient-rich diet<p>Research suggests that the ability to <a href="/hometown-health/speaking-of-health/memory-lapses-normal-aging-or-something-more" target="_self" title="Opens in same window.">maximize memory</a> function may be related to what you eat. Following an eating plan that provides a healthier selection of dietary fats and a variety of plant foods rich in phytonutrients could positively affect your health. Phytonutrients are substances found in certain plants that are believed to be beneficial for human health and help prevent certain diseases. </p> <p>There's still much to learn about what makes up a <a href="/hometown-health/speaking-of-health/5-tips-to-keep-your-brain-healthy" target="_self" title="Opens in same window.">brain-healthy</a> diet. Studies are finding that what's good for your heart also may be good for your brain. So the best bet for rich memories is to forgo unhealthy fat and remember to diversify your plant-based food portfolio.</p> <h2>Foods that boost memory</h2> <p>Diets rich in fruits, vegetables, whole grains and legumes, fish, healthier fats, and herbs or seeds boost the brain's memory functioning. Here's more about these <a href="/hometown-health/speaking-of-health/eat-the-rainbow-for-good-health" target="_self" title="Opens in same window.">powerhouse foods</a>:</p> <h3>Fruits</h3> <ul> <li>Berries are high in antioxidants that can protect the brain from oxidative damage, and prevent premature aging and memory-impairing dementia. Blueberries are a rich source of anthocyanin and other flavonoids that may improve brain function.</li> <li>Grapes are full of resveratrol, a memory-boosting compound. Concord grapes are rich in polyphenols, which have the potential to promote brain function.</li> <li><a href="/hometown-health/speaking-of-health/the-wonders-of-watermelon" target="_self" title="Opens in same window.">Watermelon</a> has a high concentration of lycopene, another powerful antioxidant. Watermelon also is a good source of pure water, which benefits brain health. Even a mild case of dehydration can reduce mental energy and impair memory.</li> <li>Avocados are a fruit rich in monounsaturated fat, which improves memory function by helping improve blood cholesterol levels when eaten in moderation in place of saturated fats.</li> </ul> <h3>Vegetables</h3> <ul> <li>Beets are rich in nitrates, a natural compound that can dilate blood vessels, allowing more oxygenated blood to reach the brain.</li> <li>Dark, leafy greens are known for their antioxidants, such as vitamin C, and have been shown to reduce age-related memory loss. Greens also are rich in folate, which can improve memory by decreasing inflammation and improving blood circulation to the brain.</li> </ul> <h3>Whole grains and legumes</h3> <ul> <li>Cracked wheat, whole-grain couscous, chickpeas, oats, sweet potatoes and black beans are examples of complex carbohydrates. Since brain cells run on glucose derived from carbohydrates and don't store excess glucose, they need a steady supply of it. Complex carbohydrates are a preferred brain food, providing a slow, sustained supply of glucose. They take longer to metabolize and are high in folate, the memory-boosting B vitamin.</li> </ul> <h3>Seafood</h3> <ul> <li>Fatty fishes, such as salmon, trout, mackerel, herring, sardines, pilchards and kippers, are rich in <a href="/hometown-health/speaking-of-health/whats-the-big-deal-about-the-mediterranean-diet" target="_self" title="Opens in same window.">heart-healthy</a> omega-3 fatty acids. These have been shown to improve memory when eaten one to two times per week. Omega-3 fatty acids don't affect low-density lipoprotein (LDL) cholesterol and can lower triglycerides. </li> <li>Shellfish and crustaceans, such as oysters, mussels, clams, crayfish, shrimp and lobster, are good sources of vitamin B12, a nutrient involved in preventing memory loss.</li> </ul> <h3>Healthier fats</h3> <ul> <li>Olive oil provides monounsaturated fat, which can help reduce LDL cholesterol levels when used in place of saturated or trans fat. Extra-virgin olive oil is the least processed type with the highest protective antioxidant compound levels.</li> <li>Nuts, such as walnuts, are a source of omega-3 fatty acids, which lower triglycerides, improve vascular health, help moderate blood pressure and decrease blood clotting.</li> </ul> <h3>Herbs or seeds</h3> <ul> <li>Cocoa seeds are a rich source of flavonoid antioxidants, which are especially important in preventing damage from LDL cholesterol, protecting arterial lining and preventing blood clots. Cocoa also contains arginine, a compound that increases blood vessel dilation.</li> <li>Rosemary and mint are in the same herb family. Rosemary has been shown to increase blood flow to the brain, improving concentration and memory. Peppermint aroma has been found to enhance memory.</li> <li>Sesame seeds are a rich source of the amino acid tyrosine, which is used to produce dopamine, a neurotransmitter responsible for keeping the brain alert and memory sharp. Sesame seeds also are rich in zinc, magnesium and vitamin B6, other nutrients involved in memory function.</li> <li>Saffron has been shown to positively affect individuals with mild to moderate Alzheimer's disease.</li> </ul> <p>Making lifestyle modifications to control your cholesterol, blood sugar and blood pressure levels, as well as not smoking, taking daily walks and keeping your weight in a healthy range can help preserve <a href="/hometown-health/speaking-of-health/when-to-seek-help-for-memory-loss" target="_self" title="Opens in same window.">memory function</a>.</p> <h2>Try this recipe that combines brain-boosting vegetables and healthier fats:</h2> <h3>Beet walnut salad</h3> <p>By Mayo Clinic Staff</p> <p>Serves 8</p> <p>1 small bunch of beets (or enough no-salt-added canned beets to make 3 cups, drained)<br> 1/4 cup red wine vinegar<br> 3 tablespoons balsamic vinegar<br> 1 tablespoon olive oil<br> 1 tablespoon water<br> 8 cups fresh salad greens<br> 1/4 cup chopped apple<br> 1/4 cup chopped celery<br> Freshly ground pepper<br> 3 tablespoons chopped walnuts<br> 1/4 cup gorgonzola cheese, crumbled</p> <p>Steam raw beets in water in a saucepan until tender (skip this step if using canned beets). Slip off skins. Rinse to cool. Slice in 1/2-inch rounds. In a medium bowl, toss with red wine vinegar.</p> <p>In a large bowl, combine balsamic vinegar, olive oil and water. Add salad greens and toss.</p> <p>Put greens onto individual salad plates. Top with sliced beets, chopped apples and celery. Sprinkle with pepper, walnuts and cheese. Serve immediately.</p> <p><em>Nutrition per serving size of 1 cup lettuce and 1/2 cup beets: 90 calories, 5 grams fat, 1.5 grams saturated fat, 115 milligrams sodium, 9 grams carbohydrates, 2.5 grams fiber, 3 grams protein.</em></p> <p><em>Elizabeth (Lizzie) Bertrand</em><em> is a registered dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/st-james" target="_self" title="Opens in same window.">St. James</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2023/salmon-topped-with-lemon.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F8DDE19F87AF664CDFBEC318432D069F" alt="Salmon topped with lemon" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Micah Dorfner6/20/2017<p>It's that time of year again: wedding season. This can be a time of blissful happiness or a time that stretches the limits of self-restraint while trying to keep your health in check. </p>How to watch your weight during wedding season<img alt="weddingfood" src="/-/media/national-files/images/hometown-health/2017/wedding-food.jpg?h=267&w=400&sc_lang=en&hash=D04B51163C669F634D76105DAB2BB280" style="width: 400px; height: 267px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>It’s that time of year again: wedding season. This can be a time of blissful happiness or a time that stretches the limits of self-restraint while trying to keep your health in check.</p> <p>It’s important to remember to limit yourself while attending a wedding. Most often, people become so caught up in the festivities they forget to remember to take care of themselves.</p> <p>Most people have more than one wedding to attend during the year which can add on pounds, if not watched closely.</p> <p>Overeating can lead to numerous health issues, such as emotional and physical damage to the body and mind. This can be due to loss of confidence and increased weight, as well as causing damage to the digestive system.</p> <h2>Here are tips for watching your wedding season weight:</h2> <h3>Participate in morning activity.</h3> <p>Go for a run or walk, or a quick workout, or go golfing. These ideas, among others, can help clear the mind, as well as help you feel calm, centered and more in control of the choices you’ll make later in the day.</p> <h3>Don’t skip meals.</h3> <p>Trying to save up calories will leave you feeling tired, angry and more likely to overconsume during cocktail hour.</p> <h3>Pace yourself.</h3> <p>Choose the amount you want to drink. One drink per course (cocktail hour, dinner and reception) is a good rule of thumb. If that’s not sensible to you, limit yourself to one drink per hour, alternating water with alcohol. This advice is for of-age wedding guests who plan to stay put. Never to drink and drive.</p> <h3>Choose wisely.</h3> <p>There’s no law saying you can’t have one of everything, although it’s good to limit yourself to a few options. Determine what you want to make room for. Try sticking to one plate, filling half with vegetables and the rest with protein and starchy vegetables, such as beans and potatoes.”</p> <h3>Dance.</h3> <p>Hitting the dance floor can help you lose 200 to 300 calories per half hour. This gives you an extra excuse to show off your dance moves — good or bad — and burn off the calories you’ve consumed during the day.</p> <p><em><a href="/providers/gabriel-berendes-md">Gabriel Berendes, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician <a href="/locations/la-crosse">La Crosse</a>, Wisconsin.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>University of Wisconsin School of Medicine and Public Health</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul>Berendes<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/gabriel-berendes-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=AF078455AD7D8531BBC094B793351761" alt="Gabriel Berendes MD" width="280" height="280" DisableNVelocity="true" />Gabriel<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13393723Gabriel Berendes, M.D.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{61776FD2-05E8-47E9-AB55-EE465BD29A19}|{FFD57D6A-3E3A-4808-8F93-B38864FDF469}<img src="/-/media/national-files/images/hometown-health/2017/wedding-food.jpg?h=267&iar=0&w=400&sc_lang=en&hash=FB61175D9527A8752AB7CC47C0EE67AE" alt="Wedding food" width="400" height="267" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Michele Halterman5/6/2024While you're enjoying the outdoors, ticks are looking for a ride — and a meal. Ticks survive on blood from humans and animals, and can transmit disease. Learn how to tame these unwelcome hitchhikers.Taming ticks: Tips to avoid or remove a tick<p>Warm weather entices you into the great outdoors. But while you're having fun golfing, camping, picnicking and hiking, ticks are looking for a ride — and a meal. Ticks live in woods, fields and grassy areas. All of them survive on blood drawn from people or animals, and they can pass along disease in the process.</p> <h2>What makes ticks tick and people sick</h2> <p>To find their next meal, ticks climb onto objects like blades of grass, leaves or shrubs and stick out their legs. When a host brushes by, they grab on. Some ticks attach quickly, while others wander, looking for places where the skin is thinner, like the ear. Ticks also like warm and dark areas, such as the armpit, behind the knee, along the scalp and in the belly button. That's where they'll grab hold and bite.</p> <p>While attached to a host, ticks can acquire or pass along disease. After feeding, most drop off. At their next feeding, ticks can transmit an acquired disease to the new host.</p> <p>Ticks are found in most regions of the country.</p> <h3>Tick-borne diseases and regions in the U.S. they're common include:</h3> <ul> <li><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/lyme-disease/symptoms-causes/syc-20374651" target="_blank" title="Opens in a new window.">Lyme disease</a>, anaplasmosis, babesiosis and Borrelia miyamotoi disease: Upper Midwest and the Northeast</li> <li>Ehrlichiosis: Southeast and South Central</li> <li>Rocky Mountain spotted fever: North Carolina, South Central and Southwest</li> <li>Relapsing fever: Great Plains, Mountain West and West Coast</li> <li>Southern tick-associated rash illness, or Lone Star tick disease: East, Southeast and South Central, but spreading north</li> </ul> <img alt="Ticks illustration" src="/-/media/national-files/images/hometown-health/2022/ticks-illustration.jpg?h=400&w=100%25&sc_lang=en&hash=409A25B8CBE93224E81B97E488A9B906" style="height: 400px; width: 100%;" /> <h2>Tips to avoid tick bites</h2> <h3>Not every tick carries disease, but it's still a good idea to avoid being bitten. These tips can help:</h3> <ul> <li>When outdoor activities take you into tick territory, wear shoes (not sandals), long pants tucked into your socks, a long-sleeved shirt, hat and gloves.</li> <li>Stick to trails when possible, and avoid walking through low bushes and long grass.</li> <li>Keep dogs leashed so they don't venture where ticks may be.</li> <li>Use insect repellents with at least 20% DEET. Repellents with up to 30% DEET can be applied to children over 2 months old but used sparingly on children under 2. Apply to clothes and exposed skin but not hands.</li> </ul> <p>The concentration of DEET in a repellent determines how long protection lasts. A concentration of 10% provides two hours of protection; 30% gives five hours. Avoid products that combine sunscreen and DEET because <a href="/hometown-health/speaking-of-health/myth-or-fact-coconut-is-an-effective-sunscreen" target="_self" title="Opens in same window.">sunscreen</a> needs to be applied more frequently than DEET.</p> <h2>Taking off ticks, treating bites</h2> <p>After spending time in a wooded or grassy area, check yourself, as well as your children and pets, for ticks. Deer ticks, which carry Lyme disease, often are no bigger than the head of a pin, so search carefully.</p> <p>Shower as soon as you come indoors. Using a washcloth on your skin can dislodge ticks that haven't attached yet. You also can put your clothes in the dryer for 10 minutes on high heat to kill lingering ticks.</p> <p>If a tick has attached, time is key. The longer it hangs on, the greater your risk of getting tick-borne diseases.</p> <h3>To remove a tick:</h3> <ul> <li>Avoid folklore remedies like painting the tick with nail polish or petroleum jelly, or using heat from a match or lighter to release its hold.</li> <li>Use fine-tipped tweezers to grab the tick firmly near its head or mouth and as close to the skin as possible.</li> <li>Pull the tick's body up and away from your skin. Avoid jerking or twisting.</li> <li>Take a photo of the tick so your healthcare professional can identify it. Dispose of the tick by putting it in alcohol or a sealed bag, wrapping it tightly in tape or flushing it down the toilet.</li> <li>After handling the tick, use soap and water to wash your hands and the area around the tick bite.</li> </ul> <p>A small, red bump often appears at the site of a tick bite and resolves over a few days. This is typical and doesn't indicate that it has transmitted a disease to that person.</p> <h4>Contact your healthcare professional if:</h4> <ul> <li><strong>You aren't able to completely remove the tick.</strong><br /> The longer the tick remains attached to your skin, the greater your risk of getting a disease.</li> <li><strong>The rash or bump gets bigger.</strong><br /> If the small red bump develops into a larger rash, perhaps with a bull's-eye pattern, it may indicate Lyme disease.</li> <li><strong>You develop flu-like signs and symptoms.</strong><br /> Fever, chills, fatigue, body and joint aches and a headache may accompany the rash. If these signs and symptoms disappear, you may still be at risk of disease.</li> <li><strong>You think the bite site is infected.</strong><br /> Signs and symptoms include redness or oozing.</li> </ul> <p>If you're a Mayo Clinic Health System patient and are concerned about a tick bite, you can call the <a href="/services-and-treatments/nurse-line" target="_self" title="Opens in same window.">Nurse Line</a> within 72 hours of removing a tick to determine the appropriate level of care.</p> <p>Don't let worry over tick-borne diseases keep you and your family indoors. You can safely enjoy your favorite summer activities with a <a href="/hometown-health/speaking-of-health/summer-fun-safety-tips" target="_self" title="Opens in same window.">few precautions</a>, like carefully checking for and removing ticks after spending time in wooded or grassy areas.</p> <p><em><a href="/providers/katie-clubb-md" target="_self" title="Opens in same window.">Katie Clubb, M.D.</a></em><em>, is a physician in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em></p><ul> <li>Creighton Model <em>FertilityCare</em> System</li> <li>Diabetes</li> <li>Fluent in Spanish</li> <li>Natural Family Planning</li> <li>Obstetrics and gynecology</li> <li>Pediatric and maternal oral health</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>United Family Medicine Residency Program</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>Minnesota Academy of Family Physicians</li> <li>Minnesota Board of Medical Practice</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Clubb<img src="/-/media/shared-files/images/medical-professionals/full/owatonna/katie-clubb-md.jpg?h=280&iar=0&w=280&hash=44CF10B1A5E11C78CFD7E938EBCAAE27" alt="Katie Clubb, M.D." width="280" height="280" DisableNVelocity="true" />{5D2B3472-5899-4575-A391-6F3EA409B2EC}Katie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14250063Katherine Clubb, M.D.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}<img src="/-/media/national-files/images/hometown-health/2022/grassy-wooded-path.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9CB9985FEA506D046A32D09D1736676A" alt="Grassy, wooded path" width="660" height="370" DisableNVelocity="true" />Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Michele Halterman6/9/2017<p>In the past several years, my family and I have watched many changes take place in our neighborhood. Most significantly, the road outside our house needed to be replaced. With the death of a loved one, we often face a similar change in landscape.</p>The nature of grief: Lessons in loss and life<img alt="fbBlog_grief17" src="/-/media/national-files/images/hometown-health/2017/sun-shining-through-woods.jpg?h=300&w=300&sc_lang=en&hash=D1301A69981F180E016E424AD9C1CF46" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;"> <p>Change is the challenge we face as something old gives way to something new. In the past several years, my family and I have watched many changes take place in our neighborhood. Most significantly, the road outside our house needed to be replaced.</p> <p>Along with the pavement and plumbing removal, we watched as tree after tree in the boulevard gave way. Following the completion of the new road, a storm came in and took many more compromised trees.</p> <p>Over the past winter, all the ash trees in the neighborhood had to go. It seems silly, but we grieved over the loss of trees that used to provide shade during our daily walks. I felt those beautiful trees also represented history and strong roots.</p> <p>With the death of a loved one, we often face a similar change in landscape. The path we once walked and the things we felt certain about and protected by, are seemingly gone in an instant.</p> <p>Keeping the memories of our loved one alive has an overwhelming responsibility. Our traditions and roots can feel compromised. It is important in times of loss to honor the natural emotions we experience and endure the heavy weight change can bring.</p> <p>In life, we are vulnerable to changes all around us, and it is natural to search for ways to protect ourselves. To know more about grief does not protect us from its place in our lives. Instead, grief can call us to find change within ourselves. We grow in our continued quest to explore meaning and purpose in our own stories and transform our perspective.</p> <p>Our neighborhood walks have since been dotted with mysterious new saplings. We have become more and more curious not just about what kind of trees they are, but what they will become for the next generation that walks this same path.</p> <p>This change reminds us that the space within ourselves that feels sorrow for what we once loved can also feel joy for the hope in what is yet to come.</p> <p>I encourage those looking to explore their own natural journey through grief to consider attending a support group to explore loss and the transformation it can bring. <a href="/classes-and-events" target="_self" title="Opens in a new window.">Explore what's available in your community.</a></p> <p><em>Trisha Lundin is a Bereavement Services counselor in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin</em></p><img src="/-/media/national-files/images/hometown-health/2017/sun-shining-through-woods.jpg?h=504&iar=0&w=504&sc_lang=en&hash=10565AC04E212BF5393D1B3C66C24EF2" alt="Sun shining through woods" width="504" height="504" DisableNVelocity="true" />GriefGrief is the natural reaction to loss. It will be unique to you, depending on your own personality and circumstances.ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Michele Halterman9/21/2023Roughly half of women experience some degree of pelvic organ prolapse, yet rarely discuss the common issue as they age. Read about the causes, symptoms and treatments available.Uterovaginal prolapse: What's that?<p>Women can share so much helpful information about how the body changes over time. While there are many health issues that women may feel comfortable discussing with their friends and family, many of the details of the aging process go undiscussed, often because of embarrassment.</p> <p>Check your knowledge about a common issue for women: pelvic organ prolapse.</p> <h2>True or False: Female organs can shift out of place.</h2> <p>True. Women's <a href="/hometown-health/speaking-of-health/addressing-pelvic-health-disorders" target="_self" title="Opens in same window.">pelvic organs</a> can shift and slip out of place, particularly as they age. Because of this, women may experience issues, such as pelvic or vaginal pressure, and may notice a sensation of a bulge near or through the vaginal opening. These are common symptoms of a condition called uterovaginal prolapse. </p> <h2>True or False: Prolapse issues happen suddenly.</h2> <p>False. Although some women may feel that they suddenly notice the prolapse, it typically develops slowly. However, the prolapse may only be obvious once it can be seen or felt. This can be distressing and cause women to see their healthcare team urgently out of fear of a serious health condition like cancer. Others may notice the change and are too embarrassed to see their healthcare team or feel it's part of the aging process.</p> <h3>Women can have one or a combination of symptoms related to a prolapse, including:</h3> <ul> <li>Inability to empty the bowels or bladder fully or easily</li> <li>Difficulty holding urine or stool, and noticing leakage from the bladder or bowels</li> <li>Needing to physically push the vaginal bulge in when they urinate or have a bowel movement</li> <li>Seeing tissue that protrudes through the vagina opening</li> </ul> <h2>True or False: Prolapse is a common issue.</h2> <p>True. Roughly half of women have some degree of prolapse, and it can affect women of various ages. Prolapse can be associated with naturally occurring changes in women's bodies, such as childbirth and menopause. However, it's most commonly diagnosed after menopause when the body's estrogen levels fall, ligaments and muscles weaken or stretch, and pelvic organs shift. While it may be common, prolapse isn't something women need to simply put up with.</p> <h2>True or False: Prolapse can be prevented.</h2> <p>True and false. Some of the factors that cause prolapse can be modified through lifestyle changes. While women can't change their genetics or age, they can work to avoid actions that cause recurring straining. Pelvic support structures also can weaken <a href="/hometown-health/speaking-of-health/pregnancy-and-pelvic-floor-health" target="_self" title="Opens in same window.">during pregnancy</a> and vaginal delivery. Strengthening and restoring support to the pelvic floor with exercises, like <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/kegel-exercises/art-20045283" target="_blank" title="Opens in a new window.">Kegel exercises</a>, can improve prolapse symptoms. </p> <h2>True or False: There is no cure for prolapse.</h2> <p>True and false. While there is no way to cure prolapse, there are ways to treat it and improve symptoms. <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">Gynecologists</a>, <a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">urologists</a> and <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapists</a> work to help resolve these issues.</p> <h3>Care teams review treatment options to allow women to make the decision that best fits their needs. Options include:</h3> <ul> <li>Choosing to do nothing to treat the prolapse, but prevent from worsening by avoiding activities that can cause strain, such as heavy lifting and constipation.</li> <li>Seeing a physical therapist to improve the strength and coordination of pelvic muscles and nerves to alleviate symptoms.</li> <li>Using a device called a pessary, which is a silicone device inserted into the vagina to help support pelvic organs. If fitted and inserted correctly, most women report not noticing the pessary when it's in place. A healthcare professional can remove, clean and replace the pessary every few months, or you can do it more frequently at home.</li> <li>Having surgery to repair the prolapse or urinary leakage.</li> </ul> <h2>True or False: Treatment can provide relief.</h2> <p>True. There is hope for women who experience prolapse.</p> <h3>Here are just a few of the improvements that patients report:</h3> <ul> <li>Relief from the feeling of pressure in the vagina.</li> <li>The ability to <a href="/hometown-health/speaking-of-health/6-helpful-tips-for-managing-urinary-retention-and-incontinence" target="_self" title="Opens in same window.">empty the bladder</a> and bowels normally.</li> <li>Reduction or elimination of leakage from the bladder or bowels.</li> <li>Less frequent visits to the bathroom.</li> <li>Increased comfort during sexual intercourse.</li> <li>No longer having tissue or organs fall toward or through the vaginal opening.</li> </ul> <p> If you're experiencing prolapse symptoms or leakage from your bladder or bowels, see your healthcare team to determine what treatment is right for you.</p> <p><a href="/providers/mary-alvarado-md" target="_self" title="Opens in same window."><em>Mary Alvarado, M.D.</em></a><em>, is an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em> </p><ul> <li>Minimally invasive surgical techniques</li> <li>Urogynecology (pelvic prolapse and incontinence)</li> </ul>M.D.<p>I believe patient care should be patient-focused rather than disease-focused and that, as providers, we must be considerate of the various backgrounds that our patients come from.</p> <p>I enjoy providing education to patients when they are unsure of both normal and abnormal processes that their bodies are going through. I appreciate being able to work with them to find solutions for their health care needs and concerns.</p> <p>Outside of work, I enjoy cooking and eating a diverse array of foods. I also enjoy hiking and traveling.</p><p><strong>Education</strong></p> <ul> <li> Doctor of Medicine, University of Texas Health Science Center</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Obstetrics & Gynecology, San Antonio Uniformed Services Health Education Consortium</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Obstetrics & Gynecology, San Antonio Uniformed Services Health Education Consortium </li> </ul> <p><strong>Certifications</strong></p> <ul> <li>DaVinci Robotics Training program</li> <li>Neonatal Resuscitation Program</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Obstetrics and Gynecology</li> <li>American Medical Association</li> </ul>Alvarado<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/mary-alvarado-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=5B616B9D345F2FFB9E8DE7A5742065E2" alt="Mary Alvarado, M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/29049054/" target="_blank" title="Opens in new window">Clinical aspects of miscarriage</a>, January/February 2018</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/19517693/" target="_blank" title="Opens in new window">Telephone-based management of lactation mastitis</a>, May 2009</li> </ul>{9B655749-C85D-4CF7-B2AF-ABE3A7F6DB14}Mary <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16265009Mary Alvarado, M.D.1{54693F31-87AF-4B21-91DB-1DEC1E21F878}|{83EB2AA2-1436-4DDC-B7BB-51F8E6A87FC9}<img src="/-/media/national-files/images/hometown-health/2023/bicycler-wearing-helmet-and-sunglasses.jpg?h=370&iar=0&w=660&sc_lang=en&hash=DB192000AE150770B0D1602939924A03" alt="Bicycler wearing helmet and sunglasses" width="660" height="370" DisableNVelocity="true" />Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Micah Dorfner6/6/2017<p>It’s estimated about 80 percent of people will suffer from low back pain in their lifetime. Knowing what to do when the time comes is important.</p>Back pain care and prevention<img alt="lowbackpaininwoman" src="/-/media/national-files/images/hometown-health/2017/lowbackpaininwoman.jpg?h=266&w=400&sc_lang=en&hash=83E3E619FA7E21D43522773F9373A699" style="width: 400px; height: 266px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>At some point in every person’s life — often yearly, if not more consistently — they experience back pain. Whether due to a traumatic event, such as slipping on ice, or something much more trivial, like bending over to pick something up, we have all injured our backs.</p> <p><span>It’s estimated about 80 percent of people will suffer from low back pain in their lifetime. The other 20 percent is likely in denial. Given the probability your future will eventually encounter back pain, knowing what to do when the time comes is important.</span></p> <p><strong><span>What causes low back pain?</span></strong></p> <p><span>Do I have <a href="http://www.mayoclinic.org/diseases-conditions/sciatica/basics/definition/con-20026478" target="_blank" title="Opens in new window">sciatica</a>? Do I have a slipped disc? Most likely, your pain is neither a disc or nerve issue. More often than not, you’ve stressed, overused and/or strained your spinal musculature.</span></p> <p><span>In some cases, there can be more significant injuries; however, the incidence of severe injury is small in comparison. You need to take care of your back muscles just the same as any other muscle in the body. For example, many runners stretch their hip and lower extremity musculature during and following running in order to prevent or treat injury. The same can apply for your spine.</span></p> <p><span>The spine is quite resilient and can take a significant amount of stress. This stress builds and gradually wears down to a point where the spine reaches a painful threshold. Oftentimes, stress has accumulated and only needs a bit more to push it into pain and sensitivity. This is why something as simple as picking an object off the floor can throw your back out.</span></p> <p><strong><span>How can I prevent back pain?</span></strong></p> <p><span>Stretching and exercising your back keeps the sensitivity and pain away — staying far from that threshold of pain. Below are a few great ways to prevent and treat back pain:</span></p> <ul style="list-style-type: disc;"> <li><strong><span>Stretch.</span></strong><span> Stretch often and regularly, especially your back, including before and after back-heavy activity (e.g. snow shoveling, yard work, washing floors, etc.).</span></li> <li><strong><span>Exercise.</span></strong><span> Find an activity you enjoy. Your muscles and joints are more resilient when they’re strong and flexible. Develop your core musculature in order to support your spine and prevent injury. Yoga and Pilates are great activities to prevent back pain and facilitate core strength.</span></li> <li><strong><span>Apply cold or heat.</span></strong><span> Apply ice/cold pack to new pain or stiffness. Otherwise, use whatever feels best. Ensure you have a cloth layer between the ice/heat and your skin to prevent skin damage.</span></li> </ul> <p><strong><span>What if my back pain is long-term?</span></strong></p> <p><span>Occasionally, back pain lingers and becomes an issue for more than a few days. If the aforementioned self-care measures aren’t taking care of your pain, address this sooner rather than later.</span></p> <p><span>When pain is present, muscle strength is inhibited and movement patterns change, placing stress on other parts of the body. Physical therapy can provide treatment and education to reduce and eliminate pain and return you to work, recreational activities and life without pain. Therapists are trained at a doctoral level to treat your pain and educate on prevention. During therapy, you’ll receive treatment based on medicine’s most up-to-date research that provides the best results.</span></p> <p><span>Certain symptoms can indicate potentially serious issues and should be addressed immediately. If you suddenly experience the inability to empty your bladder or have numbness in your groin, contact your doctor right away.</span></p> <p><strong><span>What about back pain medications?</span></strong></p> <p><span>With prolonged pain, medications can be helpful. However, you should never rely on medications, and you should never use them more than temporarily. Chronic use of opioid pain medications can be dangerous, as over-prescription has led to a large increase in opioid dependency and overdoses.</span></p> <p><span>Everyone will experience back pain at some point in their lives. The majority of people aren’t appropriate for surgery. Taking steps to prevent and treat your pain when it occurs is the best and most effective way to prevent dysfunction due to back pain. If you’re struggling with your pain, contact your local physical therapist.</span></p> <p><em><a href="/providers/jordan-moen-dpt">Joran Moen</a>, D.P.T., is a physical therapist at <a href="/locations/mankato">Mayo Clinic Health System in Mankato</a>.</em></p><ul> <li>Injury prevention</li> <li>Orthopedics</li> <li>Spine care</li> <li>Sports medicine</li> </ul>D.P.T.<p>I provide personalized care, specific to each patient’s needs, utilizing approaches and techniques supported by up-to-date and cutting-edge research. Getting to know my patients well allows me to provide positive results as well as an enjoyable experience. I enjoy interacting with patients, getting to know them and their stories.</p> <p>I grew up in a small town in Minnesota. I have participated in sports nearly my whole life. I am married and have two children who keep me on my toes and entertained and always busy. I am also a die-hard Vikings fan.</p><p><strong>Education</strong></p> <ul> <li>Doctor of Physical Therapy, University of Minnesota</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Certified Orthopedic Clinical Specialist</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Physical Therapy, Mayo Clinic College of Medicine and Science</li> </ul>Moen<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jordan-moen.jpg?h=280&iar=0&w=280&sc_lang=en&hash=5DC1BDE898CC87D4B7C7263F7270B861" alt="Jordan Moen" width="280" height="280" DisableNVelocity="true" />{4981A277-40C7-4276-8A69-F497BEB1C905}Jordan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14537541Jordan Moen, D.P.T.1{DEF55970-853F-4E96-9A4D-3413874FF059}|{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2017/lowbackpaininwoman.jpg?h=266&iar=0&w=400&sc_lang=en&hash=44DFA83183F46801BA0C33F1A2536997" alt="lowbackpaininwoman" width="400" height="266" DisableNVelocity="true" />Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.Michele Halterman7/28/2017<p>We’ve all heard the phrase “feel the burn.” Gastroesophageal reflux disease, or GERD, symptoms include heartburn and regurgitation. When it occurs twice or more weekly, it may require attention.</p>Take the burn out of GERD<img alt="fbBlog_GERD_504x504" src="/-/media/national-files/images/hometown-health/2017/fbblog_gerd_504x504.jpg?h=300&w=300&sc_lang=en&hash=A380B120E56FCE5B5E6B61975BF9FAA4" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;"> <p>We’ve all heard the phrase “feel the burn.” Gastroesophageal reflux disease, or GERD, is a common disorder that affects many adults. Symptoms can include heartburn and regurgitation. It is not uncommon or abnormal for someone to have these symptoms occasionally, especially after a large meal. </p> <p>When it occurs twice or more weekly, it may require attention. If left untreated, it could lead to Barrett’s esophagus where the lining of the esophagus becomes “stomach like” in response to abnormal acid exposure over a long period, increasing the risk of esophageal cancer.</p> <p>The recommended first step is to monitor your diet. You can try reducing or eliminating foods and beverages that can trigger heartburn, including those that are fried, fatty or spicy, and coffee and orange juice. The choices you make in your diet could cause symptoms of GERD but may not be the cause.</p> <p>If a change in your diet doesn’t help, the next step is to confirm that you have GERD. A gastroenterologist makes a diagnosis based on a thorough history and physical examination. Often, treatment begins without additional diagnostic tests using strong stomach acid-blocking medications called proton pump inhibitors, sometimes referred to as PPIs.</p> <p>There have been reports in the media over the last few years about potential side effects and complications of proton pump inhibitors. While it is true that there may be a slightly higher risk of kidney problems, pneumonia, diarrhea due to clostridium difficile, bone fracture and even dementia, these have to be placed in proper perspective, as they rarely occur. These medications should only be taken under the guidance of a medical provider.</p> <p>If you are responding to medication for GERD, you can consider surgery, especially if you don’t want to be on a lifelong medication regimen. The goal of surgery is to tighten the junction of the esophagus and stomach to prevent the reflux of stomach contents and acid. You and your gastroenterologist should discuss what the best course of treatment would be for you, based on the risks and benefits.</p> <p>The takeaway is that GERD is manageable, and there are treatment options. Listen to what your body is telling you, and take action based on your situation. There likely is a way to take the burn out of GERD.</p> <p><em>Jaime Zighelboim, M.D.</em><em>, is a gastroenterologist in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2017/fbblog_gerd_504x504-2.jpg?h=359&iar=0&w=504&sc_lang=en&hash=1E16015321C999494BF51B57D4F67134" alt="fbBlog_GERD_504x504 2" width="504" height="359" DisableNVelocity="true" />Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Michele Halterman2/10/2020<p>Does it seem like you are eating all the right foods, exercising and your weight still isn’t going down? If you’re not keeping track of what you’re eating and what you’re doing for exercise, you need to start.</p>Record keeping can help you lose weight — and keep it off<p>Are you frustrated with a lack of progress in your weight-loss efforts? Does it seem like you are eating all the right foods, exercising and your weight still isn't going down?</p> <p>If you're not keeping track of what you're eating and doing for exercise, you need to start. Record keeping is one of the most powerful tools in weight management.</p> <p>Why? Records help keep you accountable, and find out what is and is not working for you. Record keeping can help you identify problem areas to work on and notice successful strategies worth repeating.</p> <h2>How to get started</h2> <h3>Choose a tracking system. </h3> <p>Whether you prefer the old-school method of keeping notes on paper or want to use an app, the goal is to find the system that fits your style. Try this ;<a href="/-/media/local-files/eau-claire/documents/medical-services/weight-management/mayo-clinic-diet-record-tracker.pdf?sc_lang=en&hash=FAF5A394467C967CD4617BCE518CAFDC" target="_blank" title="Opens in a new window.">record tracker</a> to get you started.</p> <h3>Keep it simple.</h3> <p>The main point is to keep track of what is happening. What are you eating and drinking, and doing for exercise? In-the-moment recording is best, but at least do it as soon as possible. It won't help your weight management if you're forgetting all the mindless nibbling that occurs.</p> <h3>Be honest.</h3> <p>Your records will be a useful tool to use to determine where your successes and problem areas lie. No one needs to see them but you.</p> <h3>Be mindful of negative thinking. </h3> <p>Focus on the positive.</p> <p>Find additional <a href="/topics/weight-loss-and-bariatric-surgery">weight management resources</a> and get <a href="/locations/eau-claire/services-and-treatments/weight-management/recipes" target="_self" title="Opens in same window.">recipes</a> to help you lose weight or maintain a healthy lifestyle.</p> <p><a href="/providers/shirley-shelley-rd" target="_self" title="Opens in same window."><em>Shirley Shelley</em></a><em> is a registered dietitian in <a href="/services-and-treatments/weight-management" target="_self" title="Opens in same window.">Weight Management Services</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p>RDN<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Dietetics, University of Wisconsin-Stout</li> <li>Master's degree, Nutrition, University of Wisconsin-Stout</li> </ul>Shelley<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/shirley-shelley-rd.jpg?h=200&iar=0&w=200&sc_lang=en&hash=2A7372FA526AC9D0A7B37633E2BD7211" alt="Shirley Shelley, R.D." width="200" height="200" DisableNVelocity="true" />Shirley<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15069583Shirley Shelley, RDN1{94B2E140-AEF8-44BA-B6A9-4538B77501BC}|{2BEE5070-65FF-4406-9E59-103E06C5A535}<img src="/-/media/national-files/images/hometown-health/2020/diet-plan-oranges-tape-measure.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D7A7528DEAE496B035C14720B5E59B41" alt="Diet plan oranges tape measure" width="660" height="370" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Get Tools to Live Your HealthiestIt’s never too early — or too late — to plan ahead for health. By making preventive care for you and your family a healthy habit, you’ll help improve your well-being. Be sure to connect with your healthcare provider to discuss any further questions that you may have about your health.Michele Halterman1/6/2023Weight training isn't just for bodybuilders and athletes — everyone can get the benefits. Get started with these tips to help you build strength, balance and confidence.10 weight training tips for beginners<p>Years ago, weightlifting was thought to be reserved solely for bodybuilders and athletes. However, there has been significant research on the medical benefits of lifting weights. Everyone benefits from stronger bones and muscles. Plan to incorporate weight training into your routine, regardless of your age, ability or fitness level.</p> <p>Weight training is a type of strength training that uses weights for resistance. This could be weight machines or free weights, like dumbbells or barbells, at home or a gym. It stresses and strengthens your muscles over time.</p> <h2>Who can benefit from weight training?</h2> <p>It doesn't matter if you are 19 or 90, run marathons, or struggle to climb stairs; weight training can benefit everyone.</p> <p>It helps build muscle, strengthens bones, improves balance and prevents injuries. Often, it is helpful for people with many chronic health conditions. Overall, it helps people feel better physically and mentally.</p> <h3>Weight training also has been shown to help improve:</h3> <ul> <li>Blood pressure</li> <li>Blood sugar (diabetes)</li> <li>Brain health</li> <li>Bone density</li> <li>Cholesterol</li> <li>Chronic pain</li> <li>Heart disease</li> <li>Depression </li> <li>Metabolism </li> <li>Self-confidence</li> <li>Thinking and learning skills</li> <li>Weight management </li> </ul> <h2>Tips for getting started</h2> <p><strong> </strong></p> <h3>Here are 10 key points to remember when considering beginning a new weight training routine:</h3> <h4>1. Choose your equipment.</h4> <p>Many options are available, such as free weights, hand weights, weight machines and bands. Some exercises only use your body weight and don't require any equipment. The right choice depends on your budget and preference. They all work if used properly. </p> <h4>2. Warm up.</h4> <p>Cold muscles are more prone to injury, so consider warming up with a brisk walk for five to 10 minutes and dynamic stretching to start each training session.</p> <h4>3. Start light.</h4> <p>Start with light to moderate weights in the first few sessions. Starting light can prevent muscle soreness and lessen the chance of injury.</p> <h4>4. Increase weight slowly.</h4> <p>Gradually increasing the weight amount over a period of two to four weeks. Ten to 15 reps should become difficult as muscles tire and fatigue.</p> <h4>5. Pay attention to pain.</h4> <p>Proper weight training should reduce pain, not cause it. If you have sharp or shooting pain, stop doing that exercise. If done correctly, it also should help your bones, tendons, ligaments and muscles become stronger.</p> <h4>6. Lift slowly.</h4> <p>When lifting weights, do not use momentum. Most weight training injuries occur from swinging the weights, improper technique or lifting too heavy an amount of weight. Take about two seconds to lift the weight and four or more seconds to lower the weight. Training slower activates more muscle fibers in the targeted muscle, which will increase the benefits of strength training in the end.</p> <h4>7. Build in rest.</h4> <p>Work your muscles to fatigue on each exercise and then rest them for at least 48 hours. Lift weights two to three days a week for each muscle group.</p> <h4>8. Seek variety.</h4> <p>A good weight training program should include at least eight to 12 different exercises. These should target the major muscles of the legs, back, chest, abdomen, arms and shoulders.</p> <h4>9. Focus on one set.</h4> <p>Do at least one set on each exercise, paying attention to your form. Most people can get the results by doing one set of 10 to 15 reps of each exercise. Previously, researchers recommended at least two to three sets. However, recent research states that one set, done properly, can be just as effective as multiple sets. Multi-sets are OK if you have extra free time and enjoy spending time in the gym.</p> <h4>10. Breathe.</h4> <p>Remember always to maintain your breathing while you lift. Breathe out through the hardest part of the exercise.</p> <p>If you're new to weight training, talk with a personal trainer or another member of your health care team about the best weight training exercises for you and learn about proper form and technique to avoid injury.</p> <h4>Here are some sample routines for a total-body workout: </h4> <ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/fitness/multimedia/weight-training/sls-20076904" target="_blank" title="Opens in a new window.">10 simple weight training exercises</a></li> <li><a href="/hometown-health/speaking-of-health/15-minute-workout-resistance-bands" target="_self" title="Opens in same window.">15-minute resistance band routine</a> </li> <li><a href="/hometown-health/speaking-of-health/pump-you-up-exercise-with-dumbbells-video" target="_self" title="Opens in same window.">Dumbbell exercises</a> </li> </ul> <p>Being healthy can be hard, but the free <a href="/wellness/journey" target="_self" title="Opens in same window.">Journey to Wellness</a> program makes it easier. Cut through the noise with this free, self-guided program for individual and employer use.</p> <p><a href="/providers/mackenzie-long" target="_self" title="Opens in same window."><em>Mackenzie Long</em></a><em> is a licensed personal trainer in <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">Sports Medicine</a> and <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em> </p><ul> <li>Adolescent strength training</li> <li>Hypertrophy and muscle building</li> <li>Post-physical therapy, post-occupational therapy and surgery exercise transition</li> <li>Pre- and post-cancer exercise</li> <li>Weight loss</li> </ul><p>My philosophy for personal training is to individualize exercise prescription to each person. I take a functional approach to strength training to improve quality of life. What you do in the gym should translate to the activities you need or enjoy in your daily life.</p> <p>In my free time, my husband and I like to stay active by hiking with our dogs, skiing and weightlifting. I like to balance that out with more relaxing activities such as painting and crocheting. </p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Exercise and Sport Science, University of Wisconsin-La Crosse</li> </ul> <p><strong>Internships</strong></p> <ul> <li>Dynamic Variable Resistance Training/Functional Training, Fitness Lying Down</li> <li>Employee Wellness, Viterbo University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Certified Strength and Conditioning Specialist, National Strength and Conditioning Association</li> </ul> <p><strong>Membership</strong></p> <ul> <li>National Strength and Conditioning Association</li> </ul>Long<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/mackenzie-long.jpg?h=280&iar=0&w=280&sc_lang=en&hash=288AD403D69BD44CD2939E8B99DD55D5" alt="Mackenzie Long" width="280" height="280" DisableNVelocity="true" />Mackenzie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30156612Mackenzie Long1{7746ADF8-715B-4593-8AAB-55D7F0467848}|{EAC4F099-8A2B-4C7A-8911-5AF0769EADA7}<img src="/-/media/national-files/images/hometown-health/2022/working-out-with-resistance-bands.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E30D94EF3FD86F0A38D8A4C45B65E5DF" alt="Working out with resistance bands" width="660" height="370" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Michele Halterman9/24/2020Have you ever started a new fitness journey only to be plagued by boredom or new aches and pains? Get tips for avoiding boredom and injury with physical activity.Prevent boredom, injury during physical activity<p>Have you ever started a new fitness journey only to find yourself bored or suffering new pain in a couple of weeks? At this point, you may be asking, "Is this routine really for me?"</p> <p>This is common, but you need to find ways to make the process better to overcome these obstacles.</p> <p>The link between boredom and injuries is strong. As you get bored with a fitness routine, it is easier to skip workouts, take shortcuts with stretching or use poor form. Doing so can increase the risk of injury, which can delay or sideline your exercise goals.</p> <h2>Here are ways to overcome boredom and avoid common injuries:</h2> <h3>Combating boredom</h3> <p>If you find the thought of spending another minute on the "dreadmill" or elliptical trainer is just too much, it may be time to set <a href="/hometown-health/speaking-of-health/setting-smart-goals">SMART goals</a> and change your exercise routine. Cross-training, which incorporates different types of exercise in your schedule, can challenge and strengthen your muscles and joints that don't get used much during your normal routine.</p> <h4>Here are three ways to change it up:</h4> <ul> <li><strong>Try a new activity.</strong><br /> Cardiovascular training is any activity that increases your heart rate for a set amount of time. Explore a variety of options at home, outdoors and in the gym. You might try walking, running, cycling, swimming, cross-country skiing, stair-climbing or jumping rope. Try one of these <a href="/hometown-health/speaking-of-health/15-minute-workouts-you-can-do-at-home" target="_self" title="Opens in same window.">15-minute workouts you can do at home</a>.</li> <li><strong>Try multiple activities within the same workout.</strong><br /> Many people enjoy a "10-10-10" workout. You start on one machine for 10 minutes, then move to a second machine for the next 10 minutes and finish off with a third machine for the last 10 minutes. The little change of scenery seems to help the minutes fly by. You could even call yourself a triathlete by swimming, biking and running in the same workout.</li> <li><strong>Try a new routine during your favorite exercise.</strong><br /> Many days of the same routine can lead to boredom, whether you are running, using an elliptical trainer or cross-country skiing outdoors. If you exercise in a gym, many newer fitness machines are preprogrammed with a range of workouts designed to vary the speed, grade or resistance, simulating rolling hills, large mountains or high-intensity intervals. Varying the effort level required not only helps keep you from getting bored, but also can increase your fitness gains. If you exercise outdoors, try a new location or time of day, or exercise with a friend. If you exercise in your home, try to watch your favorite TV shows or binge that latest season to help the time go by faster.</li> </ul> <h3>Proper form</h3> <p>Technique and proper form are important when starting a new program. Don't concentrate on the amount of weight you are lifting. Instead focus on how you are doing it. Many people will perform exercises wrong and increase their risk for injury from improper form.</p> <h4>Here are some reminders: </h4> <ul> <li>Keep your knees behind your toes when doing any type of squat.</li> <li>Watch your knees in a mirror to make sure they remain parallel and don't move inward when doing squats.</li> <li>Stop your elbows from going below your body when doing a bench press.</li> </ul> <h3>Common aches and pains</h3> <p>It's normal to feel sore as you begin a new fitness program and use your muscles in new ways. Don't let this soreness stop you from working toward your goals. Stretching, ice, massage, heat and light exercise, such as walking or biking, may help alleviate any discomfort. However, <a href="/hometown-health/featured-topic/the-importance-of-movement" target="_self" title="Opens in same window.">keep moving to keep your muscles loose</a> as you recover. As you progress on your exercise journey, your muscles get stronger, and you will experience less soreness and quicker recovery.</p> <p>It's important to distinguish between mild soreness and muscle injuries. Sore muscles feel tender, tired or achy. In contrast, a sports injury usually produces sharp, stabbing or deep pains. This pain could linger even after resting. Talk with your healthcare provider if you are experiencing this type of pain.</p> <h2>Here are tips for preventing the most common exercise injuries:</h2> <h3>Shoulder pain</h3> <p><a rel="noopener" href="https://www.mayoclinic.org/symptoms/shoulder-pain/basics/definition/sym-20050696" target="_blank" title="Opens in a new window.">Pain in your shoulder</a> could be from the joint itself or from any of the many surrounding muscles, ligaments or tendons. Some common causes of shoulder pain are <a href="/hometown-health/speaking-of-health/poor-posture-can-cause-shoulder-pain" target="_self" title="Opens in same window.">poor posture</a>; <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/tendinitis/symptoms-causes/syc-20378243" target="_blank" title="Opens in a new window.">tendonitis</a>, which is inflammation in the muscles from overuse; or <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/rotator-cuff-injury/symptoms-causes/syc-20350225" target="_blank" title="Opens in a new window.">rotator cuff injury</a>, which is injury or wear and tear on the tendon tissues of the shoulder joint. You can prevent shoulder pain by practicing proper posture, and performing rotator cuff and scapular strength exercises. One of the most effective ways to accomplish both is by squeezing the muscles between the base of your shoulder blades and guiding them down toward your back pockets.</p> <h3>Knee pain</h3> <p>Similar to shoulder pain, <a rel="noopener" href="https://www.mayoclinic.org/symptoms/knee-pain/basics/definition/sym-20050688" target="_blank" title="Opens in a new window.">knee pain</a> can be caused by the joint, muscles, ligaments, tendons or bursae around the joint. The severity of knee pain can vary widely, from a slight twinge to pain that interferes with daily activities. A common type of knee pain occurs around your kneecap. This type of knee pain, called <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/patellofemoral-pain-syndrome/home/ovc-20169020" target="_blank" title="Opens in new window.">patellofemoral pain</a>, is sometimes referred to as "runner's knee" and is common in people who participate in sports that involve running or jumping. It is caused by overuse, injury, excess weight, poor alignment of the kneecap or changes underneath the kneecap. This injury is also common in young athletes, especially female athletes.</p> <p>You can prevent runner's knee by practicing proper form and mechanics during squatting and jumping activities, as well as performing exercises to stabilize the knee joint and promoting proper alignment of the knee cap.</p> <h3>Shin splints</h3> <p>Medial tibial stress syndrome, commonly called <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/shin-splints/symptoms-causes/syc-20354105" target="_blank" title="Opens in a new window.">shin splints</a>, is pain in the tibia, which is the large bone in the front of the lower leg. With this injury, shins throb and ache following running or jumping activities. Swollen, overused muscles are often the cause. However, other factors also can contribute, including flat feet and weakness in the hips or core muscles. Shin splints may be confused with or mimic stress fractures, which are more concerning.</p> <p>You can prevent or correct shin splints using various options. Rest, ice and orthotics are most commonly used to reduce inflammation and improve mechanics during running and jumping activities. Stretching is important to care for and prevent this injury. Proper footwear is important. Don't hesitate to ask your healthcare provider about what type of shoe is right for you. Your healthcare provider should evaluate persistent shin pain, or significant pain at rest or when not performing activities.</p> <h3>Back pain</h3> <p>Muscle strains and disk issues are common causes of <a rel="noopener" href="https://www.mayoclinichealthsystem.org/search-results?term=Back+pain&category=Blog+Posts" target="_blank" title="Opens in a new window.">back pain</a>. Usually, muscle strains begin as a sharp pain that dulls gradually and is sometimes accompanied by a muscle spasm. Poor form during lifting activities causes many muscle strains. Disks are the cushions between the bones in your spine. Bulging or ruptured disks can be caused by poor lifting mechanics or prolonged positioning, particularly in a flexed posture. Symptoms of disk issues include pain in the back that can cause spasms, muscle weakness, or numbness and pain that radiates into the leg or arm.</p> <p>Most back pain — even severe back pain — goes away on its own in four to six weeks with self-care, such as rest, heat or ice, over-the-counter pain medication and exercise. A general stretching routine is important when dealing with back pain. Maintaining good flexibility in your hamstrings, quads, hip flexors and lower back can help, along with exercises to strengthen your core muscles. <a href="/hometown-health/speaking-of-health/when-should-i-see-a-doctor-about-back-pain" target="_self" title="Opens in same window.">Talk with your healthcare provider if your back pain persists</a> or is accompanied by weakness or numbness, or spreads down your legs or arms.</p> <p><em><a href="/providers/troy-hoehn-atc" target="_self" title="Opens in same window.">Troy Hoehn</a> is an athletic trainer in <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">Orthopedics</a> and <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">Sports Medicine</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Acute care</li> <li>Concussion identification and management</li> <li>Injury care and prevention </li> <li>Rehabilitation</li> <li>Sports medicine</li> </ul>L.A.T., A.T.C.<p>I listen to my patient's concerns and work hard to find the right solution for them. I also try to relate to my patients and show empathy to their health conditions.</p> <p>When I'm not working I like to spend time with my wife and two sons. I'm also a sports fan and enjoy exercising. </p><p><strong>Education</strong></p> <ul> <li>Bachelor of Science, Athletic Training, Minnesota State University, Mankato</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Licensed Athletic Trainer</li> <li>Certified Athletic Trainer</li> <li>Certified Skinfold Technician</li> <li>Certified Strength and Conditioning Specialist</li> <li>ImPACT Trained Athletic Trainer</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Great Lakes Athletic Trainers Association </li> <li>Minnesota Athletic Trainers Association</li> <li>Minnesota Board of Medical Practice Athletic Trainer Advisory Committee </li> <li>MN Department of Human Services Traumatic Brain Injury Committee </li> <li>National Athletic Trainers Association</li> <li>National Strength and Conditioning Association</li> <li>Safety coordinator for the Mankato North Mankato Youth Football League</li> </ul>Hoehn<img src="/-/media/shared-files/images/medical-professionals/full/mankato/troy-hoehn-atc.JPG?h=280&iar=0&w=280&sc_lang=en&hash=82912D4AD31B73A9ACEA7F22FE5C1394" alt="Troy Hoehn ATC" width="280" height="280" DisableNVelocity="true" />Troy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21616418Troy Hoehn LAT1{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2020/pumped-woman-apple-watch.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BB7670F57F77D0F5DFF8171840884FFD" alt="Pumped woman after working out, wearing an Apple watch." width="660" height="370" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Michele Halterman6/21/2023<p>Sports physicals ensure a student athlete is healthy enough to participate in sports and compete without compromising their well-being. Now's the time to schedule these important physicals.</p>Student athletes: Have you gotten your sports physical?<p>Youth sports have become year-round activities for student athletes. As you prepare for sports camps, training events and the regular season, remember to schedule a preparticipation sports physical.</p> <p>Many states require sports physicals for student athletes entering grades seven or 10, or those who are starting to play sports for the first time. Typically, a sports physical should be performed at least four to six weeks before the sports camp, training or season begins. This gives parents and student athletes time to address any medical issues that may be identified during the physical. Here's what you need to know about these exams.</p> <h2>What is a sports physical?</h2> <p>A sports physical is an exam by a health care professional to ensure a student athlete is healthy enough to participate in sports. The exam gauges their ability to compete without compromising their well-being.</p> <p>The appointment has two main parts: a medical history review and physical evaluation. The medical history review includes questions about family illnesses, past hospitalizations or surgeries, allergies and medications. During the physical exam, a health care professional checks your height, weight, blood pressure, pulse, vision, heart, lungs, abdomen, ears, nose and throat. In addition, they assess your strength, flexibility, joints and posture. You and the health care professional also may discuss body changes, drug and alcohol use, dietary supplements and anything else you'd like to cover.</p> <p>If an issue is uncovered during a sports physical, the examiner will refer the student athlete to a primary care provider or specialist, depending on the need.</p> <h2>Why do student athletes need a sports physical?</h2> <p>Sports physicals help keep student athletes safe. These exams identify any concerns or potential health limitations related to sports participation. Identifying health issues during a sports physical gives the student athlete the opportunity to have them evaluated further and addressed in a safe, timely manner.</p> <h2>Is a sports physical the same as a regular physical?</h2> <p>No. A sports physical focuses on evaluating a student athlete's health as it relates to the sport or sports they play. A regular physical with your primary care provider still is important and more comprehensive than a sports physical.</p> <p>Sports physicals aren't intended to replace care or treatment from a primary care provider. Parents, guardians or athletes with health concerns first should consult with their primary care provider.</p> <p>To be ready to perform at your best during the season ahead, make sure your body's also ready by scheduling your sports physical.</p> <h2>Next steps:</h2> <ul> <li>Find an upcoming sports screening clinic near you by visiting our <a href="/classes-and-events" target="_self" title="Opens in same window.">Classes & Events page</a>, and searching for "sports."</li> <li>If you're referred to one of our specialists, learn about the <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">Sports Medicine services and treatments</a> we provide. </li> <li>Learn about <a href="/services-and-treatments/primary-care" target="_self" title="Opens in same window.">primary care</a>, and <a href="https://www.mayoclinichealthsystem.org/providers?service=Primary%20Care&populateTracking=True" target="_self" title="Opens in same window.">find a provider</a> near you.</li> </ul> <p><em><a href="/providers/robert-freed-do" target="_self" title="Opens in same window.">Robert Freed, D.O.</a>, is an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">Orthopedics</a> and <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">Sports Medicine</a> specialist in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p> <ul> <li>Anatomic and reverse shoulder replacements</li> <li>Arthroscopic rotator cuff repair</li> <li>Arthroscopy of the shoulder, knee and hip</li> <li>Ligament reconstruction</li> <li>Pediatric and adolescent orthopedic surgery</li> <li>Robotic-assisted joint replacements</li> <li>Sports medicine</li> <li>Total and partial knee replacements</li> <li>Upper and lower extremity fracture care</li> </ul> D.O.<p>Along with working in Orthopedics and Sports Medicine, I am also the team physician for the Bethany Lutheran Vikings and the Mankato MoonDogs.</p><p><strong>Education</strong></p> <ul> <li>Des Moines University College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, Michigan State University McLaren Macomb Hospital</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Orthopaedic Sports Medicine and Arthroscopy, University of Cincinnati Wellington Orthopaedic and Sports Medicine</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Osteopathic Board of Orthopedic Surgery</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Orthopaedic Society for Sports Medicine</li> <li>Fellow, American Academy of Orthopaedic Surgeons</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Orthopedics, Mayo Clinic College of Medicine and Science</li> </ul>Freed<img src="/-/media/shared-files/images/medical-professionals/full/mankato/robert-freed-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=393D5A2B52ADF63C7C4F96CD4EBA408D" alt="Robert Freed, D.O." width="280" height="280" DisableNVelocity="true" /> {C5F34281-7EB2-4DFB-89BA-AA05BF035A3F}Robert <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16304489Robert Freed, D.O. 1<img src="/-/media/national-files/images/hometown-health/2023/tennis-ball-on-racket.jpg?h=370&iar=0&w=660&sc_lang=en&hash=71FFA4981A45EFDA12BFA882B6E47E4F" alt="Tennis ball on racket" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Michele Halterman3/5/2024Whether you're new to running or have some experience under your feet, there's a desire to become even a bit better. These tips can set you on the road to becoming the runner you aspire to be.Want to become a better runner? Tips to step up your performance, prevent injuries<p>People choose running to stay active for a variety of reasons, including stress relief, weight loss, training for a race or for overall physical and mental wellness. No matter why you run, it's essential to have a training plan and know how to run smart to avoid injury.</p> <h2>How to train efficiently and safely</h2> <p>If you're <a href="/hometown-health/speaking-of-health/planning-for-your-big-run" target="_self" title="Opens in same window.">new to running</a>, a run-and-walk program can help you succeed. Use time increments that best suit your fitness level. For example, run for 30 seconds, walk for one minute to recover and repeat.</p> <h3>Here are some tips to consider for your running plan:</h3> <ul> <li>As a new runner, aim to lace on your running shoes three to four times per week. Start with low mileage and slowly increase.</li> <li>Don't increase your training mileage by more than 10% a week to help avoid injury. If you typically run three miles per week and want to increase your distance, add no more than 0.3 miles.</li> <li>Warm up at the start of your run for at least three to five minutes, followed by a gradual increase in intensity.</li> <li>You should be able to talk in complete sentences without being short of breath when you run. If you can't, you're likely working above your target aerobic zone.</li> <li>Cool down at the end of your run for three to five minutes to prevent blood from pooling in your legs and allow your heart rate to decrease.</li> </ul> <p>As you gain experience and confidence with your running, you may want to take part in a casual or competitive race.</p> <h3>Your training plan should include preparing for the event by mimicking the race. For example:</h3> <ul> <li>Duplicate the pace or minutes per mile you want to set for the event.</li> <li>Allow at least one easy day of training or rest for every heavy day of training.</li> <li>Incorporate <a href="/hometown-health/speaking-of-health/no-matter-your-age-or-skill-level-its-never-too-late-to-start-weight-training" target="_self" title="Opens in same window.">strength training</a> to avoid muscle imbalance.</li> <li>Stretch regularly after a run and hold the stretch for 20–30 seconds. Take care not to bounce.</li> </ul> <h2>How to best replenish your body when training</h2> <p>Improving your performance happens even when you don't have your running shoes on.</p> <h3>These factors also are part of your training:</h3> <ul> <li><strong>Diet</strong><br /> <a href="/hometown-health/speaking-of-health/fueling-your-run-with-good-nutrition" target="_self" title="Opens in same window.">Refuel after a race or workout</a> within 30–60 minutes. Choose a combination of carbohydrates and protein.</li> <li><strong>Hydrate</strong><br /> <a href="/hometown-health/speaking-of-health/water-essential-to-your-body-video" target="_self" title="Opens in same window.">Drink water</a> before, during and after you run. It's equally important to stay hydrated throughout the week, not just on the days you run.</li> <li><strong>Sleep</strong><br /> The average person needs seven and a half to eight <a href="/hometown-health/speaking-of-health/sleep-and-athletic-performance" target="_self" title="Opens in same window.">hours of sleep</a> per night. Increase this by one extra minute per night for each mile you train per week.</li> </ul> <h3>Consider these six things while training:</h3> <ol> <li>Buy <a href="/hometown-health/speaking-of-health/expert-advice-on-finding-the-best-shoe-fit" target="_self" title="Opens in same window.">good running shoes</a> and ensure they <a href="/hometown-health/speaking-of-health/how-to-determine-foot-arch-type" target="_self" title="Opens in same window.">fit your foot</a> properly. Make sure to replace your running shoes every 300–400 miles.</li> <li><a href="/hometown-health/speaking-of-health/cross-training-is-important-for-running-preparation" target="_self" title="Opens in same window.">Cross-train</a> if you find it difficult to run every day. Biking, elliptical training or swimming are excellent alternatives.</li> <li>Finish your run feeling strong, not worn out.</li> <li>It's normal to experience general muscle soreness that's gone within 24 hours.</li> <li>Stop running if pain affects your gait. <a href="/hometown-health/speaking-of-health/managing-pain-swelling-during-marathon-training" target="_self" title="Opens in same window.">Pain or stiffness</a> should improve after the first 10 minutes. If it doesn't improve, stop.</li> <li>Watch out for excessive fatigue, a higher resting heart rate, muscles that are sorer, irritability, difficulty sleeping and decreased motivation. If these appear, check in with your primary care provider.</li> <li>Have your gait analyzed to improve your running. Watch a video on what to expect during a gait analysis:<br /> <div> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/FHn_t8NPBhg" title="What to expect during a running video analysis" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> </div> </li> </ol> <p>Whether you're new to the sport or an elite athlete, running can be an enjoyable experience. Using these tips can help you become the runner you aspire to be.</p> <em><a href="/providers/leslie-grommersch-dpt" target="_self" title="Opens in same window.">Leslie Grommersch, </a><a href="/providers/kimberly-olsen-pt" target="_self" title="Opens in same window.">Kimberly Olsen, </a>and <a href="/providers/desiree-essler-pt" target="_self" title="Opens in same window.">Desiree Essler</a> are <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapists</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em><ul> <li>Orthopedics</li> <li>Sports medicine</li> </ul>D.P.T.<p>I believe in providing patient-centered, evidence-based care that is tailored to each individual’s goals and lifestyle. I enjoy working with patients recovering from orthopedic injuries, post-surgical procedures and active individuals looking to return to sport and recreation. Patients can expect a personalized rehabilitation plan focused on strength, movement quality and progressive recovery designed to help them safely return to the activities that are most meaningful to them.</p> <p>Outside of work, I enjoy spending time with my family and keeping up with my kids’ activities. I love traveling, staying active and cheering on Minnesota sports teams. Much of my free time is spent outdoors and supporting my kids in the activities they enjoy.</p><p><strong>Education</strong></p> <ul> <li>Doctor of Physical Therapy, St. Scholastica</li> </ul> <p><strong>Certification</strong></p> <ul> <li><strong></strong>Minnesota Board of Physical Therapy</li> </ul>Grommersch<img src="/-/media/shared-files/images/medical-professionals/full/mankato/leslie-grommersch-dpt.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7BDC5BDD8C00AFD34EEB259F76473548" alt="Leslie Grommersch DPT" width="280" height="280" DisableNVelocity="true" />{86ECDEF8-A8C0-48B6-85CC-9FCFA378CDDA}Leslie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15437515Leslie Grommersch, D.P.T.1{DEF55970-853F-4E96-9A4D-3413874FF059}<ul> <li>Aquatic therapy  </li> <li>Orthopedic medicine</li> <li>Sports medicine</li> <li>Vestibular</li> </ul>P.T.<p>I am passionate about helping patients achieve their goals of returning to work, daily activities and recreational activities. My specialty areas include aquatic therapy, vestibular therapy, and orthopedic and sports rehab.</p> <p>In my free time, I enjoy spending time with my family, biking on the trails around Mankato and Minnesota, walking my dog, and gardening.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Physical Therapy, Mayo Clinic School of Health Sciences</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Credentialed Clinical Instructor, American Physical Therapy Association</li> <li>Minnesota Board of Physical Therapy</li> </ul>Olsen<img src="/-/media/shared-files/images/medical-professionals/full/mankato/kimberly-olsen-pt.jpg?h=280&iar=0&w=280&sc_lang=en&hash=9FAAE935455429C0A4D51A0D93745BC0" alt="Kimberly Olsen PT" width="280" height="280" DisableNVelocity="true" />{FEA2DE2C-F235-4D61-A2E6-901AD650C612}Kimberly<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>11913177Kimberly Olsen PT1{DEF55970-853F-4E96-9A4D-3413874FF059}|{7746ADF8-715B-4593-8AAB-55D7F0467848}<ul> <li>Manual therapy</li> <li>Spine</li> <li>Sports medicine</li> <li>Temporomandibular joint dysfunction (TMJ)</li> </ul>P.T.<p><strong>Education </strong></p> <ul> <li>College of St. Scholastica</li> </ul> <p><strong>Certification </strong></p> <ul> <li><strong></strong>Minnesota Board of Physical Therapy</li> </ul>Essler<img src="/-/media/shared-files/images/medical-professionals/full/mankato/desiree-essler-pt.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4D56C7D2326F52FA1E7D0BBE35D18E81" alt="Desiree Essler PT" width="280" height="280" DisableNVelocity="true" />{098BDA88-7706-4511-8FCD-848A665819D8}Desiree<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14434831Desiree Essler PT1{DEF55970-853F-4E96-9A4D-3413874FF059}|{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2024/two-runners-in-woods.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D950099DC6862B892705B143CAD3A54D" alt="Two runners in woods" width="660" height="370" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Micah Dorfner8/22/2017Repetitive tasks can cause carpal tunnel syndrome resulting in inflammation and swelling of the wrist and putting pressure on the median nerve. Get prevention strategies and learn how O.T. can help.Carpal tunnel syndrome: Why go to occupational therapy?<img alt="carpaltunnelinwomanswrist" src="/-/media/national-files/images/hometown-health/2017/carpal-tunnel-in-womans-wrist.jpg?h=267&w=400&sc_lang=en&hash=7771962DF6C6D8C2AF87BCD94D955E7B" style="width: 400px; height: 267px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /> <p>People use their hands to complete tasks every day. Some of these tasks can be repetitive in nature and cause pain. A variety of professions — such as desk work with keyboarding, electrical work, construction and more — can put you at greater risk for pain and injury. Other risk factors include obesity, pregnancy and rheumatoid arthritis. </p> <p><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/home/ovc-20313865" target="_blank" title="Opens in new window">Carpal tunnel syndrome</a> occurs with repetitive flexion or bending at the wrist. This causes inflammation and swelling within the carpal tunnel of the wrist and puts pressure on the median nerve.</p> <p>Added pressure on the median nerve may lead to symptoms of tingling, numbness, weakness, and pain in the hand, thumb, pointer finger, middle finger and half of the ring finger. The median nerve provides the sensory and motor function to these digits, which impacts grip strength and manual dexterity. In severe cases, muscle wasting may occur at the base of the thumb.</p> <h2>Strategies to try before surgical intervention</h2> <h3>Before considering surgery for carpal tunnel syndrome, try these nonsurgical options:</h3> <ul> <li>Decrease repetitive activities that cause wrist flexion/bending.</li> <li>Rest.</li> <li>Ice wrist 10–15 minutes one to two times an hour with active symptoms.</li> <li>Take nonsteroidal anti-inflammatory drugs (NSAIDS) to relieve pain symptoms.</li> <li>Wear a wrist splint in a neutral position at night during sleep to decrease random movements and positioning.</li> <li>Talk to your provider about a corticosteroid injection for pain symptoms.</li> </ul> <h2>Importance of occupational therapy after surgery</h2> <p>If surgical intervention is the best option, it’s important to seek occupational therapy for post-op therapy to ensure proper healing and strengthening for the tissues in the hand. Many individuals develop infections, nerve damage, stiffness and pain along the scar from surgery, which may interfere with using the hand if the individual doesn't seek occupational therapy. Occupational therapists can provide the proper education and strategies to implement during the healing process.</p> <h3>Ways occupational therapists assist include: </h3> <ul> <li><strong>Edema control</strong><br /> Reducing swelling to increase active range of motion.</li> <li><strong>Pain management</strong><br /> Using modalities to decrease pain symptoms to increase movement.</li> <li><strong>Improved range of motion<br /> </strong>Aiding in functional range of motion of the hand.</li> <li><strong>Sensory re-education</strong><br /> Helping with scars that may become sensitive and impact use of the affected hand.</li> <li><strong>Splinting</strong><br /> Administering splints to ensure proper healing without risk of injury.</li> <li><strong>Preventive education</strong><br /> Assisting with modifications to everyday tasks that require repetitive wrist movements.</li> </ul> <p>Occupational therapists play a vital role in helping people return to their daily tasks, whether work activities or properly caring for themselves.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2017/carpal-tunnel-in-womans-wrist.jpg?h=267&iar=0&w=400&sc_lang=en&hash=933D04636C9195E6F8ED3CF71479733C" alt="carpal tunnel in woman's wrist" width="400" height="267" DisableNVelocity="true" />Rehabilitation TherapyRestoring movement and function to people injured or impaired by disease or injury.Michele Halterman4/1/2024Viewing an eclipse is memorable, but eye experts stress doing it safely. Looking into any type of eclipse — partial or total — poses severe risks to your eyes. Read tips for safe eclipse viewing.How to watch the solar eclipse safely<p>On April 8, a solar eclipse — when the moon blocks the sun — will be visible in North America as the sun crosses Mexico, the U.S. and Canada. A total eclipse will occur in certain locations in the U.S., and a partial eclipse will be visible in other areas of the country, including Minnesota, Wisconsin and Iowa. While the eclipse is a momentous occasion, it's something eye experts say you need to enjoy safely.</p> <h2>Eye safety during the eclipse</h2> <p>Looking into any type of eclipse — partial or total — poses severe risks to your eyes. You could permanently damage your retina or even cause blindness. It's not safe to look directly at the sun without specialized protective eyewear. </p> <p>If you plan to take part in the solar viewing, you need to use solar eclipse glasses or a solar viewer to be completely safe. Solar viewers or glasses labeled as ISO 12312-2 compliant reduce the sunlight to a safe level for viewing. </p> <p>Regular sunglasses and homemade solar filters are not safe for use. Regular sunglasses don't provide adequate eye protection like eclipse glasses, no matter how dark the sunglasses are. </p> <p>The eclipse can be viewed directly without eye protection only when the sun is entirely covered by the moon, which is called totality. During this period, you'll no longer be able to see any part of the sun through your eclipse glasses or solar viewer. </p> <p>It's crucial to immediately put on your eclipse glasses or use the solar viewer again as soon as the sun's first light is visible behind the moon.</p> <h2>Safety tips for eclipse viewing</h2> <p>Eclipse viewers should follow these safety tips from the <a rel="noopener noreferrer" href="https://www.aao.org/" target="_blank" title="Opens in new window.">American Academy of Ophthalmology</a> and the <a rel="noopener noreferrer" href="https://aas.org/" target="_blank" title="Opens in new window.">American Astronomical Society</a>:</p> <ul> <li>Always read and follow all directions that come with the solar filter or eclipse glasses.</li> <li>Carefully look at your solar filter or eclipse glasses before using them. If you see any scratches, tears or damage, don't use them.</li> <li>Before looking up at the bright sun, stand still and cover your eyes with your eclipse glasses or solar viewer. After glancing at the sun, turn away and remove your filter — don't remove it while looking at the sun.</li> <li>Help children use handheld solar viewers and eclipse glasses correctly.</li> <li>Never look at the uneclipsed or partially eclipsed sun through an unfiltered camera, telescope, binoculars or similar devices. This is important even if you're wearing eclipse glasses or holding a solar viewer at the same time. The intense solar rays coming through these devices will damage the solar filter and your eyes.</li> <li>Talk with an expert astronomer if you want to use a special solar filter with a camera, a telescope, binoculars or any other optical device.</li> </ul> <p>Have fun watching the solar eclipse, but be sure your eyes are properly protected.</p> <p><a href="/providers/robert-friese-od" target="_self" title="Opens in same window."><em>Robert Friese, O.D.</em></a><em>, is an <a href="/services-and-treatments/ophthalmology" target="_self" title="Opens in same window.">optometrist</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a>, Minnesota.</em></p><ul> <li>Comprehensive eye exams</li> <li>Contact lens fitting</li> <li>Diabetes</li> <li>Diagnoses and treatment of eye diseases</li> <li>Dry eye disease</li> <li>Glaucoma</li> <li>Macular degeneration</li> </ul>O.D.<p>I provide comprehensive eye exams, diagnoses and treatment of eye disease, dry eye disease and contact lens fitting. </p> <p>I have lived in Fairmont for 30 years. </p><p><strong>Education</strong></p> <ul> <li>Doctor of Optometry, University of California - Berkeley School of Optometry</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Diplomate, American Board of Optometry</li> </ul>Friese<img src="/-/media/shared-files/images/medical-professionals/full/fairmont/robert-friese-od.jpg?h=280&iar=0&w=280&hash=28DC7F4D3B18AA7644C9CBBA5B19C874" alt="Robert Friese OD" width="280" height="280" DisableNVelocity="true" />{D85012E4-9C42-474E-AFB0-A40376EC9035}Robert<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14474077Robert Friese, O.D.1{C5680DDD-C649-4B63-AFCC-B52A244736B7}<img src="/-/media/national-files/images/hometown-health/2017/solar-eclipse.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6AAC5A99D5FB6BE71F28211DA438CE9E" alt="Solar eclipse" width="660" height="370" DisableNVelocity="true" />Eye HealthYour eyes are responsible for providing you with vision, perhaps the most important of the senses. However, the eye is a delicate and complicated structure that needs protection. The ugly truth is that eye injuries can happen at any time and place.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Micah Dorfner8/8/2017<p>When a loved one's abilities change based on a medical condition, you may need to consider adaptive equipment. Adaptive equipment supports those in need and helps keep everyone in the home safe.</p>Adaptive equipment: Support at home for those in need<img alt="Elderly Hands" src="/-/media/national-files/images/hometown-health/2017/elderly-hands.jpg?h=267&w=400&sc_lang=en&hash=B46142D03D921F9B61B3EC9056646F0F" style="width: 400px; height: 267px; float: right; margin-bottom: 10px; margin-left: 10px;"> <p>When a loved one's abilities change based on a medical condition, you may need to consider adaptive equipment. Adaptive equipment supports those in need and helps keep everyone in the home safe.</p> <p>Here are a few pieces of equipment that may be helpful:</p> <ul style="list-style-type: disc;"> <li><strong><span>Shower bench.</span></strong><span> A shower bench can be used to assist in shower transfer. This useful addition allows for seated bathing in the shower and can eliminate the need to install a walk-in shower.</span></li> <li><strong><span>Grab bars.</span></strong><span> Grab bars can be placed in the shower, near a step or by the toilet. Grab bars can provide stability for transferring or just standing.</span></li> <li><strong><span>Raised toilet seat with arms.</span></strong><span> Having a raised toilet seat with handles helps elevate the height of the toilet, eliminating troubles with transferring on and off the toilet. This can help you avoid purchasing a raised-height toilet.</span></li> <li><strong><span>Bed rails.</span></strong><span> If your loved one is having difficulty getting in and out of bed and you don’t want to purchase a hospital bed, bed rails might be just the equipment you need.</span></li> <li><strong><span>Commode.</span></strong><span> Commodes are portable and height-adjustable toilet units. They are helpful when the bathroom is too far from the bedroom or is on another level of the house. A commode is beneficial to people who have issues getting to the bathroom on time.</span></li> </ul> <p>Consider trying adaptive equipment before exploring expensive home remodels or moving into another home. Occupational therapists can complete home visits to assess your safety and provide you with recommendations to make living at home safe.</p> <p><em>Carla Kes is an occupational therapist at <a href="/locations/new-prague">Mayo Clinic Health System in New Prague</a>.</em></p><img src="/-/media/national-files/images/hometown-health/2017/elderly-hands.jpg?h=267&iar=0&w=400&sc_lang=en&hash=7CAD6E8380AD30903799DD8A6B891E4B" alt="Elderly Hands" width="400" height="267" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.AgingLife expectancy is 75 for males and 80 for females according to the National Center for Health Statistics. We'll help you keep you informed about potential issues with aging, and steps you can take to maintain your health and keep active.Karen Sperl11/21/2023<p>If current trends continue, as many as one in three Americans will have diabetes by the year 2050. That projection is staggering, but it doesn't necessarily have to come true.</p>Diabetes: What you need to know — and do<p>If current trends continue, as many as 1 in 3 Americans will have diabetes by the year 2050. That projection is staggering — but it doesn’t necessarily have to come true. </p> <p>Almost 30 million adults and children in the U.S. have diabetes, and there are several forms of the disease.<a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/home/ovc-20340976" target="_blank" title="Opens in a new window."> Type 1 diabetes</a>, which affects approximately 5% of the U.S. population, is an autoimmune disease where the body destroys the cells in the pancreas that produce insulin. Many people think this type of diabetes is only diagnosed in children and teens, but more than half the people diagnosed with type 1 diabetes are over 30. </p> <p><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/home/ovc-20169860" target="_blank" title="Opens in a new window.">Type 2 diabetes</a> is a condition where the pancreas still produces insulin, but the body doesn’t use it appropriately. In the past, this type of diabetes usually only occurred in adults. But now that many young people are overweight and have obesity issues, this type of diabetes is developing more in children and adolescents. </p> <h2>Types of diabetes </h2> <p>In each type of diabetes, the primary health issue is elevated blood glucose. These types include:</p> <ul> <li><strong>Type 1 diabetes.</strong> This form always needs to be controlled with insulin. </li> <li><strong>Type 2 diabetes.</strong> You may be able to control the disease with diet, exercise and oral medications, but eventually, these people will need insulin to treat their condition. </li> <li><strong>Gestational diabetes.</strong> <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/home/ovc-20317173" target="_blank" title="Opens in a new window.">Gestational diabetes</a> occurs during pregnancy. It affects nearly 1 in 10 pregnancies. People who have gestational diabetes during pregnancy have a much greater risk of developing Type 2 diabetes during their lifetime. </li> </ul> <h2>Diabetes signs and symptoms </h2> <h3>Signs and symptoms of diabetes include: </h3> <ul> <li>Excessive thirst </li> <li>Frequent urination</li> <li>Weight loss </li> </ul> <h3>Left undiagnosed and untreated, diabetes can lead to severe, long-term complications, including: </h3> <ul> <li> Eye disease and blindness </li> <li>Increased risk of heart disease and stroke</li> <li>Kidney disease </li> <li>Nerve disease</li> <li>Peripheral vascular disease and amputations </li> </ul> <h2>Diabetes risk factors</h2> <h3> Risk factors for type 2 diabetes, the most common form of the disease, include:</h3> <ul> <li>Being overweight or obese.</li> <li>Having a first-degree relative with diabetes. </li> <li>Having a history of gestational diabetes or delivering a baby greater than nine pounds. </li> <li>Having high blood pressure or cholesterol. </li> <li>Having <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/prediabetes/home/ovc-20270022" target="_blank" title="Opens in a new window.">prediabetes</a>, metabolic syndrome or polycystic ovary syndrome. </li> <li>Physical inactivity. </li> </ul> <p>Certain ethnic populations also have a higher risk, including Hispanic Americans, Native Americans, African Americans, Asian Americans and Pacific Islanders. </p> <h2>Prediabetes </h2> <p>Eighty-six million Americans have prediabetes — a condition where the blood glucose levels are just starting to elevate and are not yet to the level of diabetes. Prediabetes, however, doesn’t have to become type 2 diabetes. The <a rel="noopener" href="https://www.niddk.nih.gov/about-niddk/research-areas/diabetes/diabetes-prevention-program-dpp?dkrd=prspt1922" target="_blank" title="Opens in a new window.">Diabetes Prevention Program</a> study showed that lifestyle interventions, such as diet, exercise and weight reduction, can cut the risk of developing type 2 diabetes by more than half. </p> <p>By balancing diet, exercise and medication, you can control diabetes and prevent long-term complications. However, this requires commitment on your part. Each person’s plan to control diabetes needs to be specific to them. With the right healthcare team and a strong personal support system, people with diabetes can live long and healthy lives without complications. </p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2023/two-people-looking-up-in-sky-in-winter-scene.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2EEEFE0088D4AF77DFB119D95FBCA49A" alt="Two people looking up in sky in winter scene" width="660" height="370" DisableNVelocity="true" />DiabetesIf you have diabetes, no matter what type, it means you have too much glucose in your blood, although the reasons may differ. Too much glucose can lead to serious health problems.Dawn Haller6/13/2023<p>Pinpointing the most fertile days of your cycle can increase the chances of conception. Learn the signs of ovulation and ways to track it using your body's clues and other tools.</p>Using ovulation tools to predict fertility<p>If you search for ovulation tools online, you'll quickly find that all the options can be a little overwhelming. Here's a breakdown of ovulation and what to know about tracking it.</p> <h2>Ovulation and fertility</h2> <p>Women are most fertile around the time of ovulation, which is when the body releases a mature egg from the ovary. After the egg is released, it travels to the fallopian tubes, where it can be fertilized by sperm. </p> <p>Once released, the egg has 12 to 24 hours to become fertilized. On average, <a href="/hometown-health/speaking-of-health/trying-to-get-pregnant-select-a-lubricant-that-is-most-helpful-for-sperm" target="_self" title="Opens in same window.">sperm can survive</a> inside a woman's body for three days, and up to five days, to fertilize the egg.</p> <p>The chance of <a href="/hometown-health/speaking-of-health/thinking-about-getting-pregnant-5-things-to-think-about-first" target="_self" title="Opens in same window.">getting pregnant</a> is highest when live sperm are present in the fallopian tubes during ovulation. So how can you tell if you're ovulating?</p> <h3>Does the body give signs of ovulation?</h3> <p>Most women will ovulate within four days of the middle point of their menstrual cycle. One way to track this is to use a calendar to track the length and midpoint of the menstrual cycle. </p> <h4>Signs of ovulation include:</h4> <ul> <li><strong>Change in cervical mucus</strong><br> Before ovulation, there may be an increase in clear, wet and slippery secretions from the vagina. After ovulation, the secretions become thicker and cloudy or may go away. </li> <li><strong>Change in body temperature</strong><br> Basal body temperature is the body's temperature at rest, and it increases slightly during ovulation. Tracking basal body temperature every morning before getting out of bed can indicate a pattern in the temperature. Women are most fertile during the two to three days before basal body temperature rises. </li> </ul> <p>If watching for changes in cervical mucus or tracking basal body temperature aren't effective, some people use ovulation predictor tools to track the rise in hormones that occurs before ovulation. </p> <h3>Can I use an ovulation app, or should I use an ovulation kit?</h3> <p>When <a href="/hometown-health/speaking-of-health/preparing-for-a-baby-together" target="_self" title="Opens in same window.">couples are trying to get pregnant</a>, they can start with an app. Each woman has different needs when it comes to predicting ovulation. All women should track their cycles, and a great place to do that is with an app. After details about periods are entered, the app will give the fertile time of the cycle. Having intercourse at least every other day around their most fertile time is recommended.</p> <p>If a couple has been trying to get pregnant for more than six months and <a href="/hometown-health/speaking-of-health/infertility-and-stress" target="_self" title="Opens in same window.">hasn't been able to conceive</a>, an ovulation kit, in addition to using the app, may be helpful.</p> <h3>Why should I use an ovulation kit?</h3> <p>Ovulation kits look for a rise in the luteinizing hormone, which causes women to ovulate and release an egg. When a woman is ovulating, she is at the most fertile part of her cycle and is the most likely to get pregnant. Being aware of this can help increase a woman's chances of getting pregnant.</p> <h3>When should I use the ovulation kit?</h3> <p>Typically, a woman's menstrual cycle is 24 to 38 days. A standard reference timeframe for a menstrual cycle is 28 days. With a 28-day cycle, a woman will ovulate on day 14 or 14 days before her next period starts. With a shorter or longer cycle, the ovulation day varies.</p> <p>Start testing on the first day that indicates a fertile day on the ovulation app, and test your urine once daily. A positive result would indicate to have intercourse that day and the day after.</p> <h3>How do I read the ovulation kits?</h3> <p>Like pregnancy tests, stick ovulation tests display indicator lines, with one being a control line. If the second line is as dark or darker than the first line, this indicates you will soon ovulate. These tests can be more difficult to read but are the least expensive.</p> <p>Some digital ovulation tests give "yes" or "no" responses using words or images, such as smiley faces, to tell that you'll ovulate soon.</p> <p>Other digital tests may tell how fertile you are by providing your fertile days, which are also indicated with an app. Look for the peak as a positive result, indicating that you'll ovulate soon.</p> <h3>Not getting the results you're looking for?</h3> <p>Ovulation kits aren't perfect. False positives or consistent negatives can happen. This may be caused by eggs not being released, excessive amounts of the luteinizing hormone or another ovulatory dysfunction. If you're concerned about your results, contact your health care team to discuss your fertility.</p> <h3>Learn more about ways to improve fertility:</h3> <ul> <li>To become pregnant, the complex processes of ovulation and fertilization need to work just right. Read <a href="/hometown-health/speaking-of-health/tips-to-improve-fertility" target="_self" title="Opens in same window.">tips to improve fertility</a>.</li> <li>It seems like there's endless advice on what to do when you're trying to get pregnant, but what information is accurate? Read about <a href="/hometown-health/speaking-of-health/boxers-or-briefs-4-common-fertility-myths-debunked" target="_self" title="Opens in same window.">common fertility myths</a>.</li> </ul> <p><a href="/providers/alicia-ogle-np" target="_self" title="Opens in same window."><em>Alicia Ogle</em></a><em> is a nurse practitioner in <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p> <ul> <li>Infertility</li> <li>Women's health</li> </ul> A.P.N.P., R.N. <p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Nursing, Cedarville University</li> <li>Master's degree, Nursing, University of Wisconsin-Eau Claire</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Nurse Practitioner, American Nurses Credentialing Center</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Society of Reproductive Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Obstetrics and Gynecology, Mayo Clinic College of Medicine and Science</li> </ul> Ogle<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/alicia-ogle-np.jpg?h=280&iar=0&w=280&sc_lang=en&hash=BC96CD4910532A55886115C7A5D18166" alt="Alicia Ogle, N.P." width="280" height="280" DisableNVelocity="true" /> {25F09A55-D529-46B4-A68F-D93F9C967DDA}Alicia<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14443937Alicia Ogle, A.P.N.P., R.N. 1{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{54693F31-87AF-4B21-91DB-1DEC1E21F878}<img src="/-/media/national-files/images/hometown-health/2023/close-up-of-holding-cellphone.jpg?h=370&iar=0&w=660&sc_lang=en&hash=51501488163FFC7B86E6E9D5A12E804F" alt="Close-up of holding cellphone" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.FertilityFertility issues may be due to a single cause with you or your partner or a combination of factors that may prevent a pregnancy from occurring or continuing. There are multiple safe, effective fertility therapies available.Michele Halterman9/20/2017<p>Eating five a day can get boring if you just buy the same old fruits and veggies. Learn how to get some variety at your next grocery store trip.</p>Grocery store tour: Shopping the produce aisle<p>Seeing colors or just shopping in the produce section? Vitamins and minerals are expressed through color, and fruits and vegetables have plenty of those. Although many items in the produce section  grow in the soil, they really are clean foods, meaning they’re low in sodium, fat and cholesterol, and have few added preservatives. Fruits and vegetables also are full of fiber and help keep you feeling fuller longer to add more benefit to you.</p> <p>You should eat 5–7 servings of fruits and vegetables each day, which can be difficult. To accomplish that goal, try eating a variety of colors to ensure you’re getting a variety of nutrients. Leafy vegetables are fillers, adding bulk and water to your meals. More starchy vegetables, such as peas, green beans, carrots and corn, have more carbohydrates, which doesn’t mean you shouldn’t eat them, just less of them. There are many different ways to prepare your fruits and vegetables to ensure you’re getting the recommended amount on a daily basis, and sometimes it takes trying them more than once to start to enjoy them — even for adults.</p> <p>Watch health educator Katie Johnson as she takes you through the produce aisle and tells you what you might not know about your fruits and vegetables:</p> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/ZXgMuMM9eMA" title="Shopping the produce aisle" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p>Watch other grocery store tours:</p> <ul> <li><a href="/hometown-health/speaking-of-health/grocery-store-tour-shopping-the-perimeter" target="_self" title="Opens in same window.">Shopping the perimeter</a></li> <li><a href="/hometown-health/speaking-of-health/grocery-store-tour-selecting-meat-and-dairy" target="_self" title="Opens in same window.">Selecting meat and dairy</a></li> <li><a href="/hometown-health/speaking-of-health/grocery-store-tour-shopping-the-dry-goods" target="_self" title="Opens in same window.">Shopping the dry goods</a></li> </ul><img src="/-/media/national-files/images/hometown-health/2017/fruits-and-veggies.jpg?h=504&iar=0&w=504&sc_lang=en&hash=E057B667F04BA33DC4424798C937620C" alt="Fruits and veggies" width="504" height="504" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller9/16/2022<p>Autumn brings cooler nights and changing colors on the trees. Kids are back in school, days become shorter and winter planning begins. Enjoy autumn safely with these tips. </p>Think safety in fall as weather changes<p>Nights are getting cooler, and the trees are starting to change colors as autumn begins. And routines are changing because kids are back to school, the days are shorter and winter planning is underway.</p> <h2>Think safety as you enjoy the cooler temperatures and vibrant colors:</h2> <h3>Safely warm up by the fire.</h3> <p>Inspect your fireplace before lighting the first fire. One of the simple joys of autumn is warming up in front of a fireplace.</p> <p>If you have a fireplace in your home, be sure to have it cleaned and inspected before lighting your first fire of the season. A buildup of soot and creosote can cause a chimney fire and a backup of dangerous carbon monoxide gas into your home. Keep the area around the fireplace clear and remove any hanging decorations on your mantle. Most importantly, keep a fire extinguisher nearby at all times.</p> <h3>Never leave burning candles unattended.</h3> <p>While glowing candles make any environment feel cozier, remember to keep burning candles away from anything that could burn, such as curtains, bedding or books. Also, always extinguish a candle before going to bed or leaving the house. Never leave children or pets alone with a burning candle.</p> <h3>Watch for new roadway hazards.</h3> <p>Going <a href="/hometown-health/speaking-of-health/add-health-checkup-to-teens-back-to-school-list" target="_self" title="Opens in same window.">back to school</a> brings traffic changes. School buses, students on bicycles and teen drivers are out on the roads.</p> <p>Slow down and take extra care to look for children in school zones, near playgrounds and residential areas. Also, never pass a bus with flashing red lights on, or another vehicle stopped for a pedestrian.</p> <h3>Be alert for wildlife on roadways.</h3> <p><a href="/hometown-health/speaking-of-health/11-tips-for-keeping-safe-during-hunting-season" target="_self" title="Opens in same window.">Wildlife</a> is on the move in the fall, so watch carefully for deer, turkeys and other critters crossing the road in front of your vehicle. They are most active from dusk through dawn.</p> <p>Remember that some animals — deer in particular — frequently travel in groups. If you see one crossing, more are bound to follow.</p> <h3>Share the road with harvesting equipment.</h3> <p>In rural areas, fall brings the harvest season with large <a href="/hometown-health/speaking-of-health/farm-safety-reminders-and-new-tips" target="_self" title="Opens in same window.">farming equipment on the roads</a>. Be alert for slow-moving vehicles, and give them plenty of space. This provides better visibility to you and the other driver. Remember that they may turn unexpectedly into fields or driveways. Just because you can see the equipment does not mean the other driver can see you.</p> <h3>Get the yard ready for winter.</h3> <p>You've enjoyed your beautiful lawn and garden all summer, but now is the time to prep it for a cold winter. Leaf blowers can be loud and blow more than just leaves, so wear eye and hearing protection to keep you safe from flying debris and preserve your hearing from the dangerous effects of repeated exposure to loud noises.</p> <h3>Use ladders safely.</h3> <p>Falling is one of the most common reasons for <a href="/hometown-health/speaking-of-health/emergency-vs-urgent-care-whats-the-difference" target="_self" title="Opens in same window.">emergency department</a> trips. If you plan to clean out your gutters, work as a team when using the ladder. Ladders can buckle or slip, so have someone else hold the ladder as you climb up and down.</p> <p>Keep your body weight-centered over the ladder, and don't reach too far. It is better to move the ladder a few more times than fall.</p> <h3>Get your flu shot.</h3> <p>Protect yourself from <a href="/hometown-health/speaking-of-health/facts-about-flu" target="_self" title="Opens in same window.">influenza</a> with a flu shot. The viruses found in the <a href="/hometown-health/speaking-of-health/get-flu-shot-and-covid-19-vaccine" target="_self" title="Opens in same window.">influenza vaccine</a> are inactive, so you cannot get the flu from the vaccine.</p> <p>After getting vaccinated, it takes about two weeks to develop antibodies to protect against influenza. That's why getting vaccinated early in the fall is recommended.</p> <p>The vaccine usually is available in early to mid-fall.<strong><br /> </strong></p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2022/cleaning-leaves-in-rain-gutter.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7795499BDA94DFE3CC23AC9870480FC7" alt="Cleaning leaves in rain gutter" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Michele Halterman7/31/2023Poor lighting, loose rugs and lack of handrails in the home can lead to injuries for older adults. Follow this checklist to identify possible safety issues in or around your home or that of a loved one.Household safety checklist for senior citizens<p>Every year, many senior citizens are injured in or around their homes. The <a rel="noopener" href="https://www.cpsc.gov/" target="_blank" title="Opens in a new window.">U.S. Consumer Products Safety Commission</a> estimates that an average of 2.9 million people 65 or older are treated in hospitals each year due to injuries sustained at home or on their property.  </p> <p>The most common hazard for older adults is falling inside or outside their homes. Older people also are at a greater risk than others of dying in a house fire. Many of these and other injuries result from hazards that are easy to overlook, but simple to address. By identifying these hazards and taking the necessary steps to correct them, you can prevent these injuries to yourself, guests or loved ones you’re caring for. </p> <h2>This checklist can help you identify the possible safety concerns in or around your home or that of your loved one:</h2> <ul> <li>Install smoke and carbon monoxide detectors throughout the home, and test them regularly to ensure they are working properly.</li> <li>Place a fire extinguisher in the kitchen in case of a fire when cooking.</li> <li>Set hot water heaters to no more than 120 degrees to prevent burns.</li> <li>Ensure good lighting throughout the home, especially on stairways, and in hallways and bathrooms. Use night lights as needed to ensure the walking path is well lit. Good lighting also is essential outside the home to prevent falls. Check light bulbs and change as needed. Place solar lights along sidewalks and exterior paths to ensure they are well lit.</li> <li>Have an emergency escape plan for a family member and <a href="/hometown-health/featured-topic/caregiving-self-care-during-beyond-the-covid-19-pandemic" target="_self" title="Opens in same window.">caregivers</a>. </li> <li>Make sure walking surfaces are slip resistant, flat, free of objects and in good condition. Place safety strips on inside stair steps to help prevent slipping. </li> <li>Have all fuel-burning appliances, such as furnaces and chimneys, inspected yearly by a professional to ensure they are safe to use.</li> <li>Store all medications, matches and lighters in upper cupboards out of the reach of children. All <a href="/hometown-health/featured-topic/5-tips-for-managing-medications-for-aging-parents" target="_self" title="Opens in same window">medications</a> should have child-resistant lids on the bottles.</li> <li>Never leave candles, hot plates or other potential fire sources unattended. They should be located away from flammable materials, such as curtains, furniture and blankets.</li> <li> Install ground fault circuit interrupters in potentially damp locations, such as the bathroom, kitchen, basement and on the exterior of the home, to protect against electrocution.</li> <li> Remove throw rugs from the home as they can be a trip hazard.</li> <li> Install handrails on both sides of stairs or check that existing handrails are appropriately secured to the wall.</li> <li> Arrange furniture in the home to allow a clear pathway for walking.</li> <li> Make sure sidewalks, paths and the driveway are level, free of holes and in good condition.</li> <li> In the bathroom, use slip-resistant strips or a nonslip bath mat in the tub or shower to <a href="/hometown-health/speaking-of-health/falls-and-fall-prevention" target="_self" title="Opens in same window.">prevent falls</a>.</li> <li> Mark the top and bottom stair steps with colored tape or paint to make them easier to see.</li> <li> Install grab bars in the tub or shower area and by the toilet to help with safe transfers.</li> <li> Keep your cellphone nearby so you can call for assistance in case of a fall or an emergency. Consider wearing an alarm device that will bring help should you need it. </li> </ul> <p> Following these safety suggestions will ensure your or your loved one’s home is safer for everyone. For more safety tips, contact an <a href="/services-and-treatments/occupational-therapy" target="_self" title="Opens in same window.">occupational therapist</a> to complete a detailed home assessment to identify potential safety issues in your home or that of your loved one. An occupational therapist will make recommendations based on the results of the assessment.</p> <p><em><a href="/providers/michelle-geerdes-otr-l" target="_self" title="Opens in same window">Shelly Geerdes</a> is an <a href="/services-and-treatments/occupational-therapy" target="_self" title="Opens in same window.">occupational therapist</a> in <a href="/locations/fairmont">Fairmont</a>, Minnesota.</em></p><ul> <li>Neurological conditions</li> <li>Orthopedics</li> <li>Traumatic brain injury</li> <li>Visual impairments</li> </ul>O.T.<p><strong>Education</strong></p> <ul> <li>Mount Mary College</li> <li>Iowa Lakes Community College</li> <li>Mankato Area Vocational Technical Institute</li> </ul>Geerdes<img src="/-/media/shared-files/images/medical-professionals/full/fairmont/michelle-geerdes-ot.jpg?h=280&iar=0&w=280&sc_lang=en&hash=98848BDB56754A5BF36E70A219B53224" alt="Shelly Geerdes, O.T." width="280" height="280" title="Shelly Geerdes, O.T." DisableNVelocity="true" />{71EF524F-94A5-432F-A001-97289E1FFDB8}Michelle<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13949802Michelle Geerdes, O.T.1<img src="/-/media/national-files/images/hometown-health/2023/front-of-brick-house.jpg?h=370&iar=0&w=660&sc_lang=en&hash=DCD2314008998BF5F1BDBA3FA3E2A7AE" alt="Front of brick house" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.AgingLife expectancy is 75 for males and 80 for females according to the National Center for Health Statistics. We'll help you keep you informed about potential issues with aging, and steps you can take to maintain your health and keep active.Michele Halterman3/1/2019<p>It seems like there is endless advice on what to do when you’re trying to get pregnant, but what advice is actually true? Here are answers to four common questions.</p>Boxers or briefs? 4 common fertility myths debunked<img alt="blog_504x504_boxersBriefs" src="/-/media/national-files/images/hometown-health/2017/boxers-or-briefs.jpg?h=300&w=300&sc_lang=en&hash=DB07224B8014515CD54301541C081014" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /> <p>It seems like there is endless advice on what to do when you’re <a href="/hometown-health/speaking-of-health/tips-to-improve-fertility" target="_self" title="Opens in same window.">trying to get pregnant</a>, but what advice is actually true? Here are the answers to four common questions:</p> <h4>1. Is it OK to exercise while trying to get pregnant?</h4> <p>Moderate exercise for women is just fine. By moderate, I mean up to five hours per week of activities, such as brisk walking, cycling or golfing. When a woman is trying to get pregnant and hasn’t been exercising prior to being pregnant, it’s not a great time to start a vigorous exercise routine. Moderate exercise also is recommended for men.</p> <h4>2. Are boxers better than briefs for men?</h4> <p>Scrotal temperatures normally are a few degrees lower than normal body temperature. Temperatures higher than that can reduce male fertility. Some research has shown that briefs cause a slightly higher temperature, but there is no research saying that this affects fertility. So, feel free to wear whatever is most comfortable. It’s recommended that men avoid high temperature spaces, such as saunas and hot tubs, as they can reduce fertility count for up to three months, which is the lifespan of sperm.</p> <h4>3. If a woman lies on her back after intercourse, does it increase her chance of getting pregnant?</h4> <p>Research does not support that lying on your back after intercourse makes a difference, but it surely doesn’t hurt anything. Some women like to lie on their back with their hips slightly elevated for 20 minutes after intercourse. </p> <h4>4. How long should couples try to get pregnant before seeking professional help?</h4> <p>Women under 35 with regular menstrual cycles should seek professional help after one year of frequent, unprotected intercourse. Women 35 or older with regular cycles should seek help after six months of regular, unprotected intercourse. Anyone with irregular cycles should seek help after six months of regular, unprotected intercourse. Note: Many couples who are trying to conceive don't realize that lubricants can adversely affect sperm. Find out which <a href="/hometown-health/speaking-of-health/trying-to-get-pregnant-select-a-lubricant-that-is-most-helpful-for-sperm" target="_self" title="Opens in same window.">lubricants to use when you are trying to get pregnant</a> and need sperm motility. In addition, using an ovulation kit to determine when you are most fertile can help increase your chances of becoming pregnant. Learn how to <a href="/hometown-health/speaking-of-health/using-ovulation-kits-to-predict-fertility" target="_self" title="Opens in same window.">pick out the best ovulation kit</a> for you.</p> <p><span style="color: #333333;"></span><a href="/providers/alicia-ogle-np" target="_self" title="Opens in same window."><em>Alicia Ogle</em></a><span style="color: #333333;"><em> is a nurse practitioner in <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></span></p><img src="/-/media/national-files/images/hometown-health/2017/boxers-or-briefs.jpg?h=504&iar=0&w=504&sc_lang=en&hash=ECD02AC9ECC08F58E73B5DF60BE769A2" alt="Boxers or briefs and fertility" width="504" height="504" DisableNVelocity="true" />FertilityFertility issues may be due to a single cause with you or your partner or a combination of factors that may prevent a pregnancy from occurring or continuing. There are multiple safe, effective fertility therapies available.Michele Halterman9/13/2017<p>Are you a meat and dairy fan? Learn best options for a healthy diet.</p>Grocery store tour: Selecting meat and dairy<p>For many people, meat and dairy are the main protein sources in their diet. Meat and dairy products contain fat, naturally produced by animals, but that fat contains saturated fat and cholesterol. While your body needs both of those, having too much can lead to heart problems and obesity.</p> <p>When choosing which meats to consume, make it your goal to consume more meat that is lean, such as turkey, fish and chicken. Lean meat has less visual fat and skin is removed. Eating less red meat, such as pork and beef, also may benefit your health. You can often see the fat in red meats, but if you can try to remove as much fat as possible, that’s best. </p> <p>Dairy is packed with calcium, protein and vitamin D, which boost your energy and strengthen your body. However, some dairy products are packed with fat and loaded with calories, so it’s important to watch your portion sizes when consuming these.</p> <p>Health educator Katie Johnson gives more information on the best meat and dairy selections for you in this video:</p> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/aD-cwZ13Jkc" title="Shopping the meat aisle" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p>Watch other grocery store tours:</p> <ul> <li><a href="/hometown-health/speaking-of-health/grocery-store-tour-shopping-the-perimeter" target="_self" title="Opens in same window.">Shopping the perimeter</a></li> <li><a href="/hometown-health/speaking-of-health/grocery-store-tour-shopping-the-dry-goods" target="_self" title="Opens in same window.">Shopping the dry goods</a></li> <li><a href="/hometown-health/speaking-of-health/grocery-store-tour-shopping-the-produce-aisle" target="_self" title="Opens in same window.">Shopping the produce aisle</a></li> </ul><img src="/-/media/national-files/images/hometown-health/2017/meat-and-dairy-2.jpg?h=226&iar=0&w=383&sc_lang=en&hash=C6027EB28866F93CBE22F80FB0F8E0E0" alt="Meat and Dairy 2" width="383" height="226" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Michele Halterman9/8/2017<span>Autumn colors and cool mornings in early September signal the beginning of the long-awaited hunting season. Shooting without hearing protection practically guarantees you will suffer at least some degree of hearing loss in your lifetime.</span>Huh? Hunting and your hearing<img alt="fbBlog_hunting_504x504" src="/-/media/national-files/images/hometown-health/2017/fbblog_hunting_504x504.jpg?h=300&w=300&sc_lang=en&hash=710BD86EB4A0691ECBF6F14B769B4427" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>For many Wisconsinites, autumn colors and cool mornings in early September signal the beginning of the long-awaited hunting season. Multigenerational families enjoy shooting sports and hunting. Why wouldn’t they? Wisconsin has some of the best hunting opportunities in the country. I would even argue that the beauty of our woods, prairies, lakes and streams are second to none.</p> <p>I am an avid sportsman myself, and after seeing patients in the <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">Ear, Nose & Throat Department</a> for the past 17 years, I am amazed by how many people don’t wear hearing protection when they shoot guns. I see patients every week with hearing loss, and a large number of those patients have a history of noise exposure without the use of hearing protection.</p> <p><a href="http://www.asha.org/public/hearing/Recreational-Firearm-Noise-Exposure/" target="_blank" title="Opens in a new window.">Studies</a> show that people who use guns are more likely to develop permanent hearing loss than those who don’t. Shooting without hearing protection practically guarantees you will suffer at least some degree of hearing loss in your lifetime. Aging and heredity also contribute to hearing loss, but exposure to noise, especially noise from guns, is the one preventable variable that you can control to reduce your risk hearing loss.</p> <p>To put things into perspective, the <a href="https://www.osha.gov/SLTC/noisehearingconservation/standards.html" target="_blank" title="Opens in a new window.">Occupational Safety & Health Administration</a> (OSHA) recommends that on-the-job noise exposure to noise of 115 decibels (dBA) not exceed 15 minutes per day. A .22-caliber rifle produces a noise level of 140 dBA, and a typical deer rifle can produce noise greater than 175 dBA.</p> <p>Sound levels can increase at firing ranges where sound waves bounce off walls. Permanent hearing loss can occur with a single shot if no hearing protection is used. In addition to hearing loss, tinnitus, or ringing in the ears, can develop temporarily or permanently.</p> <p>The good news is that noise-induced hearing loss is preventable. Wearing hearing protection, such as earplugs or muffs, allows you to still hear soft sounds while preventing damage to your ears from loud noises, especially with some of the more expensive options.</p> <p>You also could wear hearing protection around your neck while in the woods and quietly put it in place just before the shot. Your local sporting goods store usually carries an assortment of inexpensive, effective products.</p> <p>Set a good example and wear them when hunting with your family and friends. Help your children and grandchildren know the importance of wearing hearing protection, similar to wearing a helmet when riding a bike.</p> <p>Hearing protection is necessary when using guns. Make the effort to bring hearing protection for all shooters and bystanders when target shooting and hunting. Believe it or not, once you make this a habit, you’ll be surprised how little it affects your hunting experience.</p> <p><a href="/providers/thomas-lowry-md" target="_self" title="Opens in same window."><em>Thomas Lowry, M.D.</em></a><em>, is an ear, nose and throat physician in <a href="/locations/rice-lake" target="_self" title="Opens in same window.">Rice Lake</a>, Wisconsin.</em></p><ul> <li>Head and neck (otolaryngology) surgery</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Texas Tech University Health Sciences Center School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>General Surgery, Oregon Health & Science University</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Otolaryngology/Head & Neck Surgery, Wilford Hall Medical Center</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Otolaryngology, American Board of Otolaryngology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Alpha Omega Alpha Honor Medical Society</li> <li>American Academy of Otolaryngology – Head & Neck Surgery</li> <li>Diplomate, American Board of Otolaryngology</li> <li>Fellow, American College of Surgeons</li> <li>Wisconsin Medical Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Otolaryngology, Mayo Clinic College of Medicine and Science</li> </ul>Lowry<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/thomas-lowry-md.jpg?h=640&iar=0&w=640&sc_lang=en&hash=0A27A92283C9A0862DF1F75AA095E94E" alt="Thomas Lowry, M.D." width="640" height="640" DisableNVelocity="true" />{32D16657-0370-4705-AD0F-328543641963}Thomas<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12599689Thomas Lowry, M.D.1{18E5E65E-45C8-4C48-BD32-A914794E2AA4}|{E9B8BDBE-375B-4E7D-A1D2-2B64B5513AF7}<img src="/-/media/national-files/images/hometown-health/2017/fbblog_hunting_504x504.jpg?h=504&iar=0&w=504&sc_lang=en&hash=7D3627B75B14284C65D3F1896BDCACDC" alt="Two people hunting with guns" width="504" height="504" DisableNVelocity="true" />Ear HealthAn audiologist specializes in evaluating and treating people of all ages with hearing loss, dizziness and balance disorders. Specialty audiology consultation is available for assessment and treatment of hearing loss, tinnitus, dizziness and balance disorders.Michele Halterman8/24/2023Freshman year of college is known for new experiences, but it also presents challenges. The W-Curve model is an emotional pattern incoming students may experience during their first year in college.The W-Curve Model: Understanding a new college student’s experience<p>The W-Curve Model first was proposed in 1963 to explain adjustment to culture shock and later applied to first-year college students. It's a predictable pattern of stages students go through in adapting to the new college culture. While each college student's experience is distinctive, knowing about these typical and expected ups and downs can help make the transition to college more manageable.</p> <img alt="W Curve Hypothesis Model" src="/-/media/national-files/images/hometown-health/2023/w-curve-hypothesis-model.jpg?h=253&w=350&sc_lang=en&hash=20962EBCF5B75AA74F245E4C3014B02D"; height: 253px; width: 350px;" /> <p>Rather than panicking at the first signs of culture shock, college students and parents need to realize this is a common part of the journey during that first year. This awareness may allow students and parents to take the challenges in stride and develop <a href="/hometown-health/speaking-of-health/stressed-out-kids" target="_self" title="Opens in same window.">healthy strategies</a> for managing major life transitions.</p> <h2>The five stages of the W-Curve Model explain students' level of comfort, satisfaction and effectiveness during each stage:</h2> <h3>1. Honeymoon: The excitement stage</h3> <p>Often starting before students arrive at college, the honeymoon stage is full of excitement, stimulation and curiosity. There's often positive anticipation of meeting new people, exploring new opportunities and experiencing intriguing cultural differences. It's overwhelming while also being fun and stimulating.</p> <p>Students desire independence and tend not to become homesick during the first few days or weeks of college. New students are bombarded with events and activities, keeping the interest level high.</p> <h3>2. Culture shock: Reality sets in</h3> <p>At this stage, students may start to compare their expectations of college with reality. The changes that felt new and exciting begin to feel isolating and <a href="/hometown-health/speaking-of-health/college-students-and-depression" target="_self" title="Opens in same window.">overwhelming</a>. </p> <p>The reality of social and academic adjustments can lead to feeling lost and confused. Relationships may feel hard, and academic demands build and are more complex than may have been anticipated. Students often will compare their experiences to those of other students who seem to be doing well. </p> <p>Students may feel they don't belong and question their choice of school. Homesickness may increase, leading students to wish to return to more familiar cultures associated with home. Parents might want to <a href="/hometown-health/speaking-of-health/practical-ways-to-raise-confident-kids" target="_self" title="Opens in same window.">comfort their children</a> by encouraging them to come home but helping them make and strengthen connections at school will be most beneficial in the long term.</p> <h3>3. Initial adjustment: Settling into the demands of college life</h3> <p>As students begin to successfully manage the multitude of adjustments and get past the culture shock stage, they experience an upswing. They may have a greater sense of effectiveness and well-being, start to develop a routine, and gain confidence in their academic and social abilities. This can include making friends outside of their initial connections and finding a roommate less bothersome.</p> <p>As they regain some sense of control and normalcy, students start to reconnect to what they like about themselves and the new college culture.</p> <h3>4. Mental isolation: Comparing home and college</h3> <p>When students go home during an academic break, they may not feel as comfortable at home as they used to. Students often feel caught between their two worlds rather than belonging entirely to either place. Students may feel <a href="/hometown-health/speaking-of-health/5-tips-to-manage-stress" target="_self" title="Opens in same window.">distressed</a> at changes or events at home and with the differences between independence at home and school. Beliefs and values are challenged as students attempt to find their place in the world.</p> <p>At this time, peer conflicts may increase within their new relationships and those from high school. It's not unusual for students to decide to switch their major to something that fits their developing identity.</p> <h3>5. Acceptance and integration: Finally, balance emerges</h3> <p>Students develop stronger ties with fellow students and faculty, <a href="/hometown-health/speaking-of-health/3-health-benefits-of-volunteering" target="_self" title="Opens in same window.">get more involved</a> in campus life and understand how to succeed academically. They have a more realistic and balanced perspective of their school experiences. Students often start referring to campus as their home and feel like a part of the culture, experiencing a sense of integration and connectedness. Dependence on parents and hometown connections begins to lessen. </p> <h2>Making the first year of college a success</h2> <p> The first year at college can be challenging. Being aware of the predictable W-curve adjustment pattern can make the transition less intimidating and help family members support their student's success in college. If college is too overwhelming, help is always available, whether talking to a friend, family member, resident assistant, professor or a mental health professional.</p> <p><a href="/providers/rosean-bishop-lp" target="_self" title="Opens in same window."><em>Rosean Bishop, Ph.D.</em></a><em>, is a psychologist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Family medicine resident education</li> <li>Integrated behavioral medicine</li> <li>Resilience training</li> </ul>Ph.D., L.P.<p><strong>Education</strong></p> <ul> <li>Doctor of Philosophy, Counseling Psychology, Pennsylvania State University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Counseling Center, University of Rochester, New York</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Counseling Center, Vanderbilt University, Nashville, Tennessee</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Licensed Psychologist, Minnesota Board of Psychology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Psychological Association</li> <li>Minnesota Psychological Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine and Psychology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota</li> </ul>Bishop<img src="/-/media/shared-files/images/medical-professionals/full/mankato/rosean-bishop-phd-lp.jpg?h=200&iar=0&w=200&sc_lang=en&hash=D37783EF34004E64C8CDA884C074F5C1" alt="Rosean Bishop LP" width="200" height="200" DisableNVelocity="true" />Rosean<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15429687Rosean Bishop LP1<img src="/-/media/national-files/images/hometown-health/2017/college-freshman.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5C7AADD26B4E9AEB6041A84F12FE043F" alt="College freshman" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Micah Dorfner9/5/2017<p>Hashimoto thyroiditis, also known as Hashimoto’s disease, is the most common cause of hypothyroidism in the U.S. Hashimoto’s disease causes chronic inflammation of the thyroid, as antibodies form attacking thyroid cells due to the changes to your immune mechanisms.</p>What is Hashimoto's disease?<img alt="thyroidmedicalillustration" src="/-/media/national-files/images/hometown-health/2017/thyroidmedicalillustration.jpg?h=299&w=400&sc_lang=en&hash=E9118EB750A22CAA9856A899C2E779C7" style="width: 400px; height: 299px; float: right; margin-bottom: 10px; margin-left: 10px;"> <p>Your thyroid gland is a butterfly shaped organ located on the front of your neck. Its main function is to produce a thyroid hormone that helps regulate your metabolism. Hypothyroidism occurs when a person has a decrease in their thyroid function. Hashimoto thyroiditis, also known as Hashimoto’s disease, is the most common cause of hypothyroidism in the U.S.</p> <p>Hashimoto’s disease causes chronic inflammation of the thyroid, as antibodies form attacking thyroid cells due to the changes to your immune mechanisms.</p> <p><strong>Risk factors</strong></p> <p>Stress, infections, certain medications, and environmental and genetic factors are all thought to be triggers of Hashimoto’s disease. Hashimoto’s disease also is thought to be more common in females compared to males and is mostly seen between the ages of 30 and 50, with incidence increasing as you age.</p> <p><strong>Symptoms of Hashimoto’s disease</strong></p> <p>In some cases, people may not notice the signs or symptoms of Hashimoto’s disease, as thyroid function can be normal. In some rare cases, thyroid function may be increased. However, in most cases, a decrease in thyroid hormone production results in chronic inflammation. This can cause these symptoms:</p> <ul> <li>Fatigue</li> <li>Weight gain</li> <li>Constipation</li> <li>Dry skin</li> <li>Hair loss</li> <li>Cold intolerance</li> <li>Depression</li> <li>Menstrual irregularity</li> <li>Joint pain and muscle cramps</li> </ul> <p><strong>Problems associated with Hashimoto’s disease</strong></p> <p>Enlargement of the thyroid gland, also known as a goiter, can occur in patients with Hashimoto’s disease. Most of the time, the goiter does not cause pain. Additionally, it’s not uncommon to see thyroid nodules or abnormal growth of thyroid cells forming lumps. When thyroid nodules or a goiter become big enough, other symptoms may occur, including:</p> <ul> <li>Swallowing difficulty</li> <li>Hoarseness</li> <li>Breathing problems</li> </ul> <p><strong>Why you should seek care</strong></p> <p>If you have any of the above symptoms, your doctor may recommend you undergo a thyroid function testing and, sometimes, ultrasound to evaluate your thyroid gland and nodule size. In some cases, a rapidly enlarging thyroid gland can be related to thyroid lymphoma, which is an uncommon, yet highly treatable, form of thyroid cancer. Hashimoto’s disease also can be associated with other autoimmune disorders, such as:</p> <ul> <li>Type 1 diabetes</li> <li>Vitiligo</li> <li>Gluten sensitivity</li> <li>Rheumatoid arthritis</li> <li>Addison’s disease or pernicious anemia</li> </ul> <p><strong>Diagnosis</strong></p> <p>Hashimoto’s disease generally is diagnosed using laboratory testing. Decreased thyroid function and increased thyroid antibody levels (thyroid peroxidase and thyroglobulin antibodies) usually are adequate to establish a diagnosis.</p> <p><strong>Treatment</strong></p> <p>Treatment for Hashimoto’s disease often consists of thyroid hormone replacement using a medication called levothyroxine. Levothyroxine generally is dosed based on your weight. It’s important to make sure you follow directions while using medication of this nature, as it is recommended levothyroxine be taken on an empty stomach 30 to 60 minutes before eating. After starting on medication, thyroid hormone testing needs to be repeated in six to eight weeks for dose adjustment, with the goal of returning your thyroid hormone level to a normal range.</p> <p>Make sure to speak to your primary medical care provider if you have any questions. They can provide answers to help keep you and your thyroid healthy.</p> <p><em>Sakine Sever, M.D., is an endocrinologist at <a href="/locations/mankato">Mayo Clinic Health System in Mankato</a>.</em></p><img src="/-/media/national-files/images/hometown-health/2017/thyroidmedicalillustration.jpg?h=299&iar=0&w=400&sc_lang=en&hash=4B562C57BBF97E01EB99B7600A4AA1B1" alt="thyroidmedicalillustration" width="400" height="299" DisableNVelocity="true" />Thyroid HealthThe thyroid is a gland at the base of your neck. This important part of your body produces hormones that regulate blood pressure, body temperature, heart rate and weight. When your thyroid has problems, many aspects of your well-being can be negatively impacted. Learn more about the thyroid here.Michele Halterman9/1/2017<p>As fall approaches and students prepare to return to school, many look forward to the return of fall and winter sports. However, there are risks associated with sports participation, including concussion.</p>The real impact of a concussion<img alt="ConcussionCUFB21" src="/-/media/national-files/images/hometown-health/2017/concussion-football.jpg?h=300&w=300&sc_lang=en&hash=FF3943AF1A08F791316C49FF4F5EB653" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p><em>By Mayo Clinic Health System staff</em></p> <p>As fall approaches and students prepare to return to school, many look forward to the return of fall and winter sports. Participation in sports is rewarding. Athletes develop leadership skills, character and work ethic. Being a part of a team produces lasting memories beyond high school. However, there are risks associated with sports participation, and I would like to discuss one in particular: Concussion.</p> <h4>What is a concussion?</h4> <p>A concussion is a traumatic head injury with temporary loss of some brain function. Concussions most often are associated with contact sports, such as football, hockey and wrestling. However, concussions can occur in any sport in which one can sustain head trauma or sudden acceleration/deceleration.</p> <p>Frequently, a concussion is caused by a blow to the side of the head, which causes a sudden lateral acceleration and deceleration of the brain within the skull. These types of injuries can occur at a much lower velocity or force than a head-to-head impact, as the athlete usually cannot anticipate or brace for the side impact, as opposed to the typical head-on impact.</p> <p>Concussion has often been referred to as mild traumatic brain injury, although that term is misleading, as the long-term consequences of concussions, particularly multiple concussions, can be significant, and the “mild” term is less frequently used.</p> <h4>What are the symptoms of a concussion?</h4> <h5>Symptoms of a concussion include:</h5> <ul> <li>Headache</li> <li>Visual changes</li> <li>“Foggy” feeling</li> <li>Difficulty concentrating</li> <li>Difficulty recalling the injury</li> </ul> <h5>Other symptoms can include:</h5> <ul> <li>Emotional changes</li> <li>Nausea or vomiting</li> <li>Drowsiness</li> <li>Difficulty following conversations or lectures in school</li> <li>Difficulty doing homework</li> <li>Incoordination or difficulty with balance</li> <li>Loss of consciousness</li> </ul> <h4>What should I do if I think I have a concussion?</h4> <p>Treatment involves monitoring for symptom resolution or change, as well as physical and cognitive rest or reduction of such activities as school work, television time, playing video games and text messaging. Sometimes, physical or occupational therapy is suggested. Symptoms usually resolve within three weeks, though they may persist or complications may occur.</p> <p>It's important not to downplay concussion symptoms, as persistent symptoms are a sign that the concussion may be more extensive. Concussion severity is based more on the duration of symptoms and not on the intensity of the symptoms at the time of the injury. If you think you have a concussion, it is best to seek medical attention immediately.</p> <p>A concussion is not to be taken lightly, and with proper treatment, most recover with no long-term effects. As the science of concussion advances, our treatments and recommendations continue to evolve.</p><img src="/-/media/national-files/images/hometown-health/2017/concussion-football.jpg?h=504&iar=0&w=504&sc_lang=en&hash=B38A9A204BA38CA2BEDB5333CC507F24" alt="Concussion football players" width="504" height="504" DisableNVelocity="true" />ConcussionA concussion is a traumatic brain injury that alters the way your brain functions. Although concussions usually are caused by a blow to the head, even a “ding,” “getting your bell rung,” or what seems to be a mild bump or blow to the head can be serious. As many as 3.8 million sports- and recreation-related concussions occur in the U.S. each year.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Michele Halterman9/6/2022Sending children to college or into the real world often is a proud time for parents. But there also can be sadness, especially when it's the last child to leave home. Get tips for enjoying the transition.Tips for enjoying your empty nest<p>Sending children off to college or into the real world usually is a proud time for parents. But there also can be sadness, especially when the last child leaves home. Empty nest syndrome isn't a clinical diagnosis. Instead, it's a phenomenon where parents experience feelings of sadness and loss when the last child leaves home.</p> <p>It's common for parents to find letting go to be a painful experience — even though they encourage their children to be independent. Parents might find it difficult to suddenly have no children at home who need their care. They might miss being a part of their children's daily lives and their constant companionship. Parents with only one child or those who strongly identify with their role as a parent might have a particularly difficult time adjusting.</p> <h2>Benefits to empty nesters</h2> <p>As hard as the change may be, having an empty nest can bring benefits to parents. Recent studies suggest that an empty nest might reduce work and family conflicts. Having an empty nest also gives parents a new opportunity to reconnect with each other, improve the quality of their marriage and rekindle interests with newfound time.</p> <h2>Advice for the transition</h2> <h3>Here are a few tips if you're experiencing feelings of loss due to empty nest syndrome:</h3> <ul> <li><strong>Accept the timing. <br /> </strong><span>Avoid comparing your child's timetable to your own experience or expectations. Instead, focus on what you can do to help your children succeed when they leave home.</span></li> <li><strong>Keep in touch.</strong><br /> <span>You can continue to be close with your children after they leave home, thanks to phone calls, emails, texts, video chats and personal visits.</span></li> <li><strong>Seek support.<br /> </strong><span>Lean on loved ones for support. Share your feelings. If you feel depressed, consult your health care team.</span></li> <li><strong>Stay positive.<br /> </strong><span>Think of the extra time and energy you will have to devote to your marriage or personal interests.</span></li> </ul> <p>If your last child will soon leave home, plan ahead to keep empty nest syndrome at bay. Look for new opportunities in your personal and professional life. Keeping busy or taking on new challenges at work or home can ease the sense of loss.</p> <p><em><a href="/providers/jessica-sosso-md" target="_self" title="Opens in same window.">Jessica Sosso, M.D.</a>, is a physician in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in<a href="/locations/sparta" target="_self" title="Opens in same window.">Sparta</a>, Wisconsin.</em></p><ul> <li>Chronic disease management, including diabetes, hypertension and heart disease</li> <li>Fertility care medical consultant, including use of natural, noncontraceptive methods to treat women's health issues</li> <li>Natural family planning and fertility awareness-based methods</li> <li>Preventive health</li> </ul>M.D., M.P.H.<p>I value relationships with patients and their families. As a Family Medicine physician, I see children and adults of all ages and complexity. I seek to educate and collaborate with my patients to together make healthcare decisions consistent with their values.</p> <p>Family time with my husband and children is a priority for me, and I strive to find balance between my work and home life. I enjoy gardening, hiking, biking and quiet time spent in prayer or reading an engaging book.</p><p><strong>Education</strong></p> <ul> <li>University of Wisconsin School of Medicine and Public Health</li> <li>Master of Public Health, Portland State University</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine/Preventive Medicine, Oregon Health and Sciences University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Family Medicine, American Board of Family Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>Catholic Medicine Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Sosso<img src="/-/media/shared-files/images/medical-professionals/full/sparta/jessica-sosso-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=CB5FB5273358EABA7C138C22C38C77FA" alt="Jessica Sosso, M.D." width="280" height="280" title="Jessica Sosso, M.D." DisableNVelocity="true" />Jessica<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15588416Jessica Sosso, M.D., M.P.H.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{4CCEC5BD-06A3-471A-8B8D-4C52837DAA4E}<img src="/-/media/national-files/images/hometown-health/2022/smiling-couple-working-together.jpg?h=370&iar=0&w=660&sc_lang=en&hash=40DB6184869450C625487466034C9D13" alt="Smiling couple working together" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Michele Halterman10/25/2017<p>You might think that carpal tunnel syndrome is a new condition of the Information Age, borne from long hours of computer keyboarding. However, carpal tunnel syndrome is nothing new.</p>Carpal tunnel syndrome: When to consider treatment<img alt="Carpal Tunnel Syndrome Hands on a Keyboard" src="/-/media/national-files/images/hometown-health/2017/carpal-tunnel-syndrome-hands-on-a-keyboard.jpg?h=300&w=300&sc_lang=en&hash=4131E9BA3598602B58E0812143EEF86B" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /> <p>You might think that carpal tunnel syndrome is a new condition of the Information Age, borne from long hours of computer keyboarding. However, carpal tunnel syndrome is nothing new. Evidence of people experiencing symptoms of carpal tunnel syndrome occurs in medical records dating back to the beginning of the 20th century.</p> <h2>What is carpal tunnel syndrome?</h2> <p>Bound by bones and ligaments, the carpal tunnel is a narrow passageway — about as big around as your thumb — located on the palm side of your wrist. This tunnel protects a main nerve to your hand and nine tendons that bend your fingers. Pressure placed on the nerve produces the numbness, pain, and eventually, hand weakness that characterize carpal tunnel syndrome.</p> <p>Fortunately, for most people who develop carpal tunnel syndrome, proper treatment usually can relieve pain and numbness, and restore normal use of wrists and hands.</p> <h2>What are the symptoms of carpal tunnel syndrome?</h2> <p>Carpal tunnel syndrome typically starts gradually with a vague aching in your wrist that can extend to your hand or forearm.</p> <h3>Other common signs and symptoms include:</h3> <ul style="list-style-type: disc;"> <li>Tingling or numbness in fingers or hands</li> <li>Pain radiating or extending from the wrist up the arm to the shoulder or down into palms or fingers</li> <li>A sense of hand weakness and a tendency to drop objects</li> <li>A constant loss of feeling</li> </ul> <h2>What are treatment options for carpal tunnel syndrome?</h2> <p>If you experience mild symptoms of carpal tunnel syndrome, you can ease discomfort by taking more frequent hand rest breaks and applying cold packs to reduce occasional swelling. Other options for treatment may involve special types of physical therapy, heat, massage and other relaxation techniques.</p> <p>If signs and symptoms you attribute to carpal tunnel syndrome interfere with normal activities, including sleep, and they persist, see your health care team. If diagnosed early, there are many nonsurgical options to help improve carpal tunnel syndrome symptoms, such as wrist splinting, taking an over-the-counter anti-inflammatory drug or receiving a cortisone injection to relieve pain. If the symptoms do not respond to nonsurgical treatment methods, surgery may be an option. If left untreated, nerve and muscle damage can occur.</p> <p>To learn more about carpal tunnel syndrome or other upper extremity conditions, schedule a consultation with an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic provider</a>.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2017/carpal-tunnel-syndrome-hands-on-a-keyboard.jpg?h=504&iar=0&w=504&sc_lang=en&hash=1B755B8DAA213BC6FC80C217BC21D790" alt="Carpal Tunnel Syndrome Hands on a Keyboard" width="504" height="504" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Micah Dorfner10/24/2017<p>Halloween is rapidly approaching, and everyone is preparing for the big night of costumes, pumpkins and candy. With so much time and energy going into the planning of this night, we often get so excited that we end up forgetting about simple safety.</p>Tips to keep your Halloween safe<img alt="a-group-of-children-in-Halloween-costumes-sitting-on-a-bench-looking-at-their-candy-and-treats" src="/-/media/national-files/images/hometown-health/2017/kids-in-halloween-costumes-with-candy.jpg?h=169&w=300&sc_lang=en&hash=C5666C032A227ECB6675ED0C9C1C30E7" style="width: 300px; height: 169px; float: right; margin-bottom: 5px; margin-left: 5px;" /> <p>Halloween is rapidly approaching, and everyone is preparing for the big night of costumes, pumpkins and candy. With so much time and energy going into the planning of this night, we often get so excited that we end up forgetting about simple safety. Safety is a very important part of Halloween and shouldn’t be overlooked. Here are a few tips that will make your Halloween sweet, successful and safe.</p> <h2>Before you go out — costume safety:</h2> <ul> <li><strong>Make sure your costume fits from head to toe.</strong> Makeup is great and doesn’t obscure vision. If there’s a mask, make sure it fits and the eyeholes are big enough to see clearly.</li> <li><strong>Costumes should not be tripping hazards.</strong> If your costume is too long, pin it up or place a hem. Costumes should also be flame-resistant or retardant, especially if around any open flames, such as a jack-o-lantern.</li> <li><strong>Wear good shoes.</strong> Costume shoes are often ill-fitting and may pose tripping hazards.</li> <li><strong>Stay visible.</strong> Besides wearing lighter colors, additional reflective strips may be added to your costume to aid in others seeing you.</li> </ul> <h2>While you are out — trick-or-treating safety:</h2> <ul> <li>Make sure you’re always accompanied by family or friends.</li> <li>If you have one, bring a cell phone with you in case you need help.</li> <li>Carrying a flashlight, blinking lights or glow sticks will improve your visibility and help you see better in poorly lit places.</li> <li>Only go to houses where the lights are on.</li> <li>Try to go where the streets are well lit.</li> <li>Be careful crossing streets, especially if you’re wearing a mask.</li> <li>Don’t accept rides from anybody you don’t know.</li> </ul> <h2>After you get home — keep safe:</h2> <ul> <li>Have your parents check any candy before you eat it. Never eat candy or treats that aren’t in their original wrapper.</li> <li>Don’t share your candy with your pets or younger siblings. Candy can be bad for pets and may be a choking hazard for younger kids.</li> <li>If you have allergies (peanut, for example), make sure your treat doesn’t contain what you’re allergic to.</li> <li>Make sure you extinguish any candles or open flames.</li> <li>Don’t eat all your candy in one night. Make the sweetness of Halloween last a while.</li> </ul> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2017/kids-in-halloween-costumes-with-candy.jpg?h=169&iar=0&w=300&sc_lang=en&hash=481507496BFE6EF6A592211BA1103E27" alt="a-group-of-children-in-Halloween-costumes-sitting-on-a-bench-looking-at-their-candy-and-treats" width="300" height="169" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Michele Halterman1/5/2024Social media allows children to easily connect with friends, but the digital world can become a threat when not used safely. Get tips to help them use screened devices and social media in a safe way.Social media risks: Safeguarding children's online experience<p>Social media is a fun, easy way for adolescents to connect with friends. While most platforms require users to be 13 or older to create an account, it's common for kids to want to access social media at an earlier age. </p> <h2>It's important to teach children that even though social media can be enjoyable, there are risks, including:</h2> <ul> <li>Social media use makes kids and teens vulnerable to <a href="/hometown-health/speaking-of-health/cyberbullying-tips-to-protect-kids" target="_self" title="Opens in same window.">cyberbullying</a> and provides the opportunity to cyberbully others. </li> <li>Limited face-to-face interaction decreases filters when making comments about other people.</li> <li>Smartphones have geolocation, so unless the privacy settings are correctly set up, other users can see your child's location when they are using social media apps. </li> <li>It's easy for kids to access inappropriate content and follow or be followed by users they do not know. </li> <li>There may be the temptation to send explicit texts, photos or videos. </li> <li>In recent years, research has shown that constant social media use can negatively affect a <a href="/hometown-health/speaking-of-health/strengthen-youth-mental-health" target="_self" title="Opens in same window.">young person's mental health</a>.</li> </ul> <p>Remember, what happens on the internet stays on the internet.</p> <h2>How can you help your children be safe on social media?</h2> <p>The first step is to start a conversation about internet safety and your child's online interactions. It helps to be familiar with the specific platforms your child is using and to create your own account. Have your child show you their profile and review their friend list on each platform. Talk about the importance of carefully considering who to friend or follow online.</p> <p>Next, establish rules. Make it a rule to have no secret passwords. Have your child write their usernames and passwords in an envelope that you will only access in a scenario when you fear for your child's safety. Place the envelope in a public place in the home and update when the passwords are changed. Similarly, you should always have the unlock codes for your children's devices. A number of templates for a <a href="/hometown-health/speaking-of-health/whats-your-familys-digital-diet-plan-for-2018" target="_self" title="Opens in same window.">family social media plan</a> or cellphone contract are available online.</p> <p>Consider using a parental control app. Smartphones come with safety features, and several parental control apps are available for download. If you decide to monitor your child's social media use this way, you need to be open and honest with them about your use of parental controls.</p> <p>Lastly, and perhaps most importantly, lead by example. Consider what information you are posting about yourself and your family online. Never bully, harass or embarrass another person online. </p> <p>Encourage face-to-face communication as much as possible. Social media allows children to be passive engagers. If they can watch what others post but do not engage, they lose important aspects of <a href="/hometown-health/featured-topic/brushing-off-the-social-rust" target="_self" title="Opens in same window.">social connection</a>. </p> <p>Be aware of how much time you spend on a device. Consider following similar rules for yourself that you set for your children. </p> <h2>Tips for screen time</h2> <p>Smartphones, computers and laptops are a part of children's daily lives at home and school.</p> <h3>Consider these tips for allowing your children to have connection and collaboration on screened devices in a safe way:</h3> <ul> <li><a href="/hometown-health/speaking-of-health/6-tips-to-reduce-childrens-screen-time" target="_self" title="Opens in same window.">Limit screen time</a> for recreational purposes to two hours a day. </li> <li>Shut off or stop using screened devices at least one hour before bedtime.</li> <li>Consider implementing a rule of no screens in the bedroom to encourage <a href="/hometown-health/speaking-of-health/sleep-an-essential-element-of-success-for-children" target="_self" title="Opens in same window.">good sleep habits</a>. </li> </ul> <p> Knowing the risks and following these tips will help your children still have fun and be safe while using social media.<a href="/providers/karen-hall-lpc" target="_self" title="Opens in same window."></a></p> <p><a href="/providers/karen-hall-lpc" target="_self" title="Opens in same window."><em>Karen Hall</em></a><em> is a child and adolescent clinical therapist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window."></a><a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Adolescents and young adults with depression, anxiety, trauma, familial issues, grief and difficulties adjusting to life changes</li> <li>Families involved in county child protective services</li> <li>Specialized training with young people exploring gender identity, or gender dysphoria</li> <li>Trauma focused-cognitive behavioral therapy, or TF-CBT</li> </ul>L.P.C.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Psychology, University of Wisconsin-Stout</li> <li>Master's degree, Clinical Mental Health Counseling with a concentration in Child/Adolescent Counseling, University of Wisconsin-Stout</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Licensed Professional Counselor, Wisconsin</li> </ul>Hall<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/karen-hall-lpc.jpg?h=280&iar=0&w=280&sc_lang=en&hash=77283318A4B5FB4FD25A39DCCCF3CFCA" alt="Karen Hall, L.P.C." width="280" height="280" DisableNVelocity="true" />Karen<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16268440She/Her/HersKaren Hall, L.P.C.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}|{2B88C934-922C-4130-B661-197B59D83899}|{C4130004-0F31-48C4-AC9F-A4350A75AB24}|{F26710D2-A52B-47C8-986C-0B3D1DA0A9D0}<img src="/-/media/national-files/images/hometown-health/2020/adolescent-girls-using-social-media.jpg?h=370&iar=0&w=660&sc_lang=en&hash=800D6B1034CB7D1A98A3285E88000B43" alt="Adolescent girls using social media" width="660" height="370" DisableNVelocity="true" />Child DevelopmentWe all want our children to grow up happy and healthy. The reality is most all of them do — but at vastly different rates. Experts across Mayo Clinic Health System see thousands of children each year, and have the experience and resources to know what is normal and what may be cause for closer observation. This includes not only physical and motor skills development, but psychological and social skill advancement.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Micah Dorfner10/19/2017<p>I challenge you to not only support Breast Cancer Awareness Month but to take your own awareness of breast cancer one step further. I encourage you to be aware of the risk factors for breast cancer and what strategies you can implement in your lifestyle to reduce your risk.</p>Important information for breast cancer prevention<img alt="femalehandsholdingbreastcancerpinkribbon" src="/-/media/national-files/images/hometown-health/2017/femalehandsholdingbreastcancerpinkribbon.jpg?h=267&w=400&sc_lang=en&hash=0ECC333113D9BE3505576FC12A4147DA" style="width: 400px; height: 267px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive"> <p>It’s probably fair to assume that you’re aware October is Breast Cancer Awareness Month. Chances are you’ve participated in a 5K walk or run, given a monetary contribution to a foundation or fundraiser, or liked and shared a pink ribbon post on Facebook this month. These are all valuable ways to show and share your support of this cause.</p> <p>And it’s a worthy cause. It’s estimated that a quarter of a million new breast cancer cases will be diagnosed in the United States in 2017, making breast cancer the leading cause of cancer in American women.</p> <p>So this month, I challenge you to not only support Breast Cancer Awareness Month but to take your own awareness of breast cancer one step further. I encourage you to be aware of the risk factors for breast cancer and what strategies you can implement in your lifestyle to reduce your risk.</p> <p><strong><span>Breast cancer risk factors</span></strong></p> <ul style="list-style-type: disc;"> <li><span>Family genetics</span></li> <li><span>Reproductive history, never pregnant, or prolonged interval between menarche and first live birth</span></li> <li><span>Previous breast abnormalities </span></li> <li><span>Use of menopausal hormone therapy, especially if used for three years or more </span></li> <li><span>Increased body mass index (BMI)</span></li> <li><span>Alcohol consumption (even at moderate levels)</span></li> </ul> <p>If you have breast cancer risk factors, I recommend talking with your doctor about ways you can lower your risk and about screening for breast cancer.</p> <p><strong>Modifiable risk factors</strong></p> <p>While many of the risk factors are non-modifiable, you can reduce some. Living a healthy lifestyle (limiting alcohol consumption to less than one drink per day, exercising, controlling your weight), taking certain medications (tamoxifen, raloxifene, exemestane, anastrozole) and surgery (removal of both breasts and ovaries in women with higher risk, such as carriers of a BRCA mutation) are all strategies to help reduce your risk of developing breast cancer.</p> <p><strong>Breast cancer screening</strong></p> <p>Screening for breast cancer has been considered one of the main reasons why the mortality from breast cancer has decreased by 38 percent from 1989 until 2014. <a href="https://www.nccn.org/" target="_blank" title="Opens in new window">The National Comprehensive Cancer Network</a> recommends breast cancer screening starting at age 25, with a physical exam and risk assessment every one to three years. It’s then recommended to receive an annual screening mammogram starting at age 40. For higher risk women — those with a significant family history of breast cancer — screening may start at an earlier age, and other screening modalities, like a breast MRI, may be considered.</p> <p>So, when you see a pink ribbon signifying Breast Cancer Awareness Month, it’s not only a chance to support those battling breast cancer, it’s an opportunity for you to remind yourself of the risk factors and risk-reduction strategies. The most important prevention steps you can take are to:</p> <ul style="list-style-type: disc;"> <li><span>Be familiar with your breasts, and promptly report any changes to your health care provider.</span></li> <li><span>Be aware of any cancer history in your family, and discuss it with your health care provider.</span></li> <li><span>Follow the screening recommendations pertaining to your age and breast cancer risk.</span></li> <li><span>Stay active and exercise.</span></li> </ul> <p><em><a href="/providers/mina-hanna-md">Mina Hanna, M.D.</a>, is a <a href="/locations/albert-lea">Mayo Clinic Health System in Albert Lea</a> and <a href="/locations/owatonna">Owatonna</a> oncologist.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>Faculty of Medicine, Cairo University</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Yale-New Haven Hospital</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Hematology/Oncology, Mount Sinai Saint Luke’s Hospital</li> <li>Chief Fellow, Hematology/Oncology, Mount Sinai Saint Luke’s Hospital</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Hematology, American Board of Internal Medicine</li> <li>Internal Medicine, American Board of Internal Medicine</li> <li>Medical Oncology, American Board of Internal Medicine</li> </ul> <p><strong>Academic Appointment </strong></p> <ul> <li>Assistant Professor of Oncology, Mayo Clinic College of Medicine and Science</li> </ul>Hanna<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/mina-hanna-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B7FCC7F3F386DAB1C999D27D721232A3" alt="Mina Hanna, M.D." width="280" height="280" DisableNVelocity="true" />Mina<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20198108Mina Hanna, M.D.1{0DD9D3C9-86C5-47FC-A2CF-8AEEA4717B70}|{BCFC3BDC-CF55-458E-A41C-9360527B6CCC}<img src="/-/media/national-files/images/hometown-health/2017/femalehandsholdingbreastcancerpinkribbon.jpg?h=267&iar=0&w=400&sc_lang=en&hash=B6F215649F1CB5A7D2B97CF0A2D03E13" alt="femalehandsholdingbreastcancerpinkribbon" width="400" height="267" DisableNVelocity="true" />Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Michele Halterman7/27/2022The rate of syphilis infection is increasing across the nation. Learn more about syphilis and how you can reduce your risk of getting or spreading the infection.Syphilis: A rising community presence<p>The infection rate of syphilis is increasing. According to the <a rel="noopener" href="https://www.cdc.gov/syphilis/about/" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention</a>, the rate of infection has increased by 81% in Iowa, 28% in Minnesota and 34% in Wisconsin from 2016 to 2020. Across the country, syphilis infections increased over the same time by 52%.</p> <p>Here are answers to questions on how to prevent and treat this infection:</p> <h2>What is syphilis?</h2> <p><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/syphilis/home/ovc-20234440" target="_blank" title="Opens in a new window.">Syphilis</a> is a sexually transmitted infection spread by direct contact with skin sores. The disease starts as a painless store, typically on the genitals, rectum or mouth. After the initial infection, syphilis bacteria can remain in the body for decades before becoming active again.</p> <h3>Here is the quick breakdown on this sexually transmitted infection:</h3> <ul> <li>It's simple and cheap to prevent syphilis infection.</li> <li>Health care professionals can treat and cure syphilis with antibiotics.</li> <li>It's difficult for people to know whether they are infected or not, and untreated infections have dire health complications later.</li> </ul> <h2>Why are rates of infection increasing so quickly?</h2> <h3>Several factors can increase a person's risk of infection. The most prominent factors are:</h3> <ul> <li>Infected people not knowing they are infected.</li> <li>Infected people unknowingly spreading the infection to others.</li> <li>Newly infected people spreading the infection to others or reinfecting a previously treated person.</li> </ul> <h2>How can you protect against syphilis infection?</h2> <p>Abstinence is the ultimate protection against syphilis because you can avoid any chance of exposure to infected skin sores.</p> <h3>However, if you choose to be sexually active, you can reduce your chances of infection by:</h3> <ul> <li><strong>Having an open, direct conversation with your sexual partners.</strong><br /> It's important for both partners to be treated to prevent reinfection from each other.</li> <li><strong>Limiting sexual partners.</strong><br /> The more sexual partners you have, the higher the risk of infection.</li> <li><strong>Having only a long-term, mutually single partner who has tested negative for syphilis.</strong><br /> This also is called a monogamous relationship.</li> <li><strong>Using latex condoms.</strong> <br /> This helps provide a barrier between your partner's skin sores and your skin, lowering the risk of infection.</li> <li><strong>Being tested.</strong><br /> The CDC recommends testing for all women at their first prenatal visit, as syphilis can spread to an unborn child. Earlier treatment is associated with better baby outcomes.</li> </ul> <h2>What is the test for syphilis?</h2> <h3>Two simple and easy ways are available:</h3> <ul style="list-style-type: disc;"> <li>A blood test, which often takes only 15 minutes for the results.</li> <li>A test of the fluid from a concerning and suspicious sore.</li> </ul> <h2>Are antibiotics available to cure syphilis infection?</h2> <p>Yes. However, it is important to <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/syphilis/diagnosis-treatment/treatment/txc-20234511" target="_blank" title="Opens in a new window.">treat syphilis</a> as early as possible. Untreated syphilis infection can damage many body systems, and this damage can be irreversible.</p> <h2>What are the signs and symptoms of a syphilis infection?</h2> <p>Signs and symptoms include sores on or around the penis, vagina, anus, rectum, lips, within the mouth or on the tongue. These sores are often painless, round and firm. Because these sores are painless, they often go overlooked.</p> <h2>What can happen if I do not receive treatment?</h2> <h3>Failure to be treated for syphilis can cause:</h3> <ul style="list-style-type: disc;"> <li>Vision changes or impairment.</li> <li>Loss of balance.</li> <li>Hearing loss or new deafness.</li> <li>Stroke.</li> <li>Increased risk of HIV/AIDS infection.</li> <li>Profound lifelong health complications in infected unborn children.</li> <li>Headache.</li> <li>Dementia.</li> <li>Loss of pain and temperature sensations.</li> <li>Sexual dysfunction in men.</li> <li>Bladder incontinence.</li> <li>Permanent damage to heart valves and arteries.</li> </ul> <p>If you feel that you have been exposed to syphilis, or you only wish to have reassurance with a quick test, see your primary care provider. Responsible sexual practices and personal health awareness will reduce the rising rate of infection in the community.</p> <p><em><a href="/providers/trevor-rich-md" target="_self" title="Opens in same window.">Trevor Rich, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/mondovi" target="_self" title="Opens in same window.">Mondovi</a>, Wisconsin.</em></p><ul> <li>Academic medicine and community health education</li> <li>Community nutritional health and preventive wellness</li> <li>Critical access rural clinic and hospital care <ul> <li>Vasectomy counseling and referral service</li> <li>Contraceptive counseling and referral service, OCP prescription management</li> <li>Preconception care & planning, prenatal referral service</li> <li>Wound care and wound management</li> </ul> </li> <li>Rural athletic support</li> <li>Skilled nursing facility medical directorship</li> </ul>M.D.<p>I view my delivery of care to be shared. My role, above all else, is to be a source of evidence-based counseling, such that all my patients feel comfortable with their informed decisions about their health. Patients can expect my undivided attention and eagerness to clarify their questions.</p> <p>I’m a humble family man, who finds purpose in serving my community and neighbors.</p><p><strong>Education</strong></p> <ul> <li>Medical College of Wisconsin-Milwaukee</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Mayo Clinic Family Medicine Residency, Eau Claire</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Clozapine REMS Program</li> <li>MAT, Suboxone Waiver</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians </li> <li>Mayo Clinic Alumni Association</li> <li>Society of Teachers of Family Medicine</li> <li>The National Guard Association of the United States</li> <li>Wisconsin Academy of Family Physicians</li> <li>Wisconsin Medical Society</li> <li>Wisconsin National Guard Association, Inc.</li> </ul>Rich<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/trevor-rich-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=C35BEC1720C4B1DC110D068E43EFF155" alt="Trevor Rich, M.D." width="280" height="280" DisableNVelocity="true" />{DEC439E2-74BD-46D1-94B9-DB111539B3A8}Trevor<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20654405Family Medicine - Trevor Rich MD1{986C767E-E5DE-43F5-957F-B4212DB8E384}|{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}<img src="/-/media/national-files/images/hometown-health/2022/young-person-curly-hair-looking-left.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B73FF971BFEABEDB181152DE5322AA62" alt="Young person curly hair looking left" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Micah Dorfner10/17/2017<p>Cooking for one or two doesn’t mean you have to let your health go by the wayside and resort to meals of cold cereal, grilled cheese and canned soup, or microwave meals. With some helpful tips, you can be cooking healthy and efficiently for a smaller household in no time.</p>Tips for cooking for one or two<img alt="Couple in Kitchen Looking at Tablet" src="/-/media/national-files/images/hometown-health/2017/couple-in-kitchen-looking-at-tablet.jpg?h=267&w=400&sc_lang=en&hash=BAA1A6961C8C4D6DCE0FDBF0F1E40137" style="width: 400px; height: 267px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive"> <p>Cooking for one or two doesn’t mean you have to let your health go by the wayside and resort to meals of cold cereal, grilled cheese and canned soup, or microwave meals. With some helpful tips, you can be cooking healthy and efficiently for a smaller household in no time.</p> <p><strong>Meal planning for one or two</strong></p> <p>Good health depends on eating a diet made up of a variety of nutritious foods, including carbohydrates, proteins and fats in the right balance. Planning your meals is important, and following the plate method can make meal planning simple.</p> <p>Divide your plate using the following food-choice guidelines:</p> <ul> <li><strong>Fill half of your plate</strong><span style="color: black;"> with vegetables and fruit.</span></li> <li><strong>One-quarter of your plate</strong><span style="color: black;"> with protein rich foods.</span></li> <li><strong>One-quarter of your plate</strong><span style="color: black;"> with a starch.</span></li> </ul> <p>To keep your options healthy, make at least half of your grains whole grains, vary your veggies and fruits (eat the rainbow), get calcium-rich foods with low-fat dairy and go lean with the protein. Find more information at <a href="https://www.choosemyplate.gov/" target="_blank" title="Opens in new window">ChooseMyPlate.gov</a><span style="color: black;">. Remember to choose lots of non-starchy veggies for their nutritious benefits and to keep calories under control.</span></p> <p>To make sure your portions are adequate but not excessive, use the following visual cues:</p> <ul> <li><strong>Vegetable servings</strong> —<span style="color: windowtext;"> </span>the size of a baseball </li> <li><strong>Fruit servings</strong> —<span style="color: windowtext;"> </span>the size of a tennis ball </li> <li><strong>Carbohydrates or grain servings</strong> —<span style="color: windowtext;"> </span>the size of a hockey puck </li> <li><strong>Protein or meat servings </strong>—  the size of a deck of cards </li> <li><strong>Fat servings</strong> —<span style="color: windowtext;"> </span>the size of one or two dice </li> </ul> <p>When deciding what will be on your menu, start by finding recipes you enjoy making. You can find inspiration in cookbooks, magazines or online. Make sure to plan some days for leftovers, especially those days when you might be too busy to cook. Remember, protein should be an accompaniment to your meal, with veggies serving as the entree. So, start with veggies and plan other items around them.</p> <p><strong>Shopping for one or two</strong></p> <p>When cooking for a smaller household, it makes sense to shop the bulk bins or salad bar. That way you can get just the amount you need to prevent waste. Sure, you might pay a little more per pound, but if you actually use what you buy, you’ll be saving money in the end. You can also use the deli counter, where you can purchase only what you need; for example, a single chicken breast, one-quarter pound of meat or just a few slices of cheese. These smaller portions can keep you from the boredom of eating the same foods day after day. If you’d still rather buy larger packages, try buying in bulk and freezing smaller portions, splitting groceries with a friend, or, better yet, cooking meals together with a friend or neighbor.</p> <p><strong>Cooking for one or two</strong></p> <p>Try batch cooking, where you cook once and eat multiple times. Here are a few suggestions:</p> <ul> <li>Make a big batch of homemade soup or chili and freeze in individual portions. Muffin tins work well for this.</li> <li>Look at making a batch of brown rice and using some for a side item one day, in a casserole the next and in a stir fry the day after.</li> <li>You can make meatloaf and divide it in half. Use half for meatloaf and roll the other half into meatballs and freeze.</li> <li>Cook a pound or two of meat or a whole chicken and divide it up for casseroles, tacos, salads, etc. Keep what you can use within three to four days in the fridge and freeze the rest.</li> <li>Use extra pasta for a cold salad the next day.</li> <li>Make a roast in the crockpot one day and slice up left overs for sandwiches later. You can also freeze it in individual portions for a quick reheat later in the week.</li> </ul> <p><strong>Reducing recipes</strong></p> <p>If you enjoy cooking every day or you don’t have much freezer space, try reducing recipes using these tips:</p> <ul> <li>If a recipe calls for three eggs, use two eggs and subtract two to four tablespoons of liquid.</li> <li>If a recipe calls for a half can of beans or pumpkin, use half and refrigerate or freeze the rest.</li> <li>Remember, there are 16 tablespoons per cup, three teaspoons per tablespoon, eight fluid ounces per cup and two tablespoons per fluid ounce.</li> <li>Make sure to monitor a reduced recipe’s cook time more closely, as it will cook faster (likely five to 10 minutes earlier).</li> </ul> <p><strong>Kitchen equipment for smaller meals</strong></p> <strong> </strong> <p>Instead of a large oven, here are a few options to look at when preparing your meals:</p> <ul style="list-style-type: disc;"> <li><strong>Toaster oven. </strong>A toaster oven allows you to cook all sorts of single-serve items without heating up your kitchen. You can make small batches of one to two cookies, warm up a single serving of pizza or bake a piece of fish or chicken.</li> <li><strong>Indoor single-serving grill</strong>. This tool allows for quick cooking of single-serve items such as a burger or chicken breast.</li> <li><strong>Crockpot.</strong> A crockpot is great for batch cooking. It allows you to throw ingredients together and forget about it until hours later.</li> <li><strong>Ice cube trays and muffin pans</strong>. These items can be used for freezing leftovers. If you have leftover tomato sauce, freezing in an ice cube tray makes convenient portions for later. If you freeze soup in muffin tins, you can freeze the meaty part of the soup separate from the broth and combine them for a single bowl of soup at a later time. Once frozen, you can remove the cubes or muffins from the tray or pan and store together in a zipper-top freezer bag.</li> </ul> <p><strong>Don’t know how to cook?</strong></p> <p>Try a cooking class or consider a meal service that delivers healthy meals to your door. There are also companies that will ship recipes with all the prepped ingredients to your door so all you have to do is cook the meal. You can also consider freezer meal classes, which are available at some local grocery stores. Just package the meals for one or two. </p> <p><strong>Don’t want to cook?</strong></p> <p>If you still plan on buying frozen or convenience meals after all these ideas, make sure to check the nutrition information and compare labels. If you have diabetes, pay special attention to the total carbohydrates listed on the package. If you have high blood pressure or are on a heart-healthy diet, watch for sodium, as well as fat content — especially saturated fat.</p> <p><strong>Keeping your food safe</strong></p> <p>Be sure to refrigerate perishables in shallow dishes within two hours.  Eat leftovers within three to four days or freeze. Reheat leftovers to 165 degrees Fahrenheit. Thaw frozen foods on the bottom shelf in the fridge, not on the counter. </p> <p><strong>Easy meal ideas</strong></p> <p>To help spur easy meal ideas, see the following simple choices from each food group. Try to include a minimum of three different food groups at each meal. Be creative.</p> <p>Easy proteins:</p> <ul> <li>Eggs. They’re always a quick, easy choice. Keep hardboiled eggs in the fridge, and enjoy them as a deviled egg, egg salad or just as is.  </li> <li>Chicken breasts. Bake extra and freeze individually — chopped or whole. </li> <li>Ground beef or turkey. Brown extra and repackage into small amounts to make tacos, casseroles, spaghetti, salads, etc.  </li> <li>Low-sodium tuna, canned in water. This high-protein option makes a quick sandwich or salad.  </li> <li>Frozen fish. It can be cooked quickly and even enjoyed cold the next day. </li> <li>Canned black, red, kidney, chili beans (rinsed) and lentils. These are great vegetable sources of protein. </li> <li>Unsalted nuts or natural nut butters. Nuts are convenient and healthy </li> </ul> <p>Easy starches: </p> <ul> <li>Baked potatoes — microwave and top with leftover chili to add extra flavor </li> <li>Whole-grain pasta, brown rice, barley, quinoa </li> <li>Whole-grain bread or crackers </li> <li>Whole-grain cereals </li> <li>Whole-grain tortillas</li> <li>Microwaveable rice pouches </li> <li>Oatmeal </li> </ul> <p>Easy fruits and veggies:</p> <ul> <li>Pre-washed, pre-cut fruits and veggies </li> <li>Ready-to-eat salad bags or kits </li> <li>Baby carrots </li> <li>Salad bar items </li> <li>Frozen — without sauces, sugar or salt </li> <li>Steamer bags </li> <li>Canned — in its own juice or without salt </li> <li>Fruit cups or unsweetened apple sauce </li> </ul> <p>Easy dairy:</p> <ul> <li>Natural cheese or string cheese </li> <li>Yogurt </li> <li>Cottage cheese </li> <li>Low-fat milk</li> </ul> <p><em><a href="/providers/kristi-wempen-rdn">Kristi Wempen</a> is a clinical dietician at <a href="/locations/mankato">Mayo Clinic Health System in Mankato</a>.</em></p><ul> <li>Chronic kidney disease</li> <li>General health and wellness</li> <li>Weight management</li> </ul>RDN, LD<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Minnesota State University-Mankato</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Iowa State University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration</li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul> <p><strong>Membership</strong></p> <ul> <li>Academy of Nutrition and Dietetics</li> </ul>Wempen<img src="/-/media/shared-files/images/medical-professionals/full/mankato/kristi-wempen-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=BB7EFDC16603EA67B00B7CD0DBD528E1" alt="Kristi Wempen RDN" width="280" height="280" DisableNVelocity="true" />Kristi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14834341Kristi Wempen, R.D.N.1{2BEE5070-65FF-4406-9E59-103E06C5A535}<img src="/-/media/national-files/images/hometown-health/2017/couple-in-kitchen-looking-at-tablet.jpg?h=267&iar=0&w=400&sc_lang=en&hash=507A19CB44A7ACBF314DE70198AC2FD1" alt="Couple in Kitchen Looking at Tablet" width="400" height="267" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Michele Halterman3/25/2024Hearing loss in children can have a profound impact on their speech, social and emotional development. Learn about one technique for helping children hear.Bone-anchored implants: Treating your child's hearing loss<p>As an audiologist, I often work with parents worried about their child's hearing. <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/hearing-loss/symptoms-causes/syc-20373072" title="Opens in a new window." target="_blank">Hearing loss</a> is a significant concern for parents because it can impair speech and language skills as their child develops.</p> <p>Approximately 2 of every 1,000 infants are born with hearing loss every year, according to the <a rel="noopener noreferrer" href="https://www.asha.org/practice-portal/clinical-topics/hearing-loss-in-children/#collapse_1" target="_blank" title="Opens in a new window.">American Speech-Language-Hearing Association</a>. The newborn hearing screening conducted shortly after birth often detects the issue, but hearing loss can progress as children get older. Some estimates indicate that by adolescence, nearly 4 in 1,000 and up to 23 in 1,000 young people experience permanent hearing loss in one or both ears.</p> <h2>How hearing loss can affect a child</h2> <p>Hearing loss, whether it's in one or both ears, can profoundly influence a child's physical, social and emotional skills.</p> <h3>Some of the ways children with hearing loss are affected include:</h3> <ul> <li>They typically find it more difficult to learn vocabulary, grammar, word order and other aspects of verbal communication.</li> <li>They may have a harder time developing social and emotional skills. Many children with untreated hearing loss will report feeling isolated or unhappy in school.</li> <li>They may have difficulty hearing their own voices and not realize they're speaking loudly or mumbling because the sound of their speech isn't clear to them.</li> <li>They may experience delays in <a rel="noopener noreferrer" href="http://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/language-development/art-20045163" target="_blank" title="Opens in new window.">speech development</a> because they often can't hear quiet speech sounds, such as "s," "f" and "t."</li> </ul> <h2>Help for your child's hearing loss</h2> <p>It's crucial to appropriately manage hearing loss in children to help them succeed in their development. Children who use amplification devices, which include hearing aids, <a href="/hometown-health/speaking-of-health/beyond-hearing-aids-cochlear-implants" target="_self" title="Opens in same window.">cochlear implants</a> or bone-anchored implants (BAI), show more rapid growth patterns and better early language outcomes than those with no treatment.</p> <img alt="Hearing devices illustration" style="width: 400px; height: 225px;" src="/-/media/national-files/images/hometown-health/2024/hearing-devices-illustration.jpg?h=225&w=400&sc_lang=en&hash=1A6CB9BEB03435B565EC04C735D56B52" /> <p>While hearing aids and cochlear implants may be more familiar to parents, BAI is another surgically implantable system for hearing loss. It works by enhancing the natural ability of bone to transmit sound through a pathway to the inner ear, and bypasses the external auditory canal and middle ear. The titanium implant is placed during a short outpatient surgical procedure.</p> <p>BAI first was used in Europe in 1977 and approved by the Food and Drug Administration (FDA) for use in the U.S. in 1996. In 2002, the FDA extended its approval of BAI for treating cases of single-sided <a rel="noopener noreferrer" href="https://www.asha.org/public/hearing/sensorineural-hearing-loss/" target="_blank" title="Opens in a new window.">sensorineural deafness</a>, which is caused by damage to the inner ear.</p> <h3>The three main parts of BAI include:</h3> <ul> <li>An external sound processor, which picks up and collects sounds.</li> <li>An abutment or magnet, which connects the processor to the titanium implant and converts sound into vibrations.</li> <li>A titanium implant inserted into the bone, which integrates with the mastoid portion of the temporal bone behind the ear. The implant transfers the vibrations through the skull to the inner ear and cochlea.</li> </ul> <h2>Is your child a candidate for BAI?</h2> <h3>BAI may be used for people of all ages based on their hearing loss type, including:</h3> <ul> <li>Conductive hearing loss or hearing loss caused by a problem in the middle ear space, such as chronic ear infections or a hole in the eardrum. This type of hearing loss also may be caused by malformation of the outer ear, ear canal or ear structures, like the middle ear bones.</li> <li>Mixed hearing loss, or hearing loss caused by a problem in the middle and inner ear.</li> <li>Single-sided deafness.</li> <li>Someone born without a fully developed ear on one side.</li> <li>People who have had complicated middle ear surgeries that prevent them from using hearing aids.</li> <li>Those who have complications from constant ear drainage.</li> </ul> <p>After surgery, people with BAI regain the ability to hear more clearly and can enjoy a wide range of physical activities, including participating in sports.</p> <p>If you're concerned about hearing loss in your child or would like to schedule a hearing screening, talk with their healthcare team, who can refer you to an audiology expert for help.</p> <em><a href="/providers/katie-dease-aud">Katie Dease</a> is an <a href="/services-and-treatments/audiology" target="_self" title="Opens in same window.">audiologist</a> in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em><ul> <li>Amplification/hearing aids</li> <li>Audiometry</li> <li>Pediatrics</li> <li>Tinnitus</li> </ul>Au.D.<p><strong>Education</strong></p> <ul> <li>Doctor of Audiology, University of Wisconsin-Stevens Point</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Audiology</li> <li>Certificate of Clinical Competence, American Speech-Language-Hearing Association</li> <li>Hearing Instrument Dispenser</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Speech-Language-Hearing Association</li> </ul>Dease<img src="/-/media/shared-files/images/medical-professionals/full/mankato/katie-dease-aud.jpg?h=280&iar=0&w=280&hash=2A9E758AE48ADAA463D9362B7EE868C8" alt="Katie Dease, Au.D." width="280" height="280" DisableNVelocity="true" />{A4D89010-062B-42B7-830A-2F6D0A2BD079}Katie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15263924Katie Dease, Au.D.1{18E5E65E-45C8-4C48-BD32-A914794E2AA4}<img src="/-/media/national-files/images/hometown-health/2024/child-playing-recorder.jpg?h=370&iar=0&w=660&sc_lang=en&hash=12B4560B6D1C0C8377EE12533FD806D4" alt="Child playing recorder" width="660" height="370" DisableNVelocity="true" />Ear HealthAn audiologist specializes in evaluating and treating people of all ages with hearing loss, dizziness and balance disorders. Specialty audiology consultation is available for assessment and treatment of hearing loss, tinnitus, dizziness and balance disorders.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Michele Halterman11/17/2022<p>Lubrication can be an easy way to increase comfort during intercourse. However, many couples trying to conceive don't realize that lubricants can adversely affect sperm.</p>Trying to get pregnant? Select a lubricant most helpful for sperm<p>Lubrication can be an easy way to increase comfort during intercourse. However, many couples trying to conceive don't realize that lubricants can adversely affect sperm motility.</p> <p>Lubrication reduces the ability of sperm to move spontaneously and actively toward the egg. The sperm moves through cervical mucous in the vagina, through the uterus and fallopian tubes to the egg. While it is up for debate if lubricants decrease pregnancy rate, it is recommended to avoid most lubricants when trying to conceive.</p> <p>Lubrication can limit the ability of the sperm to be motile, or swim. This is important for the sperm to reach the egg to fertilize it. At the egg's surface, multiple sperm work together for one sperm to break through the surface to fertilize the egg.</p> <p>For couples using fertility medications to aid in getting pregnant, certain medications can cause vaginal dryness. This increases the likelihood of needing to use a lubricant during intercourse.</p> <p>Most lubricants, including saliva, can slow sperm movement. So, what should you do if you use lubricants during sex and are trying to get pregnant?</p> <p>Search for a lubricant that is hydroxyethylcellulose-based. These lubricants don't decrease sperm motility and are the most similar in consistency and viscosity to natural vaginal mucus.</p> <p>Look for lubricants that do not contain fragrances or parabens. Certain lubricants are labeled as "fertility-friendly" or "sperm-friendly." To be sold, these lubricants must be evaluated by the Food and Drug Administration (FDA). The FDA does not review lubricants labeled as "organic" or "natural."</p> <p>Do not use oils you may have in your house, such as coconut oil, as a lubricant.</p> <p>Remember that lubricant use does not make it easier to get pregnant. Lubricants can increase comfort during intercourse and are not harmful to sperm.</p> <p>If you have questions about which lubricant is right for you, talk to your health care team, or ask a preconception counselor or fertility expert.</p> <h4>Learn more about fertility:</h4> <ul> <li>It seems like there is endless advice on what to do when you’re trying to get pregnant, but what advice is actually true? Read about <a href="/hometown-health/speaking-of-health/boxers-or-briefs-4-common-fertility-myths-debunked" target="_self" title="Opens in same window.">common fertility myths</a>.</li> <li>Search for "ovulation kit" or "ovulation app" online, and you’ll quickly see that finding the right tool can be a little overwhelming. Read about <a href="/hometown-health/speaking-of-health/using-ovulation-kits-to-predict-fertility" target="_self" title="Opens in same window.">using ovulation kits to predict fertility</a>.</li> <li>To become pregnant, the complex processes of ovulation and fertilization need to work just right. Read some <a href="/hometown-health/speaking-of-health/tips-to-improve-fertility" target="_self" title="Opens in same window.">tips to improve fertility</a>.</li> </ul> <p><em><a href="/providers/alicia-ogle-np" target="_self" title="Opens in same window.">Alicia Ogle</a>, is a nurse practitioner in <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p> <ul> <li>Infertility</li> <li>Women's health</li> </ul> A.P.N.P., R.N. <p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Nursing, Cedarville University</li> <li>Master's degree, Nursing, University of Wisconsin-Eau Claire</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Nurse Practitioner, American Nurses Credentialing Center</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Society of Reproductive Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Obstetrics and Gynecology, Mayo Clinic College of Medicine and Science</li> </ul> Ogle<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/alicia-ogle-np.jpg?h=280&iar=0&w=280&sc_lang=en&hash=BC96CD4910532A55886115C7A5D18166" alt="Alicia Ogle, N.P." width="280" height="280" DisableNVelocity="true" /> {25F09A55-D529-46B4-A68F-D93F9C967DDA}Alicia<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14443937Alicia Ogle, A.P.N.P., R.N. 1{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{54693F31-87AF-4B21-91DB-1DEC1E21F878}<img src="/-/media/national-files/images/hometown-health/2022/couple-with-faces-together.jpg?h=370&iar=0&w=660&sc_lang=en&hash=873F6EC962371BAA7CD883CEA858F1CA" alt="Couple with faces together" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.FertilityFertility issues may be due to a single cause with you or your partner or a combination of factors that may prevent a pregnancy from occurring or continuing. There are multiple safe, effective fertility therapies available.JMicah Dorfner10/5/2017<p>When Cathy Klug was diagnosed with breast cancer in 1997, it came as a shock. The healthy, 43-year-old mom and school teacher had always taken care of herself and always enjoyed good health. But her positive attitude moved her forward as a true survivor.</p>Staying positive, supporting others helps Cathy fight against breast cancer<img alt="Cathy Klug Mug Shot" src="/-/media/national-files/images/hometown-health/2017/cathy-klug-mug-shot.jpg?h=300&w=200&sc_lang=en&hash=4C1AE03FFE5EF97EBBE9D06619116A51" style="height: 300px; width: 200px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /> <p>When Cathy Klug was diagnosed with breast cancer in 1997, it came as a shock. The healthy, 43-year-old mom and school teacher had always taken care of herself and always enjoyed good health. But her positive attitude moved her forward as a true survivor.</p> <p>Klug immediately said yes to joining a breast cancer survivor team when Mayo Clinic Health System in La Crosse announced in 2013 it was producing the region’s first ever dragon boat races. She saw it as an opportunity to show other survivors how strong one can be after having breast cancer. She relished the opportunity to support others — not realizing she soon would need that support herself — and reveled in both the races and the sisterhood that developed among her team members.</p> <p>“Being in a group like that — we all had different stories, but we were all cancer survivors and working together.”</p> <p>In 2015, however, Klug did not paddle. She was too weak from a second bout of breast cancer. Klug found herself dealing with two types of cancer. “I was scared. I couldn’t understand why my body was doing this,” she said.</p> <p>“The second time with cancer, it is harder for me to stay positive. I’m not as emotionally strong this time,” she said. Even the 2016 dragon boat races felt different.</p> <p>“In 2016 I was the one being supported — totally,” said Klug. “Supporting others makes you feel strong, positive; you’re helping others know they can survive. It’s strange now. I remember those feelings but I don’t have them inside.”</p> <p>Klug said her rule is to stay positive. “Being around these women helps me stay on the positive, living end of things. It’s trickier this time. I like their strength. It fuels mine.”</p><img src="/-/media/national-files/images/hometown-health/2017/cathy-klug-dragon-boat.jpg?h=300&iar=0&w=400&sc_lang=en&hash=375B221F3DFA112A7BD9F4BBA7A0687B" alt="Cathy Klug Dragon Boat" width="400" height="300" DisableNVelocity="true" />Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Michele Halterman10/17/2017<p>The CrossFit phenomenon has proven what Rocky Balboa always knew: You don’t need an expensive gym or sophisticated equipment to get in shape. If you’re willing (and able) to get pumped up, try these basic and effective moves for beginners.</p>Pump you up: Exercise with dumbbells<p>The CrossFit phenomenon has proven what Rocky Balboa always knew: You don’t need an expensive gym or sophisticated equipment to get in shape.</p> <p>“A set of dumbbells and a willingness to use them can work wonders,” says <a href="/providers/robert-freed-do" target="_self" title="Opens in same window.">Robert Freed, D.O.</a>, an orthopedic surgeon at Mayo Clinic Health System in Mankato, Minnesota</p> <p>Watch this video if you’re willing, and able, to get pumped up, to try these basic, but effective, moves for beginners:</p> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/aqRIRqsGdks" title="Exercise with dumbells" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p>The video includes:</p> <ul> <li>Bent over row</li> <li>Biceps curl</li> <li>Calf raise</li> <li>Chest press</li> <li>Reverse fly</li> <li>Squat</li> <li>Triceps extension</li> </ul> <p><em>Excerpted from mayoclinic.org</em></p><img src="/-/media/national-files/images/hometown-health/2017/fbblog_dumbbells_504x504-cropped.jpg?h=426&iar=0&w=504&sc_lang=en&hash=DDD815787D1DA47AA999A38CDAEEDCC1" alt="fbBlog_dumbbells_504x504 cropped" width="504" height="426" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Michele Halterman10/12/2017<p>You know every detail of your parents’ first date and have your grandmother’s lefse recipe committed to memory. But when your doctor asks if anyone in your family has had heart disease, you draw a blank.</p>Holiday table topics: Know your family's health history<img alt="fbBlog_tableTopics_504x504" src="/-/media/national-files/images/hometown-health/2017/holiday-table-topics.jpg?h=300&w=300&sc_lang=en&hash=5CCCED11E71615DDFEE73E31E905225E" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /> <p>You know every detail of your parents’ first date and have your grandmother’s lefse recipe committed to memory. But when your doctor asks if anyone in your family has had heart disease, you draw a blank.</p> <p>Sound familiar? If so, you’re not alone.</p> <p>“Many people don’t know their family health history,” says <a href="/providers/michael-rogge-md" target="_self" title="Opens in same window.">Michael Rogge, M.D.</a>, a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician at <a href="/locations/prairie-du-chien" target="_self" title="Opens in same window.">Mayo Clinic Health System in Prairie du Chien</a>, Wisconsin.</p> <p>It’s easy to understand why. After all, it’s more fun to talk romance (or rice pudding) than rheumatoid arthritis. But knowing your health history can have an impact now — and your future. That’s because certain medical conditions are genetic or inherited.</p> <p>“Just like you can inherit your father’s blue eyes or your mother’s curly hair, you can also inherit a predisposition to conditions such as diabetes, heart disease or cancer,” says Karen Hanson, a chaplain at Mayo Clinic Health System in Red Wing, Minnesota. Knowing your family history can help your provider decide what screening tests you might benefit from and when.</p> <p>While it can be uncomfortable to bring up, talking about your family’s medical history is important. “Knowing this information can help you decide where to focus your prevention efforts,” says Dr. Rogge. “If there’s a family history of heart disease, for example, a heart-healthy diet becomes even more important.”</p> <p>As the holiday season approaches, consider giving your family the gift of a good health history. Use your time together to talk about the diseases and conditions they — or their ancestors — have been diagnosed with.</p> <p>“After the turkey dinner, before the food coma sets in, let your family know that you want to talk about the family’s health,” Hanson says. “Let them know why, and that the discussion could benefit them and their families, as well.”</p> <p>The holidays also are a good time to talk about advance directives and living wills.</p> <p>“These documents speak for you when you can no longer speak for yourself,” says Dr. Hanson. “They outline the care you want and identify the people you want to make decisions for you if you’re no longer able to make them for yourself.”</p> <p>Dr. Rogge recommends all adults complete an advance directive or living will, especially if they have children.</p> <p>“Making health care decisions is truly a gift to your family,” he says. “The documents outline your wishes, so no one needs to guess what you’d want.”</p> <p>And, unlike a fruitcake or pair of slippers, that’s something that will be appreciated for generations to come.</p> <p>You can create your own <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://cbiit.github.io/FHH/html/index.html" target="_blank" title="Opens in a new window.">family health portrait</a> using a tool from the U.S. Surgeon General. Give it a try, and share the results with your family this holiday season.</p><img src="/-/media/national-files/images/hometown-health/2017/holiday-table-topics.jpg?h=504&iar=0&w=504&sc_lang=en&hash=34C4357061E896ED4AD792F71C2B8299" alt="Holiday table topics" width="504" height="504" DisableNVelocity="true" />AgingLife expectancy is 75 for males and 80 for females according to the National Center for Health Statistics. We'll help you keep you informed about potential issues with aging, and steps you can take to maintain your health and keep active.Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Michele Halterman3/11/2022The number of thyroid cancer cases has been increasing in the past 20 years, mainly due to advancements in imaging techniques that help detect smaller lesions. Get details about types and treatments.What is thyroid cancer?<p>The thyroid gland is a butterfly-shaped organ on the front of the neck whose main function is producing thyroid hormones to regulate metabolism, heart rate, blood pressure and body temperature.</p> <img alt="a-medical-illustration-of-thyroid-cancer" src="/-/media/national-files/images/hometown-health/2017/thyroid-cancer.jpg?h=183&w=325&sc_lang=en&hash=984B96C6636D7947E909CB2CDB73E1FE" style="width: 325px; height: 183px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive"> <p>Compared to other cancers, thyroid cancer is less common. An estimated 44,280 cases were diagnosed in 2021 in the U.S. However, this number has been increasing over the past 20 years. This could be due to improvements in imaging techniques that help find smaller lesions that may have not been found in the past.</p> <p>Overall, thyroid cancer prognosis — or the projected course of the disease — is good. The five-year relative survival rate is 98.3%.</p> <h4>Types of thyroid cancers</h4> <p>Thyroid cancer is classified based on the types of cells found in the tumor. The type of cancer is important when determining the treatment plan.</p> <h5>The types of thyroid cancers are:</h5> <ul> <li><strong>Differentiated thyroid cancers: papillary, follicular and Hurthle cell</strong><br> Papillary thyroid cancer is the most common type of thyroid cancer, accounting for 80% of all cases. It's a slow-growing cancer, and except certain subtypes, the overall prognosis is excellent. Papillary thyroid cancer can spread to lymph nodes in the neck, but even in that case, it typically responds well to treatment. Follicular thyroid cancer makes up about 10% of thyroid cancers and has a good prognosis. However, the risk of spreading to the lungs and bones is higher than papillary thyroid cancer. Hurthle cell cancer makes up about 3% of thyroid cancers. Although most patients do well, the prognosis can change based on the extent of disease at the time of diagnosis.</li> <li><strong>Medullary thyroid cancer</strong><br> This form of thyroid cancer accounts for about 4% of thyroid cancers. This distinct form of thyroid cancer, which can run in families, is linked with certain genetic endocrine syndromes. Treatment is more effective if medullary thyroid cancer is diagnosed before the cancer spreads.</li> <li><strong>Anaplastic thyroid cancer</strong><br> This is the most aggressive form of thyroid cancer, accounting for about 1% of thyroid cancers. It's a rapid-growing form of cancer with poor response to treatment.</li> </ul> <p>Rarely, lymphoma, sarcoma and other tumors can be found in the thyroid, as well.</p> <h4>Risk factors</h4> <p>The biggest risk factors for thyroid cancer include a family history of thyroid cancer, some genetic mutations, and previous radiation exposure, particularly to the head and neck region. Also, it's more common in females, as 75% of thyroid cancer patients are female.</p> <h4>Symptoms</h4> <p>Most thyroid cancers don't cause symptoms aside from a lump on the neck. Most commonly, health care professionals discover lumps during exams or incidentally on CT or ultrasound imaging of the neck. Sometimes people find lumps on their own. If the mass is large enough, it can cause symptoms, including swallowing and breathing problems, hoarseness and a cough.</p> <h4>Diagnosis</h4> <p>After a lump or nodule is detected, a fine-needle aspiration biopsy is the next diagnostic step. In this procedure, cells from the lump are collected using a thin needle and analyzed under a microscope.</p> <p>This procedure is usually well-tolerated and generally done with the guidance of ultrasound. An endocrinologist with specialized training in fine-needle aspiration biopsy can perform the procedure, as well as guide patients on treatment options based on the results.</p> <p>About 80% of thyroid nodules are benign, which means they are not cancer, and about 10% are found to be cancerous, or malignant. The remaining 10% are indeterminate, and a repeat biopsy or surgery may be considered to determine the diagnosis.</p> <h4>Treatment</h4> <p>Thyroid cancer treatment is tailored to each patient, and most thyroid cancer can be cured with treatment. However, treatment may not be needed right away if the cancer is small and has a low risk of spreading to other areas of the body. In that case, the cancer would be monitored regularly.</p> <p>For most people, surgery is necessary to remove some or all the thyroid gland. Surrounding lymph nodes also may be removed. If the entire gland is removed, thyroid hormone replacement treatment in the form of a daily pill, such as levothyroxine, would be needed to replace the thyroid function and suppress the production of a hormone that could stimulate growth of any remaining cancer cells.</p> <p>In addition to surgery, radioactive iodine treatment, external beam radiation, alcohol ablation and chemotherapy are other treatment options based on the type and stage of the cancer.</p> <p>After initial treatment, neck imaging and thyroid tumor marker levels are checked regularly to monitor for recurrence and to decide if additional treatment is needed.</p> <p><em>Omar El Kawkgi, M.B., B.Ch., is an <a href="/services-and-treatments/endocrinology" target="_self" title="Opens in same window.">endocrinologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin. He performs ultrasound-guided fine-needle aspiration biopsies in the clinic.</em></p><img src="/-/media/national-files/images/hometown-health/2022/young-adult-gazing-right.jpg?h=370&iar=0&w=660&sc_lang=en&hash=10B37E0F36AD4F21570BDE79AC67DCB8" alt="Young adult with long dark hair gazing right" width="660" height="370" DisableNVelocity="true" />Thyroid HealthThe thyroid is a gland at the base of your neck. This important part of your body produces hormones that regulate blood pressure, body temperature, heart rate and weight. When your thyroid has problems, many aspects of your well-being can be negatively impacted. Learn more about the thyroid here.CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Michele Halterman11/20/2020Your holiday traditions likely will be affected this year because of COVID-19 and family changes. Get 5 tips to help you enjoy the upcoming season and, perhaps, start new traditions.5 tips for navigating changing holiday traditions<p>Traditions play a big part in our lives during the holidays. However, it can be difficult to maintain the same traditions each year due to family changes, such as a lost loved one, unemployment, a new family member, divorce or separation, or a move. This year's COVID-19 pandemic brings additional challenges and concerns about social distancing and large group gatherings.</p> <h4>Here are 5 tips to help you navigate changes to your family holiday traditions:</h4> <h5>1. Communicate your expectations.</h5> <p>Discuss with your family which traditions may change and why. This opens a dialogue and lessens the chance of hurt feelings or misunderstanding.</p> <h5>2. Aim for what works for this year only.</h5> <p> Some traditions can be difficult to let go of but aren't practical due to family changes and the COVID-19 pandemic. Focus on what brings you meaning this year, and give yourself permission to do something different next year. Consider creating a new tradition, such as ice skating or making holiday ornaments in honor or memory of those you're not able to see in person this year.</p> <h5>3. Focus on people, not on a specific date and time.</h5> <p> You may need to celebrate a couple days earlier or later than you would have liked. But don't get so locked into your traditions that you lose sight of the most important part: spending time together. With the need for social distancing, look for creative and meaningful ways to connect safely or consider celebrating virtually. Share memories with your family and friends. Memories can bring both laughter and tears. Both are OK.</p> <h5>4. Recognize the importance of food traditions.</h5> <p>Favorite foods can remind us of happy memories and are a great way to include a family member who is gone. Serving Grandpa's pie or Aunt Anne's stuffing can nourish your body and soul. Share in the tradition by cooking or baking these favorites together with your close circle of family or friends.</p> <h5>5. Honor your feelings.</h5> <p>Give yourself permission to feel sad, tired or anxious at some point during the holidays. You're only human, and that's OK. Take a break if your emotions are too intense. Focus on small things that bring you joy, such as a walk, phone call to a loved one, letter to a friend or favorite hobby.</p> <h4>Watch a video about dealing with loss through the holidays:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/Fzg6yDWKkac" title="Dealing with loss through the holidays" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p><em><a href="/providers/peter-reisner-md" target="_self" title="Opens in same window.">Peter Reisner, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/chetek" target="_self" title="Opens in same window.">Chetek</a>, Wisconsin.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>University of Texas Medical Branch</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Practice</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Reisner<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/peter-reisner-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=E4299ECA7A6FB83591D4D4F91D0769D6" alt="Peter Reisner, M.D." width="280" height="280" DisableNVelocity="true" />Peter<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13818422Peter Reisner, M.D.1<img src="/-/media/national-files/images/hometown-health/2020/wicker-stars-with-christmas-lights.jpg?h=370&iar=0&w=660&sc_lang=en&hash=65629CDD77874EE7202187A92C59AF23" alt="Wicker stars with Christmas lights" width="660" height="370" DisableNVelocity="true" />ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Michele Halterman11/16/2017<p>Bariatric surgery is an available treatment for severe obesity that consistently achieves and maintains substantial weight loss, and improves health and quality of life. Let’s review some misconceptions.</p>6 misconceptions about bariatric surgery<a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/bariatric-surgery/in-depth/weight-loss-surgery/art-20045334" target="_blank" title="Opens in a new window."><img alt="Bariatric surgery" src="/-/media/national-files/images/hometown-health/2017/bariatric-surgery.jpg?h=300&w=300&sc_lang=en&hash=AA3F5CE3CC894C9C3CD64368F7145DED" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /></a> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/bariatric-surgery/in-depth/weight-loss-surgery/art-20045334" target="_blank" title="Opens in a new window.">Bariatric surgery</a> for weight loss is an available treatment for severe obesity that consistently achieves and maintains substantial weight loss, and improves health and quality of life. As a bariatric program behavioral health practitioner for Mayo Clinic Health System in Eau Claire, my role is to evaluate and educate patients regarding the decision to pursue surgery, and help them to prepare for surgery and the emotional, psychological and social adjustments they will face after surgery. Many patients have received feedback from concerned friends or family that surgery can fail, is the easy way out or is dangerous. Let’s review some misconceptions about bariatric surgery.</p> <h2>Misconception 1: People just need to eat less and exercise more.</h2> <p>Obesity is no longer considered an issue caused by overeating and a lack of self-control, but a complex condition resulting from multiple genetic, biologic, metabolic, behavioral, social, economic and cultural factors. Despite the science, findings from a nationally representative <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.norc.org/Research/Projects/Pages/the-asmbsnorc-obesity-poll.aspx" target="_blank" title="Opens in a new window.">survey</a> of 1,509 adults from the University of Chicago, funded by the American Society for Metabolic and Bariatric Surgery, shows a majority of people, including many medical professionals, continue to view obese people as lazy and lacking in willpower.</p> <p>When people lose weight through dieting alone, the body compensates through biological changes, including increased appetite and slower metabolism. Unfortunately, these biological changes often persist long term, which explains why people often regain weight even beyond their starting point.</p> <p> Research of individuals who achieved significant weight loss while participating in a popular TV series was consistent with these findings: 90 percent of those who participated not only regained the weight, but their metabolisms had altered to burn fewer calories. I advise my patients that people don’t fail at diets; diets fail people. Unfortunately, the diet industry is a $66 billion-a-year industry that continues to promise results to the detriment of peoples’ emotional and physical health.</p> <h2>Misconception 2: Bariatric surgery is dangerous.</h2> <p>While any surgery poses certain risks, the risk of death from surgery is considerably less for bariatric patients than for individuals affected by severe obesity who have not had the surgery. In fact, the data show up to an 89 percent reduction in mortality, as well as highly significant decreases in mortality rates due to specific diseases, including <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/cancer/basics/definition/con-20032378" target="_blank" title="Opens in a new window.">cancer</a>, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/diabetes/basics/definition/con-20033091" target="_blank" title="Opens in a new window.">diabetes</a> and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/heart-disease/symptoms-causes/syc-20353118" target="_blank" title="Opens in a new window.">heart disease</a>. After bariatric surgery, you may be able to decrease or discontinue medications for chronic conditions, such as diabetes, heart disease or <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/definition/con-20019580" target="_blank" title="Opens in a new window.">high blood pressure</a>.</p> <h2>Misconception 3: Bariatric surgery will make me thin.</h2> <p>Expected weight loss varies with the type of surgery, and your starting weight, age, gender, physical activity and medical condition. You typically will lose 30–65 percent of excess body weight, but making long-term changes in your diet and exercise routine can exceed that average. Our bariatric team views your success in terms of improved health, lifestyle changes, mobility and quality of life. If you or family and friends view success as an ideal weight or clothing size, this may not be a realistic expectation. You may end up with a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/obesity/basics/symptoms/con-20014834" target="_blank" title="Opens in a new window.">body mass index</a> that continues to be in the overweight range and still be a success based on where your journey started. Most weight loss occurs in the first year after surgery, and it is common for you to regain a small portion of your weight before stabilizing. However, it is possible for patients to gain their weight back after surgery if they do not continue with healthy eating habits and regular exercise.</p> <h2>Misconception 4: Bariatric surgery and weight loss will make me happy and improve my relationships.</h2> <p>While weight loss does provide the opportunity to have a higher quality of life, it is not a magic wand for happiness or resolving personal issues. Also, lifestyle changes with bariatric surgery can put stress on relationships if changes are not supported by friends and family. These issues are discussed throughout the process, and family involvement is encouraged.</p> <h2>Misconception 5: Bariatric surgery will keep me from overeating.</h2> <p>Temporarily, bariatric surgery can create changes in brain biochemistry to reduce cravings for sugar and make eating sweets less rewarding after surgery. This does not happen for everyone, however, and bariatric surgery will not cure binge eating, bulimia or compulsive/emotional overeating disorders. Eating disorders are assessed prior to entry into the program and, at times, can be treated while preparing for surgery. If food has become a coping mechanism, you will need to adopt healthier ways of coping before surgery, or you will be at risk of resuming unhealthy behaviors and regaining weight or developing issues with depression or anxiety.</p> <h2>Misconception 6: Bariatric surgery is the easy way out.</h2> <p>As a patient once stated, “Anyone who thinks this is the easy way out should understand what we go through.” If you are considering this procedure, preparation is often around four to six months. You are required to have multiple assessments and appointments with doctors, a dietician and exercise physiologist. In addition, I see patients for an initial evaluation, 10 group sessions and additional individual sessions as needed.</p> <p>After surgery, it is important you follow a daily regimented schedule with food and fluid intake, continue with exercise and other lifestyle changes, and continue receiving outside support. Most patients state what they regret most is not having this procedure sooner. It is rewarding to hear patients report they have increased energy to interact with their children and grandchildren, confidence to engage in social activities, the ability to buy clothes in a regular store, and that they no longer feeling dread or panic every time they go somewhere that there may not be a chair they fit in or that someone will make a cruel remark.</p> <p>Bariatric surgery, along with commitment to lifestyle change, not only provides long-term weight loss, but it significantly improves health and quality of life for many.</p> <p>If you have been considering bariatric surgery, call your primary care provider to schedule an appointment to discuss this option.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2017/bariatric-surgery.jpg?h=504&iar=0&w=504&sc_lang=en&hash=D6C1F6D4BFD46090FC4650093826A93A" alt="Bariatric surgery couple" width="504" height="504" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Michele Halterman7/8/2022It's estimated the baby blues occur in 40–80% of women after the birth of a baby. Learn how to tell if it's postpartum depression and how to get help.I just had a baby. What's happening with my moods?<p>Having a baby is one of the most important, joyful, exciting and tumultuous times in a woman's life. Just as an anticipated pregnancy can have its ups and downs, so, too, can the birth of a new baby. </p> <p>Your body has been through an enormous amount of stress in the birthing process. Many stressful physical changes happen throughout pregnancy and in the weeks to months after your baby is born. </p> <p>Your body, mind, emotions and hormones are on a roller coaster ride. Throw in sleep deprivation, discomforts and <a href="/hometown-health/speaking-of-health/breastfeeding-101-tips-for-new-moms" target="_self" title="Opens in same window.">frustrations with breastfeeding</a>, and day-to-day responsibilities, it's expected and natural that many new mothers experience mood changes.</p> <h2>The 'baby blues'</h2> <p>These mood changes are called the "baby blues."  While they differ for every woman, they share some common features. </p> <p>You may feel amazing one moment and overwhelmed the next. You may find yourself being irritable or angry with your partner or your <a href="/hometown-health/speaking-of-health/tips-for-siblings-new-baby-homecoming" target="_self" title="Opens in same window.">children</a>. You may have crying spells or suddenly have brief but powerful urges to just lie down and sleep, or to jump into your car and drive away. You may wonder, "Is any of this normal?"</p> <p>The answer is yes. Does it mean that you aren't cut out for parenthood or that you've made a mistake? Of course not. It's all a normal part of the postpartum period.</p> <p>These feelings may start in the first few days following delivery and can last up to two weeks. This timeline of symptoms vary by person. </p> <p>It's estimated the baby blues occur in 40–80% of women. It's important to remember everything you've been through for your baby and your family. Find moments to slow down, and be kind to yourself.</p> <p>Hand the baby to your partner, and take a shower or a nap. Remember your baby shower when all your friends offered to babysit? It's time to call in those favors. Get out of the house for a while. Even if you take the baby with you, a change of scenery can be beneficial to both of you. </p> <p>Baby blues are difficult, particularly when it's expected that having a new baby is supposed to be one of the happiest times in your life. Remember, these unexpected and difficult feelings are normal — and temporary — for most women. With mild symptoms, you do not need to seek treatment. As you adjust to your new life, the mood changes will improve.</p> <h2>When is it considered postpartum depression?</h2> <p>In some women, <a href="/hometown-health/speaking-of-health/addressing-your-mental-health-by-identifying-the-signs-of-anxiety-and-depression" target="_self" title="Opens in same window.">mood changes and physical discomforts</a> of the postpartum period are severe, impairing daily functioning or persisting beyond two weeks after delivery. Episodes of sadness and crying spells may last all day; you may not be able to fall asleep; or you can’t get up to eat, bathe or care for your baby. These are all signs of a condition called <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/postpartum-depression/basics/definition/con-20029130" target="_blank" title="Opens in new window.">postpartum depression</a>. In extreme cases, thoughts of self-harm or harming the baby may occur.</p> <h2>What is postpartum depression?</h2> <p>Postpartum depression is a disorder that affects approximately 10% of women. Most women experience symptoms within the first month after delivery, but symptoms can occur anytime within the first year. Some factors that make a woman more likely to develop postpartum depression are genetics, having depression at some point in the past, an unplanned pregnancy, challenges with support from partner or family, and having difficulties with breastfeeding. </p> <p>Many new moms who are affected by postpartum depression feel ashamed of the symptoms or are unable to recognize the feelings in the first place. But it's important to know that postpartum depression, like baby blues, is not caused by doing anything wrong. It's a medical problem, and treatment is available and effective. If postpartum depression goes untreated, mother and baby could be affected long term.</p> <h2>How to get help</h2> <p>If you or someone you know is having symptoms of postpartum depression, help is available. Call your health care team and let them know. </p> <p>Seek support from friends and family. And, most importantly, if you or a loved one are having thoughts of suicide or harming someone else, call a crisis hotline or 911 immediately.</p> <p><em><a href="/providers/patrick-bigaouette-md" target="_self" title="Opens in same window.">Patrick Bigaouette, M.D.</a>, is a psychiatrist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Anxiety disorders</li> <li>LGBTQIA+ populations</li> <li>Medical education</li> <li>Mood disorders</li> <li>Peripartum psychiatry</li> <li>Psychopharmacology</li> <li>Trauma- and stressor-related disorders</li> <li>Women's health</li> </ul>M.D.<p>I enjoy working with patients in managing a wide spectrum of psychiatric disorders across psychosocial stages of life. I work in a collaborative, shared decision-making approach based on biologic, psychologic and social factors. My goal is to provide high-quality, evidence-based, patient-centered care to achieve the best possible outcomes in managing psychiatric distress.</p> <p>Outside of my clinical work, I am passionate about medical education and enjoy working with resident physicians and students.</p> <p>In moving back to Minnesota from the East Coast, I enjoy staying active outdoors, going to local theater, and I am always open to book recommendations.</p><p><strong>Education</strong></p> <ul> <li>Georgetown University School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Psychiatry, Mount Sinai-Beth Israel, Icahn School of Medicine at Mount Sinai</li> </ul> <p> <strong>Residency</strong> </p> <ul> <li>Psychiatry, Mount Sinai-Beth Israel, Icahn School of Medicine at Mount Sinai, New York</li> </ul> <p><strong>Certification</strong> </p> <ul> <li>Psychiatry, American Board of Psychiatry and Neurology </li> </ul> <p><strong>Membership</strong> </p> <ul> <li>American Psychiatric Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Psychiatry, Mayo Clinic College of Medicine and Science</li> </ul>Bigaouette<img src="/-/media/shared-files/images/medical-professionals/full/mankato/patrick-bigaouette-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4A09A81BD845D197A88A6FB7DC116F24" alt="Patrick Bigaouette MD" width="280" height="280" DisableNVelocity="true" />Patrick<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30014612Patrick Bigaouette, M.D.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2022/chin-resting-on-curled-hand.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5727900889D28DB07B3BB896060E53BC" alt="Chin resting on curled hand" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Michele Halterman11/9/2017<p>When a significant person in your life has died, it may feel as though your center of gravity has been upended. Reactions may be even more prominent given the changing seasons and approaching holidays.</p>Currents of grief: Finding balance through the holiday season<img alt="Grief at the holidays" src="/-/media/national-files/images/hometown-health/2017/grief-at-the-holidays.jpg?h=300&w=300&sc_lang=en&hash=CC7497265D105E18E3286BD166F601F1" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /> <p>When a significant person in your life has died, it may feel as though your center of gravity has been upended; the idea of balance in your life, a foreign thought. You are suddenly exposed to changes you hadn't considered and are experiencing a mixture of feelings, including sadness, loneliness, anxiety, longing and anger, to name a few. Physically, you find you have less energy. Your thoughts are scattered, and you find it hard to concentrate.</p> <h2>In this brief video, I talk about the natural reactions to grief:</h2> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/Fzg6yDWKkac" title="Natural reactions to grief" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p>These reactions, along with many others, are actually common in grief. Like a rip current in the ocean, a powerful and fast-moving channel of water, you may find yourself pulled into waves of emotions and circumstances that are exhausting at times. During this time of year, reactions may be even more prominent given the changing seasons and approaching holidays. These times filled with family events and traditions also can bring a renewed sense of longing for a loved one who is no longer here.</p> <p>Facing these waves, you may feel like you'd rather take cover during the coming months. If you did that, however, you'd potentially cut yourself off from the peace and healing inherent in the holiday season. While your natural instinct may not be to embrace your grief, you may find that allowing yourself to lean into it leads you to an unexpected comfort and connection to your loved one.</p> <p>There is a familiar saying: Life is a balance of holding on and letting go. It might feel like others often place the emphasis on letting go or getting past feelings that accompany grief. If embraced, however, you might find that you need the stability of holding on. A person needs a safe space to process all of the feelings and experiences that are a part of grief.</p> <p>Finding ways to hold on to a continued bond with your loved one can provide strength and a sense of warmth to help you counteract the difficult moments ahead. It's also how you begin to make some sense of this experience and find meaning. The goal is not to forget your loved one but, rather, to uncover step by step how your life is unfolding in the present. It's a natural process, and you don't need to fight against it. True, there may be days where you want to, but in creating balance you give yourself permission to honor your journey and hold on to the love that is yours to keep. Eventually, as you look back over time, it is likely that you'll see what you've known to be true has integrated with what your soul needed to change and grow naturally.</p> <p>Throughout the holiday season, aim to follow your instincts, pace yourself, surround yourself with support, communicate your needs and incorporate memories of your loved one in ways that feel right to you.</p> <p><em>By Lisa De Sieno, Bereavement Services</em></p><img src="/-/media/national-files/images/hometown-health/2017/grief-at-the-holidays.jpg?h=387&iar=0&w=387&sc_lang=en&hash=F6B287591965B008A61D5077DD3F08D1" alt="Grief at the holidays" width="387" height="387" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.GriefGrief is the natural reaction to loss. It will be unique to you, depending on your own personality and circumstances.Micah Dorfner11/7/2017<p>Many physiological and nutritional demands occur within the body during exercise. The human body requires a continuous supply of energy to perform its many functions. As energy demands increase with exercise, additional energy must be supplied or the exercise will end.</p>How nutrients impact physical performance<img alt="young-woman-stretching-before-run" src="/-/media/national-files/images/hometown-health/2017/youngwomanstretchingbeforerun.jpg?h=266&w=400&sc_lang=en&hash=ED43BDD4E5A9C024915B619D912512E3" style="width: 400px; height: 266px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive"> <p>Many physiological and nutritional demands occur within the body during exercise. As muscles contract, the demand for oxygen, hydrogen and other key nutrients increases. The human body requires a continuous supply of energy to perform its many functions. As energy demands increase with exercise, additional energy must be supplied or the exercise will end.</p> <p><strong><span>Factors of performance</span></strong></p> <p><span>Whether a recreational athlete or an elite athlete, many factors influence performance including, but not limited to, diet, hydration, fitness level, intensity and duration. There are many factors that predict what source of fuel will be used. Proteins, fats and carbohydrates are all possible sources of fuel for exercise and muscle contraction.</span></p> <p><span>During moderate-intensity exercise, roughly half of the energy is derived from glycogen, while the other half comes from glucose in the blood and fatty acids. Carbohydrates (glucose/glycogen) serve as the primary source of fuel as duration and intensity increase. If exercise continues for a significant period of time, fatty acids will serve as the fuel source when glycogen stores are nearly depleted. It must be noted that fat metabolism cannot occur without the presence of glucose, and thus muscle glycogen and blood glucose are the limiting factors in performance. Protein or, more specifically, amino acids, will only be used as an energy source if other calories are insufficient.</span></p> <p><strong><span>Food choices</span></strong></p> <p><span>A person’s diet will influence which source of fuel is used and therefore, performance level. If a person consumes a high-carbohydrate diet, more glycogen will be used for fuel. If the diet is high in fat, fat will be used as the fuel source. A high-fat diet is not recommended as even the leanest person has plenty of stored fat for long endurance exercise. A high-fat, low-carbohydrate diet can lead to poor performance due to low glycogen stores. As a guideline for endurance athletes, roughly 60–70 percent of calories should come from carbohydrates, 10–15 percent protein and 20–30 percent from fat. You should consume a well-balanced diet containing carbohydrates, protein and fat during training periods. </span></p> <p><span>Carbohydrate intake before, during and after exercise is crucial. A high-carbohydrate pre-exercise meal not only prevents hunger pangs during exercise, it also provides optimal blood glucose levels for endurance exercising and increases glycogen stores. Avoid high-fat foods in a pre-exercise meal as it delays stomach emptying and takes longer to digest. This meal should be three to four hours before an event. </span></p> <p><span>Marathon runners talk about “hitting a brick wall.” This refers to the time when fuel sources have been drained and not replaced. When glycogen and blood glucose levels are low, the body is out of fuel and cannot keep going no matter how fast an athlete wants to go.</span></p> <p><span>For exercise lasting longer than an hour, you should ingest carbohydrates to fuel the brain and muscles. You can maintain a sufficient supply of energy by consuming 26–30 grams of carbohydrates every 30 minutes during exercise. Most sports drinks provide 15–20 grams of carbohydrate, so consuming 8–12 ounces every 15–30 minutes is recommended. As for protein, only a few amino acids can actually be used directly as energy. Thus, protein consumption during exercise is not advantageous.</span></p> <p><strong><span>Fluid intake</span></strong></p> <p><span>Muscle glycogen stores must be replaced after endurance exercise. Resynthesis of muscle glycogen is promoted when carbohydrates are consumed immediately after exercise. Unfortunately, due to an elevated body temperature, appetite is usually depressed and many athletes have difficulty consuming foods immediately after exercise. Drinking carbohydrates via a sports drink or shake provides carbohydrates and promotes rehydration. </span></p> <p><span>Adequate fluid intake is also crucial for any athlete. You should weigh yourself before and after an endurance event, especially during hot weather. For each pound lost during exercise, drink three cups of fluid. Fluids should not be restricted before, during or after an event. Athletes should not rely on thirst as a sign of fluid loss. Consume roughly 14–22 ounces of fluid before an event, 6–12 ounces every 15–30 minutes during an event, and after the event, 16–24 ounces for every pound of body weight lost.</span></p> <em><span>Anne Harguth is a registered dietitian with <a href="/locations/waseca">Mayo Clinic Health System in Waseca</a>.</span></em><img src="/-/media/national-files/images/hometown-health/2017/youngwomanstretchingbeforerun.jpg?h=266&iar=0&w=400&sc_lang=en&hash=AA1B0C0C714D16C850B0B623B35786E6" alt="young-woman-stretching-before-run" width="400" height="266" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Michele Halterman4/3/2019<p>It can come as a shock to be diagnosed with a long-term illness. It is easy to feel overwhelmed and helpless, but it’s important to know how to manage those feelings and learn how to cope with the daily stress of living with Type 2 diabetes.</p>Tips for living well with Type 2 diabetes<p><em>By Mayo Clinic Health System staff</em></p> <p><img alt="Healthy living with diabetes: Take small steps, get physical activity, take time or yourself and eat healthy." src="/-/media/national-files/images/hometown-health/2017/healthy-living-with-diabetes.jpg?h=300&w=300&sc_lang=en&hash=FAD3B048B73EDE9A09C6F90A24889667" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /></p> <p>It can come as a shock to be diagnosed with a long-term illness. It is easy to feel overwhelmed and helpless, but it’s important to know how to manage those feelings and learn how to cope with the daily stress of living with <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193" target="_blank" title="Opens in a new window.">Type 2 diabetes</a>.</p> <p>Many communities offer <a href="/classes-and-events" target="_self" title="Opens in same window.">diabetes classes or groups</a> that can help you to manage your disease.</p> <h3>Read these tips from the Healthy Living with Diabetes class:</h3> <h4><span>Take small steps</span></h4> <p><strong><span></span></strong></p> <p>It’s a stressful feeling to be diagnosed with an illness that will affect your lifestyle long-term.</p> <h5>Here are a few ideas to get your feet on the ground:</h5> <ul> <li><strong>Take small steps.</strong> <br /> Find small, weekly goals that are attainable and easier to accomplish. Long-term goals are great, but when you can accomplish something in a matter of days, you are more likely to continue to reach and set more goals for yourself.</li> <li><strong>Get physical activity.</strong><br /> If you are one who rarely engages in physical activity, start by getting outside and going for a short, 5-minute walk. Once you start, it’s easier to continue on, so start small if you need to.</li> <li><strong>Take time for yourself.</strong><br /> It is OK to feel overwhelmed. In fact, it’s normal. Take a few minutes of your day to do something that you enjoy to get you back on track to feeling like yourself.</li> <li><a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes-diet/art-20044295" target="_blank" title="Opens in a new window."><strong>Eat healthy</strong></a><strong>.</strong> <br /> Whatever that may mean for you — give it a try. Even if it’s smaller portions than you normally eat, just start there.</li> </ul> <h4>Cope with new emotions</h4> <ul> <li><strong>Think positively.</strong><br /> Positive thinking can truly affect your ability to overcome emotions you may feel you have no control over. Turn negative thoughts, such as “I’m too tired” into  “If I’m tired today, I probably got a lot done yesterday.”</li> <li><strong>Practice gratitude.</strong><br /> There are many things in life to be thankful for. Choose to think about the good over the bad.</li> <li><strong><a href="/classes-and-events" target="_self" title="Opens in same window.">Attend a diabetes-related class or support group.</a></strong><br /> These offerings allow you to share feelings with others coping with the same diagnosis. You can learn about what has helped others and maybe even help them along the way, too.</li> </ul> <h4>Easy steps to take</h4> <ul> <li>If you’re watching TV, get out of your chair every time a commercial comes on, and take a few steps around.</li> <li>Use a smaller plate when dishing up your meals, and make sure half of your plate is nonstarchy vegetables.</li> <li>If you’ve been sitting for 30 minutes, take a 2-minute break and stand up.</li> <li>If you’re feeling stressed, sit in a quiet room and turn on calming music. You can even give calming essential oils a try, such as lavender.</li> <li>Before you go grocery shopping, eat a healthy snack so you’re less likely to grab unhealthy foods.</li> <li>Remember to ask your friends and family for help if you ever feel that you need it.</li> </ul> <p>Not all tips and tricks work for everyone. Contact your health care provider for further questions and techniques that will meet your specific needs. Remember to give yourself time, and know that change doesn’t happen overnight. Although living with Type 2 diabetes often is difficult, it is manageable. Y<span>our health care team can help you answer questions and ensure you receive the care you need.</span></p> <h4>Learn more about managing diabetes:</h4> <ul> <li>Mike Krueger was committed to improving his situation with healthy lifestyle choices. Read how he learned to <a href="/hometown-health" target="_self" title="Opens in same window.">manage Type 2 diabetes</a> without medication.</li> <li>Debbie Hundley's extreme fatigue signaled Type 2 diabetes. Read how lifestyle changes in diet and exercise brought her rapid results in <a href="/hometown-health" target="_self" title="Opens in same window.">managing her diabetes</a>.</li> </ul><img src="/-/media/national-files/images/hometown-health/2017/healthy-living-with-diabetes.jpg?h=504&iar=0&w=504&sc_lang=en&hash=05A4BE89B440D9644398CAC56C4212F2" alt="Healthy living with diabetes: Take small steps, get physical activity, take time or yourself and eat healthy." width="504" height="504" DisableNVelocity="true" />DiabetesIf you have diabetes, no matter what type, it means you have too much glucose in your blood, although the reasons may differ. Too much glucose can lead to serious health problems.Michele Halterman11/10/2021A Pap test is an important screening in the early detection of cervical cancer. Did you know the frequency and type is dependent on age and health history? Read the current recommendations.An update on Pap tests<p>The guidelines about when women should have a Pap test have changed. Studies about HPV and cervical cancer conducted over the past 10–20 years have identified no advantages to having an annual Pap test over the current recommendations.</p> <h2>What is a Pap test?</h2> <p>A <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/pap-smear/multimedia/pap-test/img-20007025" target="_blank" title="Opens in a new window.">Pap test</a> or smear is the first step to the prevention and early detection of cervical cancer. The procedure tests for cellular changes in the cervix — the opening to the uterus located in the vagina — which could progress to cervical cancer.</p> <p>The specimen is collected during a speculum exam using a brush or other sampling instrument. It only takes a minute to collect the specimen, but you may experience some cramping during the collection.</p> <p>The specimen is sent to the laboratory and examined under a microscope to determine if abnormal cells are present. Using the same specimen for an <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/hpv-test/basics/definition/prc-20015066" target="_blank" title="Opens in a new window.">HPV test</a> can check for the DNA presence of 13–14 types of the most common high-risk HPV.</p> <h2>Why do you need a Pap test?</h2> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/cervical-cancer/symptoms-causes/syc-20352501" target="_blank" title="Opens in a new window.">Cervical cancer</a> occurs when cervical cells become abnormal and begin to grow out of control. An HPV infection causes most cervical cancers. HPV is a common virus passing from person to person during sexual activity, and it often causes no symptoms. HPV enters cervical cells and can cause them to change.</p> <p>Most HPV infections are associated with low-risk infections that will go away on their own. But in some cases, HPV infections don't go away. Rather, they can last for a long time. High-risk types of HPV have been linked to cervical cancer, as well as cancer of the vulva, vagina, penis, anus, mouth and throat.</p> <h3>Watch this video to learn more about why Pap tests are an effective screening tool for cervical cancer and important for women's health:</h3> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/H0SLKpt45SM" title="Ask Mayo Clinic Health System: Pap Smears" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <h2>When should you get a Pap test done?</h2> <h3>The appropriate interval and type of Pap test recommended for you will depend on your age and health history:</h3> <ul> <li><strong>Women ages 21–29</strong><br /> A Pap test should be performed every three years. A Pap test is not recommended if you're younger than 21, even if you are sexually active. However, health care experts recommend you be tested annually for sexually transmitted infections if you are sexually active.</li> <li><strong>Women ages 30–65</strong><br /> A co-test, which includes a Pap and an HPV test is recommended every five years. It's acceptable to have only the Pap test every three years. If you have an abnormal result, your provider will determine the appropriate follow-up.</li> <li><strong>Women over 65</strong><br /> Pap testing can be stopped if there are three consecutive normal Pap tests.</li> </ul> <p>Even if you do not have a Pap test, it is important for you to have an annual preventive health care visit for your well-woman care needs.</p> <p><em><a href="/providers/jennifer-bantz-md" target="_self" title="Opens in same window.">Jennifer Bantz, M.D.</a>, is an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> specializing in <a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">prenatal care</a> in <a href="/locations/chippewa-falls" target="_self" title="Opens in same window.">Chippewa Falls</a> and <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Minimally invasive laparoscopic surgery</li> <li>Pelvic floor disorders</li> <li>Urinary incontinence</li> <li>Women's health</li> </ul>M.D.<p><strong>Medical School</strong></p> <ul> <li>Wright State University School of Medicine, Dayton, OH</li> </ul> <p><strong>Internship & Residency</strong></p> <ul> <li>Obstetrics-Gynecology, University of Minnesota-Minneapolis</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Obstetrics and Gynecology, American Board of Obstetrics and Gynecology</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American College of Obstetrics and Gynecology</li> <li>American Medical Association</li> <li>Indiana Medical Society</li> </ul>Bantz<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/jennifer-bantz-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=F38356102855751E4A9D4ADC9D803873" alt="Jennifer Bantz, M.D." width="280" height="280" DisableNVelocity="true" />{9621B39D-BC71-432A-B02D-012FCCE9C7D9}Jennifer<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15159973Jennifer Bantz, M.D.1{54693F31-87AF-4B21-91DB-1DEC1E21F878}|{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}<img src="/-/media/national-files/images/hometown-health/2021/in-woods-wearing-yellow-jacket.jpg?h=370&iar=0&w=660&sc_lang=en&hash=430C5C63E1FD41AFD790856FDC1512F0" alt="In woods wearing yellow jacket" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Michele Halterman7/29/2020Choosing the right birth control can be tricky. Many factors go into selecting the option that’s right for you. Learn about your options.Choose the birth control that’s best for you<p><em>By Mayo Clinic Health System staff </em></p> <p>Choosing the right birth control can be tricky. Many factors go into selecting the option that’s right for you.</p> <h4>Our <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window." style="margin-left:0; font-size:18px;font-family:'HelveticaNeueW02-65Medi', arial, 'sans-serif';">OB-GYN</a> specialists outline popular <a href="/hometown-health/speaking-of-health/choosing-the-right-birth-control" target="_self" title="Opens in same window." style="margin-left:0; font-size:18px;font-family:'HelveticaNeueW02-65Medi', arial, 'sans-serif';">birth control methods</a> to help you determine what best fits your pregnancy prevention goals and your options for accomplishing them:</h4> <h5>Regular cycle</h5> <p>For predictable bleeding, choose an estrogen/progesterone combination available as an oral pill, patch or vaginal ring. Doses must be taken daily, weekly or monthly. Missing a dose increases pregnancy risk.</p> <h5>Lighter or not bleeding</h5> <a href="/-/media/local-files/eau-claire/documents/medical-services/ob-gyn/choosing-the-right-birth-control.pdf?sc_lang=en&hash=5CE6C62D427499C4B6E43D29121416CD" target="_blank" title="Opens in a new window."><img alt="Download a PDF to help choose your birth control." src="/-/media/national-files/images/hometown-health/2018/download-a-pdf-to-choose-your-birth-control.jpg?h=135&w=135&sc_lang=en&hash=AD03AC0FD437C05F3FD77DD4ADBDE057" style="height: 135px; width: 135px; float: right; margin-bottom: 5px; margin-left: 5px;" class="img-responsive" /></a> <p>Choose a progesterone-only option for light or no bleeding and less frequent administration. These are available as an injection, implant or IUD, lasting from three months up to five years. There is a chance for <a href="/hometown-health/speaking-of-health/dont-let-irregular-vaginal-bleeding-affect-your-quality-of-life" target="_self" title="Opens in same window.">break-through bleeding</a> with these options.<strong></strong></p> <h5>Highly effective pregnancy prevention</h5> <p>Long-lasting reversible contraception is available as an implant, or hormonal or copper IUD, lasting from three to 10 years. These options are just as effective as permanent options, but are reversible if you decide to become pregnant in the future.</p> <h5>Permanent birth control</h5> <p>If you’re ready for permanent pregnancy prevention, male and female sterilization, including vasectomy and tubal ligation are available. There is no risk of pregnancy, but these options aren’t reversible.</p> <p>Consult with your health care provider about your medical history and how it affects your birth control choice.</p> <h4>Download and print a <a href="/-/media/local-files/eau-claire/documents/medical-services/ob-gyn/choosing-the-right-birth-control.pdf?sc_lang=en&hash=5CE6C62D427499C4B6E43D29121416CD" target="_blank" title="Opens in a new window." style="margin-left:0; font-size:18px;font-family:'HelveticaNeueW02-65Medi', arial, 'sans-serif';">birth control infographic</a> for a reminder on birth control choices.</h4><img src="/-/media/national-files/images/hometown-health/2020/two-women-enjoying-a-cup-of-coffee.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7C03A46084A5A8B106F9AF124BB03C8C" alt="Two women enjoying a cup of coffee" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller5/28/2024<p>When nagging hip pain can't be ignored, a total joint replacement may be in your future. Your surgeon may recommend one of these common surgical techniques to get you moving with ease again.</p>Considering hip replacement? Learn about your surgical options<p>Are you experiencing chronic hip pain from arthritis, an injury or another condition? If you answered "yes," a hip replacement may be in your future. When making a decision about a total hip replacement, it's essential to understand your options and the benefits and risks associated with each.</p> <h2>Benefits of a total hip replacement</h2> <p>A total hip replacement can reduce pain and improve your quality of life, range of motion, ability to walk or run, and enhance or help you regain your independence. Many patients enjoy aspects of their lives that they've missed due to limitations caused by their hip pain.</p> <p>Surgery isn't automatically the first option. That's why it's essential to consult with an orthopedic professional about nonsurgical treatments. With these options, you may be able to temporarily or permanently avoid surgery.</p> <h2>Types of hip surgery</h2> <p><a rel="noopener" href="https://www.medscape.com/viewarticle/587805" target="_blank" title="Opens in new window">Research</a> suggests <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/hip-replacement/about/pac-20385042" target="_blank" title="Opens in new window">total hip replacements</a> are the most successful orthopedic surgery for chronic pain relief. Surgeons use <a href="/locations/mankato/services-and-treatments/orthopedic-surgery/joint" target="_self" title="Opens in same window">multiple techniques</a> for total hip replacements: anterior, anterolateral (Watson-Jones), transgluteal (Hardinge) and posterior. While all methods are effective, they do have some differences.</p> <p>Regardless of the technique, the advancements in hip replacement components, surgical instruments and robotic assistance during all hip replacement approaches allow for better, longer-lasting solutions.</p> <h3>Anterior surgical approach</h3> <p>The anterior approach to total hip replacement is when the surgeon enters through the front of the upper thigh. Working between the muscles eliminates the need to detach them from the bone, often called a muscle-sparing approach. The anterior approach is performed with the patient lying on their back, which aids X-ray guidance and robotic assistance and increases the accurate placement of prosthetic hip components.</p> <p>Typically, patients who undergo this procedure can expect slightly faster recovery, gait improvements and less need for walking aids. However, every patient is different, and recovery depends on factors such as body type and lifestyle. Patients who are active, in good physical shape and younger are often the best candidates for an anterior approach hip replacement.</p> <h4>Learn more about the anterior surgical approach in these videos and how it may benefit you:</h4> <p><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/rjS-Ew8-se8" title="Direct anterior approach hip replacement (Part 1)" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <p><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/o1ASeCo6ock" title="Direct anterior approach hip replacement (Part 2)" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <h3><strong>Anterolateral (Watson-Jones) approach</strong></h3> <p>With the anterolateral approach, the patient typically lies on their side, and the surgeon approaches the hip on the side and then around the front. The hip is opened between the gluteus medius, a muscle on the outside of the pelvis, and tensor fascia latae muscles, which are small muscles just in front of the hip joint. In most cases, the surgeon must cut at least a small portion of the gluteus medius muscle to provide better access to the hip joint.</p> <h3>Posterior surgical approach</h3> <p>Over the past few decades, a posterior approach has become the most common approach for hip replacement. The surgeon enters just behind the side of the hip bone, which can provide greater exposure to the pelvic bone and femur. The posterior approach is typically recommended for revision surgeries.</p> <h3>Transgluteal (Hardinge) approach</h3> <p>The transgluteal approach positions the patient on their side and the surgeon reaches the hip through the side. The surgeon opens up the hip joint by removing the front portion of the hip abductor muscles, also known as gluteus medius and gluteus minimus, from the greater trochanter, which is located on the femur, or thigh bone. This is a more extensive approach that gives broader access to the pelvis bone around the hip socket and the femur. It tends to have the lowest risk of future dislocation, but the patient may have a persistent limp due to weakness in the hip abductor muscles.</p> <h2>Total hip replacement risk</h2> <p>As with all surgeries, hip replacements come with certain risks. However, specialized surgical training, advanced technology and years of research have significantly limited the number of complications.</p> <h3>Risks from this surgery may include:</h3> <ul> <li>Blood clots</li> <li>Infection</li> <li>Fracture</li> <li>Dislocation</li> <li>Change in length of your leg</li> <li>Loosening of joint replacement components over time</li> </ul> <h2>When to consider hip treatment</h2> <h3>Talk to your orthopedic professional about hip treatment options, if you're experiencing:</h3> <ul> <li>Regular pain in your groin and front of your thigh</li> <li>Pain that limits your activity and wakes you up at night</li> <li>Difficulty putting on shoes and socks</li> <li>Challenges bending at your hip</li> <li>Lack of relief provided by over-the-counter medications and lifestyle changes</li> </ul> <p>A total hip replacement can be a positive step for your well-being. However, you need to be confident that it's right for you. Your orthopedic team will answer your questions, help you reach the best possible recovery and enhance your quality of life.</p> <h2>Next steps:</h2> <ul> <li>Find an <a rel="noopener" href="https://www.mayoclinichealthsystem.org/providers?service=Orthopedic%20Surgery&populateTracking=True" target="_blank" title="Opens in new window">orthopedic surgeon</a> near you.</li> <li>Learn about <a rel="noopener" href="https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/advances-in-hip-and-knee-replacement" target="_blank" title="Opens in new window">advancements in joint replacement</a>.</li> <li>Read about a <a rel="noopener" href="https://www.mayoclinichealthsystem.org/hometown-health/patient-stories/life-starts-with-bilateral-hip-replacement" target="_blank" title="Opens in new window">patient's experience with having both hips replaced</a>.</li> <li>Learn more about <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window">orthopedics and orthopedic surgery</a>.</li> <li>Learn how <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window">physical therapy sessions can aid your recovery</a>.</li> <li>Watch this patient video about anterior approach replacement:<br /> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/ODdqrBwWDxg" title="Hip Surgery Overview" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> </li> </ul> <p class="video-container"><em><a href="/providers/jacob-ziegler-md">Jacob Ziegler, M.D.</a>, is an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgeon</a> in <a href="/locations/mankato">Mankato</a>, Minnesota, who specializes in anterior approach total hip replacement.</em></p> <ul> <li>Direct anterior hip replacement</li> <li>Minimally invasive hip and knee replacement</li> <li>Partial knee replacements</li> <li>Robotic assisted hip and knee arthroplasty</li> </ul> M.D. <p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, University of Minnesota</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Adult Reconstruction, Insall-Scott-Kelly Institute for Orthopaedics and Sports Medicine</li> <li>Adult Reconstruction, NYU Langone Orthopedic Hospital-Hospital for Joint Diseases</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Orthopaedic Surgery</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Hip and Knee Surgeons</li> <li>Minnesota Orthopaedic Society</li> <li>Orthopaedic Trauma Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Orthopedics, Mayo Clinic College of Medicine and Science</li> </ul>Ziegler<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jacob-ziegler-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=EE50DD78035502A319D080295D6E695E" alt="Jacob Ziegler MD" width="280" height="280" DisableNVelocity="true" /> {9D2EDEA0-8D4B-411F-A2A2-06E925C765CC}Jacob <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20570325Jacob Ziegler, M.D. 1{DEF55970-853F-4E96-9A4D-3413874FF059}<img src="/-/media/national-files/images/hometown-health/2024/man-squatting-holding-recyclables.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E04214BACFA5713831FA8C3C10AA305B" alt="Man squatting holding recyclables" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Michele Halterman12/4/2019<p>The holidays often bring times of joy, love and laughter, but it’s the busiest time of the year full of shopping, baking, preparing for parties and more. Rather than letting those demands raise your stress level, try some of these tips to help you enjoy the holidays and minimize that after-holiday rut.</p>9 ways to make your holiday season jolly<p>The holidays often bring times of joy, love and laughter, but the aftereffects can sometimes bring unwelcomed stress and depression. It’s the busiest time of the year full of shopping, baking, preparing for parties, cleaning and the list goes on.</p> <p>Rather than letting those demands raise your stress level, try some of these tips to help you enjoy the holidays and minimize that after-holiday rut:</p> <h4>1. Reach out. </h4> <p>If you feel lonely or isolated, seek out community, religious or other social events, as they can offer support and companionship. <span>Work at a soup kitchen, organize a gift drive, read to a child or help your neighbor. Reaching out to others makes us feel good about ourselves and reminds us that we aren't alone in facing challenges.</span></p> <h4>2. Move.</h4> <p> Movement is great for stress and depression. Exercise, walk the dog, dance or clean to your favorite music. Learn more about <a href="/topics/exercise-and-fitness" target="_self" title="Opens in same window.">exercise and fitness</a>.</p> <h4>3. Have fun.</h4> <p> Take time to do things you find relaxing or fun. Watch your favorite movie, take an evening drive to look at lights or curl up with a hot chocolate and a good book.</p> <h4>4. Stick to a budget.</h4> <p> Before you go gift and food shopping, decide how much money you can afford to spend, and then stick to your budget. Consider alternatives, such as donating to a charity in someone’s name, giving homemade gifts or starting a family gift exchange.</p> <h4>5. Plan ahead.</h4> <p> Set aside specific days for shopping, baking, visiting friends and other activities. Plan your menus, and then make your shopping list. That will help prevent last minute scrambling to buy forgotten ingredients and gifts. For more fun, get others to join in your efforts. Plan at least one thing in your week that you look forward to after the holidays.</p> <h4>6. Let go of expectations.</h4> <p> Don't feel you need to live up to the unrealistic expectations depicted in the media or on social media. Doing too many things, spending too much money, or eating or drinking too much can lead to even greater feelings of despair. Think simple. It’s OK to say no during any time of the year.</p> <h4>7. Set aside differences.</h4> <p> Accept family members and friends as they are. Set aside grievances until after the holidays when it might be a more appropriate time for discussion. Also, be understanding if others get upset or distressed. Chances are they're feeling the effects of holiday stress and depression, too.</p> <h4>8. Share feelings.</h4> <p> Spending a holiday after a loss in the family can be difficult. Accept the feelings and open up about them to others. It may make you feel better to get it off your chest. Try to switch up old traditions to help ease the loss. Read more about <a href="/topics/grief" target="_self" title="Opens in same window.">how to manage grief</a>.</p> <h4>9. Continue healthy habits. </h4> <p>Don't let the holidays become a chaotic situation. Eating or drinking too much only adds to your stress and guilt. Have a healthy snack before holiday parties so you don't go overboard on sweets, cheese or drinks. Get plenty of sleep. Take time each day to do something relaxing. Start a new hobby. Get back on track with eating and exercise. Get more <a href="/topics/tools-for-health" target="_self" title="Opens in same window.">tools to live your healthiest life</a>.</p> <p>This year, enjoy the holidays and whatever comes after.</p> <p>If you have tried these tips and still feel overwhelmed, please contact your health care provider for more support.</p> <p><em><a href="/providers/peter-reisner-md" target="_self" title="Opens in same window.">Peter Reisner, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">family medicine</a> physician in <a href="/locations/chetek" target="_self" title="Opens in same window.">Chetek</a>, Wisconsin.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>University of Texas Medical Branch</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Practice</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Reisner<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/peter-reisner-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=E4299ECA7A6FB83591D4D4F91D0769D6" alt="Peter Reisner, M.D." width="280" height="280" DisableNVelocity="true" />Peter<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13818422Peter Reisner, M.D.1<img src="/-/media/national-files/images/hometown-health/2019/dog-with-santa-hat-in-mouth.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CFB176D5E6DCBBA1D5D518AE7C1B9610" alt="Dog with Santa hat in mouth" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Michele Halterman12/8/2022Buying toys for those special children in your life is a cherished part of the holidays. These tips can help you choose toys that are safe.Don't let unsafe toys spoil holiday fun<p>During the holidays, the hunt is on for the perfect gift for the special young people in your life. Toys are an excellent way for children to learn and become good problem solvers. But not all toys and games are created equal when it comes to safety. In 2020, it's estimated that 200,000 toy-related injuries were treated in U.S. hospital emergency departments.</p> <p>The first step when evaluating toy safety is to read the label to make sure the toy is made for your child's age group. Keep toys meant for older children out of reach of babies, toddlers and preschoolers.</p> <h2>These tips can help you choose safe toys and games — and check out those your children receive:</h2> <h3>Examine how the toy is made</h3> <h4>Giving a toy or game a close look can help avoid injuries:</h4> <ul> <li>Watch out for toys small enough for kids to inhale or put in noses, mouths or ears. This includes deflated balloons, marbles, beads and stuffed animal eyes.</li> <li>No string or cord on the toy should be long enough to form a noose, twist around a finger or toe, or choke or strangle a baby or toddler.</li> <li>Avoid toys with sharp edges, that use straight pins or staples, or have slots, hinges or holes that can pinch fingers.</li> <li>All moving parts should be securely attached.</li> <li>Stuffed toys should be made with sturdy material and thread, and not filled with small, loose pellets.</li> </ul> <h3>Beware hidden toxins</h3> <ul> <li><strong>Jewelry<br /> </strong>Some children's jewelry can contain toxic levels of cadmium and lead. If swallowed, they can cause serious health problems, including delayed brain development, kidney and bone damage, and cancer. Children under 6 are most vulnerable because they may put toys in their mouths. Laws in some states regulate toxic chemical use in toys sold in stores. But what about when you're online shopping? Be sure to: <ul> <li>Research the product and read labels, tags and product information carefully. Jewelry made in the U.S. generally is safer, so avoid jewelry you don't know where it was sourced from. Look for toxic-free certification.</li> <li>Don't buy jewelry for children under 6 unless it's labeled for their age group. For older kids, only choose jewelry tested as safe for children.</li> <li>Watch that children don't put jewelry in their mouths. Toxic exposure can come from biting, chewing or sucking on a piece of jewelry, or even worse, swallowing it.</li> </ul> </li> <li><strong>Button batteries</strong><br /> Button batteries and magnets are particularly dangerous. If swallowed, button batteries can lead to severe internal burns. If more than one magnet is ingested, they can attach inside a child's body, causing serious injury.</li> </ul> <h3>Include safety gear</h3> <p>Riding toys are fun and memorable gifts. Check that they're well-made and well-balanced to avoid rollovers. When purchasing bikes, scooters, skateboards and other riding toys that require balance, always buy safety gear, ensure it fits well and make sure the child uses it every time.</p> <h3>Store toys safely</h3> <p>Store toys for a young child in a box, container or paper bag. Plastic bags are a suffocation risk and should be thrown away after the package is opened. Toy chests should have a safety lid instead of a heavy, free-falling lid, so they can't injure or trap a child.</p> <p>As you shop for the perfect gift, whether in stores or online, remember these tips so that unsafe toys and games don't spoil holiday fun.</p> <p>Learn more at <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://toysafety.org/toy-safety/2022-10-worst-toy-list/" target="_blank" title="Opens in a new window.">World Against Toys Causing Harm</a> and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pirg.org/edfund/resources/trouble-in-toyland/" target="_blank" title="Opens in a new window.">U.S. Public Interest Research Group</a>.</p> <p><a href="/providers/paul-horvath-md" target="_self" title="Opens in same window."><em>Paul Horvath, M.D.</em></a><em>, practices <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">emergency medicine</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/menomonie" target="_self" title="Opens in same window.">Menomonie</a>, Wisconsin.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>University of Wisconsin Medical School-Madison</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Kalamazoo Center for Medical Studies</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Emergency Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Emergency Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Horvath<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/paul-horvath-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=6D9F9FFCF71AD564DF6A3FD125A4F235" alt="Paul Horvath, M.D." width="280" height="280" DisableNVelocity="true" />Paul<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13467174Paul Horvath, M.D.1<img src="/-/media/national-files/images/hometown-health/2022/toddler-playing-with-gift.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EFAE963C293D0CCCB737BA9BE028A01C" alt="Toddler playing with gift" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Michele Halterman3/24/2022Some parents don't have their children vaccinated because they fear immunizations lead to autism. Learn about a study that debunks this myth and the importance of vaccines.Link between autism and vaccination debunked<p>Vaccinations are an important way to keep your child safe and healthy. As a parent, you protect your child with shelter, safety and proper nutrition. Childhood vaccines protect children from a variety of serious or potentially fatal diseases, including diphtheria, measles, mumps, rubella, polio, tetanus, influenza, COVID-19 and whooping cough (pertussis). If these diseases seem uncommon — or even unheard of — it's usually because these vaccines are doing their job.</p> <p>If you've missed those important immunizations, you're exposing your child to these potentially dangerous, even deadly, diseases. Some parents may wonder about the benefits and risks of childhood vaccines. Others have heard myths that vaccines can cause autism.</p> <h3>Here's what you need to know:</h3> <h4>Autism spectrum disorder</h4> <p>Autism spectrum disorder is a condition related to brain development that affects how a person perceives and socializes with others. This disorder causes problems in social interaction and communication. It also includes limited and repetitive patterns of behavior.</p> <p>The term "spectrum" in autism spectrum disorder refers to the wide range of symptoms and severity.</p> <h4>Dispelling the autism myth</h4> <p>Vaccines do not cause autism. A small study in 1998 suggested a link between vaccinations and autism spectrum disorder. The study was reviewed further and retracted. In addition, the author's medical license was revoked due to falsified information.</p> <p>Since then, numerous studies have debunked a connection between autism and the measles, mumps and rubella (MMR) vaccine.</p> <p>In April 2015, JAMA published the largest study to date, analyzing the health records of over 95,000 children. About 2,000 of those children were classified at risk for autism because they had a sibling already diagnosed with autism. The study confirmed that the MMR vaccine did not increase the risk for <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/symptoms-causes/syc-20352928" target="_blank" title="Opens in a new window.">autism spectrum disorder</a>.</p> <h4>What to know about vaccines</h4> <p>Vaccinations use a dead or weakened version of viruses or bacteria to help your body trigger an immune system response. These vaccines help children develop natural immunity, while significantly reducing the risk of illness and complications, compared to acquiring immunity through natural infection.</p> <p>Usually, side effects are minor, like injection site soreness, lump or bump at the site, fatigue, fussiness, headache, decreased appetite, or low-grade fever.</p> <h4>Protecting your child, others</h4> <p>For almost all children, the benefits of getting vaccinated are much greater than the possible side effects. Complications from illnesses that children are vaccinated against are often much more severe, sometimes leading to lifelong complications, hospitalizations and death.</p> <p>Not vaccinating your children also increases the risk to others around them. Some children cannot be vaccinated due to medical reasons. Their only protection is herd immunity, where everyone surrounding an at-risk person is vaccinated against an illness. This reduces the risk to the unprotected person.</p> <p>When considering your child's health and safety, remember to factor in the <a rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/vaccines/art-20048334" target="_blank" title="Opens in a new window.">importance and necessity of proper childhood vaccinations</a>. Not only are you protecting your child, but also you will be protecting your community.</p> <p>If you have questions or concerns, talk to your child's primary care provider.</p> <p><em>Jennifer LeGare is a nurse practitioner in <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">Pediatrics & Adolescent Medicine</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2022/parent-snuggling-smiling-toddler.jpg?h=370&iar=0&w=660&sc_lang=en&hash=776417E96594226031BE4F66208D632C" alt="Parent snuggling smiling toddler" width="660" height="370" DisableNVelocity="true" />AutismAutism is one of a group of serious developmental problems called autism spectrum disorders that appear in early childhood — usually before age 3. Though symptoms and severity vary, all autism spectrum disorders affect a child's ability to communicate and interact with others.<br /><br /><br/><br/>While there is no cure for autism, intensive, early treatment can make a big difference in the lives of many children with the disorder.Child DevelopmentWe all want our children to grow up happy and healthy. The reality is most all of them do — but at vastly different rates. Experts across Mayo Clinic Health System see thousands of children each year, and have the experience and resources to know what is normal and what may be cause for closer observation. This includes not only physical and motor skills development, but psychological and social skill advancement.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Micah Dorfner12/12/2017<p>Oftentimes in a diabetic person's life, he or she may need the help of a loved one. A diabetic person encounters many stages in life. Sure, it can be difficult at times, but the more prepared you are, the better you can handle the situation.</p>Caring for a loved one with diabetes<img alt="african-american-couple-smiling" src="/-/media/national-files/images/hometown-health/2017/african-american-couple.jpg?h=266&w=400&sc_lang=en&hash=C297500AADB41D5D2DE8B273C02D5C10" style="width: 400px; height: 266px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive"> <p>As a health care provider who treats persons with diabetes, I frequently tell my patients, “I’m not the one taking care of your diabetes. You take care of your diabetes."</p> <p><span>I say this because it’s my job to educate and provide recommendations, whereas my patients are the ones responsible for the actual work to control this disease. However, there are often times in a diabetic person’s life where he or she may need the help of a loved one. A diabetic person encounters many stages in life. Sure, it can be difficult at times, but the more prepared you are, the better you can handle the situation. </span></p> <p><strong><span>Diabetes care during the early years</span></strong></p> <p><span>I’ve known a lot of parents of children with diabetes. The news of the diagnosis of diabetes in a child can be met with fear, confusion and, sometimes, even anger. Parents need to quickly learn how to adapt to the ups and downs of this disease and are often caught off guard as they enter unfamiliar territory.   </span></p> <p><span>Here are some things to remember as you care for a child with diabetes:   </span></p> <ul style="list-style-type: disc;"> <li><span>This diagnosis may mean a change in diet for your entire family. </span></li> <li><span>At first, it will feel like a moment-to-moment battle between high blood glucoses and low blood glucoses.</span></li> <li><span>It may be difficult for a sibling without diabetes, as the child with diabetes will get more attention because of the disease.   </span></li> </ul> <p><strong><span>Caring for a teenager with diabetes</span></strong></p> <p><span>Adolescence is probably the most difficult time in the life of a person with diabetes. The hormones of puberty affect behavior and also affect blood glucoses. This can be a time of rebellious behavior, which can negatively affect diabetes control. Often, this adolescent rebellion carries over to young adulthood, which is why it’s so important to lay the foundation for proper management of the disease early on.</span></p> <p><span>Parents need to walk a fine line between coaching the adolescent and relinquishing control to them so they can learn to manage the disease on their own. It’s very difficult for a parent to let go at this time so that the adolescent can learn how to take care of diabetes on their own. </span></p> <p><span>Sometimes it takes a few hard lessons to finally see why control of this disease is important. Adolescents have a difficult time seeing that anything bad can happen to them and don’t see the consequences for not taking care of this disease. However, taking care of diabetes today can help to ensure the continued health of the person with diabetes for 20-plus years down the road. </span></p> <p><strong><span>Helping adults manage their diabetes</span></strong></p> <p><span>Adulthood marks the time when a person with diabetes typically takes over all control of their disease management. This process takes preparation and an ability to be flexible. Unlike some chronic conditions, diabetes cannot be treated by simply taking a pill in the morning. The person with diabetes has to constantly juggle insulin and medications with diet, activity and stress. Blood glucose changes all the time and depends on minute decisions that the person makes moment to moment throughout the day.  </span></p> <p><span>An adult with diabetes must be able to check his or her blood glucoses regularly. Additionally, he or she needs to also administer insulin or medication to prevent his or her blood glucoses from getting too high and eat food to prevent blood glucoses from getting too low. With proper management, this becomes second nature and less taxing. </span></p> <p><strong><span>A spouse’s care for his or her diabetic loved one</span></strong></p> <p><span>Occasionally, a spouse or caregiver may be the lifesaving difference for a person with diabetes. For many patients, their spouse or caregiver can tell when they may have life-threatening low blood glucose before they even sense it. </span></p> <p><span>There are times when a diabetic person may become angry when a caregiver or spouse asks them to repeatedly check their blood glucose. A person with diabetes may also display signs of irritability and may even become combative when their blood glucose is low. It’s normal for some form of resentment to manifest on both sides when this happens. I have often counseled patients and their spouses who are dealing with these issues. </span></p> <p><span>The person with diabetes needs to realize that their loved one is only asking them to check their blood glucose because they care about them. Additionally, the caregiver also needs to understand that when their loved one’s blood glucose is low and they are irritable or combative, that it’s the diabetes and not the person causing this behavior.   </span></p> <p><strong><span>Caring for an elderly person with diabetes</span></strong></p> <p><span>Besides childhood and adolescence, another time in a diabetic person’s life when they need the most help is during their later years.</span></p> <p><span>Some considerations at this point:</span></p> <ul style="list-style-type: disc;"> <li><span>Elderly persons with diabetes may need help with diet or remembering to take medications. </span></li> <li><span>They may also have some complications of diabetes that limit their ability to take care of daily living activities. </span></li> <li><span>Assisted living centers and nursing homes may not be equipped or properly educated to take care of patients with insulin pumps or complex insulin plans. This is a time where the person with diabetes needs an advocate, which more than likely will be a spouse or family member. </span></li> </ul> <p><span>Diabetes is a life-long journey for many. Understanding the various stages in caring for those affected by this disease is helpful for both patient and caregiver. If you have any questions regarding the care of someone who has diabetes, make sure to reach out to your health care provider for additional information to best prepare you. </span></p> <p><em><span>Kristi Stemsrud is a physician assistant and certified diabetes educator in Endocrinology at <a href="/locations/mankato">Mayo Clinic Health System in Mankato</a>.</span></em></p><img src="/-/media/national-files/images/hometown-health/2017/african-american-couple.jpg?h=266&iar=0&w=400&sc_lang=en&hash=726C00366F25D9A79E020922084F5DD8" alt="african-american-couple-smiling" width="400" height="266" DisableNVelocity="true" />DiabetesIf you have diabetes, no matter what type, it means you have too much glucose in your blood, although the reasons may differ. Too much glucose can lead to serious health problems.Michele Halterman1/15/2021It's true that antibiotics are important medications when prescribed and appropriately used. But, home remedies often may be a better choice to treat your child's illness. Get answers to help you child recover quickly and safely.Should I use antibiotics or home remedies to treat my child's illness?<p>For parents, it can be hard to tell whether your child's illness requires antibiotics or if there are other ways to effectively treat his or her symptoms. To prevent overuse of these drugs, it's important to know when home remedies can be used instead of antibiotics.</p> <p>If your child has an <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/ear-infections/symptoms-causes/syc-20351616" target="_blank" title="Opens in a new window.">ear infection</a>, consider using over-the-counter pain relievers in place of antibiotics. Children's ear infections usually improve within two to three days, especially for kids who are 2 years or older. If symptoms do not improve within a few days, it would be wise to take your child in to his or her provider.</p> <h4>Use antibiotics for an ear infection if your child is age:</h4> <ul> <li>6 months or younger</li> <li> 6 months to 2 and has moderate to severe pain</li> <li>2 or older and experiencing severe symptoms</li> </ul> <p>Don't use antibiotics to treat your child's cold, flu and most other respiratory infections. Viruses cause most respiratory infections, and antibiotics don't treat viruses. Antibiotics fight bacteria. <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infectious-diseases/expert-answers/infectious-disease/faq-20058098" target="_blank" title="Opens in a new window.">Learn how bacterial and viral infections differ</a>.</p> <p>Instead, offer your child warm liquids, such as tea or soup. Both can have a soothing effect and loosen mucus. Over-the-counter saline nasal drops or saline spray also can loosen nasal mucus. Try running a cool-mist humidifier in your child's room or using steam from a hot shower for additional relief.</p> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/strep-throat/symptoms-causes/syc-20350338" target="_blank" title="Opens in a new window.">Strep throat</a> is caused by bacteria. However, most children with the symptoms of strep throat have a virus. You should ask for a strep throat test before turning to antibiotics to cure your child's symptoms.</p> <p>Ice cream, frozen fruit pops or cold beverages may soothe a sore throat. Older children can try gargling salt water or sucking on throat lozenges. Always encourage your child to get enough rest, so his or her body has a chance to recover.</p> <p>Consider getting antibiotics for your child when a cough persists for 14 days or more. Antibiotics also are necessary if a health care provider diagnoses your child with a bacterial infection, such as strep throat.</p> <p><a href="/topics/childrens-health-pediatrics" target="_self" title="Opens in same window.">Get additional information to help care for your child's health</a>.</p> <p><em><a href="/providers/tiffany-casper-do" target="_self" title="Opens in same window">Tiffany Casper, D.O.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/tomah" target="_self" title="Opens in same window">Tomah</a>, Wisconsin.</em></p><ul> <li>Pediatrics</li> <li>Skin conditions</li> <li>Women's health</li> </ul>D.O.<p><strong>Education</strong></p> <ul> <li>Doctor of Osteopathic Medicine, A.T. Still University – Kirksville College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Mercy Health System</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Medicine </li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Osteopathic Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Casper<img src="/-/media/shared-files/images/medical-professionals/full/tomah/tiffany-casper-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=1A30A61D9D6C113EA2C621F6A4AD3702" alt="Tiffany Casper DO" width="280" height="280" DisableNVelocity="true" />Tiffany<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15595587Tiffany Casper, D.O.1<img src="/-/media/national-files/images/hometown-health/2021/young-child-sipping-on-cup.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0136632FA3E5879BC876610975AE7CCE" alt="Young child sipping on cup" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Michele Halterman11/22/2022Holidays can be challenging when food is involved, but adopting a healthy eating mindset is important throughout the entire year. Read tips to improve your approach to balanced, mindful nutrition.Embrace a healthy mindset for eating — no matter the occasion<p>When it came to eating, how did this past holiday season treat you? Was there a foreboding sense of doom based on a fear of excessive cookies and snacks? Perhaps you encountered nightmares about copious amounts of food and sugarplums chasing you in the dark. While these examples may seem over the top, the feelings are real for some people, especially when food is related to addictive tendencies. That’s why adopting a healthy eating mindset is important throughout the entire year.</p> <h2>Challenges with food around holidays and events</h2> <h3>Food presents a challenge during holidays and events because:</h3> <ul> <li>Food is plentiful and readily available. </li> <li>Food items are unique when compared to everyday meals.</li> <li>Holiday foods are traditionally high in fat and calories.</li> <li>Family time often is structured around food and the act of eating.</li> <li>Food can be associated with feelings of love and security, and may remind you of people and events from the past.</li> </ul> <h2>Your exposure to food makes a difference</h2> <p>Unfortunately, the more available food is, the more you become exposed to triggers. Additionally, your resolve to abstain decreases each time you're placed in one of these situations.</p> <p>Have you ever noticed you can go an entire day eating well, only to lose all control later? This is especially evident during instances where you experience what's known as "decision fatigue." This occurs when you may become more open and vulnerable to environmental cues with additional food exposures.</p> <h2>How to lessen your responsiveness to food triggers</h2> <p>Even if you don't struggle with addictive tendencies related to food, you still face many triggers throughout the year. The good news is there are behaviors and thoughts you can adopt to help lessen your responsiveness to food triggers and alter the way you approach eating, especially during holidays and events.</p> <h3>Try these healthy eating habits for all occasions:</h3> <ul> <li>Adopting a healthy eating mindset starts with identifying the reasons you want to eat healthier. What compelling reasons come up when you consider this question?</li> <li>Having a plan is one of the most important things you can do. Anticipate when you may have more difficulty making healthy choices, and create a solid plan for those times.</li> <li>Savoring your food and being mindful will help you make better choices than eating without conscious thought.</li> <li>Instead of moving from food dish to dish, first survey the options in front of you, and decide which ones you want and how much you want before adding food to your plate.</li> <li>It's also important to allow yourself a few unhealthy food options, but decide when and where you will make those choices.</li> <li>Finally, be aware of your negative emotions and manage those through healthier means rather than using food to deal with them.</li> </ul> <h3>Additional techniques to help modify your eating behavior include:</h3> <ul> <li>Bringing fruit and vegetables to holiday gatherings to create more options for you and others.</li> <li>Eating a light snack before attending holiday events to lessen the likelihood of overeating.</li> <li>Measuring and portioning your food over the holidays.</li> <li>Increasing your level of activity and exercise.</li> <li>Committing to making changes with someone close to you.</li> <li>Banking your calories if you know you'll attend an event with more food options available.</li> </ul> <p>Don't despair if you temporarily lose control of your food choices. Remember, consistency is key and not perfection.</p> <a href="/-/media/shared-files/images/medical-professionals/full/mankato/lisa-hardesty-phdlp.jpg" target="_self" title="Opens in same window."><em>Lisa Hardesty, Ph.D.</em></a><em>, is a clinical psychologist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em><ul> <li>Co-morbid medical and behavioral health conditions</li> <li>Integrated behavioral health</li> <li>Optimizing health and well-being</li> <li>Weight management</li> </ul>Ph.D., L.P.<p><strong>Education</strong></p> <ul> <li>Master's degree, Health and Clinical Psychology, Minnesota State University-Mankato</li> <li>Doctor of Philosophy degree, Western Michigan University-Kalamazoo</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Post Doctoral Fellowship, Health Psychology, Henry Ford Hospital</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Clinical Health Psychology, American Board of Professional Psychology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Psychology, Mayo Clinic College of Medicine and Science</li> </ul>Hardesty<img src="/-/media/shared-files/images/medical-professionals/full/mankato/lisa-hardesty-phdlp.jpg?h=280&iar=0&w=280&hash=0F1D1C9CA069ED45487CBB5A40FD588A" alt="Lisa Hardesty, Ph.D., L.P." width="280" height="280" DisableNVelocity="true" />{A9A6221E-C37E-4EAE-B151-BFE624FC511D}Lisa<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>11683651Lisa Hardesty, Ph.D., L.P.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}|{94B2E140-AEF8-44BA-B6A9-4538B77501BC}<img src="/-/media/national-files/images/hometown-health/2022/cut-veggies-and-hummus.jpg?h=370&iar=0&w=660&sc_lang=en&hash=43A86D8682E67A8AE5B2E22250D2E5BC" alt="Cut veggies and hummus" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Michele Halterman1/6/2022Midwest winters can be beautiful, but ice and snow increase your risk of falling. Follow these tips to keep upright and avoid injury.How to avoid winter slips and falls<p>Forget boots — some sidewalks require ice skates. Winter in the Midwest can be beautiful, but ice and snow increase the risk of falling.</p> <p>The Centers for Disease Control and Prevention reports that about 1 million U.S. adults are injured due to slips and falls every year, with the injury rate increasing significantly as temperatures decline.</p> <h4>Falls are unexpected, but there are a few ways to decrease your risk of falling:</h4> <ul> <li><strong>Wear proper footwear.</strong><br> Be sure you have a pair of lightweight boots with good support. You also can purchase snow grips for the bottoms of your shoes or boots.</li> <li><strong>Take your time.</strong><br> Do not hurry while walking outside. Pay attention to your steps and walk slowly.</li> <li><strong>Use assistance.</strong><br> Always use handrails, a walking stick, your walker or cane when out in winter weather.</li> <li><strong>Take small steps.</strong><br> Small steps, almost from side to side, help you maintain your center of gravity. Take small steps and waddle a bit like a penguin.</li> <li><strong>Stay inside.</strong><br> On days when it is icy and you do not need to go anywhere, stay inside.</li> </ul> <p>If you do feel yourself falling, don't try to catch yourself with your arms. That can lead to more injuries. Try to take the hit on your buttock or back. After a fall, wait for someone to help you in case you are injured or to avoid subsequent falls. Some people further injure themselves by springing up after a fall instead of waiting for help.</p> <p>Remember to always use your best judgment when out and about in the ice and snow. Be careful and aware of your surroundings, and you will be on your way to a safe and healthy winter.</p> <h4>Watch this video with more tips, and learn why a fall can lead to serious complications:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/9rae0XvJq3U" title="Safety tips for walking in icy conditions" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p><em>Brittni Lair is a physician assistant in <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">Orthopedics</a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2022/standing-outside-in-winter.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C16745C683D3B9AC31C476E40EAF9FFD" alt="Standing outside in winter" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Michele Halterman7/11/2022Technology has changed how we live, interact and communicate — all of which have significant health consequences. Get tips to be intentional with screen time and create healthy media habits.What's your family's digital diet plan?<p>A group of kids sitting together all looking down at their phones — probably texting the person across from them. A family sitting together, their attention on a device, while stationed in front of the TV.</p> <p>Does either of these scenarios sound familiar?</p> <p>Screens are everywhere — our homes and cars, classrooms and restaurants, hospital and clinic lobbies, and even on gas pumps.</p> <p>The average teenager spends approximately nine hours per day looking at a screen, while younger children often spend up to six hours a day engaging with a screen.</p> <p>Technology has changed how we live, interact and communicate — all of which have significant health consequences.</p> <p>In his recent book, "Stolen Focus," author Johan Hari recounts an experience with his godson at Graceland. It was a place his godson always wanted to visit. When they went, they agreed to put away cell phones and other devices during the day and participate fully in the experience.</p> <p>As they walked through the home, Hari turned to see his godson "in a corner, holding his phone under his jacket, flicking through Snapchat." He expressed, "We can't live like this! You don't know how to be present! You are missing your life!"</p> <h2>Does the amount of screen time matter?</h2> <h3>Higher amounts of screen time are associated with:</h3> <ul style="list-style-type: disc;"> <li>Issues related to weight gain, including a correlation between increased obesity and a higher amount of screen time</li> <li>Inattention and behavioral issues in children </li> <li>Divided attention or switching quickly between tasks has a significant effect on learning and performance</li> <li>Issues in the development of face-to-face social skills</li> <li>Strain on relationships due to distractions</li> </ul> <p>One study sent a group of children to a camp for five days where no electronic devices were allowed and followed another group of children who lived life as usual. The children at the camp with no access to electronic devices did better at the end of five days in recognizing facial emotions and reading nonverbal cues. The time away from technology appeared to increase social awareness.</p> <p>And although screen time for children is significant, the same can be said for adults. With so many screens around us, parents simply aren't giving their kids the attention they need.</p> <p>Children have always had to compete for their parents' attention, but this generation is experiencing something new. Parents may be physically close but emotionally elsewhere. Talking, engaging in an activity or reading a book with your kids is critical for their language and social development.</p> <h2>How can I be intentional about devices and screen time?</h2> <h3>Here are some tips on being intentional about your family's screen time and creating healthy media habits:</h3> <ul style="list-style-type: disc;"> <li>Spend time daily talking face to face with kids, and give them your full attention.</li> <li>Put hand-held devices away during family times, such as dinner or family-based activities.</li> <li>Set a time at night when hand-held devices can be put away or placed to charge in a common area and not taken to rooms where sleep can be interrupted.</li> <li>Play a game or read a book with your kids rather than watching TV.</li> <li>Encourage periods where there's a break from technology.</li> <li>Help children and teenagers learn to prevent technology from interrupting homework or study.</li> <li>Model healthy screen time habits — your kids are watching you.</li> </ul> <em><a rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/anderson-adam-s-ph-d-l-p/bio-20535923" target="_blank" title="Opens in a new window.">Adam Anderson, Ph.D.</a>, is a psychologist at Mayo Clinic in Rochester, Minnesota.</em><img src="/-/media/national-files/images/hometown-health/2022/child-and-parent-reading-a-book.jpg?h=370&iar=0&w=660&sc_lang=en&hash=60EFE106B182D53449783BABA72E4374" alt="Child and parent reading a book" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Michele Halterman9/3/2024Risk factors don't cause or predict suicide, but identifying risks brings awareness of warning signs. Read four interventions you can do to help someone who is feeling suicidal.Preventing suicide through awareness and intervention<p>Suicide affects people from all walks of life, cultures and socioeconomic statuses. <a rel="noopener" href="https://www.cdc.gov/suicide/facts/index.html" target="_blank" title="Opens in a new window.">Suicide rates</a> increased by 36% from 2000 to 2022. <a href="/hometown-health/speaking-of-health/8-common-myths-about-suicide" target="_self" title="Opens in same window.">Suicide</a> is the second leading cause of death for people 10 to 14 and 25 to 34.</p> <p>However, suicide is preventable.</p> <p>Most people want to live, but they feel stuck because of how dire their situation feels and can't see alternative solutions. For some people, their ability to reason and problem-solve positive solutions is affected, resulting in impulsive decision-making.</p> <h2>How to help someone with suicidal thoughts</h2> <h4>Whether you are a friend, family member, co-worker, teacher or community member, two crucial things you can do to help are:</h4> <ol> <li><strong>Reach out to a person who may be struggling with suicidal thoughts.</strong><br /> It's as easy as saying, "I care, I'm here and I want to listen."</li> <li><strong>Become familiar with suicide risk factors, warning signs and what to do to help.</strong></li> </ol> <p>These two actions can make the <a href="/hometown-health/speaking-of-health/suicide-isnt-about-dying-its-about-perceived-relief" target="_self" title="Opens in same window.">difference between life and death</a>.</p> <h2>Identifying suicide risks</h2> <p>Risk factors do not cause or predict suicide. However, identifying risks helps you be aware of the possibility that someone may consider suicide.</p> <h4>Common suicide risks include:</h4> <ul> <li>Being the victim of bullying</li> <li>Feeling hopeless</li> <li>Feeling a loss of purpose</li> <li>Feeling trapped and that the only way out is death</li> <li>Feeling worthless</li> <li><a href="/hometown-health/featured-topic/brushing-off-the-social-rust" target="_self" title="Opens in same window.">Loneliness</a></li> <li>Shame, guilt and despair</li> <li>Stressful life events</li> <li>Trauma or <a href="/hometown-health/speaking-of-health/speak-out-about-abuse-or-assault" target="_self" title="Opens in same window.">abuse</a></li> </ul> <h2>What are suicide warning signs?</h2> <p>Making certain comments or exhibiting certain behaviors can often indicate a strong likelihood that someone is considering suicide.</p> <h4>Watch for someone who is:</h4> <ul> <li>Acting agitated, anxious or reckless</li> <li>Displaying extreme mood swings</li> <li>Giving away valued personal belongings</li> <li>Increasing drug or <a href="/hometown-health/speaking-of-health/recognizing-and-addressing-a-loved-ones-alcohol-abuse" target="_self" title="Opens in same window.">alcohol use</a></li> <li>Showing anger or rage, or expressing a desire to seek revenge</li> <li>Sleeping too little or too much</li> <li>Talking about being a burden to others</li> <li>Talking about feeling hopeless or having no purpose</li> <li>Talking about feeling trapped or being in unbearable pain</li> <li>Talking about wanting to die or wanting to kill themselves</li> <li>Withdrawing or isolating</li> </ul> <h2>How you can help someone who is feeling suicidal</h2> <p>Becoming more aware of suicidal risk factors and warning signs is the first step. The second step is <a href="/hometown-health/speaking-of-health/suicide-crisis-develop-safety-plan" target="_self" title="Opens in same window.">knowing what to do when someone is potentially suicidal</a>.</p> <h4>Here are four interventions to keep in mind if you're in a situation to help someone who is feeling suicidal:</h4> <ol> <li><strong>Ask.</strong><br /> Directly ask if the person is considering suicide or wants to die. Avoid asking why. Instead, request that the person help you understand his or her thought process and current struggles. Thank the person for being honest and trusting you.</li> <li><strong>Be willing to listen.</strong><br /> Get involved and suspend judgment during your conversation. Be authentic, empathetic and sincere.</li> <li><strong>Reduce risks.</strong><br /> Remove or secure all guns, ammunition, and prescription and over-the-counter medications from the person's possession. Even acetaminophen and ibuprofen can be dangerous in this situation.</li> <li><strong>Seek help for urgent needs.</strong><br /> If someone verbalizes suicidal thoughts, has a plan, or tells you they will kill themselves, call 911 immediately or take the person to the nearest emergency department.</li> </ol> <h2>Know about available resources</h2> <h4>Note these crisis phone numbers:</h4> <ul> <li><strong>988 Suicide and Crisis Lifeline</strong><br /> Call 988 or chat at <a rel="noopener" href="https://988lifeline.org/" target="_blank" title="Opens in a new window.">988lifeline.org</a>.</li> <li><strong>Crisis text line</strong><br /> Text "HOME" to 741-741.</li> </ul> <p>Everyone plays a role in suicide prevention. Stay aware of risks and warning signs, and do not hesitate to offer help when needed.</p> <p><em><a href="/providers/jessie-wolf-licsw" target="_self" title="Opens in same window">Jessie Wolf</a> is a clinical social worker in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Adjustment disorders</li> <li>Adolescent and children’s behavioral health (ages 6-17)</li> <li>Anxiety disorders</li> <li>Attention-deficit/hyperactivity disorder (ADHD) assessment and treatment with adults and children (ages 6-17)</li> <li>Depressive disorders</li> <li>Grief and loss</li> </ul>L.I.C.S.W.<p>I see children six years of age through adulthood.</p><p><strong>Education </strong></p> <ul> <li>Master's degree, Social Work, Minnesota State University-Mankato</li> </ul> <p><strong>Internships</strong></p> <ul> <li>Hospice and Palliative Care, Mayo Clinic Health System-Mankato</li> <li>Nursing Home and Rehab Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>ADHD, Certified Clinical Services Provider </li> <li>Art of Traumatic Grief Counseling, Compassionate Bereavement Care</li> <li>Licensed Independent Clinical Social Worker</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Professional Society of ADHD and Related Disorders</li> <li>National Social Work Association</li> </ul> <p><strong>Academic Rank</strong></p> <ul> <li>Instructor in Social Work, Mayo Clinic College of Medicine and Science</li> </ul>Wolf<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jessie-wolf-licsw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B680201D1A0D763676AD889806D46E00" alt="Jessie Wolf LICSW" width="280" height="280" DisableNVelocity="true" />Jessie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14640821Jessie Wolf LICSW1{2B88C934-922C-4130-B661-197B59D83899}|{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2022/two-people-talking-headphones.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8182E92B772702A589B3B2B1A492C29E" alt="Two people talking with one wearing headphones around the neck" width="660" height="370" DisableNVelocity="true" />Suicide PreventionSuicide is a major concern in the U.S. According to the Centers for Disease Control and Prevention, suicide was among the top nine leading causes of death for people ages 10–64 and the second leading cause of death for people ages 10–14 and 25–34. The positive news is that with the right information and willingness to reach out to someone in need, we all can help prevent suicide.<br /><br /><strong>If you are having suicidal thoughts, call the 988 Suicide and Crisis Lifeline at <a href="tel:988">988</a>, or chat at <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://988lifeline.org/" target="_blank" title="Opens in a new window.">988lifeline.org</a>.</strong>Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Michele Halterman12/2/2021It's easy to get caught up in the stress and chaos that accompany the holiday season. Can the stress impact your heart health or contribute to a heart attack? A cardiologist weighs in.Women's health: Can holiday stress lead to a heart attack? <p>It's easy to get caught up in the stress and chaos that accompany the holiday season each year. For some women, their busy lives become even more hectic, as additional shopping, cooking and spending combine to add even more anxiety. The result can be overwhelming. In addition, women often ignore the symptoms of heart disease and put the health needs of friends and family before their own.</p> <h4>Take a moment to view this American Heart Association video about what may seem like a typical morning family routine:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/_JI487DlgTA" title="Just a little heart attack" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p>This portrayal may seem a little over the top, but many people take pride in being able to accomplish a multitude of tasks and trying to be everything to everyone. However, this can negatively affect physical and mental health, especially if one's personal health is ignored.</p> <p>Heart disease is the No. 1 killer for men and women. More women die of heart disease than of breast cancer. Taking care of heart health is important, and that includes avoiding risk factors or behaviors that lead to heart disease, recognizing symptoms of heart disease and seeking treatment for heart disease.</p> <h2>Risk factors for heart disease</h2> <p>Traditional risk factors for coronary artery disease include high cholesterol, high blood pressure, smoking cigarettes and obesity. In addition, nontraditional risk factors, such as stress, anxiety and depression, also affect heart health.</p> <p>People often underappreciate the negative effects that psychosocial stress can have on their heart health. Psychosocial stressors are life situations that cause unusual or intense stress, such as divorce, family conflicts, death of a loved one, prolonged illness or natural catastrophe.</p> <p>Studies have shown that depression and psychosocial stress are associated with heart attacks. In addition, high stress levels have been shown to negatively affect health recovery after a heart attack. Therefore, it's important to address the traditional and nontraditional risk factors for heart disease to maintain a healthy heart. It is also important to recognize that the traditional and nontraditional risk factors for heart disease affect women differently than men.</p> <h2>How does stress lead to heart attacks?</h2> <p>Psychosocial stress can be short-term or long-term, and both types have been associated with heart disease. Exactly how stress leads to a heart attack is still being studied.</p> <p>Emotional stress can lead to an increase in blood pressure, or hypertension, which subsequently leads to heart disease and plaque buildup in the coronary arteries. Emotional stress also can lead to increased level of stress hormones, or cortisol. These hormones affect platelets and autonomic tone, which is how your body controls involuntary functions such as heart rate and blood pressure. All these factors play a role in heart disease.</p> <p>Stress also can lead to unhealthy mechanisms to cope with stress, such as stress eating or substance abuse, and not exercising, which in turn can lead to heart disease.</p> <p>Also, short-term severe stressful situations often can cause severe but usually temporary heart failure. This condition is called broken heart syndrome, also known as takotsubo cardiomyopathy, apical ballooning syndrome or stress cardiomyopathy.</p> <h3>Several risk factors can play a bigger role in the development of heart disease in women, including:</h3> <ul> <li><strong>Diabetes</strong><br> Women with diabetes are at greater risk of heart disease than men with diabetes.</li> <li><strong>Mental stress and depression</strong><br> Women's hearts are affected by stress and depression more than men's hearts. Depression makes it difficult to maintain a healthy lifestyle and follow recommended treatment, so talk to your health care provider if you're having symptoms of depression or anxiety.</li> <li><strong>Smoking</strong><br> Smoking is a greater risk factor for heart disease in women than it is in men.</li> <li><strong>Inactivity</strong><br> A lack of physical activity is a major risk factor for heart disease, and some research has found women to be more inactive than men.</li> <li><strong>Alcohol consumption</strong><br> Red wine has some qualities that suggest it's good for your health, but it needs to be consumed in moderation. This excludes other forms of alcohol. Note that calories can affect weight.</li> <li><strong>Menopause</strong><br> Low levels of estrogen after menopause significantly increase a woman's risk of developing heart disease. Also, developing premature menopause, especially before 40, markedly increases a woman's long-term risk of heart disease.</li> <li><strong>Pregnancy complications</strong><br> Research has found that if you had pregnancy complications, such as high blood pressure or diabetes, or even premature delivery, you and your baby have an increased risk of heart disease in the future.</li> <li><strong>Inflammatory diseases</strong><br> Women are more likely to have inflammatory disorders like rheumatoid arthritis or lupus. Women with these or other similar diseases have a higher risk of heart disease.</li> </ul> <p>Research is ongoing in other heart disease risk factors in women.</p> <h2>Is heart disease something only older women should worry about?</h2> <p>Women of all ages should take heart disease seriously. Women under 65, or those with the above risk factors, and especially those with a family history of heart disease, need to pay close attention to heart disease risk factors.</p> <h2>What are the differences of heart disease symptoms in women?</h2> <p>Women and men are equally likely to present with chest pain, pressure or discomfort.</p> <h4>However, women are more likely to have other associated symptoms including:</h4> <ul> <li>Neck, jaw, shoulder, upper back or abdominal discomfort</li> <li>Shortness of breath</li> <li>Pain in one or both arms</li> <li>Nausea or vomiting</li> <li>Sweating</li> <li>Lightheadedness or dizziness</li> <li>Unusual fatigue</li> </ul> <p>Don't wait until it's too late. If you experience chest pain with the symptoms mentioned above, don't wait until it is too late. It's important to call 911 right away.</p> <h2>Managing holiday stress</h2> <p>Stress can occur at different levels. A little stress associated with deadlines and obligations can help motivate people to accomplish tasks. Chronic stress is caused by extreme ongoing struggles, along with lack of control or meaning.</p> <p>For many women, the holiday season brings the most cherished moments in their lives, but also it can be among the most stressful time of year. Often this is because people carry expectations influenced by memories and societal pressures ― a smiling happy family photo on holiday cards, the smell of grandma's home cooking at Hanukkah, seeing a Christmas tree lit or singing your favorite Kwanzaa song. These sights, smells and sounds of the season in homes become the mental representations that people measure their happiness and satisfaction. However, these visions don't always match reality, and that can lead to stress.</p> <p>At any time, but especially during the holidays, the key to coping is setting realistic expectations. Take a few moments as a family to write down what would make the holidays an enjoyable time with those you love. And let go of the things that add stress and no joy.</p> <h4>Other lifestyle changes that can help curb stress during the holidays or any time during the year include:</h4> <ul> <li><strong>Increase physical exercise.</strong><br> Find an exercise regimen that works for you. This can include daily walks or riding a bicycle. Start slow and gradually lengthen these regimens over time.</li> <li><strong><a href="/hometown-health/speaking-of-health/mindfulness-meditation-improve-your-quality-of-life" target="_self" title="Opens in same window.">Practice relaxation exercises</a>.</strong><br> Incorporate muscle relaxation techniques, such as breathing exercises, to deal with anxiety and stress into your daily routine.</li> <li><strong>Make a connection to your spirituality.</strong><br> Spirituality has many definitions, but at its core spirituality helps to give your life a clearer purpose and a greater connection to the world and others. It's not necessarily connected to a specific belief system or even religious worship. Try prayer, meditation or keep a journal to express your feelings and focus your attention.</li> <li><strong>Seek professional help.</strong><br> Get an annual physical and talk to your health care provider about your health, including psychosocial stress.</li> <li><strong><a href="/topics/eat-well" target="_self" title="Opens in same window.">Eat a healthy diet</a>.</strong><br> Opt for whole grains, a variety of fruits and vegetables, low-fat or fat-free dairy products and lean meats. Avoid added sugars, saturated fats or transfats, and high amounts of salt.</li> <li><strong><a href="/hometown-health/speaking-of-health/balancing-the-risks-benefits-of-alcohol" target="_self" title="Opens in same window.">Limit alcohol</a>.</strong><br> If you have more than one drink a day, cut back. One drink is approximately 12 ounces of beer; 5 ounces of wine; or 1.5 ounces of distilled spirits, such as vodka or whiskey.</li> <li><strong><a href="/services-and-treatments/tobacco-treatment" target="_self" title="Opens in same window.">Stop smoking</a>.</strong><br> If you smoke, plan to quit.</li> <li><strong>Monitor your heart health.</strong><br> Know your numbers for blood pressure, blood glucose and cholesterol.</li> </ul> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2021/outside-wearing-knit-hat-with-coat.jpg?h=370&iar=0&w=660&sc_lang=en&hash=17E9D0C165C8807C6D4B87C85115008C" alt="Outside wearing knit hat with coat" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Stress ManagementGuidance to help you reduce and manage daily stress.ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Michele Halterman1/10/2023Do cold, dark days leave you longing for warm sunshine? Mood changes can occur with the changing seasons. Learn about seasonal affective disorder and how you can manage the symptoms.Seasonal affective disorder explained<p><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651" target="_blank" title="Opens in a new window.">Seasonal affective disorder</a>, or SAD, is a variation in mood relating to the season and is considered a form of depression. There are two types: <a href="/hometown-health/speaking-of-health/seasonal-affective-disorder-not-just-the-winter-blues" target="_self" title="Opens in same window.">fall/winter onset</a> and spring/summer onset. The type of SAD you've most likely heard of is the one with symptoms starting at the end of fall and early winter, usually improving in spring.</p> <h2>Symptoms of fall/winter onset SAD include: </h2> <ul> <li>Mood changes</li> <li>Fatigue and lower energy levels</li> <li>Sleep changes</li> <li>Withdrawal from others and activities that are usually enjoyable</li> <li>Feeling aches and pains </li> <li>Increase in appetite and, more specifically, carb cravings </li> <li>Weight gain</li> </ul> <h2>Dealing with the effects of seasonal affective disorder</h2> <p>The number of people who experience fall/winter SAD tends to be higher further from the equator. This is thought to be because of the lack of light in the winter months, which causes a drop in serotonin levels.</p> <h3>You can combat the effects of SAD by:</h3> <ul> <li>Taking prescribed medication to increase serotonin levels.</li> <li>Taking vitamin D supplements.</li> <li>Getting exercise, specifically aerobic exercise.</li> <li>Ensuring quality sleep by turning off technology at least one hour before bed, avoiding long naps during the day and keeping regular sleep and wake times, even on the weekends.</li> <li>Using light therapy.</li> </ul> <p>Light therapy can be one of the most effective ways to improve SAD and generally is considered safe. Speak to your health care professional if you have retinal disorders, or have conditions or take medications that make you sensitive to the sun.</p> <p>A sunny day is considered 50,000–100,000 LUX — the measure of illuminance — and a cloudy day is considered 2,500 LUX. Walking at least 30 minutes outside or on a cloudy day for two hours can help alleviate the symptoms.</p> <h3>However, most people can't make time to fit in two hours of walking, so there are other ways to increase daily light intake:</h3> <ul> <li><strong>A light box or lamp with 10,000 LUX</strong><br /> <img alt="Using lightbox for seasonal affective disorder" src="/-/media/national-files/images/hometown-health/2018/seasonal-affective-disorder.jpg?h=182&w=200&sc_lang=en&hash=32388A3938D4B8D9CEBD6C95AD06363B" style="width: 200px; height: 182px; float: right; margin-bottom: 5px; margin-left: 5px;" /> You only need to use the lamp for 30–60 minutes daily. Try using it first thing in the morning and at the same time every day to get the most benefit. Talk with your health care team to discuss and alternative schedule if you do not see improvement.</li> <li><strong>A dawn simulator</strong><br /> If you have difficulty waking up during dark winter mornings, a dawn simulator is an alarm clock with a light that progressively gets brighter 30–60 minutes before your alarm goes off. A dawn simulator can be used alone or in combination with a light box.</li> </ul> <p><a href="/hometown-health/featured-topic/recognizing-seasonal-affective-disorder-sad" target="_self" title="Opens in same window.">Recognizing the symptoms of SAD</a> can prevent them from becoming severe. If your symptoms persist or worsen, contact your health care professional to discuss your concerns. </p> <h2>Watch this video about seasonal affective disorder:</h2> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/TWtrS8Qvo1Q" title="Season affective disorder" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p><em><a href="/providers/kyja-stygar-md" target="_self" title="Opens in same window.">Kyja Stygar, M.D.</a>, sees patients in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em> </p><ul> <li>Behavioral health</li> <li>Family medicine</li> <li>Gender-affirming care</li> <li>Pediatrics</li> <li>Prenatal care, including deliveries at the hospital</li> <li>Women's health</li> </ul>M.D.<p>I grew up in Eau Claire and returned to the area to be near family. I enjoy the outdoors with gardening, hiking, biking and kayaking.</p><p><strong>Education</strong></p> <ul> <li>Medical College of Wisconsin-Milwaukee</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Practice, UW Health Fox Valley</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>Society of Teachers of Family Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Stygar<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/kyja-stygar-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7E96C8C7EA40638FE2257BF7C24AC8E4" alt="Kyja Stygar, M.D." width="280" height="280" DisableNVelocity="true" />{1D673FAD-1DF2-4856-A86D-ED615A7310F2}Kyja<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12585912Kyja Stygar, M.D.1{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}|{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{61776FD2-05E8-47E9-AB55-EE465BD29A19}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}|{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}<img src="/-/media/national-files/images/hometown-health/2022/winter-walking-wearing-sweaters.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BD28B76D69C09B3ACDE12EA15CE852EE" alt="Winter walking wearing sweaters" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.DepressionDepression is a medical illness that causes a persistent feeling of sadness, loss of interest and, sometimes, physical symptoms. It's also called major depression, major depressive disorder and clinical depression.Michele Halterman1/18/2018<p>You’ve been hit hard by your first cold of the season and stop by the store for supplies. <span>Herbal supplements sound like healthy, natural choices for treating colds and addressing a host of other health concerns. But that’s not necessarily true.</span></p>Supplements: What you need to know<img alt="Supplements" src="/-/media/national-files/images/hometown-health/2018/supplements.jpg?h=300&w=300&sc_lang=en&hash=70C8BD24213105E64B5771F92D49C88E" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive"> <p>You’ve been hit hard by your first cold of the season and stop by the store for supplies. Tissues? Definitely. Chicken noodle soup? Absolutely. Echinacea? Maybe not.</p> <p>Herbal supplements, such as echinacea, may sound like healthy, natural choices for treating colds and addressing a host of other health concerns. But that’s not necessarily true. In some cases, herbal supplements can even be dangerous. Here are a few things you need to know before you buy.</p> <h4>SUPPLEMENTS ARE LOOSELY REGULATED</h4> <p>Herbal supplements are considered dietary supplements by the FDA. That means they’re regulated differently than items sold as prescription or over-the-counter drugs. And those regulations <span class="RadEWrongWord" id="RadESpellError_4">aren</span>’t as strict for supplements as they are for medications.</p> <p>“Companies can sell dietary supplements without doing any safety testing and before seeking FDA approval,” says <a href="/providers/randy-foss-md" target="_self" title="Opens in same window.">Randy Foss, M.D.</a>, a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician at <a href="/locations/lake-city" target="_self" title="Opens in same window.">Mayo Clinic Health System in Lake City</a>, Minnesota. FDA oversight comes in after the supplement is on the market. “The FDA monitors the manufacturing process and responds to safety issues that come up.”</p> <h4>IS THERE TRUTH IN ADVERTISING?</h4> <p>Companies that make herbal supplements are allowed to make claims about their products’ effectiveness as long as they have evidence to support the claims. However, companies do not need to submit this evidence to the FDA. That should make you think twice about what’s on the packaging, says Dr. Foss.</p> <p>“If it sounds too good to be true, it probably is,” Dr. Foss says. Instead of trusting a product’s advertising, he recommends doing your own research. The <a href="https://ods.od.nih.gov/" target="_blank" title="Opens in a new window.">Office of Dietary Supplements</a> is one place to go for unbiased information. Your health care provider is another good resource.</p> <h4>FIND OUT WHAT'S INSIDE</h4> <p>Companies must include a complete list of ingredients on their supplement labels. Since the FDA does not test supplements, it’s up to companies to report what’s in the pills produced.</p> <p>Research has found that this honor system is not so honorable. For example, a 2015 study by the New York State Attorney General’s Office found that 4 out of 5 products tested did not include the herbs listed on their labels, and many were full of fillers, such as powdered rice. The study also found some pills included ingredients not listed on their labels, including some that could be dangerous to people with allergies.</p> <h4>WHEN TO AVOID SUPPLEMENTS</h4> <p>Certain people should avoid supplements altogether.</p> <p>“Some supplements can cause serious side effects if mixed with a prescription or over-the-counter medication,” says <a href="/providers/jamie-johannes-do" target="_self" title="Opens in same window."><span class="RadEWrongWord" id="RadESpellError_10">Jamie</span> <span class="RadEWrongWord" id="RadESpellError_11">Johannes</span>, D.O.</a>, a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician at <a href="/locations/lake-city" target="_self" title="Opens in same window.">Mayo Clinic Health System in Lake Crystal</a>, Minnesota. That includes aspirin, blood thinners and blood pressure medications. “Talk to your provider if you take medication and are thinking of adding a supplement.”</p> <p>Women who are pregnant or breastfeeding also should check with their health care providers before taking supplements.</p> <p>Visit the <a href="https://www.fda.gov/Food/DietarySupplements/default.htm" target="_blank" title="Opens in a new window.">U.S. Food & Drug Administration</a> or <a href="https://nccih.nih.gov/" target="_blank" title="Opens in a new window.">National Center for Complementary and Integrative Health</a> to learn more about supplements.</p><img src="/-/media/national-files/images/hometown-health/2018/supplements.jpg?h=504&iar=0&w=504&sc_lang=en&hash=4D1FBBDA47E4836493F66AAAD18B0641" alt="Supplements" width="504" height="504" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Integrative MedicineUnderstanding total health, not just of the body, but of the mind and the spirit, enhances the natural healing process allowing you to feel more empowered, have more energy and experience tranquility.Michele Halterman1/19/2018<p>Midwesterners know how to make the most of winter. We skate, ski, sled and snowshoe our way through the coldest months of the year. But if those standard “S” sports are starting to feel a little stale, there are plenty of other options.</p>Cold weather exercises to try<img alt="Cold weather exercsies" src="/-/media/national-files/images/hometown-health/2018/cold-weather-exercsies.jpg?h=300&w=300&sc_lang=en&hash=A5BF6426EC429468E2B684A0A3ADC6BC" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive"> <p><em>By Mayo Clinic Health System staff</em></p> <p>Midwesterners know how to make the most of winter. We skate, ski, sled and snowshoe our way through the coldest months of the year.</p> <p>But if those standard “S” sports are starting to feel a little stale, there are plenty of other options. Try one of these activities if you’re looking for a new winter workout:</p> <h4>Broomball</h4> <p>It’s like hockey, but without skates. Or a puck. And instead of a stick, players use brooms, which actually are a special stick with a molded end shaped like broom. But the team makeup is the same — three forwards, two defensive players and a goalie. And, like hockey, it’s an intense cardio workout. </p> <h4>Curling</h4> <p>There’s more to curling than meets the eye. The sweeping motion required to steer the rock — the 40-pound stone players slide across the ice — can raise your heart rate. “And you have to squat low on the ice to throw the rock, which requires balance,” Dr. Payne says.</p> <h4>Fat biking</h4> <p>Biking is not just for summer anymore. Fat biking, which involves wide tires with low air pressure, is a great way to hit the trails in the winter. “It’s low impact, but requires quite a bit of balance and challenges your core,” Dr. Payne says.</p> <h4>Skijoring</h4> <p>What do you get when you combine cross-country skiing and dog sledding? Skijoring. Harness up your pooch and hit the trails for a workout that benefits you both. Look for skijoring club information online to get started.</p><img src="/-/media/national-files/images/hometown-health/2018/cold-weather-exercsies.jpg?h=504&iar=0&w=504&sc_lang=en&hash=30618C695FC22195797CEE76EBDDE917" alt="Cold weather exercsies" width="504" height="504" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Michele Halterman4/29/2019<p>No one looks forward to their menstrual cycle and the pain and other symptoms it brings with it, but what if you’re too dry to use tampons to combat the bleeding? There are a few factors that can cause dryness and a few ways to treat the problem.</p>Too dry for tampons: Now what?<img alt="Too dry for tampons" src="/-/media/national-files/images/hometown-health/2018/too-dry-for-tampons.jpg?h=300&w=300&sc_lang=en&hash=57910C323520412C4F4208672F303785" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /> <p>No one looks forward to their menstrual cycle and the pain and other symptoms it brings with it, but what if you’re too dry to use tampons to combat the bleeding? There are a few factors that can cause dryness and a few ways to treat the problem. </p> <p>Typically, <a href="/hometown-health/speaking-of-health/vaginal-dryness-symptoms-causes-and-remedies" target="_self" title="Opens in same window.">vaginal dryness</a> isn’t normal, unless you’re starting <a href="/hometown-health/speaking-of-health/too-embarrassed-to-ask-part-3" target="_self" title="Opens in same window.">menopause</a> or just have had a baby. If those situations don’t apply to you, it could also be any of these reasons:</p> <ul> <li>Estrogen deficiency (this can have various causes) </li> <li>Menopause</li> <li>Psychological and relationship issues</li> <li>Medications for blood pressure, antihistamines, anticholinergics and birth control, specifically the Depo shot.</li> <li>Postpartum status, especially if you’re breastfeeding</li> <li>Removal of ovaries</li> <li>Douching</li> <li>Vulvar skin disorders </li> </ul> <h4>If you’re experiencing vaginal dryness, try these solutions:</h4> <ul> <li>Use vaginal lubricants that are oil- or water-based </li> <li>Use a vaginal moisturizer</li> <li>Get estrogen hormones/therapy</li> <li>Avoid wearing silk clothing or undergarments; try cotton instead. </li> <li>Avoid taking bubble baths or the use of scented soaps or lotions as these can cause more irritation and dryness </li> </ul> <p>If you’re unsure what could be causing your vaginal dryness or where to begin with the solutions, see your health care provider for further evaluation and treatment as needed.</p><img src="/-/media/national-files/images/hometown-health/2018/too-dry-for-tampons.jpg?h=504&iar=0&w=504&sc_lang=en&hash=3BB649F4C636A22710E071D31579B189" alt="Too dry for tampons" width="504" height="504" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Michele Halterman1/26/2024It's common to deal with a sore throat, runny nose or cough during winter. Taking a close look at your symptoms can help you determine if you have a common cold or if allergies may be affecting you.Is it an allergy or a common cold?<p>Did you know a sore throat or runny nose may be something other than a common cold? Taking a closer look at these and other symptoms can help you determine if it's a cold you're up against or allergies that may be affecting you.</p> <h2>Allergies occur year-round</h2> <p>If you're allergic to pollens, you may feel an improvement in <a href="/hometown-health/speaking-of-health/say-goodbye-to-springtime-allergies" target="_self" title="Opens in same window.">spring and summer allergy symptoms</a> during colder winter months. However, if you are sensitive to indoor allergens, such as mold, pet dander or dust mites, your allergy symptoms may be more pronounced during winter when you spend more time indoors, because your home's furnace dries the air and circulates allergen particles throughout your home. </p> <h2>Allergies and common cold differences</h2> <p>Colds are caused by contagious viruses, which are spread by sneezing, coughing, shaking hands or touching contaminated surfaces. Your immune system <a href="/hometown-health/speaking-of-health/7-ways-to-combat-coughs-and-colds" target="_self" title="Opens in same window.">fights off the infection</a> and your symptoms usually resolve after a couple of weeks.</p> <p>Allergies are due to an immune reaction to something in the environment, such as dust or pollen. Both colds and allergies can cause <a href="/hometown-health/speaking-of-health/solve-chronic-stuffy-nose-with-intense-cooling" target="_self" title="Opens in same window.">nasal congestion</a>, sneezing and coughing but allergies are not contagious and do not routinely resolve after a couple of weeks.</p> <h3>Consider these additional distinctions between colds and allergies:</h3> <ul> <li>A runny, <a href="/-/media/shared-files/images/regional-images/swmn/allergy/chronic-sinusitis.jpg" target="_self" title="Opens in same window.">stuffy nose</a> is common with both colds and allergies.</li> <li>Body aches are more likely to be present with colds than allergies.</li> <li>Colds most often occur during winter months. Allergies occur at any time of the year.</li> <li>Cold symptoms take a few days to appear after an infection. Allergy symptoms can begin immediately after contact with triggers.</li> <li>Colds tend to last anywhere from three to 14 days. Allergies can last days to months.</li> <li><a href="/hometown-health/speaking-of-health/why-are-you-coughing-so-much" target="_self" title="Opens in same window.">Cough often is present</a> with a cold and sometimes with allergies.</li> <li>Fatigue is sometimes present with both colds and allergies.</li> <li>Fever is rare with a cold and never with allergies.</li> <li>Itchy, watery eyes are rare with a cold but often with allergies.</li> <li>Sore throat is more likely with a cold than with allergies.</li> <li>The most crucial difference is that colds usually don't last longer than 14 days.</li> </ul> <h2>Common indoor or winter allergens</h2> <h3>Even the cleanest of homes can be a hotbed for indoor allergens. Some of the main culprits include:</h3> <ul> <li><strong>Animal dander</strong><br> Despite what you may hear, breeds of dogs or cats touted as hypoallergenic still cause allergies whether or not they shed. People are not allergic to animal hair; they're allergic to an allergen found in the saliva, dander, or dead skin flakes, and urine of any mammal.</li> <li><strong>Cockroach droppings</strong><br> Cockroaches are common pests whose droppings can cause environmental issues.</li> <li><strong>Dust mites</strong><br> These microscopic pests thrive in warm, humid environments where skin flakes collect, such as bedding, upholstered furniture and carpeting.</li> <li><strong>Indoor dust and mold</strong><br> Mold can colonize in a humidifier, causing more harm than good.</li> </ul> <h2>Tips to help reduce allergens in your home</h2> <h3>There are a few suggestions you can try to help combat indoor allergens in your home:</h3> <ul> <li>Block crevices, wall cracks and windows where cockroaches may enter. Keep food in containers with lids, use garbage cans with lids and wash dishes immediately after use. Clean under stoves, refrigerators and toasters where crumbs can accumulate.</li> <li>If you have indoor pets, keep them out of bedrooms and other rooms where you spend most of your time. Try to minimize contact and wash your hands after touching.</li> <li>Launder clothing regularly, particularly after being near pets or other allergens.</li> <li>Place zipped protectors on pillows and mattresses to keep out dust mites. </li> <li>Remove mold growth on hard surfaces in your home like bathrooms and kitchen with water, detergent and, if necessary, a 5% bleach mixture. </li> <li>Repair and seal leaking roofs or pipes. Use dehumidifiers in damp basements, making sure to empty and clean the unit regularly.</li> <li>Try to keep humidity levels low — around 40 to 50% — in your home.</li> <li>Use a high-efficiency particulate air, or HEPA, filter vacuum. These filters are <a href="/hometown-health/speaking-of-health/cleaner-air-layer-of-protection-from-covid-19" target="_self" title="Opens in same window.">rated at least 99.97% efficient</a> at trapping particles of 0.3 microns in size.</li> <li>Vacuum carpets often, or replace carpet with hardwood floor, tile or linoleum.</li> <li>Wash all bedding weekly in hot water, which is about 130 F.</li> </ul> <p><em>Richard Crockett, M.D., is an immunologist in <a href="/services-and-treatments/immunology" target="_self" title="Opens in same window.">Allergy & Asthma</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a> and <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2024/petting-a-cat.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1F662DA126B4ED9A387FEDA4F7DE0256" alt="Petting a cat" width="660" height="370" DisableNVelocity="true" />Allergy and AsthmaOur allergists provide care for your allergies, asthma and conditions that affect the immune system's ability to defend the body against foreign or abnormal cells. The main treatment goal is your satisfaction when your condition is under control and quality of life is improved.Michele Halterman9/29/2022<p>Water is essential to keep your body functioning properly. That's why you need eight to 12 cups a day. Here's how to develop healthy water habits.</p>Water: Essential for your body<p>Drinking water does more than just quench your thirst. It's essential to keeping your body functioning properly and feeling healthy.</p> <p>Nearly all of your body's major systems depend on water to function and survive. With water making up about 60% of your body weight, it's no surprise what staying hydrated can do for you.</p> <h2>Here are just a few examples of the ways water works in your body: </h2> <ul> <li>Regulates body temperature</li> <li>Moistens tissues in the eyes, nose and mouth</li> <li>Protects body organs and tissues</li> <li>Carries nutrients and oxygen to cells</li> <li>Lubricates joints</li> <li>Lessens burden on the kidneys and liver by flushing out waste products</li> <li>Dissolves minerals and nutrients to make them accessible to your body</li> </ul> <h2>How much water do you need?</h2> <p>Every day, you lose eight to 12 cups of water through breathing, perspiring, and urine and bowel movements. In general, men need at least 12 cups of fluid daily, while women require a minimum of nine cups. Factors that increase your fluid needs include exercise, hot weather, high altitude, a high-fiber diet, and increased losses from caffeine and alcohol intake.</p> <p>Adequate hydration varies from person to person. A practical way to monitor hydration is by observing the color of your urine right after you get up in the morning. Straw- or lemonade-colored urine is a sign of appropriate hydration. Dark-colored urine — about the color of apple juice — indicates dehydration.</p> <p>That's why it's important to <a href="/hometown-health/speaking-of-health/tips-for-drinking-more-water" target="_self" title="Opens in same window.">replenish your body's water supply</a> with beverages and food that contain water.</p> <p>While you should meet most of your fluid needs by drinking water, beverages such as soups, milk, 100% fruit juice and decaffeinated teas are an option. Fruits and vegetables also contain a fair amount of water. Since it's hard to track the amount of water you get from food, it's best to try for at least eight cups of fluid daily.</p> <h2>Ways to stay hydrated</h2> <p>Developing healthy water habits isn't a heavy lift.</p> <h3>By practicing some of these tips, they'll soon become a natural part of your day:</h3> <ul> <li>Start the morning off by drinking a glass of water as soon as you wake up, even before coffee.</li> <li>Carry a water bottle wherever you go.</li> <li>Set goals for yourself.</li> <li>Cut out sugary beverages to avoid empty calories.</li> </ul> <p>By consuming the minimum recommendation of water, you're helping your body function better and improving your overall health. For more information about ways to consume more water and find out if you're getting enough for your body's needs, talk to your health care professional.</p> <p>Don't like plain water? If you like the tingle of carbonated soda, try club soda, seltzer or sparkling water with a splash of fruit juice. If you're looking for a little flavor in your water, try adding a slice of lemon or lime or making fruit-infused water.</p> <h3>Here's a recipe to try:</h3> <p><strong>Strawberry basil-infused water</strong></p> <p>1 pint sliced strawberries<br /> 10 fresh basil leaves, torn<br /> 1 sliced lemon<br /> 2 quarts water</p> <p>Combine strawberries, basil and lemon in a 64-ounce pitcher. Pour water over the top and chill for at least three hours.</p> <p>This refreshing, flavored water can be stored in the refrigerator for up to two days.</p> <h2>Have more questions about hydration? In this video, physician assistant Abbie Bartz explains thirst cues and more:</h2> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/l93BXHdyd00" title="Ask Mayo Clinic Health System: Hydration Matters: Are You Drinking Enough Water?" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <p><em><a href="/providers/allyn-wergin-rdn" target="_self" title="Opens in same window.">Allie Wergin</a> is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition Counseling and Education</a> in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Bariatric surgery</li> <li>Diabetes management</li> <li>Oncology</li> <li>Weight management</li> </ul>RDN<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, St. Catherine University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration </li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul>Mahowald<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/allyn-wergin-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=74F690ED261F537AA65B66929A3356D1" alt="Allie Mahowald, RDN" width="280" height="280" DisableNVelocity="true" />{9209F8EC-1016-41AA-985F-014D9B877417}Allie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15971546Allyn Mahowald, RDN1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2022/hand-holding-water-bottle.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8CD589F24B69703757E503BA08878EF4" alt="Hand holding water bottle" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Michele Halterman2/17/2023Are you looking for a healthy food option and want to try something new or get ideas for an old favorite? Learn why cauliflower is a great choice, and get a delicious recipe.Cauliflower: A versatile nutrition superstar<p>Like many consumers, you may be on a quest for healthier food options and willing to try something new or a new take on a familiar food. If you're diagnosed with celiac disease, you may be looking for gluten-free alternatives. Or maybe you're on the hunt for lower carbohydrate choices.</p> <p>Cauliflower may be just what you're searching for. This versatile veggie can be eaten raw, cooked, roasted, grilled, baked into a pizza crust, or cooked and mashed as a substitute for mashed potatoes. You can even rice cauliflower and serve it in place of white rice.</p> <p>Cauliflower is a member of the cruciferous vegetable family along with Brussels sprouts, cabbage, broccoli, collard greens, kale, kohlrabi, rutabaga, turnips and bok choy. These vegetables all contain a compound that produces a strong, distinct odor that some find unappealing. But this family of vegetables also offers a wide range of health benefits and may reduce the risk of various types of cancer.</p> <h2>Nutrition superstar</h2> <p>When it comes to nutrition, cauliflower is a superstar. It's high in vitamins C and K, and is also a good source of folate, which supports cell growth and is essential during pregnancy. Cauliflower is fat-free and cholesterol-free. And it's low in sodium. A one-cup serving contains only 25 calories, 5 grams of carbohydrates and 2 grams of dietary fiber.</p> <h2>Choosing cauliflower</h2> <p>Look for a cauliflower head that has tight, creamy-white curds and bright-green, firmly attached leaves. Avoid those with brown spots or loose, spread-out sections.</p> <p>Buy a head of cauliflower and separate it into its sections or florets. Or for convenience, purchase a tub of washed, precut florets. Cauliflower wrapped in a cellophane bag can trap moisture and speed up spoiling. Unwrap and transfer cauliflower to a loosely sealed bag with a paper towel to help absorb moisture. Whole heads of cauliflower can be stored in the fridge for four to seven days.</p> <p>To bring more color to side dishes, salads and snacks, try green, orange or purple cauliflower.</p> <h2>New takes on a familiar veggie</h2> <p>As you look for ways to add more veggies to your plate, give cauliflower a try. Toss florets into a food processor to make a cauliflower pizza crust, or mince into small pieces for your next stir fry. And be sure to involve the kids so they learn to try this familiar veggie in new ways.</p> <p>This recipe puts a cauliflower twist on a popular side dish. Make it plant-based by leaving out the cheese.</p> <h3>Parmesan roasted cauliflower</h3> <p><strong> </strong></p> <p>Serves 6</p> <p>1/2 cup panko breadcrumbs<br /> 1/4 cup finely grated Parmesan cheese<br /> 2 tablespoons olive oil<br /> 1 teaspoon fresh lemon zest<br /> 1 teaspoon finely chopped fresh basil<br /> 1/4 teaspoon paprika<br /> 1/4 teaspoon kosher salt<br /> 3 cups small cauliflower florets</p> <p>Fill a medium pot with water and bring to a boil. Heat oven to 375 F. Lightly coat an 8-by-8-inch baking dish with cooking spray.</p> <p>In a small bowl, combine the breadcrumbs, cheese, oil, lemon zest, basil, paprika and salt until well mixed.</p> <p>Place the cauliflower in boiling water for three minutes; drain. Place in the baking dish and sprinkle the breadcrumb mixture evenly over the top. Bake for about 15 minutes or until crust is lightly brown.</p> <p>Nutritional information for 1/2-cup serving: 84 Calories, 6 grams total fat, 1 gram saturated fat, 0 grams trans fat, 4 grams monounsaturated fat, 3 milligrams cholesterol, 163 milligrams sodium,6 grams total carbohydrate, 1 gram dietary fiber, 1 gram total sugars, 3 grams protein</p> <p><a href="/providers/caitlin-terpstra-rdld" target="_self" title="Opens in same window."><em>Caitlin Terpstra</em></a><em> is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em></p>RDN, LD<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, St. Catherine University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>University of Wisconsin Hospital and Clinics</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Licensed Dietician</li> <li>Registered Dietitian</li> </ul>Terpstra<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/caitlin-terpstra-rd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=D56D6F5A2B6A4866353C6D74A8883157" alt="Caitlin Terpstra RD" width="280" height="280" DisableNVelocity="true" />Caitlin<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>19992149Caitlin Terpstra, RDN, LD1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2023/roasted-cauliflower.jpg?h=370&iar=0&w=660&sc_lang=en&hash=46C245D97B27B5F479D0C1CFF32212C6" alt="Roasted cauliflower" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Michele Halterman2/26/2018Chris Farley. Heath Ledger. Sigmund Freud. Prince. You likely recognize the names of these famous people, but you might not know what they have in common. They all died from an opioid overdose.Opioid-free anesthesia: The future of pain management<table align="right" style="width: 326px;"> <tbody> <tr> <td><img alt="Anesthesia team in Red Wing" src="/-/media/national-files/images/hometown-health/2018/anesthesia-team-in-red-wing.jpg?h=244&w=326&sc_lang=en&hash=28EE3BAE8F8C42657C9951E038CACC70" style="height: 244px; width: 326px; float: left; margin-bottom: 10px; margin-left: 0px;" class="img-responsive" /> <h5>Members of the Anesthesia team at Mayo Clinic Health System in Red Wing include, left to right, Josh Cochrane, Justin Smith and Ryan Sportel, certified registered nurse anesthetists; Shelly Barker, M.D.; and Mike Sawyer, certified registered nurse anesthetist.</h5> </td> </tr> </tbody> </table> <p>Chris Farley. Heath Ledger. Sigmund Freud. Prince. You likely recognize the names of these famous people, but you might not know what they have in common. They all died from an opioid overdose.</p> <p>Opioids are narcotics derived from poppy seeds, the most recognizable of which include morphine, OxyContin, Percocet, Vicodin, fentanyl and the illicit drug heroin.</p> <p>According to Ryan Sportel and Mike Sawyer, certified registered nurse anesthetists at Mayo Clinic Health System in Red Wing, opioid use can be traced as far back as the ancient Egyptians, who harvested opium to provide pain relief. Over thousands of years, various iterations of opioids have been used in medicine, but recent years have ushered in an unprecedented number of prescriptions for this powerful drug.</p> <h2>A medical mainstay</h2> <p>“Opioids have been a mainstay of pain treatment in the U.S. for decades,” says Sawyer. “We really started to see an uptick in opioid prescriptions in the early 1980s, when pharmaceutical companies came to providers and said, ‘If your patient needs them, they’re safe and won’t be addictive.’ But pharmaceutical companies didn’t have solid data to support those claims, and providers trusted that information and opioids.”</p> <p>The number of opioid prescriptions given and the number of related deaths have quadrupled since 1999 according to studies by John Hopkins University and The University of California San Francisco Medical Center. These studies also found that opioid use is connected to surgery. Roughly half of all surgical patients experience pain after surgery, and 24 percent of those patients can’t find adequate pain relief. There are 100 million inpatient and outpatient surgeries and procedures in the U.S. every year, and 5.9 to 6.5 percent of patients persistently use opioids after major and minor procedures, respectively. </p> <p><span>To put opioid use into perspective, the U.S. comprises 4.4 percent of the world’s population, yet consumes 80 percent of the world’s opioid supply, according to the universities’ studies. As many as 2 million Americans have a prescription opioid use disorder, which is the medical term for addiction.</span></p> <h2>Deadly drugs</h2> <p>To be sure, there are appropriate uses for prescription opioids. “In OB-GYN and other surgical branches, we believe it’s important to make sure that patients have proper pain control after surgery,” says Rubin Raju, M.D., an OB-GYN provider at Mayo Clinic Health System in Red Wing and Mayo Clinic Hospital – Methodist Campus. “Pain can impede recovery by making it difficult for patients to get out of bed and take deep enough breaths postoperative, which can lead to blood clots and cause respiratory problems, respectively. We focus on enhanced recovery after surgery, which means we want patients up and moving as quickly as possible after surgery. This practice decreases complications after surgery and facilitates recovery.”</p> <p>Although providers agree that opioids are occasionally required for the recovery process, they believe opioids should only be used as a last resort.</p> <p>“Opioids do work, for a limited period of time, but we only use them for highly acute medical needs,” says Sportel.</p> <p>If opioids do the trick, then what’s the harm in using them? Although opioids can effectively treat pain for the short term, aside from being highly addictive, they eventually can make the pain worse by stimulating nerve cells — a phenomenon called hyperalgesia, in which people become more sensitive to pain after receiving opioids.</p> <p>Sawyer says the body begins building up a tolerance to opioids the moment they enter the system, which immediately opens the door to tolerance and, possibly,<span style="color: red;"> </span>addiction. “Opioids can eventually lead to death, as they interfere with brain signals that tell the body to breathe, which results in respiratory failure,” he says.</p> <h2>Alternative options</h2> <p>Fortunately, health care providers such as Dr. Raju, Sawyer, Sportel and the rest of the anesthesia team in Red Wing have paid attention to the dangerous opioid trends and are responding with safe, effective, opioid-free pain management alternatives rooted in best- practice techniques.</p> <p>“We’re trying to do surgeries without any opioids at all,” says Sportel. Sawyer adds, “It’s a patient-based decision, and we have many options now, including peripheral nerve blocks. We incorporate patients into our process. Before surgery, we give them the evidence-based information so they can be informed consumers. We see a handful of patients per year who have addiction histories, and are concerned about opioids.” Both providers say they communicate the unique needs of each patient to the surgeon preoperative, and that a team of surgical nurse planners also regularly pass along any patient concerns.</p> <p>“There are established protocols for anesthesia care before, during and after surgery at all Mayo Clinic campuses,” Dr. Raju says. “The anesthesia team approaches surgeons to discuss the best methods for each patient, and we are very open to their recommendations.”</p> <p>It’s this team model that allows all the providers to embrace new and effective techniques and collaborate quickly to get patients the best, individualized care possible.</p> <p>“We’ve always been a practice that utilizes peripheral nerve bocks as much as we can,” says Sawyer. “We’re always looking for the next great nerve block because we know it’s better for patients. So we’re at the forefront of best practice in anesthesia.”</p> <p>Sawyer says they have had great success with nerve blocks, where anesthetists deposit local anesthetics directly next to the nerves, which blocks the brain from feeling pain.</p> <p>Opioids act differently in that they affect much more of the body than pain receptors, and can cause drowsiness, constipation, respiratory depression and euphoria. Although euphoria doesn’t sound too bad, in this case the state is caused by the opioids shutting down endorphin receptors in the brain while increasing the amount of opioid receptors. This almost immediately begins the process of addiction because it causes nerve cells to become more sensitive to pain. “The euphoric feeling is what usually causes the addiction,” says Sawyer. “Patients often continue to take opioids long after surgery, even though they might not have much pain.”</p> <p>Managing pain after surgery is a justifiable concern. Sportel says there are two excellent options for postsurgical pain management. The first is the long-acting anesthetic Exparel, which blocks pain for 48 to 72 hours. The second is a device known as a pain pump. When patients opt for a pain pump, a catheter may be placed at the affected nerve site during surgery. Patients can then take the device home for anywhere from three to six days and choose to pump medication into the painful area as needed.</p> <h2>Patient experience</h2> <p>Every patient is different in his or her pain management needs and knowledge about opioids, but JoLyn Williams, a resident of Cannon Falls, Minnesota, opted for opioid-free anesthesia during an adjustment to her intrauterine device last November at Mayo Clinic Health System in Red Wing, where she works as a registered nurse.</p> <p>“Before my surgery, providers brought up the option of opioid-free anesthesia, which would include an injection into my abdomen,” says Williams. “I’m a nurse, so I understand the dangers of opioids, and I agreed to the opioid-free method.”</p> <p>Williams says the nerve-blocking medication was placed deep enough that she had to be put under for the injections themselves, which were beneath muscle tissue, well into both sides of her abdomen. After the nerve blocks were administered, she woke up and waited for the surgery to adjust her IUD.</p> <p>“I was very groggy after the surgery, of course, but I don’t remember feeling very much pain,” says Williams. “It was my first time having surgery and being completely put under. The drugs they gave me put me into another world. It was great; they were definitely effective.”</p> <p>Williams says she had no side effects from her opioid-free anesthesia, and took Tylenol and ibuprofen to manage pain for the first two or three days after surgery. Between her essentially pain-free procedure and well-managed recovery, she says she would certainly recommend opioid-free treatment to others.</p> <p>Dr. Raju says nerve blocks result in higher patient satisfaction, help to suppress the opioid epidemic and, in general, are a much better approach to managing patients’ pain. “This method is the newest treatment plan in pain management and follows the trajectory of where pain management is headed,” he says.</p> <p>Sawyer says that although opioids were the foundation of the practice when he was trained as an anesthetist in the 1990s, the transition to opioid-free care is much needed. “There are many equally effective ways to manage pain, and we have asked many questions in the process of shifting away from administering opioids,” he says. “We consider what we’re doing a real paradigm shift.”</p><img src="/-/media/national-files/images/hometown-health/2018/anesthesia-team-in-red-wing.jpg?h=404&iar=0&w=539&sc_lang=en&hash=B4AF257058F9B27526CA77D0023DA99C" alt="Anesthesia Team in Red Wing" width="539" height="404" DisableNVelocity="true" />Michele Halterman6/1/2023Mindfulness meditation is a simple, quick way to reduce stress that you can do wherever you are. It's often part of larger treatment plans. But what is it and how can it help?How mindfulness meditation improves mental health<p>Quick and simple usually aren't terms used to describe medical treatments. Yet mindfulness meditation is a fast, easy way to reduce stress wherever you are.</p> <p>It's often recommended as part of a comprehensive treatment for physical and mental health conditions. It's considered a type of mind-body complementary medicine. You can incorporate mindfulness meditation into your routine to improve your overall health.</p> <h2>Mindfulness meditation basics</h2> <p>Mindfulness meditation is the practice of purposefully being aware of and focusing your attention on the present moment. Mindfulness allows you to be in tune with your experience — right now in this moment — and to explore with curiosity whatever sensations, thoughts and emotions are present without expectations or judgment.</p> <p>During meditation, you focus your attention and eliminate the stream of jumbled thoughts that may be crowding your mind and causing stress. This focus can result in enhanced physical and emotional well-being.</p> <h2>Benefits of mindfulness meditation</h2> <p>Mindfulness meditation engages the brain. Think of it as a form of brain exercise. Just as physical exercise keeps your body healthy, mindfulness meditation keeps your brain fit. Research has shown that just five to 15 minutes of daily meditation is all you need to begin experiencing benefits.</p> <h3>After decades of research into the practice, these benefits have been found to include an increase in:</h3> <ul> <li>Cognitive flexibility</li> <li>Diabetes control</li> <li>Emotion regulation</li> <li>Empathy</li> <li>Focus and attention</li> <li>Immune system response</li> <li>Memory</li> <li>Positive emotions</li> <li>Positive relationships</li> <li>Relaxation</li> <li>Self-compassion</li> <li>Self-esteem</li> </ul> <h3>The practice also affects many negative physical and mental symptoms, including decreases in: </h3> <ul> <li>Addictive behaviors</li> <li>Anger and hostility</li> <li>Anxiety</li> <li>Burnout</li> <li>Depression</li> <li>Emotional reactivity</li> <li>Insomnia</li> <li>High blood pressure</li> <li>Need for pain medications </li> <li>Physical pain</li> <li>Post-traumatic stress disorder symptoms</li> <li>Stress</li> </ul> <h2>How to use mindfulness meditation</h2> <p>Many people may think of mindfulness meditation as "sitting on a pillow, being still, with eyes closed." This may work for some, but there are many ways to practice mindfulness meditation.</p> <p>Practicing mindfulness involves using breathing methods, guided imagery, and other strategies to relax the body and mind and help reduce stress.</p> <h3>To try focused breathing meditation:</h3> <ul> <li>Sit down, take a deep breath and close your eyes.</li> <li>Focus on your breath as it moves in and out of your body.</li> </ul> <p>Sitting and breathing slowly for even just a minute can help.</p> <h3>Here are a few other structured mindfulness exercises to try:</h3> <ul> <li><strong>Body scan meditation</strong><br /> Lie on your back with your legs extended and arms at your sides, palms facing up. Focus your attention slowly and deliberately on each part of your body, in order, from toe to head or head to toe. Be aware of any sensations, emotions or thoughts associated with each part of your body.</li> <li><strong>Sitting meditation</strong><br /> Sit comfortably with your back straight, feet flat on the floor and hands in your lap. Breathing through your nose, focus on your breath moving in and out of your body. If physical sensations or thoughts interrupt your meditation, note the experience and then return your focus to your breathing.</li> <li><strong>Walking meditation</strong><br /> Find a quiet place 10 to 20 feet long and walk slowly. Focus on the experience of walking, being aware of the sensations of standing and the subtle movements that keep your balance. When you reach the end of your path, turn and continue walking, maintaining awareness of your sensations.</li> </ul> <h3>If you prefer guided imagery meditation, try one of these audio guides: </h3> <ul> <li><a rel="noopener noreferrer" href="https://www.mayo.edu/research/labs/mindful-breathing/~/media/B378C45DB2574C98A4C0B7825CC06D04" target="_blank" title="Opens in a new window.">Ten breath practice introduction</a></li> <li><a rel="noopener noreferrer" href="https://www.mayo.edu/research/labs/mindful-breathing/~/media/A2692AF7EEAC473FB364CB4366626BBC" target="_blank" title="Opens in a new window.">Ten breath practice</a></li> <li><a rel="noopener noreferrer" href="https://www.mayo.edu/research/labs/mindful-breathing/~/media/257EE305DB8C47549B43169B856DC05F" target="_blank" title="Opens in a new window.">What is mindfulness, and tips for the journey</a></li> <li><a rel="noopener noreferrer" href="https://www.mayo.edu/research/labs/mindful-breathing/~/media/51F2CE241F354E509A6DC7BAD2653C47" target="_blank" title="Opens in a new window.">Body scan</a></li> <li><a rel="noopener noreferrer" href="https://www.mayo.edu/research/labs/mindful-breathing/~/media/29A4D7D6E5C6440582D68A6586322C3E" target="_blank" title="Opens in a new window.">Mindful standing yoga practice</a></li> <li><a rel="noopener noreferrer" href="https://www.mayo.edu/research/labs/mindful-breathing/~/media/D0697CAACDA84F2DB55DEFF01A7DC09D" target="_blank" title="Opens in a new window.">Mindfulness meditation on the breath</a></li> <li><a rel="noopener noreferrer" href="https://www.mayo.edu/research/labs/mindful-breathing/~/media/4972C10800E14548B7C58BDC25F90E1C" target="_blank" title="Opens in a new window.">Mindfulness meditation on the body</a></li> <li><a rel="noopener noreferrer" href="https://www.mayo.edu/research/labs/mindful-breathing/~/media/9E9F133F15684F11A33BD0B30A14D16D" target="_blank" title="Opens in a new window.">Mindfulness meditation on sounds, thoughts and emotion</a></li> <li><a rel="noopener noreferrer" href="https://www.mayo.edu/research/labs/mindful-breathing/~/media/CCB6BCC63ADD4E95AF35E3648AD8059D" target="_blank" title="Opens in a new window.">The 3-minute mindful breathing for the daily journey</a></li> </ul> <p>Mindfulness is a supportive strategy to help manage many health issues. It pairs well with other medical treatments and counseling. It's a simple strategy that doesn't require a prescription or special equipment and can be practiced anywhere. Talk with your health care team about incorporating mindfulness meditation into your life, and see if it makes a difference in your health and general sense of well-being.</p> <p><a href="/providers/joel-bobby-licsw" target="_self" title="Opens in same window."><em>Joel Bobby</em></a><em> is a licensed independent clinical social worker in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</em></p><ul> <li>Anxiety</li> <li>Child/adolescent behavioral and adjustment issues</li> <li>Cognitive behavioral therapy</li> <li>Depression</li> <li>Mindfulness practices</li> </ul>L.I.C.S.W.<p>I have been providing psychotherapy care for children, adolescents and adults in Albert Lea and Austin since 2005. I enjoy partnering with my patients by using the skills they already possess and teaching them new skills to enhance functioning every day.</p><p><strong>Education</strong></p> <ul> <li>Boise State University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Licensed Independent Clinical Social Worker</li> </ul>Bobby<img src="/-/media/shared-files/images/medical-professionals/full/austin/joel-bobby-licsw.JPG?h=280&iar=0&w=280&hash=EA5AB7DD957135F1235C9B2792CD9468" alt="Joel Bobby LICSW" width="280" height="280" DisableNVelocity="true" />Joel<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14509571Joel Bobby LICSW{2B88C934-922C-4130-B661-197B59D83899}|{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}|{C4130004-0F31-48C4-AC9F-A4350A75AB24}<img src="/-/media/national-files/images/hometown-health/2023/practicing-mindfulness-meditation.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8711925E7F8F9F52E7D02D8D0A56A2CE" alt="Practicing mindfulness meditation" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Michele Halterman7/25/2023While experiencing a nosebleed may cause you to feel anxious, it's rarely life-threatening. Learn why it happens, what to do if you get one and when you should seek emergency medical care.Taking control of nosebleeds<p>At some point in their lifetimes, most people will experience a nosebleed. It's common for adults and children, especially during dry winter months.</p> <p>Although rarely life-threatening, nosebleeds can cause anxiety and sometimes are difficult to control.</p> <h2>Why do nosebleeds occur?</h2> <p>Epistaxis, more commonly known as a nosebleed, occurs when a small blood vessel in the nose ruptures. The bleeding most commonly arises from the nasal septum, the partition that divides the two sides of your nose on the inside. The rupture can occur when something traumatizes or irritates the mucosa lining of the septum. Common causes are nose-picking, forcefully blowing the nose or an impact to the outside of the nose or face.</p> <p>Nosebleeds are more likely to occur when the nasal mucosa is dry and irritated. When there is low moisture content in the air, such as in the winter when homes are warmed with furnaces or electric heat, the blood vessels are more prone to tearing. A person also may be more likely to experience a nosebleed during an allergy episode or when fighting an upper respiratory infection. </p> <p>Other less common causes of nosebleeds may lead to recurring or serious bleeding. People with clotting or blood vessel disorders like hemophilia or who use anticoagulant medications for a heart condition have a greater risk of recurring nosebleeds. Growths in the nose, perforations in the septum, uncontrolled high blood pressure and some types of nasal sprays also can increase the risk of epistaxis.</p> <h2>Types of nosebleeds</h2> <p>Anterior nosebleeds start in the front of the nose. They are the most common type of epistaxis and usually are identified by brisk bleeding from one nostril. Less commonly, nosebleeds may start from a blood vessel toward the back of the nasal cavity. This type of nosebleed is a posterior bleed and tends to be more severe, often requiring emergency treatment.</p> <h3>Follow these tips to avoid nosebleeds:</h3> <ul> <li>Avoid vigorous nose-blowing and stuffing tissues or other objects into the nose.</li> <li>Discourage children from nose-picking and keep their fingernails trimmed.</li> <li>Use over-the-counter nasal saline sprays and topical moisturizing gels to moisten the nasal mucosa.</li> <li>Use a home humidifier to keep moisture in the air during winter.</li> <li>If you smoke, consider quitting. Tobacco smoke dries out the nasal mucosa and increases the risk of nosebleeds.</li> </ul> <h2>If you get a nosebleed</h2> <p>Fortunately, most nosebleeds stop on their own after a few minutes. By staying calm and following some simple steps, most nosebleeds can be managed without medical assistance.</p> <h3>Follow these steps:</h3> <ol> <li>Gently blow your nose to clear any blood clots.</li> <li>If available, spray an over-the-counter nasal decongestant two to three times into the nostril that’s bleeding, or saturate a cotton ball with the decongestant spray and insert the cotton into the nostril that's bleeding. </li> <li>Apply direct pressure to the nose by pinching the nostrils shut for 10 to 15 minutes. Do not release pressure early to see if the bleeding has stopped. Lean slightly forward to prevent blood from going into the throat. Breathe through your mouth.</li> <li>Repeat the steps if the bleeding doesn't stop after 15 minutes.</li> <li>Seek medical attention if the bleeding doesn't stop after 30 minutes, if you have trouble breathing, have suffered severe nasal trauma or lost significant blood and feel weak.</li> <li>Once the bleeding stops, avoid nose-blowing or strenuous activity for the rest of the day. Begin a daily nasal moisturizing regimen with nasal saline or gel two to three times daily for one to two weeks.</li> </ol> <p>For serious bleeds or frequent nosebleeds, seek medical attention with your health care team or in an <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">emergency department</a>.</p> <p><a href="/providers/sara-packard-pa-c" target="_self" title="Opens in same window."><em>Sara Packard</em></a><em> is a physician assistant in <a href="/services-and-treatments/otorhinolaryngology">ENT (Otorhinolaryngology)</a> in <a href="/locations/faribault" target="_self" title="Opens in same window.">Faribault</a> and <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em></p><ul> <li>General pediatric and adult ENT</li> </ul> <p> </p>P.A.-C.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, University of North Dakota-Grand Forks</li> <li>Physician Assistant, University of South Dakota-Vermillion</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Academy of Physician Assistants</li> <li>National Commission on Certification of Physician Assistants</li> </ul>Packard<img src="/-/media/shared-files/images/medical-professionals/full/owatonna/sara-packard-pac.jpg?h=280&iar=0&w=280&hash=805319D3C3F1EABCCC8597F256DAE2DC" alt="Sara Packard PAC" width="280" height="280" DisableNVelocity="true" />Sara<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15119505Sara Packard, P.A.-C.1<img src="/-/media/national-files/images/hometown-health/2023/holding-tissue-against-nose.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4A86D2CC9169590528A7B8F26AD864BF" alt="Holding tissue against nose" width="660" height="370" DisableNVelocity="true" />Ear, Nose and Throat (ENT)Get information about symptoms, disorders and diseases affecting the ear, nose and throat, and related head and neck structures.Michele Halterman2/15/2018<p>Losing weight is hard. Doing it alone, though, is even harder. When you choose to diet and exercise on your own, you are the only one to hold yourself accountable, which makes it easier to ease up on your health journey.</p>Support increases weight loss success<img alt="Arms holding up words to spell Support" src="/-/media/national-files/images/hometown-health/2018/arms-holding-up-words-to-spell-support.jpg?h=300&w=300&sc_lang=en&hash=7D467EBFAA0A108D7E97CF7D1345F9ED" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive"> <p><em>By Mayo Clinic Health System staff</em></p> <p>Losing weight is hard. Doing it alone, though, is even harder. When you choose to diet and exercise on your own, you are the only one to hold yourself accountable, which makes it easier to ease up on your health journey.</p> <p>This is where the benefit of support groups specific to your needs comes in. Structured weight loss classes and support groups allow you to meet regularly to collaborate on ideas, and learn more from health professionals and others in similar situations. Facilitators and participants help you to jump-start your health journey and stay on track by holding you accountable, creating new ideas for meals, problem-solving challenges with social events and restaurant eating, sharing physical activity ideas and gaining support to push you through the tough times.</p> <p>If weight loss classes or support groups don’t fit your needs, asking your friends and family for support is just as beneficial. Support can include emotional or practical support, or inspiration. Knowing you have someone on your side willing to stand by you during the good times and bad throughout your journey is enough to keep you on track and feeling well while doing it.</p> <h4>Support networks are built and maintained by:</h4> <ul> <li><strong>Staying in touch with one another</strong>. Whichever side you’re on, answer texts, phone calls or emails, because support from someone you know can help you get back on track.</li> <li><strong>Understanding the necessity and importance of give and take. </strong>If you are thankful for your support network helping you along the way, tell them, and return the favor if they ever need help.</li> <li><strong>Learning who is best in what role. </strong>Someone you may be close to might not be able to fully support you right now because they are going through a rough patch of their own. Be open to finding someone who can support you in whatever way you need. </li> <li><strong>Finding a partner. </strong>Find someone who will walk or cook a healthy meal with you. The little things add up. </li> <li><strong>Joining in. </strong>Take advantage of community or neighborhood events. Socializing with those around you can be beneficial to your weight loss journey. </li> </ul> <p>If you want to lose and maintain a healthy weight, take others along with you, whether it’s friends, family, strangers or health professionals. Find your support team, whatever they may look like, to cheer you on every step of the way.</p> <p>Find additional <a href="/services-and-treatments/weight-management" target="_self" title="Opens in same window.">weight management resources</a> and <a href="/classes-and-events" target="_self" title="Opens in same window.">class information near you</a> that can help you reach your goals.</p> <p><em>Pam Franz is a registered nurse in <a href="/services-and-treatments/weight-management" target="_self" title="Opens in same window.">Weight Management Services</a> in Eau Claire, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2018/arms-holding-up-words-to-spell-support-cropped.jpg?h=401&iar=0&w=504&sc_lang=en&hash=ADFC14AC53C61D45B837A50F53E409DE" alt="Arms holding up words to spell Support cropped" width="504" height="401" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Micah Dorfner5/12/2022Food intolerances are common, but people often confuse intolerance with allergies. Learn how to distinguish between the two.Food intolerance or food allergy?<p>Food intolerances are common. But many people confuse food intolerance with food allergies.</p> <h2>Food allergy</h2> <p>A food allergy causes an immune system response that affects several organs within the body. These reactions can vary from moderate symptoms, like developing hives or a body rash, to life-threatening symptoms, such as anaphylaxis, which causes your immune system to release a flood of chemicals that can cause you to go into shock.</p> <h4>Other symptoms of food allergies include:</h4> <ul> <li>Tingling of the tongue, lips or face</li> <li>Swelling of the hands, feet, mouth or tongue</li> <li>Rapid pulse or arrhythmia</li> <li>Fainting or near-fainting spells</li> <li>Wheezing or trouble breathing</li> <li>Blurred vision</li> </ul> <p>If you experience any of these symptoms, you should speak to your primary care provider or seek emergency care.</p> <h2>Food intolerance</h2> <p>In contrast, food intolerances typically have less serious symptoms and are more commonly related to the gastrointestinal tract. The most common food intolerances are lactose (dairy) intolerance and food additive intolerances, such as MSG or flavor enhancers.</p> <p>Food intolerance is common. By adulthood, a degree of lactose intolerance develops in the vast majority of persons with African, Asian, Hispanic and American Indian descent. In African Americans, the incidence of lactose intolerance is over 70% by adulthood.</p> <h4>Food intolerances with digestive tract symptoms include:</h4> <ul> <li>Abdominal bloating </li> <li>Nonbloody diarrhea </li> <li>Excess gas </li> <li>Nausea</li> <li>Vomiting </li> <li>Abdominal pain or cramping</li> </ul> <p>Food intolerance does not cause bloody or black stools, fainting, abnormal heart rates, muscle weakness or seizures. If you experience any of these symptoms, you should speak to your primary care provider.</p> <h2>Tips, treatment for food intolerance</h2> <p>Tests can confirm food intolerance for certain foods or substances. Yet, there is no test for many foods. Try keeping a journal of what you eat, and monitor it for instances when symptoms flare up. You may discover specific foods that cause your symptoms. Try avoiding them in the future. Treatment depends on the intolerance. Typically, lactose intolerance is treated by avoiding or limiting lactose-containing foods or with drug therapy, such as an over-the-counter product.</p> <p>Since foods with dairy contain phosphorus, calcium, and other important minerals and vitamins, it's not recommended to avoid lactose unless the intolerance has been confirmed with testing. If a tolerance is confirmed, you can then discuss with your health care team whether a multivitamin or additional calcium and vitamin D supplementation are recommended.</p> <p>If you have concerns or questions about potential food allergy or food intolerance, meet with your primary care provider to determine if an allergist, gastroenterologist or registered dietitian needs to evaluate you.</p> <em><a href="/providers/victoria-louwagie-pac">Victoria Louwagie</a> is a physician assistant in Gastroenterology and Hepatology in <a href="/locations/mankato">Mankato</a>, Minnesota.</em><ul> <li>Celiac disease</li> <li>Cirrhosis</li> <li>Eosinophilic esophagitis, also called chronic immune system disease</li> <li>Liver disease</li> </ul>P.A.-C., M.S.<p>I have been a practicing physician assistant in the Mankato area for nearly 10 years. I am a grateful clinician, assistant professor and researcher. It brings me joy to care for my patients and provide disease-oriented, evidence-based medical care. I practice shared decision-making with each of my patients and their loved ones. </p> <p>I am an avid reader, and enjoy spending time with my family, camping and being on the water. </p><p><strong>Education</strong></p> <ul> <li>Master's degree, Physician Assistant Studies, Le Moyne College</li> <li>Certificate, Healthcare Administration and Management, University of Lynchburg</li> <li>Advanced Professional Practice degree, University of Lynchburg</li> </ul> <p><strong>Certification</strong></p> <ul> <li>National Commission on Certification of Physician Assistants (NCCPA)</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Academy of Doctoral Physician Assistants</li> <li>American Academy of Physician Assistants</li> <li>American College of Gastroenterology</li> <li>American Gastroenterological Association</li> <li>Minnesota Academy of Physician Assistants</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li><strong></strong>Assistant Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul> <br /> <br />Louwagie<img src="/-/media/shared-files/images/medical-professionals/full/mankato/victoria-louwagie-pac.jpg?h=280&iar=0&w=280&sc_lang=en&hash=79728B1A24856BB2CA6CA11472FCFFCE" alt="Victoria Louwagie PAC" width="280" height="280" DisableNVelocity="true" />{0EA59485-82F3-48D7-8DCC-7F3F87220D3F}Victoria<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15653421Victoria Louwagie, P.A.-C., M.S.1{DC3A2E5F-C54B-4BFA-AE04-95AE79DD4488}|{CDA27FD1-23E5-4D31-BD85-567A48B862F7}<img src="/-/media/national-files/images/hometown-health/2022/drinking-glass-of-milk.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0F3ACC05F28FC1896F82F511B249DE4D" alt="Drinking glass of milk" width="660" height="370" DisableNVelocity="true" />Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Micah Dorfner2/7/2018<p>Heart disease is one of the leading causes of death for adults in the U.S. However, there are several steps you can take to lower your risk of heart disease.</p>Q&A: It's never too early to develop heart-healthy habits<img alt="heart-being-held-by-male-and-female-hands" src="/-/media/national-files/images/hometown-health/2018/man-and-womans-hands-cradling-a-red-heart.jpg?h=225&w=400&sc_lang=en&hash=2CC1ED0B7C17835986096D6214FA8747" style="width: 400px; height: 225px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive"> <p><em>By Mayo Clinic Health System staff</em></p> <p>Heart disease, often called cardiovascular disease, refers to a variety of conditions that affect the heart and blood vessels. It’s one of the leading causes of death for adults in the United States. However, there are several steps you can take to lower your risk of heart disease. While there are some heart problems people are born with, you can prevent or better manage many heart-related issues by maintaining a healthy lifestyle. </p> <h4>What’s a good age to start acting heart healthy?</h4> <p>It’s never too early to develop heart healthy habits. Developing habits early on with good nutrition, exercise and regular health care visits can benefit you throughout life. Starting young not only strengthens your heart and may prevent disease, it also lays the foundation for better habits as an adult.</p> <h4>What kinds of foods are good for kids' and young adults’ hearts as they age?</h4> <p>Making smarter food choices leads to stronger cardiovascular and overall health. Our food selection also helps us maintain a healthy weight, which is essential for heart health. A diet rich in vegetables, fruits, low-fat dairy, whole grains and lean protein (chicken and fish) are the mainstay of heart health.</p> <h4>What are some ways kids and young adults can be heart healthy at various stages of development?</h4> <p>Being active is important at any age. For children ages 2 and older, it’s recommended they get at least 60 minutes of physical activity per day.</p> <p>Limit screen time. In other words, spend less time on the computer and television, and more time doing activities. Organized sports are a good way to get children involved in exercise and also promote teamwork. If a child is not interested in sports, other activities include walking, biking, jumping rope or simply playing outdoors.</p> <h4>What’s the impact of thinking about heart health from an early age?</h4> <p>Setting up heart healthy habits at a young age impacts future health. Maintaining a healthy weight, consuming heart healthy foods and exercising regularly can all significantly lower your chance of developing heart disease, and contributes to a longer and better quality life.</p> <h4>Is it ever too late to start thinking about heart health?</h4> <p>It’s never too late to start thinking about heart health. Even if you already have cardiovascular problems, making lifestyle changes and following a heart-healthy plan can reduce your chances of complications and help manage current problems. For instance, making lifestyle changes such as working towards a healthy weight, consuming a heart healthy diet and exercising regularly may even decrease the amount of medications you require — or make the ones you’re taking more effective.</p><img src="/-/media/national-files/images/hometown-health/2018/man-and-womans-hands-cradling-a-red-heart.jpg?h=225&iar=0&w=400&sc_lang=en&hash=7F9B9318CADAF0DBA5B695A364E64F8E" alt="Man and woman's hands cradling a red heart" width="400" height="225" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Michele Halterman9/23/2020When you hurt your back, did you know the pain could be caused by any part of your body that is compressed, stretched or has reduced blood flow? Learn how you can calm pain.Calming your pain: Is it possible?<p>When you have ongoing pain, it's common to assume the pain is stemming from the tissues that hurt. But did you know the pain could be caused by any part of your body that is compressed or stretched or has reduced blood flow?</p> <p>Research now shows that pain does not exist until the brain determines it does and that each person experiences pain differently. </p> <h4>Why we hurt</h4> <p>Stress, anxiety and your level of pain tolerance can affect how you experience pain and the severity of that pain. Unfortunately, determining the cause of pain is not always simple, and an MRI, CT scan or X-ray cannot always tell us why we hurt.</p> <p>Results from a study in the Journal of Bone & Joint Surgery showed diagnostic imaging discovered herniated discs in 36% and spinal stenosis in 21% of participants 60 and older. However, 90% of these people had no symptoms of low back pain.</p> <h4>Understanding pain</h4> <p>As a physical therapist, I help guide my patients in understanding what they can do about their pain, especially chronic pain. This type of pain, also known as persistent pain, is ongoing for more than three months and related to your brain signaling danger.</p> <p>When your brain is trying to interpret tissue signals, it may be influenced by temperature, pressure, stress, movement, blood flow and immunity. Then it may dedicate additional spinal cord and brain matter to processing incoming signals. When this occurs, your body and brain become hypersensitive to any variation in tissues. Your brain has created a sensitive environment with multiple inputs and a heightened danger signal. In essence, it's like a house alarm that normally triggers when a brick has been thrown through the window, but now sends the same signal when a leaf blows against the front door.</p> <p>Anxiety, emotional stress and nervousness trigger chemicals in the nervous system to bypass tissue messages to the brain and set off an alarm even before you think of moving or doing whatever it is that normally causes you pain.</p> <h4>How to calm pain</h4> <p>With this understanding of neuroscience and the hypersensitive brain, you can learn to move and free your body from false pain signals. To get started, you need to move your body to increase blood flow to your tissues, change the position of your body, and activate your nerves in your limbs and spine to send normal messages to the brain.</p> <h4>Learning to move again</h4> <p>The thought of moving again may be scary if you felt the movement was painful before, but gentle movement can be beneficial.</p> <h5>Here's how to get started moving again:</h5> <ul> <li><strong>Focus on breathing.</strong><br /> Taking deep breaths from your diaphragm can quiet the nervous system.</li> <li><strong>Start with small movements.</strong><br /> Focus on movements that you can perform for one or two minutes, and then gradually branch out to different or new ways of moving.</li> <li><strong>Focus on one section of your body.</strong><br /> Use mindfulness exercises to focus on and feel the gentle movement of one part of your body. Then let it go and move to another part. This can help you let go of the fear of feeling the pain.</li> <li><strong>Graduate to positions or thoughts of activities that previously would have triggered a pain response.</strong><br /> This helps train your brain away from pain using specific imagery and returns to normal response.</li> </ul> <p>Talk with your primary care provider or a physical therapist if you are experiencing chronic pain. The more you know about calming your pain, the better your life can be. You can do it.</p> <p><em><a href="/providers/carol-gardner-pt" target="_self" title="Opens in same window.">Carol Gardner</a> is a <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapist</a> in <a href="/locations/red-wing" target="_self" title="Opens in same window.">Red Wing</a>, Minnesota.</em></p> <ul> <li>Pelvic health for women and men</li> <li>Women's health issues</li> </ul> P.T. <p>I strive to assist people to get back to what matters most to them. I see patients with pelvic and spine issues, back pain, pre- and postpartum clients and osteoporosis issues. I believe in educating my patients in self symptom management.</p> <p>I have completed advanced certifications to deepen my expertise in areas related to pelvic health.</p> <p> I enjoy gardening, walking, traveling and activities with family and friends.</p> <p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Physical Therapy, University of Wisconsin-La Crosse</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Clinical Specialist, Women's Health Physical Therapy</li> <li>Pelvic Muscle Dysfunction Biofeedback, Biofeedback Certification International Alliance</li> </ul> Gardner<img src="/-/media/shared-files/images/medical-professionals/full/red-wing/rehab-services/carol-gardner-pt.jpg?h=280&iar=0&w=280&sc_lang=en&hash=70644BE0CC9078268D1F702C9DD70AC0" alt="Carol Gardner PT" width="280" height="280" DisableNVelocity="true" /> {6CE3A6BA-43F7-4D2E-A3D9-4805E50C1F4F}Carol<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15835073Carol Gardner, P.T. 1{986C767E-E5DE-43F5-957F-B4212DB8E384}|{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}<img src="/-/media/national-files/images/hometown-health/2020/stretching-yoga-pose-outdoors.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8A2CF9BFC21C2A0E67960643184577C9" alt="Stretching yoga pose outdoors" width="660" height="370" DisableNVelocity="true" />Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Michele Halterman4/9/2025Knee replacement surgery is the most effective treatment for alleviating the pain, swelling and loss of mobility from knee arthritis. Find out how nonsurgical options also can provide relief.Knee arthritis: 5 alternatives to knee replacement surgery<p>Millions of people in the U.S. endure knee arthritis, which can cause pain, stiffness and a decrease in activity level and quality of life. Eventually, this often leads to knee replacement surgery, which remains the most effective treatment for permanent pain relief. However, knee replacement should be reserved as a last resort.</p> <h2>Here are five minimally invasive options you and your orthopedic surgeon can try before committing to knee replacement surgery:</h2> <h3>1. Physical therapy</h3> <p>Knee arthritis typically makes the knee joint painful and stiff. Consulting with a physical therapist can increase the strength of the muscles supporting the knee and reduce pain. Therapists can use ice and heat, electrical nerve stimulation and other therapies to increase blood flow to the knee. Working with a licensed therapist can be much more effective than what you can do on your own.</p> <h3>2. Medications</h3> <p>Although physicians typically try to limit the number of medications prescribed, several medications for knee arthritis have been proven to help. Over-the-counter nonsteroidal anti-inflammatory medications, also known as NSAIDs, can effectively reduce pain, swelling and stiffness associated with knee arthritis. These medications are readily available and typically well-tolerated by most patients. In addition to NSAIDs, several supplements also reduce knee arthritis symptoms. The two most commonly used for knee arthritis are glucosamine sulfate and hyaluronic acid.</p> <h3>3. Injections</h3> <p>If you continue to experience pain from knee arthritis after trying medications and therapy, the next step typically is to get an injection. This process usually starts with a corticosteroid injection, which can drastically reduce inflammation, pain and swelling. These injections can be effective and long-lasting. If cortisone doesn't provide the desired relief, hyaluronic acid injections are another option. Hyaluronic acid lubricates the knee, which can improve mobility and reduce pain.</p> <h3>4. Arthroscopic surgery</h3> <p>Arthroscopic surgery is a minimally invasive knee surgery performed with a camera inserted through small incisions. The surgery can be used to repair cartilage or meniscus tears inside the knee, or to remove bone or cartilage fragments. If you have symptoms such as sharp pain, catching or locking, then arthroscopic surgery may be option for you. This type of surgery could delay or eliminate the need for knee replacement surgery.</p> <h3>5. Osteotomy</h3> <p>With osteotomy, the surgeon makes a cut in your shin or thigh bone to shift the load away from the arthritic area of the knee. This procedure typically is recommended for younger patients with deformity or damage only in one side of the knee. Although considered an alternative to knee replacement surgery, osteotomy might make it difficult for patients to undergo successful knee replacement surgery at a later time.</p> <h2>Making the decision</h2> <p>When it comes to choosing a treatment for knee arthritis, your surgeon should consider all possible alternatives to knee replacement surgery. Deciding on the best possible treatment option is a process both you and your surgeon should determine together.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/looking-at-hand-on-knee.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3F06A076F7B47DC26E7B3FB9CADEB0AD" alt="Looking at hand on knee" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Michele Halterman6/16/2022Resiliency is the ability to become strong, healthy or successful after something bad happens. Learn how you can provide support and help build resiliency when children face bullying, illness or divorce.Fostering resiliency in children<p>Life happens, even for children. Bullying, school problems, hunger, problems at home, illness, divorce. The list goes on.</p> <p><a href="/hometown-health/speaking-of-health/stressed-out-kids" target="_self" title="Opens in same window.">Stress can affect children</a> the same way it affects adults. But what can you do to help those children who need a little support?</p> <p>Resiliency is the ability to become strong, healthy or successful again after something bad happens. It can turn victims into survivors and enable survivors to succeed.</p> <h2>Adults can help build resiliency in children by: </h2> <ul> <li><strong>Encouraging communication of feelings</strong><br /> It's important for children to feel safe to communicate their feelings.</li> <li><strong>Avoiding isolation</strong><br /> Make sure your children are interacting with other people.</li> <li><strong>Teaching empathy through helping others</strong><br /> Helping others can empower children to overcome their own situation.</li> <li><strong>Practicing self-care</strong><br /> To support good health, maintain a routine. <a href="/hometown-health/speaking-of-health/sleep-an-essential-element-of-success-for-children" target="_self" title="Opens in same window.">Get enough sleep</a>, eat nutritious food and allow for downtime.</li> <li><strong>Acknowledging that change is a part of life</strong><br /> Although it can be challenging to accept and adapt to change, everyone can get through it.</li> </ul> <p>These techniques can reduce the number of lost school days, illnesses, emotional outbursts and feelings of worry and fear. If these techniques don't help your children as much as you had hoped, seek help from mental health professionals to ensure your child's safety and well-being.</p> <h2>Learn more about resiliency:</h2> <ul> <li>Children often are referred to as the forgotten or invisible grievers. Learn <a href="/hometown-health/speaking-of-health/do-children-grieve" target="_self" title="Opens in same window.">how to support grieving children</a>.</li> <li>Texting and social media can be a great way for children to connect. However, they also can be avenues for bullying.</li> <li>Confident children know their own goodness, and that they are worthy of being loved and belonging with their friends and family. Use these <a href="/hometown-health/speaking-of-health/practical-ways-to-raise-confident-kids" target="_self" title="Opens in same window.">practical ways to raise healthy children</a>.</li> </ul> <p><a href="/providers/julie-conway-lpc" target="_self" title="Opens in same window."><em>Julie Conway</em></a><em> is a counselor in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Adolescents with mental health and/or alcohol and other drug abuse issues</li> </ul>L.P.C.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Social Work, University of Wisconsin - La Crosse</li> <li>Master's degree, Community Counseling, Winona State University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Licensed Professional Counselor</li> </ul>Conway<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/julie-conway-ms-lpc.jpg?h=280&iar=0&w=280&sc_lang=en&hash=8F708432A91E86501D87B857B9A47255" alt="Julie Conway MS LPC" width="280" height="280" DisableNVelocity="true" />Julie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12730475Julie Conway, L.P.C.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2022/teen-smiling-yellow-backpack-straps.jpg?h=370&iar=0&w=660&sc_lang=en&hash=83616F80541DB756BCC572EAAB16D5C1" alt="Teen smiling, wearing backpack with yellow straps" width="660" height="370" DisableNVelocity="true" />ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Child DevelopmentWe all want our children to grow up happy and healthy. The reality is most all of them do — but at vastly different rates. Experts across Mayo Clinic Health System see thousands of children each year, and have the experience and resources to know what is normal and what may be cause for closer observation. This includes not only physical and motor skills development, but psychological and social skill advancement.Michele Halterman3/10/2018<p>Even though shopping the perimeter of the grocery store is the best place to get nutritious foods, sometimes you need cereal, canned foods or peanut butter. Know what to look for on the packages before you put those items in your cart.</p>Grocery store tour: Shopping the dry goods<p>Even though shopping the perimeter of the grocery store is the best place to get nutritious foods, sometimes you just can’t avoid those center aisles. Whether you need cereal, canned foods or simple goods, such as peanut butter, you should always know what to look for on the packages before you put those items in your cart.</p> <p>There are many health claims on food packages that can be misleading. Packages that sit on the shelf at eye level with the bright colors and fun prizes inside are usually aiming towards children. Some companies target adults by claiming their products help lower cholesterol or that they’re a good source of some specific nutrient. However, the only way to understand the facts is to take the time to read the nutrition label. Some of the most nutritious foods don’t come with labels, but if the food you choose does, make sure you really know what it means.</p> <p>Watch health educator Katie Johnson explain food claims, nutritional value importance and more in this video:</p> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/FN4wy-A8Hi0" title="Grocery store tour: Shopping the dry goods" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <h4>Watch other grocery store tours:</h4> <li><a href="/hometown-health/speaking-of-health/grocery-store-tour-shopping-the-perimeter" target="_self" title="Opens in same window.">Shopping the perimeter</a></li> <li><a href="/hometown-health/speaking-of-health/grocery-store-tour-selecting-meat-and-dairy" target="_self" title="Opens in same window.">Selecting meat and dairy</a></li> <li><a href="/hometown-health/speaking-of-health/grocery-store-tour-shopping-the-produce-aisle" target="_self" title="Opens in same window.">Shopping the produce aisle</a></li><img src="/-/media/national-files/images/hometown-health/2018/colorful-cereal-in-a-bowl.jpg?h=326&iar=0&w=326&sc_lang=en&hash=14333E2728F9E04F843327AB2EF70966" alt="colorful cereal in a bowl" width="326" height="326" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Michele Halterman3/23/2018<p> Most of us grocery shop in the center aisles, when we really should mainly be shopping in the outside perimeters. This is where you’ll find the freshest foods, including produce, meat and dairy.</p>Grocery store tour: Shopping the perimeter<p>Have you ever wondered if you’re grocery shopping the right way? Most of us tend to spend the most time shopping in the center aisles, when you really should spend the most time shopping in the outside perimeters of the store. This is where you’ll find the freshest foods, including produce, meat and dairy. </p> <p>Fresh foods are generally healthier than the processed foods you’ll find in the center aisles. Because the items in the outside perimeter are fresh, you can better control the fat and sodium intake in your diet. Maintaining a healthy diet means watching what is added to foods, as well. Many foods in the center aisles contain preservatives. Preservatives are chemicals or additives in food that keep them shelf stable and make them last longer. If foods don’t have any added preservatives, then they need to be refrigerated to keep fresh.</p> <h4>Watch health educator Katie Johnson explain more about preservatives, shopping along the perimeters and more in this video:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/RjwfxfBPq3Y" title="Grocery store tour: Shopping the perimeter" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <h4>Watch other grocery store tours:</h4> <ul> <li><a href="/hometown-health/speaking-of-health/grocery-store-tour-selecting-meat-and-dairy" target="_self" title="Opens in same window.">Selecting meat and dairy</a></li> <li><a href="/hometown-health/speaking-of-health/grocery-store-tour-shopping-the-dry-goods" target="_self" title="Opens in same window.">Shopping the dry goods</a></li> <li><a href="/hometown-health/speaking-of-health/grocery-store-tour-shopping-the-produce-aisle" target="_self" title="Opens in same window.">Shopping the produce aisle</a></li> </ul><img src="/-/media/national-files/images/hometown-health/2018/apple-varieties-in-a-grocery-store.jpg?h=397&iar=0&w=397&sc_lang=en&hash=1682647F630096E48481E543B8DA7BDA" alt="apple varieties in a grocery store" width="397" height="397" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Michele Halterman2/22/2023While closing your eyes for a few minutes during your busy day may seem like a good idea, it’s important to consider the effects napping may bring. Here are tricks to get the most out of your naps.How to get the most out of napping<p>While closing your eyes for a few minutes during your busy day may seem like a good idea, it’s important to consider the effects napping may bring.</p> <p>The time of day and length of time you nap can provide benefits or create problems. Knowing when to nap and providing yourself with a suitable napping environment will produce the greatest benefits.</p> <h2>Consider why you’re napping</h2> <p>Before lying down to take a daily nap, you may want to consider why you began taking these naps. If you've been working the night shift or are a new parent, you probably have reason to be closing your eyes for a while. On the other hand, if you feel that a nap is essential to your daily functioning, you may have a bigger health problem that should be addressed with your health care team.</p> <p>Talking to your health care team is the best way to find out why you’re experiencing increased fatigue. The reasons for your exhaustion could be anything from having a sleep disorder, such as sleep apnea, to a side effect from a new medication.</p> <h2>Drawbacks to napping</h2> <h3>Two drawbacks of napping include:</h3> <p><strong>1. Sleep inertia<br /> </strong>Sleep inertia can involve waking up feeling groggy and disoriented after a nap. This can become a problem if you have places to be or tasks to complete after you wake up from your nap.</p> <p><strong>2. Nighttime sleep problems<br /> </strong>Problems can arise if your naps are too long or close to bedtime. Try not to nap if you experience insomnia or poor sleep quality at night, as napping may worsen these problems. Short naps are the best when trying to avoid interference with nighttime sleep.</p> <h2>Benefits of napping</h2> <h3>Taking naps can provide many benefits to your health, such as:</h3> <ul> <li>Improved mood</li> <li>Quicker reaction time</li> <li>Better memory</li> <li>Increased alertness</li> <li>Reduced fatigue</li> <li>Enhanced relaxation</li> </ul> <h2>When to nap</h2> <h3>Did you know there are certain times when a nap may be more beneficial to your health? Take a nap:</h3> <ul> <li>If you're experiencing new fatigue, but monitor your symptoms and discuss any concerns with your health care team.</li> <li>If you're about to experience sleep loss, such as a long travel day or workday.</li> <li>If you want to make naps a part of your daily routine. In this situation, have a planned time of day and length of time to keep your schedule on track.</li> </ul> <h2>Best way to nap</h2> <h3>Here are four tricks to make your naps more effective:</h3> <p><strong>1. Set aside an allotted amount of time.<br /> </strong>If you wake up feeling groggy after a nap, you're sleeping too long. The ideal nap length is between 15 and 30 minutes.</p> <p><strong>2. Plan to take naps in the afternoon.<br /> </strong>The idea time to nap is around 2 p.m. or 3 p.m. This is because you’re likely to experience a lower level of alertness or sleepiness following lunch. You're also more like to avoid interference with nighttime sleep if you nap around this time. However, some people may adjust their napping times to fit their work or school schedules.</p> <p><strong>3. Create a tranquil environment.<br /> </strong>Some people struggle to sleep during the day, but there are actions you can take to help you become more relaxed. Eliminate distractions when napping, so turn off any screens, such as your phone. Find a quiet space with minimal light to improve your naps. Adjusting the room temperature to what is comfortable for you also can make your space more comfortable.</p> <p><strong>4. Give yourself time to wake up.<br /> </strong>Allowing yourself enough time to wake up before resuming activities after your nap is important, as you may feel groggy or less alert.</p> <p>Talk with your health care team if you struggle with ongoing daytime fatigue. A physical exam or sleep study may be necessary to rule out health conditions that are affecting the quality of your sleep.</p> <p><em><a href="/providers/tiffany-casper-do" target="_self" title="Opens in same window">Tiffany Casper, D.O.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/tomah" target="_self" title="Opens in same window.">Tomah</a>, Wisconsin.</em></p><ul> <li>Pediatrics</li> <li>Skin conditions</li> <li>Women's health</li> </ul>D.O.<p><strong>Education</strong></p> <ul> <li>Doctor of Osteopathic Medicine, A.T. Still University – Kirksville College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Mercy Health System</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Medicine </li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Osteopathic Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Casper<img src="/-/media/shared-files/images/medical-professionals/full/tomah/tiffany-casper-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=1A30A61D9D6C113EA2C621F6A4AD3702" alt="Tiffany Casper DO" width="280" height="280" DisableNVelocity="true" />Tiffany<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15595587Tiffany Casper, D.O.1<img src="/-/media/national-files/images/hometown-health/2023/person-napping-head-on-pillow.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5594218167E935F7E4E89F22641203A7" alt="Person napping with head on pillow" width="660" height="370" DisableNVelocity="true" />SleepSleep is essential to good health. It's one of the body's basic needs. But, what do you do when you have troubles sleeping, or getting enough hours of sleep? Michele Halterman2/8/2022Ectopic pregnancies may be rare. However, when one is discovered, it needs to be taken seriously. Learn about common themes discussed during the diagnosis of an ectopic pregnancy.Ectopic pregnancy: Signs, treatment and future fertility<p><a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/ectopic-pregnancy/symptoms-causes/syc-20372088?_ga=2.199951982.1127688332.1642996394-1714672406.1642431452" target="_blank" title="Opens in new window.">Ectopic pregnancies</a> may be rare. However, when an ectopic pregnancy is discovered, it needs to be taken seriously.</p> <p>Ectopic pregnancy occurs when a fertilized egg attaches itself outside of the uterus. It attaches to the fallopian tube 90% of the time. However, in other instances, it can attach to the ovary, cesarean section scar, cervix or even the abdomen. If attached to the abdomen, the danger of complications is significantly increased.</p> <p>It's rare for an ectopic pregnancy to coexist with another normal intrauterine pregnancy. Yet it's still possible and poses critical challenges in diagnosis and treatment. Luckily, it's an uncommon event, except in patients receiving fertility treatments, where the prevalence is a ratio of 1 in 100, as compared to 1 in 30,000 in spontaneous pregnancies.</p> <h4>Signs, symptoms of ectopic pregnancy</h4> <p>An ectopic pregnancy doesn't have specific symptoms and e health care professionals can easily miss it if they fail to keep it in mind. Symptoms related to ectopic pregnancy do vary between showing no symptoms, especially during the very early stages, to severe lower abdominal pain with dizziness caused by massive internal bleeding.</p> <p>Presentation and symptoms also vary, depending on the location of the ectopic implantation. Commonly reported symptoms of ectopic pregnancies include vaginal spotting and vague lower abdominal or pelvic pain.</p> <p>It's important to track your periods. When you miss your period, especially if you're not on reliable birth control, you should perform a pregnancy test and follow up with your health care professional as soon as possible. This helps you document a potential pregnancy's location and viability at around five to six weeks of gestation and increases the chance of early diagnosis and treatment of an ectopic pregnancy.</p> <p>Visit your health care professional even sooner if you experience abnormal bleeding or pain with a positive pregnancy test, as these could be early signs of an impending rupture.</p> <h4>Ectopic pregnancy diagnosis</h4> <p>Ectopic pregnancy is diagnosed when the gestational sac with a live fetal pole or yolk sac is found outside an empty uterine cavity. Sometimes, diagnosis can be challenging if the ectopic pregnancy is in its early stage and the sac is not yet visible by ultrasound.</p> <p>In these scenarios, pregnancy hormone levels are monitored for the rate of rise, which tends to be abnormal in cases of pregnancy in ectopic implantations.</p> <p>Treatment for ectopic pregnancy</p> <p>Treatment of ectopic pregnancy depends on the gestational age, symptoms and location of the gestational sac. Advanced ectopic pregnancy usually presents with rupture, pain or severe bleeding, and in these situations, surgical treatments are often indicated for surgical removal of the pregnancy and control of bleeding to protect the mother.</p> <p>If ectopic pregnancy is diagnosed early and before the onset of symptoms, a medication can be used to stop the growth of the pregnancy and allow the body to absorb it without removing the fallopian tubes.</p> <p>In the case of a tubal pregnancy, surgical treatments include laparoscopic surgery to remove the ectopic tissue and repair the fallopian tube. If the fallopian tube is significantly damaged, it might need to be removed. The condition of the fallopian tube and degree of damage by the ectopic pregnancy usually determines the recommended approach.</p> <h4>Risk factors for ectopic pregnancy</h4> <p>Bearing in mind that about half of ectopic pregnancies occur in patients who have no known risk factors. The risk of ectopic pregnancy increases when the free passage of the fertilized egg from getting into the uterine cavity is affected.</p> <h5>This may include:</h5> <ul> <li>Scarred or interrupted fallopian tube, whether due to prior surgery or infection ― most commonly chlamydia</li> <li>Pregnancies that are a product of infertility treatment</li> <li>A prior ectopic pregnancy</li> </ul> <h4>Coping, support after ectopic pregnancy</h4> <p>Ectopic pregnancy is a pregnancy where an embryo is formed causing the emotional toll of this loss. This rivals the experience of women who experience a miscarriage or neonatal loss. Add to that the possibility of losing an organ like the fallopian tube and the anxiety of not being able to conceive in the future. The process of <a href="/hometown-health/speaking-of-health/seeking-support-when-grieving" target="_self" title="Opens in same window.">grief after a pregnancy loss</a> could take several weeks. You might feel numb, sad, guilty, angry and apprehensive about the future.</p> <h5>It's normal to feel this way. Continue to take care of yourself with:</h5> <ul> <li>Adequate sleep</li> <li>Exercise</li> <li>Proper nutrition</li> <li>Avoidance of drugs and alcohol, and cigarette smoking ― all of which might negatively affect the grieving process</li> </ul> <p>Most women who experience ectopic pregnancy and treatment will achieve a successful pregnancy in the future, even if they've lost one fallopian tube as part of the therapy. There is a 10% risk of recurrence, which is why it's important to work with your health care team when planning for a future pregnancy. Also, early documentation of an intrauterine gestational sac is of paramount importance.</p> <h4>Chance of conceiving after ectopic pregnancy</h4> <p>Since fertility treatments are risk factors for ectopic pregnancy and since ectopic pregnancy is a risk factor for another ectopic pregnancy, treatment of ectopic pregnancy and how that treatment affects fertility is a complex issue.</p> <p>Studies that have looked at the difference in fertility after treatment of ectopic pregnancy showed that medical treatment of early ectopic pregnancies with medication, compared to surgical treatments sparing the fallopian tube, had no adverse fertility outcome.</p> <p>Also, women who were treated with surgery that spared the fallopian tubes and fallopian tube removal surgery had almost the same rate of pregnancy after treatment, given the other fallopian tube is healthy.</p> <p>In the event the other fallopian tube is damaged or absent, it's better to try to spare the fallopian tube to maximize fertility potential, with the slight increased risk of recurrence. In the event of severe damage of the tube and need for its removal, the reproductive potential with no functional fallopian tubes will be severely compromised. If this is the case, fertility treatments like in vitro fertilization will be the only way to achieve pregnancy.</p> <em><a href="/providers/tarek-khalife-md" target="_self" title="Opens in same window">Tarek Khalife, M.D.</a>, is an OB-GYN in <a href="/locations/mankato" target="_self" title="Opens in same window">Mankato</a> and <a href="/locations/new-prague" target="_self" title="Opens in same window">New Prague</a>, Minnesota.</em><ul> <li>Adenomyosis</li> <li>Endometriosis</li> <li>Female sexual dysfunction, pain and vulvar disease, such as lichen sclerosus and lichen planus</li> <li>Fibroid treatment</li> <li>Heavy or irregular menstrual bleeding</li> <li>In-office treatment, including LEEP procedures, colposcopy and hysteroscopy</li> <li>Minimally invasive surgery for treatment of gynecologic disorders, such as laparoscopy and hysteroscopy</li> <li>Obstetric and advanced gynecologic 3D ultrasound</li> <li>Pelvic pain</li> <li>Robotic surgery</li> <li>Urine incontinence</li> <li>Uterovaginal prolapse</li> <li>Vaginal natural orifice transluminal endoscopic surgery (VNOTES)</li> </ul>M.D.<p>Every patient will have ample time to explain her condition and shed light on what matters to her most, as we navigate her treatment options. It is very imperative that the patient understands our partnership in managing her condition and identifies us as her support team to focus on her treatment and recovery.</p> <p>The most rewarding aspect of my time with the patient is when I get to educate them about their body and how disease affects its balance. It is my goal to allow my patient to graduate from her care with enough knowledge that she would use to teach and advocate for herself and to other women in her community. This way touches the patient’s life and the communities' lives at large.</p> <p>Outside of work, I do enjoy biking, swimming and camping. I am also a remote-control plane hobbyist, and I love grilling and cooking Lebanese cuisine.</p><p><strong>Education</strong></p> <ul> <li>Beirut Arab University</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>Obstetrics and Gynecology, Henry Ford Health System-Wayne State University</li> <li>Obstetrics and Gynecology, American University of Beirut Medical Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Minimally Invasive Gynecologic Surgery, American Board of Obstetrics and Gynecology</li> <li>Fellow, American College of Obstetrics and Gynecology</li> </ul> <p><strong> Memberships</strong></p> <ul> <li>American Association of Gynecologic Laparoscopists</li> <li>American College of Obstetrics and Gynecology</li> <li>International Society for the Study of Women's Sexual Health</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Obstetrics and Gynecology, Mayo Clinic College of Medicine and Science</li> </ul>Khalife<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/tarek-khalife-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A39C3DF2BF499DCA00FE29E1F7699D5D" alt="Tarek Khalife MD" width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/36088274/" target="_blank" title="Opens in new window">Retroperitoneal causes of genitourinary pain syndromes: Systemic approach to evaluation and management</a>, October 2022.</li> <li><a rel="noopener" href="https://www.sciencedirect.com/science/article/pii/S0002937821006074?via%3Dihub" target="_blank" title="Opens in new window">Pregnancy with IUD in place</a>, May 2021.</li> <li><a rel="noopener" href="https://www.liebertpub.com/doi/abs/10.1089/gyn.2021.0041" target="_blank" title="Opens in a new window">Intraoperative genitourinary injuries during a hysterectomy: Risks, management, and mitigation strategies</a>, May 2021.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/30398979" target="_blank" title="Opens in new window. ">The endogenous opioid system: Role and dysfunction caused by opioid therapy</a>, March 2019.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/28118169" target="_blank" title="Opens in new window. ">The K-technique: A novel technique for laparoscopic apical suspension using barbed sutures</a>, April 2017.</li> </ul>{CA02D1B4-DD8D-4C67-B975-FFCAEB25CAEF}Tarek<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20407092Tarek Khalife, M.D.1{83EB2AA2-1436-4DDC-B7BB-51F8E6A87FC9}|{54693F31-87AF-4B21-91DB-1DEC1E21F878}<img src="/-/media/national-files/images/hometown-health/2022/ivory-sweater-hoop-earrings.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0A6D14A891C31291520763FA127A8F37" alt="Wearing ivory knit sweater and hoop earrings, looking out window" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Prenatal CareOB-GYN and Family Medicine providers offer exactly the care you need for starting or growing your family, including pregnancy planning and prenatal care.Dawn Haller2/1/2024<p>Setting resolutions and goals may be done with the best intentions, but it's easy to have them break down over time. So why do people fall short of goals to make healthy diet and lifestyle changes?</p>Establishing healthy behaviors that stick<p>Many people make <a href="/hometown-health/speaking-of-health/resolutions" target="_self" title="Opens in same window">healthy resolutions</a> or set goals with the best intentions, only to see them fall short or break down completely over time. It's common to read about research and medical studies that promote a healthy lifestyle's psychological and physical benefits. So why do you still fall short of your intentions to make <a href="/hometown-health/speaking-of-health/12-healthy-habits-for-families" target="_self" title="Opens in same window">healthy diet and lifestyle changes</a>?</p> <h2>A few common reasons people tend to give up on changes to behaviors include:</h2> <ul> <li><strong>Perceived dislike of exercise</strong><br /> Studies show that people overestimate how difficult it is to exercise. As a result, you may tend to give up before you even begin a new exercise program or training regimen.</li> <li><strong>Toxic eating environment</strong><br /> Quick, cheap and tempting food options are a constant pressure from a multibillion-dollar marketing industry. These highly targeted psychological messages may leave you wondering if you're in charge of your eating behaviors or, instead, are being conditioned to choose convenience over more nutritious options.</li> <li><strong>Setting too many goals or creating an all-or-nothing plan</strong><br /> People tend to change too many behaviors or routines at a time. Creating restrictive changes that lead to feelings of deprivation or lower mood can result in an "on or off" or "all or nothing" plan that can't be maintained.</li> <li><strong>Consistency is complicated</strong><br /> Whether you choose a lifelong goal or a temporary objective, staying motivated requires complex planning and follow-through. Establishing <a href="/hometown-health/speaking-of-health/making-new-years-resolutions-that-stick" target="_self" title="Opens in same window">healthy behaviors that stick</a> requires a different mindset and recognition that putting effort toward something important contributes to the promotion of an improved mood and well-being.</li> </ul> <h2>Tips to stay motivated</h2> <h3>If you want to make your habits permanent, you need to:</h3> <ul> <li>Alter your mindset and challenge negative thoughts and beliefs.</li> <li>Anticipate lapses and recover quickly.</li> <li>Remind yourself that you deserve to feel good and that your plan will get you there.</li> <li>Start with one small change, celebrate success and add more changes over time.</li> <li>Use positive self-talk such as "I'm an exerciser" and "I'm someone who eats healthy options," to embed identity shifts into your plan.</li> </ul> <p>Your thoughts determine how you feel about yourself, which affects your behavior, mood, interactions with others and progress toward your goals. When you identify positive thoughts, make sure to practice them. </p> <h3>Consider using this path to help spur on your healthy behaviors:</h3> <ul> <li><strong>Getting started:</strong> <ul> <li>Develop <a href="/hometown-health/speaking-of-health/setting-smart-goals" target="_self" title="Opens in same window">positive and realistic goals</a> for yourself.</li> <li>Find multiple ways to remind yourself of your goal.</li> <li>Identify why you want to meet this goal. </li> <li>List the behaviors you feel are unhealthy.</li> <li>Select one of the identified behaviors that you would like to change.</li> </ul> </li> </ul> <ul> <li><strong>Creating your plan of action:</strong> <ul> <li>Brainstorm ways to change this behavior and start small.</li> <li>Devise a plan to promote this strategy.</li> <li>Identify potential obstacles that could interfere with your goal.</li> <li>Identify your options for support.</li> <li>Set a date for when you want to achieve your goal.</li> </ul> </li> </ul> <ul> <li><strong>Reaching your goal:</strong> <ul> <li>Counter destructive thoughts with more constructive ones.</li> <li>Consider what you must do to maintain change when you complete your goal.</li> <li>Don't expect perfection; anticipate imperfection.</li> <li>Evaluate your successes when you reach your goal.</li> <li>Note how you feel now that you have worked to meet your goal.</li> <li>Select another goal and restart the process when you're ready.</li> </ul> </li> </ul> <h2>Don't let a lapse keep you from your goal</h2> <p>A lapse is a slight error, slip or pause in progress most people face at some point during the journey. Relapse occurs when lapses string together and a person returns to their former behavior. Remember that a lapse is normal and doesn't always lead to a relapse. Anticipate that a setback can and will occur. Then, figure out which triggers led to the lapse. </p> <h3>Common triggers include:</h3> <ul> <li>A certain time of day.</li> <li>A challenging life event.</li> <li>Negative emotions, boredom or a shift from your initial intentions.</li> <li>Particular foods and visual cues.</li> <li>People who have an influence on your life.</li> <li>Social events, celebrations or your customs.</li> </ul> <p>Remember, the danger is not the slip but how you react to that lapse.</p> <p><em><a href="/providers/lisa-hardesty-phd-lp" target="_self" title="Opens in same window">Lisa Hardesty, Ph.D.,</a></em><em> is a clinical psychologist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window">Psychiatry & Psychology</a> in </em><em><a href="/locations/mankato" target="_self" title="Opens in same window">Mankato</a></em><em>, Minnesota.</em></p><ul> <li>Co-morbid medical and behavioral health conditions</li> <li>Integrated behavioral health</li> <li>Optimizing health and well-being</li> <li>Weight management</li> </ul>Ph.D., L.P.<p><strong>Education</strong></p> <ul> <li>Master's degree, Health and Clinical Psychology, Minnesota State University-Mankato</li> <li>Doctor of Philosophy degree, Western Michigan University-Kalamazoo</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Post Doctoral Fellowship, Health Psychology, Henry Ford Hospital</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Clinical Health Psychology, American Board of Professional Psychology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Psychology, Mayo Clinic College of Medicine and Science</li> </ul>Hardesty<img src="/-/media/shared-files/images/medical-professionals/full/mankato/lisa-hardesty-phdlp.jpg?h=280&iar=0&w=280&hash=0F1D1C9CA069ED45487CBB5A40FD588A" alt="Lisa Hardesty, Ph.D., L.P." width="280" height="280" DisableNVelocity="true" />{A9A6221E-C37E-4EAE-B151-BFE624FC511D}Lisa<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>11683651Lisa Hardesty, Ph.D., L.P.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}|{94B2E140-AEF8-44BA-B6A9-4538B77501BC}<img src="/-/media/national-files/images/hometown-health/2024/vacuum-sealed-veggies.jpg?h=370&iar=0&w=660&sc_lang=en&hash=25047ED9F4A72B67718F0939487592BD" alt="vacuum sealed veggies" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Michele Halterman6/29/2023The term "menopause" can be daunting on its own, but coupled with the words "abnormal bleeding" may cause extra concern. Consulting with your care team will determine the cause and next steps.Should you be concerned about postmenopausal bleeding?<p>The term "menopause" can be daunting on its own, but couple it with the words "abnormal bleeding" or "postmenopausal bleeding," and you may begin to feel overwhelmed by questions about what that means for your health.</p> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397" target="_blank" title="Opens in a new window.">Menopause</a> is a normal, physiological event that can occur naturally or be induced through medical interventions, such as surgery, pelvic radiation therapy, chemotherapy or systemic illness. Women are considered in menopause once they have not had a menstrual cycle for one year.</p> <p>During menopause, women may experience a return of vaginal bleeding that may be light spotting or a heavy flow. In these situations, women should seek guidance from their care team.</p> <h2>Is the return of bleeding normal?</h2> <p>Bleeding after menopause is not normal. Although bleeding may be caused by your activity level, or by an infection or thinning of the vaginal or vulvar skin, it also could be a symptom of something more serious. Postmenopausal bleeding could be caused by uterine polyps or fibroids, thyroid abnormalities, bleeding disorders or thinning of the lining of the uterus, called atrophy.</p> <p>More serious causes of postmenopausal bleeding include cancer and hyperplasia, which is the formation of abnormal cells within the lining of the uterus.</p> <h3>Common risk factors for hyperplasia or cancer include:</h3> <ul> <li>Having a thyroid disorder</li> <li>Having diabetes</li> <li>Having polycystic ovarian syndrome</li> <li>Being obese</li> <li>Later onset of menopause — mid to late 50s</li> <li>Smoking</li> </ul> <h2>Seeking medical attention</h2> <p>Women who have experienced a return of bleeding during menopause should consult with their care team right away. After a physical exam and further questions, your health care professional may recommendation a pelvic ultrasound.</p> <p>Based on the results of the ultrasound, your care team may proceed with an endometrial biopsy if it appears the endometrial lining is thickened. A biopsy is a procedure that removes a small amount of tissue from the uterus for review by the pathology lab. The tissue can be obtained through different approaches, including hysteroscopy or dilation and curettage. Your care team can help you determine the right approach for you.</p> <p>During a hysteroscopy procedure, a small camera is inserted through the cervix into the uterus to visualize the inside of the uterine cavity. The benefits of this procedure are that the biopsy is performed under direct visualization, and if any polyps or fibroids are present, the health care professional can treat and remove them during the procedure.</p> <p>Depending on the reason for the bleeding, your care team can tell you about treatment options and recommend the best choice for you. Options range from hormone therapy to surgical procedures, such as a hysterectomy. If your bleeding is caused by cancer, your health care professional will refer you to a gynecologic oncologist.</p> <p> Simply put, women who experience postmenopausal bleeding should take it seriously and seek medical attention right away. There are many causes of bleeding after menopause. Careful evaluation can determine the cause and best treatment option for you.</p> <p><a href="/providers/katie-casper-md" target="_self" title="Opens in same window."><em>Katie Casper, M.D.</em></a><em>, is an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Advocacy</li> <li>Contraception</li> <li>Evaluation and management of pelvic pain</li> <li>High-risk pregnancy</li> <li>International health care of underserved communities</li> <li>Laparoscopic surgery and other minimally invasive surgical techniques</li> <li>Preventive health care</li> <li>Treatment of abnormal uterine bleeding</li> </ul>M.D.<p>I believe the best patient care happens through listening and education. Health care is always evolving, and I believe it is critical for providers to pursue excellence through continued education and innovation.</p> <p>I will strive to empower you with knowledge so we can work together to create your individualized management plan. I look forward to getting to know you and want to optimize your health care throughout your lifespan.</p> <p>I enjoy many hobbies and actives in my spare time. After work, I generally partake in some sort of physical activity – kickboxing, strength training or hiking. I enjoy spending time at home with my husband and puppy dog. I am an avid golfer and like being outside any chance I get! I also enjoy creating healthy and delicious plant-based meals for my family.</p><p><strong>Education</strong></p> <ul> <li>Doctor of Medicine, University of Minnesota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Obstetrics and Gynecology, Creighton University School of Medicine-Phoenix</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Certified Holistic Nutritionist, American Fitness Professionals & Associates </li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Gynecologic Laparoscopists</li> <li>American College of Obstetrics & Gynecology </li> </ul>Casper<img src="/-/media/shared-files/images/medical-professionals/full/mankato/katie-casper-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=70DE9576AA96A312C2C550A790093017" alt="Katie Casper, M.D." width="280" height="280" DisableNVelocity="true" />Katie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30122594 Katie Casper, M.D.1{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}|{54693F31-87AF-4B21-91DB-1DEC1E21F878}<img src="/-/media/national-files/images/hometown-health/2021/relaxing-with-coffee-candle-book.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C1F117B42EB054A6A1E113D427A4BB67" alt="Relaxing with coffee, burning candle and book" width="660" height="370" DisableNVelocity="true" />MenopauseMenopause is the permanent end of menstruation and fertility, defined as occurring 12 months after your last menstrual period.Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Michele Halterman3/8/2018<p>When you think of yoga, your first thought is probably of a woman in a contorted position. However, it's important to note that yoga is for both men and women, and can be beneficial to young athletes.</p>Yoga: Making a name in sports<img alt="Young male athletes doing yoga" src="/-/media/national-files/images/hometown-health/2018/young-male-athletes-doing-yoga.jpg?h=300&w=300&sc_lang=en&hash=56110164EF41BF29B8F702D5A70E9262" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive"> <p>Yoga continues to gain popularity in the U.S., especially with women. When you think of yoga, your first thought is probably of a woman in a contorted position. Although this can look like yoga, it also is important to note that yoga is for both men and women, and can be personalized for any skill level. People who benefit most from the practice of yoga are those who are able to find their edge that is specific to their own body and working from that point.</p> <p><strong>BENEFITS TO ATHLETES</strong></p> <p>Over the past few years, I have worked with the varsity wrestling team from Lincoln High School in Lake City, Minnesota, on the understanding that yoga and its benefits can be derived from combining strength, flexibility and balance when working out. The process of alignment in poses to balance muscle groups that support joints truly is a mind-body connection. When learning proper alignment in each pose and as individuals accept their endpoint, flexibility will slowly change, balance of the joint will occur, and the muscle groups surrounding that joint will become stronger and more effective.</p> <p>This often is a tough concept for people to accept, especially for male athletes who often have dense, large muscles. I use the analogy about how runners don’t just start running marathons or even 1–2 miles — they work up to that distance at a slow and steady speed. But, for whatever reason, we do not have that same tenacity and patience when it comes to stretching. We take on the concept that if we can’t get into a pose, our body must not allow for it.</p> <p>I was guilty of being that person who would run 6–10 miles and never spend a minute stretching. I would then become so tight that running became too difficult. So I decided to incorporate yoga into my life It has taught me to have patience with my body and accept where I am at in that moment. Through this process, I discovered a deep layer of core muscles that truly allow ease in movement. I am not alone in this idea, as many pro athletes and teams also have discovered the benefits of yoga.</p> <p><strong>TAKING IT TO THE NEXT LEVEL</strong></p> <p>These seven important benefits can help take athletes to the next level:</p> <ol> <li><strong>Strength</strong> — Working into lunges will strengthen thigh muscles, and plank poses will help work through upper body and core. Working on static positions that consistently make you hold up your own body weight builds lean muscle mass.</li> <li><strong>Flexibility</strong> — The long muscles of the body can get tight and overused, resulting in limitation of movement and compression through the joints. Working on elongating these muscles help balance, decompress the spine and provide ease of movement through the shoulders and hips.</li> <li><strong>Balance</strong> — Most dynamic activity and sporting events require solid balance that is built from the ground up. When we are involved in an activity, our eyes often are focused on the challenge in front of us. We need our body’s unconscious awareness to understand where we are in our space to decrease risk of fall and injury. In yoga, most poses teach proper alignment and foot placement that enhance our balance in preparation for dynamic challenges.</li> <li><strong>Endurance</strong> — Sun Salutations are long held standing poses that teach you to tune into your body and by using your breath will help guide you to pace yourself.</li> <li><strong>Core</strong> — Yoga practices all focus on the spine and the deep muscles of the body that support your spine as well as your pelvic and shoulder girdles. By using closed chain poses your body gets the proper feedback to stabilize the body through your center.</li> <li><strong>Stability</strong> — For those who are tight, it is important to understand even the most flexible people must focus on stability. Learning to stabilize the surrounding joints and not lock/hang on them will help to decrease sprains, prevent tearing and overall decrease the risk of joint degeneration.</li> <li><strong>Recovery</strong> — Learning your edge, or your limit, gives you a better understanding of what your body needs to recover. Athletes tend to push their bodies to the limit and by understanding and respecting the limits of your body will allow you to heal and recover faster.</li> </ol> <p><strong>GETTING STARTED</strong></p> <p>There are many great resources available online that offer full yoga classes. You just need 15 minutes and a quiet space. The strength, balance and equanimity you will get from any practice will improve your well-being and the athlete that is in you.</p> <p><em>Marcia Walker</em><em> is a <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapist</a> at Mayo Clinic Health System in Lake City.</em></p><img src="/-/media/national-files/images/hometown-health/2018/young-male-athletes-doing-yoga.jpg?h=300&iar=0&w=300&sc_lang=en&hash=8DFB16860FB66D37280596C143CCB3BC" alt="Young male athletes doing yoga" width="300" height="300" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Micah Dorfner3/7/2018<p>Eating out can fit into a healthy lifestyle even if you’re working on weight maintenance or weight loss. From cooking methods, condiments, portion control and beverages, there are plenty of options for ensuring your lunch meeting doesn’t derail your goals for healthy eating.</p>Going out for lunch? How to stick to healthy habits<img alt="young-women-eating-lunch-on-restaurant-patio" src="/-/media/national-files/images/hometown-health/2018/healthy-lunch.jpg?h=267&w=400&sc_lang=en&hash=A3C4666FF5B6C1BBD0F665DD27FB4296" style="width: 400px; height: 267px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /> <p>It’s 11:30 a.m. on a Monday and you realize you must leave soon for a lunch meeting at a local restaurant. Your initial thought is, “What on earth am I going to eat? I just started my diet today.”</p> <p><span>Staying on track while dining out can certainly be a challenge. Portions have drastically increased over the past several years, making determining the proper portion size difficult. In other words, you might find yourself wondering, “How much should I actually be eating?”</span></p> <p><span>On top of that, many options are loaded with calories from fat and sugar. According to <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.rwjf.org/" target="_blank" title="Opens in new window">Robert Woods Johnson Foundation</a> study, “A Nation at Risk: Obesity in the United States,” adults currently consume an additional 300 calories per day in comparison to food consumption in 1985. Although there are many reasons for this, restaurant choices have been one contributing factor. Fortunately, eating out can fit into a healthy lifestyle even if you’re working on weight maintenance or weight loss. From cooking methods, condiments, portion control and beverages, there are plenty of options for ensuring your lunch meeting doesn’t derail your goals for healthy eating.</span></p> <h2><span>Salad selections</span></h2> <p><span>Your initial instinct is to go with a salad. After all, you always hear about the importance of eating more vegetables, and salads are an easy choice for getting more veggies while dining out. Surprisingly, salads can and often contain just as many calories if not more than a burger, typically due to a significant amount of fat and/or sugar from various salad toppings and dressings.  </span></p> <p><span>To ensure your salad really is as healthy as you want it to be, ask for the dressing on the side, which allows you to control the amount you consume. Sauces, dressing, creams, gravies and butter are often provided in excess and are dense sources of calories and fat. Try dipping your fork in the dressing prior to each bite, which provides the satisfying mouthfeel you get from the dressing without all the extra calories. Alternatively, when packing your own lunch from home, shake or toss your salad, which can significantly reduce the amount of dressing you need to use by evenly coating your lettuce, spinach or other greens.  </span></p> <h2><span>Appropriate food portions</span></h2> <p><span>If salad is not at the top of your list for lunch choices, there are plenty of other methods for choosing healthier options within the main entrees and sandwich sections. Aim to avoid keywords including fried, buttered, sautéed, au gratin and crispy. These words often refer to high-fat and high-calorie options. Instead, browse for words such as broiled, baked, grilled, poached, roasted or steamed, which are low-fat methods for preparing foods. </span></p> <p><span>Look for healthy side items, including steamed vegetables or rice pilaf blend. Think about what your portion sizes really should<em> </em>be, not what most people want<em> </em>them to be. Decrease your servings of starches like bread, potatoes, rice and pasta to about the size of your first, and limit your meat portion to the size of the palm of your hand. Fill more of your plate with fruits and vegetables when possible as these are very low in calories and high fiber.</span></p> <p><span>Consider asking your server if there is a lunch menu or if half portions are allowed. If neither is an option, you could consider sharing an entrée with a colleague or asking for a to-go box at the beginning of the meal. Before you begin eating, remove yourself from being a member of the “clean plate club” and put half your lunch in the to-go container to reduce the temptation of finishing your meal. </span></p> <h2><span>Quenching your thirst</span></h2> <p><span>The server asks for your beverage order, and you’re tempted to request a caffeinated soda to help make it through remainder of the day. However, reconsider your beverage choice, because one of the simplest ways to cut total daily calories is by being conscientious of what you’re drinking. </span></p> <p><span>Many restaurant beverages are a source of excess calories and sugar and contain very little nutritional quality. We know beverages have calories; however, we often don’t understand not just how many calories they contain but also the impact they have on our total health — including weight management, blood sugar control and heart health. Rethink and aim for water, diet pop or unsweetened tea. Sparkling or carbonated waters are great alternatives if you’re looking for bubbles and fizz. If plain water is not satisfying for you, consider adding lemon or fruit for infused water taste or even using a splash of 100 percent fruit juice.</span></p> <h2><span>Dessert while dieting</span></h2> <p><span>You have mastered the menu and feel pretty good with the choices you’ve made, but then the dreaded word “dessert”<em> </em>is mentioned. You may think to yourself “How can I have dessert if I’m on a diet?” Dessert definitely can fit and is considered part of a balanced diet, as long as it’s consumed in moderation and portion-controlled. Look for bite-size options, or, once again, try splitting a dessert with colleagues. Additionally, consider splurging on only one course. If you already had an appetizer, skip the dessert. If you didn’t start with an appetizer and chose a relatively low-calorie meal and beverage, a dessert is more feasible. </span></p> <p><span>Remember, dining out is a normal and expected part of life that should still be enjoyed even when you’re attempting to eat better for weight loss or other health reasons. </span></p> <em><span><a href="/providers/caitlin-terpstra-rdld">Caitlin Terpstra</a> is a registered dietitian who provides nutrition counseling at <a href="/locations/owatonna">Mayo Clinic Health System in Owatonna</a>.</span></em>RDN, LD<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, St. Catherine University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>University of Wisconsin Hospital and Clinics</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Licensed Dietician</li> <li>Registered Dietitian</li> </ul>Terpstra<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/caitlin-terpstra-rd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=D56D6F5A2B6A4866353C6D74A8883157" alt="Caitlin Terpstra RD" width="280" height="280" DisableNVelocity="true" />Caitlin<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>19992149Caitlin Terpstra, RDN, LD1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2018/healthy-lunch.jpg?h=267&iar=0&w=400&sc_lang=en&hash=C6FE83652A7A6484E2DBC8C8AAF0D973" alt="Young women eating lunch on restaurant patio" width="400" height="267" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Michele Halterman2/27/2019<p>Spring break is right around the corner, but family fun doesn’t mean you have to travel far. There are many things you can do close to home and won’t break the budget.</p>10 tips to make the most out of your staycation<img alt="Two young boys exploring a map indoors" src="/-/media/national-files/images/hometown-health/2018/two-young-boys-exploring-a-map-indoors.jpg?h=300&w=300&sc_lang=en&hash=F1F127E60AC5CA9D72B45C2FE9A9F844" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /> <p>Spring break is right around the corner, but family fun doesn’t mean you have to travel far. There are many things you can do close to home and won’t break the budget. Make the most out of staying local, and try new things as a family. You never know what you might find around town.</p> <p>Check out these 10 tips for your next staycation:</p> <ol> <li><strong>Get outside.</strong> If there’s still snow on the ground, try cross-country skiing or snowshoeing trails. Make sure you’re on the correct designated trails before getting started. If the snow has melted, check out hiking or walking trails around town.</li> <li><strong>Go swimming. </strong>It might not be the ocean, but swimming is a great way to release built-up energy and adds a little fun to your staycation. Check out your local hotels, schools or community centers, and spend a day at the pool.</li> <li><strong>Try adventuring. </strong>If spending time in the snow isn’t your thing, try downloading apps to get you outside and moving. You can download geocaching and Pokemon Go for free on your phone. You never know where they will lead you, but remember to be safe.</li> <li><strong>Check out the library. </strong>Local libraries hold a lot of free family friendly events. Once you’re there, you can check out books to learn more about different cultures and foods that you can make at home.</li> <li><strong>Rather be camping? </strong>Camp out in your living room. You can build a fort, make s’mores over the stovetop or in the microwave, sing camp songs and play your favorite board games.</li> <li><strong>Tackle a home repair project. </strong>Take advantage of the extra hands around the house and spend a day working on a home repair project together.</li> <li><strong>Take a trip to the zoo. </strong>You don’t need to be somewhere tropical to see exotic animals. Take a day trip to a zoo or aquarium.</li> <li><strong><a href="/hometown-health/speaking-of-health/coloring-is-good-for-your-health" target="_self" title="Opens in same window.">Get crafty</a>. </strong>Find local places that offer art activities for kids and adults. Display your art around the house as new decoration.</li> <li><strong>Cheer on your local teams. </strong>You don’t need to spend a ton of money or watch professional sports teams to have a good time. Cheer on your local high school or college teams instead.</li> <li><strong>Be a tourist in your own town. </strong>You never know what hidden treasures might be around your town. Check out theaters, museums, roller rinks, bowling alleys and more for a busy, fun-filled day close to home.</li> </ol> <p>Try out some of these ideas to make the most of your family staycation and enjoy your time together.</p> <p><strong>LEARN MORE</strong></p> <ul> <li>Meditation can produce a deep state of relaxation and a tranquil mind. Read more about<a href="/hometown-health/speaking-of-health/mindfulness-meditation-improve-your-quality-of-life" target="_self" title="Opens in same window."> improving your quality of life with meditation</a>.</li> </ul><img src="/-/media/national-files/images/hometown-health/2018/two-young-boys-exploring-a-map-indoors.jpg?h=504&iar=0&w=504&sc_lang=en&hash=B4B404146F1B6FE74D2D979120CB6A71" alt="Two young boys exploring a map indoors" width="504" height="504" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Michele Halterman3/31/2020Male or female, health care professionals now recommend screenings for colorectal cancer beginning at age 45. A colonoscopy is the gold standard. Here's what to expect before and during the procedure.What to expect before, during a colonoscopy<p>Health care professionals recommend screenings for colorectal cancer beginning at age 45. Preparing for colon cancer screening can be uncomfortable or inconvenient, but it's necessary for detecting cancer and could be lifesaving.</p> <p>A colonoscopy is the gold standard for colon cancer screenings. The doctor can view your entire colon and rectum and any abnormal tissue, such as polyps, and tissue samples or biopsies will be removed through the scope during the exam.</p> <p>As part of your decision to undergo a colonoscopy, consider your willingness or ability to follow the preparation instructions for specific colon cancer screening tests. You are required to avoid solid foods the day before the exam, adjust your medications and take a special prep laxative prescribed by your provider to empty your colon. You will need to limit daily activities accordingly and anticipate some level of gastrointestinal discomfort.</p> <img alt="colon illustration" src="/-/media/national-files/images/hometown-health/2018/colon-illustration.jpg?h=300&w=300&sc_lang=en&hash=63F8A49AD2E488535052B017DD0E3C08" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive"> <h4>What will it be like the day of the procedure?</h4> <p>The procedure takes about 30 to 60 minutes. You will need to allow for additional time to check in and recover after the procedure if you received sedation.</p> <p>During a colonoscopy, a long, flexible tube called a colonoscope is inserted into the rectum. A tiny video camera at the tip of the tube allows the doctor to detect changes or abnormalities inside the entire colon. If you are not sedated, you may choose to watch the video during the procedure.</p> <p>When sedation is used, it can take several hours to wear off, and you will need someone to take you home. Patients are more often choosing to have a sedation-free colonoscopy.</p> <p>Rare complications may include bleeding from the site where a biopsy was taken, or a polyp or other abnormal tissue was removed, or bleeding from a tear in the colon or rectum wall. Cramping or bloating might occur afterward.</p> <h4>What about cost and insurance issues?</h4> <p>Find out how much colon cancer screenings cost, as well as which tests your insurance company covers. Consider whether you're willing to pay out of pocket if necessary. Screening is recommended starting at age 45 and generally repeated every 10 years if no abnormalities are found and you don't have an increased risk of colon cancer.</p> <p>A colonoscopy may also be recommended earlier if there is a family history of colon cancer diagnosis in your first degree relatives. A good rule of thumb is to start screenings 10 years prior to your family member’s age of diagnosis. For example, if your parent was diagnosed at 53, begin your screenings at 43.</p> <h4>What's the bottom line?</h4> <p>Choosing to have a colon cancer screening test may not be an easy decision, but it's a potentially lifesaving one. There are various screenings available, so discussing these options with your health care provider is important.</p> <p>Commit to a screening schedule based on your personal risk factors. Remember, the earlier colon cancer is detected, the easier it is to treat.</p> <h4>Learn more about colorectal cancer:</h4> <ul> <li><a href="/hometown-health/speaking-of-health/reducing-your-risk-for-colon-cancer" target="_self" title="Opens in same window.">Reduce your risk for colon cancer</a>.</li> <li>Learn the <a href="/hometown-health/speaking-of-health/colorectal-cancer-basics" target="_self" title="Opens in same window.">common signs and symptoms of colon cancer</a>.</li> <li>Understand your <a href="/hometown-health/speaking-of-health/understanding-your-colon-cancer-screening-options" target="_self" title="Opens in same window.">colon cancer screening options</a>.</li> <li>Read <a href="/hometown-health/speaking-of-health/5-questions-about-stool-dna-tests-for-colon-cancer" target="_self" title="Opens in same window.">FAQ about the stool DNA test for colon cancer</a>.</li> </ul> <p><em>Jamie Zighelboim, M.D., is a <a href="/services-and-treatments/gastroenterology-and-hepatology" target="_self" title="Opens in same window.">gastroenterologist</a> in Eau Claire, Wisconsin.</em></p> <img src="/-/media/national-files/images/hometown-health/2020/colon-cancer-affects-men-and-women-equally.jpg?h=309&iar=0&w=550&sc_lang=en&hash=51B3F659C606491B095A11A6693B3160" alt="Colon cancer affects men and women equally" width="550" height="309" DisableNVelocity="true" />Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Colorectal HealthGet screening and treatment for colorectal cancer symptoms, and learn about risk factors and prevention strategies.Michele Halterman10/13/2025<p>If you have diabetes, you might encounter the effects of complications as you move into the latter part of your life. According to the Centers for Disease Control and Prevention, 50 percent of adults age 65 and older have prediabetes and 25 percent have diabetes.</p>Life with diabetes: What happens as we age?<img alt="Diabetes illustration with people, medicine, insulin, food" src="/-/media/national-files/images/hometown-health/2018/diabetes-illustration.jpg?h=300&w=300&sc_lang=en&hash=5D9F41425F0DF68263864F2E56677526" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /> <p>If you have diabetes, you might encounter the effects of complications as you move into the latter part of your life. According to the Centers for Disease Control and Prevention, 50 percent of adults age 65 and older have prediabetes and 25 percent have diabetes. Prediabetes is a condition in which blood sugar levels are higher than they should be, but not yet high enough to be diagnosed with diabetes.</p> <p>These conditions are caused by multiple factors, including insulin resistance, usually as a result of obesity and inactivity; reduced insulin production from the pancreas; and loss of muscle mass.</p> <h4>EFFECTS OF DIABETES AND AGING</h4> <ul> <li><strong>Life-limiting complications</strong> — Having diabetes can result in nerve damage and persistent pain, vision loss, kidney dysfunction, memory changes, urinary incontinence or slow-healing wounds.</li> <li><strong>Premature death</strong> — The likelihood of premature death increases due to co-existing conditions, such as heart disease, high blood pressure or stroke.</li> <li><strong>Increased falls and injury</strong> — Low blood sugar levels, vision or hearing loss, and balance changes from neuropathy may increase your chance of falling and injury.</li> <li><strong>Medication conflicts</strong> — You may be taking multiple medications to treat health conditions, which puts you at increased risk for side effects or drug interactions.</li> <li><strong>Dexterity and vision loss</strong> — Your fingers or hands may not work as well as they used to, or your eyesight may be poor, making it difficult to use insulin or injectable medications.</li> <li><strong>Financial burden</strong> — Medication and testing supplies needed to treat your diabetes can be costly, which could create budget constraints.</li> <li><strong>Memory loss or function</strong> — You may not remember or think as clearly as before and may need assistance from relatives or friends.</li> <li><strong>Poor nutrition</strong> — You may have limited access to healthy food because of finances or lack of transportation.</li> <li><strong>Depression</strong> — Your level of independence may decrease due to changes in vision, mobility or finances, and you may become depressed.</li> </ul> <h4>PARTICIPATION IN YOUR TREATMENT PLAN</h4> <p>Early detection and treatment of diabetes and prediabetes can reduce your risk for long-term complications. It’s important to work with your diabetes care team to individualize your treatment plan, including limiting hypoglycemia, or low blood sugars, and cardiovascular conditions, such as hypertension, or high blood pressure, and lipid management.</p> <p>Other ways you can be an active participant in your treatment plan include to:</p> <ul> <li>Talk with your health care provider about medication costs, vision loss, dexterity or balance concerns, memory loss or symptoms of depression.</li> <li>Discuss your diabetes care plan with your endocrinologist or diabetes educator. You also may want to meet with a dietitian to help you with meal plans.</li> <li>Gather resources from aging and disability resource centers, including information on physical activity, food assistance or other support options.</li> <li>Schedule a yearly dilated eye exam to closely monitor your eye health for vision problems or eye diseases.</li> <li>Do exercises that include balance, strength training and cardio to optimize your health.</li> <li>Use portion control for your meals. Remember to include vegetables, fruits, protein and calcium, while cutting down on sugary beverages and alcohol.</li> <li>Use assistive devices, such as walkers, to help you be more active if you have balance concerns.</li> <li>Check your feet and skin daily, and seek out prompt medical help if problems arise.</li> <li>Check your blood sugars frequently so you can identify changes in your blood sugar pattern. Notify your provider of concerns.</li> </ul> <h4>YOUR DIABETES JOURNEY GOALS</h4> <p>Set some realistic personal goals in your diabetes journey. Work with your health care team to promote positive health. Gather support from your family, friends and community to improve your quality of life.</p> <p>Do you know your risk? Take the <a rel="noopener" href="https://donations.diabetes.org/site/SPageServer/?pagename=Diabetes_Risk_Test&source=dorg&cate=link&loca=alert-day" target="_blank" title="Opens in a new window.">American Diabetes Association's 60-second test</a> to find out.</p> <em>By Mayo Clinic Health System staff.</em><img src="/-/media/national-files/images/hometown-health/2018/diabetes-illustration.jpg?h=504&iar=0&w=504&sc_lang=en&hash=AC83353A8543FB1939715FF7F08727FD" alt="Diabetes illustration with people, medicine, insulin, food" width="504" height="504" DisableNVelocity="true" />DiabetesIf you have diabetes, no matter what type, it means you have too much glucose in your blood, although the reasons may differ. Too much glucose can lead to serious health problems.Dawn Haller1/9/2025You probably remember having some form of the safe sex talk with your parents or other adults with the focus around pregnancy prevention. It's equally important to talk about sexually transmitted infections.Sexually transmitted diseases: What you need to know<p>You probably remember having some form of <a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/sexual-health/in-depth/sex-education/art-20044034" target="_blank" title="Opens in a new window.">safe sex talk</a> with your parents or other adults. The focus of the conversation was likely around pregnancy, or at the minimum, how not to get pregnant. These conversations, including choosing abstinence, are extremely important to have with young adults, and it's equally important to discuss the topic of <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/sexually-transmitted-diseases-stds/symptoms-causes/syc-20351240" target="_blank" title="Opens in a new window.">sexually transmitted infections (STIs)</a>.</p> <h3>What's an STI?</h3> <p>"I tested positive for <a href="/hometown-health/speaking-of-health/syphilis-a-rising-community-presence" target="_self" title="Opens in same window.">syphilis</a>, and I'm not sure what that means," or "Did you know 1 in 5 people have herpes?" may not be a socially acceptable lunch topic, but it's a common conversation at a medical visit. Most patients have some information regarding STIs, but there's confusion and misinformation on the subject. Sexual health concerns are sometimes ignored due to fear of the unknown.</p> <p>STIs generally are acquired by sexual contact, but some may be passed from mother to infant during pregnancy or childbirth, or through blood transfusions or shared needles. The organisms that cause STIs may pass from person to person in blood, saliva, semen or vaginal fluids. STIs can have a range of symptoms, including no symptoms, so it's possible to contract an STI from someone who seems perfectly healthy or who may not even be aware of the infection.</p> <h4>Common STIs</h4> <p>Although there are many different types of STIs, the most common are <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/chlamydia/symptoms-causes/syc-20355349" target="_blank" title="Opens in a new window.">chlamydia</a> and <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/genital-herpes/symptoms-causes/syc-20356161" target="_blank" title="Opens in a new window.">genital herpes</a>.</p> <p>Chlamydia is a common infection, especially in teens and young adults. Often, there are no signs or symptoms of the infection, so it can be passed unknowingly to partners. Chlamydia is treated easily with antibiotics, but if all sexual partners are not treated, the infection will continue to spread or reinfection can occur. To help ensure all partners receive medication for the infection, partner treatment, called expedited partner therapy, can be prescribed.</p> <p>The legal scope of expedited partner therapy varies from state to state. For example, in Minnesota, a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window">healthcare professional</a> can prescribe treatment to the partner(s) without a medical evaluation. There may be an out-of-pocket expense for the medication. After treatment, rescreening is recommended in two to three months, then annually or with any new exposure. If chlamydia goes untreated, it can cause future fertility problems.</p> <p>Genital herpes can also be contracted or passed without being aware of the infection because there may not be any signs or symptoms of the virus. Genital herpes is passed during vaginal, oral or anal sex. It's an infection that can't be cured. Genital herpes can be painful, and cause blisters and open sores on the genital area. While symptoms can be treated, the virus remains in the body.</p> <h4>Protect yourself</h4> <p>Making informed decisions about your partner and choosing when to be sexually active are important in preventing your exposure to STIs. Share your sexual history with your partner and ask them to share theirs with you so you can make wise sexual decisions. You also may ask to bring your partner to <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window">gynecology</a> appointments to have open, honest conversations with your healthcare professional.</p> <p>Condoms are still the best barrier protection against STIs. However, condom use has become less common because of improved <a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/birth-control/in-depth/birth-control-options/art-20045571" target="_blank" title="Opens in a new window.">birth control</a> methods. <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/contraceptive-implant/about/pac-20393619" target="_blank" title="Opens in a new window.">Long-acting reversible contraceptives</a>, such as an IUD or rod implants, are nearly 100% effective in preventing pregnancy but don't protect against STIs. Even though condoms can't prevent the spread of all infections, it's better to be safe than to not use one at all.</p> <p>It's recommended that all people ages 9–45 get the <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/hpv-infection/in-depth/hpv-vaccine/art-20047292" target="_blank" title="Opens in new window. ">HPV vaccine</a> to prevent contracting HPV, a sexually transmitted virus that can cause cancer. The best immune response occurs when the vaccine is given around 11 or 12 years of age. For those under age 15, the immunization is a two-shot series. For those over age 15, a three-shot series is administered over six months.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2021/stds-what-you-need-to-know.jpg?h=370&iar=0&w=660&sc_lang=en&hash=832BEE8ED9778DB95D8703F583DF20A3" alt="Man and woman sitting and looking at each other" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Prenatal CareOB-GYN and Family Medicine providers offer exactly the care you need for starting or growing your family, including pregnancy planning and prenatal care.Micah Dorfner4/24/2018<p>Whenever you want to improve your exercise capacity, it’s important to understand progressive overload. Progressive overload means challenging your muscles and body by gradually increasing the stress put on them. </p>Progressive overload: Get stronger in a healthy way<p><span><img height="440" alt="woman-tying-running-shoe" width="660" src="/-/media/national-files/images/hometown-health/2018/woman-tying-running-shoe.jpg?sc_lang=en&hash=0BC1330DA1B25C83FBA9DA6F5E31331E" class="img-responsive"> </span></p> <p><span>Whenever you want to improve your exercise capacity, it’s important to understand progressive overload. Progressive overload means challenging your muscles and body by gradually increasing the stress put on them. For example, increasing weight lifting repetitions or the speed at which you run over the course of time. The idea is that you slightly push yourself — in a healthy way — with each workout, ultimately resulting in improved performance and strength.</span></p> <p><strong><span>Progressive overload uses</span></strong></p> <p><span>Progressive overload is most often used in strength training but can also be used for marathon training. The secret to long-term success and staying healthy is to gradually challenge yourself a as you progress with your exercise program. If you progress too quickly, it can have a negative impact on your performance and lead to injury, excess fatigue and even upper respiratory infections.</span></p> <p><strong><span>The 10 percent rule</span></strong></p> <p><span>Each person is different, and there’s no magic exercise formula for everyone. However, one of the most popular training philosophies is the 10 percent rule. The basic premise is to not increase your running mileage more than 10 percent per week. This rule usually works well for young, healthy, moderately trained athletes. If you’re older, have orthopedic issues, are recovering from an injury or have other health issues, the 10 percent rule may be too much. Consult your health care provider or an exercise specialist if you have concerns.</span></p> <p><strong><span>Gain without pain</span></strong></p> <p><span>Proper exercise training should reduce your chance of injury, increase your energy and generally help you feel good. If this isn’t the case, you might be overtraining. Many people still have the “no pain, no gain” attitude, which can actually be quite harmful to your body. A good progressive overload program should have no pain and little or no muscle soreness.</span></p> <p><span>Challenge yourself to get into better shape, do more and increase running mileage without much muscle soreness. Progressive overload and the 10 percent rule may turn out to be the right approach for you.</span></p> <em><span>Chip Gay<span style="color: #222222;"> is a clinical exercise specialist at </span><a href="/locations/mankato">Mayo Clinic Health System in Mankato</a><span style="color: #222222;">.</span></span></em><img src="/-/media/national-files/images/hometown-health/2018/woman-tying-running-shoe.jpg?h=440&iar=0&w=660&sc_lang=en&hash=4B95B6A7232F045C6B13B3B9490CBE0B" alt="Person tying running shoe" width="660" height="440" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Michele Halterman4/23/2018<p>When preparing for the birth of your new baby, you likely completed a checklist to ensure you had everything ready to go before your bundle of joy arrived. Set up crib. Check. Purchase diapers. Check. Attend childbirth education classes. Check. Gather colostrum. Wait, what?</p>Boost infant health with breast milk before baby's birth<img height="371" alt="Mother and father looking at infant" width="660" src="/-/media/national-files/images/hometown-health/2018/mother-and-father-looking-at-infant.jpg?sc_lang=en&hash=0196447CAC88D326C2735158A0B7D00B" class="img-responsive"> <p>When preparing for the birth of your new baby, you likely completed a checklist to ensure you had everything ready to go before your bundle of joy arrived. Set up crib. Check. Purchase diapers. Check. Attend childbirth education classes. Check. Gather colostrum. Wait, what?</p> <p>Women who are 37 weeks or more pregnant now have the option to gather and store their colostrum to have it on hand when their baby is born. Colostrum, considered to be the early milk produced by women in their second trimester, is an antibody-rich immune booster that is vital to the health of infants. Colostrum promotes the development of normal gut flora, prevents the growth of harmful bacteria and aids in the optimal absorption of nutrients in the small intestines.</p> <p>“The first week is critical for a diet of only breast milk to reduce the risk of future illnesses and to ensure the mother’s healthy milk supply for months to come,” says Anne Beckman, an international board-certified lactation consultant at Mayo Clinic Health System in <a href="/locations/red-wing" target="_self" title="Opens in same window.">Red Wing</a>, Minnesota. “Moms who are able to start practicing may have a small supply of their own breast milk available immediately upon delivering should the baby need it.”</p> <p><strong>HOW TO COLLECT COLOSTRUM</strong></p> <p>Lauren Buck, new mom to baby Silas, had never heard of collecting colostrum until one of her early prenatal appointments with <a href="/providers/jana-brand-cnp" target="_self" title="Opens in same window.">Jana Brand</a>, a nurse practitioner in <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in Red Wing.</p> <p>Years earlier, Lauren had been diagnosed with polycystic ovarian syndrome, a hormonal disorder that affects the reproductive system, potentially causing fertility issues. The diagnosis coupled with her husband’s paralysis, made getting pregnant difficult. But, with the help of fertility treatments, Buck soon learned she was pregnant.</p> <p>Knowing that polycystic ovarian syndrome can decrease a mother’s milk supply or make it difficult for her to produce milk after giving birth, Lauren’s provider gave her educational materials on the colostrum collection process. “After hearing about the process and learning about the benefits, I never considered not collecting my colostrum,” says Lauren. “I would rather have too much milk than not enough at such a critical point in my baby’s life.”</p> <p>Just before entering week 37, Lauren met with Jenna Reinhart, an international board-certified lactation consultant in Red Wing. During this appointment, Jenna showed Reinhart exactly how the process worked using hand expressing to collect and store the milk. “After that appointment, I collected colostrum every day until I delivered,” says Lauren. “Some days I would get more than others and noticed an increase in my supply as I got closer to my due date.”</p> <p>Along with the other personal belongings she packed for her hospital stay, Lauren packed her frozen colostrum. The colostrum would be stored in the labor room’s freezer and be available immediately after her baby was born, if needed.</p> <p><strong>BREASTFEEDING MADE EASIER</strong></p> <p>Lauren and her husband welcomed their son, Silas, into the world at a healthy 6 pounds, 13 ounces. “Silas learned to latch and suck immediately after birth, which I partially credit to my comfort level from knowing what to expect from hand expressing,” says Lauren. Her collected colostrum did not go to waste. “I ended up using my stored colostrum throughout his first week of life,” she says. “It was wonderful being able to give my husband a chance to feed him, which also gave me a few extra minutes to rest.”</p> <p>“I will forever be grateful to Anne and Jenna for their support and encouragement throughout this journey,” says Lauren. “It was such wonderful experience that I can’t help but share it with all of my friends and family.”</p><img src="/-/media/national-files/images/hometown-health/2018/mother-and-father-looking-at-infant.jpg?h=371&iar=0&w=660&sc_lang=en&hash=B465319C7FD76CA61137CBBEB4A6065D" alt="Mother and father looking at infant" width="660" height="371" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Micah Dorfner4/16/2018<p>Nothing gets me more motivated than signing up for a race, putting it on the calendar and working toward that goal. <span>My excitement about marathons and running means I tend to get a lot of running-related questions from friends and coworkers. Here are some of the most common questions I get and my thoughts.</span></p>Running Q&A: Choosing the right distance, increasing miles and more<p><img height="439" alt="runners-feet-on-pavement" width="660" src="/-/media/national-files/images/hometown-health/2018/running-feet.jpg?sc_lang=en&hash=0A0B4E9937DA3DECB87315C24400B643" class="img-responsive"></p> <p>Nothing gets me more motivated than signing up for a race, putting it on the calendar and working toward that goal. It’s not important what the specific goal or distance is — it could be to win, to place or just to finish. Every runner and every goal is different.  </p> <p>My excitement about marathons and running means I tend to get a lot of running-related questions from friends and coworkers. Here are some of the most common questions I get and my thoughts.<br> <br> <strong>Q: I’m thinking about doing a 5k/10k/half marathon/marathon on this particular date. Do you think I have enough time to train for it? <br> A:</strong> That’s an excellent question with a complicated answer. It depends on your age, your running experience, how much time you have to train, your history of past injuries, your goals for the race, your baseline mileage and other unique factors. Keep in mind that choosing a distance should only be one part of your goal — showing up healthy and injury-free on race day should also be key factors in deciding your distance. This might mean scaling back a longer-distance goal, but be sure to consider if you’d rather be healthy, injury-free and meet your goal or set a “stretch goal” and risk training a bit harder. </p> <p><strong>Q: If training is going well, how do I increase my mileage?</strong><br> <strong>A:</strong> A common principle in the running world that I agree with is the “10 percent rule”.  The 10 percent rule goes something like this: don’t increase your mileage by more than 10 percent per week. That’s it. There is nothing magical about it. This simply means don’t increase the distance of any one run or your overall weekly mileage by more than 10 percent. For example, if you are currently running a maximum of three miles at a time, that means the following week your maximum distance would be 3.3 miles. Your maximum the following week should be 3.63, and so on. While perhaps overly simplistic, it’s a good starting point for many novice runners. </p> <p><strong>Q: Really? That’s doesn’t seem like much of an increase!<br> A:</strong> True, but increasing speed and distance is not something that can be rushed without risk of injury. While I would never claim to be trainer, coach or even a particularly good runner, there is one thing that I am really good at — getting injured. Pushing too hard and suffering an injury may set you back more quickly than just taking your time and letting your body adapt to the longer distances.<strong> </strong>In the end, I like to subscribe to old adage, “It’s better to show up 10 percent undertrained than 1 percent over-trained.” </p> <p><strong>Q:  What’s the difference between a runner and a jogger? <br> A: </strong>That’s easy — it’s just the entry form for the race. Being a runner is simply committing to the process and putting yourself out there for everyone to see on race day. It’s scary, exhilarating, exhausting, and it fills you with pride. Take an honest inventory of your current level of fitness and use the 10 percent rule as a starting point, and come race day, you will be a (an uninjured) runner!</p> <p> <em><a href="/providers/christopher-crocker-pac">Chris Crocker</a> is a surgery physician assistant at <a href="/locations/mankato">Mayo Clinic Health System in Mankato</a>. He is a runner, exercise enthusiast and has participated in the Mankato Marathon. </em></p>P.A.-C.<p><strong>Education</strong></p> <ul> <li>Master's degree, Cardiology, University of Nebraska</li> </ul> <p><strong>Certification</strong></p> <ul> <li>National Commission on Certification of Physician Assistants</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Surgery, Mayo Clinic College of Medicine and Science</li> </ul>Crocker<img src="/-/media/shared-files/images/medical-professionals/full/mankato/christopher-crocker-pac.jpg?h=280&iar=0&w=280&hash=E58456E7436932753F3902D1D67BED33" alt="Christopher Crocker PAC" width="280" height="280" DisableNVelocity="true" />{459EAB22-8CDB-42C1-BE40-EA7882BAC29D}Chris<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13424530Chris Crocker, P.A.-C.1{CE631A85-B409-4C11-907C-39868E49E636}<img src="/-/media/national-files/images/hometown-health/2018/running-feet.jpg?h=439&iar=0&w=660&sc_lang=en&hash=9D3B429B7E7F3FB010595506025BC0A5" alt="runners-feet-on-pavement" width="660" height="439" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Michele Halterman7/2/2024Tapering or decreasing the length of your training runs before a race can improve your race-day performance. Learn why and how to design your taper.How tapering maximizes your potential on marathon day<p>The taper is an essential aspect of training that many new runners need to remember to incorporate into their training program. Tapering means reducing your training load before a competition to optimize performance on race day. It's the rest period before race day to reduce the effects of muscle fatigue brought on by months of rigorous training.</p> <p>During marathon training, muscle power diminishes, stores of glycogen (a form of glucose) deplete and overall muscle fatigue accumulates. The tapering period minimizes the adverse effects of a long-distance training schedule, so your muscles will be fresh and fatigue-free on race day, significantly reducing your injury risk.</p> <h2>What are the benefits of tapering?</h2> <h3>Adding tapering to your training can:</h3> <ul> <li>Bolster your immune system to lower your risk of being sick on race day</li> <li>Improve your running economy, which is the oxygen your body needs to run at a given pace</li> <li>Replenish glycogen stores so that you have the necessary amount of fuel stored in your body on race day</li> <li>Repair damaged muscle tissue, which restores muscle fibers and allows them to work their best when you need them the most.</li> <li>Reduce the psychological stresses of training, which will help you be mentally strong on race day</li> <li>Improve sleep quality so that you get the rest you need leading up to the race</li> </ul> <h2>What are the guidelines for tapering?</h2> <p>People often wonder how to define "rest" during tapering and how to make sure it's helping performance and not hurting it.</p> <p>A meta-analysis of 27 studies published in the journal Medicine & Science in Sports & Exercise showed that a tapering strategy most likely to give you significant performance improvements for two weeks, where the training volume is progressively decreased by 41–60% without modifying the training intensity or frequency.</p> <p>This means altering your training volume by decreasing only the length of each training session. The most common way is to reduce the number of miles run per session in the two to three weeks leading up to race day, depending on the length of the race.</p> <h2>How do you calculate your rate of progression during the taper?</h2> <p>For example, if you're running six miles two or three times a week during your peak training period, you'll want to drop that mileage by 41-60%, approximately 2.5 to 3.5 miles.</p> <h3>Here's how to calculate this:</h3> <ul> <li>41% of 6 miles: 6x0.41=2.46, so 6-2.46=3.54 miles</li> <li>60% of 6 miles: 6x0.60=3.6, so 6-3.6=2.4 miles</li> </ul> <p>One way to do this is to run three to four miles per run the first week and two to three miles per run the second week.</p> <p>Remember that the other key piece of the findings is to keep the intensity or frequency of your training the same during the taper. So, if you're running four times per week during your peak training, you should continue to run four times per week. If you're training at a 10-minute per mile pace, you should continue to train at that pace during the taper.</p> <p>The taper strategy will vary based on the length of your race. The longer the race, the longer the taper.</p> <h3>The taper lengths for the most popular race distances are:</h3> <ul> <li>Marathon — 19 to 22 days</li> <li>15K race — 11 to 14 days</li> <li>5K or 10K race — seven to 10 days</li> </ul> <h4>This chart shows suggested taper percentages based on some common race distances:</h4> <table> <tbody> <tr> <td> <table align="center" class="telerik-reTable-3" style="border: 0px solid;"> <tbody> <tr class="telerik-reTableOddRow-3" style="color: #666666;"> <td class="telerik-reTableFirstCol-3" style="padding: 0in 5.4pt; text-align: left; background-color: #e7ebf7;"><strong>Race distance</strong></td> <td class="telerik-reTableLastCol-3" style="padding: 0in 5.4pt; text-align: left; background-color: #e7ebf7;"><strong>3rd week before race</strong></td> <td class="telerik-reTableLastCol-3" style="padding: 0in 5.4pt; text-align: left; background-color: #e7ebf7;"><strong>2nd week before race</strong></td> <td class="telerik-reTableLastCol-3" style="padding: 0in 5.4pt; text-align: left; background-color: #e7ebf7;"><strong>Race week</strong></td> </tr> <tr class="telerik-reTableFooterRow-3" style="color: #3a4663; background-color: #c4d1e3;"> <td class="telerik-reTableFooterFirstCol-3" style="padding: 0in 5.4pt; text-align: left;">Marathon</td> <td class="telerik-reTableFooterLastCol-3" style="padding: 0in 5.4pt; text-align: left;">20%</td> <td class="telerik-reTableFooterLastCol-3" style="padding: 0in 5.4pt; text-align: left;">40%</td> <td class="telerik-reTableFooterLastCol-3" style="padding: 0in 5.4pt; text-align: left;">60%</td> </tr> <tr class="telerik-reTableFooterRow-3" style="color: #3a4663; background-color: #c4d1e3;"> <td class="telerik-reTableFooterFirstCol-3" style="padding: 0in 5.4pt; text-align: left;">15K to 30K</td> <td class="telerik-reTableFooterLastCol-3" style="padding: 0in 5.4pt; text-align: left;">0%</td> <td class="telerik-reTableFooterLastCol-3" style="padding: 0in 5.4pt; text-align: left;">30%</td> <td class="telerik-reTableFooterLastCol-3" style="padding: 0in 5.4pt; text-align: left;">50%</td> </tr> <tr class="telerik-reTableFooterRow-3" style="color: #3a4663; background-color: #c4d1e3;"> <td class="telerik-reTableFooterFirstCol-3" style="padding: 0in 5.4pt; text-align: left;">5K to 10K</td> <td class="telerik-reTableFooterLastCol-3" style="padding: 0in 5.4pt; text-align: left;">0%</td> <td class="telerik-reTableFooterLastCol-3" style="padding: 0in 5.4pt; text-align: left;">20%</td> <td class="telerik-reTableFooterLastCol-3" style="padding: 0in 5.4pt; text-align: left;">50%</td> </tr> </tbody> </table> <br /> </td> <td> </td> </tr> </tbody> </table> <p>Plan to taper only for your key or peak races. If you taper for every race, you'll miss the key physical conditioning needed to get into optimal shape.</p> <p>Remember to also strive for quality sleep and good nutrition during the taper and the week of the race. Both are needed to promote physical recovery and allow your muscles to repair and rebuild.</p> <p><em><a href="/providers/leslie-grommersch-dpt" target="_self" title="Opens in same window.">Leslie Grommersch</a>, <a href="/providers/kimberly-olsen-pt" target="_self" title="Opens in same window.">Kimberly Olsen</a> and <a href="/providers/desiree-essler-pt" target="_self" title="Opens in same window.">Desiree Essler</a> are <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapists</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Orthopedics</li> <li>Sports medicine</li> </ul>D.P.T.<p>I believe in providing patient-centered, evidence-based care that is tailored to each individual’s goals and lifestyle. I enjoy working with patients recovering from orthopedic injuries, post-surgical procedures and active individuals looking to return to sport and recreation. Patients can expect a personalized rehabilitation plan focused on strength, movement quality and progressive recovery designed to help them safely return to the activities that are most meaningful to them.</p> <p>Outside of work, I enjoy spending time with my family and keeping up with my kids’ activities. I love traveling, staying active and cheering on Minnesota sports teams. Much of my free time is spent outdoors and supporting my kids in the activities they enjoy.</p><p><strong>Education</strong></p> <ul> <li>Doctor of Physical Therapy, St. Scholastica</li> </ul> <p><strong>Certification</strong></p> <ul> <li><strong></strong>Minnesota Board of Physical Therapy</li> </ul>Grommersch<img src="/-/media/shared-files/images/medical-professionals/full/mankato/leslie-grommersch-dpt.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7BDC5BDD8C00AFD34EEB259F76473548" alt="Leslie Grommersch DPT" width="280" height="280" DisableNVelocity="true" />{86ECDEF8-A8C0-48B6-85CC-9FCFA378CDDA}Leslie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15437515Leslie Grommersch, D.P.T.1{DEF55970-853F-4E96-9A4D-3413874FF059}<ul> <li>Aquatic therapy  </li> <li>Orthopedic medicine</li> <li>Sports medicine</li> <li>Vestibular</li> </ul>P.T.<p>I am passionate about helping patients achieve their goals of returning to work, daily activities and recreational activities. My specialty areas include aquatic therapy, vestibular therapy, and orthopedic and sports rehab.</p> <p>In my free time, I enjoy spending time with my family, biking on the trails around Mankato and Minnesota, walking my dog, and gardening.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Physical Therapy, Mayo Clinic School of Health Sciences</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Credentialed Clinical Instructor, American Physical Therapy Association</li> <li>Minnesota Board of Physical Therapy</li> </ul>Olsen<img src="/-/media/shared-files/images/medical-professionals/full/mankato/kimberly-olsen-pt.jpg?h=280&iar=0&w=280&sc_lang=en&hash=9FAAE935455429C0A4D51A0D93745BC0" alt="Kimberly Olsen PT" width="280" height="280" DisableNVelocity="true" />{FEA2DE2C-F235-4D61-A2E6-901AD650C612}Kimberly<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>11913177Kimberly Olsen PT1{DEF55970-853F-4E96-9A4D-3413874FF059}|{7746ADF8-715B-4593-8AAB-55D7F0467848}<ul> <li>Manual therapy</li> <li>Spine</li> <li>Sports medicine</li> <li>Temporomandibular joint dysfunction (TMJ)</li> </ul>P.T.<p><strong>Education </strong></p> <ul> <li>College of St. Scholastica</li> </ul> <p><strong>Certification </strong></p> <ul> <li><strong></strong>Minnesota Board of Physical Therapy</li> </ul>Essler<img src="/-/media/shared-files/images/medical-professionals/full/mankato/desiree-essler-pt.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4D56C7D2326F52FA1E7D0BBE35D18E81" alt="Desiree Essler PT" width="280" height="280" DisableNVelocity="true" />{098BDA88-7706-4511-8FCD-848A665819D8}Desiree<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14434831Desiree Essler PT1{DEF55970-853F-4E96-9A4D-3413874FF059}|{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2024/three-people-running-ourdoors.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B754F32016FA671229791A83FCD93A3A" alt="Three people running ourdoors" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Michele Halterman11/23/2022Growth isn't easy, requiring pain along with joy. Discover why working through grief brings the opportunity to experience healing, peace and growth.The space between grief and growth<p>Grief is an emotion that often changes daily — bringing good days and bad, ups and downs. It's not linear and doesn't follow an expected path. Rather, it takes more of a spiraling trajectory, spinning back onto itself at times, bringing confusion, distraction and numbness to things that once brought joy.</p> <p>In general, our lives are full of constant change that often greets us in ways we don't expect. In grief, there may be many days we feel overwhelmed, distracted, empty and filled with loneliness. Other days may be a bit brighter, and it may feel possible to grow from grief even though we know that growth may take time.</p> <p>Growth rarely is easy and almost always brings with it at least some measure of pain. People who are grieving are no strangers to pain. It may be difficult at times to believe that any good, including growth, can come from such pain.</p> <p>After the death of a loved one, there is an emptiness in our hearts and souls that never can be filled in the same way again. But this deep longing can bring with it the knowledge of the strength and beauty of the relationship we shared with our loved one. It can remind us that the love we enjoyed with them isn't bound by time or space, but remains forever.</p> <p>This love and the bonds we form in life are precious, and the time and space we share are sacred. With the constant stress in life of responding to texts, calls and emails, and the presence of violence and tragedy in the news, we may get caught up in those stresses and fail to truly address our own pain and sorrow.</p> <p>It can be hard to find time to notice changes that take place in our hearts. It can be hard to open ourselves to the pain we feel as we grieve. To do so requires courage and strength — two attributes we may feel we lack during grief's journey. If we can bring ourselves to face grief — to ride the wave of it and allow it into our lives — we may find that we are not swept away, but instead, are slowly given glimpses of light and perhaps some measure of peace.</p> <p>If you're walking the path of grief, I encourage you to find time to spend with your grief, whether through journaling, talking to a family member or a counselor, engaging in some form of expression of your grief through art or music, or simply by sitting quietly in a favorite chair and letting your memories and tears flow.</p> <p>It also can help to take a page from mindfulness exercises and focus on your breathing as you sit. Breathe in for a count of four, hold for a count of four and breathe out for a count of four.</p> <p>In these ways, you can dip your toe into what might seem like the vast ocean of grief, loss and pain. Working through your grief, in whatever small way you are able, also can give you the opportunity to begin to experience healing, peace and growth.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/writing-in-journal-with-pen.jpg?h=370&iar=0&w=660&sc_lang=en&hash=AD79C0E22120D3B27ACE75DB91593ADD" alt="Writing in journal with pen" width="660" height="370" DisableNVelocity="true" />ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.GriefGrief is the natural reaction to loss. It will be unique to you, depending on your own personality and circumstances.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Micah Dorfner4/2/2018The thirst mechanism can be an unreliable signal to for athletes to hydrate. Get guidelines for liquid consumption before, during and after a race.Tips to keep runners hydrated<img alt="bottle-of-water-pouring-into-glass" src="/-/media/national-files/images/hometown-health/2018/water-pouring-from-bottle-to-glass.jpg?h=266&w=400&sc_lang=en&hash=BEE7A292E5AD0B5C9653C8D9B00B0AF2" style="width: 400px; height: 266px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /> <p>Fluid needs vary by individuals. The <a rel="noopener" href="https://nam.edu/" target="_blank" title="Opens in a new window.">National Academy of Medicine</a> determined that adequate intake for men is roughly 13 cups and women is nine cups per day. For athletes, the thirst mechanism can be an unreliable signal to drink. Your observed thirst may be reduced because you’re focusing so much on the activity in which you’re participating.</p> <h2>Guidelines for liquid consumption before, during and after a race:</h2> <ul> <li><strong>Before</strong><br /> Drink 2 cups (16 ounces) of water two to three hours before the race. Then drink 1 cup (8 ounces) of water 10 to 20 minutes before a run.</li> <li><strong>During</strong><br /> Drink 1 cup (8 ounces) of fluid every 20 minute during your run. Sports drinks are a good choice when running longer than 60 minutes as they provide minerals and salts the body loses through sweat. In addition, sports drinks contain carbohydrates, which can help boost endurance.</li> <li><strong>After</strong><br /> Following the race, it’s important to start rehydrating. Start with 12 ounces of fluid. In the hours following a marathon, runners should continue to sip on fluids to rehydrate. If you have a chance to weigh yourself, a good rule of thumb is to drink 24 ounces of liquid for each pound lost during the race. Sipping fluids over time maximizes fluid retention and is preferable to drinking large amounts in one sitting. </li> </ul> <h2>Signs and Symptoms of dehydration</h2> <ul> <li><strong>Early signs</strong><br /> Thirst, flushed skin, premature fatigue, increased body temperature, faster breathing and pulse rate, increased perception of effort and decreased exercise capacity</li> <li><strong>Later signs</strong><br /> Dizziness, increased weakness and labored breathing with exercise.</li> </ul> <p>If you’re concerned you may be dehydrated, seek medical assistance.</p> <p><em><a href="/providers/allyn-wergin-rdn">Allie Wergin</a> is a registered dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/new-prague" title="Opens in same window">New Prague</a>, Minnesota.</em></p><ul> <li>Bariatric surgery</li> <li>Diabetes management</li> <li>Oncology</li> <li>Weight management</li> </ul>RDN<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, St. Catherine University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration </li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul>Mahowald<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/allyn-wergin-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=74F690ED261F537AA65B66929A3356D1" alt="Allie Mahowald, RDN" width="280" height="280" DisableNVelocity="true" />{9209F8EC-1016-41AA-985F-014D9B877417}Allie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15971546Allyn Mahowald, RDN1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2018/water-pouring-from-bottle-to-glass.jpg?h=266&iar=0&w=400&sc_lang=en&hash=D9E3DEAE894F58DDC475A5D59C9099ED" alt="Water pouring from a bottle into a glass" width="400" height="266" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Michele Halterman3/17/2023Kale earns the title "superfood" due to the vitamins A, B6, C, K, folate, fiber, carotenoids and manganese it contains. Find out why its color, texture and peppery flavor also make it a mealtime superstar, and get a delicious recipe.Kale: Discover the 'secret powers' of this superfood<p>Although it may seem like it, kale isn't a new vegetable. Thomas Jefferson experimented with several varieties of kale at his Monticello estate in the early 1800s. It's long been popular in northern Europe and now throughout the U.S. Before becoming a popular salad green, kale was often used in restaurants as a decorative garnish on plates.</p> <p>But over the past 10 years, the popularity of kale has skyrocketed. You've probably heard it referred to as a superfood. Here's more about its not-so-secret powers.</p> <h2>Types of kale include:</h2> <ul> <li>Curly kale is of one the most common types with its pungent, peppery flavor. The bright-green leaves look like ruffles.</li> <li>Dinosaur kale is also common. Its narrow, green leaves are wrinkly like dinosaur skin, which are attached to a firm stem that should be removed.</li> <li>Redbor kale has ruffled leaves ranging in color from a deep red to purple.</li> <li>Russian kale is harder to find. It has flat, fringed leaves ranging in color from green to red to purple. Its flavor is more sweet and peppery.</li> </ul> <p>Kale is available at local farmers markets and grocery stores. You can buy it in fresh bunches or prewashed and trimmed in bags. Local gardeners also plant kale for their own use on the dinner table.</p> <p>How do you pick out the best bunch of kale? The leaves and stalks should be dark green with small- to medium-sized leaves free of any yellowing or browning. Kale leaves should be firm and dry, not wilted and mushy.</p> <p>To store kale, wrap it loosely and store in the fridge for up to five days. If kept longer, the leaves tend to toughen.</p> <h2>Nutrition superstar</h2> <p>Kale is a nutrition superstar due to the amounts of vitamins A, B6, C, K, folate, fiber, carotenoids and manganese it contains. One cup of raw kale has just 20 calories. The Department of Agriculture's MyPlate recommends any child and adult who is over the age of 9 eat at least 1.5–2 cups of dark-green vegetables every week.</p> <p>Kale is a member of the cruciferous vegetable family, along with cauliflower, Brussels sprouts, cabbage, broccoli, collard greens, kohlrabi, rutabaga, turnips and bok choy. These vegetables offer health benefits, including supporting the immune system, regulating blood pressure and potentially reducing the risk of various types of cancer.</p> <p>People who may need to avoid or limit kale intake are those who form oxalate-containing kidney stones or take the blood thinners Coumadin or warfarin. Be sure to check with your health care professional or dietitian if you have questions.</p> <h2>Adding kale to your meals</h2> <p>Kale holds its texture well when cooked, and it can be steamed, stir-fried, roasted or eaten raw. You can blend it into smoothies, roast it to make kale chips, wilt it into soup, mash it with potatoes or turn it into pesto. You may want to remove the middle rib by hand or with kitchen shears because it can be tough, fibrous and taste bitter.</p> <p>A good goal is to fill half your plate with fruits and vegetables every day. Here's where kale can work its superpower. Tear leaves and blend them into your morning smoothie, or use the whole kale leaf as a replacement for tortillas or bread when making a sandwich. For extra crunch, replace your regular potato chips with some roasted kale chips. For dinner, make a hearty bean soup with kale.</p> <h3>Try this meatless version of a Midwestern favorite made with kale:</h3> <h4>Cream of wild rice soup</h4> <p>Serves 4</p> <ul> <li>1/2 tablespoon canola oil</li> <li>1 1/2 cups diced yellow onion</li> <li>1 cup diced carrot</li> <li>1 cup diced celery</li> <li>2 cloves garlic, minced</li> <li>1 1/2 cups chopped kale</li> <li>1 tablespoon minced parsley</li> <li>2 cups low-sodium vegetable stock</li> <li>1 teaspoon fennel seeds, crushed</li> <li>1 teaspoon ground black pepper</li> <li>1 cup unsalted prepared white beans (or about half of a 15.5 ounce can of white beans, rinsed and drained)</li> <li>2 cups 1% milk</li> <li>1/2 cup wild rice, cooked</li> </ul> <p>In a soup pot over medium heat, add canola oil, and saute onion, carrot, celery and garlic until lightly brown. Stir in kale, parsley, stock and spices. Bring to a boil. In a blender, puree beans with milk. Add bean mixture to soup, bring to simmer and add rice. Cook for 30 minutes. Serve in warmed bowls.</p> <p>Nutrition for 1 serving (2 cups): 236 calories, 4 grams total fat, 1 gram saturated fat, 0 grams trans fat, 2 grams monounsaturated fat, 6 milligrams cholesterol, 180 milligrams sodium, 38 grams total carbohydrates, 7 grams fiber, 12 grams total sugars, 0 grams added sugars, 12 grams protein.</p> <p><a href="/providers/caitlin-terpstra-rdld" target="_self" title="Opens in same window."><em>Caitlin Terpstra</em></a><em> is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em></p>RDN, LD<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, St. Catherine University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>University of Wisconsin Hospital and Clinics</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Licensed Dietician</li> <li>Registered Dietitian</li> </ul>Terpstra<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/caitlin-terpstra-rd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=D56D6F5A2B6A4866353C6D74A8883157" alt="Caitlin Terpstra RD" width="280" height="280" DisableNVelocity="true" />Caitlin<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>19992149Caitlin Terpstra, RDN, LD1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2023/kale-salad.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C55280E91AEA00D8708708CF6199C16D" alt="Kale salad" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller5/24/2018<p>Are you at risk for colon cancer? You can find out by answering a variety of questions with our colon cancer screening tool.</p>Gut check: Colon cancer risks and screening<img height="370" alt="Faces of three people montagejpg" width="660" src="/-/media/national-files/images/hometown-health/2018/faces-of-three-people-montagejpg.jpg?h=370&w=660&sc_lang=en&hash=2B2C33CCA4F5DF265C7EE5D7919224DA" style="height: 370px; width: 660px;" class="img-responsive" /> <p>Are you at risk for colon cancer? You can find out by answering a variety of questions with our colon cancer screening tool. These easy-to-answer questions are related to your age, health, and family and personal history, and affect your chances of developing colon cancer.</p> <a href="/-/media/national-files/documents/hometown-health/2019/colon-risk-assessment.pdf?sc_lang=en&hash=A50D8C774CF207A0976E7CD6829BF474" target="_blank" title="Opens in a new window."><img alt="Take this quiz to assess your colon health" src="/-/media/national-files/images/hometown-health/2018/take-this-quiz-to-assess-your-colon-health.jpg?h=135&w=135&sc_lang=en&hash=4F365C5E0E6018C894364BFCC75FDF99" style="height: 135px; width: 135px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /></a> <p>If you answer “yes” to any of the questions, you should see your primary health care provider for more information on colon cancer screening.</p> <p>For more information on colon cancer screenings, read our “<a href="/hometown-health/speaking-of-health/what-to-expect-before-and-during-a-colonoscopy" target="_self" title="Opens in same window.">What to expect before, during a colonoscopy</a>” blog.</p> <img src="/-/media/national-files/images/hometown-health/2018/faces-of-three-people-montagejpg.jpg?h=370&iar=0&w=660&sc_lang=en&hash=147F16D23F49D996363C4C9ED41B7AF4" alt="Faces of three people montagejpg" width="660" height="370" DisableNVelocity="true" />Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Get Tools to Live Your HealthiestIt’s never too early — or too late — to plan ahead for health. By making preventive care for you and your family a healthy habit, you’ll help improve your well-being. Be sure to connect with your healthcare provider to discuss any further questions that you may have about your health.Dawn Haller5/29/2018<p>It’s easy to get into a rut with the foods we eat. Challenge your family to discover new vegetables this summer.</p>Veggie challenge for your whole family<img height="371" alt="Hands preparing variety of vegetables" width="660" src="/-/media/national-files/images/hometown-health/2018/hands-preparing-variety-of-vegetables.jpg?h=371&w=660&sc_lang=en&hash=06DA5E8A0291AB2D8C4CF07686B9BBDC" class="img-responsive" style="height: 371px; width: 660px;"> <p>It’s easy to get into a rut with the foods we eat. Challenge your family to discover new vegetables this summer. Some ideas to get you started include beets, kohlrabi, dandelion greens, eggplant or kale. See how many new vegetables your family can check off.</p> <a href="/-/media/national-files/documents/hometown-health/2019/veggie-challenge.pdf?sc_lang=en&hash=9AD822E87B1DC20F28A32848C1EC6171" target="_blank" title="Opens in a new window."><img alt="Download the Veggie Challenge" src="/-/media/national-files/images/hometown-health/2018/download-the-veggie-challenge.jpg?h=165&w=165&sc_lang=en&hash=B3964D6E8B11910F5CEF11AB01C8E06D" style="height: 165px; width: 165px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive"></a> <p>Here are a couple of recipes to get you started.</p> <p><strong>Baby beets and carrots with dill</strong></p> <ul> <li>1 lb. red and yellow baby beets, about 1½ inches in diameter</li> <li>½ lb. baby carrots, peeled</li> <li>2 teaspoons butter</li> <li>1 tablespoon extra-virgin olive oil</li> <li>1½ teaspoons fresh lemon juice</li> <li>2 teaspoons chopped fresh dill, plus sprigs for garnish</li> </ul> <p>If the beet greens are still attached, cut them off, leaving about 1 inch of the stem intact. If the carrots are varied sizes, cut the larger ones into halves and thirds for even cooking. In a large pot fitted with a steamer basket, bring 1 inch water to a boil. Add the unpeeled beets, cover and steam until tender, 20–25 minutes. Remove from the pot and cut into quarters. Set aside and keep warm. Check the pot, add water to a depth of 1 inch, if necessary, and return to a boil. Add the baby carrots, cover and steam until tender, 5–7 minutes. Remove from the pot. In a large bowl, toss the carrots with the butter, olive oil, lemon juice and chopped dill. Add the beets, toss gently to combine and transfer to a serving dish. Serve immediately, garnished with the dill sprigs.</p> <p><strong>Roasted root vegetables with cumin and coriander</strong></p> <ul> <li>½ lb. sweet potatoes, peeled and cut into 1-inch pieces</li> <li>½ lb. parsnips, peeled and cut into 1-inch pieces</li> <li>½ lb. rutabagas, peeled and cut into 1-inch pieces</li> <li>½ lb. turnips, peeled and cut into 1-inch pieces</li> <li>2 tablespoons olive oil</li> <li>1 teaspoon ground cumin</li> <li>1 teaspoon ground coriander</li> <li>½ teaspoon salt</li> <li>¼ teaspoon freshly ground pepper</li> <li>2 tablespoons chopped fresh cilantro (fresh coriander)</li> </ul> <p>Position a rack in the lower third of the oven and preheat to 400 degrees F. In a large bowl, combine the vegetables, olive oil, cumin, ground coriander and salt. Toss well to coat. Arrange the vegetables in a single layer on a large baking sheet. Roast, stirring or shaking the vegetables every 15 minutes, until tender and evenly browned, about 45 minutes. Sprinkle with the pepper; taste and adjust the seasoning. Transfer to a serving dish and sprinkle with the fresh cilantro. Serve hot or at room temperature.</p> <p><a href="https://mayoclinichealthsystem.org/topics/eat-well" target="_blank" title="Opens in a new window.">Find more recipe ideas here</a>.</p><img src="/-/media/national-files/images/hometown-health/2018/hands-preparing-variety-of-vegetables.jpg?h=371&iar=0&w=660&sc_lang=en&hash=EAAED280246BC03649965FD0F5546C9E" alt="Hands preparing variety of vegetables" width="660" height="371" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller5/21/2018<p>Adverse childhood experiences, or ACEs, are negative events in a child’s life that can have lasting effects on health and well-being. There are multiple ways to build and strengthen a child’s resilience and help lessen the consequences of ACEs.</p>Overcoming adverse childhood experiences<img alt="Ripped paper childhood to adulthood illustration" src="/-/media/national-files/images/hometown-health/2018/ripped-paper-childhood-to-adulthood-illustration.jpg?h=300&w=300&sc_lang=en&hash=B090F419C2B7A1A758D1FC3A5754118D" style="height: 300px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive" /> <p>Adverse childhood experiences, or ACEs, are negative events in a child’s life that can have lasting effects on health and well-being. The phrase came about during the CDC-Kaiser Permanente Adverse Childhood Experiences Study, first published in 1998. The study looked at how childhood trauma affects long-term health.</p> <p>In situations of prolonged childhood trauma, a child’s brain and body will produce an overload of stress hormones that can harm the function and structure of the brain. Because children’s brains are developing at a rapid pace, this can be particularly harmful to them, changing how they will learn, respond to stress and make decisions for the rest of their life. Childhood trauma can lead to the adult onset of chronic diseases, such as heart disease, depression, drug abuse, violence and being a victim of violence.</p> <p><strong>ACES EXAMPLES</strong></p> <p>Examples of ACEs include:</p> <ul> <li>Experiencing parental divorce or separation</li> <li>Having a family member who is incarcerated</li> <li>Living with a family member who is addicted to alcohol or other substances</li> <li>Living with a family member who is depressed or has other mental illnesses</li> <li>Experiencing physical and emotional neglect</li> <li>Experiencing physical, emotional and sexual abuse</li> <li>Witnessing a mother being abused</li> </ul> <p>ACEs occur more commonly than you’d expect. In Wisconsin, more than half of all adults have experienced one adverse childhood experience in their past. The more ACEs an individual has experienced, the higher their risk climbs for lasting health impacts.<span>  </span></p> <p><strong>COMBATING ACES</strong></p> <p>While ACEs are related to health and behaviors later in life, they are not a guarantee of anything. The negative health effects of ACEs can be tempered when people have a strong support system and the skills to successfully cope with life’s challenges. This coping ability is called resilience.</p> <p>There are multiple ways to build and strengthen a child’s resilience and help lessen the consequences of ACEs. This support could include:</p> <ul> <li>Caregiver knowledge and application of positive parenting skills</li> <li>Children’s social and emotional health</li> <li>Close relationships with competent caregivers or other caring adults</li> <li>Communities that support health and development</li> <li>Concrete support for parents and families</li> <li>Having a sense of purpose</li> <li>Individual problem-solving skills and self-regulation abilities</li> <li>Parental resilience</li> <li>Social connections</li> </ul> <p>These kinds of support tactics help a child feel safe more quickly after experiencing ACEs and help to neutralize the impact. It’s particularly important for caregivers to help create strong, protective relationships for children that can allow them to stay strong, even when facing adversity. If the child’s protective networks are in good working order, development can flourish even in the face of severe adversity. If these systems are not strong, either before or after the ACE, then the risk for developmental problems is much greater. </p> <p><strong>A FRAMEWORK FOR HOPE</strong></p> <p>The framework that ACEs provide helps us look at health in a new way. Understanding risk factors provides a new way to approach people in our lives who may benefit from extra support. It is important for everyone to know that no matter the experience, there is always hope for a positive outcome. Risk does not define destiny.</p> <p>Get more information from these resources:</p> <ul> <li><a rel="noopener" href="https://www.dhs.wisconsin.gov/aces/index.htm" target="_blank" title="Opens in a new window.">Wisconsin Department of Health</a></li> <li><a rel="noopener" href="http://www.health.state.mn.us/divs/cfh/program/ace/index.cfm" target="_blank" title="Opens in a new window.">Minnesota Department of Health</a></li> </ul><img src="/-/media/national-files/images/hometown-health/2018/ripped-paper-childhood-to-adulthood-illustration.jpg?h=504&iar=0&w=504&sc_lang=en&hash=A76E89655998A24EE461709FBABED498" alt="Ripped paper childhood to adulthood illustration" width="504" height="504" DisableNVelocity="true" />Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller4/23/2025A gluten-free diet helps manage symptoms of celiac disease and other medical conditions associated with gluten. Find out how it can affect your overall nutritional needs.Gluten-free: What does that mean?<p>Gluten is a protein found in certain grains, such as wheat, barley, rye, and a cross between wheat and rye called triticale.</p> <p>A gluten-free diet helps manage symptoms of celiac disease and other medical conditions associated with gluten consumption. This type of diet also has gained popularity among people without gluten-related medical conditions. The claimed benefits of the diet are improved health, weight loss and increased energy.</p> <p>Removing gluten from your diet likely changes your overall intake of fiber, vitamins and other nutrients. Therefore, regardless of your reasons for following a gluten-free diet, it's important to know how it can affect your overall nutritional intake.</p> <h2>These medical conditions require a gluten-free diet:</h2> <ul> <li><strong>Celiac disease</strong><br /> This is an autoimmune disorder in which gluten triggers immune system activity that damages the lining of the small intestine. Over time, this damage prevents the absorption of nutrients from food.</li> <li><strong>Gluten sensitivity</strong><br /> This causes some of the same signs and symptoms associated with celiac disease, including abdominal pain, bloating, diarrhea, constipation, foggy brain, rash or headache, even though there is no damage to the tissues of the small intestine. Studies show that the immune system plays a role, but the process isn't well-understood.</li> <li><strong>Gluten ataxia</strong><br /> This is an autoimmune disorder in which gluten affects certain nerve tissues, and causes problems with muscle control and voluntary muscle movement.</li> <li><strong>Wheat allergy</strong><br /> Like other food allergies, wheat allergy is the result of the immune system mistaking gluten or some other protein found in wheat as a disease-causing agent, similar to a virus or bacteria. The immune system creates an antibody to the protein, prompting an immune system response that may result in congestion, breathing difficulties and other symptoms.</li> </ul> <p>Your health care team or a dietitian can help you make appropriate dietary choices to maintain a well-balanced diet with the diagnosis of any of these conditions.</p> <h2>What to look for on food labels</h2> <p>When you are buying groceries, you need to read labels to determine if they contain gluten. Foods that contain wheat, barley, rye or triticale — or an ingredient derived from them — must be labeled with the name of the grain in the label's content list.</p> <p>Foods that are labeled gluten-free, according to the Food and Drug Administration rules, must have fewer than 20 parts per million of gluten.</p> <h4>Foods with these labels may include:</h4> <ul> <li>Naturally gluten-free food</li> <li>A prepared food that doesn't have a gluten-containing ingredient</li> <li>Food that has not been cross-contaminated with gluten-containing ingredients during production</li> <li>Food with a gluten-containing ingredient that has been processed to remove gluten</li> </ul> <p>Alcoholic beverages made from naturally gluten-free ingredients, such as grapes or juniper berries, can be labeled gluten-free. An alcoholic beverage made from a gluten-containing grain can carry a label stating the beverage was processed, treated or crafted to remove gluten. However, the label must state that gluten content cannot be determined and the beverage may contain some gluten.</p> <h2>Processed foods that contain gluten</h2> <p>Wheat, barley or rye are commonly found in processed foods. Wheat gluten frequently is added as a thickening or binding agent, or for flavoring or coloring. It's vital to read the labels of processed foods to determine if they contain these grains.</p> <p>In general, if a gluten-free diet is advised for you, consume foods not as gluten-free with caution. Look specifically for those made with corn, rice, soy or other gluten-free grain.</p> <h2>Medications and supplements</h2> <p>Prescription and over-the-counter medications may use wheat gluten as a binding agent. Talk to your health care provider or pharmacist about the medications you're taking. Dietary supplements that contain wheat gluten must list wheat as an ingredient on the label.</p> <h2>Eating gluten-free at home, in restaurants</h2> <p>It’s particularly important for people with celiac disease to avoid exposure to gluten.</p> <h4> These tips can help you prevent cross-contamination in your own food preparations at home and avoid gluten-containing food when you eat out:</h4> <ul> <li>Store gluten-free and gluten-containing foods in different places.</li> <li>Keep cooking surfaces and food storage areas clean and sanitized.</li> <li>Wash dishes and cooking equipment thoroughly.</li> <li>Read restaurant menus online ahead of time, if possible, to be sure there are options for you.</li> <li>Eat out early or late when a restaurant is less busy and better able to address your needs.</li> </ul> <p>Gluten-free recipes can have the same nutritional value and great taste as traditional recipes. Don't hesitate to explore gluten-free foods. In some cases, gluten-free recipes can have added benefits, such as increased fiber and protein.</p> <h2>Try these gluten-free recipes today:</h2> <h4>Apricot and almond crisp</h4> <p> Serves 6<br /> Dietitian's tip: This apricot dessert uses no flour and is gluten-free when made with certified gluten-free oats.</p> <p>Ingredients</p> <ul> <li>1 teaspoon olive oil</li> <li>1 pound apricots, halved with pits removed</li> <li>1/2 cup almonds, chopped</li> <li>1 tablespoon oats (certified gluten-free)</li> <li>1 teaspoon anise seeds</li> <li>2 tablespoons honey</li> </ul> <p>Directions</p> <p>Heat oven to 350 degrees. Brush olive oil in 9-inch glass pie dish. Chop apricots and place in pie dish. Sprinkle almonds, oats and anise seeds on top. Drizzle with honey. Bake for 25 minutes, until almond topping is golden and apricots are bubbling up. Serve warm.</p> <p>Nutritional analysis per 1/2 cup serving: 134 calories, 6 grams total fat, 0.5 grams saturated fat, trace trans fat, 4 grams monounsaturated fat, 0 milligrams cholesterol, 1 milligram sodium, 17 grams total carbohydrate, 3 grams dietary fiber, 6 grams added sugars, 3 grams protein</p> <h4>Italian chicken and vegetable packet</h4> <p>Serves 1<br /> Dietitian's tip: This recipe may also be prepared on the grill. Use heavy-duty aluminum foil and place it off to the side of the flame. Turn midway through the cooking time.</p> <p>Ingredients</p> <ul> <li>1 skinless, boneless chicken breast, about 3 ounces</li> <li>1/2 cup diced zucchini</li> <li>1/2 cup scrubbed and diced potato</li> <li>1/4 cup diced onion</li> <li>1/4 cup sliced baby carrots</li> <li>1/4 cup sliced mushrooms</li> <li>1/8 teaspoon garlic powder</li> <li>1/4 teaspoon Italian seasoning or oregano</li> </ul> <p>Directions</p> <p>Heat oven to 350 degrees. Cut off a 12-inch sheet of heavy-duty aluminum foil or parchment paper. Fold the foil or parchment paper in half, unfold and spray with cooking spray. Center the chicken breast on the sheet. Top with zucchini, potato, onion, carrots and mushrooms. Sprinkle garlic powder and Italian seasoning on the chicken and vegetables. Bring the foil together and make small, overlapping folds down the length of the packet to seal. Twist the two ends several times to make a tight seal so the liquid won't escape during cooking. Place the packet on a cookie sheet and bake for 45 minutes, until chicken and vegetables are tender.</p> <p>Nutritional analysis per serving: 207 calories, 2.5 grams total fat, 0.5 grams saturated fat, trace trans fat, 0.5 grams monounsaturated fat, 62 milligrams cholesterol, 72 milligrams sodium, 23 grams total carbohydrate, 3 grams dietary fiber, 0 grams added sugar, 23 grams protein</p> <p><em>Kjersten Nett is a registered dietitian in Albert Lea and Austin, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2022/hands-making-gluten-free-food.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F34CD4A5E315CF2F9143CDF36C2031FF" alt="Hands making gluten-free food" width="660" height="370" DisableNVelocity="true" />Celiac DiseaseCeliac disease is a digestive condition triggered by consumption of the protein gluten, which primarily is found in bread, pasta, cookies, pizza crust and many other foods containing wheat, barley or rye.Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Michele Halterman3/31/2022Glaucoma, sometimes called the silent thief of sight, is a group of eye conditions that damage the optic nerve, which is critical for good vision. Learn what to do to protect and secure your sight.Don’t be fooled by glaucoma — the silent sight thief<p>Glaucoma, sometimes called the silent thief of sight, is a group of eye conditions that damage the optic nerve, which is critical for good vision. This damage is often caused by an abnormally high pressure in the eye.</p> <p>Glaucoma is one of the leading causes of blindness in the U.S. It can occur at any age but is more common in older adults. The most common form of glaucoma has no warning signs. You may notice patchy blind spots in your side or central vision. But the vision loss is often so gradual that you may not notice a change in vision until the condition is at an advanced stage.</p> <h4>Protect your sight</h4> <p>If you are 40 or older, or have a family history of glaucoma, you are at a higher risk of developing glaucoma. Many people with glaucoma do not realize they have the condition until they are seen for a routine exam.</p> <p>You can help protect vision in you and your family members by getting a comprehensive dilated eye exam at least once every two years. During this exam, you will be screened for eye diseases, such as glaucoma. The dilated exam may show changes in the shape and color of the optic nerve fibers due to pressure. Lowering eye pressure in the early stages of glaucoma slows progression of the disease and helps save vision.</p> <h4>Secure your sight</h4> <p>While treatment for glaucoma cannot restore vision if it has already been lost, it can preserve remaining sight. Typically, many forms of glaucoma are first treated with daily eye drops or a laser procedure. The procedure is safe and performed in the office with no restrictions on activity by the day after the procedure. If eye drops or a laser procedure are not effective enough or cannot be tolerated, surgical procedures may be needed.</p> <p>A new procedure called ab interno canaloplasty (ABiC) is a minimally invasive surgery to treat patients with glaucoma. Some ophthalmologists have advanced training in treating patients with eye diseases, such as glaucoma. During training, I learned to perform ABiC directly from the surgeon who invented the procedure.</p> <p>During the procedure, a small catheter is used to flush out the part of the eye that drains pressure, resulting in lower eye pressure and better control of glaucoma. No stent or device is left behind in the eye after the procedure as they often are in traditional surgeries. The procedure has less risk of infection and quicker vision recovery than with traditional glaucoma procedures.</p> <p>If your glaucoma cannot be controlled by eye drops or laser treatment, ABiC may be an option for you. In addition, if you are experiencing decreased vision due to cataracts, the procedure usually can be performed at the same time as cataract surgery with little added risk. Afterward, you may need fewer or no eye drops to treat your glaucoma.</p> <h4>Prevention of sight loss is a team effort</h4> <p>Treating glaucoma successfully is a team effort between you and your health care team. Share your concerns with your primary care provider, especially if you have a family history of glaucoma or other eye conditions.</p> <p>Schedule your routine eye exam with an optometrist or ophthalmologist. If you are diagnosed with glaucoma, your care team will talk with you about your lifestyle and develop a treatment plan to protect you from the silent thief of sight.</p> <p><em><a href="/providers/matthew-cooke-md" target="_self" title="Opens in same window.">Matthew Cooke, M.D.</a>, is an <a href="/services-and-treatments/ophthalmology" target="_self" title="Opens in same window.">ophthalmologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Cataract surgery</li> <li>Medical and surgical treatment of glaucoma</li> </ul>M.D.<p>I try to help my patients to understand their eye condition and treatment options so we can work together as a team to preserve or improve their sight. </p> <p>In my spare time, I enjoy spending time with my wife and our dog, hiking, watching sports, reading, playing cards and board games, and traveling.</p><p><strong>Education</strong></p> <ul> <li>University of Michigan-Ann Arbor</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Ophthalmology, Medical College of Wisconsin-Milwaukee</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Glaucoma, Dean McGee Eye Institute, University of Oklahoma-Oklahoma City</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Glaucoma Society</li> <li>American Academy of Ophthalmology</li> <li>American Society of Cataract and Refractive Surgery</li> <li>Christian Ophthalmology Society</li> </ul>Cooke<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/matthew-cooke-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=5EFB4B65F4B85B591A2DC8E0B7D98DC0" alt="Matthew Cooke, M.D." width="280" height="280" DisableNVelocity="true" />{C3420D2E-E59E-4685-8536-30A36F2AC68C}Matthew<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>10430113Matthew Cooke, M.D.1{C5680DDD-C649-4B63-AFCC-B52A244736B7}<img src="/-/media/national-files/images/hometown-health/2022/photographer-behind-a-camera.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9A55468EAD7BFE6E92F2B58E3E22A858" alt="Photographer behind a camera" width="660" height="370" DisableNVelocity="true" />Eye HealthYour eyes are responsible for providing you with vision, perhaps the most important of the senses. However, the eye is a delicate and complicated structure that needs protection. The ugly truth is that eye injuries can happen at any time and place.Michele Halterman7/13/2022While medical science works to further understand the human microbiome's role in your daily health, answers to common questions can help you better understand probiotics.An introduction to probiotics<p>Recently, there's been a lot of conversation in the media about probiotics. As a nutritionist, I often answer questions from patients looking to know more about probiotics and their publicized health benefits. While medical science works to further understand the role the microbiome plays in your daily health, there are a few questions we can shed some light on to help you gain a better understanding of probiotics.</p> <h2>What are probiotics?</h2> <p>Probiotics are live, active microorganisms ingested to alter the gastrointestinal flora for health benefits. They often are referred to as good bacteria in the gut and compete with bad bacteria to support the body in establishing optimal digestion and aid immune function.</p> <h2>Why are probiotics important to your health?</h2> <p>Probiotics help create a balance in a healthy digestive system. Gastrointestinal problems can occur when this balance breaks down either due to illness, a course of antibiotics, a diet lacking nutrient-dense food or the overgrowth of unfriendly bacteria.</p> <h3>Although more research is needed, there is evidence that probiotics may help:</h3> <ul> <li>Prevent or treat diarrhea caused by infections and antibiotics</li> <li>Improve symptoms of irritable bowel syndrome</li> <li>Boost immune system</li> <li>Reduce inflammation and allergies</li> </ul> <h2>Are probiotics right for everyone?</h2> <p>Probiotics have a good safety record for people who are generally healthy. If they occur at all, side effects usually consist of mild digestive symptoms like gas. As with any drug or supplement, always talk to your health care team before taking any probiotic. This is especially important if you have a suppressed immune system, as some people occasionally report serious complications, such as infections.</p> <h2>What foods contain probiotics?</h2> <h3>Some probiotic-rich foods include:</h3> <ul> <li>Kefir</li> <li>Kimchi</li> <li>Kombucha</li> <li>Miso</li> <li>Pickles</li> <li>Sauerkraut</li> <li>Tempeh</li> <li>Yogurt</li> </ul> <h2>What should I consider when researching probiotics?</h2> <p>The potential benefits of probiotics are widespread, but there's no one-size-fits-all application. There are many different probiotics, each strain performing a separate function or producing a different benefit in the body. Additionally, probiotic supplementation is an exciting and growing area of research. The current literature supports their use for various conditions, primarily within digestive health.</p> <h3>Things to consider:</h3> <ul> <li>Find the right strain for your individual needs.</li> <li>Follow storage instructions, as some probiotics need to be refrigerated.</li> <li>Check the expiration date of the probiotic you're using.</li> <li>Try foods or supplements. Either is fine, though supplements generally have higher concentrations of probiotics.</li> </ul> <p>Most importantly, eat a diet rich in nutrients and high in fiber — including fruits, vegetables and whole grains. Probiotics feed off of fiber and build colonies that will keep your gut in a healthy balance.</p> <p>If you have questions or concerns about probiotics, make sure you to discuss them with your health care team.</p> <em><a href="/providers/allyn-wergin-rdn" target="_self" title="Opens in same window">Allie Wergin</a> is a <em>registered <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">dietitian-nutritionist</a> </em> <a href="/locations/new-prague" target="_self" title="Opens in same window">New Prague, Minnesota</a>.</em><ul> <li>Bariatric surgery</li> <li>Diabetes management</li> <li>Oncology</li> <li>Weight management</li> </ul>RDN<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, St. Catherine University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration </li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul>Mahowald<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/allyn-wergin-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=74F690ED261F537AA65B66929A3356D1" alt="Allie Mahowald, RDN" width="280" height="280" DisableNVelocity="true" />{9209F8EC-1016-41AA-985F-014D9B877417}Allie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15971546Allyn Mahowald, RDN1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2022/pickles.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E09817CFD8CDFEBA754BC54660020A18" alt="Pickles" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Michele Halterman6/4/2018<p>Snap, crackle and pop may be welcome sounds at the breakfast table. But when you hear a pop on the playing field, it’s not something to cheer. A torn ACL usually is a season-ending injury.</p>How to prevent an ACL injury<img height="370" alt="Runner holding knee" width="660" src="/-/media/national-files/images/hometown-health/2018/runner-holding-knee.jpg?sc_lang=en&hash=DE23FEA309802495D6C798F7DA6A475C" class="img-responsive"> <p>Snap, crackle and pop may be welcome sounds at the breakfast table. But when you hear a pop on the playing field, it’s not something to cheer.</p> <p>“Many patients will tell me they heard or felt a pop when they tore their ACL,” says <a href="/providers/mitchell-nesvik-dpt" target="_self" title="Opens in same window.">Mitchell Nesvik</a>, a physical therapist at Mayo Clinic Health System in <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>.</p> <p>The ACL, or anterior cruciate ligament, is one of the major ligaments in the knee. Tearing that ligament is one of the most common — and devastating — injuries facing athletes.</p> <p>“A torn ACL is usually a season-ending injury,” Mitchell says. “Most athletes will need surgery to repair the injury, and recovery and rehab take months.”</p> <p>Around 200,000 people tear their ACL each year. Most of them play sports, like basketball, soccer and tennis, which require players to jump, lunge and pivot. Around 70 percent of ACL tears are noncontact injuries. And the majority of those injured are female.</p> <p>“Women are 3 to 6 times more likely to tear their ACL than men,” Mitchell says.</p> <p>Studies suggest that women’s jumping and landing techniques are part of the reason for the difference. Many women also have a strength imbalance in the muscles in their legs, with stronger quadriceps than hamstrings. That imbalance may allow the shinbone to move too far forward, overextending the ACL.</p> <p>That’s the bad news. Fortunately, Mitchell says there’s good news, as well.</p> <p>“There are things you can do to prevent an ACL injury,” MItchell explains.</p> <h4>FOCUS ON FORM</h4> <p>Many ACL injuries are a result of landing wrong after a jump. Practicing good jumping techniques can help minimize that risk. That includes:</p> <ul> <li>Landing evenly on both feet</li> <li>Bending the knees when landing</li> <li>Aligning the body with the feet during landing</li> <li>Keeping knees shoulder width apart during landing</li> </ul> <p>Focusing on exercises that strengthen the core and help with balance also can help improve jumping technique.</p> <p>“A strong core gives you more control over your torso and provides stability when you have to switch directions quickly,” Mitchell says.</p> <h4>STRENGTHEN LEG MUSCLES</h4> <p>Strong, balanced muscles in the legs help protect the knees. Since weak hamstrings are thought to play a role in many ACL injuries, exercises that target those muscles may be especially beneficial. Stability ball hamstring curls are one great option. Deadlifts are another. Add in squats and lunges, which work the quadriceps, hamstrings and glutes, for all-over leg strengthening.</p><img src="/-/media/national-files/images/hometown-health/2018/runner-holding-knee.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8D1A5D11F8766BBAAE5F0078EC26A587" alt="Runner holding knee" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Michele Halterman12/29/2022Variety is key to a healthy diet. It turns out, it's also key to a healthy fitness routine. Incorporate these five fitness elements to ensure success.The 5 elements of fitness<p>Variety is key to a healthy diet. It turns out, it's also key to a healthy fitness routine.</p> <p>A well-rounded routine should include a variety of activities that work different areas of your body. A mix also prevents boredom and lowers your risk of getting injured.</p> <h2>Try to include each of these activities in your weekly routine:</h2> <h3>1. Aerobic conditioning</h3> <p>Activities that get your heart rate up help keep your heart healthy, boost your mood and positively affect numerous chronic conditions. Exercises include walking, running, biking, swimming, rowing, exercising using an elliptical machine and more.</p> <h3>2. Strength training</h3> <p>When lifting free weights or using your body weight, think whole body, including legs, arms, stomach and back. Strength training helps build muscle, strengthen bones and prevent injuries if done properly. It also can improve balance with repetitive training. You can use free weights or weight machines to perform different <a rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/strength-training/art-20046031" target="_blank" title="Opens in a new window.">strength training exercises</a>, such as squats, chest presses, leg presses, bicep curls and others.</p> <h4>3. Flexibility activities</h4> <p>Flexibility improves your joints' range of motion and makes daily tasks easier. Stretch after your workout when your muscles are warm. <a rel="noopener noreferrer" href="https://www.mayoclinic.org/img-20145509" target="_blank" title="Opens in a new window.">Tai chi</a> and <a rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/stress-management/multimedia/yoga-poses/sls-20464430" target="_blank" title="Opens in a new window.">yoga</a> also can be used to improve flexibility.</p> <h4>4. Posture exercises</h4> <p>Proper body alignment not only helps prevent pain and injury, but also can boost your confidence and mood. Improving your posture will likely take time and conscious effort, but the feel-good benefits are worth it. Some exercise ideas include <a rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/adult-health/multimedia/back-pain/sls-20076265?s=7" target="_blank" title="Opens in a new window.">back exercises</a>, <a href="/hometown-health/speaking-of-health/15-minute-workout-core" target="_self" title="Opens in same window.">core strengthening routines</a>, yoga and Pilates.</p> <h4>5. Balance training</h4> <p><a rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/fitness/multimedia/balance-exercises/sls-20076853" target="_blank" title="Opens in a new window.">Balance training</a> improves your body's ability to react quickly to everyday missteps, which helps prevent falls. During exercise, balance also helps you move more efficiently for improved performance and injury prevention. Try single-leg lifts or tai chi.</p> <p>Consistency and safety also play key roles in a fitness routine. Exercise is medicine. Just like medicine, it should be taken almost every day. Think of it as a lifelong activity. Ideally, your week would include at least two days of strength training per week and at least 150 minutes of moderate aerobic activity. Flexibility, posture and balance training can be worked throughout the week.</p> <p>Finally, consider safety as you exercise. Start slowly and gradually increase time and intensity in your routine. This can prevent injury and build long-term habits.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2018/running-shoes-on-a-wooded-trail.jpg?h=370&iar=0&w=660&sc_lang=en&hash=916A14B99E8FCE88D0C36B30FDACA2D6" alt="Running shoes on a wooded trail" width="660" height="370" DisableNVelocity="true" />Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Michele Halterman6/4/2018<p>Some days feel like a sprint; others, a marathon. Here’s an easy breakfast recipe to fuel your day.</p>Fill your tank with an easy, healthy breakfast<img height="370" alt="Hands holding oats" width="660" src="/-/media/national-files/images/hometown-health/2018/hands-holding-oats.jpg?sc_lang=en&hash=E931D38CE69B2FA219D2EDFA5ACCFA56" class="img-responsive"> <p>Some days feel like a sprint; others, a marathon. Here’s an easy breakfast recipe to fuel your day:</p> <p><strong>Overnight Refrigerator Oatmeal</strong></p> <p>Ingredients</p> <ul> <li>1/3 cup skim milk or soy milk</li> <li>1/4 cup unsweetened applesauce</li> <li>1/4 cup old-fashioned rolled oats</li> <li>1/4 cup Greek low-fat plain yogurt</li> <li>1/4 cup diced apples or blueberries</li> <li>1 1/2 teaspoons dried chia seeds</li> <li>1/4 teaspoon cinnamon</li> </ul> <p>Directions</p> <ul> <li>Place all of the ingredients in a 1-pint mason jar.</li> <li>Screw on the lid, and shake until well-combined.</li> <li>Refrigerate overnight, and eat chilled.</li> </ul> <p>Serves 1; 193 calories</p><img src="/-/media/national-files/images/hometown-health/2018/hands-holding-oats.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E791F7A6E689947282CA1B6B471B8E41" alt="Hands holding oats" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Michele Halterman2/24/2023Restless nights tossing and turning can leave you feeling tired. If you have trouble falling or staying asleep, learn how to observe your sleep patterns and try five ways to improve your sleep.5 ways to get better sleep<p>You're not alone if you have trouble falling or staying asleep. Many people struggle with sleep — and that's a problem, since sleep plays a crucial role in your health, energy levels and ability to function at your best. Most adults require seven to eight hours of sleep each night to feel well-rested and energized each day.</p> <p>If restless nights have become the norm for you or you find that your sleep is not refreshing, start by observing your sleep patterns. Take note of how much you sleep each night, what factors contribute to your sleep, how rested you feel the next morning and how sleepy you feel throughout the day.</p> <h2>After observing your sleep patterns for one to two weeks, try these five strategies to help improve your sleep:</h2> <h3>1. Minimize light and sound.</h3> <p>These two environmental factors can impact your quality and quantity of sleep. Darkness causes your brain to release melatonin for a calming, sleepy effect. As a result, it's important to minimize your exposure to light before bedtime. Even the light from your computer, TV or other devices might make it more difficult to fall asleep. Ban these devices from your bedroom, and create a dark space using blackout shades or an eye mask. Noise also can interfere with your ability to sleep. Try using a fan or a noise machine to block out unwanted noises.</p> <h3>2. Get comfortable.</h3> <p><a href="/-/media/national-files/documents/hometown-health/2019/get-your-zzzz-flier.pdf?sc_lang=en&hash=767CD1ACF4BEB71828804AD62826FBE0" target="_blank" title="Opens in a new window."><img alt="Download a PDF for five sleep hygiene tips." src="/-/media/national-files/images/hometown-health/2019/download-a-pdf-for-five-sleep-hygiene-tips.jpg?h=135&w=135&sc_lang=en&hash=4188BF4B1D8D85ABB7E8262E73BDF274" style="height: 135px; width: 135px; float: right; margin-right: 5px; margin-bottom: 5px;"></a>Adults spend about a third of their lives asleep, so it's worthwhile to invest in bedding that comforts and relaxes you. Before climbing into bed, try lowering your thermostat a few degrees. Your core temperature drops during rest, and keeping your room chilly will aid in this natural temperature drop.</p> <h3>3. Keep a routine.</h3> <p>Just like kids, adults sleep better when they have a bedtime routine. Stick to a regular sleep schedule. Aim to go to bed and wake up at the same time, during the week and on weekends. Doing the same thing before bed each night can help prepare your body for rest and condition your brain for sleep. Stick to activities that promote relaxation, such as gentle stretching, writing in a journal, reading or meditation.</p> <h3>4. Manage stress.</h3> <p>How you handle stress can significantly affect your ability to fall and stay asleep. While stress isn't all bad, it can disrupt your sleep when it turns into worry or anxiety. If your busy mind keeps you up at night, try practicing stress management techniques bedtime. Listening, but not watching, sleep talk-down meditations can help clear your mind. Experiment with aromatherapy, deep breathing, keeping a gratitude journal or other meditation.</p> <h3>5. Get out of bed.</h3> <p>If you lie in bed stressing about your inability to sleep, get out of bed and do something that will promote relaxation. This might be reading an uninteresting book, practicing a relaxation technique or focusing on your breath. When you begin to feel sleepy, head back to bed. Avoid spending time in bed frustrated about sleep.</p> <p>Make sleep a priority. Even if you're already sleeping soundly, these tips can help.</p> <h4>If you're still not getting enough sleep, use these additional suggestions until you get the sleep you need to feel your best each day:</h4> <ul> <li>Keep a written log of your sleep schedule this week.</li> <li>Turn off your electronic devices — including your phone and TV— an hour before bed each night.</li> <li>Do some gentle stretches before bed to help you relax.</li> </ul> <p>Continue making adjustments until restless nights become a thing of the past. If you struggle with sleep despite these measures, it may be time to talk with your health care team.</p> <p><em>Rachel Ziegler, M.D.</em><em>, is a physician in <a href="/services-and-treatments/neurodiagnostics" target="_self" title="Opens in same window.">Sleep Medicine</a> in <a href="/locations/fairmont">Fairmont</a> and <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2023/looking-at-temperature-phone-app.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A1006D96FE2752B6551E61EF80028044" alt="Looking at temperature phone app" width="660" height="370" DisableNVelocity="true" />SleepSleep is essential to good health. It's one of the body's basic needs. But, what do you do when you have troubles sleeping, or getting enough hours of sleep? Get Tools to Live Your HealthiestIt’s never too early — or too late — to plan ahead for health. By making preventive care for you and your family a healthy habit, you’ll help improve your well-being. Be sure to connect with your healthcare provider to discuss any further questions that you may have about your health.Michele Halterman8/9/2022Do you feel sluggish or unmotivated? If so, it's time to develop an energy management plan to live a happier, healthier and more productive life.7 tips to live a happier life<p>Do you wake up feeling sluggish most mornings? Have caffeinated beverages become a necessity to help power you through the day?</p> <p>If this sounds familiar, it's time to ditch the quick fixes you rely on, and develop an energy management plan. Getting started may seem daunting, but soon you'll be energized to keep going once you recap the benefits of a happier, healthier and more productive lifestyle.</p> <h2>What is energy management?</h2> <p> Think of your energy as a limited resource, like money in an account. You begin the day with a certain amount to spend. The amount varies from person to person based on factors, such as age, sleep, stress levels, medical conditions and lifestyle. </p> <p>Activities and interactions withdraw energy from or deposit energy into your account. While you may not always have control over activities that deplete your energy, you can take steps to deposit more energy into your account.</p> <h2>Follow these seven tips to increase your energy and live a happier, healthier, more productive life:</h2> <h3>1. Eat nourishing food.</h3> <p>A well-balanced, healthy diet is at the core of well-being. But it's common to regard healthy eating primarily as a tool for weight loss. According to the 2020 Dietary Guidelines for Americans, a balanced diet high in fruits and vegetables, lean protein, low-fat dairy and whole grains is needed for optimal energy. You really are what you eat.</p> <p>Consume a variety of foods from all the food groups to get a range of nutrients to provide energy throughout the day. Opt for fresh or frozen fruits and vegetables, especially nutrient-dense dark, leafy greens and broccoli, as well as orange vegetables, like carrots and sweet potatoes. You can choose from many types of fish and legumes to choose from for healthy protein options. Aim to eat 3 ounces of whole-grain cereals, breads, rice or pasta daily.</p> <h3>2. Sleep seven to eight hours per night.</h3> <p> Prioritizing sleep is one of the best things you can do to set yourself up for a successful, energized day. Sleep deprivation can perpetuate serious health conditions, as well as negatively affect your mood, motivation and energy levels. Getting quality sleep is a healthy habit many people need to improve. Most adults need at least seven to eight hours of shut-eye each night, so what prevents them from getting it? </p> <p>Observe your sleep patterns if you struggle with sleep. Take note of how much you sleep each night, factors that contribute to your sleep or lack of it, how rested you feel, and how much energy you have during your day. Then try sleep strategies to improve your sleep, like creating a relaxing and restful environment, minimizing light and noise, establishing a bedtime routine, managing stress, and turning off electronic devices.</p> <p>Whatever you decide to start with, be consistent. Utilizing the same sleep routine and sleep strategies will help develop your body's internal alarm clock and can lead to improved sleep quality. With improved sleep quality, people experience better health, and improved emotional well-being, lower risk of diseases, and are more productive.</p> <h3>3. Keep company with good people.</h3> <p> Maximize the amount of time that you spend with people you enjoy being around. Connecting with others who radiate positivity and have similar interests will excite and energize you.</p> <p>On the other side, people you don't relate to or who have negative outlooks, complain often, or make poor choices will only drain your energy account. Be selective about the company you keep.</p> <p>It's important to set limits and boundaries to protect yourself and conserve your energy when around people who do not refill your energy reserves.</p> <h3>4. Avoid news overdose.</h3> <p> Consuming news is an important way to stay connected to what's happening in the world. It can be educational, entertaining and even uplifting.</p> <p>Unfortunately, the news too frequently is filled with stories of suffering. These stories can skew your view of the world and cause you to focus on your worst fears instead of recognizing the good that surrounds you.</p> <p>You can't avoid these stories altogether, but try to minimize your exposure when you can, especially during trying times.</p> <h3>5. Get regular exercise.</h3> <p> Do you find yourself feeling lethargic halfway through the day? Have you ever gotten winded by simple everyday duties, such as grocery shopping or household chores? The Department of Health and Human Services recommends that adults complete at least 150 minutes of moderate intensity physical activity each week. Contrary to what you might believe, this will add to your energy account and not subtract from it.</p> <p>Exercise relieves stress and tension, strengthens muscles and boosts endurance, and helps your body work more efficiently during other physical tasks or activities.</p> <h3>6. Do something meaningful each day.</h3> <p> What do you feel passionate about? Do you have a special talent that you'd like to practice more often or share with others? Do something you enjoy every day, even if it's a simple act like cooking a healthy meal or listening to your favorite song. Putting effort into the things that matter most to you will help you use and reserve your energy in ways that will bring out the best in you.</p> <h4>7. Think good thoughts for others.</h4> <p> Maintaining a compassionate mindset is another way to conserve energy. One example of practicing this way of thinking is called kind attention. For example, try to make eye contact with a stranger and smile, while thinking "I wish you well." This positive act can, instead, keep you from judging that person. Judging others can cause us to place judgment on ourselves, and that type of negative internal dialogue can be exhausting.</p> <p>You'll feel better with each step you take toward this important self-care investment.</p> <h2>Here are a few simple activities that will help you become more mindful of caring for yourself:</h2> <ul> <li><strong>Monitor your energy.</strong><br /> Take your energy "temperature" at various points throughout the day, assigning it a number from 1 to 10, with 10 being the highest energy level. Pay attention to the details of your day so you can identify the people or events that impact you the most.</li> <li><strong>Make incremental changes.</strong><br /> Once you are aware of some of the people or events that sabotage your energy, consider your next steps. Rather than tackling everything at once, choose an area that is important to you, and be realistic with the goals you set. For instance, if disorganization in your home is a big source of daily stress, pick one cabinet, closet or drawer to clear out each week instead of overwhelming yourself with doing it all at once. Then move on to your next goal when you feel ready.</li> <li><strong>Plan and prioritize.</strong><br /> Take note of the times during the day when your energy levels tend to be the highest. Decide how you can take advantage of those moments by prioritizing important tasks when you are feeling fresh and productive.</li> </ul> <p><em><a href="/providers/jolene-hanson-licsw" target="_self" title="Opens in same window.">Jolene Hanson</a> is a clinical social worker in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><p>Children ages six through adult:</p> <ul> <li>Adjustment disorders</li> <li>Anxiety disorders</li> <li>Obsessive-compulsive disorders</li> <li>Phobias</li> <li>Posttraumatic stress disorder</li> <li>Trauma-related disorders</li> </ul>L.I.C.S.W.<p>I have been practicing in the mental health field for over 15 years. My work is a collaborative approach with the patient to determine goals for treatment and ways to achieve these goals. I am passionate about my practice and continue to strive for the best patient care possible through on-going education, attentive listening and empathetic communication.</p> <p>In my free time, I enjoy being outdoors with my family along with running and playing volleyball.</p><p><strong>Education</strong></p> <ul> <li>Master’s degree, Social Work, Minnesota State University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Clinical Social Work, Mayo Clinic Health System</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Certified in Cognitive Processing Therapy</li> <li>Certified in Trauma-focused Cognitive Behavioral Therapy</li> <li>Trained in Eye Movement Desensitization and Reprocessing (EMDR)</li> <li>License Independent Clinical Social Worker, State of Minnesota</li> </ul> <p><strong>Membership</strong></p> <ul> <li>EMDR International Association </li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor of Social Work, Mayo Clinic College of Medicine and Science</li> </ul>Hanson<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jolene-hanson-licsw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7483CB6D0C345431B3BDB2662F609078" alt="Jolene Hanson LICSW" width="280" height="280" DisableNVelocity="true" />Jolene<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15448835Jolene Hanson, L.I.C.S.W.1<img src="/-/media/national-files/images/hometown-health/2022/shielding-sun-from-eyes-with-hand.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2298BB19D9F9C4E777B3C7B10B4E0285" alt="Smiling person shielding sun from eyes with hand" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Dawn Haller11/2/2022Sex addiction is an underreported mental health disorder that can be damaging to relationships and physical health. Discover the signs to look for and how it's treated like other addictions.Does society have a sex addiction problem?<p>The term "sex addiction" is casually used to describe behavior that seems to have become more common, or at least is more commonly reported in the media.</p> <p>Compulsive sexual behavior, or sex addiction, is classified by the World Health Organization as a mental health disorder. Behaviors associated with it are treated with techniques to help resist a temptation, urge or impulse. This is like many psychiatric disorders, including addiction to pornography or online sex services.</p> <h2>Sex behavior as an addiction</h2> <p>Sex addiction is a dependence on the reward experience of sex. Addiction is the consistent inability to abstain in controlling behavior or craving. It's a disease of the brain that creates motivation to keep repeating an activity to fulfill relief and reward the brain.</p> <p>Addictions come in many forms from heroin and alcohol to shopping and <a href="/hometown-health/speaking-of-health/dont-bet-on-it" target="_self" title="Opens in same window.">gambling</a>. They often are circular with multiple cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death. This is true for the sexually addicted person as well. Death can occur due to unsafe activity, disease, extreme jealous behavior or suicide.</p> <h3>Signs of sex addiction could include: </h3> <ul> <li>Difficulty postponing or controlling sexual urges</li> <li>Repetitive sexual activities or engaging in fantasies that cannot be stopped or controlled</li> <li>Little or no satisfaction from performing sexual activities, leaving the person wanting more</li> <li>Conflicts in relationships, work or other commitments due to focus on sexual activity</li> <li>Guilt or shame over behaviors</li> <li>Engaging in risky or inappropriate behaviors, such as public sex, sex without protection or exhibitionism</li> <li>Criminal sexual offenses in extreme cases</li> </ul> <h2>Sexual addiction facts</h2> <p>The statistics on sex addiction are difficult to determine accurately, partly because this type of addiction used to be ignored. Approximately 6% to 8% of U.S. adults could be classified as addicted to sex. This could be up to 24 million people.</p> <p>The rate of sex addiction may be increasing due to increased access to sexual material, including pornography, apps devoted to hookups and sexual topics on the internet. A study found that 4.7 million U.S. adults spend up more than 11 hours per week looking at pornography online.</p> <p>People often wonder if only men are affected by sex addiction. While it's more common in men, women also can be addicted. Women may have a more difficult time finding help due to stigma, and they're outnumbered by men in self-help groups.</p> <h2>Environmental impact</h2> <p>What are some causes of sexual addiction? It's important to first understand that the brain can become addicted to most anything that combines reward and avoidance. The more intense the reward experience, the more likely addiction will develop.</p> <p>Researchers have found that alcohol addiction has a genetic component with many genes affecting a person's risk. Addiction specialists suspect this may affect a person's risk for other addictions as well. This is because chemicals in the brain, called neurotransmitters, carry messages across nerves. Under the right conditions, rewarding behaviors become addictive because of how the brain reacts to the neurotransmitters already there. A person's age and stage of development also plays a role. Children and adolescents are significantly more likely to develop an addiction to drugs and behaviors.</p> <p>The environment also feeds addictive behaviors. Many aspects of U.S. society attempt to capture and hold a person's attention. The phrase "sex sells" has long been a mainstay of the advertising industry, evident on TV and the internet, and in print.</p> <p>Pornography is well-established as a vehicle of sexual addiction. People are more vulnerable to addictive behavior under stressful conditions as they seek escape and avoidance. A history of abuse, especially sexual abuse, also can increase a person's vulnerability.</p> <h2>Where to find help</h2> <h3>Treating sex addiction is much like treating other addictions. Options include:</h3> <ul> <li><strong>Counseling and therapy</strong><br /> This option can be effective, and some therapists specialize in treating sex addiction.</li> <li><strong>Medications</strong><br /> There are some helpful medications, especially when combined with therapy. A patient must meet with a psychiatrist for medication.</li> <li><strong>Self-help groups</strong><br /> These are groups of people that come together for mutual support and education. Most are open to people with addictions and their families. These groups take confidentiality seriously, and group times and locations are not publicly advertised. Often, a person interested in joining needs to be interviewed by a group member before attending.</li> <li><strong>Inpatient treatment</strong><br /> Intensive or inpatient treatment options are limited but do exist.</li> </ul> <p>Sex addiction affects people in many ways and can be damaging to relationships and possibly physical health. If you or someone you know has been affected by sex addiction, contact a local behavioral health professional who can help guide you through your concerns.</p> <p><em><a href="/providers/brien-gleeson-lpc-csac" target="_self" title="Opens in same window.">Brien Gleeson</a> is a licensed professional counselor in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p> <ul> <li>Adult children of alcoholics and co-dependency</li> <li>Families impacted by addiction</li> </ul> L.P.C., CSAC <p>I specialize in patients ages 10 and older.</p> <p><strong>Education</strong></p> <ul> <li>Social Work, University of Wisconsin-Eau Claire</li> <li>Guidance & Counseling - Alcohol and Other Drug Abuse, University of Wisconsin-Stout</li> </ul> <p><strong>Internships</strong></p> <ul> <li>Alcohol and Other Drug Abuse, Lutheran Social Services-Fahrman Center</li> <li>Social Work, Child & Family Services</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Clinical Substance Abuse Counselor</li> <li>Licensed Professional Counselor</li> </ul>Gleeson<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/brien-gleeson-lpc-csac.jpg?h=200&iar=0&w=200&sc_lang=en&hash=9897E606B8D6CE708B01D434A2CF31E6" alt="Brien Gleeson, L.P.C., CSAC" width="200" height="200" DisableNVelocity="true" /> {0AFC5615-156D-4364-B866-752114EC92E2}Brien<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14604442Brien Gleeson, L.P.C. 1{67744200-E25F-439A-8B70-572A5A091172}|{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2022/one-hand-on-top-of-another.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5E30E53F6A39D368211554D507A1E574" alt="One hand on top of another" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller6/25/2018<p>Addiction changes the brain in a way that limits your ability to feel happy. In time, and with sobriety, the brain heals and learns to send the right cues again.</p>Finding happiness, gratitude in sobriety<img alt="Two happy Asian young women piggybacking" src="/-/media/national-files/images/hometown-health/2018/two-happy-asian-young-women-piggybacking.jpg?h=370&w=660&sc_lang=en&hash=0417132B8C7E4BB1073E9A26BA670A4B" class="img-responsive" style="height: 370px; width: 660px;" /> <p>Addiction changes the brain in a way that limits your ability to feel happy. In time, and with sobriety, the brain heals and learns to send the right cues again. Like most things learned, it takes practice. Happiness won't automatically return in your sobriety. If you've been looking for happiness, take charge. You can change it with your thoughts, choices and actions.</p> <h2>Here's how to get started on the path to creating a happier you.</h2> <h3>Invest in relationships</h3> <p>Surround yourself with happy people. Being around people who are content boosts your own mood.</p> <p>Friends and family help you celebrate life's successes and support you in difficult times.</p> <p>Let people know that you appreciate what they do for you or even just that you're glad they're part of your life. I try to make it a point to tell my grandchildren, whenever I am with them, that I love them.</p> <h3>Express gratitude.</h3> <p>Gratitude is more than saying thank you. It's a sense of wonder, appreciation and thankfulness for life. Make a commitment to practice gratitude.</p> <p>Each day, identify at least one thing that enriches your life.</p> <p>When you find yourself thinking an ungrateful thought, substitute a grateful one. For example, replace "My sister forgot my birthday" with "My sister has always been there for me in tough times."</p> <p>Let gratitude be the first and last thought of the day.</p> <h3>Find your purpose.</h3> <p>People who strive to meet a goal or fulfill a mission are happier than those who don't. Having a goal provides a sense of purpose, bolsters self-esteem and brings people together. Are you engaged in something you love? If not, ask yourself these questions:</p> <ol> <li>What excites and energizes me?</li> <li>What are my proudest achievements?</li> <li>How do I want others to remember me?</li> </ol> <h3>Live in the moment.</h3> <p>Don't postpone joy waiting for a day when your life is less busy or less stressful. That day may never come. Instead, look for opportunities to savor the small pleasures of everyday life. For instance, driving my granddaughter to school. It could be considered a chore or task, but I savored the candid conversation and enjoyed her company on our drive together. Focus on the positives in the present, don't dwell on the past and forget about worrying about the future. Today is the day.</p> <p><em>By Fountain Centers staff</em></p><img src="/-/media/national-files/images/hometown-health/2018/two-happy-asian-young-women-piggybacking.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5EF629694DCE5EABDCCF33C95DB5E0D0" alt="Two happy young women piggybacking" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Substance AbuseInformation for helping those with alcohol and other drug abuse concerns.Dawn Haller12/7/2022People reporting a penicillin allergy have their allergy designation removed with allergy testing more than 90% of the time. Find out who should be tested and what to expect.Why should I be evaluated for a penicillin allergy?<p>Taking action to be evaluated for a penicillin allergy can impact your health, safety and wallet. According to the Centers for Disease Control and Prevention, 10% of the U.S. population reports a <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/penicillin-allergy/symptoms-causes/syc-20376222" target="_blank" title="Opens in a new window.">penicillin allergy</a>, but less than 1% is allergic after testing. Common penicillins include ampicillin, amoxicillin and Augmentin.</p> <p>Penicillin allergy is an abnormal reaction of your immune system to the antibiotic drug prescribed for treating various bacterial infections. These medications are used often to <a href="/hometown-health/speaking-of-health/do-ear-infections-always-need-to-be-treated-with-antibiotics" target="_self" title="Opens in same window.">treat ear infections</a>, strep throat, sinus infections and to prevent dental infections.</p> <p>Common signs and symptoms of an allergic reaction can include skin redness, itching, rash or swelling. These symptoms can occur for other reasons. Some symptoms, such as nausea, vomiting or diarrhea, are common when taking antibiotics. They frequently are misdiagnosed as an allergy.</p> <p>When a penicillin allergy is reported, health care professionals substitute different antibiotics, often using more expensive and less effective antibiotics. Penicillins are the safest and most effective antibiotics for many infections.</p> <p>Avoiding penicillin antibiotics is associated with higher health care costs, increased risk for antibiotic resistance and less effective antibiotic therapy.</p> <h2>Potential benefits of penicillin allergy evaluation</h2> <p>People with a penicillin allergy have their allergy removed with allergy testing more than 90% of the time. Because penicillin allergy often does not persist for life, patients with severe penicillin allergy histories often are able to retake this medication safely if directed by a health care professional.</p> <p>Approximately 80% of patients with a severe penicillin allergy lose their sensitivity after 10 years. Determining that a patient is not actually allergic to a medication can allow for better treatment options, targeted therapy, and a decrease in hospital stays and medication costs.</p> <h2>Who should be evaluated for a penicillin allergy?</h2> <p>Any patient with a history of a reaction to a penicillin antibiotic, including amoxicillin and Augmentin, or who does not use certain antibiotics out of concern for such reactions should be evaluated. The best time to be evaluated for an allergy is when you are healthy.</p> <p>Discussing medication allergies can be a part of <a href="/hometown-health/speaking-of-health/trust-primary-care-provider" target="_self" title="Opens in same window.">routine health maintenance</a> with your primary care team. Addressing medication allergies also is good to do before having surgery and for women considering pregnancy. Pregnant women can be safely evaluated for a penicillin allergy.</p> <h2>What to expect during penicillin allergy testing</h2> <p>A health care professional will use an FDA-approved skin test to diagnose penicillin allergy. <a rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/allergy-tests/about/pac-20392895" target="_blank" title="Opens in a new window.">Penicillin skin testing</a> involves pricking the skin, placing a small amount of allergen on the punctured skin and injecting a small amount between the layers of the skin. The test sites are examined for a reaction. If the testing is negative, the patient can safely undergo an oral challenge to amoxicillin.</p> <p>In an oral challenge, amoxicillin is given to confirm that the patient can safely take the medication. The evaluation process takes three hours. In low-risk people, an oral challenge can be performed without skin testing.</p> <p>If you have questions about penicillin allergy and evaluation, talk with your primary care team or an allergy specialist.</p> <p><em><a href="/providers/adela-taylor-md" target="_self" title="Opens in same window.">Adela Taylor, M.D.</a>, sees patients in <a href="/services-and-treatments/immunology" target="_self" title="Opens in same window.">Allergy & Asthma</a>, in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Angioedema (welts below the skin)</li> <li>Atopic dermatitis</li> <li>Food allergies</li> <li>Medication allergy</li> <li>Pediatric asthma</li> <li>Urticaria (hives)</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Medical University of Warsaw</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Pediatric and Adolescent Medicine, Mayo Clinic School of Graduate Medical Education</li> <li>Pediatric Allergy and Immunology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Pediatric Allergy and Immunology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Allergy and Immunology, American Board of Allergy and Immunology</li> <li>Diplomate, American Board of Pediatrics</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Allergy, Asthma & Immunology</li> <li>Joint Council of Allergy, Asthma and immunology</li> <li>Wisconsin Medical Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Taylor<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/adela-taylor-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=FF6FA06FF41A37127EEE585DCA8A3F55" alt="Adela Taylor, M.D." width="280" height="280" DisableNVelocity="true" />{94F9636D-A44F-4A1B-BB6B-110B3CA6B06B}Adela<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>11922869Adela Taylor, M.D.1{9D6C5FE2-E6DA-4A63-9DD8-CE124BD4E4B7}<img src="/-/media/national-files/images/hometown-health/2022/flower-gardening-blue-shirt.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1C5F816BD1278E249FB573066D850A96" alt="Person with blue shirt flower gardening" width="660" height="370" title="Person with blue shirt flower gardening" DisableNVelocity="true" />Allergy and AsthmaOur allergists provide care for your allergies, asthma and conditions that affect the immune system's ability to defend the body against foreign or abnormal cells. The main treatment goal is your satisfaction when your condition is under control and quality of life is improved.Medication ManagementNearly 70% of Americans take at least one prescription drug, and more than half take two.Dawn Haller6/18/2018<p>Concerned about taking prescription medications for your frequent headaches? Get the facts for relief.</p>Headache medication: Get the facts<img height="370" alt="Girl with headache and fingers on temples" width="660" src="/-/media/national-files/images/hometown-health/2018/girl-with-headache-and-fingers-on-temples.jpg?sc_lang=en&hash=8C69977FD988F0F8D23BE468E41E1FB8" _rdeditor_temp="1" class="img-responsive">They can be pounding, piercing, throbbing or dull, but no matter what, they are always a pain. <p>Nearly all adults experience headaches at some point in their lives. When I see a patient in the office for chronic headaches, they are looking for two things: reassurance and relief.</p> <p>First, they want reassurance their headaches are not symptoms of more serious conditions, such as a brain tumor. The reality is the vast majority of headaches are not related to tumors or other worrisome conditions.</p> <p>We then discuss treatment options to help find the best relief from their headache pain. There are many treatment options available, including lifestyle changes and medications. Prescription medications are available to treat acute headaches, prevent future headaches, and/or reduce the severity and frequency of headaches. However, some people are reluctant to try these types of medications. Here are some of common concerns I hear:</p> <h4>“I’m worried about the side effects.”</h4> <p>This is a common and understandable concern for any medication — prescription or over-the-counter. Health care providers typically start a patient on the lowest dose available and then gradually increase it over time. There are many different categories of medications, each with different potential side effects, and you and your provider should discuss the best option for you. For example, if you have high blood pressure or sleep difficulties, there are some headache medications that may be more appropriate. Likewise, because of the variety of options, your provider can switch to another medication if any side effect outweighs the benefits.</p> <p>Also, many patients with chronic headaches rely on over-the-counter pain medication frequently for pain relief. These medications also can have serious side effects if taken in high doses over the long term. A lower dose prescription preventive headache medication may have fewer or less potential serious side effects compared to long-term, over-the-counter medications.</p> <h4>“I’m worried I’ll become addicted.”</h4> <p>Prescription medication abuse is common in our society, and you should ask about the addiction possibility of all the medications you take. Narcotic pain medications, which have the highest risk for addition, are not generally used for headache management.</p> <h4>“I already take too many medications and don’t want another one.”</h4> <p>I encourage patients to count the number of over-the-counter pain medications they take weekly to treat their headaches. Considering a prescription medication may reduce the numbers of pills taken per week. It’s important to note that over-the-counter pain medications offer relief for occasional headaches, but taking too many over-the-counter medications can cause rebound headaches, especially if you exceed recommended daily dosages. Daily caffeine consumption use also can cause rebound headaches. Your daily cup of coffee or jolt of soda may be part of your pounding head. Be sure to read product labels to make sure you are not consuming more caffeine than you realize.</p> <p>I encourage you to talk with your primary care provider if serious, painful and chronic headaches impact your work and daily activities more than one day per week. Relief is often possible with prescription medications and lifestyle modifications. Don’t give up or become discouraged if the first option you try is not the best fit for you.</p> <p><em><a href="/providers/angela-oldenberg-np" target="_self" title="Opens in same window.">Angela Oldenberg</a> is a nurse practitioner in <a href="/services-and-treatments/neurology" target="_self" title="Opens in same window.">Neurology</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Memory disorders</li> <li>Sports concussions</li> <li>Stroke</li> </ul>C.N.P.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Nursing, College of St. Scholastica</li> <li>Master's degree, Nursing, University of Wisconsin-Eau Claire</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Adult Nurse Practitioner, American Nurses Credentialing Center</li> <li>Advance Practice Nurse Prescriber</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Neurology, Mayo Clinic College of Medicine and Science</li> </ul>Oldenberg<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/angela-oldenberg-np.JPG?h=280&iar=0&w=280&sc_lang=en&hash=D5AD46D600A370D50EE83A7509D89A54" alt="Angela Oldenberg, N.P." width="280" height="280" DisableNVelocity="true" />{E0BFC8AE-B723-4AB5-93EF-94AD051C52DB}Angela<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14316731Angela Oldenberg, C.N.P.1{2951D78A-CC76-4C49-B556-549282DF4345}|{D68138A4-E93F-4DDA-BA2A-9B9545F14DD3}<img src="/-/media/national-files/images/hometown-health/2018/girl-with-headache-and-fingers-on-temples.jpg?h=370&iar=0&w=660&sc_lang=en&hash=58DE1DEA2824DC44FE16334868FF37A5" alt="Girl with headache and fingers on temples" width="660" height="370" DisableNVelocity="true" />HeadacheHeadache is pain in any region of the head that feels like a sharp pain, throbbing sensation or dull ache. It may develop gradually or suddenly, and last for minutes or days.Medication ManagementNearly 70% of Americans take at least one prescription drug, and more than half take two.Dawn Haller6/15/2018<p>Varicose veins are more than just a cosmetic issue. Learn about minimally invasive treatment options that can ease pain and discomfort while improving the look of your legs.</p>Is there a simple treatment for varicose veins?<img height="370" alt="Females with legs crossed seated on a bench" width="660" src="/-/media/national-files/images/hometown-health/2018/females-with-legs-crossed-seated-on-a-bench.jpg?sc_lang=en&hash=B92A5EDFB397B25580E3C8EA03BC3CC5" class="img-responsive"> <p>The weather is getting warmer, and many people are planning summer vacations and weekend getaways. But for some people, their legs and varicose veins may be causing some hesitation. Varicose veins are more than just a cosmetic issue and can lead to more serious health conditions, such as ulcers or blood clots.</p> <p>Varicose veins are swollen, enlarged blood vessels, most frequently on the legs, that often are bulging, rope-like and blue in appearance. Your symptoms could include:</p> <ul style="list-style-type: disc;"> <li>An achy or heavy feeling in your legs</li> <li>Muscle cramping, burning, throbbing or swelling in your lower legs</li> <li>Itching around one of your veins</li> <li>Worsened pain after sitting or standing for a long time</li> <li>Bleeding from the veins</li> <li>Skin ulcers near your ankle</li> </ul> <p>Self-care measures, such as exercise, weight loss, smoking cessation, leg elevation and using compression stockings, help many people. However, it is time to talk to your doctor if you are concerned about how your veins look and feel, and self-care measures haven’t stopped your condition from getting worse.</p> <p>You may have heard stories from the past about vein stripping or other invasive treatments. These treatments often had scarring and a longer recovery time. Technology has advanced in recent years, and we have many minimally invasive treatment options that can make a difference.</p> <p>Radiofrequency or laser ablation surgeries produce good results with little downtime. In these treatments, we use heat or light to damage the inside of the vein, ultimately causing it to collapse and fade away. Another option is sclerotherapy, which injects a solution that causes the vein to collapse. The process of destroying the veins begins immediately, and most people see full results in about two months. After treatment, your blood circulation is not reduced because it already has been rerouted to other healthy veins nearby.</p> <p>So, if painful, uncomfortable or unsightly varicose veins are slowing down your summer plans, schedule an appointment with your health care provider today.</p> <p><em><a href="/providers/timothy-berkseth-md" target="_self" title="Opens in same window.">Timothy Berkseth, M.D.</a>, is a <a href="/services-and-treatments/surgery" target="_self" title="Opens in same window.">general surgeon</a> in <a href="/locations/barron" target="_self" title="Opens in same window.">Barron</a>, Wisconsin.</em></p><ul> <li>Caring for patients with colon and breast cancer</li> <li>Endoscopy</li> <li>Laparoscopic surgery</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Medical College of Wisconsin</li> </ul> <p><strong>Residency</strong></p> <ul> <li>General Surgery, Gundersen Lutheran Medical Foundation</li> </ul> <p><strong>Certification</strong></p> <ul> <li>General Surgery, American Board of Surgery</li> </ul>Berkseth<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/tim-berkseth-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=DFAAF6AF6BF685C914121524E109E5B3" alt="Tim Berkseth, M.D." width="280" height="280" DisableNVelocity="true" />{7E45CD6F-E44A-4DFD-A1B3-22388892AB75}Timothy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15091988Timothy Berkseth, M.D.1{CE631A85-B409-4C11-907C-39868E49E636}<img src="/-/media/national-files/images/hometown-health/2018/females-with-legs-crossed-seated-on-a-bench.jpg?h=370&iar=0&w=660&sc_lang=en&hash=DA7BB48849D8CE6AF6F741BF929B7507" alt="Females with legs crossed seated on a bench" width="660" height="370" DisableNVelocity="true" />SurgeryHaving surgery is a major event in your life. We know this and make every effort to keep you as comfortable as possible, focusing on you as an individual. Our surgeons and staff work as a coordinated team treating a wide variety of illnesses ranging from simple to complex. We offer comprehensive, advanced care and service to every patient.Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Blood ClotsBlood clots can occur under many circumstances and in many locations. Blood clots that form in response to an injury or a cut are beneficial, stopping potentially dangerous bleeding. However, a number of conditions can cause you to develop blood clots in critical locations, such as your lungs and brain, and they require medical attention.Dawn Haller6/25/2019<p>Do your summer plans include a music festival? Check out these tips so your experience doesn't end on a sour note.</p>4 safety tips for summer festivals<img height="370" alt="Sitting people enjoying a festival" width="660" src="/-/media/national-files/images/hometown-health/2018/sitting-people-enjoying-a-festival.jpg?sc_lang=en&hash=BC092EE15095AA9644396017F7509690" class="img-responsive" /> <p>Attending local or regional music festivals is an annual tradition for many people. The festivals can be a fun time to reconnect with friends while enjoying great music. I have staffed many first-aid tents at music festivals and helped attendees with a variety of medical issues over the years.</p> <h2>Here are a few safety tips to remember so your music festival experience doesn't end on a sour note:</h2> <h3>Stay hydrated.</h3> <ul> <li><strong>Bring a reusable water bottle.</strong><br /> At sweltering summer events, dehydration can creep up unexpectedly. Bringing your own water bottle is key to having the best experience possible. Most festivals have easy water filling stations.</li> <li><strong>Sip early and often.</strong><br /> With your attention focused on the festival activities, it's possible that you will forget to drink water until you begin feeling thirsty. However, thirst is a sign that you're already dehydrated, which is proven to dampen your mood and energy. Get more <a href="/hometown-health/speaking-of-health/tips-for-drinking-more-water" target="_self" title="Opens in same window.">tips for drinking water</a>.</li> <li><strong>Check your urine.</strong><br /> You should be using the restroom about every two hours if you are well-hydrated, and your urine should be light yellow in color. If it's a darker color, similar to apple juice, you need to consume more water.</li> </ul> <h3>Protect your skin.</h3> <ul> <li><strong>Apply sunscreen.</strong><br /> Ultraviolet radiation is extreme during the summer, and it can take as little as 11 minutes in the midday sun to get <a href="/hometown-health/speaking-of-health/sunburn-treatment-what-works" target="_self" title="Opens in same window.">sunburned</a>. Choose a broad-spectrum, water-resistant sunscreen with an SPF of 30 or greater. Reapply every two hours or more often if you're sweating.</li> <li><strong>Find the shade.</strong><br /> Many music festival venues lack shade. Do your best to find and remain in the shade between 10 a.m. and 4 p.m. when the sun's rays are the strongest. It will make a difference in keeping your skin safe.</li> <li><strong>Wear a hat and sunglasses.</strong><br /> Large, floppy hats can help protect your face from the sun. Protect your eyes and the delicate skin around them by wearing sunglasses with UVA and UVB protection. Even if the sun doesn't bother your sight much, it's still important to keep your eyes safe by protecting them from UV rays.</li> </ul> <h3>Be mindful of medications and alcohol.</h3> <ul> <li><strong>Remember your medications.</strong><br /> Some festival-goers forget to bring along their prescription medications. You may not be able to fully enjoy the festival if you stop taking necessary medications.</li> <li><strong>Avoid mixing alcohol and medications.</strong><br /> Alcohol can make some medications less effective or even useless. Mixing alcohol with some medications can cause issues you won't want to deal with when you're enjoying a festival, including nausea, vomiting, headaches, fainting or loss of coordination. It also could put you at risk for internal bleeding, heart problems and breathing difficulties.</li> <li><strong>Beware of over-the-counter pain relievers and sleeping medication.</strong><br /> Drinking alcohol while taking ibuprofen can cause nausea, stomach bleeding and, possibly, liver damage. Sleep medications mixed with alcohol can cause increased drowsiness, difficulty breathing and memory problems.</li> </ul> <h3>Control campfires.</h3> <ul> <li><strong>Keep things under control.</strong><br /> Hopefully, the festival grounds provide fire rings or pits. If not, choose a location at least 15 feet from tent walls, shrubs, low-hanging branches, trees or other flammable objects. Keep a source of water, a bucket and shovel nearby at all times for extinguishing. Don't burn aerosol cans, pressurized containers, glass or aluminum cans. When putting out the fire, pour lots of water on it to drown all embers, not just the glowing ones.</li> </ul> <p><em>Kirk Gunderson is a paramedic with <a href="/services-and-treatments/medical-transport" target="_self" title="Opens in same window.">Mayo Medical Transport</a>.</em></p><img src="/-/media/national-files/images/hometown-health/2018/sitting-people-enjoying-a-festival.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E0752D9C2047762F7C49FD6E07F2EAA5" alt="Sitting people enjoying a festival" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Dawn Haller3/8/2022Words of wisdom can help you achieve and maintain a level of serenity during a recovery journey. Many sayings are easy to remember and can be impactful when you put them to use in your life.What words of wisdom work for recovery?<p>Recovery sayings pack a world of wisdom and are easy to remember when you need to use them. They're a lifesaver for many people. Some are simple to understand, and some are not so clear. They are simply short instructions, but the challenge begins when you put them to work.</p> <h3>These recovery sayings can help get you started:</h3> <h4>The Serenity Prayer</h4> <p>Three mantras are combined to help you achieve and maintain a level of serenity:</p> <ul> <li>"God grant me the serenity to accept the things I cannot change." This conveys acceptance and patience.</li> <li>"The courage to change the things I can." This conveys that you realize it's only your actions and behaviors that you have any control over.</li> <li>"And the wisdom to know the difference." This conveys listening to that small voice of my conscience, and let kindness and caring guide your actions.</li> </ul> <h4>'Live and let live'</h4> <p>When you become upset about someone's behavior or action, it is important to ask yourself if there is anything you can do to change the person or situation. Most of the time, you cannot. Accept the person or situation as it is. It may help to remember that you don't know what went into the making of the event or the person's history.</p> <h4>'Do the next right thing'</h4> <p>If you can do something good for a person or improve a situation, you will feel better if you actually do it. This also reminds you that when acting in a way that doesn't sit well with your conscience, your next action can be you doing the right thing.</p> <h4>'How important is it really?'</h4> <p>There may have been times you wanted to do something with others only to discover that is not what they want to do. Most of the time, it's no big deal and you decide on something else to do. But every now and then, you may have your heart set on an activity, and your ego steps in and keeps you from enjoying whatever activity the group agreed on.</p> <p>Lack of acceptance blocks your serenity and keeps you from enjoying what you're doing. It can even grow into resentment. To be healthy in your recovery, it is important for you to set ego aside and ask yourself, "How important is it really?"</p> <p>There are hundreds of sayings, and whenever you find yourself unsettled, agitated, gloomy, restless, irritable or discontented, one of these adages may help you see your way to a better day. Words of wisdom can help conquer cravings and direct actions, simplify life, live up to your values and add quality to recovery.</p> <p><em><a href="/providers/siri-kabrick-cnp" target="_self" title="Opens in same window.">Siri Kabrick</a> is a nurse practitioner in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a>, Minnesota.</em></p><ul> <li>Adolescent mental health</li> <li>Anxiety</li> <li>Depression</li> <li>Women's health</li> </ul>APRN, C.N.P.<p>I partner with patients to identify the most effective treatment for their problem. I enjoy educating patients, dispelling myths and reducing stigma surrounding mental illness, and empowering patients to improve their quality of life. I strive to connect patients to resources that will have a positive impact on their recovery. I feel it's a privilege to have patients trust me with their mental health care.</p> <p>I am married to my loving and supportive husband, Chris. I have three daughters and two step-daughters, two sons-in-law and two grandsons. I enjoy quilting, scrapbooking, reading and playing piano. I am also a Girl Scout lifetime member, leader, volunteer and parent.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Adult Nurse Practitioner, St. Catherine University</li> <li>Psychiatric-Mental Health Nurse Practitioner, Rush University College of Nursing</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Adult Nurse Practitioner, American Nurses Credentialing Center</li> <li>Certified Nurse Practitioner, Minnesota Board of Nursing</li> <li>Psychiatric-Mental Health Nurse Practitioner, American Nurses Credentialing Center</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Psychiatric Nurses Association</li> <li>Minnesota Advanced Practice Registered Nurse Coalition/li> </li> <li>Sigma Theta Tau International Honor Society of Nursing</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Psychology, Mayo Clinic College of Medicine and Science</li> </ul>Kabrick<img src="/-/media/shared-files/images/medical-professionals/full/fairmont/siri-kabrick-aprn-cnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7965DA5263917445B7C76056099A7570" alt="Siri Heille CNP" width="280" height="280" DisableNVelocity="true" />{526482EA-708D-4175-8709-E97F91352839}Siri<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14288737Siri Kabrick, APRN, C.N.P.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2022/listening-with-earbuds-grey-sweater.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3414A23180A4BCE7EEE7D211366E356B" alt="Listening with earbuds grey sweater" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller7/11/2023Life doesn’t immediately return to normal for cancer survivors because they’re done with radiation or chemotherapy. Learn why it's important to address needs with a survivorship care plan.The importance of a cancer survivorship care plan<p>Cancer care doesn’t end when treatment is over. Life doesn’t immediately return to normal because you are done with radiation or chemotherapy. You may have long-term physical and emotional effects after treatment and likely have questions about follow-up care and what to expect in the future.</p> <p>Cancer may have affected your finances, employment, relationships or spiritual beliefs. For these reasons and many others, cancer survivors' needs must be addressed in a survivorship care plan.</p> <p>Many cancer centers provide resources for cancer survivors. You may be scheduled for a cancer survivorship appointment as you complete cancer treatment. This visit provides education and resources to help you transition from cancer treatment to wellness. During the visit, you'll meet with a nurse, physician or nurse practitioner and a social worker to review your treatment. You'll receive a survivorship care plan in addition to resources and follow-up care information.</p> <h2>A survivorship care plan is a complete record of your cancer history. It may include:</h2> <ul> <li>Contact information for providers</li> <li>Diagnosis and stage of cancer</li> <li>Details about treatment type — such as surgery, chemotherapy, radiation, transplantation, hormone therapy or others — with beginning and ending dates</li> <li>Emotional effects you may experience and the support services available</li> <li>Possible late and long-term effects of treatment and their symptoms</li> <li>Recommended cancer screenings and other recommended testing and follow-up appointments</li> <li>Wellness recommendations, including a healthy diet, exercise and smoking cessation information</li> </ul> <p>A survivorship care plan ensures you get the best possible healthcare as you go forward after treatment. Giving your care team a copy of your plan is helpful so they are aware of treatments you received, side effects and recommended follow-up care. It's also important to keep a copy for yourself so you have a personal record of your cancer care.</p> <p>The survivorship care plan empowers you to use the tools you’ve been given or tap additional resources as you move forward and successfully transition to life after cancer treatment. It's a good idea to contact your care team if you have any questions or concerns. Even though you're done with treatment, your care team continues to be available to provide resources and follow-up care.</p> <h2>Next steps:</h2> <ul> <li><a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">Find a cancer specialist</a> near you.</li> <li>Gather tips for <a href="/hometown-health/speaking-of-health/emotional-recovery-after-cancer-treatment" target="_self" title="Opens in same window.">emotional recovery after cancer</a>.</li> <li>Discover the <a href="/hometown-health/speaking-of-health/keep-moving-the-importance-of-exercise-in-cancer-survivorship" target="_self" title="Opens in same window.">benefits of an exercise routine after cancer</a>.</li> <li>Learn about <a href="/hometown-health/speaking-of-health/living-in-fear-cancer-recurrence" target="_self" title="Opens in same window.">managing the fear of cancer recurrence</a>.</li> </ul> <p><em>Sarah Lewis is a social worker and <a href="/locations/eau-claire/services-and-treatments/oncology/cancer-guide" target="_self" title="Opens in same window.">cancer guide</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2023/writing-in-a-notebook.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1CAA23BBB43A6F854BC038E7475A2AAC" alt="Writing in a notebook" width="660" height="370" DisableNVelocity="true" />CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Micah Dorfner6/5/2018<p>Distance running — a 10k, half marathon or full marathon — all are high-calorie-burning endurance events that require a solid nutrition plan. Depending on your body weight, the duration of the run and the intensity of your training schedule, you’ll need to adjust your nutrition plan or fuel accordingly</p>Fueling strategies for distance runners<img height="376" alt="people-running-a-marathon" width="660" src="/-/media/national-files/images/hometown-health/2018/marathon-runners.jpg?sc_lang=en&hash=3B6F73008CB0A6E5A59173E0BDF1CA39" class="img-responsive"> <p>Distance running — a 10k, half marathon or full marathon — all are high-calorie-burning endurance events that require a solid nutrition plan. Depending on your body weight, the duration of the run and the intensity of your training schedule, you’ll need to adjust your nutrition plan or fuel accordingly. In fact, timing your meals to match demands of the sport can be the difference between finishing strong or not finishing at all.</p> <p>Key nutrients that provide energy are carbohydrates, protein and fat. Here are some tips and ideas to help fuel your practice and competition:</p> <h4>CARBOHYDRATES</h4> <p>During intense training periods in which you’re training for one to three hours each day, carbohydrates should make up most of your diet. Eat 2.7 to 4.5 grams of carbohydrate per pound of body weight per day. For example, a 135-pound runner would need 365 to 607 grams of carbohydrate per day.</p> <p>Choose high-quality carbohydrates, such as whole-grain breads, cereals, rice, pasta and starchy vegetables, fruit, and low-fat milk and yogurt.</p> <p>These foods have 15 grams of carbohydrate:</p> <ul> <li>One slice of bread</li> <li>One 6-inch tortilla</li> <li>1/2 cup corn</li> <li>1/2 cup mashed potatoes</li> <li>1/2 medium baked potato or sweet potato</li> <li>1/3 cup rice</li> <li>3 cups popcorn</li> <li>One small apple</li> <li>15 grapes</li> <li>Two tangerines</li> <li>2 tablespoons raisins</li> <li>1/2 cup orange juice</li> <li>3 cups green beans</li> <li>1 1/4 cup milk or yogurt</li> </ul> <h4>PROTEIN</h4> <p>Protein provides the building blocks for muscle mass. You need about 0.6 to 0.8 grams of protein per pound of body weight. For example, a 135-pound runner would need 81 to 108 grams of protein per day. It’s important to know that eating more than the recommended amount will not build lean mass faster.</p> <p>Choose protein foods, such as lean beef and pork, chicken and turkey, beans, nuts, eggs and low-fat dairy products.</p> <p>These foods have 7 grams of protein:</p> <ul> <li>1 ounce cheese</li> <li>1 ounce beef, pork, chicken or turkey</li> <li>1/4 cup cottage cheese</li> <li>1/2 cup black beans or kidney beans</li> <li>One whole egg</li> <li>2 tablespoons peanut butter</li> <li>1 cup milk or plain yogurt</li> </ul> <h4>FATS</h4> <p>There’s no specific recommendation for fat for runners, but healthy fats should be a part of every runner’s diet. Healthy fats include nuts and seeds, nut butters, avocado, and olive or canola oil.</p> <h4>FUEL BEFORE, DURING AND AFTER A WORKOUT</h4> <p>If possible, eat three to four hours before a long training run or competition. Aim for a low-fat meal with 200 to 300 grams of carbohydrates and about 30 grams of lean protein. This will ensure you have enough fuel but will leave time for your stomach to empty before you start your run. An example would be a turkey sandwich with baked chips and a side of fruit.</p> <p>If there isn’t enough time to eat three to four hours prior to run or race, eat a snack one to two hours before. Good choices include fruit, milk, a bowl of cereal, yogurt, a small bagel with peanut butter, or cheese and crackers. If there’s less than an hour before exercise, the best choice may be liquids, such as a sports drink or a low-fat liquid meal replacement.</p> <p>For training runs lasting longer than one to two hours, try to eat 30 to 60 grams of carbohydrate every hour. Choices include sports drinks, sodium, potassium, and energy gels or chews with water.</p> <p>After practice, recover with a carbohydrate and protein-rich snack. Carbohydrates will replace muscle glycogen that was lost during a long training run or race, and protein stimulates muscle protein repair. Ideas include a turkey or grilled chicken sandwich, low-fat chocolate milk, cottage cheese and fruit, or cheese and crackers.</p> <p>If you’re planning on running the next day, start your recovery within 30 minutes after training. If the following day is a rest day, add recovery foods to your next meal.</p> <p><em><a href="/providers/allyn-wergin-rdn" target="_self" title="Opens in same window.">Allie Wergin</a> is a registered dietitian nutritionist in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Bariatric surgery</li> <li>Diabetes management</li> <li>Oncology</li> <li>Weight management</li> </ul>RDN<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, St. Catherine University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration </li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul>Mahowald<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/allyn-wergin-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=74F690ED261F537AA65B66929A3356D1" alt="Allie Mahowald, RDN" width="280" height="280" DisableNVelocity="true" />{9209F8EC-1016-41AA-985F-014D9B877417}Allie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15971546Allyn Mahowald, RDN1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2018/marathon-runners.jpg?h=376&iar=0&w=660&sc_lang=en&hash=4E767754A112226D18EE60680F33FC3B" alt="people-running-a-marathon" width="660" height="376" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller4/8/2025<p>Eating as a family can be more than just shared conversations — it’s building relationships. Nutrition educator Katie Johnson shares a few tips that can make it easier to plan and prep meals.</p>Family meals: Building relationships<p>Eating as a family can be more than just shared conversations — it’s building relationships, disconnecting from outside distractions, and modeling food choices and behavior for children. It’s important to spend quality time together as a family, but life sometimes gets in the way. It can be tough to round up your family. Spending time in the kitchen and at the dinner table together is a great way to grow as a family and dedicate time together in the midst of busy schedules. You don’t need a four-course meal to get your family together.</p> <p>To reduce stress, plan and prep easy meals, Katie Johnson, nutrition educator, has a few tips that can make it easier:</p> <ul style="list-style-type: disc;"> <li><strong>Start small</strong>. Start out planning just one day a week to sit down as a family to enjoy a meal together.</li> <li><strong>Disconnect from devices</strong>. Take this family time to disconnect from the outside world and connect with each other to build stronger relationships.</li> <li><strong>Create meaningful conversation</strong>. Go around the table and have each person talk about the best part of their day and troubleshoot any challenges ahead. Be sure to talk about something each of you is looking forward to.</li> <li><strong>Plan meals ahead of time. </strong>Rather than scrambling to find a recipe last minute, plan ahead to ensure you have all the ingredients needed.</li> </ul> <h4>MAKING MEAL PLANNING SIMPLE</h4> <p>Meal planning is a great way to get ahead of the game and feel prepared for family dinners. If weekdays are too hectic, prepping meals can save time so you can more easily squeeze in family dinners. Here are some ways to make meal prepping and planning a little easier:</p> <ul> <li><strong>Plan ahead. </strong>Determine what meals you are going to make next week. Make your shopping list based on the ingredients for those meals, so you can grab everything you need in one trip to the store. Use <a href="/hometown-health/speaking-of-health/tips-for-healthy-eating-in-a-hurry" target="_self" title="Opens in same window.">kitchen shortcuts to keep healthy eating quicker and easier</a>.</li> <li><strong>Dedicate time once a week. </strong>Set aside a couple of hours just one day a week so you can prep meals.</li> <li><strong>Prep ingredients ahead of time.</strong> As soon as you get home from the grocery store, peel and cut fruits and vegetables so they’re ready when you want them.</li> <li><strong>Cook reusable ingredients.</strong> Prepare food to use for multiple meals, such as rice or fresh-cut veggies.</li> <li><strong>Get kids in the kitchen.</strong> Divvy up tasks. Younger children can hand rip vegetables, while older children can chop them. Getting kids in the kitchen and experimenting with new foods increases the chances they will eat what they prepare. </li> <li><strong>Divide food. </strong>Put your prepped meals into individual containers right away for each day of the week so they’re ready for when you need them. </li> </ul> <p>Family meals can be enjoyable and fruitful if you plan ahead.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2018/two-young-girls-and-mother-preparing-a-meal.jpg?h=283&iar=0&w=504&sc_lang=en&hash=08E0865148545123524FF00DC0B26CCF" alt="Two young girls and mother preparing a meal" width="504" height="283" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller2/28/2019<p>The early years in a child’s life have a significant effect on his or her future learning, behavior and well-being. Adverse childhood experiences, known as ACEs, create toxic levels of stress that can harm brain development.</p>Breaking the adverse childhood experiences cycle<img height="371" alt="Man showing computer parts to children" width="660" src="/-/media/national-files/images/hometown-health/2018/man-showing-computer-parts-to-children.jpg?sc_lang=en&hash=208983BA4829DD258305E8BB86EE53A5" class="img-responsive"> <p>The early years in a child’s life have a significant effect on his or her future learning, behavior and well-being. If a child has been through severe trauma while his or her brain is still developing, there can be major social and health consequences later in life. Adverse childhood experiences, known as ACEs, create toxic levels of stress that can harm brain development. These experiences can look like physical, emotional and sexual abuse; alcohol and/or drug abuse; incarceration; lack of mental health stability; domestic abuse; parental divorce; or emotional or physical neglect.</p> <h4>BREAKING THE CYCLE</h4> <p>If a child grows up in a household that has several of these experiences, the likelihood of long-term impacts increases. While it may get harder to break the cycle the greater the adversity, it doesn’t mean it isn’t possible. Creating stable, nurturing relationships that <a href="/hometown-health/speaking-of-health/fostering-resiliency-in-kids" target="_self" title="Opens in same window.">build trust between an adult and a child</a> with adverse childhood experiences can be the starting point of breaking the cycle. You don’t have to be an immediate family member or an expert in this field to be a good role model for a child. It can start with the simple question, “Are you OK?” and build from there. Opening up conversations about how children feel and why they feel that way can help them build trust in you and explore their feelings in a way that they maybe hadn’t been able to do before.</p> <h4>ASKING QUESTIONS</h4> <p>If you see a child who you think needs this kind of supportive mentor, ask yourself three questions:</p> <ol> <li>“Can I be a mentor?” </li> <li>If not, “Do I know someone who could be a mentor or connect the child with a mentor?”</li> <li>If yes, “Can I support the programs that mentor those children in any way?”</li> </ol> <p>These programs, like Big Brothers Big Sisters and the Boys and Girls Club, shows kids who may have adverse childhood experiences what stable and caring people look like, and gives them a safe place to be. Such programs provide training for adult volunteers; have rigorous and reliable screening practices for adult mentors in order to protect children; and provide consistent oversight, training and support for volunteers. The relationships that children build with their mentor might be their only look into a life that has stability. Being a caring adult and building a relationship with a child who has a higher adverse childhood experiences score can buffer for the damaging effects of toxic stress.</p> <h4>BUILDING HOPE</h4> <p>What children experience in the earlier stages of life does not have to have a negative effect on their futures, but that requires us to step in to help. If you know a child you think may be struggling or have experienced some trauma, trust your instincts and step in. Building a stable relationship with the child can help buffer for <a href="/hometown-health/speaking-of-health/overcoming-adverse-childhood-experiences" target="_self" title="Opens in same window.">adverse childhood experiences</a> and help them to live a fulfilling life he or she deserves. If you don’t know of anyone in need but want to help, consider connecting with local youth service organizations to see if you can volunteer or donate. Roll up your sleeves, and make a difference.</p><img src="/-/media/national-files/images/hometown-health/2018/man-showing-computer-parts-to-children.jpg?h=371&iar=0&w=660&sc_lang=en&hash=DCDDCB17D6165224A8D33E014FEE0E30" alt="Man showing computer parts to children" width="660" height="371" DisableNVelocity="true" />Child DevelopmentWe all want our children to grow up happy and healthy. The reality is most all of them do — but at vastly different rates. Experts across Mayo Clinic Health System see thousands of children each year, and have the experience and resources to know what is normal and what may be cause for closer observation. This includes not only physical and motor skills development, but psychological and social skill advancement.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Michele Halterman6/22/2023It may feel uncomfortable to talk about low libido. Yet, a better understanding of some of the issues, causes, myths and treatments may help put you in the mood more often.Let's talk low libido<p>It may feel uncomfortable to talk about low libido with your partner and your health care team. Unfortunately, it's a common problem that affects adults everywhere, yet many people have never been asked about their sexual health by their health care teams.</p> <p>Although it may be difficult to discuss, sexual health is important and factors that are causing low libido should be addressed. Many primary care, psychology and OB-GYN professionals are trained to care for and treat hypoactive sexual desire disorder, or HSDD. This is the persistent or recurrent deficiency or absence of sexual fantasies and desire for sexual activity. It's often referred to as having a low libido and can cause significant distress and relationship problems.</p> <p>There's no magic pill for low libido. The desire for sex is based on a complex interaction of many things that affect intimacy, including physical and emotional well-being, experiences, beliefs, lifestyle and relationship status. A thorough evaluation of your symptoms and possible causes, along with an individualized treatment plan, may put you in the mood more often.</p> <h2>Here's what you need to know about low libido.</h2> <h3>Low libido in men</h3> <h4>Some of the most common causes of low libido in men include:</h4> <ul> <li><strong>Physical issues</strong><br /> Increased weight, diabetes, high blood pressure, endocrine disorders and high cholesterol can affect the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/symptoms-causes/syc-20355776" target="_blank" title="Opens in a new window.">ability to maintain an erection</a> or decrease sex drive. These conditions also can lead to low energy and low self-image which can cause a significant loss of libido. In many cases, this can be corrected through diet, exercise and medical management.</li> <li><strong>Pornography</strong><br /> This is a big cause for many men. Pornography permeates many committed relationships and can change how men view sexuality. For some, it causes pseudo-low libido, which is when a person is still interested in sex but not in a healthy way. This often leads to unrealistic expectations of body image, confusion about what an intimate encounter is and, in some cases, negative sexual behavior. The internet is a large contributor. Often, people who are committed to changing their behaviors are referred to sexual addiction counseling to manage this effectively.</li> <li><strong>Loss of intimacy</strong><br /> I'm always amazed at how dedicated and committed people are to their jobs, sports teams or extracurricular activities but treat relationships like a given, self-maintaining entity. This simply isn't the right approach. Relationships, intimacy and sexual health require work and effort. In many cases, a lack of emotional connection can lead to low libido in both partners.</li> <li><strong>Medications</strong><br /> Many medications used for anxiety and depression can lower libido in men and, in some cases, delay orgasm. While some men have no side effects, others may encounter significant issues. It's important to note that you should not stop taking any medication without first talking with your health care team.</li> <li><strong>Alcohol and drug use</strong><br /> Increased alcohol use can reduce testosterone levels and increase the risk of erectile dysfunction and low libido. Illicit drugs often increase sex drive in the short term but have significant long-term negative effects on sexual function. Depending on the substance, drug use can cause a decrease in testosterone levels and erectile dysfunction or change how the brain responds to activities that were previously viewed as pleasurable, like sex.</li> </ul> <p>Remember, the answer to treating a low libido is more than turning to medications. Acknowledging there's an issue and seeking professional help can be the start of getting back something great.</p> <h3>Low libido in women</h3> <p>The issue of <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/low-sex-drive-in-women/symptoms-causes/syc-20374554" target="_blank" title="Opens in a new window.">low libido in women</a> is even more complex, with causes ranging from past negative and abusive experiences with sex to fatigue and stress.</p> <h4>The most common causes of low libido in women include:</h4> <ul> <li><strong>Life stressors and fatigue</strong><br /> After growing their families, many women are not only weeks behind on quality sleep but also haven't exercised in months and eat only when they can find a spare second. It's no wonder they say that they feel exhausted and sexually dead. They often confide that they don't feel like they could have a sexual or intimate encounter even after a long time. </li> <li><strong>Medications</strong><br /> Depression and anxiety lead to lowered libido. Yet, medications to treat these conditions could be making it worse or even causing it. This isn't a reason to stop taking an important medication, but it's definitely a topic to discuss with a sexual health specialist.</li> <li><strong>Weight gain</strong><br /> Weight gain can lead to low energy, negative self-image and loss of intimacy with your significant other.</li> <li><strong>Hormone changes</strong><br /> Estrogen levels drop during menopause and can greatly affect libido. It can cause vaginal dryness and lead to painful or uncomfortable sex. While not as common, hormonal contraceptives also can cause lower libido. In some women, they cause vaginal irritation which leads to a decreased willingness to initiate a sexual experience. </li> <li><strong>Sexual pain or dyspareunia</strong><br /> If it hurts, why would you do it? The good news is that pain during sex can often be treated. The first step is to be evaluated by a sexual health specialist who will recommend a treatment plan, which could include a referral to a psychology specialist or pelvic floor physical therapist.</li> <li><strong>Relationship issues</strong><br /> For many women, emotional closeness is essential for sexual intimacy. Problems in the relationship like a lack of connection, unresolved conflicts or trust issues can be a major contributor to a low sex drive.</li> <li><strong>Previous trauma</strong><br /> Previous physical or emotional trauma can affect the way people experience sex and lead to low libido. Sexual desire and arousal often are numbed in people who have been physically or sexually abused. Women who have been abused often avoid sexual contact because the neural networks in their brains associate sex with power, fear or pain. This makes intimacy difficult. Even a previous consensual, yet negative, sexual experience can reduce a woman's desire for sex in the future.</li> </ul> <h2>How to get help for low libido</h2> <p>First, talk with a health care professional who specializes in and has been trained in treating sexual health. Your primary care provider will be able to recommend a trusted expert. </p> <p>During your first appointment, the provider will conduct a comprehensive health history, evaluation and physical exam. Blood tests may be necessary to check hormone levels and check for thyroid problems, liver disorders or other conditions.</p> <p>Treatment plans focus on the many causes of low libido. Sex education and counseling may be recommended, especially to address relationship issues. Medication and hormone therapy options are available to boost libido.</p> <h2>Tips to combat low libido</h2> <h3>Healthy lifestyle changes can make a difference and combat low libido:</h3> <ul> <li><strong>Start an exercise program.</strong><br /> Regular aerobic exercise and strength training can increase your stamina, improve your body image, lift your mood and boost your libido.</li> <li><strong>Plan a trip — but leave the kids at home.</strong><br /> Take a dedicated vacation for just yourself or with your significant other. Don't go with other couples. This can be a distraction as you look to reconnect. Setting aside time for intimacy can help put your sex drive back on track.</li> <li><strong>Communicate.</strong><br /> Yes, something as simple as sitting across from each other at a restaurant as you start to communicate again can do wonders. Make sure you keep topics light and have no expectation of an encounter later. Let the moment simply be about spending time with each other.</li> <li><strong>Reduce stress.</strong><br /> Find ways as a couple to better cope with work and home stress. Are there chores that can be stopped or done by someone else or commitments that can be skipped? Seek out <a href="/hometown-health/speaking-of-health/5-tips-to-manage-stress" target="_self" title="Opens in same window.">ways to reduce stress</a> in daily life. </li> <li><strong>Ditch bad habits.</strong><br /> Smoking, illegal drugs and excess alcohol can all dampen your sex drive. Ditching these bad habits may help give your sex drive a boost and improve your overall health.</li> </ul> <p>People don't have to meet a specific medical definition or wait for low libido to worsen before seeking help. If you are bothered by low or decreased sex drive, there are changes and treatments that can move you in the right direction. </p> <p><em><a href="/providers/graham-king-md" target="_self" title="Opens in same window">Graham King, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician specializing in sexual and women's health in <a href="/locations/mankato">Mankato</a>, Minnesota.</em></p> <p> </p><ul> <li>Community fitness outreach programs</li> </ul>M.D.<p>I enjoy caring for the health needs of families from prenatal care and pediatrics to adult medicine, and specialize in women's health and reproductive health. I focus on listening and hearing my patients, and forming partnerships with them in delivering their care.</p> <p>I am married to an elementary school teacher with four energetic boys who are active in community, school and sports. I enjoy playing guitar and piano, writing educational blogs and practicing healthful living. </p> <p>I am an 80s rock superfan and love going to concerts with my family and friends. I also enjoy Vikings, Twins, Wild and Maverick sports.</p><p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Mercy Hospital</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Sutter Health Family Medicine Residency Program</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Family Medicine</li> <li>Mayo Clinic Quality Fellow, Bronze Level</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Medical Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>King<img src="/-/media/shared-files/images/medical-professionals/full/mankato/graham-king-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=78048D61A3A60EF1DF00C06F2F6CCBEE" alt="Graham King MD" width="280" height="280" DisableNVelocity="true" />{46521252-3F34-48F2-80D2-338AA6DD4C22}Graham<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14899019Graham King, M.D.1<img src="/-/media/national-files/images/hometown-health/2023/holding-hands-on-leg.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2B492DF8964DEB7B92B6268F0553EBF4" alt="Couple holding hands resting on partner's leg" width="660" height="370" DisableNVelocity="true" />Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller3/14/2019<p>Busy day? We all know how hard it can be to fit a workout into our schedule, but why not get started with a 15-minute home workout using a stability ball?</p>15-minute workout: Core<img height="370" alt="Workout with stability ball" width="660" src="/-/media/national-files/images/hometown-health/2018/workout-with-stability-ball.jpg?sc_lang=en&hash=33FBABB63FDDDC9AF73330DBA87B6376" class="img-responsive" /> <p>Busy day? We all know how hard it can be to fit a workout into our schedule, but why not get started with a 15-minute home workout? Working with a stability ball allows you to fully engage your core, which can help prevent back pain.</p> <h2>Muscles worked</h2> <p>These exercises are meant to engage and work your core, which consists of your abdominal and back muscles.</p> <h2>Get started</h2> <p>You'll need to grab a stability ball and, if you prefer, a yoga mat, for exercises requiring you to lay on the floor. You can find these at your local drugstore or online. If you're completing this workout at a gym, most gyms have all of this equipment for you to use. Give yourself enough space to perform these exercises.</p> <p><strong><a href="/-/media/national-files/documents/hometown-health/2019/15-minute-workout-core.pdf?sc_lang=en&hash=034B04775555264F7918A794AFE7BBCF" target="_blank" title="Opens in a new window.">Follow these instructions for a quick, 15-minute core workout.</a></strong></p> <h2>More workouts</h2> <ul> <li>Engage your glutes, hamstrings, quads, biceps, triceps, shoulders and back muscles with this <a href="/hometown-health/speaking-of-health/15-minute-workout-resistance-bands" target="_self" title="Opens in same window.">resistance band workout</a>.</li> <li>Target your biceps, triceps, shoulders, back, quads, hamstrings and glutes with this <a href="/hometown-health/speaking-of-health/15-minute-workout-combo-exercises" target="_self" title="Opens in same window.">combo exercise workout</a>.</li> </ul><img src="/-/media/national-files/images/hometown-health/2018/workout-with-stability-ball.jpg?h=370&iar=0&w=660&sc_lang=en&hash=46C3661D4F91B8CC476DA40F4C05F778" alt="Workout with stability ball" width="660" height="370" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Get Tools to Live Your HealthiestIt’s never too early — or too late — to plan ahead for health. By making preventive care for you and your family a healthy habit, you’ll help improve your well-being. Be sure to connect with your healthcare provider to discuss any further questions that you may have about your health.Dawn Haller11/7/2022Although urine incontinence, or the involuntary leakage of urine, is a common symptom that affects 1 in 2 women, it's not normal. Learn about evaluation and treatment options.Is urine incontinence normal for women?<p>Urine incontinence, or the involuntary leakage of urine, is a common symptom that affects 50% of adult women. Prevalence of this problem increases with age, as up to 75% of women over 65 report urine leakage. A woman's physical, social and psychological well-being is negatively impacted. Quality of life at home and in the workplace may deteriorate.</p> <p>Despite being a common problem, only 25% to 61% of women who experience weekly urine incontinence episodes discuss the problem with their health care teams. Some women may find it too embarrassing to discuss symptoms, while others may think it is normal for them to experience incontinence after childbirth or with aging.</p> <p>Urine incontinence is not a singular issue; rather, it's caused by several factors. Many factors often coexist and increase the severity of symptoms and complexity of treatment.</p> <p>The two most common types of urine incontinence are stress incontinence and urge incontinence. A combination of both also can occur and is called mixed incontinence.</p> <h2>Stress incontinence</h2> <p>Stress incontinence is involuntary urine leakage in relationship to physical activities, such as coughing, laughing, sneezing, jumping or even walking.</p> <p>The term "stress" is used to define this type of incontinence because the stress exerted on the bladder and the neck of the bladder by increased abdominal pressure results in failure of the weakened continence mechanisms and causes urine leakage.</p> <p>Women with this type of incontinence tend to stop doing their favorite sports or recreational activities and try to adapt to a less-active lifestyle.</p> <h3>Treatment options for stress incontinence</h3> <p>Often, women with stress incontinence issues are referred to pelvic floor physical therapists who specialize in women's health. The therapist will coach on how to conduct Kegel exercises to strengthen pelvic floor muscles to work more effectively and efficiently. If this doesn't improve symptoms after adequate trial, other treatment options are considered.</p> <p>There also is increased awareness and availability of in-home pelvic floor muscle training devices that are meant to help people perform better pelvic floor training. They're usually in the form of an application-based biofeedback device that is inserted vaginally to gauge strength of the pelvic floor muscle contraction. Others provide electrical muscle stimulation to result in passive muscle contraction. Some devices are in the form of vaginal weights with various shapes and sizes. Data to support these muscle-training devices is limited yet promising for women with mild or moderate stress incontinence.</p> <p>Nonsurgical treatment options also are available. An intravaginal pessary is one of the most popular and commonly used options. Pessary is a silicone-based device that is fitted to the vagina and inserted by a health care professional in the clinic. Different types of pessaries are used for different pelvic floor problems, such as urine incontinence and uterovaginal prolapse. Pessary shapes and sizes vary to fulfill the function and maintain comfort. The knob present in incontinence ring pessaries push on the urethra to overcome the stress pressure imposed by daily activities. Most people have immediate symptom relief, and it's reversible upon removal of the device.</p> <p>Over-the-counter options are available as well. An incontinence tampon, also called Impressa, is worn for 12 hours and is not reusable. Other devices that are placed vaginally and provide similar support as the pessary are available, like Uresta. It's a small, bell-shaped device that's inserted into the vagina at the beginning of each day or before any activity that usually results in urinary leakage. The device can be worn for the entire day or used just for certain activities.</p> <p>These devices should be removed at the end of each day and before intercourse. Studies are limited, yet show comparable effectiveness with no adverse effects.</p> <p>Surgical options are available for women without adequate relief with other options or when these therapies fail. The midurethral sling is the most used surgical procedure. It has a high success rate and can provide rapid relief for patients with low risk of complications. The sling procedure uses a synthetic mesh material that is positioned to replace the damaged fibromuscular support of the urethra and reestablishes the continence mechanism.</p> <p>The procedure carries an 85% to 95% success rate, with mesh complications reported at less than 3% if cases. The sling procedure is considered minor surgery. Patients often are discharged home the same day with minor limitations. This is the single most investigated procedure with strong cure rates, making it the gold standard of care.</p> <p>Urethral bulking is a minor surgical procedure in which synthetic material is injected into the wall of the urethra near the bladder. This adds volume to the wall of the urethra to help provide support of the urethra and better control of urine flow. Although the overall success and cure rate are lower than sling operations and these injections often need to be repeated, they're less invasive and offer faster recovery.</p> <h2>Urge incontinence</h2> <p>Even though stress incontinence is distressing, urge incontinence usually causes higher distress in women. It's defined as the compelling sudden urge to void that cannot be delayed or postponed, and results in urine leakage. This type of incontinence does impose more restrictions on a woman's lifestyle. Women tend to practice toilet mapping strategies, and limit outings and social activities because of the fear of social embarrassment.</p> <p>This type of incontinence usually is caused by the inability of the bladder to allow pressure-free storage of urine under normal bladder capacity. The bladder tends to contract and increase pressure that results in the strong urge to void and often is associated with urine loss.</p> <p>Risk factors are usually related to increasing age, obesity, family history, menopausal symptoms and medical conditions, such as diabetes or multiple sclerosis, as well as smoking and urogenital microbiome.</p> <h3>Treatment options for urge incontinence</h3> <p>Treatments for this type of condition also should address the underlying cause, such as better diabetic control; weight loss; or limiting of bladder irritants, like smoking, alcohol, caffeine and carbonated beverages. Bladder retraining with timed voiding intervals may provide significant relief for some patients and can be quite effective.</p> <p>Medications that relax bladder muscles can improve urge incontinence symptoms as a second-line treatment. The most reported side effects include dry mouth, constipation, heartburn and dry eyes. A newer class of medications avoid some of these side effects; however, they may cause slight elevations in blood pressure.</p> <p>Peripheral tibial nerve simulation is a third-line treatment option offered in the clinic setting that uses an acupuncture-like needle and mild electric simulation. The treatment consists of 12 sessions lasting 30 minutes each with optional once-a-month maintenance therapy options.</p> <p>Bladder muscle Botox injections are being used in patients who have severe symptoms. Injections offer reasonable improvements in symptoms for six months or longer, with common side effects being related to urine retention or urinary tract infections. These injections must be repeated every six to nine months.</p> <p>Sacral nerve modulation is a viable option for women with severe symptoms, especially those who do not respond to conventional first- and second-line treatments. This is the surgical implantation of a device that helps modulate the neuronal circuitry to render the bladder more receptive to urine with decreased urgency and urinary leakage symptoms.</p> <p>Although urine incontinence is common, it's not normal. It's important to have a thorough evaluation to determine the type of incontinence and potential causes. Treatment options are available to help women improve the quality of their lives. Discuss your symptoms and concerns with your health care professional.</p> <h4>Watch this video to learn more about urinary incontinence treatments, including sacral neuromodulation therapy:</h4> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/HNIMJx5I-Ys" title="Urinary incontinence treatments" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <p><em><a href="/providers/tarek-khalife-md" target="_self" title="Opens in same window.">Tarek Khalife, M.D.</a>, and <a href="/providers/gokhan-anil-md" target="_self" title="Opens in same window.">Gokhan Anil, M.D.</a>, are <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYNs</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a> and <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Adenomyosis</li> <li>Endometriosis</li> <li>Female sexual dysfunction, pain and vulvar disease, such as lichen sclerosus and lichen planus</li> <li>Fibroid treatment</li> <li>Heavy or irregular menstrual bleeding</li> <li>In-office treatment, including LEEP procedures, colposcopy and hysteroscopy</li> <li>Minimally invasive surgery for treatment of gynecologic disorders, such as laparoscopy and hysteroscopy</li> <li>Obstetric and advanced gynecologic 3D ultrasound</li> <li>Pelvic pain</li> <li>Robotic surgery</li> <li>Urine incontinence</li> <li>Uterovaginal prolapse</li> <li>Vaginal natural orifice transluminal endoscopic surgery (VNOTES)</li> </ul>M.D.<p>Every patient will have ample time to explain her condition and shed light on what matters to her most, as we navigate her treatment options. It is very imperative that the patient understands our partnership in managing her condition and identifies us as her support team to focus on her treatment and recovery.</p> <p>The most rewarding aspect of my time with the patient is when I get to educate them about their body and how disease affects its balance. It is my goal to allow my patient to graduate from her care with enough knowledge that she would use to teach and advocate for herself and to other women in her community. This way touches the patient’s life and the communities' lives at large.</p> <p>Outside of work, I do enjoy biking, swimming and camping. I am also a remote-control plane hobbyist, and I love grilling and cooking Lebanese cuisine.</p><p><strong>Education</strong></p> <ul> <li>Beirut Arab University</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>Obstetrics and Gynecology, Henry Ford Health System-Wayne State University</li> <li>Obstetrics and Gynecology, American University of Beirut Medical Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Minimally Invasive Gynecologic Surgery, American Board of Obstetrics and Gynecology</li> <li>Fellow, American College of Obstetrics and Gynecology</li> </ul> <p><strong> Memberships</strong></p> <ul> <li>American Association of Gynecologic Laparoscopists</li> <li>American College of Obstetrics and Gynecology</li> <li>International Society for the Study of Women's Sexual Health</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Obstetrics and Gynecology, Mayo Clinic College of Medicine and Science</li> </ul>Khalife<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/tarek-khalife-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A39C3DF2BF499DCA00FE29E1F7699D5D" alt="Tarek Khalife MD" width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/36088274/" target="_blank" title="Opens in new window">Retroperitoneal causes of genitourinary pain syndromes: Systemic approach to evaluation and management</a>, October 2022.</li> <li><a rel="noopener" href="https://www.sciencedirect.com/science/article/pii/S0002937821006074?via%3Dihub" target="_blank" title="Opens in new window">Pregnancy with IUD in place</a>, May 2021.</li> <li><a rel="noopener" href="https://www.liebertpub.com/doi/abs/10.1089/gyn.2021.0041" target="_blank" title="Opens in a new window">Intraoperative genitourinary injuries during a hysterectomy: Risks, management, and mitigation strategies</a>, May 2021.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/30398979" target="_blank" title="Opens in new window. ">The endogenous opioid system: Role and dysfunction caused by opioid therapy</a>, March 2019.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/28118169" target="_blank" title="Opens in new window. ">The K-technique: A novel technique for laparoscopic apical suspension using barbed sutures</a>, April 2017.</li> </ul>{CA02D1B4-DD8D-4C67-B975-FFCAEB25CAEF}Tarek<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20407092Tarek Khalife, M.D.1{83EB2AA2-1436-4DDC-B7BB-51F8E6A87FC9}|{54693F31-87AF-4B21-91DB-1DEC1E21F878}<ul> <li>Advanced laparoscopy and robotic surgery </li> <li>Fecal incontinence</li> <li>Minimally invasive pelvic surgery</li> <li>Overactive bladder </li> <li>Pelvic organ prolapse </li> <li> Sacral neuromodulation (Interstim) therapy</li> <li>Urinary incontinence</li> <li>Urogynecology</li> <li>Women's health</li> </ul>M.D.<p>I manage a patient-centric, collaborative practice and have a strong desire to heal and inspire hope to my patients. I strongly believe that there is no “doctor” without the “patient,” and I entrust my team to deliver the best care to meet the needs of our patients. </p> <p>In my free time, I love to travel with my family and read. I also enjoy problem solving. </p><p><strong>Medical School</strong></p> <ul> <li>University of Ankara Faculty of Medicine</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>Obstetrics & Gynecology, Baylor College of Medicine</li> <li>Obstetrics & Gynecology, West Virginia University - Charleston Division, Charleston Area Medical Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Obstetrics & Gynecology (ABOG)</li> <li>Female Pelvic Medicine & Reconstructive Surgery</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Obstetrics & Gynecology, Mayo Clinic College of Medicine and Science</li> </ul>Anil<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/gokhan-anil-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=6C4C4DE9D551A107FCA92ACD73B4EA64" alt="Gokhan Anil MD" width="280" height="280" DisableNVelocity="true" /><li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.liebertpub.com/doi/abs/10.1089/gyn.2021.0041" target="_blank" title="Opens in a new window">Intraoperative Genitourinary Injuries During a Hysterectomy: Risks, Management, and Mitigation Strategies</a>, May 2021</li>{0C431270-7870-45F2-83FE-F912E09A9495}Gokhan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14974142Gokhan Anil, M.D.1<img src="/-/media/national-files/images/hometown-health/2022/two-people-hugging-laughing.jpg?h=370&iar=0&w=660&sc_lang=en&hash=90EDBD9D7C5FB16386183C294C4B4DE5" alt="Two people side hugging and laughing" width="660" height="370" title="Two people side hugging and laughing" DisableNVelocity="true" />Urinary IncontinenceThe loss of bladder control is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that's so sudden and strong you don't get to a toilet in time. For most people, simple lifestyle changes or medical treatment can ease discomfort or stop urinary incontinence.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Dawn Haller8/3/2023Ever wonder why your fingers wrinkle in the water or why you shiver when it's cold? Learn the answers to these questions and more about why your body reacts to certain conditions.Q&A: The science behind weird body reactions<p>Every day our bodies do some rather strange and unusual things. Here are some questions and answers that give the science behind why these happen.</p> <h2>Why do fingers wrinkle in water?</h2> <p>Initially, it was thought that fingers wrinkled in water because of the fluid shifts that occur between the tissues and the surrounding water. Evolutionary experts are finding evidence that it may have helped humans get a better grip on objects in the water. People who have nerve damage to their fingers or toes often won't have this same wrinkling of fingers.</p> <h2>Why can I sometimes hear a pulse in my ears?</h2> <p>You feel a pulse in your ears for a variety of reasons. Tinnitus often is described as a ringing in the ears, but there is a variation where you can feel and hear the pulse in your ears. This is called pulsatile tinnitus. Elevation in blood pressure or an ear canal blockage can cause you to hear your pulse. An abnormality of the arteries by the ears also can cause this sensation. This is a reason to talk with your health care team.</p> <h2>Why do I shiver when it's cold?</h2> <p>You shiver when you're cold because it's a way to quiver your muscles to create heat. Your body always tries to keep its temperature as close to 98.6 degrees as possible.</p> <h2>Why do some people sneeze when they look up at the sun?</h2> <p>This is called the photic sneeze reflex, nicknamed the "sun sneeze." Here's the theory behind this reaction: The optic nerve, which senses a change in light, lies close to the trigeminal nerve, which controls sneezing. A typical sneeze is caused by irritation in the nose, which fires the trigeminal nerve to trigger a sneeze. When you step out of a dark room and into bright light, the pupils constrict. This rapid reflex is initiated by the optic nerve and may give the sensation of irritation in the nose, bringing on the sneeze. Not everyone has this reaction, and it's not clear why some people have it while others don't.</p> <h2>Why do I get a stitch in my side from running?</h2> <p>A side stitch is caused by irritation to the diaphragm, a muscle that separates the lung cavity and the abdominal cavity. Novice runners or those stepping up their pace or distance are more apt to get side stitches. Sometimes it's caused by too-rapid breathing or eating an inappropriate meal before running. If you get a side stitch, slow your pace, stretch your core muscles and focus on slow, rhythmic breathing. </p> <h2>Why does my eyelid randomly twitch?</h2> <p>Twitching of the eyelid is called blepharospasm. It isn't known exactly why this happens, but fatigue, caffeine and stress are common culprits. I recommend stretching the muscle that's twitching by gently pulling with your fingertip on the area and getting extra rest. Typically, the twitching goes away on its own. If the twitching lasts more than a couple of days or you have difficulty opening your eyelid, it's time to seek an evaluation from a health care professional.</p> <p><a href="/providers/amy-rantala-md" target="_self" title="Opens in same window."><em>Amy Rantala, M.D.</em></a><em>, sees patients in <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">Orthopedics</a> and <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">Sports Medicine</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Musculoskeletal care</li> <li>Nonsurgical orthopedic care</li> <li>Sports medicine</li> <li>Sports-related concussion management</li> </ul>M.D.<p>I believe in working together with my patients to maximize their health and physical abilities. Actively listening to patients to hear their story and assist them in meeting their health goals is exceptionally important to me. I have been a family medicine physician for 20+ years. It is an honor to serve the Chippewa Valley.</p> <p>My sports medicine practice is inclusive of uniformed athletes; athletes just starting their exercise program and trying to make it to the finish line; athletes trying to set a personal record; and active patients pursuing their passions. We all have an athlete in us and exercise is the best medicine.</p> <p>I am fortunate to be married to my wonderful, supportive husband and have three sons and two dogs. I like to do anything active outside. My personal passions are cross-country and downhill skiing, as well as biking and running. I am an avid reader and really like to travel and eat good food.</p><p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Sports Medicine, University of Chicago</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Family Medicine, American Board of Family Medicine</li> <li>Certificate of Added Qualification in Sports Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Practice</li> <li>American College of Sports Medicine</li> <li>American Medical Society for Sports Medicine</li> <li>Tri-County Medical Society</li> <li>Wisconsin Academy of Family Physicians</li> <li>Wisconsin Medical Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Rantala<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/amy-rantala-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B7A534FAE36A7D091C9F77015DD8E152" alt="Amy Rantala, M.D." width="280" height="280" DisableNVelocity="true" />{4F47E9FB-6E1F-41F8-9D4C-335E9C8FAFB8}Amy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13342967Amy Rantala, M.D.1{7746ADF8-715B-4593-8AAB-55D7F0467848}|{DEF55970-853F-4E96-9A4D-3413874FF059}|{2951D78A-CC76-4C49-B556-549282DF4345}<img src="/-/media/national-files/images/hometown-health/2018/fingers-wrinkled-by-water.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5F83F142969570E38D22F28A39648B4A" alt="Fingers wrinkled by water" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller7/16/2018<p>Busy day? We all know how hard it can be to fit a workout into our schedule, but why not get started with a 15-minute home workout using combo exercises?</p>15-minute workout: Combo exercises<img height="370" alt="Workout with stretch bands" width="660" src="/-/media/national-files/images/hometown-health/2018/workout-with-resistance-bands-2.jpg?sc_lang=en&hash=F133B89BF89A89CB4BF430BA379335CE" class="img-responsive"> <p>Busy day? We all know how hard it can be to fit a workout into our schedule, but why not get started with a 15-minute home workout? Working with a resistance band and in circuits will help you get your heart rate up, which will increase fat burn and muscle building. These combo exercises are great for targeting two muscle groups in one move.</p> <h4>MUSCLES WORKED</h4> <p>These exercises target your biceps, triceps, shoulders, back, quads, hamstrings and glutes.</p> <h4>GET STARTED</h4> <p>You’ll need to grab a resistance band and find a sturdy pole or object you can wrap the band around. You also will need a stability ball and a set of dumbbells with the weight you prefer. You can find all of this equipment at your local drugstore or online. If you’re performing these exercises at a gym, most gyms will have this equipment for you to use.</p> <p><strong><a href="/-/media/national-files/documents/hometown-health/2019/15-minute-workout-combo-exercises.pdf?sc_lang=en&hash=0D43C1D2DFD972AFC725ADD98B39D1E5" target="_blank" title="Opens in a new window.">Follow these instructions for a quick, 15-minute, full-body workout.</a></strong></p><img src="/-/media/national-files/images/hometown-health/2018/workout-with-resistance-bands-2.jpg?h=370&iar=0&w=660&sc_lang=en&hash=40E6362CBB2C7B1AC63C5712C0AAD25F" alt="Workout with resistance bands" width="660" height="370" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Get Tools to Live Your HealthiestIt’s never too early — or too late — to plan ahead for health. By making preventive care for you and your family a healthy habit, you’ll help improve your well-being. Be sure to connect with your healthcare provider to discuss any further questions that you may have about your health.Dawn Haller10/5/2022<p>When rapid growth or weight gain occurs, especially during teenage years, it's common for stretch marks to appear. Learn how medical treatment can improve the look of stretch marks.</p>Are stretch marks normal for teens?<p>Teens face many struggles navigating through growing up: changing body, new responsibilities and freedoms, as well as social life adjustments. Change can be difficult to accept for teenagers, especially when it comes to their bodies and the way they view themselves. One unwelcomed change can be stretch marks or "striae distensae."</p> <h2>How stretch marks develop</h2> <p>It's common for stretch marks to appear during teen years when rapid growth of weight gain occurs. Other factors that make teens predisposed to stretch marks appearing include a genetic risk or family history of stretch marks, pregnancy, being overweight or obese, or topical or oral steroids, like prednisone.</p> <p>Stretch marks occur when skin gets overstretched. They can occur in the abdomen, chest, hips, lower back and thighs. Because of the connective tissue and collagen in these areas, stretching too much causes the purple-reddish scars to appear. Over time, they usually become white and thinner.</p> <h2>Remedies for stretch marks</h2> <p>Many parents and teens turn to the internet to figure out what they can do about stretch marks. What they'll find is advice to try a variety of so-called "miracle cures" spanning from coffee grounds to lemon juice to vitamin E to a host of creams. Some sources even say to cover the marks in plastic wrap. It can be difficult to know what is true and what is just an old wives' tale.</p> <p>Home remedies, such as cocoa butter, vitamin E oils and glycol, will claim to make stretch marks fade or disappear. Most likely, these will not help with the disappearance of stretch marks. However, they will not cause harm if you try them.</p> <h3>Medically, there are several ways to treat stretch marks, including:</h3> <ul> <li><strong>Retinoid cream</strong><br /> This prescription helps rebuild collagen in the skin, which can help make the scar tissue appear more like the undamaged skin and improve the appearance of stretch marks.</li> <li><strong>Light and laser therapies</strong><br /> These help stimulate the growth of collagen or elastin in the skin and can reduce the red appearance.</li> <li><strong>Microdermabrasion</strong><br /> This is a hand-held device that blows crystals into the skin, refining the layer of skin, which can make it appear like normal again.</li> </ul> <p>If you notice stretch marks appearing on your body, talk to your health care provider about what options may be best for you.</p> <p><em><a href="/providers/kevin-boyd-md" target="_self" title="Opens in same window.">Kevin Boyd, M.D.</a>, is a pediatric <a href="/services-and-treatments/dermatology" target="_self" title="Opens in same window.">dermatologist</a> and dermatopathologist in <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Acne</li> <li>Childhood psoriasis</li> <li>Eczema</li> <li>Warts</li> </ul>M.D.<p>I enjoy exploring the outdoors, especially with my dog, Wolfie. My interests include international and domestic travel, environmental issues/tree hugging, and classical music, both as a soloist and ensemble member.</p><p><strong>Education</strong></p> <ul> <li>University of Missouri School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Pediatrics, Nationwide Children's Hospital</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Dermatology, University of Alabama at Birmingham</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Dermatopathology, New York University</li> <li>Pediatric Dermatology, Mayo Clinic School of Graduate Medical Education</li> <li>Dermatology and Genetics, University of Alabama at Birmingham</li> <li>Pediatric Dermatology Clinic Research Fellowship, Rady Children's Hospital</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Dermatology</li> <li>American Boards of Dermatology and Pathology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Dermatology</li> <li>Society for Pediatric Dermatology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Dermatology, Mayo Clinic College of Medicine and Science</li> </ul>Boyd<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/kevin-boyd-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=E9C5B9DE7FB503047DD0292ABE459DBF" alt="Kevin Boyd, M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/29415745/" target="_blank" title="Opens in a new window.">Cutaneous neurofibromas in Neurofibromatosis type I: a quantitative natural history study</a>, February 2018.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/22471276/" target="_blank" title="Opens in a new window.">Acute inpatient presentation of kwashiorkor: not just a diagnosis of the developing world</a>, April 2013.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/22940405/" target="_blank" title="Opens in a new window.">Nonmalignant cutaneous findings associated with vemurafenib in patients with metastatic melanoma</a>, December 2012.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/20605257/" target="_blank" title="Opens in a new window.">Phenotypic variability among café-au-lait macules in neurofibromatosis type 1</a>, June 2010.</li> </ul>{103D783B-8DB5-44CF-96A4-9F331C1EDEAA}Kevin P.<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30011372Kevin P. Boyd, M.D.1{276FDCB2-F341-4C45-B04B-F71FB963B8CB}<img src="/-/media/national-files/images/hometown-health/2022/kneeling-on-paddleboard.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1134D08CBE2B992F1D51AF5556CBE507" alt="Kneeling on paddleboard" width="660" height="370" DisableNVelocity="true" />Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller2/20/2024<p>Mindfulness has become a popular concept. Frequently thought of as a way to manage stress and improve focus, discover the benefits of mindfulness practice for helping with chronic pain.</p>Use mindfulness to cope with chronic pain<p>Mindfulness has become a popular concept. It can provide many benefits, including helping you manage stress and improve focus. But what is mindfulness?</p> <p>According to Jon Kabat-Zinn, a leader in <a rel="noopener noreferrer" href="https://www.umassmemorialhealthcare.org/center-mindfulness" target="_blank" title="Opens in new window">mindfulness practice</a>, "Mindfulness is awareness that arises through paying attention, on purpose, in the present moment, nonjudgmentally."</p> <p>Mindfulness principles and practices have been proven to help people manage symptoms of stress, anxiety, depression and other mental health conditions. Extensive research also has been conducted on the effectiveness of mindfulness as a tool for chronic pain management.</p> <p>An estimated 50 million U.S. adults experience chronic pain that lasts longer than three months, according to the Centers for Disease Control and Prevention (CDC). Chronic pain can occur after an injury or without apparent damage or previous bodily injury.</p> <p>Common types of chronic pain include lower back, migraine and headache, neck and facial. Living with chronic pain can have a significant effect on your relationships and quality of life, as well as your physical and mental health. It can also affect your mobility, independence and ability to work.</p> <p>It's common for people with chronic pain also to have symptoms of depression, anxiety and increased stress. People living with chronic pain often struggle with effectively managing pain while actively participating in life.</p> <h2>Managing chronic pain with mindfulness</h2> <p>Increasing evidence points to regular mindfulness practice as a method to reduce a person's pain experience. In 2015, Fadel Zeidan, Ph.D., and his colleagues conducted a study to investigate the effectiveness of mindfulness practice in pain management. They found that brain images of participants who received mindfulness as treatment had less activation in the parts of their brains that manage pain messages. Their research also has shown that some participants have been able to reduce, and sometimes eliminate, the use of pain medications through ongoing daily mindfulness practice.</p> <p>Mindfulness exercises help people to focus their mind and body in the moment without judgment. Daily mindfulness practice can help people living with chronic pain manage negative or worrisome thoughts about the pain. These thoughts are normal and can affect mood and increase pain. Being able to focus on relaxing the body, noticing the breath and body sensations as being there just as they are, can help manage pain, as well as reduce depression and anxiety symptoms.</p> <h2>Getting started with mindfulness</h2> <p>While it can be helpful to work with a mindfulness professional or psychotherapist to learn the concept of mindfulness, you can find many resources to get started on your own. Books, CDs, and smartphone and tablet apps are available for free or purchase that teach and help you put into practice mindfulness meditation to manage pain and other conditions. Many mindfulness practitioners have programs specifically for pain management, as well as generalized resources available for purchase through online retailers or local bookstores.</p> <p>You can find many mindfulness exercises online, including on YouTube. <a rel="noopener noreferrer" href="https://connect.mayoclinic.org/" target="_blank" title="Opens in a new window.">Mayo Clinic Connect</a> offers online resources and information on mindfulness and other health topics. Mayo Clinic Connect provides access to the Mindful Breathing Lab resources, which offer free audio mindfulness exercises.</p> <p>If you'd prefer to experience mindfulness in a group setting, local community agencies often offer mindfulness retreats, workshops and therapy groups throughout the year. These can be a great way to experience guided mindfulness meditation led by an experienced facilitator.</p> <h2>Giving mindfulness a try</h2> <p>Accessing information on mindfulness is easier than ever thanks to its growing popularity and modern technology. If you're living with pain, mindfulness could be a helpful tool for you.</p> <p><em><a href="/providers/lori-sodeman-lgsw" target="_self" title="Opens in same window">Lori Sodeman</a> is a social worker in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window">Family Medicine</a> in </em><em><a href="/locations/st-james" target="_self" title="Opens in same window">St. James</a></em><em>, Minnesota.</em></p><ul> <li>Adjustment disorders</li> <li>Adolescent behavioral health </li> <li>Anxiety and depressive disorders</li> <li>Chronic illness/chronic pain</li> <li>Community social service resources</li> <li>Grief/Loss</li> </ul>L.G.S.W.<p><strong>Education</strong></p> <ul> <li>University of North Dakota, Grand Forks</li> </ul> <p><strong>Licensure</strong></p> <ul> <li><strong></strong>Minnesota Board of Social Work</li> </ul>Sodeman<img src="/-/media/shared-files/images/medical-professionals/full/mankato/lori-sodeman-lgsw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=65DAE8796981841F65D239D025DABC70" alt="Lori Sodeman LGSW" width="280" height="280" DisableNVelocity="true" />Lori<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15044203Lori Sodeman LGSW1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}|{2B88C934-922C-4130-B661-197B59D83899}|{67744200-E25F-439A-8B70-572A5A091172}|{C4130004-0F31-48C4-AC9F-A4350A75AB24}|{262E035D-975E-4C94-96C9-6A8EA4E4040B}<img src="/-/media/national-files/images/hometown-health/2018/man-on-park-bench-earbud.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6E6496705A0470C4A130C5A4EFE33090" alt="man on park bench earbud" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Pain ReliefApproximately 50 million people in the U.S. live with chronic pain. If you experience chronic pain, you're not alone. Learn about the ways to deal with painful disorders, from at-home solutions to drug treatments, injectable or implantable therapies to surgery.Michele Halterman8/23/2022While dietitians recommend you get vitamins and minerals through your diet, this isn't always possible. If you don't consume enough fruits and vegetables, a multivitamin may fill nutritional gaps.Why take vitamin and mineral supplements?<p>Many vitamins and minerals are essential, contributing to the body's normal function. While dietitians recommend that you obtain most vitamins and minerals through your diet, this isn't always possible. </p> <p>For example, if you don't consume enough fruits, vegetables or other <a href="/hometown-health/speaking-of-health/eat-the-rainbow-for-good-health" target="_self" title="Opens in same window.">healthy foods</a>, a multivitamin may fill nutritional gaps. A multivitamin also may be beneficial if you have certain food allergies or intolerances, are pregnant, or have a disease or condition that affects nutrient intake. </p> <h2>Here are a few tips regarding supplements:</h2> <ul style="list-style-type: disc;"> <li><strong>Avoid megadoses.<br> </strong>High-dose supplements can cause toxic levels of nutrients to build up in your body. Select a vitamin that provides about 100% of the daily value, unless your health care professional tells you otherwise. A brand-name product is not necessary.</li> <li><strong>Look for "USP Verified" on the label.</strong><br> This label ensures the product meets strength, quality and purity standards set forth by U.S. Pharmacopeia, a testing organization.</li> <li><strong>Be aware of extras.</strong><br> Don't feel the need to purchase products with special ingredients, or added herbs, enzymes, amino acids or unusual ingredients. These extras usually add nothing but cost.</li> <li><strong>Check the expiration date.</strong><br> <a href="/hometown-health/speaking-of-health/should-i-take-vitamins-and-supplements-after-weight-loss-surgery" target="_self" title="Opens in same window.">Vitamins and supplements</a> can become less effective over time.</li> <li><strong>Ask the experts.</strong><br> Check with your health care professional or pharmacist if you have questions about what vitamin and mineral supplements you should take.</li> </ul> <p>A multivitamin cannot replace a healthy, <a href="/hometown-health/speaking-of-health/10-nutrition-myths-debunked" target="_self" title="Opens in same window.">well-balanced diet</a>. The body recognizes and absorbs the nutrients naturally found in foods much better than a supplement. </p> <p>For example, when it comes to vitamin C, you can obtain 100% of your needs by taking a vitamin C capsule. Or you can <a href="/hometown-health/speaking-of-health/add-citrus-colors-and-flavors-to-meals" target="_self" title="Opens in same window.">consume an orange</a> and receive not only vitamin C, but also beta carotene, calcium and other nutrients. </p> <p>But which is a better choice? </p> <p> The orange is a better choice. Because many foods also contain fiber and phytochemicals — substances that may protect against certain cancers, heart disease, osteoporosis and diabetes. Supplements don't include these substances. However, as mentioned above, a daily vitamin is sometimes a good option to support health and well-being.</p> <p><em>Anne Harguth is a registered dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2022/looking-at-vitamin-container.jpg?h=370&iar=0&w=660&sc_lang=en&hash=21540D100ADF7B2DAE10F5B314A30C5D" alt="Looking at vitamin container" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller7/2/2018<p>Busy day? We all know how hard it can be to fit a workout into our schedule, but why not get started with a 15-minute home workout?</p>15-minute workout: Resistance bands <img height="370" alt="Woman using resistance bands" width="660" src="/-/media/national-files/images/hometown-health/2018/workout-with-resistance-bands.jpg?sc_lang=en&hash=C3E77D9F3BBC3971ED50DDB4C4AD2E73" class="img-responsive"> <p>Busy day? We all know how hard it can be to fit a workout into our schedule, but why not get started with a 15-minute home workout? Working with a resistance band and in circuits will help you get your heart rate up, which will increase fat burn and muscle building. </p> <h4>MUSCLES WORKED</h4> <p>These five exercises will engage your glutes, hamstrings, quads, biceps, triceps, shoulders and back muscles. </p> <h4>GET STARTED</h4> <p>You’ll need to grab a resistance band. You can get these from your local drugstore or online. If you’re completing this workout at a gym, most gyms have this equipment for you to use. Give yourself enough space to perform these exercises.</p> <p><a href="/-/media/national-files/documents/hometown-health/2019/15-minute-workout-resistance-bands.pdf?sc_lang=en&hash=8E9BCA5510E730BC14D2810D761D8AFE" target="_blank" title="Opens in a new window."><strong>Follow these instructions for a quick, 15-minute, full-body workout using resistance bands</strong></a><strong>.</strong></p><img src="/-/media/national-files/images/hometown-health/2018/workout-with-resistance-bands.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9F412A4F350A463C2A20BEF460E3865E" alt="Workout with resistance bands" width="660" height="370" DisableNVelocity="true" />Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Get Tools to Live Your HealthiestIt’s never too early — or too late — to plan ahead for health. By making preventive care for you and your family a healthy habit, you’ll help improve your well-being. Be sure to connect with your healthcare provider to discuss any further questions that you may have about your health.Dawn Haller12/29/2022Changes to your body and brain are normal with age. Yet there are some things you can do to help slow the decline in memory and lower your risk of developing Alzheimer’s disease or other dementias.6 tips to keep your brain healthy<p>Changes to your body and brain are normal as you age. However, there are some things you can do to help slow any decline in memory and lower your risk of developing Alzheimer's disease or other dementias.</p> <h2>Here are six things I recommend to my patients in order of importance:</h2> <h3>1. Exercise regularly.</h3> <p>Exercise has many known benefits, and regular physical activity also benefits the brain. Multiple research studies show that physical active people are less likely to experience a <a href="/hometown-health/speaking-of-health/memory-loss" target="_self" title="Opens in same window.">decline in their mental function</a> and have a lower risk of developing Alzheimer's disease.</p> <p>These benefits result from increased blood flow to your brain during exercise. It also tends to counter some of the natural reduction in brain connections that occur during aging, reversing some of the problems. </p> <p>Aim to exercise several times per week for 30 to 60 minutes. You can walk, swim, play tennis or do any other moderate aerobic activity that increases your heart rate.</p> <h3>2. Get plenty of sleep.</h3> <p>Sleep plays an important role in your brain health. Some theories state that sleep helps clear abnormal proteins in your brain and consolidates memories, which boosts your overall memory and brain health. </p> <p>Aim for seven to eight consecutive hours of sleep per night, not fragmented sleep of two- or three-hour increments. Consecutive sleep gives your brain the time to consolidate and store your memories effectively. <a href="/hometown-health/speaking-of-health/do-i-have-sleep-apnea" target="_self" title="Opens in same window.">Sleep apnea</a> harms your brain's health and could be why you may struggle to get consecutive hours of sleep. Talk with your health care team if you or a loved one suspects you have sleep apnea.</p> <h3>3. Eat a Mediterranean diet.</h3> <p>Your diet plays a large role in your brain health. Consider following a Mediterranean diet, which emphasizes plant-based foods, whole grains, fish and healthy fats, such as olive oil. It incorporates less red meat and salt than a typical American diet.</p> <p>Studies show people who closely follow a <a href="/hometown-health/speaking-of-health/whats-the-big-deal-about-the-mediterranean-diet" target="_self" title="Opens in same window.">Mediterranean diet</a> are less likely to have Alzheimer's disease than people who don't follow the diet. Further research is needed to determine which parts of the diet help brain function the most. However, we know that omega fatty acids found in extra-virgin olive oil and other healthy fats are vital for your cells to function correctly, appear to decrease your risk of coronary artery disease, increase mental focus and slow cognitive decline in older adults.</p> <h3>4. Stay mentally active.</h3> <p>Your brain is similar to a muscle — you need to use it or lose it. There are many things that you can do to keep your brain in shape, such as doing crossword puzzles or Sudoku, reading, playing cards or putting together a jigsaw puzzle. Consider it cross-training your brain. Incorporate different types of activities to increase the effectiveness.</p> <p>Most health care teams don't recommend the paid brain-training programs available. These programs often overpromise results or focus on memorization skills that aren't useful in everyday life. Your brain can get just as good of a workout through reading or challenging yourself with puzzles. Finally, don't watch too much TV, as that is a passive activity and does little to stimulate your brain.</p> <h3>5. Remain socially involved.</h3> <p>Social interaction helps ward off <a href="/hometown-health/speaking-of-health/addressing-your-mental-health-by-identifying-the-signs-of-anxiety-and-depression" target="_self" title="Opens in same window.">depression and stress</a>, which can contribute to memory loss. Look for <a href="/hometown-health/speaking-of-health/maintaining-healthy-relationships-is-important-as-we-age" target="_self" title="Opens in same window.">opportunities to connect with loved ones, friends and others</a>, especially if you live alone. Research links solitary confinement to brain atrophy, so remaining socially active may have the opposite effect and strengthen the health of your brain.</p> <h3>6. Keep your blood vessels healthy.</h3> <p>The health of your arteries and veins is important to your heart health but it is also critical for brain health. Get your blood pressure, blood sugar and cholesterol checked regularly and take steps to keep your numbers within a normal range.</p> <p>Increase your physical activity, eat a Mediterranean diet and decrease your sodium consumption to lower blood pressure and cholesterol values. Finally, tobacco and alcohol use are impactful on brain health as well, so only drink alcohol in moderation and don't smoke. Moderate drinking is defined as up to one drink per day for women and up to two drinks per day for men.</p> <p><a href="/providers/kelsey-kidd-cnp" target="_self" title="Opens in same window."><em>Kelsey Kidd</em></a><em> is a nurse practitioner in <a href="/services-and-treatments/neurology" target="_self" title="Opens in same window.">Neurology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p>APRN, C.N.P., M.S.N.The entirety of my healthcare-related career has been spent working in the neurological setting. I am very passionate in regard to this field of patient care and I think that shows through my comprehensive approach to caring for patients. My goal is to provide care that encompasses each patient as a whole and to help each patient be as successful as they can in their daily life. I believe in care that is centered around each individual person which is why I love getting to know my patients. I also think the most successful care comes from working as a team and involving everyone in making important decisions.<br /> <br /> In my spare time I love spending time with my family! We love all things sports, being outside, and exploring our new home state of Minnesota!<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Nursing, South Dakota State University</li> <li>Master's degree, Nursing, <span>Clarkson College</span></li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Practice, The American Academy of Nurse Practitioners</li> </ul>Kidd<img src="/-/media/shared-files/images/medical-professionals/full/mankato/kelsey_kidd_cnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=3FBC6A57DDE264BF76A50D4D0E84EBD8" alt="Kelsey Kidd, C.N.P." width="280" height="280" title="Kelsey Kidd, C.N.P." DisableNVelocity="true" />Kelsey<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30092307Kelsey Kidd, APRN, C.N.P., M.S.N.1<img src="/-/media/national-files/images/hometown-health/2022/hands-sorting-puzzle-pieces.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6939B7CC934E256B5E913F9AFFF7B34D" alt="Hands sorting puzzle pieces" width="660" height="370" DisableNVelocity="true" />Dementia/Alzheimer's DiseaseDementia isn't a specific disease. Instead, dementia describes a group of symptoms affecting thinking and social abilities severely enough to interfere with daily functioning. Many causes of dementia symptoms exist. Alzheimer's disease is the most common cause of a progressive dementia. AgingLife expectancy is 75 for males and 80 for females according to the National Center for Health Statistics. We'll help you keep you informed about potential issues with aging, and steps you can take to maintain your health and keep active.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Michele Halterman6/21/2024Cool, juicy and sweet. There's nothing like a perfectly ripe melon on a summer day. But that refreshing treat also is packed with nutrients from folate to antioxidants. Learn the inside story.Discover the sweet health benefits of summertime melons<p>When it comes to melons, which one is your favorite? Whether it's cantaloupe, honeydew or <a href="/hometown-health/speaking-of-health/the-wonders-of-watermelon" target="_self" title="Opens in same window.">watermelon</a>, these summertime favorites contain some sweet health benefits.</p> <h2>Smart snack, rich in nutrients</h2> <p>Cantaloupe and honeydew melons belong to the muskmelon family and first grew in the Middle East. Watermelon originated in Africa. All three melons have a wide range of varieties. Look for varieties you haven't tried before and introduce yourself and your family to something new.</p> <h2>Here's how melons stack up nutritionally:</h2> <ul> <li><strong>Cantaloupe</strong><br /> A one-cup serving of cantaloupe has only 53 calories, but it contains 106% of the daily recommended value for vitamin A and 95% of the daily recommended value for vitamin C. It's also a good source of potassium and folate.</li> <li><strong>Honeydew</strong><br /> One cup of honeydew has 60 calories, 51% of the daily recommended value for vitamin C and 11% of the daily recommended value for potassium. Honeydew also contains fiber, folate and vitamin B6.</li> <li><strong>Watermelon</strong><br /> Watermelon is the lowest in calories, with 46 calories per one-cup serving. It's loaded with the antioxidant <a href="/hometown-health/speaking-of-health/eat-the-rainbow-for-good-health" target="_self" title="Opens in same window.">lycopene</a>, which is linked to decreased risk of cancer, heart disease and age-related eye disorders. It also contains vitamins A and C, and potassium. Because melons are high in <a href="/hometown-health/speaking-of-health/water-essential-to-your-body-video" target="_self" title="Opens in same window.">water</a> and contain potassium, they're fantastic choices for maintaining <a href="/hometown-health/speaking-of-health/6-ways-to-manage-high-blood-pressure" target="_self" title="Opens in same window.">healthy blood pressure</a> levels.</li> </ul> <h2>How to choose the pick of the crop</h2> <p>How do you pick the perfect melon? Choose a firm melon with no obvious bruising and one that's heavy for its size, which gives a clue to how juicy it is. Watermelon is best when it has a yellow belly, indicating it could have ripened in the field instead of the store or marketplace. One variety of honeydew melon — the Santa Claus — turns yellow as it ripens. The more yellow it is, the sweeter the flavor.</p> <h2>Prepping melons and serving ideas</h2> <p>Uncut melon can be stored at room temperature. Before cutting, wash the melon under running water and gently scrub the exterior with a brush to remove soil or contamination. After cutting into the melon, remove the fruit from the rind. Then, store the chunks or slices in an airtight container in the refrigerator for up to five days. Or, after cutting larger melons such as watermelon, cover tightly with plastic wrap and refrigerate for up to five days.</p> <h3>While a juicy slice of melon is refreshing and nutritious all on its own, here are other ideas for serving melons:</h3> <ul> <li>Add melon chunks to the mix when making your favorite fruit smoothie.</li> <li>Grill slices of cantaloupe or honeydew on a hot grill for one to two minutes on each side, which enhances their sweet flavor. Serve as a side with chicken, pork or fish or top with a scoop of ice cream for dessert.</li> <li>Make melon kabobs by threading grapes, melon and cheese cubes onto skewers for a fun snack or easy appetizer. Refrigerate until you're ready to serve them.</li> <li>Puree melon with a pinch of sugar and a splash of lime juice to make frozen pops. Pour the mixture into molds and freeze.</li> <li>Infuse water by chilling it with melon slices for a flavored summertime beverage with no added sugar.</li> </ul> <p>Try this quick, cool, creamy melon salad for breakfast, lunch or dessert. For a plant-based version, use a yogurt substitute.</p> <h4>Creamy Spiced Melon Salad</h4> <p>By Mayo Clinic<br /> Serves 4</p> <p>2 cups diced assorted melon, such as cantaloupe, honeydew or watermelon<br /> 1/2 cup plain or vanilla low-fat or nonfat yogurt<br /> 1/4 teaspoon nutmeg<br /> 1/8 teaspoon clove<br /> 1/8 teaspoon cinnamon<br /> Orange zest (about 1 tablespoon) and juice (about 3 tablespoons)</p> <p>In a large bowl, mix all ingredients to combine. Serve cold.</p> <p>Nutrition per serving (½ cup): 52 calories, trace total fat, 31 milligrams sodium, 11 grams total carbohydrate, 0 grams added sugars, 1 gram fiber, 2 grams protein.</p> <p><a href="/providers/corrinna-lenort-rdn" target="_self" title="Opens in same window."><em>Corrinna Lenort</em></a><em> is a registered dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition Counseling & Education</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a>, Minnesota.</em></p><ul> <li>Diabetes</li> <li>Weight management</li> </ul>RDN, LD<p>Patients can expect feeling seen and heard during appointments. I strongly believe in individualized nutrition care based on a patient's main concerns and health goals they want to focus on. My nutrition philosophy is small, sustainable changes for long-term success.</p> <p>I enjoy spending time with my family and friends. My hobbies include nice evening walks, being outside and squeezing in short exercises when a busy life schedule allows the opportunity. I aim to meet needs of people I encounter in my day. I enjoy cooking and trying new recipes; quick and easy are most realistic for me.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Dietetics, South Dakota State University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Dietetic Program, University of South Dakota Center for Disabilities</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetics Registration</li> <li>Minnesota Board of Dietetics and Nutrition Practice</li> </ul>Lenort<img src="/-/media/shared-files/images/medical-professionals/full/fairmont/corrinna-lenort-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=19F275E4907F391664940C0314CB187E" alt="Corrinna Lenort, R.D.N." width="280" height="280" DisableNVelocity="true" />Corrinna<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30259811Corrinna Lenort RDN1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2024/family-eating-watermelon.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D1BE016E881FA445E9CD3D4DEEE93365" alt="Family eating watermelon" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller5/15/2025Maintaining relationships and strong social networks as you age can contribute to a longer, healthier life. Read why having positive relationships is as important for health as nutrition and exercise.Maintaining healthy relationships with age<p>Positive relationships can be as important to your health and well-being as nutrition and physical activity. Even though relationships with others may evolve, maintaining a strong social network as you age can contribute to a longer, healthier life.</p> <p>A social network is simply a group of people close to you. This network — made up of friends, family, co-workers, neighbors and others — is how you give and receive instrumental and emotional support.</p> <p>Instrumental support is the tangible help you give or receive through acts, such as providing transportation for a neighbor to an appointment or offering child care for friends or family. Emotional support is intended to lift someone's spirits, relieve sadness, give encouragement or offer advice.</p> <h2>Giving relationships direction</h2> <p>Think of your networks and relationships as a convoy traveling down the road of life with you. Some of your relationships are in it for the long haul. Others use the on- or offramps, and some take different roads entirely. Relationships in your convoy change over time, but all provide support and contribute to your well-being along the journey.</p> <p>As people age, the road can feel lonely. Caring for children or aging parents can make it challenging to maintain friendships. This is normal, and means you must be more intentional about establishing and maintaining relationships, which isn't easy.</p> <h2>Devoting time to relationships</h2> <h3>If you're looking to expand your social network, try a few of these ideas:</h3> <ul> <li><strong>Take note of current connections.</strong><br /> Do an inventory of who is already in your social network. Are there people you have already met you could reconnect with?</li> <li><strong>Make the effort to reach out.<br /> </strong>In today's connected world, getting in touch with someone is as simple as a phone call, text message or video visit. If you prefer a method involving less technology, <a href="/hometown-health/speaking-of-health/kindness-in-action-brings-healthy-rewards" target="_self" title="Opens in same window.">send a handwritten card</a> or letter. </li> <li><strong>Go where people are.</strong><br /> Attend events, church or community activities. <a href="/classes-and-events" target="_self" title="Opens in same window.">Look for classes</a> or groups with people who have interests similar to yours.</li> <li><strong>Reap the benefits of volunteering.</strong><br /> <a href="/hometown-health/speaking-of-health/3-health-benefits-of-volunteering" target="_self" title="Opens in same window.">Join or volunteer</a> for a club or cause that interests you. Volunteering not only improves your physical and mental health, and provides a sense of purpose, but it's also a great way to build new relationships.</li> <li><strong>Extend and accept invitations.</strong><br /> Don't worry if your social skills feel a bit rusty. An invitation to meet for coffee or go for a walk around the neighborhood may brighten someone else's day as much as it does yours.</li> <li><strong>Be available.</strong><br /> Relationships take time and effort. Whether connecting with a friend you've known for a long time or someone you just met, be present in the moment, and give your full attention to the person and situation.</li> </ul> <p>In addition to helping provide the necessary support, establishing and maintaining positive relationships also is good for your health. They can <a href="/hometown-health/speaking-of-health/how-to-create-happiness" target="_self" title="Opens in same window.">boost your happiness</a>, reduce stress, improve confidence and help you cope with traumatic events.</p> <p> Adults with a strong social network have a reduced risk of depression, lower blood pressure and tend to maintain a healthier body mass index, or BMI. Building new friendships and investing time in maintaining relationships can help you on the highway of life and the path to better health.</p> <em>By Mayo Clinic Health System Staff</em><img src="/-/media/national-files/images/hometown-health/2023/two-people-working.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8C64C8832BF96DFB755FCEB84C7FB21D" alt="Two people working" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Micah Dorfner7/26/2023Returning to school can be exciting for some students but cause worry or anxiety for others. Get tips for helping your student adjust to new routines, friends and school expectations.Back to school: Tips to help students adjust<p>With fall just around the corner, back-to-school season is quickly approaching. This can be an exciting time as it's one step closer to graduation, college or joining the workforce. It's also a time for new beginnings: new friends, reconnecting with previous friends, meeting different teachers and picking up new school supplies.</p> <p>Going back to school also can be a scary, trying time for some students. Their worries may be related to adjusting to attending a new school, fear of what this school year will be like, being accepted by classmates or teachers and feeling pressure to get good grades.</p> <h2>While these often are normal emotional thought responses to starting school, these tips can help your student adjust:</h2> <ul> <li><strong>For students attending a new school, visit the school campus prior to the year starting if possible.</strong><br /> Many schools will offer student, parent and teacher conferences before school starts, so everyone can meet. Additionally, it allows an opportunity for parents and students to see the new school.</li> <li><strong>Review homework expectations.</strong><br /> Identify where at home your children will sit to do homework each day, such as at their desk or the kitchen table. When are they expected to start their homework? Right after they get home or after having a snack and a 30-minute break? Review expectations for grades and how the family will address academic challenges. Setting expectations prior to school starting will help both children and parents.</li> <li><strong>Develop a good sleep routine.</strong><br /> On average, children ages 6–13 require nine to 11 hours of sleep each night. Children ages 13–17 require an estimated eight to 10 hours of sleep per night. Develop consistent sleep routines so your student is able to mentally and emotionally prepare for bedtime. For example, put all electronics away one hour before bedtime, and keep charging stations away from bedrooms to decrease distractions. Additional routine items may be taking a shower, reading a bedtime story, getting a drink or snack and brushing teeth.</li> <li><strong>Eat a healthy breakfast each morning.</strong><br /> Proper nutrition can help prepare students for learning. If they're hungry, they're more likely to have difficulty focusing.</li> <li><strong>Have a plan for school-related conflicts.<br /> </strong>School years are a time for students to learn how to navigate relationships outside of their family and prepare them for adulthood. At times, that may mean working through a conflict or disagreement with a peer or teacher. Discuss the first step to developing conflict solutions with your child while keeping in mind that the goal of parenting is to raise independent adults. It's a natural response for parents to want to solve and protect children from conflict. However, stepping in too often decreases their ability to develop the skills and confidence needed to be an independent adult who can self-advocate. Developing an approach to help your student process and develop solutions with you will help with their skill development and help you identify serious issues that require parental involvement.</li> </ul> <p>There are times when routines and plans aren't enough. If you suspect your child is not adjusting well to school and anxiety or depression may be a contributing factor, reach out for additional support. Connect with the school social worker or counselor. You also can seek support outside of the school system through a behavioral health provider or your primary care provider.</p> <p><em><a href="/providers/jessie-wolf-licsw">Jessie Wolf </a>is a licensed clinical social worker in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Adjustment disorders</li> <li>Adolescent and children’s behavioral health (ages 6-17)</li> <li>Anxiety disorders</li> <li>Attention-deficit/hyperactivity disorder (ADHD) assessment and treatment with adults and children (ages 6-17)</li> <li>Depressive disorders</li> <li>Grief and loss</li> </ul>L.I.C.S.W.<p>I see children six years of age through adulthood.</p><p><strong>Education </strong></p> <ul> <li>Master's degree, Social Work, Minnesota State University-Mankato</li> </ul> <p><strong>Internships</strong></p> <ul> <li>Hospice and Palliative Care, Mayo Clinic Health System-Mankato</li> <li>Nursing Home and Rehab Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>ADHD, Certified Clinical Services Provider </li> <li>Art of Traumatic Grief Counseling, Compassionate Bereavement Care</li> <li>Licensed Independent Clinical Social Worker</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Professional Society of ADHD and Related Disorders</li> <li>National Social Work Association</li> </ul> <p><strong>Academic Rank</strong></p> <ul> <li>Instructor in Social Work, Mayo Clinic College of Medicine and Science</li> </ul>Wolf<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jessie-wolf-licsw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B680201D1A0D763676AD889806D46E00" alt="Jessie Wolf LICSW" width="280" height="280" DisableNVelocity="true" />Jessie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14640821Jessie Wolf LICSW1{2B88C934-922C-4130-B661-197B59D83899}|{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2023/parent-helping-child-with-backpack.jpg?h=370&iar=0&w=660&sc_lang=en&hash=983AF5740AEA1103831067023887AB18" alt="Parent helping child with backpack" width="660" height="370" DisableNVelocity="true" />Back to SchoolChildren's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller9/28/2018<p>Life is messy. But you can develop your resiliency muscles with simple, quick practices.</p>Resiliency in modern times<img height="370" alt="Young woman thinking and writing" width="660" src="/-/media/national-files/images/hometown-health/2018/young-woman-thinking-and-writing.jpg?sc_lang=en&hash=F05A77FEFA6DF1A383788DAB4DC2FB35" class="img-responsive" /> <p>In the words of Tieraona Low Dog, M.D., one of my wise and passionate teachers: “Life is messy!” She was sharing this in a recent docuseries with the context of discussing balance and resiliency. In her wisdom, she shares that it no longer is about the “illusion of a balanced life.” Rather, it is about resiliency and how well you can come back to your center.</p> <p>As I listened to her, I realized there was truth to what she was saying. I have been a mental health counselor for over 27 years. In that time, I often have focused on helping people find balance in their lives to deal with daily stressors. However, as each year goes by, there are more and more stressors that arise, and seemingly less and less time to implement the many coping strategies you may have learned.</p> <h4>Develop your resiliency muscle</h4> <p>Take a moment to think of your top five stressors and how you manage them. If what you’re doing is working for you, share that with others in your life. If what you’re doing isn’t quite doing it, there are some quick ways you can develop your resiliency muscle.</p> <p>Remember that your brain is operating from a primitive place of survival when you had to be able to quickly react to threats, such as an animal attack that affected your life and ability to get food to sustain your family. Now, you may encounter daily threats, yet the brain isn’t naturally wired to handle them. These threats are different and constant versus centuries ago when a threat may have been only once a day, and then you would recover. Today’s threats happen at work, and in your personal and social life. It could be fear of losing your job, difficulty paying the bills, that your power may be shut off, wondering if your partner still loves you, your child going to daycare or a health issue. The list is endless. The good news is that through research and great thought leaders, such as Amit Sood, M.D., author of “The Mayo Clinic Guide to Stress-free Living,” there are simple, quick practices that can help you return to center and adapt to your ever-changing environment.</p> <h4>Practice to build resiliency</h4> <p>Dr. Sood explains one simple, life-changing practice called morning gratitudes. Each morning when you wake up and before getting out of bed, think of five people or animals you are grateful for. See each one individually in your mind, and say a silent thank you. Do this for two weeks, and see if you notice anything shift in how you handle stress and interactions with others. By doing this, you are activating the love hormone called oxytocin rather than the stress hormone called cortisol. Your brain and heart will thank you for this. You can find more practices to build resiliency in his book.</p> <p>Remember Dr. Low Dog’s words: “Life is messy!” Be compassionate and loving with yourself and others as you learn to navigate this new world. You are a change agent capable of making the world a kinder, more loving place.</p> <p><em><a href="/providers/sarah-stinson-lpc" target="_self" title="Opens in same window.">Sarah Stinson</a> is a licensed professional counselor in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/red-wing" target="_self" title="Opens in same window.">Red Wing</a>, Minnesota.</em></p><ul> <li>Eating disorders treatment and prevention</li> <li>Healing Touch</li> <li>Mindfulness</li> <li>Stress Management and Resiliency Training (SMART)</li> </ul>M.S., L.P.C., L.P.C.C.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Psychology, Winona State University</li> <li>Master's degree, Community Counseling, St. Cloud State University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Certified Healing Touch Instructor (CHTP/I)</li> <li>Certified Healing Touch Practitioner (CHTP/I)</li> <li>Certified Massage Therapist</li> <li>Licensed Professional Counselor, Minnesota and Wisconsin</li> </ul> <p><strong>Fellowship</strong></p> <li>Fellow, Academy of Integrative Health and Medicine (AIHM)</li>Stinson<img src="/-/media/shared-files/images/medical-professionals/full/red-wing/sarah-stinson.jpg?h=280&iar=0&w=280&sc_lang=en&hash=59889EC2825310D74211E2DC2531FB57" alt="Sarah Stinson" width="280" height="280" DisableNVelocity="true" />Sarah <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15830667Sarah Stinson, M.S., L.P.C., L.P.C.C.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2018/young-woman-thinking-and-writing.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1105C27CF835EFCAF82EF257C46F7F09" alt="Young woman thinking and writing" width="660" height="370" DisableNVelocity="true" />ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller8/31/2020<p>Ovarian cancer takes the lives of thousands of women each year. Knowing symptoms and risk factors can increase your chances of early diagnosis and recovery.</p>Ovarian cancer: Get the facts<p>Ovarian cancer is a common cancer among women and often is fatal in later stages of the disease. The cancer starts in the ovaries, and spreads to the abdomen and pelvis if it is not diagnosed and treated early.</p> <h4>Here are some important statistics to know about ovarian cancer:</h4> <ul> <li>More than 60 women will be presented with a diagnosis each day.</li> <li>Roughly 270 mothers, daughters, wives and friends will be taken from our lives each week.</li> <li>1 in 78 women have a chance of receiving an ovarian cancer diagnosis.</li> </ul> <h4>Detecting ovarian cancer</h4> <p>An important part of treatment is to detect the signs of ovarian cancer early. It often is not detected until the cancer moves into the pelvis and abdomen, which makes it more difficult to treat. An early diagnosis can improve the chances of successful treatment. If you are experiencing these symptoms, see your health care provider:</p> <ul style="list-style-type: disc;"> <li>Quickly feeling full when eating</li> <li>Abdominal bloating or swelling</li> <li>Weight loss</li> <li>Frequent need to urinate</li> <li>Changes in bowel habits</li> <li>Discomfort in the pelvic area</li> </ul> <h4>Ovarian cancer risk factors</h4> <p><a href="/-/media/national-files/documents/hometown-health/2019/get-the-facts-ovarian-cancer.PDF?sc_lang=en&hash=71293A54365F7E71138177BD86BE2051" target="_blank" title="Opens in a new window."><img alt="Download a PDF about ovarian cancer." src="/-/media/national-files/images/hometown-health/2018/download-a-pdf-about-ovarian-cancer.jpg?h=135&w=135&sc_lang=en&hash=2CE72EC821004D8A5312EC8A03EE43CA" style="width: 135px; height: 135px; float: right; margin-bottom: 5px; margin-left: 5px;" class="img-responsive" /></a>Family history of ovarian cancer and personal factors can play a role in your chances of receiving a diagnosis.</p> <h5>These factors could increase your risk of ovarian cancer:</h5> <ul> <li>Obesity</li> <li>Genetics</li> <li>Hormone replacement therapy</li> <li>Family history</li> <li>Personal history of cancer or endometriosis</li> <li>Increasing age or reproductive history and infertility</li> </ul> <h4>Decreasing risk factors</h4> <h5>While it is important to watch for symptoms, there are some factors that could decrease your risk, including:</h5> <ul> <li>Oral contraceptive use</li> <li>Pregnancy and breastfeeding</li> <li>Removal of the ovaries and fallopian tubes</li> <li>Hysterectomy or tubal ligation</li> </ul> <p>Ovarian cancer takes the lives of thousands of women each year. Knowing symptoms to watch for and risk factors can increase the chances of diagnosing ovarian cancer early, which can increase your chances of beating it.</p> <h4>Learn more about ovarian cancer:</h4> <ul style="list-style-type: disc;"> <li><a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">Read about Michelle Messer's journey with stage 4 ovarian cancer</a>.</li> </ul> <h4> Dr. Suzette Peltier describes common signs and symptoms of the ovarian cancer, screening tools, misconceptions about the CA 125 test and the importance of early detection and treatment:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed//7QPphoDcP_c" title="Ovarian cancer Q&A" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p><img src="/-/media/national-files/images/hometown-health/2018/caricature-woman.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F1F04AEFE0BA2D1E9F246E20AFEBB671" alt="Caricature woman and health drawings" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller1/17/2023Talking early with your children about the risks of marijuana and alcohol use may prevent the first use. Get tips to start a conversation about avoiding substance use.How youth marijuana, alcohol use impacts life<p>Marijuana use reached an all-time high in 2021 compared to the previous 10 years among young adults aged 19-30. On the other hand, a slight yet significant <a rel="noopener" href="https://nida.nih.gov/research-topics/trends-statistics/monitoring-future" target="_blank" title="Opens in a new window.">decline in marijuana use</a> was seen for eighth, ninth<sup>,</sup> and 12th graders compared to 2020. It has been postulated that limited peer contact and increased parental supervision due to COVID-19 could have contributed to this decline. It will be interesting to see the future trends of marijuana use among this age group.</p> <h2>Marijuana use in teens</h2> <p>Marijuana contains more than 500 chemicals, of which <a rel="noopener" href="https://nida.nih.gov/publications/drugfacts/cannabis-marijuana" target="_blank" title="Opens in a new window.">delta-9-tetrahydrocannabinol (THC)</a> is considered the primary psychoactive (mind-altering) compound. The concentration of THC in a marijuana product is directly proportional to its potency or how much of a high it will give when consumed. Marijuana use among adolescents and young adults can affect normal brain development, leading to problems in learning, memory, coordination, reaction time and judgment. </p> <p>Excessive and frequent use of marijuana is associated with hallucinations, paranoia, and a range of emotional problems. The severe form of marijuana abuse is called marijuana use disorder. Youth who use marijuana at an early age, in high amounts and with the risk factors mentioned above are more prone to developing marijuana use disorder.</p> <h2>Alcohol use in teens</h2> <p>Key findings in a national survey on drug and alcohol use reported that binge drinking by young adults reached pre-pandemic levels in 2021 after a decrease in 2020. For men, binge drinking is five or more drinks consumed on one occasion. These numbers are cause for concern. The proportion of eighth, 10th, and 12th graders' alcohol use has declined in the past 10 years, but the present numbers are still troubling, especially regarding binge drinking.</p> <p>Studies show that the use of alcohol is associated with tobacco use and risky behaviors. The use of alcohol also is associated with youth mortality from motor vehicle accidents or suicide and disruptions in significant day-to-day life with school, work and family that are important for healthy development. </p> <h2>Marijuana and alcohol co-use</h2> <p>Marijuana and alcohol are the most used substances by adolescents and young adults. People who use either substance report use of the other substance in their lifetime, or concurrent use. A significant proportion of people also report consuming marijuana and alcohol simultaneously. The concurrent and simultaneous use of marijuana and alcohol is of major concern because of its association with greater negative social and medical health consequences. For example, co-use is associated with impaired driving, involvement in the criminal justice system, and higher rates of alcohol and cannabis use disorders and psychiatric problems. </p> <h2>What parents need to know about substance use</h2> <p>Talking early with your child about the risks of substance use and continuing this discussion over time may prevent the first use and protect your child's brain and day-to-day functionality. If you suspect your child is using substances, have an <a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/tween-and-teen-health/in-depth/teen-drug-abuse/art-20045921" target="_blank" title="Opens in a new window.">open dialogue</a> without making negative or angry comments. </p> <p>Offer your child educational material and facts about substance use. Involve your child's primary care professional to educate your child and screen for substance use so an appropriate referral for addiction treatment can be made.</p> <h2>Learn more about youth substance use:</h2> <ul> <li><a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/tween-and-teen-health/in-depth/teen-drug-abuse/art-20045921" target="_blank" title="Opens in a new window.">Teen drug abuse: Help your teen avoid drugs</a></li> <li><a rel="noopener" href="https://www.cdc.gov/youth-behavior/risk-behaviors/substance-use-among-youth.html?CDC_AAref_Val=https://www.cdc.gov/healthyyouth/substance-use/" target="_blank" title="Opens in a new window.">High-risk substance use among youth</a></li> <li><a rel="noopener" href="https://nida.nih.gov/research-topics/parents-educators/conversation-starters" target="_blank" title="Opens in a new window.">Parent conversation starters</a></li> </ul> <p><a href="/providers/pravesh-sharma-md"><em>Pravesh Sharma, M.D.</em></a><em>, is a psychiatrist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/eau-claire">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Adolescent addiction psychiatry</li> <li>Cannabis use disorder and its complex interrelationship with psychotic symptoms</li> <li>Community psychiatry</li> <li>Suicide prevention</li> <li>Systems of care</li> </ul>M.D.<p>Meeting patients where they are, and educating the community and youth about mental health disorders are an important component of patient care.</p> <p>In my free time, I enjoy cooking, travelling, biking, reading, and watching movies.</p><p><strong>Medical School </strong></p> <ul> <li>Rajiv Gandhi Medical College, Thane, Maharashtra, India</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Adult/General Psychiatry, Texas Tech University Health Sciences Center</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Child and Adolescent Psychiatry, Johns Hopkins School of Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Child and Adolescent Psychiatry</li> <li>American Psychiatric Association</li> </ul>Sharma<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/pravesh-sharma-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=0F964036343201B2B10E1D1C1CC3942F" alt="Pravesh Sharma, M.D." width="280" height="280" DisableNVelocity="true" />Pravesh<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20777116Psychiatry + Psychology - Pravesh Sharma MD1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2023/teen-outdoors-looking-to-left.jpg?h=370&iar=0&w=660&sc_lang=en&hash=93E995C0D2999E82F9AE6444645388D1" alt="Teen outdoors looking to left" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Child DevelopmentWe all want our children to grow up happy and healthy. The reality is most all of them do — but at vastly different rates. Experts across Mayo Clinic Health System see thousands of children each year, and have the experience and resources to know what is normal and what may be cause for closer observation. This includes not only physical and motor skills development, but psychological and social skill advancement.Substance AbuseInformation for helping those with alcohol and other drug abuse concerns.Dawn Haller9/13/2022<p>Parenting a child or teen with ADHD can be difficult. However, behavioral parent training — a technique that uses positive reinforcement — can help.</p>Parenting a child, teen with ADHD<p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/adhd/symptoms-causes/syc-20350889" target="_blank" title="Opens in a new window.">Attention-deficit/hyperactivity disorder</a> (ADHD) is the most common childhood mental health problem. ADHD affects an estimated 6 million children ages 3–17, according to the Centers for Disease Control and Prevention. The behavior of children with ADHD often seriously disturbs relationships with parents, teachers, peers and siblings, and leads to academic problems. </p> <h2>ADHD complicated by additional disorders</h2> <p>Children and teens with <a href="/hometown-health/speaking-of-health/what-is-adhd" target="_self" title="Opens in same window.">ADHD</a> are at increased risk of developing depression, anxiety and substance abuse disorders. And children who don't receive treatment are at greater risk of becoming underachievers in school, getting in trouble, being disciplined for uncontrollable behaviors, and struggling with socializing and making friends.</p> <p>These challenging behaviors can make parenting children and teens with ADHD more difficult. Parents often turn to specialists to help manage children's specific needs. Specialists can include psychiatrists, psychologists, therapists and special education teachers. </p> <h2>Managing ADHD behaviors with behavioral parent training</h2> <p>Parents are the best people to manage ADHD behaviors. Children and teens with ADHD require a higher level of parenting. This is referred to as "superparenting." Behavioral parent training teaches superparenting skills led by specialists trained in working with children with ADHD and their families.</p> <p>Behavioral parent training is the recommended first line of treatment. It's an effective treatment for children and teens with ADHD to improve behavior, self-control and self-esteem. It teaches parents how to nurture children and teens through positive techniques. </p> <p>This form of parent training teaches new skills or strengthens existing skills for parents to <a href="/hometown-health/speaking-of-health/helping-a-child-with-adhd-develop-social-skills" target="_self" title="Opens in same window.">teach and guide their children and teens to manage ADHD behaviors</a>. When used by parents, these techniques teach children and teens to control their behavior better, leading to improved functioning at school and home. In addition, parent training is shown to strengthen the relationship between the parent and child and decrease negative or problem behaviors.</p> <p>Clinical therapists teach behavioral parent training in an individual or group format. Clinical therapists experienced with ADHD teach parents the skills necessary to parent a child or teen with ADHD. Families who choose group therapy can benefit from the support of other families dealing with an ADHD diagnosis.</p> <p>Other treatments toted as helping with ADHD but not proven effective include play therapy, computer games, biofeedback and the use of dietary supplements.</p> <h2 style="background: white; margin-top: 0in;">Pandemic's effect on children with ADHD</h2> <p style="background: white; margin-top: 0in;">Children experienced many changes during the COVID-19 pandemic. Children with ADHD may find it harder to adapt to school after a period of online learning when there was increased access to electronic devices and digital media. Research will need to be conducted to determine if ADHD symptoms, behavioral concerns, executive functioning difficulties and family struggles grew due to increased digital media use during the pandemic.</p> <p>Parenting is challenging. Parenting a child or teen with ADHD is even more challenging. Fortunately, <a href="/hometown-health/speaking-of-health/5-tips-to-manage-adhd-in-children" target="_self" title="Opens in same window.">techniques for parents</a> and treatment options can ease the challenges of raising children with ADHD.</p> <p> </p> <p>Contact <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> or <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">Pediatric & Adolescent Medicine</a> in your community for more information or resources.</p> <em><a href="/providers/janice-schreier-lcsw" target="_self" title="Opens in same window.">Janice Schreier</a> is child and adolescent clinical therapist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em><ul> <li>Anxiety</li> <li>Attention deficit hyperactivity disorder</li> <li>Bipolar disorders</li> <li>Chemical dependency</li> <li>Depression</li> <li>Eating disorders</li> <li>Facilitates social skills groups for adolescents with autism spectrum disorders</li> <li>Individual, family and group therapy</li> <li>Obsessive-compulsive disorders</li> <li>Post-traumatic stress disorder</li> <li>Reactive attachment disorder</li> <li>Trauma</li> <li>Treatment for children 7–17 and young adults</li> </ul>L.C.S.W.<p><strong>Education</strong></p> <ul> <li>Addiction Counseling, Viterbo University</li> <li>Bachelor's degree, Social Work, University of Wisconsin-La Crosse</li> <li>Master's degree, Social Work, University of Wisconsin-Milwaukee</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Autism Spectrum Disorders</li> <li>Licensed Clinical Social Worker, Substance Abuse Specialty</li> </ul>Schreier<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/janice-schreier-msw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=42215A8A31EDEE2903AC5F89E6D23B11" alt="Janice Schreier MSW" width="280" height="280" DisableNVelocity="true" />Janice<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15449963Janice Schreier, L.C.S.W.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2022/child-and-parent-playing-hand-games.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7973C10D0C849D821FCA65D16B995CCA" alt="Child and parent playing hand games" width="660" height="370" DisableNVelocity="true" />ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller4/4/2022Learning your ABCs the first time helped you read. Now they could save your life by alerting you to changes in moles that could signal melanoma — the most serious type of skin cancer.The ABCDEs of moles<p>Learning your ABCs the first time helped you read. Now they could save your life. That's because these ABCs can alert you to changes in moles that could signal melanoma — the most serious type of skin cancer.</p> <p>Moles are a common type of skin growth. They often appear as small brown spots and are caused by clusters of pigmented cells. Moles generally appear during childhood and adolescence. Most people have 10 to 40 moles, some of which may change in appearance or fade away over time.</p> <p>Most moles are harmless. Rarely do they become cancerous. Monitoring moles and other skin lesions patches is an important step in detecting skin cancer, especially malignant melanoma.</p> <p>The first signs of melanoma are usually a change to an existing mole or a new skin growth. They're usually found on skin that has seen a lot of sun, like your face, scalp, arms, back or calves. However, melanoma can be found in areas that are not exposed to the sun.</p> <p>Your best chance of beating melanoma is to catch it early.</p> <h2>This ABCDE guide can help you determine if a mole or spot may indicate melanoma or other skin cancers:</h2> <ul> <li><strong>A</strong>symmetrical shape: One half is unlike the other half and not round or oval</li> <li><strong>B</strong>order: Notched, irregular or scalloped borders</li> <li><strong>C</strong>olor: Multiple colors, changes in color or uneven color</li> <li><strong>D</strong>iameter: Larger than 1/4 inch or a pencil eraser</li> <li><strong>E</strong>volving: Change in size, shape, color or height; new signs and symptoms, such as itchiness, tenderness or bleeding; or nonhealing sores</li> </ul> <p>It's important to watch for moles that stick out or appear different than other moles. They are sometimes referred to as "ugly ducklings" and should raise your suspicion of melanoma. Cancerous, or malignant, moles vary greatly in appearance. Some may show all the features listed above. Others may have only one or two. </p> <p>Check out the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.skincancer.org/skin-cancer-information/melanoma/melanoma-warning-signs-and-images/do-you-know-your-abcdes" target="_blank" title="Opens in a new window.">Skin Cancer Foundation's slideshow</a> of the ABCDEs of moles to become familiar with atypical moles.</p> <p>If you notice any of these changes, schedule an appointment with your health care team.</p> <h2>Learn more about skin care:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/3-sun-safety-reminders" target="_self" title="Opens in same window.">3 sun safety reminders</a></li> <li><a href="/hometown-health/speaking-of-health/simple-steps-to-prevent-skin-cancer" target="_self" title="Opens in same window.">5 simple steps to help prevent skin cancer</a></li> </ul> <p><em><a href="/providers/melanie-dixon-md" target="_self" title="Opens in same window.">Melanie Dixon, M.D.</a>, is a physician in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota, with special interest in dermatology and skin care.</em></p><ul> <li>Acne</li> <li>Skin cancer screening exams </li> </ul>M.D.<p>As a family medicine physician with a special interest in dermatology, my goal is to provide thorough and compassionate care for my patients. I enjoy treating a wide variety of dermatologic conditions for patients of all ages.</p> <p>I am a mom of three teenage boys who keep me busy! In my spare time, I love playing and singing music with my husband, gardening, and exploring the outdoors — with sunscreen of course!</p><p> <strong>Education</strong></p> <ul> <li>University of Minnesota</li> </ul> <p><strong>Residency</strong></p> <ul> <li>United Family Medicine Residency Program</li> </ul> <p><strong>Certification </strong></p> <ul> <li><strong></strong>American Board of Family Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Alpha Omega Alpha (AOA) Honor Medical Society </li> <li>Minnesota Medical Associations</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Dixon<img src="/-/media/shared-files/images/medical-professionals/full/mankato/melanie-dixon-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=24994F681CF9EF3BD60B386BA7BB1D57" alt="Melanie Dixon MD" width="280" height="280" DisableNVelocity="true" />Melanie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15868524Melanie Dixon, M.D.1<img src="/-/media/national-files/images/hometown-health/2022/moles-on-neck-closeup.jpg?h=370&iar=0&w=660&sc_lang=en&hash=16854D629228D5AEDC8772ABDEA2D840" alt="Moles on neck closeup" width="660" height="370" DisableNVelocity="true" />Skin CancerSkin cancer — the abnormal growth of skin cells — most often develops on skin exposed to the sun. But this common form of cancer can also occur on areas of your skin not ordinarily exposed to sunlight.Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Dawn Haller9/11/2025Bring fun, flavor and healthy foods to your kids’ lunch bags by taking inspiration from the fair. Thread meats, cheeses, veggies, fruit or even mini waffles on skewers for an easy-to-make lunch.Not just for the fair: Lunch on a stick<p> Back-to-school time means back to homework for the kids — and back to packing school lunches for parents. This year, take your inspiration from the fairgrounds, and try layering your kids favorite foods on a wooden skewer or cake pop stick.</p> <p>Involve kids in meal preparation when possible. It can be a fun experience and a great way for kids to learn some kitchen basics, as well as about nutrition and even math. When kids are part of the process, they're more likely to eat what's served.</p> <h2>Give these tips a try:</h2> <ul> <li>Talk about the importance of choosing a variety of food groups at meals, and the benefits of eating healthy foods, including building strong bones and muscles, providing energy for activities, and giving your body the vitamins and minerals it needs.</li> <li>Use food pieces to demonstrate shapes: round tomatoes, square cheese, rectangular meat slices and oval grapes.</li> <li>As you cut ingredients, talk about fractions, such as halves, quarters and eighths.</li> <li>Have children help with washing the fruits or vegetables or rolling up the meat and cheese slices.</li> <li>Older children can learn knife skills.</li> </ul> <p>When building balanced meals — even meals on a stick — try to include at least three to four food groups for a well-rounded meal with a good variety of nutrients.</p> <h2>Food groups include:</h2> <ul> <li>Proteins like tofu, pork, beef, lamb, chicken, seafood, eggs, beans, seeds and nuts</li> <li>Dairy products, such as yogurt, milk and cheese, and dairy alternatives, like soy milk</li> <li>Vegetables and fruits that are fresh, frozen or canned</li> <li>Grains like bread, tortillas, pasta, rice, cereal and potatoes</li> </ul> <h2>These meal examples include three or more food groups and give you some ideas on how to get started creating fun, easy lunches to pack or eat at home:</h2> <ul> <li><strong>Sandwich kabobs</strong><br /> Layer cubed bread, meat, cheese and folded leaves of lettuce. Consider adding cherry tomatoes, pickle slices or olives. Pack mustard and mayo in small containers for dipping.</li> <li><strong>Sandwich roll-ups</strong><br /> Roll lunch meat and sliced cheese, and then skewer with a pretzel rod.</li> <li><strong>Italian kabobs</strong><br /> Layer cooked cheese tortellini with salami or pepperoni slices and leaves of spinach. Send along marinara sauce for dipping.</li> <li><strong>Pizza kabobs</strong><br /> Slide premade pizza crust slices onto a wooden skewer, and add mozzarella balls, pepperoni slices and fresh basil. Serve with a side of pizza sauce for dipping.</li> <li><strong>Breakfast for lunch</strong><br /> Alternate small pieces of French toast or mini waffles with berries or banana slices. Include a side of yogurt for dipping.</li> <li><strong>Salad on a stick</strong><br /> Skewer chunks of romaine lettuce, cherry tomatoes, sliced cucumbers, cheese and hard-boiled eggs. Send along a side of your child's favorite dressing.</li> <li><strong>Dessert</strong><br /> Layer marshmallows and brownie chunks for an easy sweet treat. Or try small rice crispy treats with strawberries.</li> <li><strong>Fruity treat</strong><br /> Skewer your child's favorite fruits, such as grapes, strawberries, melon cubes, banana slices or apple wedges, and include a pudding cup for dipping.</li> </ul> <p>Insulated lunch bags will keep foods cold. Fill a water bottle and freeze. Add it to the lunch bag not only to provide chilling, but also a cold drink for your child come lunchtime.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2022/fresh-fruit-on-wood-skewers.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E97C710EE290D972F8D1C64FC9948443" alt="Fresh fruit on wood skewers" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller9/27/2023<p>Each year, around 13 million people in the U.S. are infected with human papillomavirus, or HPV. Most will never know it. Learn how to protect your family.</p>HPV immunization: Who can benefit?<p>Each year, around 14 million people in the U.S. are infected with <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/hpv-infection/symptoms-causes/syc-20351596" target="_blank" title="Opens in a new window.">human papillomavirus</a>, or HPV. Over 42 million U.S. adults have the virus, and most will never know it. But for some, the infection can prove deadly.</p> <p>That's because two strains of the virus cause the vast majority of <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/cervical-cancer/symptoms-causes/syc-20352501" target="_blank" title="Opens in a new window.">cervical cancer</a>, which is difficult to treat, especially if it has spread beyond the cervix.</p> <p>Most HPV infections don't lead to cancer, but some can. In addition to cervical cancer, HPV infections have been linked to genital warts and <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/vaginal-cancer/symptoms-causes/syc-20352447" target="_blank" title="Opens in a new window.">vaginal</a>, <a rel="noopener" href="https://www.cancer.org/cancer/penile-cancer.html" target="_blank" title="Opens in a new window.">penile</a>, <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/anal-cancer/symptoms-causes/syc-20354140" target="_blank" title="Opens in a new window.">anal</a>, <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/mouth-cancer/symptoms-causes/syc-20350997" target="_blank" title="Opens in a new window.">oral</a> and <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/throat-cancer/symptoms-causes/syc-20366462" target="_blank" title="Opens in a new window.">throat</a> cancers.</p> <p>These are devastating cancers which usually don't cause symptoms until the cancers are advanced and harder to treat. Fortunately, there's a vaccine to prevent HPV patients, and I strongly recommend this vaccine to all my patients.</p> <h2>Who and when to vaccinate</h2> <p>The Centers for Disease Control and Prevention (CDC) estimates that 92% of cancers caused by HPV could be prevented by vaccination. The best time to receive the HPV vaccine is before exposure to the virus, which is the most common sexually transmitted infection in the U.S. The immunization is recommended for ages 9 to 26.</p> <p>The CDC recommends that all 11- and 12-year-olds receive two doses of HPV vaccine at least six months apart. Teens and young adults up to age 26 also can be vaccinated. Some adults ages 27 to 45 also may decide to get the HPV vaccine based on a discussion with their healthcare providers.</p> <h2>Side effects and safety</h2> <p>The CDC and Food and Drug Administration monitor vaccines in the U.S. and have a wealth of data on the safety and effectiveness of the HPV vaccine. Potential side effects are mild and similar to those that might be experienced with other vaccines, such as soreness, swelling or redness at the vaccination site.</p> <p>Less common side effects include headache, nausea, vomiting, fatigue or weakness. And although it's rare, the HPV vaccine causes some people to feel dizzy or faint. Sitting for 15 minutes after the injection can lower the risk of fainting.</p> <p>The bottom line is that this is a safe, effective vaccine that can prevent several types of cancer in males and females. It's an easy way for parents to protect their kids far into the future, and it will benefit them for the rest of their lives.</p> <h2>Not just for kids</h2> <p>The HPV vaccine is just one of a list of vaccines that people should get in childhood and as an adult. Vaccines for adults are recommended based on age, prior vaccinations, health, lifestyle, occupation and travel destinations.</p> <p>The recommended vaccination schedule is updated every year, and changes range from the addition of a new vaccine to tweaks in current recommendations. To determine exactly which vaccines you need now and which vaccines are coming up, check the <a rel="noopener" href="https://www.cdc.gov/vaccines/?CDC_AAref_Val=https://www.cdc.gov/vaccines/schedules/" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention website</a>.</p> <p><a href="/providers/ganesh-namachivayam-md" target="_self" title="Opens in same window."><em>Ganesh Namachivayam, M.D.</em></a><em>, is a <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">pediatrician</a> in <a href="/locations/barron" target="_self" title="Opens in same window.">Barron</a> and <a href="/locations/rice-lake" target="_self" title="Opens in same window.">Rice Lake</a>, Wisconsin.</em></p><ul> <li>Comprehensive pediatric care from birth through adolescence</li> </ul>M.D., M.P.H.<p><strong>Education</strong></p> <ul> <li>Stanley Medical College</li> <li>Master's degree, Public Health, Northern Illinois University</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Advocate Lutheran General Children's Hospital</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Educational Commission for Foreign Medical Graduates</li> <li>Mayo Clinic Quality Fellow, Bronze Level+ </li> <li>Neonatal Resuscitation Program Instructor, American Heart Association</li> <li>Pediatric Fundamental Critical Care Support, Society of Critical Care Medicine</li> <li>Pediatrics, American Board of Pediatrics</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Pediatrics</li> <li>American Board of Pediatrics</li> <li>American College of Physician Executives</li> <li>American Public Health Association</li> <li>Mayo Clinic Alumni Association</li> <li>Stanley Medical College</li> <li>U.S. Department of Health and Human Services</li> <li>Wisconsin Medical Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Pediatrics, Mayo Clinic College of Medicine and Science</li> </ul>Namachivayam<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/ganesh-namachivayam-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=5BA42B17D1000464A759B784B7BCB1EB" alt="Ganesh Namachivayam, M.D." width="280" height="280" DisableNVelocity="true" />Ganesh <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15619265Ganesh Namachivayam, M.D., M.P.H.1{02421E57-1F9C-4F00-BF77-56DA854DCF27}|{61776FD2-05E8-47E9-AB55-EE465BD29A19}<img src="/-/media/national-files/images/hometown-health/2023/child-holding-ball.jpg?h=370&iar=0&w=660&sc_lang=en&hash=19F78E5F9BB1B1CB8A2A13E9CFEDB117" alt="Child holding ball" width="660" height="370" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Dawn Haller3/9/2023<p>For years, turning 50 came with a special birthday message from your health care team: Time to have a colonoscopy. Read about the change in guidelines to begin screening at age 45.</p>5 things you can do to keep your colon healthy<p>For years, turning 50 came with a special birthday message from your primary care provider: Time to have a <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/colonoscopy/about/pac-20393569" target="_blank" title="Opens in a new window.">colonoscopy</a>.</p> <p>Now that message will be coming a bit sooner. Updated screening guidelines recommend that most people get their first colonoscopy at age 45.</p> <p><a href="/hometown-health/speaking-of-health/colorectal-cancer-basics" target="_self" title="Opens in same window.">Colon cancer</a> is the third-leading cause of cancer-related deaths in the U.S., and rates have been increasing in younger people. The change in the guideline is designed to help catch those cancers earlier, when they're more likely to be curable.</p> <h2>No matter your age, there are five steps you can take to avoid developing colon cancer:</h2> <h3>1. Eat your veggies and healthy fats.</h3> <p>Research has shown that the Western diet correlates to higher colon cancer rates. People who eat high-fiber diets are less likely to develop the disease. Limit the amount of meat you eat, especially processed meats. Focus on consuming healthy fats found in olive oil, salmon rich in Omega-3, avocados and nuts, as well as limiting low-processed fats found in fried food.</p> <h3>2. Get moving.</h3> <p>You know exercise benefits your heart and can help you maintain your weight. It also may lower your risk of developing some types of cancer, including colon cancer. Aim for 30 minutes of moderate exercise on most days of the week.</p> <h3>3. Watch your weight.</h3> <p>According to the American Cancer Society, carrying extra pounds increases your risk of colon cancer and cancers of the rectum, esophagus, pancreas, kidney and breast in postmenopausal women, among others. Talk to your health care team if you need help losing weight.</p> <h3>4. Limit alcohol and don't smoke.</h3> <p>If you choose to drink alcohol, do so moderately. That means no more than one drink a day for women or two drinks a day for men. And if you smoke, quit. Your health care team can offer tips or refer you to a program to help you stop.</p> <h3>5. Follow screening guidelines.</h3> <p>It's so important that we're going to end where we began. One of the most important cancer prevention strategies is following the colon cancer screening guidelines based on age, risk factors and family history. Multiple <a href="/hometown-health/speaking-of-health/understanding-your-colon-cancer-screening-options" target="_self" title="Opens in same window.">colon cancer screening options</a> are available.</p> <p>A colonoscopy is more than a screening tool. It can <a href="/hometown-health/speaking-of-health/reducing-your-risk-for-colon-cancer" target="_self" title="Opens in same window.">reduce your risk for colon cancer</a> by discovering precancerous changes, called <a href="/hometown-health/speaking-of-health/polyps-colon-cancer-culprits" target="_self" title="Opens in same window.">polyps</a>, and removing them before they develop into cancer.</p> <h4>Read more about colorectal cancer:</h4> <ul> <li><a href="/hometown-health/speaking-of-health/5-questions-about-stool-dna-tests-for-colon-cancer" target="_self" title="Opens in same window.">5 questions about stool DNA tests for colon cancer</a></li> <li><a href="/hometown-health/speaking-of-health/benefits-of-sedation-free-colonoscopy" target="_self" title="Opens in same window.">Benefits of sedation-free colonoscopy</a></li> <li><a href="/hometown-health/speaking-of-health/colorectal-cancer-myths-and-facts" target="_self" title="Opens in same window.">Colorectal cancer myths and facts</a></li> </ul> <p><em>By Mayo Clinic Health System Staff.</em> </p><img src="/-/media/national-files/images/hometown-health/2023/selecting-fruit-in-grocery-store.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C44CAECD7A3DB3E9A1CBCA161D8E074F" alt="Selecting fruit in grocery store" width="660" height="370" DisableNVelocity="true" />Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Colorectal HealthGet screening and treatment for colorectal cancer symptoms, and learn about risk factors and prevention strategies.Dawn Haller1/14/2021Think you're ready to take on the challenge to lose the extra weight? This readiness assessment can help you get on track for success. Are you ready to change habits to lose weight?<p>Your success in losing weight depends, in large part, on your readiness to take on the challenge. If you start before you're ready, it can be harder to succeed. Knowing that you need to make changes in your life and actually doing it are two different things.</p> <p>Use this short interactive assessment to see if you're ready to start a weight loss plan, and learn what steps to take if you're not quite there. At the end of the assessment, you will be able to print a results summary to share with your health care provider.</p> <p>If you are looking for a change, learn more about the <a href="/healthy-weight" target="_self" title="Opens in same window.">variety of weight loss options</a> that can make a difference.</p> <p><em><a href="/providers/rhonda-jenson" target="_self" title="Opens in same window.">Rhonda Jensen</a> is a <a href="/services-and-treatments/weight-management" target="_self" title="Opens in same window.">weight management educator</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p> <h4>Take the weight loss readiness assessment:</h4><ul> <li>Lifestyle and behavior changes</li> <li>Nutrition</li> <li>Weight management</li> </ul>I am a weight management educator. I help patients with behavior, lifestyle and nutrition changes to help them get to and maintain a healthy weight.<p><strong>Education </strong></p> <ul> <li>Vocational Rehabilitation, University of Wisconsin-Stout</li> </ul>Jenson<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/rhonda-jenson.JPG?h=280&iar=0&w=280&sc_lang=en&hash=65B478A03A514D221E16B99AB77490D3" alt="Rhonda Jenson" width="280" height="280" DisableNVelocity="true" />Rhonda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13783599Rhonda Jenson1{94B2E140-AEF8-44BA-B6A9-4538B77501BC}<img src="/-/media/national-files/images/hometown-health/2021/items-promoting-healthy-weight.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B9A448B28132B90272024F04ABF88B39" alt="Items promoting healthy weight" width="660" height="370" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Get Tools to Live Your HealthiestIt’s never too early — or too late — to plan ahead for health. By making preventive care for you and your family a healthy habit, you’ll help improve your well-being. Be sure to connect with your healthcare provider to discuss any further questions that you may have about your health.Dawn Haller3/1/2019<p>It's hard to ignore when things are feeling a little off "down there." Learn about six factors that can contribute to bacterial vaginosis.</p>6 contributors to bacterial vaginosis<img height="371" alt="Female with pelvic pain" width="660" src="/-/media/national-files/images/hometown-health/2018/female-with-pelvic-pain.jpg?sc_lang=en&hash=E5F8744296DA36BBA59B364344D97284" class="img-responsive" /> <p>Have you ever thought about how when your body is healthy, you don’t even notice your vagina? But when things are a little off, it’s hard to ignore. Bacterial vaginosis is a common bacterial infection of the vagina that rarely goes unnoticed. It sometimes can be confused with a yeast infection or sexually transmitted disease, such as trichomoniasis, but it is not an <a href="/hometown-health/speaking-of-health/sexually-transmitted-diseases-what-you-need-to-know" target="_self" title="Opens in same window.">STD</a>.</p> <p>With bacterial vaginosis, bacteria growth can cause uncomfortable symptoms, including a change in vaginal discharge or odor — often described as being white or gray in color and having a fish-like odor. Some women will experience inflammation and itching. However, itching is uncommon.</p> <h4>Bacterial vaginosis causes</h4> <p>Low levels of the bacteria that cause bacterial vaginosis are normally found in the vagina. It becomes a problem when too much of the bacteria grow.</p> <p>Several factors can make increase the number of bacteria, including:</p> <ol> <li><strong>Sex.</strong> Semen impacts the pH level in the vagina, which can contribute to a higher rate of bacteria growth. </li> <li><strong>Douching.</strong> Douching with vinegar or antiseptics causes inflammation and can increase the risk of infections. This also can eliminate some good bacteria.</li> <li><strong>Diet change.</strong> Anything that affects the gastrointestinal tract or internal body system can affect the normal balance of bacteria. Also, a poor diet can affect the ability of the body to return to normal state.</li> <li><strong>Nylon underwear/tight yoga pants.</strong> Wearing nylon underwear or tight yoga pants can block air movement in the vaginal area, which can cause increased bacteria growth. </li> <li><strong><a href="/hometown-health/speaking-of-health/you-dont-need-fancy-products-for-good-feminine-hygiene" target="_self" title="Opens in same window.">Heavily perfumed/antibacterial soaps</a>.</strong> Using soap with a lot of scent or an antibacterial agent spurs bacteria growth.</li> <li><strong>Sweating.</strong> When you work out, your clothes get wet, which encourages bacteria growth.</li> </ol> <h4>Bacterial vaginosis treatment</h4> <p>The first instinct often is to look online for home remedies because it seems too embarrassing to seek medical care. Home remedies include a borax suppository, yogurt, garlic supplements, hydrogen peroxide or diluted tea tree oils. These treatments aren’t well-studied, so we do not recommend trying to treat bacterial vaginosis at home with them. Seeing a primary care provider or gynecologist is the best and safest option for treatment. Bacterial vaginosis is not transferrable to male partners, but is to female partners, so both females should consider being treated.</p> <p>It is fairly common for bacterial vaginosis to recur. If this happens, a medical provider should be consulted for other treatment options specific to your case. Bacterial vaginosis can be uncomfortable and frustrating to deal with, which is why it’s important to seek medical care. Don’t deal with it longer than you have to.</p> <p>See your primary health care provider or <a href="/hometown-health/speaking-of-health/when-should-a-female-start-seeing-a-gynecologist" target="_self" title="Opens in same window.">OB-GYN</a> if you suspect you have bacterial vaginosis.</p> <p><em><a href="/providers/carla-toft-cnm" target="_self" title="Opens in same window.">Carla Toft</a> is a certified nurse-midwife <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em> </p>Women's healthCNM, A.P.N.P.<p>I am proud to join the Mayo Clinic Health System team. I enjoy the full scope of women’s care, but have a passion for labor and delivery.</p> <p>In my free time, I enjoy walking, cycling, cooking, and reading historical fiction and mysteries.</p><p><strong>Education</strong></p> <ul> <li>Bachelor’s degree in Nursing, Mount St. Mary College</li> <li>Master’s degree in Nursing, University of Texas-El Paso</li> </ul> <p><strong>Certification</strong></p> <ul> <li><strong></strong>American Midwifery Certification Board</li> </ul>Toft<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/carla-toft-cnm-apnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B45A0F9648D2B20A2AE44EE9D6B40202" alt="Carla Toft, CNM, A.P.N.P." width="280" height="280" DisableNVelocity="true" />{8E99B0A3-53F1-43C8-B660-F2F87255B6A5}Carla<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>19994192Carla Toft, CNM, A.P.N.P. 1<img src="/-/media/national-files/images/hometown-health/2018/female-with-pelvic-pain.jpg?h=371&iar=0&w=660&sc_lang=en&hash=9D4A17EE3E20D7E13427A59C7320A4C4" alt="Female with pelvic pain" width="660" height="371" DisableNVelocity="true" />Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller4/19/2022Type 2 diabetes can affect your body’s major organs. Learn about achieving three goals that can help protect them so you can have a healthy, enjoyable life.How to live well with diabetes<p><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193" target="_blank" title="Opens in a new window.">Type 2 diabetes</a> can be easy to ignore, especially in the early stages. But diabetes affects many major organs, including your heart, blood vessels, nerves, eyes and kidneys. It's important to control your blood sugar levels to prevent complications and live well with diabetes.</p> <h2>What does living well with diabetes look like?</h2> <h3>If you have Type 2 diabetes, you should achieve and maintain three main goals to manage it well, and live a healthy, active and enjoyable life:</h3> <ol> <li><strong>Keep your <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/a1c-test/about/pac-20384643" target="_blank" title="Opens in a new window.">A1C</a> level under 7%.</strong></li> <li><strong>Control your blood pressure.</strong> For most people, the blood pressure goal should be under 130/80 mmHg, or millimeters of mercury.</li> <li><strong>Manage your cholesterol.</strong> People with diabetes should aim for their low-density lipoprotein, or LDL or "bad" cholesterol, number to be between 70 and 100 to reduce the risk of heart attack and stroke.</li> </ol> <h3>You can achieve these three goals by:</h3> <ul> <li><strong>Eating well.</strong><br /> Choose foods lower in carbohydrates and higher in protein and healthy fats. Healthy carbohydrates are found in fruits, vegetables and whole grains. Limit carbohydrates from soda, juice, alcohol, white breads, pastas and desserts.</li> <li><strong>Moving more.</strong><br /> Physical activity helps maintain blood sugar in a normal range. Aim for a minimum of 30 minutes of moderate-intensity physical activity per day. Take a <a rel="noopener" href="https://newsnetwork.mayoclinic.org/discussion/get-walking-with-this-12-week-walking-schedule/" target="_blank" title="Opens in a new window.">short walk</a> after each meal to prevent a blood sugar spike after eating.</li> <li><strong>Aiming to maintain a healthy weight.</strong><br /> You control what you eat and how active you are. Consider small changes, such as using a smaller plate with meals.</li> <li><strong>Not smoking.</strong><br /> Smoking increases the risk of various diabetes complications.</li> <li><strong>Visiting your primary care professional, and taking medications as prescribed.</strong><br /> Your healthcare team is your care partner to identify problems and provide guidance to keep you feeling well.</li> </ul> <p>As you work to control your diabetes and reach these three goals, it's important to check your A1C levels every three to six months. Your healthcare team will determine the frequency of your A1C checks based on how well-controlled your diabetes has been.</p> <p>Regular checks will ensure that your treatment plan is working. If it's not, or diet and exercise aren't enough to control your blood sugar, you'll know that you need to make some adjustments. This might mean more aggressive lifestyle modifications, medications or <a href="/hometown-health/speaking-of-health/closing-the-loop-with-insulin-pumps" target="_self" title="Opens in same window.">insulin therapy</a>.</p> <p>If you've been told you have prediabetes, working to achieve these three goals will reduce or delay progression toward Type 2 diabetes.</p> <p>If your blood sugar is consistently out of your target range or you're not sure what to do, contact your healthcare team or a diabetes educator. </p> <p>Get more information and healthy living tools on the <a href="/wellness-hub" target="_self" title="Opens in same window.">Live Well portal</a>.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/couple-head-on-shoulder-laughing.jpg?h=370&iar=0&w=660&sc_lang=en&hash=79F26CFD5417C94599D7B4E212F25146" alt="Couple with head resting on shoulder and laughing" width="660" height="370" DisableNVelocity="true" />DiabetesIf you have diabetes, no matter what type, it means you have too much glucose in your blood, although the reasons may differ. Too much glucose can lead to serious health problems.Dawn Haller8/10/2020Help your kids clean up their hand-washing skills before school starts. Here are some tips and a coloring sheet to get them motivated.Clean up your hand-washing skills<p>Bacteria and germs are all around us and live on every surface we touch. They can cause influenza and other common infections. The good news is there’s an easy way to protect yourself from germs: hand-washing. The best way to prevent the spread of germs that can cause influenza and other infections is by washing your hands. Whether at school, work, home or in public, it is important to be mindful of what you touch and wash your hands.</p> <p>It can be easy to forget what it takes to wash well. And if you’re in a rush, it’s easy to skimp on your efforts.</p> <p><a href="/-/media/local-files/eau-claire/documents/miscellaneous/how-to-wash-your-hands-color.pdf?sc_lang=en&hash=A091E5CD3A46CCA01E6507EF407474B4" target="_blank" title="Opens in a new window."><img alt="Download and print a handwashing flyer." src="/-/media/national-files/images/hometown-health/2018/download-and-print-a-handwashing-flyer.jpg?h=135&w=135&sc_lang=en&hash=270A2E19B47EFAEE58A19EC750F0C008" style="height: 135px; width: 135px; float: right; margin-bottom: 5px; margin-left: 5px;" class="img-responsive" /></a></p> <h2>How to wash your hands</h2> <h3>Here are a few tips to clean up your hand-washing skills:</h3> <ul> <li>Scrub your hands together for 20 seconds using warm water. Cold water does not remove germs and oils as well as warm water. Oils on your hand can hold bacteria and germs.</li> <li>Sing the “ABCs” song twice to be sure you scrub long enough. The scrubbing motion with soap removes the germs.</li> </ul> <p><a href="/-/media/local-files/eau-claire/documents/miscellaneous/how-to-wash-your-hands-color.pdf?sc_lang=en&hash=A091E5CD3A46CCA01E6507EF407474B4" target="_blank" title="Opens in a new window.">Download a flyer about proper hand-washing technique</a> to post in your home or office as a reminder.</p> <h2>When to wash your hands</h2> <h3>There are certain times that it’s extra important to wash hands to avoid putting germs in your body or sharing your germs with others:</h3> <ul> <li>Before you eat</li> <li>After you sneeze or blow your nose</li> <li>After you play or are in a public place</li> <li>After you use the bathroom</li> </ul> <a href="/-/media/local-files/eau-claire/documents/miscellaneous/wash-hands-coloring-sheet.pdf?sc_lang=en&hash=CD50ECE2A1BC302AFD280BEE12BF4772" target="_blank" title="Opens in a new window."><img alt="Download and print a handwashing coloring sheet." src="/-/media/national-files/images/hometown-health/2018/download-and-print-a-handwashing-coloring-sheet.jpg?h=135&w=135&sc_lang=en&hash=0FEDA59711918B50B928D3C44B78C4D1" style="height: 135px; width: 135px; float: right; margin-bottom: 5px; margin-left: 5px;" class="img-responsive" /></a> <h2>Other ways to stop the spread of germs</h2> <h3>While hand-washing is a great defense, other actions can help prevent the spread of germs:</h3> <ul> <li>Avoid close contact with other people and crowds</li> <li>Stay home when you are sick</li> <li>Cover your mouth and nose while sneezing or coughing</li> <li>Avoid touching your eyes, nose or mouth</li> <li>Clean and disinfect surfaces or objects</li> </ul> <p><a href="/-/media/local-files/eau-claire/documents/miscellaneous/wash-hands-coloring-sheet.pdf?sc_lang=en&hash=CD50ECE2A1BC302AFD280BEE12BF4772" target="_blank" title="Opens in a new window.">Download a coloring sheet to remind your children about hand-washing</a>.</p><img src="/-/media/national-files/images/hometown-health/2020/sprayer-killing-germs.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B1D13657D2B2CE5A57412F63BEE3AF2B" alt="Sprayer killing germs" width="660" height="370" DisableNVelocity="true" />Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Get Tools to Live Your HealthiestIt’s never too early — or too late — to plan ahead for health. By making preventive care for you and your family a healthy habit, you’ll help improve your well-being. Be sure to connect with your healthcare provider to discuss any further questions that you may have about your health.COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Back to SchoolDawn Haller12/2/2022Like adults, children vary in expression and experience of grief. There is no right or wrong way to grieve. Learn how to talk to children about grief and model healthy ways of grieving.Supporting children through times of grief<p>As parents and caregivers of children, it can be challenging to see them struggle or feel hurt, particularly if you're uncertain how to best support them. Regardless of age, grief and loss touch everyone's lives and affects each differently.</p> <p>As adults attending to your own loss, you can be overwhelmed with the emotional and sometimes physical pain that accompanies the grieving process. The healing journey can start with support from the presence, guidance and encouragement of family and friends.</p> <h2>Invisible grief</h2> <p>Children often are referred to as the forgotten or invisible grievers. You may not always see children’s grief displayed outwardly. Internally, children may feel and react to emotions that are difficult to express.</p> <p>They might not have the words or understanding of what they feel to communicate or process what they're going through. You may think of children as being resilient. Still, it's only through understanding what they're experiencing and then providing presence, support and coping tools to foster healthy exploration of the emotion and learn from it to build resiliency.</p> <p>Like adults, children have a wide range of reactions to grief and loss that can be affected by multiple variables. Children’s behavior often can be regressive when feelings are not verbalized. It's important to realize that while a child may not be talking about a loss, they're most certainly thinking about it.</p> <h2>Talking to children about grief</h2> <h3>Normalize and validate grief using these strategies:</h3> <ul> <li>Talk about grief to begin awareness.</li> <li>Share language on how to talk about grief.</li> <li>Understand how grief and loss may impact children.</li> </ul> <p>One example of saying this is: "I feel sad since your grandmother passed away. I miss her, and when I think about her, that makes me cry. My tears allow me to let some of my sadness release a bit. After I cry, I still miss her and am sad, but I feel better for a while. Being sad and missing the person is to be expected when they pass on. And releasing the feelings instead of trying to push them away is helpful."</p> <p>Another example of talking to a sibling is: "I miss your brother so much that I am feeling so many feelings at once. I am sad. I am angry. I am lonesome for him. When I feel that way, it helps me to talk to my friend. She listens and sits with me. When I'm done talking, she may suggest we take a walk or play cards. I still miss your brother and wish he were here with us, but I feel a little better at that moment. Grief hits us differently, but being with others, crying when we need to, and trying different things to feel better all help."</p> <h2>Recurring grief patterns</h2> <p>Grief also is cyclical for children. They may grieve the loss multiple times through different developmental stages in life as understanding deepens. Like adults, children vary in expression and experience of grief. It's important to remember that there is no right or wrong way to grieve. </p> <p>Parents and caregivers can't protect a child from the pain of loss. Creating a warm, safe and accepting environment for children supports the grief experience and establishes the foundation for healing.</p> <p>It's important to take your cues from children. Depending on the developmental stage, they may not be able to stay with their emotion for extended amounts of time. You may see children in tears one moment and then playing the next moment. You can learn from children by taking the emotion as it comes and releasing it to move on to another action. </p> <h2>Modeling healthy ways of grieving</h2> <p>Just like other firsts in our lives, we learn by watching and imitating others.</p> <p>Help make meaning about the loss and normalize talking about grieving the loved one. An important part of grief is finding ways to continue a relationship with the deceased person even though they  no longer are present.</p> <p>What can that look like daily, on holidays or the anniversary of the death?</p> <p>Talk with your children about how they're feeling or thinking. Offer answers to questions, but don't overload with more information than what the child is asking or what is developmentally appropriate. It's OK to be honest and direct.</p> <h3>Ways to support a grieving child include:</h3> <ul> <li>Having a consistent and regular routine. Eating well, staying hydrated, doing physical activity and getting good sleep are vital.</li> <li>Being patient and gentle, not to add additional stress. </li> <li>Allowing for moments of connection and assisting in the expression of grief.</li> <li>Providing opportunities to remember and talk about the person who has died.</li> <li>Listening without judgment or adverse reaction.</li> <li>Offering reassurance, teach your children to breathe through their feelings.</li> <li>Incorporate mindfulness to notice their feelings right now and let them know it's ok to name the emotions and not fight them.</li> <li>Encourage children to notice how the feelings will come and go, sometimes intense and sometimes mild. </li> <li>Creating outlets for healing through time outdoors, arts and crafts, writing or journaling, music, watching a movie, or spending time with friends. </li> </ul> <p>Children may grieve differently than a parent or sibling, and it's important to recognize and accept that. Many good books for children explain the grieving process to help guide conversations and provide language to prompt and answer children's questions.</p> <p>Lastly, it’s healthy and normal for children to need connection with peers to play, laugh and have time aside from talking about the loss. This is part of the healing and grieving process. </p> <p>If you feel grief has become complicated for your children, resources are available to help, including grief support groups, your health care team or faith leaders, employee assistance programs through your employer, and professional counseling services.</p> <p>Grieving isn't about pushing the pain away or getting through it fast and moving on. Grief is a natural and necessary part of healing.</p> <p>When you honor grief, you heal and grow through grief. You can't take away your children's pain, but it can be an opportunity to teach them to grieve in a good way and watch them learn to heal. </p> <p><em><a href="/providers/sarah-cormell-lcsw" target="_self" title="Opens in same window.">Sarah Cormell</a> is a licensed clinical social worker in <a href="/services-and-treatments/family-medicine">Family Medicine</a> in <a href="/locations/menomonie" target="_self" title="Opens in same window.">Menomonie</a>, Wisconsin.</em></p><ul> <li>Child and adolescent mental health</li> <li>Family systems</li> <li>Grief and loss</li> <li>LGBTQI mental health</li> <li>Obsessive-compulsive disorders</li> <li>Personality disorders</li> <li>Relationships, mediation, divorce</li> <li>Stress management</li> <li>Substance abuse, relapse prevention</li> <li>Suicidal ideation</li> <li>Trauma</li> </ul>L.C.S.W.<p>My role as a helper is to listen and work with patients to meet their wellness goals through evidence-based, psychological therapeutic interventions. I offer knowledgeable, engaging, supportive, nonjudgmental holistic care in a wrap-around care environment for individuals and families. I enjoy and respect the individuality of each person across all walks of life and ages to treat the whole person with effective solutions for long-term personal success and well-being.</p> <p>I enjoy reading, running, the outdoors, time with friends and family, music, good food and learning.</p><p><strong>Education</strong></p> <ul> <li>Bachelor’s degree, Sociology, University of Wisconsin–Eau Claire</li> <li>Master’s degree, Social Work, University of Wisconsin–Madison School of Social Work</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Licensed Clinical Social Worker</li> <li>Licensed Substance Abuse Counselor</li> </ul> <p><strong>Membership</strong></p> <ul> <li>National Association of Social Workers</li> </ul>Cormell<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/sarah-cormell-lcsw.JPG?h=280&iar=0&w=280&sc_lang=en&hash=48F4147373097C6279174DF703C2F049" alt="Sarah Cormell, L.C.S.W." width="280" height="280" DisableNVelocity="true" />Sarah<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30058903Sarah Cormell, L.C.S.W.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{67744200-E25F-439A-8B70-572A5A091172}|{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2022/child-hugging-adult.jpg?h=370&iar=0&w=660&sc_lang=en&hash=22EA25499ECAB3300C1A44D1078C2709" alt="Child hugging adult" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Child DevelopmentWe all want our children to grow up happy and healthy. The reality is most all of them do — but at vastly different rates. Experts across Mayo Clinic Health System see thousands of children each year, and have the experience and resources to know what is normal and what may be cause for closer observation. This includes not only physical and motor skills development, but psychological and social skill advancement.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller10/15/2025<p>Are you skipping breakfast because you think it will help you lose weight? We'll explain why you should think differently.</p>Think outside the cereal box<img alt="Overnight oats in a jar with a spoon, cinnamon sticks and cut apple" src="/-/media/national-files/images/hometown-health/2018/overnight-oats-in-a-jar.jpg?h=370&w=660&sc_lang=en&hash=CC798347D31C452B2BCFF5EF2728A97C" class="img-responsive" style="height: 370px; width: 660px;" /> <p>Do you find yourself asking, “Should I eat breakfast or not?”</p> <p>Some people opt out of eating breakfast because they think skipping breakfast will help them shed some pounds. Or they are running late and just don’t take the time to plan for the most important meal of the day.</p> <p>Nearly 70 percent of Americans overweight or clinically obese, and the data simply does not support this decision. Studies consistently show that taking the time to eat a nutritious morning meal helps prevent weight gain. Many of the nutrients, vitamins and minerals in this meal can support your health, as well as your weight.</p> <p>When you eat a healthy breakfast, it improves your ability to concentrate at work or school and enhances your performance. With a little planning and preparation, you can get your day off on the right foot by including a healthy meal.</p> <p>While some cold cereal can be a healthy alternative, eating it every morning can get a little boring. Perhaps you just need to think outside the cereal box.</p> <p>Here are some options for you to consider:</p> <ul> <li>Oatmeal can be prepared overnight in a slow cooker. Add berries or apples when you’re ready to eat. Do you prefer the apples cooked in it? See the recipe below.</li> <li>A veggie omelet can be prepared ahead of time in a muffin tin for portion control, and it is easier to take and go if you are in a hurry.</li> <li>Make a batch of hard-boiled eggs, and grab one out of the refrigerator to eat with a banana for a quick, healthy option. </li> <li>Pair plain yogurt with fresh fruit for a refreshing breakfast.</li> <li>Make a high-protein smoothie by adding kale, spinach or fruit to power up your morning.</li> <li>If you like a high-fiber cold cereal, change it up by adding your favorite fruit.</li> <li>Try a nontraditional option with leftovers from a previous healthy meal by eating the salad or chicken from yesterday’s lunch or dinner.</li> </ul> <p>When you consider how valuable breakfast can be for you, you surely will want to take the time to plan this into your busy lifestyle. </p> <p><em>By Mayo Clinic Health System staff. </em></p> <hr /> <h4>RECIPE</h4> <p><strong>OVERNIGHT SLOW COOKER APPLE AND CINNAMON STEEL-CUT OATMEAL</strong></p> <p><strong>Ingredients</strong> </p> <ul> <li>2 apples, peeled, cored, cut into ½-inch pieces (2½ to 3 cups chopped) </li> <li>1½ cups fat-free milk (or substitute nondairy alternative like almond milk) </li> <li>1½ cups water </li> <li>1 cup uncooked steel-cut oats </li> <li>2 tablespoons brown sugar (or substitute maple syrup or other desired sweetener) </li> <li>1½ tablespoons butter, cut into 5-6 pieces (optional) </li> <li>½ teaspoon cinnamon </li> <li>1 tablespoon ground flaxseed </li> <li>¼ teaspoon salt</li> <li>Optional garnishes: chopped nuts, raisins, maple syrup, additional milk or butter</li> </ul> <p><strong>Directions</strong> </p> <p>Coat inside of 3½ quart or larger slow cooker with cooking spray. Add all ingredients (except optional toppings) to slow cooker. Stir, cover and cook on low for approximately 7 hours (slow cooker times can vary). Spoon oatmeal into bowls or use glass canning jars if taking on the go. Add optional toppings, if desired. Store leftovers in refrigerator. Leftovers freeze well. To reheat single servings, put 1 cup cooked oatmeal in microwave-proof bowl. Add 1&frasl;3 cup fat-free milk. Microwave on high for 1 minute; stir. Continue cooking for another minute or until hot. Recipe can be doubled in 6-quart or larger slow cooker. Increase cooking time 1 hour.</p> <p>Nutritional analysis per ¾-cup serving: 149 calories, 3.6 g fat, 27.3 g carbs, 3.9 g fiber, 4.9 g protein</p><img src="/-/media/national-files/images/hometown-health/2018/overnight-oats-in-a-jar.jpg?h=370&iar=0&w=660&sc_lang=en&hash=90CDFD09225E795216162BD918BF50DF" alt="Overnight oats in a jar with a spoon, cinnamon sticks and cut apple" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller3/23/2022Whether you're a casual or competitive athlete, sports put tremendous pressure on your feet, ankles and legs. Here's how to choose a shoe that best fits your foot.How to determine your foot arch type<p><em>Updated May 16, 2023</em></p> <p>Are you thinking of buying a new pair of athletic shoes? Sports can place tremendous pressure on the feet, ankles and legs, whether you're a casual athlete or participate in competitive sports. For example, running and jumping generate impact force through the legs that is three to five times a person's body weight.</p> <p>Choosing athletic shoes for specific sports activities can improve comfort and performance. They also can prevent injuries.</p> <p>One thing to know before you buy is what type of foot arch you have. If you're not sure about your foot arch type, dip your foot in water, step on a piece of cardboard and examine the print that remains. After examining the print, use the <a href="/-/media/national-files/documents/hometown-health/2019/determine-your-foot-arch-type.pdf?sc_lang=en&hash=42110BECE9A8CD11AE32BB4914C83AEA" target="_blank" title="Opens in a new window.">Determine Your Foot Arch chart</a>.</p> <h2>Here are descriptions of arch types and shoe characteristics that complement and support your foot:</h2> <h3>Neutral (medium) arch</h3> <p>If the middle part of your arch is about half filled, this means you have a neutral arch. Your arch naturally supports your body weight and pronates, or rolls in, under a normal load.</p> <p>Look for shoes with firm midsoles, straight to semi-curved lasts — the shape of the sole and the footprint the shoe is built around — and moderate rear-foot stability.</p> <h3>Flat (low) arch</h3> <a href="/-/media/national-files/documents/hometown-health/2019/determine-your-foot-arch-type.pdf?sc_lang=en&hash=42110BECE9A8CD11AE32BB4914C83AEA" target="_blank" title="Opens in a new window."><img alt="Identify your arch PDF" src="/-/media/national-files/images/hometown-health/2018/download-a-pdf-to-identify-your-foot-arch.jpg?h=135&w=135&sc_lang=en&hash=0AD104224013B71360500F07F292F8E5" style="height: 135px; width: 135px; float: right; margin-bottom: 5px; margin-left: 5px;" class="img-responsive" /></a> <p>If your footprint looks like a complete foot, then you have a flat arch. Your arch probably collapses when you walk or run. Your low arches may contribute to muscle stress and joint problems.</p> <p>You may benefit from a walking shoe with a straight last and motion control to help stabilize your feet.</p> <h3>High arch</h3> <p>If you see little of your footprint, you likely have a high arch. High arches may cause excessive strain on joints and muscles. Your feet may not absorb shock well, especially if you perform high-impact or jumping activities.</p> <p>Look for shoes with cushioning to compensate for the lack of natural shock absorption and a curved last.</p> <h2>Comfort counts most</h2> <p>Use these tips as a guide for choosing the right athletic shoe for your feet. But when the sole meets the road, comfort and how the shoes fit are what count the most toward performance and preventing injury.</p> <p><em><a href="/providers/stephanie-kvas-dpm" target="_self" title="Opens in same window.">Stephanie Kvas, D.P.M.</a>, is a <a href="/services-and-treatments/podiatry" target="_self" title="Opens in same window.">podiatrist</a> in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a> and <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><ul> <li>Ankle arthroscopy</li> <li>Arthritic conditions</li> <li>Bunion surgery</li> <li>Community education and outreach</li> <li>Community health and wellness</li> <li>Diabetic wound care</li> <li>Flatfoot reconstruction</li> <li>Hammertoe surgery</li> <li>Limb salvage</li> <li>Pediatric foot and ankle conditions</li> <li>Reconstructive foot and ankle surgery  </li> <li>Sports injuries</li> <li>Traumatic fracture care</li> </ul>D.P.M. <p>I am committed to developing a meaningful patient-doctor relationship with each of my patients. I encourage patients to take an active role in their medical care and work with them to select a treatment plan that is right for them. </p> <p>As a Minnesota native, I'm exceptionally excited to join Mayo Clinic Health System in New Prague. My extensive training in reconstructive foot and ankle surgery has prepared me for my role as a surgical podiatrist at Mayo Clinic Health System. </p> <p>I look forward to providing foot and ankle care to the region and being an active member of the community. </p><p><strong>Education</strong></p> <ul> <li>Midwestern University Arizona College of Podiatric Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Podiatric Medicine & Surgery, Reconstructive Rearfoot/Ankle, Hennepin County Medical Center</li> </ul> <p><strong>Certification</strong></p> <ul> <li>State of Minnesota Board of Podiatric Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Foot and Ankle Surgeons</li> <li>American Podiatric Medical Association</li> <li>Minnesota Podiatric Medical Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Podiatric Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Kvas<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/stephanie-kvas-dpm.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A7F1FBFFDD180559BD4211C661476E99" alt="Stephanie Kvas DPM" width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Utilization+of+Fluorescence+Microangiography+in+Pediatric+Acute+Compartment+Syndrome%3A+A+Case+Report" target="_blank" title="Opens in new window. ">Utilization of Fluorescence Microangiography in Pediatric Acute Compartment Syndrome: A Case Report</a>, January 2020</li> <li><a rel="noopener noreferrer" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Utilization+of+Fluorescence+Microangiography+in+Pediatric+Acute+Compartment+Syndrome" target="_blank" title="Opens in new window. ">Utilization of Fluorescence Microangiography in Pediatric Acute Compartment Syndrome: A Case Report</a>, February 2019</li> </ul>{ED85D0D4-A69F-4AFC-8DF7-CC90B84DFB35}Stephanie <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21681643Stephanie Kvas, D.P.M.1{D170DE7F-251A-4290-9CC3-0A9B8D67B28A}<img src="/-/media/national-files/images/hometown-health/2022/tying-green-laces-on-blue-tennis-shoes.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9D4660E76DCBBD11E83A993A9D60E1A0" alt="Tying green laces on blue tennis shoes" width="660" height="370" DisableNVelocity="true" />Foot HealthPodiatry is a branch of medicine devoted to the study of diagnosis, medical and surgical treatment of disorders of the foot, ankle and lower extremity.Get Tools to Live Your HealthiestIt’s never too early — or too late — to plan ahead for health. By making preventive care for you and your family a healthy habit, you’ll help improve your well-being. Be sure to connect with your healthcare provider to discuss any further questions that you may have about your health.Dawn Haller10/5/2018<p>Providers and patients alike now have access to an incredible wealth of knowledge through the internet. Learn a few tricks to finding a credible source.</p>How to search like a doctor<img height="370" alt="Online search" width="660" src="/-/media/national-files/images/hometown-health/2018/online-search.jpg?sc_lang=en&hash=8CB2142A047F4E83481259C6A130D881" class="img-responsive"> <p>The internet is a great source of information. Providers and patients alike now have access to an incredible wealth of knowledge. But not all of the information found on the internet is true.</p> <p>If you turn to your favorite search engine to figure out if your cough is caused by Ebola or cancer, you should probably find a new strategy. Online systems for checking symptoms just aren’t that accurate. In a recent study, doctors were successful in making an accurate diagnosis 84 percent of the time versus 51 percent of people using an online tool to diagnose themselves. On the other hand, there are some great resources out there for those diagnosed with a specific disease to learn more about it. Just make sure you’re viewing a reputable site. Most providers appreciate a patient’s efforts to learn more about their disease, but be sure to check with your provider to ensure what you’re learning matches with your disease.</p> <p>Web-based tools increasingly are used as part of medical care. It sure was slick when I recently was able to order a medication refill and pick it up within 20 minutes. Even better was getting diagnosed and treated using an online tool.</p> <p>This past spring, I was pretty sure I had strep throat. In the past, I would have had to make an appointment that I didn’t have time for, and my doctors’ time was spent seeing me for a simple diagnosis instead of treating other patients with more complicated issues. Now, I am able to use Patient Online Services, the patient portal, go through a bunch of questions about my symptoms, and within an hour, I was notified that I had strep throat. An antibiotic prescription was sent to the pharmacy for me. If you haven’t looked at Patient Online Services lately, you really should.</p> <p>No website is completely free of errors or out-of-date information, so it is important to look at the information with a critical eye. A few tricks to finding out if a source is credible include:</p> <ul> <li>Check the date the information was updated.</li> <li>Check the “About us” section for the author or publisher’s qualifications and reputations.</li> <li>Look for any evidence of peer-review published data as opposed to testimonials.</li> <li>Look for reviews or comments to see if any doctors have responded to the information.</li> <li>Stick to websites with endings such as .org, .gov or .edu, because .com can sometimes be unreliable.</li> <li>Avoid websites that ask for payment or for you to sign up using a username and password.</li> </ul> <p>When you are researching medical advice, you should look at the organization providing you the information because there are medical facilities or sites that are more reputable than others.</p> <h4>Five examples of reputable organizations and websites are:</h4> <ol> <li><a href="/" target="_self" title="Opens in same window.">Mayo Clinic Health System</a> is a network of clinics and hospitals serving communities in Iowa, Minnesota and Wisconsin. Their community-based doctors and patients are supported by the highly specialized expertise and resources of Mayo Clinic. This partnership is dedicated to providing quality health care close to home.</li> <li>The <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.diabetes.org/" target="_blank" title="Opens in a new window.">American Diabetes Association</a> gives extensive information about diabetes, treatments and ongoing research. It also offers advice on nutrition and meal planning, fitness regimes and lifestyle changes, and connects people with support groups in their communities. </li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://medlineplus.gov/" target="_blank" title="Opens in a new window.">MedlinePlus</a><span>.gov </span>offers information on wellness, drugs, diseases and other health topics. It also has an extensive searchable medical encyclopedia and a medical dictionary that gives spelling and pronunciation tips. This site also offers health information in more than 40 different languages.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://familydoctor.org/" target="_blank" title="Opens in a new window.">Family Doctor</a> is sponsored by the American Academy of Family Physicians and presents broader information on the patient experience, not only offering information on conditions and treatments, but tips for choosing a provider, understanding medical bills, navigating insurance coverage and advocating for yourself as a patient. This site also provides helpful information on children’s health and development issues, from toilet training to dog bites to acne.</li> <li>The <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.heart.org/" target="_blank" title="Opens in a new window.">American Heart Association</a> provides all the necessary information one might need to learning about keeping a healthy heart. It teaches you about the warning signs of a heart attack, how to perform hands-only CPR and provides information on health topics, such as healthy eating, healthy living and fitness. </li> </ol> <p>The important thing to remember when researching health information online is that you should try to stick to credible sources, and never replace the trained eye and diagnosis of an experienced health professional with a diagnosis by “Dr. Search Engine.” The internet is there to assist you and perhaps calm your fears temporarily (or not, in some cases) until you can see your provider. Keep in mind that your provider has your medical history on file and knows more about you than any search engine does, so please be safe and contact your provider if you ever have any concerns.</p> <p><em><a href="/providers/andrew-calvin-md" target="_self" title="Opens in same window.">Andrew Calvin, M.D.</a>, is a <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li><a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/echocardiogram/basics/what-you-can-expect/prc-20013918" target="_blank" title="Opens in a new window.">Echocardiography</a></li> <li><a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/echocardiogram/basics/what-you-can-expect/prc-20013918" target="_blank" title="Opens in a new window."> </a><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/definition/con-20019580" target="_blank" title="Opens in a new window.">Hypertension</a></li> <li><a rel="noopener" href="http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/definition/con-20019580" target="_blank" title="Opens in a new window."> </a><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/basics/definition/con-20020865" target="_blank" title="Opens in a new window.">Lipid disorders</a></li> <li>Medical education</li> <li> Preventive cardiology</li> <li> <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/stress-test/about/pac-20385234" target="_blank" title="Opens in a new window.">Stress testing</a></li> <li>Valve disorders</li> </ul>M.D., M.P.H.<p>I'm a specialist in cardiovascular medicine with a passion for prevention of cardiovascular disease, cardiovascular physiology and noninvasive testing. I seek to match the best available treatments to my patients’ preferences and values through shared decision-making.</p> <p>In addition to practicing clinical cardiology, I have the privilege of serving as Chair of Education for Mayo Clinic Health System. I love working with medical students, residents, and trainees, as it helps improve our practice. I am also passionate about ongoing professional education, with leadership roles as an Associate Dean in the Mayo Clinic School of Continuous Professional Development, a member of the Cardiovascular Disease Approval Committee of the American Board of Internal Medicine, and a member of the board of directors of the Wisconsin Medical Society.</p><p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> <li>Master of Public Health, University of Minnesota School of Public Health</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Internal Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Cardiovascular Disease, Mayo Clinic School of Graduate Medical Education</li> <li>Echocardiography, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Cardiovascular Disease, American Board of Internal Medicine</li> <li>Internal Medicine, American Board of Internal Medicine</li> <li>Adult Comprehensive Echocardiography, National Board of Echocardiography</li> <li>Special Qualification in Preventive Cardiology, Mayo Clinic </li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Cardiology</li> <li>American College of Physicians</li> <li>American Heart Association</li> <li>American Medical Association</li> <li>American Society of Echocardiography</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Associate Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Calvin<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/andrew-calvin-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=950E112EFF943E2362105E122B66405C" alt="Andrew Calvin, M.D." width="280" height="280" DisableNVelocity="true" />{9552C266-D741-4612-8CB3-21B67C81B413}Andrew<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14765101Andrew Calvin, M.D.1{676428F6-179A-4C9B-9B23-5F1E40032A38}<img src="/-/media/national-files/images/hometown-health/2018/online-search.jpg?h=370&iar=0&w=660&sc_lang=en&hash=050002FD6E177B64B9D2A977A5B2D8D9" alt="Online search" width="660" height="370" DisableNVelocity="true" />Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Michele Halterman9/21/2020<p>It's time to break the vicious cycle of exercise and diet plans that simply aren't sustainable. To start your path to better health, change one thing.</p>Better health starts by changing one thing<p>Life is busy as we juggle work, kids and family along with other obligations. The hectic pace we keep often makes it difficult to cook a healthy meal or find time to work out and take care of ourselves. One of the side effects of this self-neglecting behavior is an increase in body weight. Many times, the resulting scenario involves a closet filled with clothes we either dream of fitting into again or look at selling to start over.</p> <p>Adding insult to injury is the diagnosis by our health care provider that because of this weight gain, we also now are <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/prediabetes/symptoms-causes/syc-20355278" target="_blank" title="Opens in new window.">prediabetic</a> with borderline cholesterol levels and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/prehypertension/symptoms-causes/syc-20376703" target="_blank" title="Opens in new window.">prehypertensive</a> blood pressure. Understandably, this causes even higher levels of stress, guilt and depression that can lead to negative behavior, such as comfort eating and additional weight gain.</p> <p>We end up feeling guilty because we should know better.</p> <h4>In response to our ill-fitting clothes that cause psychological and literal discomfort, we come up with a plan to lose the weight, including:</h4> <ul> <li>Ridding our homes of any dessert, candy, soda and processed food</li> <li>Promising to buy and eat only whole foods made from scratch</li> <li>Going to the gym five days a week and working out for one hour each time</li> <li>Hiring a life coach to help get our life together</li> <li>Reducing stress from work and our jobs</li> </ul> <p>Sound familiar? Most of us do OK for three to four weeks then slowly revert to old habits that leave us feeling more discouraged and adding even more weight.</p> <h4>Start your path to better health</h4> <p>It’s time to break the vicious cycle of exercise and diet plans that simply aren’t sustainable. To start your path to better health, I want you to change one thing: Simplify your goals.</p> <p>Instead of coming up with six or seven goals right from the start, focus on one thing you can change either in your diet, exercise habits or weekly routine.</p> <p>For example, the recommended physical activity per week for cardiac health and weight loss is five to six sessions of at least 30 minutes of aerobic exercise. This is a great goal many people can achieve.</p> <p>Start by committing to 30 minutes at the gym with the eventual goal of one hour. Recent studies show that even one visit to the gym, while not optimal, is still better than not going at all. Plus, you can feel good knowing you’ve had success and, perhaps in a month or two, squeeze in some additional time on another day. Even adding a 30-minute walk with your significant other or a pet several times a week is great. It all starts by changing one thing.</p> <h4>One change can make a positive difference to your health</h4> <p>Think about this: If you’re someone who drinks multiple sodas daily, you can lose upwards of 10 pounds a year simply by reducing your intake of one soda per day, even if you change nothing else. This is a theoretical number based on calories alone. Yet, you’re creating success for yourself by changing one thing.</p> <p>Try eating a salad every other day with a meal. This is something you can manage and feel successful with. Eventually, you can implement other healthy things into your eating routine. For example, add a water bottle with fruit infusions at work to help keep you hydrated and lower your urge to snack. Plus, it’s a great alternative to other drink options throughout the day.</p> <p>Here’s something else to think about: When a child starts to learn a skill — whether it’s reading, sports or whatever — they experience success. This experience builds momentum and provides confidence that leads to long-term sustainability.</p> <p>Motivation by success works much better than motivation by guilt. Unfortunately, much of our motivation to change is guilt-based. This doesn’t work with motivating our children or with managers and leaders with employees in the workplace. So why do we expect it to work here?</p> <p>Remember these simply are examples of ways to make healthy adjustments in our lives that will give you the confidence to change one thing.</p> <p><em><a href="/providers/graham-king-md" target="_self" title="Opens in same window.">Graham King, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Community fitness outreach programs</li> </ul>M.D.<p>I enjoy caring for the health needs of families from prenatal care and pediatrics to adult medicine, and specialize in women's health and reproductive health. I focus on listening and hearing my patients, and forming partnerships with them in delivering their care.</p> <p>I am married to an elementary school teacher with four energetic boys who are active in community, school and sports. I enjoy playing guitar and piano, writing educational blogs and practicing healthful living. </p> <p>I am an 80s rock superfan and love going to concerts with my family and friends. I also enjoy Vikings, Twins, Wild and Maverick sports.</p><p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Mercy Hospital</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Sutter Health Family Medicine Residency Program</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Family Medicine</li> <li>Mayo Clinic Quality Fellow, Bronze Level</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Medical Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>King<img src="/-/media/shared-files/images/medical-professionals/full/mankato/graham-king-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=78048D61A3A60EF1DF00C06F2F6CCBEE" alt="Graham King MD" width="280" height="280" DisableNVelocity="true" />{46521252-3F34-48F2-80D2-338AA6DD4C22}Graham<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14899019Graham King, M.D.1<img src="/-/media/national-files/images/hometown-health/2018/smiling-woman-with-arms-crossed.jpg?h=371&iar=0&w=660&sc_lang=en&hash=689EC2FFCC0D963D3F47AE758DE86A81" alt="Smiling person with arms crossed leaning on a railing" width="660" height="371" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Dawn Haller11/5/2019Are you eyeing up the leftover Halloween candy? Or, planning the next holiday feast? These helpful strategies can keep the weight off and still allow you to enjoy the holiday festivities.Tips for staying on track during 'national eating season'<p><em>By Mayo Clinic Health System staff</em></p> <p>This time of year marks the beginning of what is often referred to as “national eating season” — the time between Halloween and New Year’s Day. It can be a challenging time of year with an abundance of high-calorie food, lots of social events and many time-honored traditions that revolve around eating. It can make sustaining momentum with your weight management difficult.</p> <p>It is important to be aware of these challenges. You cannot afford to have many high-calorie days. Every choice has a consequence. Own your choice. You can get back in control. But how?</p> <p>Your weekly level of physical activity can make a significant difference in your weight management. Increasing your physical activity level during the holiday season will make it more likely that you will stay focused on your food choices.</p> <p>Consider what could happen if you average a number of weekly physical activity calories for the next 10 weeks. You could lose or not gain these pounds just with physical activity:</p> <ul> <li>1,000 activity calories = 2.9 pounds</li> <li>1,500 activity calories = 4.3 pounds</li> <li>2,000 activity calories = 5.7 pounds</li> <li>2,500 activity calories = 7.1 pounds</li> <li>3,000 activity calories = 8.6 pounds</li> <li>3,500 activity calories = 10 pounds</li> <li>4,000 activity calories = 11.4 pounds</li> </ul> <h4>Here are 8 additional tips and strategies to keep the weight off and still allow you to enjoy the holiday festivities:</h4> <h4>1. Eat before an event.</h4> <p>Have a meal before you go so you arrive full. This is the most important thing you can do if you can’t miss the event.</p> <h4>2. Make your foods ahead of time, and bring them with you.</h4> <p>Having a blended shake in a thermos or an entree with vegetables you make and bring can minimize the need to rely on willpower and self-control.</p> <h4>3. Prepare a healthy dish for everyone.</h4> <p>No one needs to know it’s your healthy food. This way, you can enjoy the occasion guilt-free.</p> <h4>4. Offer to bring a vegetable tray or a fruit salad.</h4> <p>You can prepare it yourself or buy one at the grocery store. Once you arrive, don’t be bashful about eating the food you brought.</p> <h4><strong>5. Arrive fashionably late.</strong></h4> <p>Don’t make your appearance until the meal is finished. Just be sure to call ahead and explain why you’re doing this.</p> <h4>6. Ask if there will be water and other low- or no-calorie beverage options.</h4> <p>Or, bring your own.</p> <h4>7. Keep track of what you eat daily.</h4> <p>This will help you stay connected to your diet and reinforce your positive behaviors.</p> <h4>8. Join a weight management program.</h4> <p>The structure and group support can help get you through the holidays and keep you on track year-round.</p> <p>Find additional <a href="/services-and-treatments/weight-management" target="_self" title="Opens in same window.">weight management resources</a>, read our <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://mayoclinichealthsystem.org/hometown-health?topic=Weight%20Loss%20and%20Bariatric%20Surgery" target="_blank" title="Opens in a new window.">blogs about weight management</a> and <a href="/classes-and-events" target="_self" title="Opens in same window.">find class information near you</a> that can help you reach your goals.</p><img src="/-/media/national-files/images/hometown-health/2018/spoon-with-ornaments-and-measuring-tape.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F168784A8021408C30121EE6C79F3818" alt="Spoon with ornaments and measuring tape" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller12/20/2022<p>Whether you're starting a new exercise program, trying to eat healthier or find some time for yourself, setting SMART goals positions you for success.</p>Setting SMART goals for success<p>In January, you switch to new calendars and embrace a new year. For many people, it's a good time to evaluate physical and mental health, and reflect on the changes you want to make in the coming year.</p> <p>About half of U.S. adults make at least one New Year's resolution tied to their health. Some will try to kick a bad habit, while others will try to pick up a good one. Either way, getting the courage to make a healthy change is the first step.</p> <p>Making significant, long-lasting change is hard, however. Habits are easy to fall back into because they provide a sense of comfort.</p> <p>Daily challenges, changes and stresses may have you hesitating on what resolutions to make for the coming year. As you reflect on your resolutions, it's important to spend time preparing, planning and setting a SMART goal to position you for long-term success.</p> <h2>SMART goals are:</h2> <ul> <li><strong>Specific</strong><br> Eating healthier sounds like a good idea, but what does it really mean? Aim for specific goals instead, such as eliminating soda, eating five servings of vegetables a day or limiting your daily sugar intake to 30 grams of added sugar.</li> <li><strong>Measurable</strong><br> Make the goal one you can measure. A goal of walking more is not so easily measured, so change it to walking three days a week so you can monitor your progress.</li> <li><strong>Attainable</strong><br> Avoid aiming too high or too low. Think like Goldilocks and find a goal that feels just right.</li> <li><strong>Realistic</strong><br> Losing 10 pounds a week sounds great. But it's an impossible goal that will leave you discouraged and more likely to give up on your efforts. <a href="/hometown-health/speaking-of-health/organizing-and-executing-weight-loss-goals">Choosing realistic goals</a> you can meet will reinforce your efforts and keep you moving forward. Losing 1 pound per week is a realistic and sustainable goal.</li> <li><strong>Trackable</strong><br> <p>Choosing specific, measurable goals means you can track your improvement over time. Write your efforts down in a journal or track them on an app so you can see how far you've come.</p> </li> </ul> <p>Remain confident, be patient and stay focused on your goal. Soon you will be on your way to a healthier lifestyle this new year.</p> <p><em>Joanne Genewick, D.O., is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2022/sitting-on-sofa-writing-in-journal.jpg?h=370&iar=0&w=660&sc_lang=en&hash=231DA7793706043425706E8FC0436457" alt="Sitting on sofa writing in journal" width="660" height="370" DisableNVelocity="true" />Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller11/15/2018<p>When you pay attention to what you are eating and how you eat, it can not only improve your health, but also your mind.</p>Fuel for your mind<img height="370" alt="Healthy foods: Salmon, eggs, nuts, avocado, broccoli, blueberries" width="660" src="/-/media/national-files/images/hometown-health/2018/salmon-eggs-nuts-broccoli-blueberries.jpg?sc_lang=en&hash=C7D5B687AC5F14857579C8F12DBDAF09" class="img-responsive"> <p>Do you ever think about your surroundings while you eat? Do you consider the health benefits of enjoying a meal with friends and family? Mindful eating is not just what you eat, but where and how you eat. It is more than downing your food. It is an enriching experience, and you should feel energized after a meal.</p> <p><a href="https://www.facebook.com/MayoClinicHealthSystem/videos/265457604084567/" target="_blank" title="Opens in a new window.">Watch this video to see Katie Johnson, a health educator at Mayo Clinic Health System, discuss mindful eating</a> with <a href="/providers/laura-knudsen-rdn-cd" target="_self" title="Opens in same window.">Laura Knudsen</a>, a registered dietitian:</p> <h4>CHOOSE YOUR FOOD</h4> <p>A good place to start eating mindfully is with the food itself. Choose healthy foods. Food that is good for the heart also is good for the mind, such as: </p> <ul> <li>Beans</li> <li>Berries</li> <li>Fish</li> <li>Green leafy vegetables</li> <li>Nuts</li> <li>Olive oil</li> <li>Poultry</li> </ul> <p>These foods help with memory and alertness and can even help prevent Alzheimer’s disease. Eating fish once a week is shown to provide good mind power.</p> <p>To eat mindfully, it is important to avoid certain foods. These foods cause weight gain and can lead to conditions such as high cholesterol, Type 2 diabetes and heart disease. Some foods to avoid are:</p> <ul> <li>Butter</li> <li>Fast food</li> <li>Fried food</li> <li>Pastries</li> <li>Red meat</li> <li>Stick margarine</li> </ul> <p>Before you go to the store, make a plan. Create a rough menu for the week, and base your grocery list on the menu. Consider creating a weekly schedule of when to eat certain foods, such as having “meatless Monday,” fish on Tuesday and Friday, and poultry on Thursday and the weekend. While at the store, remember that the closer a food is to its natural form, the healthier the food is in general. Buy whole-wheat noodles instead of boxed macaroni and cheese. Rather than picking up fruit snacks, opt for fresh or frozen fruits. Produce that is in season often is cheaper and has better flavor.</p> <h4>SET THE MOOD</h4> <p>Where you eat is just as important as what you eat. Keep your eating place clean and free of clutter. If you have decorations for your table, set them out. A couple candles or a vase of flowers can brighten up the space. Try to enjoy your meals with others. Eating with family and friends is a great way to spend time together.</p> <h4>TAKE YOUR TIME</h4> <p>When you sit down to eat, set aside 20 to 30 minutes for each meal. It can take 20 minutes to feel full after eating. By slowing down, you can eat 100 calories less per meal. You also will feel more satisfied and renewed, and have less food cravings between meals.</p> <p>People who take a lunch break away from their desk tend to be more productive at work, so make lunchtime a part of your day. Taking a lunch break improves alertness and concentration, and provides higher energy levels. Try taking a break with some of your co-workers, even if it is just for 15 minutes. When there is a social aspect to eating, you naturally slow down because you talk.</p> <p>Consider setting small goals to start. Statistically, you do better when you have small goals and increase these goals after success. For example, consider sitting down as a family for dinner or making yourself a healthy breakfast once per week. What goals can work for you?</p> <p>When you pay attention to what you are eating and how you eat, it can not only improve your health, but also your mind.</p><img src="/-/media/national-files/images/hometown-health/2018/salmon-eggs-nuts-broccoli-blueberries.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CFC6D1A000543EBDC2A59D6CA212299C" alt="Healthy foods: Salmon, eggs, nuts, avocado, broccoli, blueberries" width="660" height="370" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Michele Halterman12/1/2022It's easy to get overwhelmed with the stress and chaos the holiday season brings. Get tips to make this year's season relaxing and enjoyable.Resilience: Prepping for a busy holiday season<p>During the holiday season, it is easy to get caught up in the stress and chaos that can accompany this time of the year. Already demanding lives become even more hectic as additional shopping, cooking and spending combine to add even more anxiety. For most people, the result can be overwhelming.</p> <p>What if there was a way you could plan ahead to <a href="/hometown-health/speaking-of-health/fend-off-holiday-stress-with-these-tips" target="_self" title="Opens in same window.">counter the stress</a>? Start with identifying the issue. Note the busyness of the season is coming despite the best desire to avoid it. Next, remind yourself of times when you overcame difficult. Build on this by broadening the sense of your abilities. </p> <h2>Make a plan for the holidays</h2> <p>Instead of planning to de-stress from the inevitable, try to embrace the hectic holidays by prepping for a busy holiday season. Helpful tips can make this holiday season the most relaxing and enjoyable yet.</p> <h3>Practice holiday resilience by asking yourself these questions:</h3> <ul> <li>What resources do you need to feel confident about facing the upcoming fall/winter season?</li> <li>Who will support you when needed? </li> <li>What do you want to think about when facing the upcoming seasons?</li> <li>What would you like to remember about this season after it's done?</li> <li>If you knew this was your last fall/winter season, what would you prioritize?</li> <li>What barriers to joy and happiness will you face during the upcoming months, and how can you overcome them one by one?</li> </ul> <h2>Overcome challenges with positivity</h2> <p>Learn how to stay ahead of holiday <a href="/hometown-health/speaking-of-health/can-stress-lead-to-a-heart-attack" target="_self" title="Opens in same window.">stress</a> and see it as a challenge rather than a threat. Consider this a marathon and not a sprint. Practice slow, steady movements to approximate your desired behaviors and thoughts over time.</p> <p>Along the way, expect the unexpected, as life rarely goes as planned. Allowing yourself flexibility in thinking and planning can go a long way toward fostering good health and well-being.</p> <p>Try to view upcoming challenges as manageable based on your resources rather than a threat that must be changed or avoided. This builds up emotional and cognitive resources to assist you in facing those challenges. Create a list or a mental tally of the things you like about the season. The list may be short, but you can focus on these when times feel challenging.</p> <p>Over time and with practice, you can strengthen your emotional muscle and find that challenges get easier. Remember to think positively. For instance, if you tell yourself that today will be a bad day, you're more likely to experience a negative mood and feel overwhelmed. Instead, tell yourself that today will be a hard day, but you've tackled problems more significant than this in the past. Small changes matter and allow you to better prepare for the upcoming holiday season challenges.</p> <p><em><a href="/providers/lisa-hardesty-phd-lp" target="_self" title="Opens in same window.">Lisa Hardesty, Ph.D.</a>, is a clinical psychologist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Co-morbid medical and behavioral health conditions</li> <li>Integrated behavioral health</li> <li>Optimizing health and well-being</li> <li>Weight management</li> </ul>Ph.D., L.P.<p><strong>Education</strong></p> <ul> <li>Master's degree, Health and Clinical Psychology, Minnesota State University-Mankato</li> <li>Doctor of Philosophy degree, Western Michigan University-Kalamazoo</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Post Doctoral Fellowship, Health Psychology, Henry Ford Hospital</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Clinical Health Psychology, American Board of Professional Psychology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Psychology, Mayo Clinic College of Medicine and Science</li> </ul>Hardesty<img src="/-/media/shared-files/images/medical-professionals/full/mankato/lisa-hardesty-phdlp.jpg?h=280&iar=0&w=280&hash=0F1D1C9CA069ED45487CBB5A40FD588A" alt="Lisa Hardesty, Ph.D., L.P." width="280" height="280" DisableNVelocity="true" />{A9A6221E-C37E-4EAE-B151-BFE624FC511D}Lisa<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>11683651Lisa Hardesty, Ph.D., L.P.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}|{94B2E140-AEF8-44BA-B6A9-4538B77501BC}<img src="/-/media/national-files/images/hometown-health/2022/adding-ribbon-to-present-wrapping.jpg?h=370&iar=0&w=660&sc_lang=en&hash=85D6EE490055E33CECB2935AEC4963D6" alt="Adding ribbon to present wrapping" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Michele Halterman9/6/2023The number of Americans with diabetes is staggering. Discover the alarming statistics of this serious health concern, and learn how diabetes can be managed or prevented with lifestyle changes.Diabetes: Prevention and warning signs<p>The topic of diabetes as a serious health concern in the U.S. is nothing new. Most people understand that unhealthy lifestyle choices, such as a lack of physical activity and a diet high in saturated fat and sugar, put you at risk for diabetes and other health conditions.</p> <p>The number of Americans with diabetes is staggering. According to the Centers for Disease Control, 37.3 million people had diabetes in 2019 — 11.3% of the U.S. population.</p> <p>Approximately 96 million American adults — more than 1 out of 3 — have prediabetes, a health condition that occurs when blood sugar levels are higher than usual but not high enough yet to be diagnosed as Type 2 diabetes. Of those people with <a href="/hometown-health/speaking-of-health/ive-been-diagnosed-with-prediabetes-what-does-that-mean" target="_self" title="Opens in same window.">prediabetes</a>, 80% don't know they have it. Prediabetes puts you at increased risk for developing Type 2 diabetes.</p> <h2>What is diabetes?</h2> <p>Mayo Clinic defines diabetes mellitus as a group of diseases that affect how your body uses blood sugar, or glucose. Diabetes is a condition in which your body cannot manage the glucose level in your blood.</p> <p>In addition to <a href="/hometown-health/speaking-of-health/can-children-develop-type-2-diabetes" target="_self" title="Opens in same window.">Type 2 diabetes</a>, there is Type 1 diabetes, which is known as juvenile diabetes or <a href="/hometown-health/speaking-of-health/closing-the-loop-with-insulin-pumps" target="_self" title="Opens in same window.">insulin-dependent</a> diabetes and is a chronic condition. Some people develop diabetes during pregnancy, known as gestational diabetes.</p> <h2>What are the warning signs of diabetes?</h2> <h3>Common signs of Type 1 and Type 2 diabetes include:</h3> <ul> <li>Extreme hunger</li> <li>Fatigue</li> <li>Frequent infections</li> <li>Frequent urination</li> <li>Increased thirst</li> <li>Irritability</li> <li>Slow-healing sores</li> <li>Unexplained weight loss</li> </ul> <p>For people with prediabetes, symptoms often don't appear in the early stages. For those with Type 1, symptoms usually come on quicker and more severely.</p> <h2>How can I prevent or manage diabetes?</h2> <h3>While there is no way to prevent Type 1 diabetes, you can take steps to prevent or delay prediabetes or Type 2 diabetes complications:</h3> <ul> <li>Stay at a healthy weight. You have the final decision on what you eat and how active you are.</li> <li>Eat a <a href="/hometown-health/speaking-of-health/eat-the-rainbow-for-good-health" target="_self" title="Opens in same window.">diet rich in vegetables</a>, fruits, whole grains and lean sources of protein, and choose water over sweetened beverages. Limit unhealthy trans fats and heavily processed foods like cookies, candy and chips.</li> <li>Ensure your portions are within the recommended sizes. Using a smaller plate with meals is an easy way to control portion sizes.</li> <li>When dining out, keep in mind that restaurants tend to serve larger portions that can be up to double the amount of food you usually eat. To keep your meal portions similar to what you would eat at home, consider sharing a meal with someone else, choose a <a href="/hometown-health/speaking-of-health/going-out-for-lunch-how-to-stick-to-healthy-habits" target="_self" title="Opens in same window.">smaller meal</a> size like a lunch entrée rather than a dinner entrée, and eat slowly so you'll feel when you're full.</li> <li>Try to exercise at a moderate pace for 30 minutes a day most days of the week. Add activity to your day by taking a brisk walk, raking leaves or riding a bike. Running, weightlifting and high-intensity training can be included in your workout if you choose after receiving approval from your healthcare team.</li> </ul> <p>If you have questions or concerns about diabetes, talk with your healthcare team. If you're looking for ways to live a healthier life, help is available from your primary care provider, registered dietitian nutritionists and certified diabetes educators.</p> <p><em><a href="/providers/allyn-wergin-rdn" target="_self" title="Opens in same window.">Allie Wergin</a> is a <em>registered <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">dietitian nutritionist</a></em> in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Bariatric surgery</li> <li>Diabetes management</li> <li>Oncology</li> <li>Weight management</li> </ul>RDN<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, St. Catherine University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration </li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul>Mahowald<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/allyn-wergin-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=74F690ED261F537AA65B66929A3356D1" alt="Allie Mahowald, RDN" width="280" height="280" DisableNVelocity="true" />{9209F8EC-1016-41AA-985F-014D9B877417}Allie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15971546Allyn Mahowald, RDN1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2023/raking-and-bagging-leaves.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6268AD5BA20CD319C38B1963ED963D85" alt="Raking and bagging leaves" width="660" height="370" DisableNVelocity="true" />DiabetesIf you have diabetes, no matter what type, it means you have too much glucose in your blood, although the reasons may differ. Too much glucose can lead to serious health problems.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Michele Halterman5/1/2024If cooking a healthy meal at home seems like a reach, one approach can make it a reality. That's weekly meal planning. Yes, there's work upfront, but it saves time on the busy weeknights. Learn how.Timesaving tips for cooking healthy meals<p>Living a busy, fast-paced life can make it hard to find the motivation to cook a <a href="/hometown-health/speaking-of-health/use-95210-to-refresh-healthy-habits" target="_self" title="Opens in same window.">healthy meal</a> at home. However, learning some shortcuts in the kitchen can keep your <a href="/hometown-health/speaking-of-health/establishing-healthy-behaviors-that-stick" target="_self" title="Opens in same window.">healthy eating goals</a> on track and help you avoid <a href="/hometown-health/speaking-of-health/sensible-snacking" target="_self" title="Opens in same window.">grazing on unhealthy snacks</a>, grabbing the first thing you see in the fridge or going out for fast food.</p> <h2>Why cook at home?</h2> <p>Research shows that maintaining a <a href="/healthy-weight" target="_self" title="Opens in same window.">healthy weight</a> is challenging when you eat out too frequently. Restaurant portions often are super-sized and can easily contain a day's worth of calories and <a href="/hometown-health/speaking-of-health/is-sea-salt-healthier-than-table-salt" target="_self" title="Opens in same window.">sodium</a>.</p> <p>With a bit of planning, cooking at home can be doable and enjoyable.</p> <h2>Timesaving strategies</h2> <p>Menu planning is one of the best ways to cook healthy meals. Sure, meal planning takes time on the front end. But if done right, it saves you valuable time in the kitchen.</p> <h3>One easy way to start meal planning is to pencil in theme nights, such as:</h3> <ul> <li>Meatless Monday</li> <li>Taco Tuesday</li> <li>Leftover Wednesday</li> <li>Breakfast for dinner Thursday</li> <li>Fish Friday</li> <li>Soup and salad Saturday</li> </ul> <p>Set Sunday aside for planning and prepping meals for the week. That might be the day you treat yourself to a dine-in or take-out dinner.</p> <p>If you prefer to improvise, you can still create a healthy, balanced meal. <a rel="noopener" href="https://www.myplate.gov/whatsonmyplate" target="_blank" title="Opens in a new window.">Use the plate method</a> to evaluate your meal by asking:</p> <ul> <li>Do I have three food groups represented?</li> <li>Do I have the right portions?</li> </ul> <p><a href="/hometown-health/speaking-of-health/123-approach-to-eating-fruits-and-vegetables" target="_self" title="Opens in same window.">Start with the vegetables</a> since they should be the largest portion of your meal. If there aren't any planned for your meal, add carrot or celery sticks, sliced tomatoes or a spinach salad.</p> <h2>Step-by-step meal planning</h2> <h3>These steps can simplify and streamline your meal planning:</h3> <h4>Step 1: Set aside time twice a week for food prep.</h4> <p>Chop and cook ahead for the next three to four days. Pack veggies or meats in meal-sized portions for the fridge.</p> <h4>Step 2: Try batch cooking.</h4> <h5>Cook once for multiple meals. Here are some ideas:</h5> <ul> <li>Cook a big batch of brown rice. Use some for a side dish one day, in a casserole the next and in a stir fry the day after.</li> <li>Brown extra ground meat and divide it up for casseroles, tacos and salads. Refrigerate what you can use within three to four days and freeze the rest in recipe-ready portions.</li> <li>Prepare extra pasta and set aside some for a cold salad the next day.</li> <li>Make a large pot of homemade soup or chili and <a href="/hometown-health/speaking-of-health/freezing-preserves-food-freshness" target="_self" title="Opens in same window.">freeze</a> it in smaller portions.</li> <li>Mix a double recipe of meatloaf and divide it in half. Bake one half as a meatloaf, roll the other half into meatballs and freeze. You also can freeze leftover meatloaf slices for sandwiches.</li> <li>Simmer chicken breasts or a roast in the crockpot, and slice leftovers for sandwiches later. You also can freeze individual portions for a quick reheat later in the week.</li> </ul> <h4>Step 3: Overlap ingredients.</h4> <p>Think of different meals with similar ingredients and assign them to the same week's plan. For example, a meal of brown rice, chicken and sauteed vegetables one day can become a chicken, rice and veggie soup the next. The same basic ingredients can be used for veggie lasagna and veggie pizza. Prep all the veggies for a week's worth of meals.</p> <h4>Step 4: Recycle your menus.</h4> <p>Once you plan out a few weeks, repeat the menus. You'll know what worked and what didn't, so tweak your menus as needed.</p> <h2>Timesaving cooking ideas</h2> <h3>Mason jar meals</h3> <p>Try preparing meals in a Mason jar. They're portable, have fixed portions, and can be low in fat and sodium because you control the ingredients. Create a variety of salads, yogurt parfaits, scrambled eggs, pasta or overnight oats and pack them in each jar. Make ahead of time so they're ready to go when you are.</p> <h3>Sheet pan suppers</h3> <p>No one likes washing the dirty prep and cooking dishes. But you can cut down on the quantity of dishes by using a single sheet pan to bake a complete meal. Choose a larger sheet pan to bake salmon or chicken and roasted vegetables, chicken fajitas or a seafood boil. Cut items that take longer to cook, such as meat, potatoes and root vegetables, into smaller pieces so everything is done at the same time. Use the same concept for one-pot meals, such as chili, soups, stews and casseroles, to save on cleanup time.</p> <h3>Foil pack meals</h3> <p>For easy-to-clean-up meals, place a piece of fish, chicken or a ground beef patty on individual sheets of aluminum foil. Add frozen vegetables and seasonings and, if desired, sprinkle with a bit of cheese or add quartered small red potatoes. Securely fold the top and sides of the foil, and bake in the oven or cook on the grill. </p> <h3>Try these healthy meal ideas when you're in a hurry:</h3> <ul> <li><strong>Fried egg sandwich</strong><br /> Serve on a whole-grain English muffin along with a piece of fruit.</li> <li><strong>Light lunches</strong><br /> Mix-and-match tuna or hummus, whole-grain crackers, fruit and veggie sticks, and a glass of milk.</li> <li><strong>Main dish pasta salad</strong><br /> Mix leftover cold pasta with tuna or another protein, vegetables and light mayo.</li> <li><strong>Microwaved oatmeal</strong><br /> Pair with fruit and a hard-boiled egg.</li> <li><strong>Prepared frozen meals</strong><br /> Look for meals that include whole grains and have 600 milligrams or less of sodium per serving. Serve veggies or yogurt with fruit as sides.</li> <li><strong>Stir fry</strong><br /> Saute steak, chicken or tofu with frozen vegetables and brown rice.</li> <li><strong>Whole-grain pita pizza<br /> </strong>Add a side salad.</li> </ul> <h2>You're ready to meal plan</h2> <p>Remember, the key is to balance your meal by including at least three of the <a rel="noopener" href="https://www.usda.gov/media/blog/2017/09/26/back-basics-all-about-myplate-food-groups" target="_blank" title="Opens in a new window.">five food groups</a>: fruits, vegetables, grains, protein foods and dairy. Think about <a href="/hometown-health/speaking-of-health/eat-the-rainbow-for-good-health" target="_self" title="Opens in same window.">"eating the rainbow"</a> as you choose fruits and vegetables to reach the five to nine recommended servings per day.</p> <p>Healthy meal planning doesn't need to be difficult or time-consuming. Make a quick check to see what's in your <a href="/hometown-health/speaking-of-health/spring-into-better-health-pantry-edition" target="_self" title="Opens in same window.">pantry</a>, <a href="/hometown-health/speaking-of-health/spring-into-better-health-refrigerator-edition" target="_self" title="Opens in same window.">refrigerator</a> and <a href="/hometown-health/speaking-of-health/spring-into-better-health-freezer-edition" target="_self" title="Opens in same window.">freezer</a>. Then, based on those ingredients, create a plan and a weekly grocery shopping list to match.</p> <p><em><a href="/providers/kristi-wempen-rdn" target="_self" title="Opens in same window.">Kristi Wempen</a> is a registered dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Chronic kidney disease</li> <li>General health and wellness</li> <li>Weight management</li> </ul>RDN, LD<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Minnesota State University-Mankato</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Iowa State University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration</li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul> <p><strong>Membership</strong></p> <ul> <li>Academy of Nutrition and Dietetics</li> </ul>Wempen<img src="/-/media/shared-files/images/medical-professionals/full/mankato/kristi-wempen-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=BB7EFDC16603EA67B00B7CD0DBD528E1" alt="Kristi Wempen RDN" width="280" height="280" DisableNVelocity="true" />Kristi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14834341Kristi Wempen, R.D.N.1{2BEE5070-65FF-4406-9E59-103E06C5A535}<img src="/-/media/national-files/images/hometown-health/2024/meals-prepped-in-containers.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D48E298216EBDA3EBD465EE9DA64F9E5" alt="Meals prepped in containers" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller8/27/2019<p>Although crow’s feet and lines around your mouth and on your forehead indicate a life filled with laughter, they can make you look older than you feel. Don’t despair, though, as there are things you can do to return to a refreshed and well-rested look.</p>I don’t feel as old as the person I see in the mirror — what can I do to look refreshed?<p>There is nothing more startling that looking in the mirror and not recognizing your reflection. I’ve heard from patients that they woke one day to see their parent’s face staring back at them in the mirror. When did that happen? Although crow’s feet and lines around your mouth and on your forehead indicate a life filled with laughter, they can make you look older than you feel. Don’t despair, though, as there are things you can do to return to a refreshed and well-rested look.</p> <p>The first step to looking refreshed is to figure out what is causing you to appear older than you feel. It could be fine lines, wrinkles, saggy skin, droopy eyelids, uneven skin tone and texture, or a combination of these. Then you can explore treatment options to address these trouble areas. There are many nonsurgical options to help with fine lines, wrinkles and saggy skin, while droopy eyelids and saggy eyebrows would require a surgical procedure.</p> <h2>Botox</h2> <p>A nonsurgical treatment option for facial lines and wrinkles is <a rel="noopener" href="http://www.mayoclinic.org/tests-procedures/botox/basics/definition/prc-20009036" target="_blank" title="Opens in a new window.">Botox injections</a>. Botox uses various forms of <a href="/hometown-health/speaking-of-health/is-botox-the-fix-for-all-facial-wrinkles" target="_self" title="Opens in same window.">botulinum toxin to temporarily paralyze or relax muscle activity</a> and is effective for wrinkles caused by muscle movement, such as those when you smile, laugh or squint. Carefully placed Botox injections can restore a youthful appearance to facial skin for three to five months.</p> <h2>Fillers</h2> <p>As you age, natural collagen and elastin in your skin lessens. The result is dryer, thinner skin that is less well-supported, so fine lines and wrinkles appear. Fillers, such as hyaluronic acid (Juvederm) or other injections, as well as laser skin resurfacing, are nonsurgical options to lift the skin and smooth out lines and wrinkles. They restore volume loss and give you a fresher appearance. Your natural beauty can be restored as the silhouette of your face is returned.</p> <h2>Surgical procedures</h2> <p>Finally, sagging skin can cause you to look older. For example, eyebrows tend to slide as you age and can make you look tired, angry or sad. Droopy eyelids and puffy bags below your eyes can make you look older and more tired than you actually feel, not to mention interfere with your vision. In these situations, your surgeon may recommend surgical procedures, such as a blepharoplasty. Some of these may be covered by insurance, while others are considered cosmetic.</p> <h2>Cryolipolysis</h2> <p>CoolSculpting, also known as <a href="/hometown-health/speaking-of-health/10-things-you-can-do-during-a-cryolipolysis-procedure" target="_self" title="Opens in same window.">cryolipolysis</a>, is a noninvasive cosmetic procedure that can be used to <a href="/hometown-health/speaking-of-health/chin-up-this-disappearing-act-can-be-your-secret" target="_self" title="Opens in same window.">reduce the size of a double chin</a>. </p> <p>Don’t let the mirror bring you down. Learn about the many treatment options, and discuss them with your health care provider so you can appear refreshed and youthful every time you look the mirror.</p> <p><em><a href="/providers/yvonne-pierpont-md" target="_self" title="Opens in same window">Yvonne Pierpont, M.D.</a>, is a plastic surgeon in <a href="/services-and-treatments/plastic-and-reconstructive-surgery" target="_self" title="Opens in same window">Plastic & Reconstructive Surgery</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Arm lifts (brachioplasty)</li> <li>Body contouring</li> <li>Body lifts</li> <li>Breast augmentation</li> <li>Breast cancer</li> <li>Breast reduction</li> <li>Eyelid lift or eyelid surgery (blepharoplasty)</li> <li>Mastectomy </li> <li>Oculoplastics</li> <li>Skin cancer and reconstruction</li> <li>Skin removal surgery</li> <li>Thigh lifts</li> <li>Tummy tucks (abdominoplasty)</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Maryland School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Plastic Surgery, University of South Florida</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Facial Plastic and Breast and Body Surgery, Clevens Face and Body Specialists</li> <li>Research, University of South Florida</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Plastic Surgery </li> </ul> <p><strong>Membership</strong></p> <ul> <li>Wisconsin Medical Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Plastic Surgery, Mayo Clinic College of Medicine and Science</li> </ul>Pierpont<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/yvonne-pierpont-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=31D9B46DB7EACA47CE4C2E20F1944E0F" alt="Yvonne Pierpont, M.D." width="280" height="280" DisableNVelocity="true" />Yvonne<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20840870Yvonne Pierpont, M.D.1{3D1714E2-ECE8-4D0A-98A0-A4318C6DA2C3}<img src="/-/media/national-files/images/hometown-health/2018/female-looking-in-a-mirror.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3B3A32C83E6ACC21A491BAE328126FB1" alt="Female looking in a mirror" width="660" height="370" DisableNVelocity="true" />Plastic and Reconstructive SurgeryPlastic and reconstructive surgery provides services that not only include cosmetic or aesthetic surgery, but also surgical repair of congenital deformities, laser surgery, postsurgical reconstruction, such as breast, head and neck defects, and microsurgery.Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Dawn Haller12/17/2018<p>Medication synchronization is a prescription autofill program. Read how Deb Gregory's pharmacy team coordinated automatic medication refills and synced fill schedules to make life a little easier for her.</p>Medication synchronization increases prescription efficiency<img height="370" alt="Pharmacist and patient with prescription" width="660" src="/-/media/national-files/images/hometown-health/2018/pharmacist-and-patient-with-prescription.jpg?sc_lang=en&hash=B7244AA6EC66C5DB650F9F760676D553" class="img-responsive"> <p>A new medication synchronization program at <a href="/locations/osseo" target="_self" title="Opens in same window.">Mayo Clinic Health System – Oakridge in Osseo</a> is making the pick-up process easier and quicker for patients like Deb Gregory.</p> <p>“Because I’m on many medications, I was making multiple trips to the pharmacy because they were coming due at different times,” says Deb, 62, a retired teacher from Osseo, Wisconsin.</p> <p>Medication synchronization, or med sync for short, is a prescription autofill program. Pharmacists work with patients to coordinate automatic refilling of medications and sync fill schedules.</p> <h4>ONE-STOP PRESCRIPTIONS</h4> <p>“We oversee filling prescriptions for patients,” says Michael Whittlinger, a pharmacist who helped start the program. “If the medication needs refills or is expired, we help to manage that ahead of time so the patient is not surprised by coming in and learning there are no refills available. We’re trying to make things as easy as possible.”</p> <p>About 250 patients in Osseo are enrolled in the optional program. Those who prefer to call in refills, speak with a pharmacist or use Patient Online Services, the patient portal, can continue to do so.</p> <p>In addition to making the process more convenient for patients and cutting down trips to the pharmacy, it also encourages medication adherence. Sometimes patients may find that they miss taking a dose here and there. With medication synchronization, the patient’s pharmacy team is watching the fills, which may increase the likelihood that the patient stays on track by adding a higher degree of accountability.</p> <h4>INCREASED EFFICIENCY</h4> <p>Efficiency was a factor behind launching the program — not just for patients, but also for pharmacy staff. Tracking when medications are due allows staff to refill prescriptions during slower times versus having refills called in or requested in an urgent manner.</p> <p>“It’s a win-win,” Michael says. “It really helps our workflow quite a bit and helps patients get prescriptions when they are needed.”</p> <p>Prescribers have responded positively, as well. Medication synchronization confirms that patients are picking up medications as prescribed and clearly shows dispense history.</p> <p>Deb, who has diabetes and heart issues and has undergone joint replacement surgeries, learned of the program through the pharmacy.</p> <p>“They let me know about it and asked if I would be interested in trying it,” she says. “I thought it was a great idea.”</p> <p>She now has one monthly pickup for all of her medications.</p> <p>“It’s really nice. I get a notification that my prescriptions are filled and usually ahead of when I actually need them,” Deb says. “I don’t have to go in that day, but they’re ready for me, which is just awesome.”</p> <p>She adds that she appreciates still being able to ask questions of her pharmacist when she comes in.</p> <p>“They’re very cordial, very helpful — none of that has changed,” Deb says. “This is just a nice added feature.”</p> <p><a href="/services-and-treatments/pharmacy" target="_self" title="Opens in same window.">Check with your local pharmacy</a> for more information about the medication synchronization program.</p><img src="/-/media/national-files/images/hometown-health/2018/pharmacist-and-patient-with-prescription.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B8E5E184BC1EDEC552DEC3A401BCA785" alt="Pharmacist and patient with prescription" width="660" height="370" DisableNVelocity="true" />Dawn Haller11/30/2022<p>The holidays are magical time of the year. Make sure your children or young guests are kept safe with these helpful tips.</p>8 tips for keeping children safe during the holidays<p>The hustle and bustle of the holiday season can be a fun, exciting time. However, holiday decorations, parties and cold weather can threaten children.</p> <h2>Keep these safety tips in mind while preparing for the holidays:</h2> <h3>1. Manage your Christmas tree.</h3> <p>If you have a real tree, ensure the tree stand is always filled with water so the tree doesn't dry out and pose an increased fire hazard. If you buy an artificial tree, make sure it is made from fire-retardant material. Make sure the stand is flat on the ground, and decorate the tree to equally distribute weight.</p> <h3>2. Keep flames away.</h3> <p>Don't leave children alone in a room with lighted candles, matches, lighters, fireplaces, or any other sources of flame or heat.</p> <h3>3. Watch for tempting seasonal decor.</h3> <p>Keep decorations out of reach of children and secured to the wall. Any object small enough to fit through a toilet paper tube can obstruct a child's airway. Closely supervise children if they're helping you decorate, especially when handling lighting, ornaments and breakable objects.</p> <h3>4. Keep plants out of little hands.</h3> <p>Keep mistletoe, holly berries and poinsettias out of reach of children, as each is toxic when ingested.</p> <h3>5. Remember electricity safety.</h3> <p>Use power strips with built-in circuit breakers. Avoid putting too many plugs into one electrical outlet. Keep cords out of the way or behind furniture, and insert electrical outlet covers into unused outlets. Purchase lights with the UL Listed mark, which certifies that the product has been tested to meet safety requirements.</p> <h3>6. Find safe toys.</h3> <p>Make sure your children's toys are age-appropriate and the batteries cannot be easily removed. Batteries shaped like disks, or button batteries, pose a choking risk to young children. Avoid placing gifts under the tree that contain glass, perfume or cologne, poisonous substances or sharp materials.</p> <h3>7. Monitor alcohol in the home.</h3> <p>Keep alcohol out of reach of children. Quickly clean up leftover drinks.</p> <h3>8. Bundle up and use safety gear.</h3> <p>Dress children properly for the weather, making sure that their hands, feet and heads are covered. Supervise children and make sure they wear the correct safety gear for sledding, skiing, snowboarding, ice skating and other outdoor activities.</p> <p>Carefully inspecting your home and taking care of any safety hazards can ensure you and your children have a happy and safe holiday season. Get additional <a href="/topics/safety" target="_self" title="Opens in same window.">safety information</a> for you and your family.</p> <em><a href="/providers/peter-reisner-md" target="_self" title="Opens in same window.">Peter Reisner, M.D.</a>, sees patients in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/chetek" target="_self" title="Opens in same window.">Chetek</a>, Wisconsin.</em>M.D.<p><strong>Education</strong></p> <ul> <li>University of Texas Medical Branch</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Practice</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Reisner<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/peter-reisner-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=E4299ECA7A6FB83591D4D4F91D0769D6" alt="Peter Reisner, M.D." width="280" height="280" DisableNVelocity="true" />Peter<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13818422Peter Reisner, M.D.1<img src="/-/media/national-files/images/hometown-health/2022/toddler-by-holiday-lights.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1A95152A19731162642E7B814A4358D6" alt="Toddler by holiday lights" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Dawn Haller12/13/2018<p>Did you know that truck driving is among the most hazardous occupations in the U.S.? Fortunately, there are steps to take to improve and maximize the health and safety of professional drivers.</p>7 steps to take to maximize health, safety of professional drivers<img height="370" alt="Trucking Safety" width="660" src="/-/media/national-files/images/hometown-health/2018/trucking-safety.jpg?sc_lang=en&hash=D7DEB431375F89F68063A93A452128A5" class="img-responsive"> <p>Did you know that truck driving is among the most hazardous occupations in the United States? It’s true. Motor vehicle accidents account for about 40 percent of work-related deaths each year. Workers who are on the road are continually at risk for involvement in serious motor vehicle collisions. Furthermore, drivers often find themselves working irregular hours and can be away from home for long periods of time, making it difficult to get find time to exercise and eat a healthy diet. Fortunately, there are many steps to take to help improve the overall health and well-being of drivers.</p> <p>Here are a seven considerations for employers and professional drivers to ensure safe travels with every mile on the road:</p> <h4>1. Hard wire safety measures.</h4> <p>When we think about truck driver health, the first thing that often comes to mind is the sedentary lifestyle and what can be done to promote regular exercise and a healthy diet. Although this is important to address, there are several other safety measures that take priority.</p> <p>First and foremost, all truck drivers and their passengers should wear seat belts when driving. Wearing a seat belt can reduce the risk of death by 80 percent in the case of a serious accident. For employers, it’s important to make sure that all trucks are equipped with the proper seat belts and that the importance of compliance with seat belt laws is strictly enforced.</p> <p>Employers should make sure that all of their commercial vehicles are routinely inspected to ensure that vehicles are in proper working order and that all safety related equipment is in optimal condition. Regular truck maintenance can reduce noise, which can protect drivers from work-related hearing loss. It also can reduce excessive vibration that, in some cases, can cause osteoarthritis and chronic back problems with long-term exposure.</p> <h4>2. Prohibit or limit electronic device use while driving.</h4> <p>With the increasing use of cellphones, distracted driving has become a growing problem in the U.S. The Federal Motor Carrier Safety Administration (FMCSA) currently prohibits the use of hand-held cellphones while transporting. The use of hands-free devices is still permitted. However, these devices can still distract drivers and are probably not any safer. The use of hands-free devices has been associated with motor vehicle collision rates that are similar to what has been seen for drivers who use hand-held devices.</p> <p>Many trucking companies have taken steps to limit cellphone use among drivers. Some employers have even banned the use of all electronic devices while driving. Drivers should be encouraged to pull over and stop if they plan to use a cellphone or other hand-held device. Distracted driving is a major cause of serious accidents, and truck drivers should also be on the lookout for drivers around them who may be driving distracted. </p> <h4>3. Stay awake. </h4> <p>In addition to distracted driving, another major threat to driver safety is drowsy-driving. According to the Centers for Disease Control and Prevention (CDC), 1 in 25 drivers report having fallen asleep while driving in the past 30 days. Risk factors for falling asleep at the wheel include not getting enough sleep every night, shift work with an irregular sleep schedule, an undiagnosed sleep disorder such as sleep apnea, and the use of medications that cause drowsiness.</p> <p>Employers should actively take steps to make sure their drivers have a regular sleep schedule and are getting adequate sleep. Flexibility should be built into drivers’ schedules to allow for breaks when they feel tired. Drivers also should be given sufficient time to meet deadlines and actively encouraged to pull over when they are tired. When employers are heavily focused meeting tight deadlines, it can push drivers to their limits, increasing the chances for a serious accident. Although motor vehicle crashes may appear to be uncommon occurrences, it is well worthwhile to take preventive measures as the consequences can be costly when they do happen.</p> <h4>4. Consider important preventive screenings.</h4> <p><a href="/hometown-health/speaking-of-health/do-i-have-sleep-apnea" target="_self" title="Opens in same window.">Sleep apnea</a>, a common cause of drowsy driving, has been a major topic of discussion in recent years. Drivers with sleep apnea are known to have increased accident rates compared to drivers without sleep apnea. Major risk factors for sleep apnea include obesity, high blood pressure, having a large neck circumference and daytime sleepiness. The diagnosis of sleep apnea usually is confirmed with an overnight sleep study. In many cases, testing can be performed in a patient’s own home without the need to go to the hospital.</p> <p>When drivers with sleep apnea are adequately treated, it reduces daytime sleepiness, and improves overall concentration and awareness. It also can  reduce blood pressure and decrease a driver’s overall risk of having a heart attack or stroke. Many employers are starting to offer routine sleep apnea screening for their employees to help reduce accident risk and improve overall worker health.</p> <h4>5. Encourage a healthy lifestyle.</h4> <p>When on the road for long periods of time it can be challenging to exercise regularly and eat a healthy diet. Drivers should strive for at least 150 minutes of moderate exercise activity, such as brisk walking, each week. Exercise schedules often can be planned before a driver sets off on a trip. Preplanning and sticking to a routine can help improve compliance with regular physical activity recommendations.</p> <p>Employers may consider instituting programs in which they monitor how many steps their drivers are taking each day using electronic devices, such as cellphones and electronic fitness trackers. Regular exercise and a healthy diet not only decrease the risk of heart disease, diabetes, cancer and other health issues, it also improves concentration and awareness on the road, and can reduce chances of motor vehicle collisions. </p> <h4>6. Terminate tobacco use.</h4> <p>For those who use tobacco products, smoking cessation is the single most important thing one can do to improve overall health and well-being. Employers should strongly encourage smoking cessation among their drivers. This may include offering incentives and rewards, as well as providing low-cost access to smoking cessation programs and medical providers. Quitting smoking is a difficult undertaking, and the chances for long-term success have been shown to be substantially improved with medical help and supportive services.</p> <h4>7. Be vigilant. </h4> <p>Although commercial drivers are required to obtain medical clearance to drive at a minimum of every two years, employers still should remain vigilant in monitoring the health of their workers. If an employee has unexpectedly been out of work for an extended period of time, this could be a sign that a driver may have a significant underlying medical problem. If an employer has concerns that an employee may have developed a new medical condition that could impair their ability to drive, the employer can request that the driver undergo a return-to-work or fitness-for-duty medical evaluation to ensure that they are safe to drive and meet medical guidelines. Having pre-established protocols in place for how to handle medical leave and return to work after an absence can be a valuable resource for employers. </p> <p>At the end of the day, employers and drivers should work together to identify and address specific health needs and concerns as they arise. A culture of safety and partnership can go a long way toward maximizing the productivity of an organization. There are many hazards on our roadways, and it’s important to remember that the biggest threats to health and safety are still some of the most obvious and well-known hazards. It’s important not to underestimate the importance of the basics, such as wearing a seatbelt and quitting smoking. Tackling these key issues will improve the health and safety of drivers, and the community as a whole.</p> <p><em><a href="/providers/scott-riester-md-phd" target="_self" title="Opens in same window.">Scott Riester, M.D., Ph.D.</a>, sees patients in <a href="/services-and-treatments/occupational-health" target="_self" title="Opens in same window.">Occupational Medicine</a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a> and <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</em></p><ul> <li>Occupational related musculoskeletal disorders</li> <li>Research interests in clinical and translational sciences</li> </ul>M.D., Ph.D.<p><strong>Education</strong></p> <ul> <li>Medical degree at the University of Toledo College of Medicine in Toledo, Ohio</li> <li>Ph.D. in clinical and translational sciences at Mayo Clinic in Rochester, Minnesota</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>Orthopedic surgery residency and a clinician investigator program at Mayo Clinic in Rochester, Minnesota</li> <li>Occupational medicine residency at HealthPartners in St. Paul, Minnesota</li> </ul>Riester<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/scott-riester-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=C0767D9F8D7F5B4453507460B029F2C0" alt="Scott Riester, M.D." width="280" height="280" DisableNVelocity="true" />Scott<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15076415Scott Riester MD PhD1<img src="/-/media/national-files/images/hometown-health/2018/trucking-safety.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9AF00588A92F5D95C721B687A0D76FDD" alt="Person buckling up in big truck" width="660" height="370" DisableNVelocity="true" />Occupational MedicineBusiness success depends upon the productivity of the workforce. Occupational medicine helps businesses and organizations prevent and manage occupational and environmental injuries, illnesses and disabilities.Dawn Haller2/21/2023Feeling overwhelmed and stressed? It can be the challenge of balancing the pressures of work and school with the desire to connect with others. Here are five tips to keep stress manageable.5 tips to manage stress<p>In today's society, stress and change often are thought of as the same thing. Stress is a physiological and psychological response to a change in a situation the body and mind find to be overwhelming.</p> <p>With the fast pace of work and home, being constantly inundated with technology and still wanting to have time to connect with those around you, life can feel overwhelming and stressful at times. You may often ask yourself how you should manage stress.</p> <h2>Try these five tips to manage stress and reduce the overall stress of day-to-day activities:</h2> <h3>1. Use guided meditation.</h3> <p><a rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/stress-management/multimedia/meditation/vid-20084741" target="_blank" title="Opens in new window.">Guided meditation</a> is a great way to distract yourself from the stress of day-to-day life. There are many guided meditations available online that can help you find five minutes of centered relaxation.</p> <h3>2. Practice deep breathing.</h3> <p><a href="/hometown-health/speaking-of-health/mindfulness-meditation-improve-your-quality-of-life" target="_self" title="Opens in same window.">Deep breathing</a> is a great way to reduce the activation of your sympathetic nervous system, which controls the body's response of fight or flight to a perceived threat. Deep breaths taken in for a count of five seconds, held for two seconds and released for a count of five seconds, can help activate your parasympathetic nervous system to rest and digest, which helps reduce the overall stress and anxiety you may be experiencing.</p> <h3>3. Maintain physical exercise and good nutrition.</h3> <p><a href="/hometown-health/speaking-of-health/establishing-healthy-behaviors-that-stick" target="_self" title="Opens in same window.">Physical exercise and nutrition</a> are two important components in how you respond to stress. When your body is healthy, your mind can be healthy and vice versa. Physical exercise is proven to be a great stress reliever and also helps to improve your overall quality of life. Nutrition is important because stress can deplete certain vitamins, such as A, B complex, C and E. Maintaining proper nutrition not only helps your body feel better, but your mind as well, which allows you to better combat stress.</p> <h3>4. Manage social media time.</h3> <p>Spending time on social media sites can become stressful, not only by what you might see on them, but also because the time might best be spent enjoying visiting with friends, being outside enjoying the weather or reading a great book. In addition, many people use social media at night, which may worsen sleep due to increased stress at the exact time people are trying to wind down for the evening, resulting in fewer overall hours of quality sleep.</p> <h3>5. Connect with others.</h3> <p>Humans are social beings. You need to have <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/friendships/art-20044860" target="_blank" title="Opens in a new window.">connections with people</a> to feel supported. Finding a sense of community, whether at work, with a religious organization or through shared activities, such as organized sports, is important to your well-being. Enjoying a shared activity allows you to find support and foster relationships that can be supportive in difficult times.</p> <p><a href="/providers/brian-hesler-md" target="_self" title="Opens in same window."><em>Brian Hesler, M.D.</em></a><em>, is a psychiatrist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a>, Minnesota.</em></p><ul> <li>Anxiety</li> <li>Bipolar disorder</li> <li>Depression</li> <li>Dual diagnosis</li> <li>Schizophrenia</li> </ul>M.D.<p>I believe in the patient-centered, individual approach to treating mental health. Collaboration between inpatient-stabilization providers and consistent outpatient providers is the cornerstone of delivering high quality care.</p> <p>I enjoy the outdoors with my dog. I have a small farm in Wisconsin, but I am originally from Chicago.</p><p><strong>Education</strong></p> <ul> <li>University of Illinois College of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Anesthesiology, Cleveland Clinic Foundation</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Psychiatry, Rush University Medical Center</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Clinical Research, Cleveland Clinic Foundation</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Psychiatry, American Board of Psychiatry and Neurology</li> </ul>Hesler<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/brian-hesler-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=0E7711987358B86719CC2FE323ECE5FE" alt="Brian Hesler, M.D." width="280" height="280" DisableNVelocity="true" />Brian<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30190397Brian Hesler, M.D.1{C4130004-0F31-48C4-AC9F-A4350A75AB24}|{2B88C934-922C-4130-B661-197B59D83899}<img src="/-/media/national-files/images/hometown-health/2023/bearded-person-laughing.jpg?h=370&iar=0&w=660&sc_lang=en&hash=012AB89C73A8B3A5A64232BFA35AB262" alt="Bearded person laughing" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Dawn Haller1/29/2019<p>Staying heart healthy can be a challenge — especially when good intentions bump into balancing work, family and taking care of yourself. Our Cardiology staff share tips for combating some common pitfalls of heart health.</p>Heart-healthy tips from the front line<img height="370" alt="Hands holding a virtual heart" width="660" src="/-/media/national-files/images/hometown-health/2019/hands-holding-a-virtual-heart.jpg?sc_lang=en&hash=E68C25657A66CC7109928F644477A9C6" class="img-responsive" /> <p>Staying heart healthy can be a challenge — especially when your good intentions bump into your real life. It’s hard to balance work, family and taking care of yourself.</p> <p><a href="/providers/anita-anderson-pac" target="_self" title="Opens in same window.">Anita Anderson</a>, a physician assistant, and Emran Mohammad, a certified nurse practitioner, both in <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">Cardiology</a> at <a href="/locations/mankato" target="_self" title="Opens in same window.">Mayo Clinic Health System in Mankato</a> share tips for combating some common pitfalls of heart health:</p> <h4>Subdue stress</h4> <p>When you’re stressed, your body releases adrenaline, providing the fuel for the fight-or-flight response needed to help you cope with a big challenge — like running from a lion. That burst of adrenaline may have helped keep our ancestors alive. But today, it’s an oversized response to the threats of modern life, such as work deadlines or disagreements with a family member. In fact, the stress response has become a threat itself as it may lead to <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410" target="_blank" title="Opens in a new window.">high blood pressure</a>, which is a risk factor for <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/syc-20350613" target="_blank" title="Opens in a new window.">coronary artery disease</a>. It also may lead to <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/heart-arrhythmia/symptoms-causes/syc-20350668" target="_blank" title="Opens in a new window.">heart rhythm disturbances</a>, and even <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/heart-failure/symptoms-causes/syc-20373142" target="_blank" title="Opens in a new window.">heart failure</a>. That’s why it’s so important to learn to manage stress, Anita says.</p> <p>“Our modern stressors are part of our everyday lives,” Anita says. “They aren’t going to go away, so we need to learn to deal with them in a healthy way. I find I’m much better able to cope with stressful days when I’m getting regular exercise, and making time to see friends and family. If I do find myself feeling anxious in a particular situation, I typically take a few deep breaths or go for a short, one-to-two minute walk. It also is helpful to decompress with someone who is close to me and not keep all my emotions bottled inside. All of this has a way of calming me down.”</p> <h4>Schedule sleep</h4> <p>It may seem harmless to skimp on sleep. But there’s a cost to trying to get by on too little. One study found adults over 45 who slept fewer than six hours per night were about twice as likely to have a stroke or heart attack as people who slept six to eight hours per night.</p> <p>“It can be hard to power down at night,” Emran says. “Especially with our use of electronics. It’s easy to tell yourself you’re just going to peek at social media for a minute or answer one more email. But that can creep into what should be your sleeping time. Instead, try using technology to help you get to bed. I set an alarm on my phone for around 30 minutes before I want to be in bed. Then I turn off my electronics, get ready for bed and spend some time reading a book or magazine before going to sleep.”</p> <h4>Cleanliness is next to ...</h4> <p>One more tip from the heart pros: Make clean hands and teeth a priority. There seems to be a connection between <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/endocarditis/symptoms-causes/syc-20352576" target="_blank" title="Opens in a new window.">gum disease and heart disease</a>, so brush and floss every day. And there are a number of viruses and types of bacteria that can lead to dangerous heart infections. Frequent hand-washing can help you avoid infection.</p> <h5>Read more about how to keep your heart healthy:</h5> <ul> <li>Read more <a rel="noopener noreferrer" href="https://mayoclinichealthsystem.org/hometown-health?topic=Heart%20Health" target="_blank" title="Opens in a new window.">heart health blogs</a>.</li> <li>Learn how to <a href="/hometown-health/speaking-of-health/clean-up-your-hand-washing-skills" target="_self" title="Opens in same window.">clean up your hand-washing skills</a>.</li> <li>Try <a href="/hometown-health/speaking-of-health/5-ways-to-get-better-sleep" target="_self" title="Opens in same window.">five strategies to get better sleep</a>.</li> </ul><img src="/-/media/national-files/images/hometown-health/2019/hands-holding-a-virtual-heart.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F32C1CFC7A1ADA2B9AA8290306BD4878" alt="Hands holding a virtual heart" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller1/31/2023Interval training makes your heart alternate between working hard and recovering. Learn why this style of training has big benefits, and get started with a training plan.Interval training for heart health<p>When it comes to exercise, what's best for your heart: slow and steady or fast and furious?</p> <p>How about a combination of both? Interval training — alternating short bouts of higher-intensity effort with longer bouts of less-intense activity — has big benefits for your heart. Interval training makes your heart alternate between working hard and recovering.</p> <h3>The benefits of doing this work-and-recovery pattern multiple times in a single workout include:</h3> <ul> <li>Improving cardiorespiratory fitness, increasing your body's ability to consume oxygen by making your heart and lungs stronger and more efficient.</li> <li>Increasing the efficiency of your body's energy systems.</li> <li>Promoting preservation of lean muscle while promoting fat loss.</li> <li>Shortening the length of your workouts by producing the same output in a shorter amount of time.</li> </ul> <p>If you have a health condition, consult your health care team before increasing or changing your exercise routine. If you are starting an exercise program, wait at least two weeks before adding interval training to your routine.</p> <h2>Interval training plan</h2> <h3>To try it yourself, follow this 20- to 40-minute plan, adapted from Mayo Clinic:</h3> <ol> <li>Walk slowly, working up to a moderate pace for five minutes.</li> <li>Increase your speed so you're walking briskly.</li> <li>After five minutes of brisk walking, increase your speed to jog or walk faster, or add a grade on the treadmill for 30 seconds to two minutes.</li> <li>Once it gets difficult or your breathing becomes heavy, slow down to walking at a moderate pace for one to three minutes.</li> <li>Repeat steps two, three and four for 10 to 30 minutes.</li> <li>To cool down, walk at a slower pace for five minutes.</li> </ol> <p>If you're already a runner, alternate jogging and sprinting in steps 2 to 4.</p> <p>For general fitness, aim for at least 30 minutes of moderate aerobic exercise most days of the week. To add interval training to your exercise routine, substitute two to three days of interval training for your regular workout.</p> <p>For optimal heart health, also add two to three days of strength training a week. If you do the correct amount of exercise, you should feel good when you finish your workout.</p> <h2>Get more information about fitness:</h2> <ul> <li>Learn how to <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/exercise-intensity/art-20046887" target="_blank" title="Opens in a new window.">measure exercise intensity</a>.</li> <li>Include these<a href="/hometown-health/speaking-of-health/the-5-elements-of-fitness" target="_self" title="Opens in same window."> five elements of fitness</a> into your routine.</li> <li>Get a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/5k-run/art-20050962" target="_blank" title="Opens in a new window.">5K run/walk seven-week training schedule for beginners</a>.</li> <li>Find <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://mayoclinichealthsystem.org/topics/exercise-and-fitness" target="_blank" title="Opens in a new window.">fitness classes and articles</a>.</li> </ul> <p><em><a href="/providers/melinda-hahm" target="_self" title="Opens in same window.">Melinda Hahm</a> is a clinical exercise physiologist in <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">Cardiology</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Diseased population</li> <li>Helping patients to find ways to become more physically active and incorporate exercise into their lifestyle</li> </ul>ACSM-CEP<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Exercise Physiology, Winona State University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Clinical Exercise Physiologist, American College of Sports Medicine</li> <li>Senior Fitness Training Specialist, American Academy of Health and Fitness</li> </ul>Hahm<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/melinda-hahm.JPG?h=280&iar=0&w=280&sc_lang=en&hash=07CDEFA0A5AA9AA76DB482AC9AF90A59" alt="Melinda Hahm" width="280" height="280" DisableNVelocity="true" />Melinda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13271296Melinda Hahm, ACSM-CEP1{94B2E140-AEF8-44BA-B6A9-4538B77501BC}<img src="/-/media/national-files/images/hometown-health/2023/white-smartwatch-on-wrist.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1E5AAB2A66F3369B8D02BACB6C63BC5C" alt="White smartwatch on wrist" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Dawn Haller1/24/2019<p>Heart disease is the most common cause of death among both men and women in the U.S. But women have unique signs and risk factors that may still be overlooked or misunderstood.</p>Women and heart disease: Understanding unique signs, risks<img height="370" alt="Women talking around a laptop" width="660" src="/-/media/national-files/images/hometown-health/2019/women-talking-around-a-laptop.jpg?h=370&w=660&sc_lang=en&hash=63D2C1555F1BA8251FD640B629348AFC" class="img-responsive" style="height: 370px; width: 660px;" /> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/heart-disease/symptoms-causes/syc-20353118" target="_blank" title="Opens in a new window."><span>Heart disease</span></a> is the most common cause of death among both men and women in the U.S. It’s a fact that still surprises many people.</p> <p>“For generations, heart disease was thought of as a man’s disease,” says <a href="/providers/breno-pessanha-md" target="_self" title="Opens in same window.">Breno Pessanha, M.D.</a>, a cardiologist at Mayo Clinic Health System in <a href="/locations/faribault" target="_self" title="Opens in same window.">Faribault</a> and <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota. </p> <p>Today, there’s a growing awareness of the impact heart disease has on women. But women have unique signs and risk factors that may still be overlooked or misunderstood.</p> <h4>Women's heart attack symptoms</h4> <p>Like men, most women who have <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/heart-attack/symptoms-causes/syc-20373106" target="_blank" title="Opens in a new window.">heart attacks</a> experience chest pain, pressure or discomfort. But those often aren’t their most prominent symptoms.</p> <p>Instead, women are more likely to report:</p> <ul> <li>Neck, jaw, shoulder, upper back or abdominal discomfort</li> <li>Shortness of breath</li> <li>Pain in one or both arms</li> <li>Nausea or vomiting</li> <li>Sweating</li> <li>Lightheadedness or dizziness</li> <li>Unusual fatigue</li> </ul> <p>Dr. Pessanha says it’s important for women experiencing these symptoms to call 911.</p> <p>“Women sometimes downplay their symptoms or attribute them to something other than a heart attack,” says Dr. Pessanha. “Getting help quickly is important to minimize damage to the heart.”</p> <h4>Unique risk factors</h4> <p>Women’s risk factors also differ from men’s. Some risk factors affect both women and men, but not equally. Smoking, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444" target="_blank" title="Opens in a new window.">diabetes</a>, mental stress and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007" target="_blank" title="Opens in a new window.">depression</a> all play a bigger role in women developing heart disease.</p> <p>Other risk factors belong to women alone. Pregnancy complications, such as <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/preeclampsia/symptoms-causes/syc-20355745" target="_blank" title="Opens in a new window.">preeclampsia</a> or gestational diabetes, can increase the chance a woman will develop <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410" target="_blank" title="Opens in a new window.">high blood pressure</a>, diabetes and heart disease later in life. The drop in estrogen during menopause also can increase a woman’s chances of developing heart disease.</p> <h4>Hormone replacement therapy and your heart</h4> <p>In the 1980s and 1990s, hormone therapy often was prescribed to help treat some of the symptoms women experience during menopause. But concerns arose about whether the therapy increased the likelihood of developing heart disease. Researched showed therapy that combined two hormones — estrogen and progestin — did slightly increase the risk of developing cardiovascular disease. But for women using estrogen alone, there was no increase.</p> <p>“Women should talk with their provider about menopause hormone therapy,” <a href="/providers/andrea-branson-apnp" target="_self" title="Opens in same window.">Andrea Branson</a>, a nurse practitioner in Cardiology at <a href="/locations/la-crosse" target="_self" title="Opens in same window.">Mayo Clinic Health System in La Crosse</a>, Wisconsin, says. “The benefits and risks depend on age, as well as the age they reached menopause.”</p> <h4>Prevention</h4> <p>Staying heart healthy is the same for women and men. “Eat right, exercise and maintain a healthy weight. If you smoke, quit. Learning to manage stress is important, too.” says Andrea. “And if you’ve been diagnosed with heart disease, follow your provider’s treatment recommendations.”</p> <p>Read more stories about <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://mayoclinichealthsystem.org/hometown-health?topic=Heart%20Health" target="_blank" title="Opens in a new window.">heart health</a>.</p><img src="/-/media/national-files/images/hometown-health/2019/women-talking-around-a-laptop.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E060CC9B380E6AE06BBA3669CEEB6521" alt="Women talking around a laptop" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Michele Halterman5/4/2022<p>When people struggle to cope with stressful situations, depression and anxiety become more noticeable. Learn how to identify the symptoms, and get coping tips.</p>Identifying signs of anxiety and depression<p>What is stress, and what happens when you can't cope well with it?</p> <p>Stress can present itself after being fired from a job, going through a divorce or losing a loved one. Even getting married, transitioning to a new job or having a baby can cause stress. Everyone experiences stress at one time or another.</p> <p>Many people define stress as either good or bad when it's neither. Stress is an event you view as out of your control, and it typically occurs outside your daily routines. How you react shapes your ability to cope with these and other similar events in the future.</p> <p>When people struggle to cope with stressful situations, depression and anxiety become more noticeable.</p> <p>Anxiety and depressive disorders are common. These illnesses affect more than 40 million adults in the U.S., or about 18% of the population, every year. The World Health Organization has estimated that the COVID-19 pandemic led to a 27.6% increase in depression and 25.6% increase in anxiety disorders worldwide in 2020.</p> <h2>The most common anxiety disorders include:</h2> <ul> <li><strong>Specific phobias</strong><br /> Phobias could be related to animals, like spiders, cats or dogs; the natural environment, such as heights, storms or being in water; blood injection injury, which is a fear of needles or invasive medical procedures; or locations, like airplanes, elevators or enclosed places.</li> <li><strong>Social anxiety disorder</strong><br /> This is a fear of being around other people or in social situations.</li> <li><strong>Generalized anxiety disorder</strong><br /> This is an overall worry about many different things.</li> <li><strong>Separation anxiety</strong><br /> This is an excessive fear of, or anxiety concerning, separation from attachment figures or items.</li> <li><strong>Panic disorder</strong><br /> This is an abrupt surge of intense fear or discomfort.</li> </ul> <h2>The most common depressive disorders include:</h2> <ul> <li><strong>Major depressive disorder</strong><br /> This is a depressed mood that lasts for a two-week period. This could occur as a single or recurrent episode.</li> <li><strong>Persistent depressive disorder</strong><br /> This is a depressed mood that occurs almost every day for at least two years</li> </ul> <p>It's common for those struggling with anxiety disorders to also struggle with depression or vice versa. Close to 10% of the world's population suffers from anxiety and depression. However, while anxiety and depressive disorders are highly treatable, only a small percentage of affected people receive treatment.</p> <h2>How are stress, anxiety and depression connected?</h2> <h4>Anxiety and depression can be caused by several things, including:</h4> <ul> <li>Genetics</li> <li>Environmental exposure</li> <li>Personality</li> <li>Life events</li> </ul> <h2>Early signs of anxiety and depression</h2> <p>An early warning sign for anxiety or depression occurs when someone begins avoiding things once enjoyed.</p> <h4>Other warning signs for anxiety include:</h4> <ul> <li>Shakiness</li> <li>Increased heart rate</li> <li>Tightness in the chest</li> <li>Rapid breathing</li> <li>Racing thoughts</li> </ul> <h4>Meanwhile, warning signs for depression include:</h4> <ul> <li>Isolating oneself</li> <li>Frequently thinking negative thoughts</li> <li>Recurring feelings of sadness</li> <li>Advanced signs of anxiety and depression</li> </ul> <h4>Advanced signs of generalized anxiety disorder include:</h4> <ul> <li>Excessive worry occurring more days than not for at least six months</li> <li>Feeling restless</li> <li>Fatigue or frequently feeling tired</li> <li>Difficulty concentrating</li> <li>Irritability</li> <li>Muscle tension</li> <li>Sleep disturbances, like difficulty falling or staying asleep</li> <li>Distress or impairment in social, occupational or other important areas of functioning</li> </ul> <h4>Advanced signs of a major depressive disorder include:</h4> <ul> <li>Feeling down or depressed most of the day, nearly every day</li> <li>Diminished interest in activities you once enjoyed</li> <li>Significant changes in your weight (increase or decrease)</li> <li>Difficulty with sleep, like difficulty falling, staying asleep or sleeping too much</li> <li>Fatigue or frequently feeling tired</li> <li>Difficulty concentrating</li> <li>Recurrent thoughts of death</li> <li>Distress or impairment in social, occupational or other important areas of functioning</li> </ul> <h2>To cope with anxiety and depression, try these tips:</h2> <h4>Try diaphragmatic and square breathing techniques.</h4> <p>Diaphragmatic breathing involves taking a deep breath from your diaphragm. Your stomach should expand as you breathe in. Square breathing techniques involve taking a deep breath in for five counts, holding this deep breath for five counts, exhaling for five counts and finally holding for five counts before repeating. The entire time should be spent focusing on your breath versus the stressful event.</p> <h4>Challenge your thoughts.</h4> <p>This involves not judging situations — good or bad — and focusing on what you're feeling and identifying what's in your control. Your primary areas of control are acknowledgement of your emotions, feelings and your reaction to stressful situations. It is also important to focus on the facts of the situation. Sometimes your anxious and depressive thoughts are not always based in facts. Facts are 100% absolute — not assumptions.</p> <h5>Ask yourself:</h5> <ul> <li>What am I feeling?</li> <li>What are these emotions?</li> <li>How would I like the situation to turn out?</li> <li>What are the facts?</li> </ul> <p>Then identify small, specific goals to get to your desired outcome. If you fail to acknowledge your emotions and feelings and attach a negative thought to a situation, the outcome of that situation will result in avoidance and increased anxiety and depression.</p> <h4>Focus on the facts.</h4> <p>Challenge yourself to find the facts in a situation and acknowledge whatever emotions and feelings the situation reveals. Doing so increases the likelihood you'll be able to cope effectively with a stressful situation.</p> <h2>When to seek professional help</h2> <h4>It's best to talk to a health care professional when:</h4> <ul> <li>You find it difficult to function in your daily life.</li> <li>You no longer participate in activities you once enjoyed.</li> <li>You find it difficult to get out of bed.</li> </ul> <h2>Treatment for anxiety and depression</h2> <p>Medications and psychotherapy are effective for most people with depression and anxiety. Your primary care provider or psychiatrist can prescribe medications to relieve symptoms. Many people benefit from outpatient psychotherapy, like cognitive behavioral therapy or dialectical behavioral therapy.</p> <p>Additional treatment can include changing your exercise or eating habits, using social supports, getting enough sleep, changing your responses to stress, avoiding alcohol and recreational drugs, and joining a support group.</p> <p>If you have severe depression or anxiety, you may need to use crisis resources, like contacting a crisis hotline, going to the nearest emergency department for a mental health evaluation or participating in an inpatient or outpatient treatment program until your symptoms improve.</p> <h2>Why it's important to address your mental health</h2> <p>It's important for people to address their mental health to live lives that are fulfilling. Acknowledging and treating your mental health helps create resilience. It also teaches you to better cope. Then when a similar situation occurs, you are equipped to handle it.</p> <p>Stressful situations are going to happen. How you react can determine how these situations will affect you. Many resources are available regarding anxiety, depression and stress. Talk to your health care team if you have concerns about your mental health.</p> <p><strong>Call or text <a href="tel:988">988</a> for the 988 Suicide and Crisis Lifeline.</strong></p> <p><em><a href="/providers/jolene-hanson-licsw" target="_self" title="Opens in same window.">Jolene Hanson</a> is a social worker in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in<a href="/locations/mankato" target="_self" title="Opens in same window."> Mankato</a>, Minnesota.</em></p><p>Children ages six through adult:</p> <ul> <li>Adjustment disorders</li> <li>Anxiety disorders</li> <li>Obsessive-compulsive disorders</li> <li>Phobias</li> <li>Posttraumatic stress disorder</li> <li>Trauma-related disorders</li> </ul>L.I.C.S.W.<p>I have been practicing in the mental health field for over 15 years. My work is a collaborative approach with the patient to determine goals for treatment and ways to achieve these goals. I am passionate about my practice and continue to strive for the best patient care possible through on-going education, attentive listening and empathetic communication.</p> <p>In my free time, I enjoy being outdoors with my family along with running and playing volleyball.</p><p><strong>Education</strong></p> <ul> <li>Master’s degree, Social Work, Minnesota State University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Clinical Social Work, Mayo Clinic Health System</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Certified in Cognitive Processing Therapy</li> <li>Certified in Trauma-focused Cognitive Behavioral Therapy</li> <li>Trained in Eye Movement Desensitization and Reprocessing (EMDR)</li> <li>License Independent Clinical Social Worker, State of Minnesota</li> </ul> <p><strong>Membership</strong></p> <ul> <li>EMDR International Association </li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor of Social Work, Mayo Clinic College of Medicine and Science</li> </ul>Hanson<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jolene-hanson-licsw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7483CB6D0C345431B3BDB2662F609078" alt="Jolene Hanson LICSW" width="280" height="280" DisableNVelocity="true" />Jolene<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15448835Jolene Hanson, L.I.C.S.W.1<img src="/-/media/national-files/images/hometown-health/2022/looking-at-window-mild-expression.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5ED2ED1B955325C99A90F7022F556716" alt="Looking out a window with a mild expression" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.AnxietyFeelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. Symptoms may start during childhood or the teen years and continue into adulthood. We have the experts who can help diagnose and treat anxiety concerns.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Suicide PreventionSuicide is a major concern in the U.S. According to the Centers for Disease Control and Prevention, suicide was among the top nine leading causes of death for people ages 10–64 and the second leading cause of death for people ages 10–14 and 25–34. The positive news is that with the right information and willingness to reach out to someone in need, we all can help prevent suicide.<br /><br /><strong>If you are having suicidal thoughts, call the 988 Suicide and Crisis Lifeline at <a href="tel:988">988</a>, or chat at <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://988lifeline.org/" target="_blank" title="Opens in a new window.">988lifeline.org</a>.</strong>Dawn Haller7/16/2019<p>Botox is a great treatment for some, not all, <span style="color: #333333;">facial wrinkles</span>. Learn about other treatment options that can help restore a more youthful appearance.</p>Is Botox the fix for all facial wrinkles?<p>It seems that everywhere you look, clinics and spas are offering <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/botox/about/pac-20384658" target="_blank" title="Opens in a new window.">Botox injections</a> to eliminate facial wrinkles. However, it is important to understand what Botox can and, more importantly, cannot do. If you were a carpenter with only a hammer in your tool belt, then everything would look like a nail. The same is true for Botox. Just because a clinic or spa offers Botox injections does not mean it is right treatment for all of your facial wrinkles.</p> <h2>There are two different types of facial wrinkles — dynamic and static — and each should be treated differently:</h2> <h3>Dynamic wrinkles</h3> <p>Dynamic wrinkles are caused by muscle movement, such as those when you smile, laugh or squint. Common dynamic wrinkles include crow’s feet around your eyes and lines on your forehead. Botox uses various forms of botulinum toxin to temporarily paralyze or relax muscle activity and is a good option for dynamic wrinkles. It can smooth out wrinkles and restore a more youthful appearance.</p> <h3>Static wrinkles</h3> <p>Static wrinkles are caused by a loss of elasticity and collagen in your skin, or damage caused by the sun or smoking. Your skin becomes thinner and drier, and the silhouette of your face changes with age due to volume loss. Some providers may recommend Botox for static wrinkles, but fillers are much more effective. Fillers lift the skin, smooth out lines and wrinkles, restore volume loss and give you a fresher appearance. Common fillers including hyaluronic acid (Juvederm) are particularly suited for fine lines and wrinkles around your mouth. For many people, a combination of Botox and fillers will produce the best results.</p> <p>Botox and fillers must be used only under a doctor's care. It's important that injections be placed precisely in order to avoid side effects. If you are considering these treatments to <a href="/hometown-health/speaking-of-health/what-can-i-do-to-look-refreshed" target="_self" title="Opens in same window.">improve your appearance</a>, ask for a referral from your primary care doctor or look for a doctor who has experience in administering Botox and filler treatments. A skilled and properly certified doctor will review your goals and help you determine which options best suit your needs and health.</p> <p>Plastic surgeons specialize in a wide variety of treatments to help patients look, feel, and function better. Read <a href="/hometown-health/speaking-of-health/what-is-plastic-surgery" target="_self" title="Opens in same window.">"What is plastic surgery?"</a> to learn more about how they can work closely with you to help you achieve your goals.</p> <p>Laser skin resurfacing can renew your skin’s appearance and texture with minimal downtime.</p> <p><em><a href="/providers/yvonne-pierpont-md" target="_self" title="Opens in same window">Yvonne Pierpont, M.D.</a>, is a plastic surgeon in <a href="/services-and-treatments/plastic-and-reconstructive-surgery" target="_self" title="Opens in same window">Plastic & Reconstructive Surgery</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Arm lifts (brachioplasty)</li> <li>Body contouring</li> <li>Body lifts</li> <li>Breast augmentation</li> <li>Breast cancer</li> <li>Breast reduction</li> <li>Eyelid lift or eyelid surgery (blepharoplasty)</li> <li>Mastectomy </li> <li>Oculoplastics</li> <li>Skin cancer and reconstruction</li> <li>Skin removal surgery</li> <li>Thigh lifts</li> <li>Tummy tucks (abdominoplasty)</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Maryland School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Plastic Surgery, University of South Florida</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Facial Plastic and Breast and Body Surgery, Clevens Face and Body Specialists</li> <li>Research, University of South Florida</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Plastic Surgery </li> </ul> <p><strong>Membership</strong></p> <ul> <li>Wisconsin Medical Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Plastic Surgery, Mayo Clinic College of Medicine and Science</li> </ul>Pierpont<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/yvonne-pierpont-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=31D9B46DB7EACA47CE4C2E20F1944E0F" alt="Yvonne Pierpont, M.D." width="280" height="280" DisableNVelocity="true" />Yvonne<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20840870Yvonne Pierpont, M.D.1{3D1714E2-ECE8-4D0A-98A0-A4318C6DA2C3}<img src="/-/media/national-files/images/hometown-health/2019/womans-face-after-botox.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B06A5C9EEDE97FF9815F8710AE43EF1F" alt="Woman's face before and after Botox" width="660" height="370" DisableNVelocity="true" />Plastic and Reconstructive SurgeryPlastic and reconstructive surgery provides services that not only include cosmetic or aesthetic surgery, but also surgical repair of congenital deformities, laser surgery, postsurgical reconstruction, such as breast, head and neck defects, and microsurgery.Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Dawn Haller8/23/2019<p>Urge incontinence — the loss of bladder control — is a sudden, intense urge to urinate followed by an involuntary loss of urine. Treatment options range from conservative to more invasive.</p>What is urge incontinence, and how is it treated?<p>There are many different types of urinary incontinence — the loss of bladder control. One of the most common types is urge incontinence, which is characterized by a sudden, intense urge to urinate followed by an involuntary loss of urine. You may need to urinate often, including throughout the night.</p> <p><a href="/hometown-health/speaking-of-health/is-urine-incontinence-normal-for-women" target="_self" title="Opens in same window.">Urinary incontinence is more common among women</a> with approximately 17% of women and 3% to 11% of men experiencing urge incontinence at some point in their lives. Fortunately, there are many different treatment options for urge continence ranging from conservative to more invasive.</p> <h2>Conservative ways to treat urinary incontinence include:</h2> <ul> <li><strong>Dietary changes</strong><br /> Try to eliminate or cut back on how much caffeine you consume, such as in coffee and tea. In addition, limit the amount of carbonated drinks and acidic foods, such as oranges and pineapples, in your diet. Caffeine prompts your body to get rid of fluids, which causes you to need to urinate. Also, the acids in carbonated drinks and some foods can irritate your bladder and cause you to go more often. </li> <li><strong>Manage constipation</strong><br /> For some people, urinary incontinence is a symptom of constipation. Your rectum is located near your bladder and shares many of the same nerves. Hard, compacted stool in your rectum can cause these nerves to be overactive and increase urinary frequency.</li> <li><strong>Physical therapy</strong><br /> A therapist can explain different exercises to do to strengthen the muscles that help control urination. Also known as Kegels, these exercises are especially effective for stress incontinence but  also may help urge incontinence.</li> </ul> <h2>There are two primary categories of medications used to treat urge incontinence, including:</h2> <ul> <li><strong>Anticholinergics</strong><br /> These medications help relax your bladder, and can be helpful for urge incontinence and overactive bladder. There are a few side effects to be aware of, including dry mouth and eyes, constipation and difficulty completely emptying your bladder.</li> <li><strong>Beta 3 agonist</strong><br /> This category of medications relaxes the bladder muscle and can increase the amount of urine your bladder can hold. It also may increase the amount you are able to urinate at one time instead of small amounts more frequently. This is a newer category of medications, and your insurance provider may require that you try other conservative or medication options first.</li> </ul> <p>Your health care provider will help you determine which is right for you and your condition.</p> <h2>If you have had little luck with other incontinence interventions, you may need to consider these interventional therapies:</h2> <ul> <li><strong>Botox</strong><br /> <a href="/hometown-health/speaking-of-health/how-do-bladder-botox-injections-work" target="_self" title="Opens in same window.">Injections of Botox into the bladder muscle</a> may benefit you if you have an overactive bladder. Botox generally is prescribed only if medications or conservative treatments haven't been successful.</li> <li><strong>InterStim therapy</strong><br /> With this therapy, a small device the size of a pacemaker is placed under the skin in your hip area. A lead wire is connected to the device and sends electrical impulses to the sacral nerves, which control bladder contraction and function.</li> <li><strong>Percutaneous tibial nerve stimulation (PTNS)</strong><br /> This therapy is designed to stimulate the nerves responsible for bladder control using the tibial nerve in your lower leg. During the procedure, a small, slim needle electrode is inserted near your tibial nerve and connected to a battery-powered stimulator. The impulses travel to the tibial nerve and then to the sacral nerve, which controls bladder control and function.</li> </ul> <h4>Watch this video to learn more about urinary incontinence treatments including sacral neuromodulation therapy:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/HNIMJx5I-Ys" title="Urinary incontinence" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p><strong>Read more helpful <a href="/hometown-health/speaking-of-health/6-helpful-tips-for-managing-urinary-retention-and-incontinence" target="_self" title="Opens in same window.">tips and lifestyle changes that can help you manage urinary retention and incontinence</a>.</strong></p><ul> <li>Benign prostatic hyperplasia (BPH)</li> <li>Continence</li> <li>Low testosterone</li> <li>Overactive bladder</li> </ul>P.A.-C.<p>I enjoy developing personal and trusting relationships with my patients and their families.</p> <p>In my free time, I like to spend time with my family.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Health Sciences, Mountain State University</li> <li>Master's degree, Physician Assistant Studies, Mountain State University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>National Commission on Certification of Physician Assistants</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Physician Assistants</li> <li>Urological Association of Physician Assistants</li> </ul>Johnston<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/susan-johnston-pac.JPG?h=280&iar=0&w=280&sc_lang=en&hash=290155B0686C2925938BF2179D5CC301" alt="Susan Johnston, P.A.-C." width="280" height="280" DisableNVelocity="true" />Susan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20941919Susan Johnston, P.A.-C.1{83EB2AA2-1436-4DDC-B7BB-51F8E6A87FC9}|{BFAFB863-D571-4781-ADD9-1398B77B549E}<img src="/-/media/national-files/images/hometown-health/2019/illustrated-woman-with-hands-over-pelvic.jpg?h=370&iar=0&w=660&sc_lang=en&hash=909E08CF6D71A81698C7F17FA1A6A9D4" alt="Illustrated woman with hands over pelvic area" width="660" height="370" DisableNVelocity="true" />Urinary IncontinenceThe loss of bladder control is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that's so sudden and strong you don't get to a toilet in time. For most people, simple lifestyle changes or medical treatment can ease discomfort or stop urinary incontinence.Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Dawn Haller5/13/2024Whether you're an athlete, have a physically demanding job or just want to remain as active as possible, learn how a sports medicine professional can help you reach your goals.Could you benefit from a sports medicine consult? Check out these top 5 FAQ<p>Are you curious about whether seeing a sports medicine professional is right for you? These top five questions about sports medicine can help you with the answer.</p> <h2>1. Do you need to be an athlete to benefit from a sports medicine evaluation or clinic appointment?</h2> <p>Even if you don't consider yourself athletic but want to increase your physical activity or stay strong for your job, a sports medicine professional can be a great resource. They can tailor a plan to maximize your workout routine based on your interests and goals and help you reduce your risk of injury, whether you're on the field, at the gym or on a work site.</p> <h2>2. What makes a primary care sports medicine physician qualified to treat people?</h2> <p>These professionals have advanced training in the science of sports medicine. Sports medicine professionals can help maximize your body's systems and reduce pain so you can avoid time away from sports or other physical activities due to injuries.</p> <h3>The training these professionals undergo is extensive and includes:</h3> <ul> <li>Undergraduate training</li> <li>Four years of medical school</li> <li>Three to four years of residency training</li> <li>One to two years of fellowship training</li> </ul> <p>In addition, primary care sports medicine physicians are required to pass a certification examination in sports medicine to obtain a Certificate of Added Qualification in Sports Medicine.</p> <p>Sports medicine physicians are expected to complete continued medical education and recertification every 10 years to distinguish them from other physicians without this specialized training.</p> <h2>3. What's the difference between a primary care sports medicine physician and an orthopedic sports medicine surgeon?</h2> <p>An orthopedic sports medicine surgeon is trained in those areas, as well as surgical treatment of those conditions. Together, they create a comprehensive team to improve performance, prevent injury, guide rehabilitation, and relieve joint and muscle pain.</p> <h2>4. What types of conditions are treated by a sports medicine physician?</h2> <h3>Common musculoskeletal and orthopedic conditions that sports medicine physicians treat include acute injuries, such as:</h3> <ul> <li>Activity-specific injuries</li> <li>Fractures</li> <li>Low back or neck sprains</li> <li><a href="/hometown-health/speaking-of-health/how-to-keep-moving-with-arthritis" target="_self" title="Opens in same window.">Osteoarthritis</a></li> <li>Overuse injuries</li> <li>Shoulder, elbow, wrist, hand, hip, knee, foot, or ankle sprains</li> <li>Strains</li> </ul> <h3>Because of additional training, primary care sports medicine physicians, and some orthopedic sports medicine physicians and surgeons also:</h3> <ul> <li>Counsel athletes on decisions to return to play</li> <li>Provide training for Injury prevention</li> <li>Treat sports-related <a href="/hometown-health/speaking-of-health/the-real-impact-of-a-concussion" target="_self" title="Opens in same window.">concussions</a></li> </ul> <h2>5. What sports or team play activities does a sports medicine physician support?</h2> <h3>Most primary care sports medicine physicians and orthopedic sports medicine surgeons serve as team physicians for local or national sports teams and can provide:</h3> <ul> <li>Care of sports-related medical needs</li> <li>Coordination of care with other sports medicine team members, including athletic trainers, physical therapists and surgical specialists</li> <li>Injury assessment</li> <li>Management or prevention</li> <li>Preparticipation physicals</li> </ul> <p>Athletes and nonathletes alike benefit from the care of sports medicine professionals. These experts advise sports professionals, weekend warriors, anyone who wants to begin or return to being active, and people whose work involves high physical demands, such as strength, endurance, flexibility and coordination. They all require the same expert care to function as fully and safely as possible.</p> <h2>Next steps:</h2> <ul> <li>Learn more about <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">Sports Medicine services and treatments</a>.</li> <li>Read how a <a href="/hometown-health" target="_self" title="Opens in same window.">basketball stand-out benefited from specialized care</a>e. </li> <li>Read more about <a href="/hometown-health/speaking-of-health/sprained-your-ankle-now-what" target="_self" title="Opens in same window.">ankle</a>, <a href="/hometown-health/speaking-of-health/what-can-go-wrong-with-upper-arms" target="_self" title="Opens in same window.">arm</a> and <a href="/hometown-health/speaking-of-health/why-does-my-shoulder-ache" target="_self" title="Opens in same window.">shoulder</a> strains and sprains.</li> <li>Watch a video on what to expect at your sports medicine consultation:<br /> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/JBvCXbmmRUw" title="What to expect during your sports medicine consultation" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> </li> </ul> <p><a href="/providers/robert-freed-do" target="_self" title="Opens in same window."><em>Robert Freed, D.O.</em></a><em>, is an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedics</a> and <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">sports medicine</a> specialist in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p> <ul> <li>Anatomic and reverse shoulder replacements</li> <li>Arthroscopic rotator cuff repair</li> <li>Arthroscopy of the shoulder, knee and hip</li> <li>Ligament reconstruction</li> <li>Pediatric and adolescent orthopedic surgery</li> <li>Robotic-assisted joint replacements</li> <li>Sports medicine</li> <li>Total and partial knee replacements</li> <li>Upper and lower extremity fracture care</li> </ul> D.O.<p>Along with working in Orthopedics and Sports Medicine, I am also the team physician for the Bethany Lutheran Vikings and the Mankato MoonDogs.</p><p><strong>Education</strong></p> <ul> <li>Des Moines University College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, Michigan State University McLaren Macomb Hospital</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Orthopaedic Sports Medicine and Arthroscopy, University of Cincinnati Wellington Orthopaedic and Sports Medicine</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Osteopathic Board of Orthopedic Surgery</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Orthopaedic Society for Sports Medicine</li> <li>Fellow, American Academy of Orthopaedic Surgeons</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Orthopedics, Mayo Clinic College of Medicine and Science</li> </ul>Freed<img src="/-/media/shared-files/images/medical-professionals/full/mankato/robert-freed-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=393D5A2B52ADF63C7C4F96CD4EBA408D" alt="Robert Freed, D.O." width="280" height="280" DisableNVelocity="true" /> {C5F34281-7EB2-4DFB-89BA-AA05BF035A3F}Robert <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16304489Robert Freed, D.O. 1<img src="/-/media/national-files/images/hometown-health/2024/player-bouncing-tennis-ball.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C55E48779EB1C9DD8D88661CCE198971" alt="Player bouncing tennis ball" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller8/17/2023Kindness is more than behavior — it's a quality of being. Kindness often is simple and free. Try a few easy ways to boost your kindness and enjoy the benefits of a longer, healthier life.The art of kindness<p>Kindness is more than behavior. The art of kindness involves harboring a spirit of helpfulness, being generous and considerate, and doing so without expecting anything in return.</p> <p>Rather than viewing it exclusively as an action, think of kindness as a quality of being you can cultivate. Giving kindness often is simple, free and health-enhancing.</p> <h2>Good for the body</h2> <p>Kindness has been shown to increase self-esteem, empathy and compassion, and improve mood. It can decrease blood pressure and cortisol, a hormone directly correlated with stress levels. People who give of themselves in a balanced way also tend to be healthier and live longer.</p> <p>Kindness can increase your sense of connectivity with others, decrease loneliness, combat low mood and improve relationships. It also can be contagious, encouraging others to join in with their own generous deeds.</p> <p>Looking for ways to show kindness can give you something to focus on, especially if you are anxious or stressed in certain social situations.</p> <h2>Good for the mind</h2> <p>Physiologically, kindness can positively change your brain by boosting levels of serotonin and dopamine. These neurotransmitters produce feelings of satisfaction and well-being, and cause the pleasure and reward centers in your brain to light up. Endorphins, your body's natural painkiller, also may be released when you show kindness.</p> <p><a href="/hometown-health/speaking-of-health/how-to-create-happiness" target="_self" title="Opens in same window.">Discover ways you can create happiness.</a></p> <h2>Be kind to yourself</h2> <p>When sharing kindness, it's not just how you treat other people — it's also about how you extend those same behaviors and intentions to yourself. I believe you can be kinder in your own self-talk and <a href="/wellness/gratitude" target="_self" title="Opens in same window.">practice gratitude</a>.</p> <p>People are good at verbally beating themselves up which does not work as a pep talk. Rather, negativity often causes you to unravel and may even create a vicious cycle of regularly getting down on yourself. You wouldn't talk to your neighbor the way you sometimes speak to yourself. This is what I call the good neighbor policy, which can be helpful. If you wouldn't say it to your good neighbor, don't say it about yourself.</p> <h2>Take action</h2> <p>Start your day with this question: "How am I going to practice kindness today?" For a homework assignment, I have invited some patients to pay attention and periodically document their evidence of kindness to others and especially to themselves during the day. This positive focus is like planting positive seeds in your mind garden. Where focus goes, energy flows.</p> <p>A young client recently asked if I wanted them to get on the ARK. When I asked what that meant, the client replied, "Acts of random kindness." How about you? Are you willing to get on the ARK?</p> <p>Consider joining Mayo Clinic Health System's <a href="/wellness/kindness" target="_self" title="Opens in same window.">Kickstart Kindness program</a> to start your kindness journey. The program offers many ideas on how to extend kindness to yourself, your community, environment, home, family, co-workers and others.</p> <p> Finally, I'd like to leave you with this quote by the Dalai Lama: "Be kind whenever possible. It is always possible."</p> <p><em><a href="/providers/steve-siegle-lpc" target="_self" title="Opens in same window.">Steve Siegle</a> is a licensed professional counselor in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/menomonie" target="_self" title="Opens in same window.">Menomonie</a>, Wisconsin.</em></p>Psy.D., L.P.C.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Concordia College</li> <li>Master's degree, Counseling and Psychological Services, St. Mary's College</li> <li>Doctor of Psychology, Southern California University for Professional Studies</li> </ul> <p><strong>Internship</strong></p> <ul> <li>St. Gabriel's Hospital</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Licensed Professional Counselor</li> <li>Practitioner of Neuro-Linguistic Programming </li> </ul>Siegle<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/steve-siegle-lpc.JPG?h=280&iar=0&w=280&sc_lang=en&hash=B9296D266CD453E1F406298AE0ED0BFF" alt="Steve Siegle, L.P.C." width="280" height="280" DisableNVelocity="true" />Steve<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14477467Steve Siegle, Psy.D., L.P.C.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2020/painting-red-heart-on-window.jpg?h=370&iar=0&w=660&sc_lang=en&hash=335B615D00A18C290B660A0B34348A44" alt="Painting red heart on window" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller5/3/2022<p>Botox injections are not just for facial wrinkles. They also can be used for ongoing bladder continence issues. Find out how and if it hurts to get them.</p>How do bladder Botox injections work?<p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/botox/about/pac-20384658" target="_blank" title="Opens in a new window.">Botox injections</a> are not just for wrinkles on your face. They also can be used to help if you have ongoing bladder continence issues. Botox is one option to treat urge incontinence or overactive bladder in people who have not had success with other treatment options.</p> <p>Urinary incontinence is common and can impair your social, physical or mental well-being. Approximately 17% of women and 3% to 11% of men suffer from urge incontinence at some point in their lives. </p> <p>Urge incontinence is the unintentional loss of urine caused by your bladder contracting.</p> <h2>With an overactive bladder you may:</h2> <ul> <li>Feel a sudden urge to urinate that is difficult to control.</li> <li>Experience incontinence, which is the involuntary loss of urine, as soon as you feel the need to urinate.</li> <li>Urinate frequently — up to eight or more times per day.</li> <li>Wake up two or more times in the night to urinate.</li> </ul> <p>It's important to understand that urge incontinence and overactive bladder are not caused by physical activity or movement, such as when you cough, exercise or sneeze. That type of incontinence would be classified as stress incontinence. It's possible to have stress and urge incontinence at the same time.</p> <a href="/-/media/national-files/documents/hometown-health/2019/botox-uses.pdf?sc_lang=en&hash=BEC2214D996E5BDFABC54C3846DF8536" target="_blank" title="Opens in a new window."><img alt="Download a PDF about Botox's many uses." src="/-/media/national-files/images/hometown-health/2019/download-a-pdf-about-botoxs-many-uses.jpg?h=135&w=135&sc_lang=en&hash=9532CAA7B1C57A3F8EB5461B2D5E8076" style="height: 135px; width: 135px; float: right; margin-bottom: 5px; margin-left: 5px;" class="img-responsive" /></a> <p>A urologist can inject Botox into your bladder to treat urge incontinence or overactive bladder. This helps the muscles relax, which will give you more time to get to the bathroom when you feel the need to urinate. The injections are done in the clinic, and most patients tolerate the injections well. They do not "hurt" as you may expect, but you may have some short-term discomfort. Many patients have compared it to a period cramp.</p> <p>The good news is that most people get symptom relief quickly, in as short as a few days. The treatment results last about six months, and you can have additional injections. One possible side effect is urine retention, and it is not recommended for males with a risk or history of enlarged prostate.</p> <p>While incontinence is more common as we age, it is not a normal part of aging. Unfortunately, too many people wait too long to talk to their health care team about their symptoms. There are many different treatment options available, which can have a positive impact on the quality of your life. Don't hesitate to discuss them with your health care provider.</p> <p>When considering Botox injections, ask for a referral from your primary care provider or search for a health care professional who is experienced with these types of treatments. Injections need to be precisely placed to avoid side effects.</p> <h2>Learn more about Botox:</h2> <ul> <li>Read how <a href="/hometown-health/speaking-of-health/botox-as-a-treatment-for-chronic-migraines" target="_self" title="Opens in same window.">Botox can be used as a treatment for chronic migraines</a> and how <a href="/services-and-treatments/neurology" target="_self" title="Opens in same window.">Botox changed the life of one woman by decreasing her migraines</a>.</li> <li>Read about <a href="/hometown-health/speaking-of-health/is-botox-the-fix-for-all-facial-wrinkles" target="_self" title="Opens in same window.">what type of wrinkles Botox can and cannot fix</a>.</li> <li>Download an infographic that shows <a href="/-/media/national-files/documents/hometown-health/2019/botox-uses.pdf?sc_lang=en&hash=BEC2214D996E5BDFABC54C3846DF8536" target="_blank" title="Opens in a new window.">range of medical conditions currently treated by Botox</a>.</li> </ul> <p><em><a href="/providers/susan-johnston-pac" target="_self" title="Opens in same window.">Susan Johnston</a> is a physician assistant in <a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Benign prostatic hyperplasia (BPH)</li> <li>Continence</li> <li>Low testosterone</li> <li>Overactive bladder</li> </ul>P.A.-C.<p>I enjoy developing personal and trusting relationships with my patients and their families.</p> <p>In my free time, I like to spend time with my family.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Health Sciences, Mountain State University</li> <li>Master's degree, Physician Assistant Studies, Mountain State University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>National Commission on Certification of Physician Assistants</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Physician Assistants</li> <li>Urological Association of Physician Assistants</li> </ul>Johnston<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/susan-johnston-pac.JPG?h=280&iar=0&w=280&sc_lang=en&hash=290155B0686C2925938BF2179D5CC301" alt="Susan Johnston, P.A.-C." width="280" height="280" DisableNVelocity="true" />Susan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20941919Susan Johnston, P.A.-C.1{83EB2AA2-1436-4DDC-B7BB-51F8E6A87FC9}|{BFAFB863-D571-4781-ADD9-1398B77B549E}<img src="/-/media/national-files/images/hometown-health/2022/brimmed-hat-sunny-day.jpg?h=370&iar=0&w=660&sc_lang=en&hash=679DDA60D457255BCE9D44C11C713F73" alt="Wearing brimmed hat on sunny day" width="660" height="370" DisableNVelocity="true" />Urinary IncontinenceThe loss of bladder control is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that's so sudden and strong you don't get to a toilet in time. For most people, simple lifestyle changes or medical treatment can ease discomfort or stop urinary incontinence.Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Micah Dorfner2/22/2019<p>Like most moms, Samantha Kaul doesn’t have time for injuries. But last winter, she slipped on a patch of ice, resulting in breaking her wrist for the second time.</p>Busy mom doesn't let broken wrist — or winter — win<p><img height="440" alt="samantha-kaul-standing-with-moondogs-mascot-muttnik" width="660" src="/-/media/national-files/images/hometown-health/2019/sam-and-muttnik.jpg?h=440&w=660&sc_lang=en&hash=7F353407645776DF26064F48B9B32FAE" class="img-responsive" style="height: 440px; width: 660px;" /></p> <p>Like most moms, Samantha Kaul doesn’t have time for injuries. But last winter, she slipped on a patch of ice, resulting in breaking her wrist for the second time.</p> <p>The injury, which left her unable to complete even the most basic daily tasks, such as driving her kids to activities, making dinner and typing, happened as these things often do — during a routine, normal day.</p> <p>Samantha, a realtor, was checking on a property when her foot found a patch of ice on a sidewalk covered by a fresh layer of snow. She fell, landing on her wrist, leaving her right side immobile. Fortunately, her co-worker was with her and helped get Samantha to the <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">Emergency Department</a> at <a href="/locations/mankato" title="Opens in same window">Mayo Clinic Health System in Mankato</a>.</p> <p>“This certainly wasn’t on my agenda for the day,” says Samantha, who has a fifth-grade daughter and a son in high school. “The whole thing felt like I was in a scene from a medical television show.”</p> <p>Because she had broken her wrist before, her injury was severe. Although the <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">Orthopedics</a> and <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">Sports Medicine</a> team was able to avoid surgery, they reminded Samantha to be extra careful as any future injury could result in permanent damage to her wrist.</p> <p> “Everybody was amazing,” says Samantha. “As horrible as it was, I have a lot of respect for everyone who assisted me, including the poor woman in the Emergency Department who helped me take my coat off even though I couldn’t move my arm. I don’t know how she did it.”</p> <p><img alt="samantha-kaul-with-daughter-and-son" src="/-/media/national-files/images/hometown-health/2019/samantha-with-kids.jpg?h=225&w=300&sc_lang=en&hash=DC79E39754599E23AAE10EE5E678AD5C" style="width: 300px; height: 225px; margin-right: 10px; margin-left: 10px; float: left;" class="img-responsive" />Just five hours after arriving at the Emergency Department, she was able to help pick up her daughter from dance class. “They put me back together and sent me on my way,” laughs Samantha.</p> <p>Throughout her ordeal, Samantha has maintained a positive outlook. During her recovery, she even took the advice from the Orthopedics team to heart, proceeding with extra caution. “I like to be challenged. If I put my mind to something, I like to think I can take it on. But, I admit, ice is a concern of mine now.”</p> <p><span>In fact, the Orthopedics and Sports Medicine team says they see a spike in winter weather-related injuries with wrist injuries being among the most common.</span></p> <p>“We see a lot of these of injuries, especially after snowfalls, when ice patches are harder to see,” says <a href="/providers/jacqueline-corona-md" target="_self" title="Opens in same window.">Jacqueline Corona, M.D.</a>, an orthopedic surgeon and hand surgery specialist at Mayo Clinic Health System in Mankato. “This year has been especially dangerous. I often advise patients to take their time walking, assure they have proper foot wear and use assistive devices as needed. I keep removable ice cleats in my car to wear in poorly shoveled and salted areas. Fall prevention is key.”</p> <p>Samantha, who is a huge baseball fan, is now doing well. By summer, she was back to driving her daughter to dance class, chopping vegetables for dinner, typing with both hands and spending time at the ballpark. In fact, last summer, Samantha threw out the first pitch at the Mankato MoonDogs baseball game and was honored as a Mayo Clinic Health System extraordinary patient.</p> <p>“Our goal is to prevent injuries from happening in the first place,” says Dr. Corona, “but when they do happen, we want to help get people back to their active lives as soon and as safely as possible.”</p><img src="/-/media/national-files/images/hometown-health/2019/sam-and-muttnik.jpg?h=440&iar=0&w=660&sc_lang=en&hash=CFD08CB0B49BE20AA57A5857BFFD00D9" alt="Samantha Kaul standing with Muttnik, Moondogs mascot" width="660" height="440" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller2/1/2019<p>Teenagers with acne may develop low self-esteem and mental health issues. Follow these five tips to help your teenager manage acne.</p>5 tips to help your teen manage acne<img height="370" alt="Dad and son arm in arm" width="660" src="/-/media/national-files/images/hometown-health/2019/dad-and-son-arm-in-arm.jpg?sc_lang=en&hash=FC516D530E424553FB8622D99A003D96" class="img-responsive" /> <p>Acne can affect more than physical appearance. Teenagers with acne may develop low self-esteem and mental health issues. Some teens are even bullied by classmates and peers for having acne. Paying careful attention to your teen’s feelings and practicing proper acne care can reduce distress.</p> <h2>Follow these five tips to help your teenager manage acne:</h2> <h3>1. Look for signs of mental health issues. </h3> <p>Teens with acne may develop low self-esteem, <a href="/hometown-health/speaking-of-health/could-you-be-depressed" target="_self" title="Opens in same window.">depression</a> and <a href="/hometown-health/speaking-of-health/tips-to-help-ease-anxiety" target="_self" title="Opens in same window.">anxiety</a>. </p> <h4>Some signs to watch for include:</h4> <ul> <li>Feelings of sadness that last two weeks or longer</li> <li>Loss of interest in activities your teen once enjoyed</li> <li>Avoidance of social activities</li> <li>Sleeping too little or too much</li> <li>Poor performance or attendance at school</li> <li>Feeling anxious, irritable or worthless</li> </ul> <h3>2. Take your teen’s feelings about acne seriously.</h3> <p>Even acne that is not severe can affect how your teen feels about his or her appearance.</p> <h4>3. Treat acne early.</h4> <p>Early treatment of acne can help prevent scarring and control future breakouts as your teen ages into adulthood. This also could prevent the need for a stronger acne medication with more side effects. Studies have shown that when acne clears, self-esteem tends to rise. Learn more about <a href="/hometown-health/speaking-of-health/tips-for-managing-teen-acne" target="_self" title="Opens in same window.">managing acne</a> for teenagers.</p> <h4>4. Manage and reduce stress.</h4> <p>Stress can cause acne to flare and lead to breakouts. Finding healthy ways to manage stress and reducing stressful situations can prevent acne. Read our blogs for more information about <a rel="noopener noreferrer" href="https://mayoclinichealthsystem.org/hometown-health?topic=Stress%20Management" target="_blank" title="Opens in a new window.">stress management</a>.</p> <h4>5. Make an appointment with a dermatologist</h4> <p>If your teen has not seen relief with over-the-counter products, or is shy or embarrassed about having acne, he or she should see a <a href="/services-and-treatments/dermatology" target="_self" title="Opens in same window.">dermatologist</a> for next steps.</p> <p>Acne can take a toll on a teenager’s self-esteem. By paying attention to your teen’s feelings and taking steps to properly manage acne, you can help your teen manage acne.</p> <em><a href="/providers/manjunatha-md" target="_self" title="Opens in same window.">Dr. Manjunatha</a> is a <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">pediatrician</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em> <hr /> <p><em>Information adapted from the American Academy of Dermatology</em></p><ul> <li>Adolescent acne</li> <li>Allergy and asthma</li> <li>Anemia in children</li> <li>Anxiety</li> <li><span style="color: #202124; background-color: #ffffff;">Attention-deficit/hyperactivity disorder (</span>ADHD)</li> <li>Bedwetting issues</li> <li>Depression</li> <li>Lyme disease</li> <li>Migraine headache</li> <li>Newborn care</li> <li>Urinary and kidney problems</li> </ul>M.D.<p>I chose to work at Mayo Clinic Health System since it provides the highest quality of medical care in the Midwest.</p> <p>I look forward to helping create individualized care plans for my patients and their wellness goals. I manage the physical, mental and emotional well-being of children in every stage of development. I believe in developing a trusting relationship and always value parents’ input in childcare decision-making.</p> <p>In my spare time, I enjoy playing cricket and tennis, watching movies, listening to music and spending time with my wife and two sons.</p><p><strong>Education</strong></p> <ul> <li>Jawaharlal Nehru Medical College</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Pediatrics, Marshfield Clinic Health System</li> <li>Pediatrics, Royal College of Pediatrics and Child Health</li> <li>Pediatrics, Mysore Medical College and Research Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Pediatrics</li> <li>Neonatal Resuscitation Program</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Pediatrics, Mayo Clinic College of Medicine and Science</li> </ul>Manjunatha<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/fnu-manjunatha-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=DF32FB2C272DE3D15C5BB00CDBA7B053" alt="Fnu Manjunatha, M.D." width="280" height="280" DisableNVelocity="true" />Fnu<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20712260Fnu Manjunatha, M.D.1{61776FD2-05E8-47E9-AB55-EE465BD29A19}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}|{9B57996D-7C65-499B-8DB5-FBB37D1A5DD1}<img src="/-/media/national-files/images/hometown-health/2019/dad-and-son-arm-in-arm.jpg?h=370&iar=0&w=660&sc_lang=en&hash=657AB80530C3444E29CBF06AE76E07B4" alt="Dad and son arm in arm" width="660" height="370" DisableNVelocity="true" />Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Micah Dorfner3/28/2019<p>Spring is just around the corner, and with the warmer weather comes the desire to wear shorts and show off your legs. Every year at this time, we see an increase in visits for people who are finally fed up with their painful and unsightly varicose veins.</p>Get a leg up on summer with relief for varicose veins<p><img height="442" alt="woman-touching-varicose-veins-on-leg" width="660" src="/-/media/national-files/images/hometown-health/2019/varicose-veins-2.jpg?sc_lang=en&hash=4AD936C99996FEEEC1D2B36B18C9169B" class="img-responsive" /></p> <p>Spring is just around the corner, and with the warmer weather comes the desire to wear shorts and show off your legs. Every year at this time, we see an increase in visits for people who are finally fed up with their painful and unsightly <a rel="noopener noreferrer" href="https://mayoclinichealthsystem.org/locations/mankato/services-and-treatments/vascular-medicine/varicose-veins" target="_blank" title="Opens in new window.">varicose veins</a>.</p> <h4>MORE THAN A COSMETIC PROBLEM</h4> <p>Varicose veins are common and affect up to 50 percent of adults. When present, this condition affects more than just the appearance of the leg. These tortuous, abnormal veins often lead to painfully swollen, aching and tired legs that get worse with even a minimal amount of exercise or standing. At worst, they can be indicative of a progressive disease process called chronic venous insufficiency, which causes poor wound healing, ulcers and, in severe cases, can lead to amputation.</p> <h4>SYMPTOMS OF VARICOSE VEINS</h4> <p>Varicose veins form when internal valves break down and allow blood to flow in the wrong direction down the leg and pool within the veins. This causes the vein to stretch and dilate, leading to swelling, aching and pain.</p> <p>To make matters worse, veins often <span style="color: #333333;">can</span> bulge more and more to hold the increasing amount of blood, which results in even more persisting discomfort. Compression stockings may offer temporary relief by holding the veins in place. However, they’re not a permanent solution to fix the veins or stop the disease from progressing. <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/varicose-veins/expert-answers/spider-veins/faq-20058284" target="_blank" title="Opens in new window.">Spider veins</a>, a mild form of varicose veins, occur within the skin layer instead of under it as with varicose veins. Spider veins usually <span style="color: #333333;">are</span> harmless, though they sometimes <span style="color: #333333;">can</span> cause aching, burning or pain, especially when you've been standing for long periods.</p> <p>Fortunately, modern medicine has been active in the diagnosis and treatment of this common disorder. With a simple office visit and painless ultrasound, we’re able to diagnose your condition and offer multiple treatment options. With the latest minimally invasive techniques, we can treat the disease by closing the broken veins in place and literally turn off the faucet causing the abnormal filling.</p> <h4>TREATMENT FOR VARICOSE VEINS</h4> <p>Most treatments for varicose veins are conducted with local numbing medicine and one or two tiny needle pokes. Treatment options include closing the broken veins to halt abnormal blood flow, removal of bulging, painful veins through tiny punctures or pin-point injections to close the smallest veins in place. There is no cutting, sutures or long recovery. In many cases, a patient can drive themselves to and from the treatment, returning to work the next day.</p> <p>Ultimately, the initial step is to decide that you want to end this problem once and for all. If you’re suffering from bulging, unsightly veins, and have issues with leg pain, swelling, redness, restlessness, ulcers or wounds, make an appointment to see your health care provider today. Relief from your varicose veins is just a few easy steps away.</p> <p><em><a href="/providers/andrew-chow-md" target="_self" title="Opens in same window.">Andrew Chow, M.D.</a>, is a vascular interventional radiologists in<a href="/locations/mankato" target="_self" title="Opens in same window."> Mankato</a>, Minnesota.</em></p> <ul> <li>Interventional radiology</li> <li>Interventional vascular</li> </ul> M.D. <p>Outside of work, I enjoy soccer, skiing/snowboarding, photography and traveling.</p> <p><strong>Education</strong></p> <ul> <li>The Ohio State University College of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Internal Medicine, The Ohio State University Medical Center</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Diagnostic Radiology, The University of Texas Medical Branch at Galveston</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Vascular and Interventional Radiology, The University of Texas Medical Branch at Galveston</li> <li>Musculoskeletal Radiology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Memberships</strong> </p> <ul> <li>Society of Interventional Radiology</li> <li>Radiological Society of North America</li> <li>American College of Radiology</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Diagnostic Radiology, American Board of Radiology</li> </ul> Chow<img src="/-/media/shared-files/images/medical-professionals/full/mankato/andrew-chow-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=22BF4CD7072449EC0755522499566DCA" alt="Andrew Chow, M.D." width="280" height="280" DisableNVelocity="true" /> <ul> <li><a rel="noopener noreferrer" href="https://www.ncbi.nlm.nih.gov/pubmed/22901504" target="_blank" title="Opens in new window.">Microscopic and endoscopic anterior communicating artery complex anatomy</a>, October 2012.</li> <li><a rel="noopener noreferrer" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Multimodal+imaging+and+detection+approach+to+18F-FDG-directed+surgery%3A+a+single-institution+cumulative+retrospective+experience." target="_blank" title="Opens in new window.">Multimodal imaging and detection approach to 18F-FDG-directed surgery: a single-institution cumulative retrospective experience</a>, November 2011.</li> <li><a rel="noopener noreferrer" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Setting+up+a+microneurosurgical+skull+base+lab%3A+technical+and+operational+considerations." target="_blank" title="Opens in new window.">Setting up a microneurosurgical skull base lab: technical and operational considerations</a>, July 2011.</li> </ul> Andy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15262936Andrew Chow, M.D. 1<img src="/-/media/national-files/images/hometown-health/2019/varicose-veins-2.jpg?h=442&iar=0&w=660&sc_lang=en&hash=88978363E132F72A9D58055CAA8143A1" alt="Woman touching varicose veins on leg" width="660" height="442" DisableNVelocity="true" />SurgeryHaving surgery is a major event in your life. We know this and make every effort to keep you as comfortable as possible, focusing on you as an individual. Our surgeons and staff work as a coordinated team treating a wide variety of illnesses ranging from simple to complex. We offer comprehensive, advanced care and service to every patient.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Dawn Haller3/26/2019<p>The average American consumes 22 teaspoons — or 355 calories — of added sugar daily. <span style="color: #333333;">How much is too much, and where can you find hidden sugar?</span></p>Are you consuming too much sugar?<img height="370" alt="Sugar on a spoon" width="660" src="/-/media/national-files/images/hometown-health/2019/sugar-on-a-spoon.jpg?sc_lang=en&hash=FA88C9387ED2A9C1220122D293DDB5AC" class="img-responsive"> <p>Most Americans consume too much sugar. Only 200 calories, or 10 percent, of a daily intake of 2,000 calories should come from added sugars. According to the Food and Drug Administration (FDA), the average American consumes 22 teaspoons — or 355 calories — of added sugar every day. Consuming too much sugar sets the stage for several health issues, including:</p> <ul style="list-style-type: disc;"> <li>Increased fat in blood</li> <li>Poor nutrition</li> <li>Tooth decay</li> <li>Weight gain</li> </ul> <p><a href="/-/media/national-files/documents/hometown-health/2019/sugar-in-your-food.pdf?sc_lang=en&hash=2A7C2DE468531353E3E64893E1CBBCA4" target="_blank" title="Opens in a new window."><img alt="Download a PDF about sugar." src="/-/media/national-files/images/hometown-health/2019/download-a-pdf-about-sugar.jpg?h=185&w=185&sc_lang=en&hash=B783E1DF3950F60A9DB690B6AEED8B59" style="height: 185px; width: 185px; float: right; margin-bottom: 5px; margin-left: 5px;" class="img-responsive"></a>Some foods, such as fruits, milk and vegetables, contain natural sugar, which is OK to consume. What you should watch out for is processed sugars and sweeteners. These hidden sugars are in foods such as crackers, <a href="/hometown-health/speaking-of-health/rethink-your-drink-beware-of-hidden-sugar" target="_self" title="Opens in same window.">drinks</a>, pasta sauces and even pizza. When checking the ingredients list, look for the words “malt,” “syrup” and those ending in “-ose.” These added sugars go by many names, including:</p> <ul style="list-style-type: disc;"> <li>Agave nectar</li> <li>Cane sugar</li> <li>Corn syrup</li> <li>Evaporated cane juice</li> <li>Fructose</li> <li>Glucose</li> <li>Invert sugar</li> <li>Malt syrup</li> <li>Maltose</li> <li>Raw sugar</li> <li>Rice syrup</li> <li>Sucrose</li> </ul> <p>If you’re not sure about a certain food, be sure to check the nutrition label and ingredients list. Knowing what to look for will keep you from consuming too much sugar.</p><img src="/-/media/national-files/images/hometown-health/2019/sugar-on-a-spoon.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C4E9CCE8AF877D886107A2DDC1AEA07B" alt="Sugar on a spoon" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller3/21/2019Pregnancy is an exciting time in life, but it also is a time of big lifestyle changes. If you are thinking about starting a family, it's a good idea to consider how starting a family will impact your life and prepare for those changes.5 ways to prepare before starting a family<img height="370" alt="Young couple on a bed" width="660" src="/-/media/national-files/images/hometown-health/2019/young-couple-on-a-bed.jpg?sc_lang=en&hash=D4623048DD29D2C58A212FC0A6A3D9B2" class="img-responsive" /> <p>Pregnancy is an exciting time in life, but it also is a time of big lifestyle changes. If you are thinking about starting a family, it’s a good idea to consider the impact children will have on your life. Knowing what to prepare for, such as changes you need to make to your diet and how to deal with pregnancy while working, will help you better plan to have a baby.</p> <h4>Review these five ways to prepare for pregnancy:</h4> <h4>1. Nutrition</h4> <p>The foods you eat and beverages you drink will provide nutritional support to your baby. It is important to think about <a href="/hometown-health/speaking-of-health/thinking-about-getting-pregnant-5-things-to-think-about-first" target="_self" title="Opens in same window.">what you consume</a> while pregnant by following these tips:</p> <ul style="list-style-type: disc;"> <li>Begin taking <a rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-vitamins/art-20046945" target="_blank" title="Opens in a new window.">prenatal vitamins</a> even if you are not yet pregnant. Look for vitamins that are high in iron, vitamin D and contain 400 micrograms of folic acid. The neural tube develops into the brain and spinal cord of pregnancy — sometimes before you even know you are pregnant. Taking vitamins containing folic acid can help prevent neural tube defects.</li> <li>Eat a healthy diet that includes fruits, vegetables, whole grains, proteins and dairy in appropriate amounts. Limit sugar and fat intake.</li> <li>Limit alcohol when you are trying to become pregnant. Once you find out you are pregnant or suspect you are pregnant, stop drinking alcohol.</li> <li>Limit caffeine to less than 200 milligrams per day, the equivalent of about one or two 6- to 8- ounce cups.</li> </ul> <h4>2. Lifestyle changes</h4> <p>If you are trying to become pregnant, you likely will need to make lifestyle changes, such as:</p> <ul> <li>Aim for a healthy weight prior to pregnancy. Being underweight or overweight can present challenges during pregnancy.</li> <li>Stop your birth control. It may take a few weeks for your ovulation cycle to return to normal. Having at least one normal period before conceiving will help you estimate when you ovulate. If you are taking combination birth control pills, you can expect your period to return within 30 days of stopping. Fertility may take longer to achieve if you are on a long-term birth control method, such as the progestin injection. Fifty percent of women who discontinue injections conceive within 10 months of their last shot.</li> <li>Stay current on your vaccinations.</li> <li>Do not smoke.</li> <li>Schedule a preconception appointment with your health care provider to discuss any <a href="/hometown-health/speaking-of-health/are-you-ready-to-have-a-baby" target="_self" title="Opens in same window.">possible health conditions that may affect your pregnancy</a>.</li> <li>Avoid stress by making daily to-do lists to prioritize tasks and sharing frustrations with a supportive co-worker, friend or loved one.</li> </ul> <p>If you are already pregnant:</p> <ul> <li>Perform 30 minutes of moderate exercise each day to maintain a healthy pregnancy.</li> <li>Remember that pregnancy affects your hormones. You may suffer from nausea, increased urination, food aversions and heartburn. Hormones also may cause you to feel higher emotions or mood swings. This is normal, but talk to your provider if your feelings are intense.</li> <li>Go to bed early, and make sure you get at least 8 hours of sleep per night. Sleeping on your left side maximizes blood flow to the body and eases swelling.</li> </ul> <h3>3. Working during pregnancy</h3> <p>Most women are able to <a href="/hometown-health/speaking-of-health/work-more-comfortably-while-pregnant" target="_self" title="Opens in same window.">work during pregnancy</a>, but consider these extra precautions:</p> <ul> <li>Avoid nausea triggers, exposure to harmful substances, heavy lifting, excessive noise, heavy vibrations, prolonged standing and extreme temperature.</li> <li>Eat snacks, such as crackers and other bland food, to help prevent nausea. Foods high in iron and protein can help prevent fatigue.</li> <li>Take short, frequent breaks.</li> <li>Drink fluids throughout the day.</li> </ul> <h4>4. Child care</h4> <p>It is never too early to start looking at child care options. If you plan to work and raise a child, you can usually expect to return to work six to 12 weeks after your child is born. You may choose to have a family member, friend or nanny take care of your child, or you may decide to have your child attend daycare or enroll them in an early childhood education program.</p> <p>If you choose a child care option at a daycare or early childhood education program, you will need to decide on a facility and secure a spot months beforehand. Use these tips to help you:</p> <ul> <li>Determine which daycare or program is right for your family. Look at your options, and consider the cost and availability, as well as individual needs your family may have.</li> <li>Look for child care programs that focus on partnerships with families. This can include an open-door policy, regular parent-teacher conferences, family events, volunteer opportunities and regular communication with caretakers.</li> <li>Create a plan for days that your child cannot attend their usual child care program, such as if your child becomes sick or the daycare is closed on a day you work. Establish a plan with a family member, friend or another caretaker, and look into child care centers with sick child programs. Check with your employer to discuss sick day and vacation policies to determine your flexibility if you need to stay home with your sick child.</li> <li>Prepare for the transition period. Being in a new place with new people can cause your child to become more emotional. You also may find this transition challenging. Plan a routine with regular pick-up and drop-off times with similar caretakers and children. Talk to your child’s caretaker or teacher about ways to ease the transition, such as reading to your child in the care facility before leaving for the day.</li> </ul> <h4>5. Preparing your home</h4> <p>Take some extra precautions around your home to ensure your child’s safety as they grow. For example:</p> <ul> <li>Anchor furniture to the wall to prevent it from falling on toddlers who like to climb.</li> <li>Move furniture away from windows, and install window stops that prevent the window from opening further than 4 inches.</li> <li>Set the thermostat on your water heater below 120 degrees Fahrenheit.</li> <li>Keep electrical cords and wires out of the way, and cover unused electrical outlets with safety caps.</li> <li>Install smoke and carbon monoxide detectors inside the nursery and hallway outside of the room.</li> </ul> <p>In the excitement of finding out you are pregnant, be sure to schedule an appointment with your pregnancy provider as soon as you find out. Prenatal care can address any issues you have during pregnancy, and your provider will help guide you through many of the changes you face.</p> <p><em><a href="/providers/emily-sisco-cnm" target="_self" title="Opens in same window.">Emily Sisco</a> is a <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">certified nurse-midwife</a> in <a href="/locations/chippewa-falls" target="_self" title="Opens in same window.">Chippewa Falls</a> and <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Women's health</li> </ul>CNM, A.P.N.P.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Nursing, The College of St. Scholastica</li> <li>Master's degree, Nursing, Nurse-midwifery, Frontier Nursing University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Midwifery Certification Board</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Obstetrics and Gynecology, Mayo Clinic College of Medicine and Science</li> </ul>Sisco<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/emily-sisco-cnm-apnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A4F2BDD68011B1A02C60E704EBCA1AFA" alt="Emily Sisco, CNM, A.P.N.P." width="280" height="280" DisableNVelocity="true" />{AEF7E618-7BAA-41EA-B194-D06AEEC89C79}Emily<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15640680Emily Sisco, CNM, A.P.N.P.1{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{54693F31-87AF-4B21-91DB-1DEC1E21F878}<img src="/-/media/national-files/images/hometown-health/2019/young-couple-on-a-bed.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F34598EF852217202D33EB54F4AF9606" alt="Young couple on a bed" width="660" height="370" DisableNVelocity="true" />Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller3/21/2019<p>Eczema can make children uncomfortable, irritable and sleep deprived, which often leads to behavioral issues. Learn how treating your child's eczema can help the whole family.</p>Treating your child’s eczema can help the whole family<img height="370" alt="Young girl with itchy skin" width="660" src="/-/media/national-files/images/hometown-health/2019/young-girl-with-itchy-skin.jpg?sc_lang=en&hash=283449FA44EC3C3C80C8EC17B47BD081" class="img-responsive"> <p>Eczema — also known as atopic dermatitis — is a fairly common skin condition that affects about 15 percent of children. The condition usually improves as children age. But for some, it can be persistent and frustrating. Many parents find that eczema impacts the entire family, causing their child to be uncomfortable, irritable and sleep deprived, all of which can cause behavioral issues. Treating symptoms early can help your child feel better, which can help the whole family. </p> <h4>ECZEMA SYMPTOMS</h4> <p>Your child should be seen by a dermatologist who can make a clinical diagnosis of your child by looking at his or her skin. These symptoms can indicate that your child has eczema:</p> <ul> <li><strong>Rash, especially those developed in babies</strong><br> Infants commonly develop rashes on their cheeks and on the outside of their arms and legs. In older children, eczema is more common in the elbow crease and behind the knee. While these are common areas, rashes can appear virtually anywhere on the body.</li> <li><strong>Itching</strong><br> Eczema can cause severe itching, which can be worse at night.</li> <li><strong>Feelings of being uncomfortable</strong><br> Scratching may cause the skin to become raw, sensitive and swollen.</li> <li><strong>Trouble sleeping</strong><br> Lack of sleep can lead to behavioral issues at home and school. </li> </ul> <h4>ECZEMA CAUSES</h4> <p>These factors can increase the chances of your child developing eczema:</p> <ul> <li><strong>Family history</strong><br> Your child may be at a higher risk for eczema if a relative has eczema, asthma, or allergies; however, anyone can develop eczema.</li> <li><strong>Abnormal skin</strong><br> Skin is a barrier that protects against bacteria, irritants and allergens. Children with an abnormal skin barrier lose moisture from the skin and are more sensitive to external irritants and/or allergic substances and bacteria in the environment. This all leads to dry skin, inflammation and infections. </li> </ul> <h4>ECZEMA TREATMENTS</h4> <p>Dermatologists will provide information helpful in reducing flare-ups and may prescribe medications, such as a topical steroid medicine, to treat flare-ups and alleviate itching. Topical steroid medications are the most effective treatment for eczema. If used properly under the direction of a dermatologist, topical steroids are safe to use. There also are other topical medications available to treat eczema. </p> <h4>Use these methods to reduce your child’s eczema flare-ups:</h4> <ul> <li>Apply a fragrance-free moisturizer to your child’s skin twice daily.</li> <li>Use fragrance-free soaps and bath cleansers.</li> <li>Avoid fabric softener, and opt for fragrance-free laundry detergent. Detergents labeled “free and clear” are recommended for children with eczema.</li> <li>Watch for infection, as it can worsen eczema. Open areas of the skin are more prone to infections. Infections often cause eczema flare-ups. If your child develops an infection, a provider may prescribe oral antibiotics to treat it.</li> <li>Have your child take a diluted bleach bath once or twice per week. Bleach chlorinates water to help decrease bacteria and the frequency of infections. Add ¼ to ½ cup of regular household bleach to a 40-gallon tub of warm water. Your child should soak in the tub from the neck down or just the affected part of the skin. After 10 to 15 minutes, rinse off with clear water, pat dry and apply a moisturizer. Diluted bleach baths will not help if only used to treat flares, so they should be taken regularly as a preventive measure.</li> <li>Give your child an antihistamine to help with itching and sleep at night.</li> </ul> <p>Eczema can be frustrating for children and parents alike. Early treatment and attention to symptoms can help improve your child’s skin, mood and behavior, as well as avoid potential disruption of family life.</p> <p><em><a href="/providers/sheila-galbraith-md" target="_self" title="Opens in same window.">Sheila Galbraith, M.D.</a>, is a <a href="/services-and-treatments/dermatology" target="_self" title="Opens in same window.">dermatologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Acne</li> <li>Birthmarks</li> <li>Eczema</li> <li>Pediatric dermatology</li> </ul>M.D.<p>In my free time, I enjoy running, hiking, cross-country skiing, cooking, gardening and spending time with my family at our cabin.</p><p><strong>Education</strong></p> <ul> <li>University of Iowa, College of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Virginia Mason Medical Center</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Medical College of Wisconsin-Milwaukee</li> </ul> <p><strong>Fellowship</strong></p> <p>Pediatric Dermatology, Medical College of Wisconsin/Children's Hospital of Wisconsin</p> <p><strong>Membership</strong></p> <ul> <li>American Academy of Dermatology</li> <li>Dermatology Foundation</li> <li>Society for Pediatric Dermatology</li> <li>Wisconsin Dermatological Society</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Dermatology and Pediatric Dermatology, American Board of Dermatology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Dermatology, Mayo Clinic College of Medicine and Science</li> </ul>Galbraith<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/sheila-galbraith-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A10C2022D15CDFEEE8EE981391A52F33" alt="Sheila Galbraith, M.D." width="280" height="280" DisableNVelocity="true" />Sheila<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13050036Sheila Galbraith, M.D.1{276FDCB2-F341-4C45-B04B-F71FB963B8CB}|{20D94572-B26A-4FB7-8C9D-7555CE785162}<img src="/-/media/national-files/images/hometown-health/2019/young-girl-with-itchy-skin.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EBF35EC672B1D9462FED85041D68745A" alt="Young girl with itchy skin" width="660" height="370" DisableNVelocity="true" />Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller12/12/2023<p>The thyroid gland makes a hormone that regulates metabolism. Sometimes it can make too little or too much of the hormone, resulting in thyroid disease. Find out the types, symptoms and treatments.</p>Thyroid disease: Learn the types, symptoms and treatments<p>Most people have heard of the <a rel="noopener" href="https://www.mayoclinic.org/thyroid-gland/img-20007063" target="_blank" title="Opens in a new window.">thyroid gland</a>, but many do not know or understand what it does. The thyroid gland is an endocrine gland. It makes hormones called thyroid hormones, which help regulate the body's metabolism. The gland is shaped like a butterfly and is located in the front of the neck below the Adam's apple.</p> <p>Problems occasionally can <a href="/hometown-health/speaking-of-health/do-not-blame-your-thyroid" target="_self" title="Opens in same window.">occur in the thyroid</a> gland, with the most common being overactivity and underactivity.</p> <h2>What is hypothyroidism?</h2> <p>One of the most common problems affecting the thyroid gland is <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284" target="_blank" title="Opens in a new window.">hypothyroidism</a>. This condition occurs when the gland stops making enough hormone. The most common cause of hypothyroidism is <a href="/hometown-health/speaking-of-health/what-is-hashimotos-disease" target="_self" title="Opens in same window.">Hashimoto's</a> thyroiditis, an autoimmune disorder that ultimately causes the gland to stop working. In early stages, hypothyroidism may not cause noticeable symptoms.</p> <h3>Symptoms of hypothyroidism may vary, and can include:</h3> <ul> <li>Fatigue</li> <li>Weight gain</li> <li>Constipation</li> <li>Dry skin</li> <li>Coarse hair and skin</li> <li>Muscle weakness</li> <li>Slowed heart rate</li> </ul> <p>Hypothyroidism is treated with thyroid hormone medicine that is effective when taken at the correct dose. If left untreated, hypothyroidism can lead to high cholesterol and heart problems over time. </p> <h2>What is hyperthyroidism?</h2> <p>Some disorders of the thyroid gland cause it to be overactive and make too many thyroid hormones, a condition called <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/hyperthyroidism/symptoms-causes/syc-20373659" target="_blank" title="Opens in a new window.">hyperthyroidism</a>. Hyperthyroidism usually is caused by an autoimmune disease called <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/graves-disease/symptoms-causes/syc-20356240" target="_blank" title="Opens in new window.">Graves' disease</a>. It also can be caused by a metabolically active thyroid nodule making too much hormone or by a short-lived thyroid gland inflammation. Graves' disease can be treated with medication, radioactive iodine therapy or surgery. Graves' disease can lead to Graves' ophthalmopathy, or thyroid eye disease, which can cause vision loss, eye pain or bulging eyes.</p> <h3>Symptoms of hyperthyroidism also vary and can include:</h3> <ul> <li>Losing weight without trying</li> <li>Rapid heart rate</li> <li>Sweating</li> <li>Diarrhea</li> <li>Nervousness</li> <li>Muscle weakness</li> <li>Thinning skin and brittle hair</li> </ul> <h2>Other thyroid disorders</h2> <p>Other disorders of the thyroid gland often require <a href="/hometown-health/speaking-of-health/surgical-options-when-a-gland-goes-awry" target="_self" title="Opens in same window.">surgery for treatment</a>. A thyroid lobectomy, known as hemilobectomy, is a surgery that removes part of the gland. During a total thyroidectomy, the entire gland is removed. <a href="/hometown-health/speaking-of-health/what-is-thyroid-cancer" target="_self" title="Opens in same window.">Thyroid cancer</a> treatment usually requires total thyroidectomy and, in some cases, removal of lymph nodes in the neck. Many small thyroid cancers can now be treated with a lobectomy.</p> <p>Some noncancerous nodules become large enough to cause pain and problems swallowing and breathing. When this happens, partial or total thyroidectomy is recommended. A person who has part of their thyroid gland removed may need to take hormone replacement after surgery. When a person has the entire gland removed, they will need to take replacement hormones for life.</p> <h2>When to seek treatment for thyroid symptoms</h2> <p>Consider seeing your primary care professional if you have signs and symptoms of hypothyroidism or hyperthyroidism, or if you can feel a nodule in the lower front of your neck. Your healthcare team will take a detailed medical history and perform a physical exam. Your care may include lab tests, a neck ultrasound and referral to an endocrinologist or an ear, nose and throat specialist. If surgery is needed, you will be referred to an ear, nose and throat surgeon or general surgeon with expertise in performing thyroid procedures who will evaluate and discuss your options.</p> <p>Thyroid disorders are relatively common in adults. Fortunately, nearly all thyroid problems can be managed successfully when identified early.</p> <p><em>Omar El Kawkgi, M.B., B.Ch.</em><em>, is an <a href="/services-and-treatments/endocrinology" target="_self" title="Opens in same window.">endocrinologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2023/person-brushing-long-grey-hair.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EE73CBE1D0EF12ACE549F65598B0F849" alt="Person brushing long grey hair" width="660" height="370" DisableNVelocity="true" />Thyroid HealthThe thyroid is a gland at the base of your neck. This important part of your body produces hormones that regulate blood pressure, body temperature, heart rate and weight. When your thyroid has problems, many aspects of your well-being can be negatively impacted. Learn more about the thyroid here.Dawn Haller1/12/2024From beverages to food and medication, you may consume caffeine to help you concentrate or be alert. Learn how much is too much when it comes to caffeine and the hidden sources you may not know about.Caffeine consumption: How much is too much, hidden sources<p>You probably know that tea and coffee contain caffeine, but did you know it also can be found in other drinks, food and some medications? You're not alone if you depend on caffeine t o help you concentrate or be alert. About 90% of U.S. adults consume a form of caffeine every day, according to the American Heart Association.</p> <h2>How much caffeine is too much?</h2> <p>Caffeine content in beverages widely varies. For most adults, consuming up to 400 milligrams of caffeine daily does not have adverse side effects. Depending on the type of beverage, that can be roughly four cups of brewed coffee, 10 cans of cola or two energy shot drinks.</p> <h3>While consuming some caffeine is OK, too much can cause side effects, including:</h3> <ul> <li>Fast heartbeat</li> <li><a href="/hometown-health/speaking-of-health/does-caffeine-treat-or-trigger-headaches" target="_self" title="Opens in same window.">Headaches</a></li> <li>High blood pressure</li> <li><a href="/hometown-health/speaking-of-health/sleep-is-the-foundation-for-healthy-habits" target="_self" title="Opens in same window.">Insomnia</a></li> <li>Muscle tremors</li> </ul> <p>Adolescents and young adults must be cautious when drinking caffeine, and children should avoid it altogether. People who are sensitive to caffeine's effects or take certain medications should avoid consuming too much caffeine. People who are pregnant, <a href="/hometown-health/speaking-of-health/5-ways-to-prepare-before-starting-a-family" target="_self" title="Opens in same window.">want to become pregnant</a> or are breastfeeding should talk with their healthcare team about caffeine consumption.</p> <h2>Common caffeine sources</h2> <p><span style="line-height: 107%;">If you reach for different types of beverages throughout the day, you may be drinking more caffeine than you realize. With a cup of coffee or tea with breakfast, a soda in the afternoon and a piece of chocolate after supper, caffeine is part of your daily eating habits.</span></p> <h3>Some of the most common sources of caffeine are:</h3> <ul> <li>Chocolate</li> <li>Coffee</li> <li>Medication</li> <li>Soda</li> <li>Tea</li> </ul> <p><a href="/-/media/national-files/documents/hometown-health/2019/hidden-sources-of-caffeine.pdf?sc_lang=en&hash=585839628E4D8747B948BBB01DF99AB6">Caffeine also can hide</a> under some names that are less recognizable. <a href="/hometown-health/speaking-of-health/rethink-your-energy-drink" target="_self" title="Opens in same window.">Energy drinks</a> have additives that contain caffeine to enhance the effects of the drink. Knowing about these additives can help you avoid consuming more caffeine than you thought, so be sure to check labels before you buy.</p> <h3>Some common additives that contain caffeine include:</h3> <ul> <li>Cartinine</li> <li>Choline</li> <li>Ginseng</li> <li>Glucuronolactone</li> <li>Guarana</li> <li>Inosol</li> <li>Kola nut</li> <li>Malic acid</li> <li>Maltodextrin</li> <li>Niacin</li> <li>Pantothenic acid</li> <li>Taurine</li> <li>Theanine</li> <li>Tyrosine</li> <li>Yerba mate</li> </ul> <p>Caffeine in powder or liquid form can be particularly dangerous. The Food and Drug Administration has warned that high levels of caffeine can cause serious health problems. One teaspoon of powdered caffeine is the same as drinking 28 cups of coffee, which is significantly more than the recommended level.</p> <h2>Kicking a caffeine habit</h2> <p>If caffeine becomes more of a hindrance than a help, you may want to consider cutting back. This can be challenging because an abrupt decrease can cause withdrawal symptoms like <a href="/hometown-health/speaking-of-health/6-tips-for-headache-relief" target="_self" title="Opens in same window.">headaches</a>, fatigue and difficulty focusing.</p> <h3>To lessen caffeine withdrawal symptoms, try these tips:</h3> <ul> <li>Be aware of and track how much caffeine you consume throughout the day.</li> <li>Cut back gradually so your body gets used to lower levels of caffeine.</li> <li>Check products you use for caffeine, such as over-the-counter pain relievers.</li> <li>Shorten the brew time of tea to cut down on the caffeine content, or choose an herbal tea that doesn't have caffeine.</li> <li>Switch to decaffeinated beverages, which have a similar taste but much less caffeine than their full-strength counterparts.</li> </ul> <p>Contact your primary care provider for guidance or evaluation if you're struggling with persistent or severe caffeine withdrawal symptoms.</p> <p><a href="/providers/brian-burroughs-pac" target="_self" title="Opens in same window."><em>Brian Burroughs</em></a><em> is a physician assistant in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> with special interest in headache treatment, in <a href="/locations/red-wing" target="_self" title="Opens in same window.">Red Wing</a>, Minnesota.</em></p><ul> <li>Community health and wellness</li> <li>Diabetes</li> <li>Headaches</li> <li>Hypertension</li> <li>Nutrition</li> <li>Psychiatry</li> </ul>P.A.-C.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Biology and Nutrition, St. John’s University</li> <li>Master's degree, Physician Assistant Studies, DeSales University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Added Qualification in Headache Medicine</li> <li>Board Certified - Advanced Diabetes Management</li> <li>Certified Diabetes Care and Education Specialist</li> <li>Certified Hypertension Clinician</li> <li>Physician Assistant, National Commission on Certification of Physician Assistants</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Physician Assistants</li> <li>American College of Physicians</li> <li>Association of Diabetes Care and Education Specialists</li> <li>Minnesota Academy of Physician Assistants</li> <li>National Headache Foundation</li> <li>National Lipid Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Burroughs<img src="/-/media/shared-files/images/medical-professionals/full/red-wing/brian-burroughs-pajpg.jpg?h=280&iar=0&w=280&sc_lang=en&hash=6E3ED7F75144592AF7CC4BD3FB1400C4" alt="Brian Burroughs, P.A.-C." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://journals.sagepub.com/doi/10.1177/2633559X231173946" target="_blank" title="Opens in new window.">Approach to screening for depression in persons with diabetes</a>, May 2023.</li> </ul>Brian<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21656568Brian Burroughs, P.A.-C.1<img src="/-/media/national-files/images/hometown-health/2024/opening-lid-on-coffee-cup.jpg?h=370&iar=0&w=660&sc_lang=en&hash=AA1F20B0AF3B50531D495DB132E5ECA0" alt="Opening lid on coffee cup" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller12/8/2021When you feel supported and not alone, you can better cope with difficulty in your life. Boost your sense of belonging with these 5 tips.Is having a sense of belonging important?<p>Having a sense of belonging is so important, considering the groups and labels we give ourselves and others. We are members of families, sporting teams, hobbyists, spiritual groups, charities, political parties, cities, countries and nationalities, to name a few. Nearly every aspect of our lives is organized around belonging to something.</p> <p>The sense of belonging is fundamental to the way humankind organizes itself. If it was unimportant, we would live solitary lives only coming together for procreation then quickly kicking the children out of our lives as soon as they could walk. We would have no families, communities or organized government.</p> <p>We cannot separate the importance of a sense of belonging from our physical and mental health. The social ties that accompany a sense of belonging are a protective factor helping <a href="/hometown-health/speaking-of-health/5-tips-to-manage-stress" target="_self" title="Opens in same window.">manage stress</a> and other behavioral issues. When we feel we have support and are not alone, we are more resilient, often coping more effectively with difficult times in our lives. Coping well with hardships decreases the physical and mental effects of these situations.</p> <p>We begin life with the most crucial of needs — attachment to a caregiver. This is the beginning of our fundamental need for belonging. Studies have shown that children who have not achieved a healthy attachment in their young life have lower self-esteem, a more negative worldview, are mistrustful and can have a perception of rejection.</p> <p>Depression, anxiety and <a href="/hometown-health/speaking-of-health/suicide-isnt-about-dying-its-about-perceived-relief" target="_self" title="Opens in same window.">suicide</a> are common mental health conditions associated with lacking a sense of belonging. These conditions can lead to social behaviors that interfere with a person’s ability to connect to others, creating a cycle of events that further weakens a sense of belonging.</p> <p>Gratefully, we do have control in making changes in our lives to break this cycle and bolster our sense of belonging.</p> <h4>Boost your sense of belonging</h4> <h5>So what can you do to increase the sense of belonging in your children and yourself?</h5> <ul> <li><strong>Make an effort.</strong><br /> The most crucial ingredient to building a sense of belonging is effort. You cannot belong if you don't choose to make the effort to engage with others. It may feel uncomfortable at first to meet new people, but give it time, as you may need to practice self-talk. Soon the actions will become second nature. Behavioral activation and opposite action are effective strategies for getting yourself to put in the effort. Action often is needed to feel motivated.</li> <li><strong>Be mindful of others.</strong> <br /> Think less about yourself while with others and make the other person or the group your focus. Making conversation is critical to increasing your sense of belonging. It is important to mutually ask questions, make small talk, self-disclose skillfully and listen to people's responses.</li> <li><strong>Keep and teach an open mind.</strong><br /> Try new activities and meet new people. Consider new ways of thinking. Lead by example so your children can see how it works. Put in effort to seek activities and groups of people who you share common interests with. You may need to make it happen to start. Encourage and support your children to get involved.</li> <li><strong>Practice an attitude of acceptance.</strong><br /> Recognize that others have different ways of being, which don't have to change you. Focus on similarities rather than differences. Similarities tend to increase bonding. If you feel that people are not like you, focus on a mutual goal, such as a volunteer opportunity. Teach children to validate the feelings of others.</li> <li><strong>Validate action.</strong><br /> If creating a sense of belonging is challenging for you, remember it is likely challenging for your child, as well. Give them the encouragement you would give yourself. Validate them, just like you need to validate your own action. Remind children and yourself that it can feel discouraging at times and it will get better by continuing to put in the work.</li> </ul> <p><em><a href="/providers/angela-theisen-lcsw" target="_self" title="Opens in same window.">Angela Theisen</a> is a psychotherapist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Behavioral therapy</li> <li>Chronic mental illness</li> <li>Depression and anxiety</li> <li>Individual, couple and family therapy</li> <li>Personality disorders</li> </ul>L.C.S.W.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Psychology, College of St. Catherine</li> <li>Master's degree, Social Work, University of Illinois-Champaign</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Licensed Clinical Social Worker</li> </ul>Theisen<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/angela-theisen-lcsw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=5D9B806BD75FE7B8FC04136702B9A77A" alt="Angela Theisen, L.C.S.W." width="280" height="280" DisableNVelocity="true" />{FF9B919D-292C-4F0E-A169-713C11DD7B2A}Angela<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14802660Angela Theisen, L.C.S.W.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}|{C4130004-0F31-48C4-AC9F-A4350A75AB24}|{2B88C934-922C-4130-B661-197B59D83899}<img src="/-/media/national-files/images/hometown-health/2021/adult-leaning-down-to-child.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B016F833DF9FCB59653A86D5A11BCB3D" alt="Adult leaning down to child" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller2/8/2023Preparing the nursery is an exciting part of the journey to welcoming a new baby. When it comes to safety, there are key areas to evaluate for potential hazards.How safe is your nursery?<p>After months of anticipation, you've welcomed your child into the world. Your main priority now is to keep your little miracle safe. Your baby will be spending much time in the nursery, so it's important to check for, and correct, any potential safety hazards.</p> <h2>Take a few minutes to evaluate each part of your nursery with these tips in mind:</h2> <h3>Crib and bassinet safety</h3> <p>Sudden infant death syndrome (SIDS) is the unexplained death of an infant under 1. While the exact cause of SIDS remains under investigation, research has shown that a safe sleeping environment has an impact on prevention.</p> <h4>Safe sleep guidelines are recommended to help reduce the risk of sleep-related infant death, including:</h4> <ul> <li>Always lay babies to sleep on their backs on a firm, flat surface. A mattress should fit snugly into the frame of the crib or bassinet, with no gaps. </li> <li>Avoid co-sleeping. Your baby should have his or her own sleeping space in a crib or bassinet. It's recommended that the baby sleeps in the same room as the caregiver for at least the first six months of life.</li> <li>Do not place loose blankets, bumpers, pillows or stuffed animals in a crib with a sleeping infant.</li> </ul> <h3>Window safety</h3> <p>Windows can pose a threat no matter how high they are above ground.</p> <h4>To ensure your children's safety around windows in the nursery and other parts of your home, it's recommended to:</h4> <ul> <li>Move furniture away from windows.</li> <li>Supervise children in rooms with open windows.</li> <li>Never rely on screens to prevent falls.</li> <li>Install a stop that prevents windows from opening further than 4 inches.</li> <li>Install window guards to cover the lower portion of the window.</li> <li>Open double-hung windows only from the top.</li> <li>Secure cords from blinds or curtains out of reach of children.</li> </ul> <h3>Nursery safety tips</h3> <h4>Additional safety recommendations in the nursery include taking steps to:</h4> <ul> <li>Place a night light in the nursery and any nearby bathroom and hallway.</li> <li>Install smoke and carbon monoxide detectors, and check their function regularly.</li> <li>Anchor heavy furniture, such as dressers and bookshelves, to the wall. Safety straps or wall anchor kits can be purchased separately if the furniture does not come with them.</li> </ul> <h3>Safety outside the nursery</h3> <h4>While it's important to keep furniture inside the nursery safe for infants, you also should pay attention to other furniture in your home, including:</h4> <ul> <li>Never leave a baby unattended on an elevated surface.</li> <li>Place bassinets or car seats on the floor rather than on tables, counters, beds or other furniture.</li> <li>Place bumpers or guards on sharp corners of furniture.</li> </ul> <h2>Read more about childhood safety:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/caring-for-your-childs-eyes" target="_self" title="Opens in same window.">Caring for your child's eyes</a></li> <li><a href="/hometown-health/speaking-of-health/keeping-childrens-teeth-healthy" target="_self" title="Opens in same window.">Keeping children's teeth healthy</a></li> <li><a href="/hometown-health/speaking-of-health/the-facts-about-vaccinations" target="_self" title="Opens in same window.">Protect your child with proper vaccinations</a> </li> <li><a href="/hometown-health/speaking-of-health/noisy-gifts-staying-ear-healthy-this-holiday-season" target="_self" title="Opens in same window.">Protect children's hearing from noisy toys, gifts</a></li> <li><a href="/hometown-health/speaking-of-health/5-sneaky-halloween-costume-health-concerns" target="_self" title="Opens in same window.">5 sneaky Halloween costume health concerns</a></li> </ul> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2023/baby-sleeping-in-crib.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8E743A26070A67C5F21F76CCDBA82044" alt="Baby sleeping in crib" width="660" height="370" DisableNVelocity="true" />Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller11/9/2022Menopause, often referred to as the "change of life," is a natural part of aging, but the symptoms can be bothersome. Learn about the signs and symptoms, and get treatment options.Menopause: Change of life Q&A<h2>What is menopause?</h2> <p>Menopause is the time in a woman's life when she stops having monthly periods. It's often referred to as the change of life and marks the transition between a woman's childbearing and nonchildbearing years. Menopause is a natural part of aging and occurs due to the gradual loss of estrogen — a hormone produced in the ovaries.</p> <h2>What are the signs and symptoms of menopause?</h2> <p>Menopause is diagnosed primarily by its symptoms and usually occurs between the ages of 45 and 55, with an average age of 51. Women often develop irregular periods, hot flashes, night sweats, mood swings and fatigue as estrogen production declines. These symptoms usually develop three to five years before a woman's last period — a time referred to as perimenopause.</p> <p>If a woman is 45 or older and stops menstruating altogether, then a presumptive diagnosis of menopause can be made. It's officially diagnosed when a woman has been without a period for one year. Most women in this group don't need any lab testing to confirm menopause, especially if they have menopausal symptoms, such as hot flashes or vaginal dryness.</p> <p>If a woman is under 45 and stops having periods or thinks she may be having menopause symptoms, then she should talk with her health care provider. She may need testing to see if it's menopause or another problem causing her symptoms. Women should see their health care provider if they have menopausal symptoms that are bothersome, heavy bleeding during or between their periods, or if they start bleeding again after completing menopause.</p> <p> Menopause affects all women regardless of race or socioeconomic background but is an individualized experience. Some women have more estrogen-related symptoms and find menopause extremely bothersome, while others notice little difference in their daily lives.</p> <h2>What are the long-term complications of menopause?</h2> <p style="margin-bottom: 12px;">Long-term complications are linked to the decreased levels of estrogen associated with menopause. Osteoporosis, which is thinning of the bones, leads to a decrease in bone mass which may lead to curvature of the spine, fractures and pain. The risk of cardiovascular disease, including heart attacks and strokes, also is increased in postmenopausal women.</p> <h2>What are the treatment options for menopause?</h2> <p>Medical treatments for menopausal symptoms include hormone replacement therapy, antidepressants and anti-seizure medications. Estrogen replacement is the most effective treatment for menopausal symptoms.</p> <p>While there have been concerns in the past about the safety of hormone therapy, for most healthy women seeking help with menopausal symptoms, it's safe, low-risk and effective. Hormone therapy typically is given for up to five years and is not recommended for women with a history of breast cancer, heart disease or stroke.</p> <p>In addition to hormone replacement therapies, some types of antidepressants can help ease hot flashes and other menopausal symptoms — even in women who are not depressed. There also are anti-seizure medications that can help treat hot flashes in some women.</p> <p>Women should speak to a health care provider before taking any natural remedies, as some may not be safe, especially for women with a history of breast cancer.</p> <p>There are many treatments for menopause that don't have hormones, including calcium supplements and vitamin D for the prevention of osteoporosis.</p> <p>Eating a reasonable diet full of nutritious foods also will help manage menopause. Nutrition recommendations include increasing fruits, vegetables and whole grains, especially foods high in vitamin C and carotene, and decreasing foods high in saturated fat, cholesterol, salt and processed sugars.</p> <p>Regular exercise benefits the heart and bones, helps regulate weight and improves mood. Weight-bearing exercises help increase bone mass and reduce the risk of fracture. Finally, smokers are encouraged to quit because studies show that smoking intensifies hot flashes.</p> <p>Menopause is a normal part of a woman's life and doesn't always need to be treated. However, menopausal symptoms can be disruptive. Women having bothersome symptoms should see a health care provider. Effective treatments for the relief of symptoms are available.</p> <p>While menopause isn't always a transition many women welcome, it's important to remember there is life after menopause.</p> <p><em>Ginny Clementson is a nurse practitioner based in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota, specializing in <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> and <a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">prenatal care</a>, and sees patients through virtual (video) appointments. </em></p><img src="/-/media/national-files/images/hometown-health/2022/middle-aged-person-white-sweater.jpg?h=370&iar=0&w=660&sc_lang=en&hash=327D189736ACE9D90CC0672A54EBE806" alt="Middle-aged person wearing a white sweater" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller4/22/2019<p>A visit to the hospital can be a terrifying experience for children. Learn how Haley Bate, a child life specialist, helps the child and his or her family adjust to and cope with the environment and many events that happen during a visit to the hospital.</p>A day in the life of a child life specialist<img height="370" alt="Haley Bate and pediatric patient" width="660" src="/-/media/national-files/images/hometown-health/2019/haley-bate-and-pediatric-patient.jpg?sc_lang=en&hash=A8C2BE05E4143DCD7404B92B4B0BA4C8" /> <p>For children, a visit to the hospital can be a terrifying experience. Haley Bate, child life specialist at Mayo Clinic Health System in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin, helps <span style="color: #333333;">the child and his or her family</span> make this experience more relaxing. T<span style="color: #333333;">hrough therapeutic play, age-appropriate education and preparation, and expressive activities to reduce fear, anxiety and pain, Haley </span>helps the them adjust to and cope with the environment and many events that happen during a visit to the hospital.</p> <p>Haley works with patients and their families in the <a href="/services-and-treatments/surgery" target="_self" title="Opens in same window.">Surgery</a> Department at the <a href="/locations/sparta" target="_self" title="Opens in same window.">Sparta</a> and La Crosse campuses, as well as procedural areas and inpatient in La Crosse. She works the typical 40 hours per week, but her schedule revolves around seeing patients.</p> <p>As the first patient arrives for the day, sometimes as early as 6:30 a.m., Haley introduces herself to the child and his or her family. While the nurse, anesthesiologist, surgeon and other health care providers already have introduced themselves, Haley’s introduction is a bit different. She wants to be a familiar and comforting face to the child before and after they undergo surgery or testing.</p> <p>Haley has learned that emotions children feel during a visit to the hospital vary. While one child may be calm and unfazed, another may be anxious and fearful. She has to use different approaches to support different children. Haley usually can tell shortly after meeting the child how best to support them. If the child is calm, she can provide toys and other activities to keep them occupied. If the child seems fearful, Haley will play with the child while they are waiting for the surgery or test and sometimes uses donated tie blankets to provide comfort. To ensure there are no surprises, she can show patients images of the operating rooms on her tablet.</p> <p>While they are waiting, Haley also explains the processes that will be involved during this particular child’s surgery or test. If the child will receive anesthesia, she sometimes brings with a similar mask that will deliver the anesthetic. The child can try the mask on if they wish. <span style="color: #333333;">Children sometimes are fearful during the anesthesia process, and need someone to comfort and support them. </span>She<span style="color: #333333;"> works closely with the anesthesia team and often supports the child until the anesthetics are fully administered. </span>If the child will need an IV for the operation, Haley brings an IV without a needle to show the child. This helps the child become comfortable ahead of time with some of the equipment that will be used.</p> <p>After the child is in surgery or done with testing, Haley follows up with the family. This is a crucial part of her job, because surgery can be just as scary for the family as it is for the child. She can put worries at ease and talk about how the child<span style="color: red;"> </span>coped during the anesthesia induction.</p> <p>When surgery is complete and the child is in the recovery room, Haley helps staff assess the child’s needs or gives them some information from when she met with them prior to surgery. She encourages parents to be present during this time and often will bring parents to recovery, preparing them on the way for what to expect when their child wakes up. Children often are confused and emotional, which can be distressing for parents if they don’t expect it. When they are finished in the recovery room, the child returns to the room in which they began. If she has a few moments in between patients, she’ll stop in to provide praise for how the child did that day. At this point, the kids usually are eating and walking around. She likes to see them feeling better before they go home.</p> <p>While Haley is not working with a child and their family, she is in meetings, working on projects and presentations, and taking part in staff education.</p><img src="/-/media/national-files/images/hometown-health/2019/haley-bate-and-pediatric-patient.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BF004B1AF67855969401794861554EDA" alt="Haley Bate and pediatric patient" width="660" height="370" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller11/9/2023When your eyeball turns a shade of pink or red, and you have a watery and inflamed eye, it's a sign of conjunctivitis. Learn why the best option to treat pink eye may be to care for it at home.A closer look at pink eye: Self-care tips for conjunctivitis<p>You may be familiar with the commonly used term "pink eye" used to describe conjunctivitis. The condition is an inflammation or infection of the membrane that lines your eyelid and the white part of your eyeball. The whites of your eyes become inflamed and a more visible shade of pink or red. Your eyes also may be watery or have a discharge, and your eyelids may be red or puffy. </p> <h2><strong>What causes pink eye?</strong></h2> <h3>Pink eye is common, especially in children. It can result from various causes, including:</h3> <ul> <li><a href="/hometown-health/speaking-of-health/allergy-q-and-a" target="_self" title="Opens in same window.">Allergies</a></li> <li>Bacteria</li> <li>Injury to the eye</li> <li>Irritants like dirt, smoke or pool chlorine</li> <li>Reaction to eyedrops or contact lenses</li> <li>Viruses, including the common cold</li> </ul> <h2>How is pink eye treated?</h2> <p>Based on recent evidence and research, your best option to treat pink eye may be to care for it at home. You should avoid going to work or school if the eye has drainage. A virus causes most cases of pink eye. You may only experience eye symptoms, but with viral conjunctivitis, you also may have a runny nose, sore throat, cough or fever.</p> <p>Viral conjunctivitis often begins in one eye and spreads to the other eye within a few days. It's contagious and can easily be passed to another person through coughing, sneezing or any contact with the liquid that drains from an infected eye.</p> <p>You usually <a href="/hometown-health/speaking-of-health/3-reasons-why-you-did-not-receive-antibiotics-from-your-provider" target="_self" title="Opens in same window.">don't need antibiotic drops</a> or ointments to treat pink eye. They don't help alleviate the symptoms or make you less contagious. It's difficult to distinguish between viral and bacterial conjunctivitis, but both typically are self-limiting, meaning the illness will go away on its own.</p> <h2>How can I manage and relieve pink eye symptoms?</h2> <ul> <li><strong>Keep your eyes clean.<br /> </strong>Clear any discharge from your eyes with water and a clean, lint-free cloth. Wipe from the inner corner of your eye to the outer corner. Avoid touching your eyes with anything other than a clean cloth, and <a href="/hometown-health/speaking-of-health/clean-up-your-hand-washing-skills" target="_self" title="Opens in same window.">wash your hands</a> often with soap and warm water.</li> <li><strong>Apply a compress to your eyes.</strong><br /> A warm, moist compress applied to the infected eye can ease discomfort. Soak a clean cloth in warm or cool water, depending on your preference. To decrease the risk of spreading pink eye from one eye to the other, only use the cloth to cover one infected eye.</li> <li><strong>Consider eye drops.</strong><br /> Over-the-counter lubricating eye drops, such as artificial tears, may help with symptoms. Don't use eye drops that are advertised to treat redness since they may worsen your symptoms.</li> </ul> <h3>See a healthcare professional if you have any of these symptoms:</h3> <ul> <li>Any eye pain that is more than mild</li> <li>Blurry vision that doesn't clear with blinking</li> <li>Sensitivity to light</li> <li>Warm, red swelling around the eye</li> <li>Worsening symptoms after three days with no associated cold symptoms</li> <li>Vision loss</li> </ul> <h3>Certain people also should seek guidance from a healthcare professional regarding pink eye symptoms, including:</h3> <ul> <li>Anyone with recent trauma or surgery to or around the eye</li> <li>Contact lens wearers experiencing any eye pain</li> <li>Infants less than 6 months</li> <li>Those who are immunocompromised</li> </ul> <p>Symptoms of viral conjunctivitis can last up to two weeks, but typically are most severe earlier in the illness. You or your child can return to work or school if the drainage is controllable and you follow good hand hygiene.</p> <h2>Learn more about the symptoms and causes of pink eye in this video:</h2> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/Z_REzv459q8" title="Pink Eye (Conjunctivitis): Symptoms & Causes" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2023/parents-holding-toddler.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1C873D80C5FE834CF73ECD1C18A131AC" alt="Parents holding toddler" width="660" height="370" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Eye HealthYour eyes are responsible for providing you with vision, perhaps the most important of the senses. However, the eye is a delicate and complicated structure that needs protection. The ugly truth is that eye injuries can happen at any time and place.Dawn Haller4/18/2019<p>You want to eat healthy, but what does “healthy” on a package really mean? How many calories does an item labeled “calorie-free” have? Learn the meanings of common food package claims.</p>14 common food package claims<img alt="Illustrated food packages" src="/-/media/national-files/images/hometown-health/2019/illustrated-food-packages.jpg?h=370&w=660&sc_lang=en&hash=B262D2E7D991D5214740134CE109A49E" class="img-responsive" style="height: 370px; width: 660px;" /> <p>You want to <a href="/hometown-health/speaking-of-health/looking-to-try-something-new-start-with-what-you-eat" target="_self" title="Opens in same window.">eat healthy</a>, but knowing what the claims on food packages mean can be hard to understand and overwhelming. What does “healthy” on a package really mean? How many <a href="/hometown-health/speaking-of-health/keep-track-of-bite-lick-and-taste-calories" target="_self" title="Opens in same window.">calories</a> does an item labeled “calorie-free” have?</p> <h2>Learn the meanings of 14 common food package claims so you can make wise choices the next time you’re at the grocery store:</h2> <h3>1. Calorie-free</h3> <ul> <li>Less than 5 calories</li> </ul> <h3>2. Fat-free or sugar-free</h3> <ul> <li> <p>Less than ½ gram of fat or sugar</p> </li> </ul> <h3>3. Gluten-free, no gluten, free of gluten or without gluten</h3> <ul> <li>Less than 20 parts per million of gluten</li> </ul> <h3>4. Good source of</h3> <ul> <li>Provides at least 10% of the daily value of a particular vitamin or nutrient</li> </ul> <h3>5. Healthy</h3> <ul> <li>Low fat</li> <li>Low saturated fat</li> <li>Less than 480 milligrams of sodium</li> <li>Less than 95 milligrams of cholesterol</li> <li>At least 10 percent of the daily value of vitamins A, C and D; iron; protein; calcium; fiber; or potassium</li> <li>Food does not need to be low in total fat but has a fat profile makeup of predominantly monounsaturated and polyunsaturated fats</li> </ul> <h3>6. High fiber</h3> <ul> <li>5 or more grams of fiber</li> </ul> <h3>7. High in</h3> <ul> <li>Provides 20% or more of the daily value of a specified nutrient</li> </ul> <h3>8. Light or lite</h3> <ul> <li>One-third fewer calories of the usual food</li> <li>Half the fat of the usual food</li> </ul> <h3>9. Low calorie</h3> <ul> <li>Less than 40 calories</li> </ul> <h3>10. Low cholesterol</h3> <ul> <li>Less than 20 milligrams of cholesterol</li> <li>2 grams or less of saturated fat</li> </ul> <h3>11. Low sodium</h3> <ul> <li>Less than 140 milligrams of sodium</li> </ul> <h3>12. Natural</h3> <ul> <li>No added artificial or synthetic ingredients (includes color additives)</li> </ul> <h3>13. Organic</h3> <ul> <li>Ingredients are produced without synthetic fertilizers and pesticides, farmed to reduce pollution, and provide safe and healthy livestock habits</li> <li>At least 95% of ingredients are organic</li> <li>Label may include USDA organic seal or organic claim</li> </ul> <h3>14. Reduced</h3> <ul> <li>Less than 25% of the specified nutrient or calories than the usual product</li> </ul> <p>The next time you are at the grocery store, pay attention to claims on food and beverage packages. Understanding the true meaning can help you better achieve your goals of eating healthy.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2019/illustrated-food-packages.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C557205EF8A894AE25E70481D64ECB66" alt="Illustrated food packages" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller4/16/2019<p>Are all the Easter goodies too tempting for your waistline? Hop to success with these six simple tips.</p>6 steps to enjoy Easter while managing weight<img alt="Girl eating chocolate and other food" src="/-/media/national-files/images/hometown-health/2019/girl-eating-chocolate-and-other-food.jpg?h=370&w=660&sc_lang=en&hash=3DF376AF2BE7552E58B184106ADCBD72" class="img-responsive" style="height: 370px; width: 660px;" /> <p>What comes to mind when you think of Easter? Would it be an Easter basket filled with high-calorie treats, and a meal of ham, buns, mashed potatoes, salads and desserts? Well, you can have both and lose or maintain your weight too.</p> <h2>Follow these six simple steps:</h2> <h3>1. Enjoy a healthy breakfast that includes lean protein.</h3> <p>Protein will help control your appetite.</p> <h4>Consider these options: </h4> <ul> <li>Veggie omelet</li> <li>Yogurt and fruit</li> <li>Fruit smoothie</li> </ul> <h3>2. Eat fruits or veggies for snacks.</h3> <h3>3. Consider a lighter lunch, such as:</h3> <ul> <li>A vegetable salad with lean protein, including a hard-boiled egg, chicken, tuna or cottage cheese</li> <li>Soup and half a sandwich</li> <li>Mixed fruit drizzled with yogurt or cottage cheese</li> </ul> <h3>4. Incorporate lower-calorie items into the main meal.</h3> <p>Eat a baked potato instead of mashed potatoes with butter and sour cream. Add steamed veggies and 4 to 6 ounces of ham. The whole idea is to swap high-calorie foods with low-calorie options.</p> <h3>5. Get active. </h3> <p>Go for a walk or play a game of basketball — just move. Remember, if you weigh 150 pounds, you have to walk a mile to burn off 1 ounce of chocolate.</p> <h3>6. Use portion control.</h3> <p>Have a small portion of those treats in the basket if you really want one. Remember, the operative goal is a small portion.</p> <h4>Keep in mind:</h4> <ul> <li>1 ounce of chocolate = 150 calories</li> <li>Each marshmallow chick = 28 calories and all sugar</li> <li>1 solid milk chocolate bunny = 900 calories</li> <li>9 malted eggs = 200 calories</li> </ul> <p>If the treats are tempting for you, you may want to get rid of the Easter basket on Monday. Remember, if it’s not there, you won’t eat it.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2019/girl-eating-chocolate-and-other-food.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D0254844F21A811222D92BF83C77442D" alt="Girl eating chocolate and other food" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller4/15/2019<span style="color: #333333;">Hoarding used to be referred to as collecting or saving items. Family members were sometimes called pack rats who seemingly never threw anything away. Whatever the term, people who participate in hoarding activities have gone from being virtually unheard of to almost being a household word.</span>Hoarding: Are we defined by our things?<img height="370" alt="Hoarding" width="660" src="/-/media/national-files/images/hometown-health/2019/hoarding.jpg?sc_lang=en&hash=FAF1AD09B513EB0715C3585946FC5DF5" class="img-responsive" /> <p>Hoarding used to be referred to as collecting or saving items. Family members were sometimes called pack rats who seemingly never threw anything away. Whatever the term, people who participate in hoarding activities have gone from being virtually unheard of to almost being a household word. People who hoard have trouble resisting acquiring things and tend to save too many possessions, which eventually start to create problems in their living space.</p> <h2>How many items are too many?</h2> <p>Acquiring too many items usually happens when the situation becomes overwhelming and intimidating along with thoughts of getting rid of possessions. Our possessions tend to own us instead of us owning our possessions. Because this condition has caused so much anguish for so many, hoarding has been given a diagnosis as a disorder by the <a rel="noopener" href="https://www.psychiatry.org/" target="_blank" title="Opens in a new window.">American Psychiatric Association</a> and is published as such in the <em>Diagnostic and Statistical Manual of Mental Disorders</em>. With these acknowledgements, <a rel="noopener" href="https://www.psychiatry.org/patients-families/hoarding-disorder/what-is-hoarding-disorder" target="_blank" title="Opens in a new window.">education and treatments</a> have become available.</p> <h2>What are the four main criteria that define hoarding disorder?</h2> <ol> <li>Persistent difficulty in discarding or parting with possessions regardless of their value. Hoarding is about the volume of possessions and how the items are organized.</li> <li>The difficulty of discarding possessions acquired is due to a perceived need to save the items and the distress associated with getting rid of them.</li> <li>These symptoms result in the accumulation of possessions that congest and clutter a person's active living areas and substantially compromise their intended use. A hoarding disorder may be so bad that portions of the home are difficult to use or access.</li> <li>The accumulation of items causes clinically significant distress or impairment in personal, social, occupational or other areas of functioning. Ask yourself this question: Does your stuff interfere with your being able to live comfortably, and is your living environment safe?</li> </ol> <h2>Why do people hoard?</h2> <h3>There are multiple reasons people hoard, including:</h3> <ul> <li>Some believe that items may be useful or valuable to them in the future.</li> <li>Items have a sentimental value, are unique or irreplaceable.</li> <li>Some items may be conceived as too good a bargain to pass up or throw away.</li> <li>Items a person acquires also may jog a pleasant or a sentimental memory.</li> <li>The person can't decide where the item belongs so they just keep it.</li> <li>They may feel safe from the outside world when surrounded by their things and don't want to let past experiences go without these items.</li> </ul> <p>Some studies indicate these behaviors start during childhood or early adolescence and after a bad traumatic experience. Studies also show this may run in families, either from role modeling or genetics. Statistics show that the rate of hoarding may be 5 percent, or 1 in 20 people.</p> <h2>How can I help?</h2> <p>Educate yourself about what a hoarding condition is and what it can lead to. Realize in most cases you need to respect the person's freedom of choice as to what they want in their own home. You may suggest to the person you know that they see a medical provider who may recommend a consult with a mental health expert in this field. There also are other resources in the community. If there are safety or health issues in the home, you may want to consider notifying other legal or community resources. Avoid confrontational situations with the person, but try to help with gentle recognition and strive for gradual change. Most importantly, aim to provide understanding, compassion and hope.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2019/hoarding.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A04983E86E86E640C20A0A8CC4563F8B" alt="Hoarding" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller12/30/2022If your goal is to eat more fruits and veggies, learn how counting to three can help you reach five or more servings a day.1-2-3 approach to eating fruits and veggies<p>Is it a challenge for you to eat all five servings of fruits and vegetables every day? The 1-2-3 approach can help you pack in all your servings — and more — throughout the day.</p> <h2>Get six servings by eating:</h2> <ul> <li>1 serving with breakfast</li> <li>2 with lunch </li> <li>3 with dinner and snacks </li> </ul> <p>Remember that the serving size for fruits and vegetables is about 4 to 6 ounces.</p> <h4>Measurements for one serving can differ depending on the food, such as:</h4> <ul> <li>1 cup of raw or cooked fruits and vegetables</li> <li>½ cup of legumes</li> <li>3 cups of leafy greens </li> </ul> <p>When you add fruits and vegetables to your meals and snacks, you'll find that getting six servings can be easy and fun. Keep fresh, frozen and canned fruits and veggies on hand so it's easy to add them to meals and your favorite dishes.</p> <h3>Use these ideas for each mealtime:</h3> <h4>Breakfast:</h4> <ul> <li>Make a smoothie with fresh or frozen fruit. Try adding a handful of spinach or kale.</li> <li>Mix berries and chopped fruits into batter for pancakes, muffins and waffles.</li> <li>Top your cereal, oatmeal or yogurt with fruit, such as berries, peaches, apples or bananas. </li> <li>Add vegetables, such as peppers, onions and spinach, to omelets, hash browns or breakfast potatoes.</li> <li>Bring a piece of fruit for an on-the-go breakfast.</li> </ul> <h4>Lunch:</h4> <ul> <li>Add extra vegetables to your sandwich or wrap. If you're eating out, ask for extra veggies.</li> <li>Make homemade vegetable soup for lunch. If you're buying prepared soup, compare nutrition labels and choose the option with the lowest amount of sodium.</li> <li>Build a salad with at least 3 cups of leafy greens. You can add chopped vegetables and fruit for more flavor and texture.</li> <li>Use leftover vegetables from last night's dinner as a side dish.</li> <li>Top a baked potato with salsa or broccoli.</li> </ul> <h4>Dinner:</h4> <ul> <li>Make a stir fry for dinner with lots of vegetables.</li> <li>Grill vegetables with a minimal amount of oil or oil spray. Thread them on a kebab or toss in a grill basket. Grilling works for fruits, including peaches, pineapples and mangoes.</li> <li>Add extra vegetables to pasta sauces, casseroles and soups. Good options are onions, peas, beans, tomatoes, peppers and spinach.</li> <li>Steam, microwave or roast vegetables for an easy side dish. Use either fresh or frozen veggies.</li> <li>Serve a vegetable-based soup, such as a hearty mixed vegetable, squash, cauliflower, potato, corn or broccoli soup.</li> <li>Incorporate fruit into your dessert. Add it to gelatin desserts, make a parfait with yogurt or just serve fruit cut into chunks or slices.</li> </ul> <h4>Snacks:</h4> <ul> <li>Keep raw veggies or a piece of fruit at your desk for an easy snack.</li> <li>Pack dried fruit in your purse, pocket or backpack to nibble on during the day.</li> <li>Dip apple slices or baby carrots in small amounts of peanut butter or almond butter. Try sprinkling cinnamon on apple slices.</li> <li>Put fruits and vegetables in easily accessible locations, such as the front of your fridge or counter, which will stop you from reaching for unhealthy foods when you're hungry. If you're low on time, try buying prepared trays with fruits and veggies that are already washed and cut.</li> </ul> <p>Remember that when it comes to fruits and vegetables, more is always better. Don't be afraid to go over the recommended servings. Eating more of these foods can help crowd out higher-calorie foods and satisfy your hunger and cravings for something sweet. Making fruits and veggies a regular part of your diet is as easy as 1-2-3.</p> <p><em>Anne Harguth</em><em> is a registered dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2022/eating-an-apple.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0E1964120D66596E386A40E0B6E4DDD2" alt="Eating an apple" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Dawn Haller5/29/2019<p>When it comes to skincare, you have lots of options, including peels, Botox and laser resurfacing. It can be challenging to determine which can target your skin’s needs. But there is a new hydrating skin renewal procedure that's a good option for nearly anyone.</p>Soften, smooth skin with new skin renewal procedure<img height="370" alt="Two women smiling" width="660" src="/-/media/national-files/images/hometown-health/2019/two-women-smiling.jpg?sc_lang=en&hash=84D97AE2A6D302E6BC3B5D47D76F1CE8"> <p>When it comes to skincare, you have lots of options, including peels, <a href="/hometown-health/speaking-of-health/is-botox-the-fix-for-all-facial-wrinkles" target="_self" title="Opens in same window.">Botox</a> and laser resurfacing. With the amount of procedures available, it can be challenging to determine which can target your skin’s needs. But there is a new hydrating skin renewal procedure that is a good option for nearly anyone. It infuses serums, antioxidants and hyaluronic acid into the skin for a more radiant, youthful complexion. </p> <h2>The new procedure targets skin concerns, including:</h2> <ul> <li>Acne-prone skin and enlarged pores</li> <li>Brown spots</li> <li>Elasticity and firmness</li> <li>Fine lines and wrinkles</li> <li>Photo damage</li> <li>Skin tone and texture</li> </ul> <h2>How the skin renewal procedure works</h2> <p>At your initial consultation appointment, a nurse will help you create a treatment plan uniquely tailored for your skincare needs. If you have any open sores or an active rash on the treatment area, you will be advised to wait until the symptoms have resolved to receive the treatment. The procedure takes about 30 to 60 minutes and has best results when done once a month. It cleanses, hydrates and protects your skin with a delivery system that extracts and delivers a unique serum.</p> <h3>These are the steps of the procedure: </h3> <ol> <li><strong>Exfoliation</strong> — Skin is cleansed and exfoliated with an antioxidant solution.</li> <li><strong>Peel</strong> — A light, nonirritating glycolic/salicylic acid chemical peel is applied to the newly exfoliated skin.</li> <li><strong>Extraction</strong> — Impurities are removed from the pores using a gentle and painless suction technology.</li> <li><strong>Fusion</strong> — Now that the pores are open and better able to receive hydration, the skin is bathed in a solution rich in peptides and antioxidants.</li> </ol> <p>After the procedure, you will notice that your skin immediately feels softer, smoother and ultimately, looks more radiant. A follow-up appointment is not required, but a series of treatments is more beneficial than receiving just one. </p> <p><strong>Learn more about <a href="/services-and-treatments/cosmetic-services" target="_self" title="Opens in same window.">cosmetic services</a>.</strong></p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2019/two-women-smiling.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D947DD9693C86E2B7D48C9CFB8F7C8F1" alt="Two women smiling" width="660" height="370" DisableNVelocity="true" />Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Dawn Haller10/15/2025When you think about managing your weight, eating healthy foods and physical activity come to mind. But have you thought about your eating environments? Tackle them with some addition, subtraction and saying no.3 steps to control your environment and weight<img height="370" alt="Illustration comparing fast food to healthy food" width="660" src="/-/media/national-files/images/hometown-health/2019/illustration-comparing-fast-food-to-healthy-food.jpg?h=370&w=660&sc_lang=en&hash=C72CEF1A278CC7D477711C90DA91A4EB" style="height: 370px; width: 660px;" /> <p>When you think of weight and health management, you naturally think of eating low-fat and low-sugar foods, a minimum of five fruits or veggies a day, lean protein, healthy grains and physical activity. Making proactive changes will make it easier to manage your calorie intake. To achieve this, look to your environment for support.</p> <p>Major environments include:</p> <ul> <li>Car</li> <li>Food shopping</li> <li>Holidays</li> <li>Home</li> <li>Social events and restaurants</li> <li>Travel and vacations</li> <li>Work</li> </ul> <p> Manage your environments with these three steps:</p> <h4>1. Addition</h4> <ul> <li>You can’t eat healthy if it’s not there. Add healthy food to each of your environments.</li> <li>If it’s not there, bring it. Fruits and veggies are fast food — the healthy kind. They can be bagged to create a grab-and-go snack. Plan to bring them while traveling or in your car.</li> <li>Bring produce when your workplace has a celebration. You may be the only one to do it, and your co-workers may enjoy it.</li> <li>Call ahead to a restaurant to ensure it has a menu that supports your mission. Many restaurants have online menus.</li> <li>During holidays, substitute ingredients with healthy versions, such as applesauce instead of oil in a cake. Prepare meals with less added fat and sugar.</li> <li>Create a grocery list before shopping and stick to it.</li> <li>Eat before going to any of your environments so you are not tempted to make unhealthy choices.</li> </ul> <h4>2. Subtraction</h4> <ul> <li>Toss foods that won’t support weight control or health management. Go through your kitchen or wherever you store foods to clean house.</li> <li>If there are a few items you choose to keep, limit the quantity or store them out of sight.</li> </ul> <h4>3. Saying no</h4> <ul> <li>You may have to bow out of some activities — and that’s OK. Consider suggesting healthier alternatives to social activities with family and friends, such as bowling or going for a walk instead of drinks or going out to dinner.</li> <li>Restaurant eating can be a weight-gain plan unless you choose wisely. If you do dine out, consider look for healthier restaurants and meals, such as a plain baked potato with salsa, steamed veggies without added fat and lean protein, such as grilled chicken or fish. Many of the healthier options can be found as side dishes on the menu.</li> </ul> <p>Remember that it takes thought, effort and planning — but the payback is worth it. Don’t forget physical activity. You always <span style="color: #333333;">can</span> go for a walk when those around you are eating your trigger foods.</p> <p>Get more tips on <a href="/topics/nutrition">eating healthy</a>, <a href="/topics/exercise-and-fitness" target="_self" title="Opens in same window.">exercise</a> and <a href="/topics/weight-loss-and-bariatric-surgery" target="_self" title="Opens in same window.">losing weight</a> to help you achieve better health.</p> <p><em>By Mayo Clinic Health System staff. </em></p><img src="/-/media/national-files/images/hometown-health/2019/illustration-comparing-fast-food-to-healthy-food.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3E381BFD51C2861DC82A7F979A3F1CB9" alt="Illustration comparing fast food to healthy food" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller4/23/2025Do you know your gut houses up to 1,000 different species of bacteria? Read the two ways to keep your gut health in balance with foods you may already eat every day.Good bacteria for your gut<p>The lining of your digestive tract — like every surface of your body — is covered in microorganisms, mostly bacteria. This microecosystem, called a microbiome, plays a large role in your health. Your mood and behavior also may be impacted by the microorganisms living in your microbiome.</p> <p>You may be surprised to hear your gut houses up to 1,000 different species of bacteria. By nourishing different types of bacteria, you can keep your microbiome in balance.</p> <p>What you feed your microbiome matters. Most healthy adults can safely incorporate prebiotics and probiotics to their diet. A healthy microbiome promotes a healthy immune system and supports a weight management plan.</p> <h2>There are two ways to maintain a healthy gut:</h2> <h3>1. Prebiotics</h3> <p>Prebiotics help the microbes already in your microbiome to grow by giving them the foods they like. Prebiotics are found in many fruits and vegetables containing complex carbohydrates, such as fiber. You may already have these foods in your pantry or fridge, including apples, bananas, berries, carrots, flax seed, garlic, oats and sweet potatoes.</p> <h3>2. Probiotics</h3> <p>Probiotics add living microbes directly to your microbiome to improve the balance of microorganisms. The most common type of probiotic food is yogurt. Certain cheeses, kombucha, kimchi, pickles and sauerkraut are other bacteria-fermented foods containing probiotics.</p> <p>When you're familiar with the variety of foods containing prebiotics and probiotics, you can easily incorporate these ingredients in your meals and favorite recipes. These foods may be a staple in your diet without realizing the health benefits for your microbiome.</p> <h2>Try this recipe containing prebiotic and probiotic foods, including banana, oats and yogurt:</h2> <h3>Banana oatmeal pancakes</h3> <p>By Mayo Clinic Staff<br /> Servings: 6 (12 pancakes)</p> <p>½ cup old-fashioned rolled oats<br /> 1 cup hot or boiling water<br /> 2 tablespoons canola oil<br /> 2 tablespoons brown sugar<br /> ½ cup whole-wheat flour<br /> ½ cup all-purpose flour<br /> 1 ½ teaspoons baking powder<br /> ¼ teaspoon baking soda<br /> ¼ teaspoon salt<br /> ¼ teaspoon ground cinnamon<br /> ½ cup skim milk<br /> ¼ cup fat-free plain yogurt<br /> 1 mashed banana<br /> 1 egg</p> <p>In a large bowl, combine the oats and hot water. Let sit for 1 to 2 minutes until the oats are creamy and tender. Stir in oil and sugar; set aside to cool slightly. In a medium bowl, combine the flours, baking powder, baking soda, salt and ground cinnamon. Whisk to blend. Add the milk, yogurt and banana to the oats and stir until well-blended. Beat in the egg. Add the flour mixture to the oat mixture and stir until just moistened. Place a nonstick frying pan or griddle over medium heat. Once hot, spoon ¼ cup pancake batter into the pan. Cook for about 2 minutes, until the top surface of the pancake is covered with bubbles and the edges are lightly browned. Flip the pancake and cook for another 2 to 3 minutes. Repeat with remaining pancake batter.</p> <p>Nutrition information per two-pancake serving: 192 calories, 6 grams fat, 0 grams saturated fat, 0 grams trans fat, 4 grams monounsaturated fat, 302 milligrams sodium, 30 grams total carbohydrate, 2 grams dietary fiber, 6 grams protein</p> <p><strong>Download a <a href="/-/media/national-files/documents/hometown-health/2019/good-bacteria-for-your-gut.pdf?sc_lang=en&hash=DBEB03689B920827C915894D6D6BACE7" target="_blank" title="Opens in a new window.">list of prebiotic and probiotic foods with good bacteria for your gut</a>, and read more <a href="https://mayoclinichealthsystem.org/topics/eat-well" target="_self" title="Opens in same window.">healthy recipes and tips</a>.</strong></p> <p><em><a href="/providers/amanda-gingrasso-dnp" target="_self" title="Opens in same window.">Amanda Gingrasso</a> is a nurse practitioner in <a href="/services-and-treatments/gastroenterology-and-hepatology" target="_self" title="Opens in same window.">Gastroenterology and Hepatology</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p> <ul> <li>General gastroenterology (GI)</li> <li>Pancreas</li> </ul> APRN, C.N.P., D.N.P.<p>I believe in providing individualized care. The patient should be provided with all options to be able to choose the plan that is right for them. The needs of the patient should be at the forefront of each encounter. I strive to do all I am able for each patient in my capacity. It is imperative to thoroughly communicate and empathize with the patient to build a trusting relationship.</p> <p>I enjoy creating connections with patients and their families. It is rewarding to be part a patient's life and to see them through difficult times. I am proud to practice with a phenomenal team. </p> <p>I grew up in La Crosse. I am married and have one son. I enjoy camping and spending time on our boat, with my family. I also enjoy traveling and visiting with family as much as I can.</p> <p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Nursing, Viterbo University</li> <li>Doctorate degree, Family Nurse Practitioner, Viterbo University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Association of Nurse Practitioners</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Nurse Practitioners</li> <li>American College of Gastroenterology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Medicine, Mayo Clinic College of Medicine and Science</li> </ul> Gingrasso<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/amanda-gingrasso-aprn-cnp-dnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=5499BBEF63209FB19F150BFE3534F727" alt="Amanda Gingrasso, APRN, C.N.P., D.N.P." width="280" height="280" title="Amanda Gingrasso, APRN, C.N.P., D.N.P." DisableNVelocity="true" /> Amanda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15430693Amanda Gingrasso, APRN, C.N.P., D.N.P. 1{CDA27FD1-23E5-4D31-BD85-567A48B862F7}|{63CBB755-37F9-4058-9120-6CD50C94BD16}<img src="/-/media/national-files/images/hometown-health/2022/grilling-vegetables.jpg?h=370&iar=0&w=660&sc_lang=en&hash=06920CDAD6E5EBC5B9E1B0D09B0D5539" alt="Grilling vegetables" width="660" height="370" DisableNVelocity="true" />Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller7/31/2020After age 30, you start to lose bone mass. Get 5 tips to build stronger bones and combat that loss.5 ways to build strong bones as you age<p>The older you get, the harder it is to maintain bone strength.</p> <p>“We continue to build bone mass until age 30,” says <a href="/providers/tina-dreger-md" target="_self" title="Opens in same window.">Tina Dreger, M.D.</a>, an orthopedic surgeon at Mayo Clinic Health System in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin. “After age 30, we break down more bone than we rebuild.”</p> <h4>Dr. Dreger offers 5 tips for combating that bone loss:</h4> <h5>1. Think calcium.</h5> <p>Women up to age 50 and men up to age 70 need 1,000 milligrams daily; women over 50 and men over 70 should get 1,200 milligrams daily.</p> <h5>2. And vitamin D.</h5> <p> Aim for 600 to 800 international units (IUs) daily.</p> <h5>3. Exercise.</h5> <p>Weight-bearing exercise (i.e., walking) and resistance exercise (i.e., weightlifting) help slow bone loss.</p> <h5>4. Don’t smoke.</h5> <p>Smoking can increase bone loss.</p> <h5>5. Drink alcohol moderately, if at all.</h5> <p> More than a drink a day for women or men over 65, or two drinks for men 65 or under, can speed bone loss.</p> <h4>Two bonus tips:</h4> <h5><strong>1. Remember protein</strong>.</h5> <p> Protein is one of the building blocks of bone. While most people get plenty of protein in their diets, some do not. Make sure your diet includes lean sources of protein, such as eggs, lentils, white-meat poultry, lean beef, dairy, shrimp and soy.</p> <h5>2. Maintain an appropriate body weight.</h5> <p>Being underweight increases the chance of bone loss and fractures. Excess weight now is known to increase the risk of fractures in your arm and wrist. As such, keeping body weight in check is good for bones just as it is for health in general.</p> <h4>Read more about bone health and exercise:</h4> <ul> <li>Learn more about <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-20351968" target="_blank" title="Opens in a new window.">osteoporosis</a>.</li> <li>Explore <a href="/topics/exercise-and-fitness">exercise tips and ideas</a> prepared by Mayo Clinic Health System experts.</li> </ul><img src="/-/media/national-files/images/hometown-health/2019/young-woman-smiling-sun-shining.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1CCEFF3DB9E6B6DC00DC4AACE7F3966B" alt="Young woman smiling with sun shining in the background" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.AgingLife expectancy is 75 for males and 80 for females according to the National Center for Health Statistics. We'll help you keep you informed about potential issues with aging, and steps you can take to maintain your health and keep active.Dawn Haller5/21/2019Don't let back pain slow you down. Learn how to stretch and strengthen your back properly to keep you moving.Exercises for a happy back<img height="370" alt="Hands touching back due to pain" width="660" src="/-/media/national-files/images/hometown-health/2019/hands-touching-back-due-to-pain.jpg?h=370&w=660&sc_lang=en&hash=809F4DE1CFEF060D7A4C8419BF475F07" style="height: 370px; width: 660px;" /> <p>Oh, my aching back!</p> <p>Sound familiar? If so, you’re not alone. “It’s estimated that 80 percent of all Americans will develop low back pain at some point in their lives,” says Jason Banks, <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapist</a> at Mayo Clinic Health System in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota. “It’s one of the most common reasons people see their health care providers and the most common condition we treat in Physical Therapy.”</p> <a href="/-/media/national-files/documents/hometown-health/2019/exercises-for-a-healthy-back.pdf?sc_lang=en&hash=D2DF9CECEEE3C7B9B1D5307EA84CF338" target="_blank" title="Opens in a new window."><img alt="Download a PDF to learn exercises for a happy back." src="/-/media/national-files/images/hometown-health/2019/download-exercises-for-happy-back.jpg?h=135&w=135&sc_lang=en&hash=BB34090A7572A0D9EBE31EFB293AD2B5" style="height: 135px; width: 135px; float: right; margin-bottom: 5px; margin-left: 5px;" /></a> <p>To avoid back pain, Jason says to pay attention to posture, body mechanics, diet and sleep positions. He says it’s also important to stretch and strengthen the muscles in your back and core. Here’s one stretch to get you started:</p> <h4>KNEE TO CHEST STRETCH</h4> <ol> <li>Lie on your back with your knees bent and feet flat on the floor.</li> <li>Using both hands, pull up one knee and press it to your chest. Tighten your abdominals, and press your spine to the floor. Hold for 5 seconds.</li> <li>Return to the starting position and repeat step 2 with the opposite leg.</li> <li>Return to the starting position and then repeat with both legs at the same time.</li> <li>Repeat each stretch two to three times — preferably once in the morning and once at night.</li> </ol> <p>If you’ve hurt your back, or have osteoporosis or other health conditions, be sure to check with your health care provider first. </p> <h4>LEARN MORE</h4> <ul> <li><a href="/-/media/national-files/documents/hometown-health/2019/exercises-for-a-healthy-back.pdf?sc_lang=en&hash=D2DF9CECEEE3C7B9B1D5307EA84CF338" target="_blank" title="Opens in a new window.">Download a PDF for three back stretches.</a></li> <li><a href="https://mayoclinichealthsystem.org/topics/move-more" target="_self" title="Opens in same window.">Learn ways to get and stay physically fit.</a></li> <li><a href="https://mayoclinichealthsystem.org/topics/tools-for-health" target="_self" title="Opens in same window.">Get tools to live your healthiest.</a></li> </ul><img src="/-/media/national-files/images/hometown-health/2019/hands-touching-back-due-to-pain.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3348B0708285630253A21769D25F54B4" alt="Hands touching back due to pain" width="660" height="370" DisableNVelocity="true" />Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.Get Tools to Live Your HealthiestIt’s never too early — or too late — to plan ahead for health. By making preventive care for you and your family a healthy habit, you’ll help improve your well-being. Be sure to connect with your healthcare provider to discuss any further questions that you may have about your health.Dawn Haller9/22/2025Hear about a diet plan that seems too good to be true? It probably is. Learn the signs of a fad diet and three key elements in all healthy plans.Don't fall for fad diets<p>When it comes to weight loss, most people would like a quick fix. The internet is full of diet plans that promise rapid results and sound too good to be true. </p> <p>The problem is, they probably are. </p> <p>Fad diets are attractive because they promise something everyone wants: an easy and quick way to lose a lot of weight. However, losing weight comes down to a formula that health care professionals have known for a long time: combining eating a variety of healthy foods in reasonable proportions with regular exercise.</p> <h4>Fad diet signs</h4> <p>But how can you evaluate if a diet plan is just a fad or a good option for the long run?</p> <h5>Steer clear of plans that have any of these telltale signs of fad diets:</h5> <ul> <li><strong>They promise rapid weight loss.</strong><br /> If a plan promises losses of more than 2 pounds a week, proceed with caution. </li> <li><strong>They require eliminating foods.</strong><br /> Beware of diets that claim entire food groups, such as carbohydrates, are bad. You need to eat a variety of foods to get the nutrition your body needs.</li> <li><strong>They have rigid rules.</strong><br /> Some fad diets require purchasing expensive meal replacement products, such as protein shakes or weight loss bars. Others may emphasize eating predominantly one type of food, such as meat, grapefruit or cabbage soup. </li> <li><strong>They severely restrict calories.</strong><br /> You'll lose weight anytime you severely restrict your calories. But this extreme approach is unhealthy and unsustainable. Calories are the fuel your body needs to function. Use this <a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/weight-loss/in-depth/calorie-calculator/itt-20402304" target="_blank" title="Opens in a new window.">calorie calculator</a> to estimate the daily calories your body needs to maintain your current weight. Adjustments can be made to this calorie level for weight loss. Speak with your health care provider or dietitian to figure out what the right number of calories is for you.</li> </ul> <h4>Three key elements to weight loss</h4> <h5>To lose weight and keep it off, look for a plan that includes:</h5> <ol> <li><strong>Variety<br /> </strong>A healthy diet includes fruits and vegetables, whole grains, low-fat dairy products, lean protein, nuts and seeds, and even a sweet treat once in a while. To ensure you're getting the right amount of nutrients to nourish your body, choose a plan that includes all of the food groups. It also is important your eating pattern is appealing and tasty. Otherwise, it won't be something you'll stick with.</li> <li><strong>Exercise<br /> </strong>Achieving a healthy weight is easier when you are eating healthfully and exercising. Look for a plan that recognizes the importance of movement. Get <a href="/hometown-health/speaking-of-health/taking-the-first-step-starting-restarting-an-exercise-program" target="_self" title="Opens in same window.">tips for starting, or restarting, an exercise program</a>.</li> <li><strong>A long-term plan<br /> </strong>The changes you make should be ones you can live with forever. I don't even like using the word "diet" because so many people think of it in terms of something you do for a while and then stop. There's no finish line when it comes to healthy eating and being active.</li> </ol> <p>If you're looking for guidance, several healthy plans meet the criteria outlined, including the <a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/weight-loss/in-depth/mayo-clinic-diet/art-20045460" target="_blank" title="Opens in a new window.">Mayo Clinic Diet</a>, the <a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/multimedia/mediterranean-diet/sls-20077104" target="_blank" title="Opens in a new window.">Mediterranean diet</a> and <a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-20050989" target="_blank" title="Opens in a new window.">Dietary Approaches to Stop Hypertension, or DASH, diet</a>.</p> <p><a href="/healthy-weight" target="_self" title="Opens in same window.">Explore additional healthy weight resources and information.</a></p> <p><em>By Mayo Clinic Health System staff. </em></p><img src="/-/media/national-files/images/hometown-health/2022/blending-smoothie-hand-blender.jpg?h=370&iar=0&w=660&sc_lang=en&hash=49984822A904BAA97EAF16602AB915EE" alt="Blending smoothie hand blender" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller4/23/2025Thinking about trying a gluten-free diet? Learn why it's not necessarily a healthy option for everyone.Do you need to say goodbye to gluten?<img alt="Two people making bread" src="/-/media/national-files/images/hometown-health/2019/two-people-making-bread.jpg?h=370&w=660&sc_lang=en&hash=45FA5AD4C8F8F20FDA986CAF21E4B3CD" style="height: 370px; width: 660px;" /> <p>A trip through almost any grocery store reveals this truth: it's never been easier to be gluten-free. The increase in readily available gluten-free products is good news for people with celiac disease and some other medical conditions. But the easy access may also be encouraging other people to go gluten-free.</p> <p>Many people think following a gluten-free diet is a healthier way to eat, but that's not always true. The diet makes a tremendous difference to people whose bodies don't process gluten well, but following a gluten-free diet isn't necessarily a healthy choice for all.</p> <h2>Who needs to be gluten free?</h2> <h3>Gluten — a protein found in grains including wheat, barley and rye — causes symptoms in people with a number of conditions, including:</h3> <ul> <li>Celiac disease — an autoimmune disorder in which gluten triggers an immune system response and leads to symptoms, including abdominal pain, bloating, diarrhea, fatigue and weight loss.</li> <li>Untreated celiac disease, which leads to damage to the lining of the small intestine and prevents nutrients from being absorbed</li> <li>Nonceliac gluten sensitivity, which causes some of the same symptoms as celiac disease, but does not damage the small intestine</li> <li>Gluten ataxia, another autoimmune disorder, which affects nerve tissues and causes problems with muscle control</li> <li>Wheat allergy, which also involves an immune system response to gluten causing congestion, breathing difficulties or other symptoms</li> </ul> <p>Eliminating gluten from the diet is essential and highly recommended for people with these conditions. If you suspect you're gluten-sensitive, it's best to work with your gastroenterologist to determine if you need to be gluten-free and how careful you need to be.</p> <p>A diagnosis means eliminating a wide array of foods made with wheat, barley or rye. Some, such as bread and cereal, are easy to recognize. But gluten can be found in some unexpected products, including beer, hot dogs, salad dressings and even some medications. There’s a steep learning curve after diagnosis, and it can be challenging to discover all the places that gluten hides.</p> <h2>Does gluten-free equal healthy?</h2> <p>While a gluten-free diet is a medical necessity for people with certain conditions, many other people are choosing to go gluten-free for other reasons.</p> <p>A gluten-free diet’s intention is not weight loss, nor is it necessarily always healthier than a typical diet. For example, a gluten-free cake mix is not going to be healthier than a regular mix. In fact, manufacturers may add more sugar or saturated fat to improve flavor.</p> <p>In addition, many foods with gluten are fortified with vitamins and minerals. The gluten-free versions may not be. People who follow a gluten-free diet, either for medical or personal reasons, may need to work harder to ensure they're getting the nutrients they need.</p> <p>Everyone should focus on getting enough daily servings of fruits and vegetables. The typical American diet doesn't include enough, and they’re naturally gluten-free. If you do have celiac disease or another condition that makes you sensitive to gluten, focus on consuming naturally gluten-free foods and their products, such as quinoa and rice.</p> <p>If you suspect you have celiac disease or gluten intolerance, see your healthcare provider before going gluten-free.</p> <h2>Learn more about celiac disease and gluten:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/14-common-food-package-claims" target="_self" title="Opens in same window.">14 common food package claims</a></li> <li><a href="/hometown-health/speaking-of-health/10-nutrition-myths-debunked" target="_self" title="Opens in same window.">10 nutrition myths debunked</a></li> </ul> <em>Kjersten Nett</em><em> is a <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">registered dietitian</a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a> and <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</em><img src="/-/media/national-files/images/hometown-health/2019/two-people-making-bread.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F8C7B6A6C2D15EE8E0886ABD3A685C14" alt="Two people making bread" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller8/12/2020About 80% of adults experience back pain at some time in their lives. For most people, it will go away on its own with self-care. So, how do you know when to see your doctor about your back pain?When should I see a doctor about back pain?<p>About 80% of adults experience back pain at some time in their lives. It's one of most common reasons people see a doctor or miss work. The pain can range from a dull ache to sharp, sudden and debilitating pain.</p> <p>For most people, back pain is mechanical in nature, which means the elements of your back and how they move together has changed.</p> <h2>Possible back conditions could include:</h2> <ul> <li><strong>Muscle or ligament strain</strong><br /> Heavy lifting or a sudden awkward movement can strain the muscles or ligaments in your back. Also, if you are overweight or in poor physical condition, the constant strain on your back can cause muscle fatigue and muscle spasms.</li> <li><strong>Bulging or ruptured disk</strong><br /> Disks are the cushions between the bones in your spine. You can have bulging or ruptured disks that may or may not cause pain by compressing a nerve root and causing pain that radiates into the leg.</li> <li><strong>Arthritis</strong><br /> Disks may narrow over time and cause your vertebrae to grind together resulting pain.</li> </ul> <p>Most back pain — even severe back pain — goes away on its own in four to six weeks with self-care, such as rest, heat or ice, over-the-counter pain medication and exercise.</p> <p>Surgery often is effective to correct a spinal deformity or instability issue. Surgery also is helpful to treat pain radiating down a leg due to compression of a nerve root in the spine if other conservative treatments have failed. However, surgery is not considered a good treatment for generalized back pain.</p> <p>So how do you know when to see your doctor about your back pain?</p> <h3>Here are a few causes or symptoms that indicate it is time to schedule an appointment:</h3> <ul> <li>Follows a fall, blow to your back or other injury</li> <li>Is constant or intense pain, especially at night or when you lie down</li> <li>Spreads down one or both legs, especially if the pain extends below your knee</li> <li>Causes weakness, numbness or tingling in one or both legs</li> <li>Occurs with swelling or redness on your back, which could indicate an infection</li> <li>Occurs with unintended weight loss</li> <li>Occurs with new bowel or bladder control problems</li> </ul> <p>Also, if you have a history of cancer, talk with your health care provider about any new pain you are experiencing, including back pain.</p> <p><em><a href="/providers/tk-schiefer-md" target="_self" title="Opens in same window.">T.K. Schiefer, M.D.</a>, is a <a href="/services-and-treatments/neurosurgery" target="_self" title="Opens in same window.">neurosurgeon</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Herniated discs</li> <li>Spinal deformity</li> <li>Spinal stenosis, also known as narrowing of the spinal canal</li> <li>Spondylolisthesis, also known as slipped vertebrae</li> <li>Traumatic brain injuries</li> <li>Traumatic spine injuries, such as fractures and spinal cord injury</li> <li>Tumors, spinal and brain</li> </ul>M.D. <p>I view the doctor-patient relationship as a partnership. We will work together to find solutions to treat your condition and improve your quality of life. </p> <p>Since we are working together, it is very important we are on the same page and develop a plan as a team. To help facilitate this, first, I will ask you questions to get details about what is going on. Second, I usually perform a neurological examination pertinent to your problem. Third, we typically review your imaging studies together to better understand the problem. Finally, we have an open and honest discussion about possible solutions and treatments, both surgical and non-surgical. </p> <p>Sometimes non-surgical treatments may be the best option. I only offer and recommend a surgery if I feel it is in your best interest and something I would recommend to one of my own family members. I also try to avoid “doctor jargon” and explain things so they are straight forward and easy to understand. I look forward to partnering together in your neurosurgical care. </p> <p>I am a husband and father of four children. I am very active in my church community and enjoy serving others. I am an Eagle Scout and worked as scoutmaster for my sons' troop for many years. I enjoy traveling, backpacking, being outdoors, staying physically fit and personal finance/investing.</p> <p><strong>Education</strong></p> <ul> <li>Mayo Clinic Alix School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Preliminary Surgery, Mayo Clinic College of Medicine and Science</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Neurologic Surgery, Mayo Clinic College of Medicine and Science</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Neurological Surgery</li> <li>Certificate in Clinical and Translational Science, Mayo Graduate School</li> <li>Silver Level Certification, Mayo Clinic Quality Academy</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Neurological Surgeons</li> <li>Congress of Neurological Surgeons</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Neurosurgery, Mayo Clinic College of Medicine and Science</li> </ul> Schiefer<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/tk-schiefer-md.jpg?h=200&iar=0&w=200&sc_lang=en&hash=5328718020A2786933F34ECF5D6846CB" alt="T.K. Schiefer, M.D." width="200" height="200" DisableNVelocity="true" /> <ul> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/25545552/" target="_blank" title="Opens in new window">In-hospital neurologic deterioration following fractures of the ankylosed spine: a single-institution experience</a>, May 2015.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/24476904/" target="_blank" title="Opens in new window">Significance of cochlear dose in the radiosurgical treatment of vestibular schwannoma: controversies and unanswered questions</a>, May 2014.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/22084629/" target="_blank" title="Opens in new window">Moving forward: advances in the treatment of movement disorders with deep brain stimulation</a>, November 2011.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/19929340/" target="_blank" title="Opens in new window">Importance of the vasculature in cyst formation after spinal cord injury</a>, October 2009.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/18423548/" target="_blank" title="Opens in new window">Epidermoids of the cerebellopontine angle: a 20-year experience</a>, December 2008.</li> </ul> {000BB0CC-A7F9-4570-B165-7B3E176167E9}T.K.<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14270005T.K. Schiefer, M.D. 1{4EA2A40E-3721-48EC-AFC9-E6D0E13BCDEC}|{993AF103-0FE1-4CF2-9F2A-3D064CDA9F32}<img src="/-/media/national-files/images/hometown-health/2023/securing-bike-on-car-roof-rack.jpg?h=370&iar=0&w=660&sc_lang=en&hash=44EF64D4E0B272C85A83867F05A7AFE6" alt="Securing bike on car roof rack" width="660" height="370" DisableNVelocity="true" />Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.NeurosurgeryNeurosurgery treats disorders that impact any part of the nervous system, which may include the brain, spine or peripheral nerves. Conditions treated range from life-threatening brain tumors, to disorders impacting quality of life, such as back pain and carpel tunnel syndrome.Dawn Haller3/20/2024If you're planning international travel, checking in with a travel medicine specialist can help ensure you're informed, prepared and protected against possible health risks.Stay healthy abroad: Why you should see a travel medicine specialist before your trip<p>As you get ready to travel to another country, you probably have many details to coordinate and plan. One essential task, depending on where those travels take you, may be to make an appointment to see a travel medicine specialist.</p> <p>A travel medicine specialist assesses travel-related risks and provides information to ensure your health and safety while minimizing the potential for health-related situations during on your trip.</p> <h2>Adding a consultation to your travel to-do list</h2> <p>A consultation with a travel medicine specialist includes discussing travel-related illnesses, risk factors for infectious and noninfectious diseases, <a href="/hometown-health/speaking-of-health/questions-about-vaccines-and-travel" target="_self" title="Opens in same window.">required immunizations</a>, health regulations and drug-resistant organisms you may encounter.</p> <p>It's crucial to schedule a pretravel consultation at least two weeks or preferably, four to eight weeks, before your trip to ensure you get complete protection from any needed vaccinations.</p> <h3>When requesting a travel medicine consultation, be prepared to provide information about your trip, including:</h3> <ul> <li>All countries you're visiting</li> <li>Any transportation, accommodation or other unusual circumstances </li> <li>Dates and duration of travel</li> </ul> <p>A travel medicine specialist will review your itinerary before your consultation to identify country-by-country health risks, such as exotic infectious agents, the potential for altitude sickness or heat exhaustion, as well as appropriate vaccinations and possible need for malaria prevention medications.</p> <h2>Your opportunity to learn about staying healthy abroad</h2> <p>A consultation gives you the opportunity to learn about health risks you may face while you're traveling and once you reach your destinations.</p> <h3>Based on your itinerary, the travel medicine specialist may: </h3> <ul> <li>Explain the risks of infection from mosquito-borne illnesses and the steps for protecting yourself. This includes reviewing medications to prevent <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/malaria/symptoms-causes/syc-20351184" target="_blank" title="Opens in a new window.">malaria</a>, which is a potentially life-threatening illness.</li> <li>Ensure you receive protection against vaccine-preventable illnesses, such as <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/hepatitis-a/symptoms-causes/syc-20367007" target="_blank" title="Opens in a new window.">hepatitis A</a> or <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/typhoid-fever/symptoms-causes/syc-20378661" target="_blank" title="Opens in a new window.">typhoid fever</a>, and verify that other <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/vaccine-guidance/art-20536857" target="_blank" title="Opens in a new window.">routine vaccinations</a> are current.</li> <li>Evaluate your overall health for travel and discuss with you how to manage preexisting conditions.</li> <li>Give tips for preventing jet lag, motion sickness, altitude illness and <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/deep-vein-thrombosis/symptoms-causes/syc-20352557" target="_blank" title="Opens in a new window.">blood clots</a>.</li> <li>Review how to prevent and treat <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/travelers-diarrhea/symptoms-causes/syc-20352182" target="_blank" title="Opens in a new window.">traveler's diarrhea</a>, the most common travel-related illness.</li> <li>Help you reduce the chance of becoming ill during travel.</li> <li>Provide a <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/viral-hemorrhagic-fevers/symptoms-causes/syc-20351260" target="_blank" title="Opens in a new window.">yellow fever</a> vaccination and an <a rel="noopener noreferrer" href="https://wwwnc.cdc.gov/travel/page/icvp" target="_blank" title="Opens in a new window.">International Certificate of Vaccination</a>, also known as a yellow card, if you travel to a country where the vaccine is recommended or required.</li> <li>Review food and water precautions. Contaminated food and water can pose disease risk for travelers, many of which are transmitted via swallowing or coming in contact with impure water, such as fresh or sea water and swimming pools.</li> </ul> <p>Be sure to ask the specialist any questions you may have about your personal health, and raise any safety concerns about your travel itinerary.</p> <h2>What to do if you got sick on your trip</h2> <p>Once you return home, a travel medicine specialist also can conduct a comprehensive post-travel evaluation of any illnesses you may have picked up while away, including parasitic infections and other tropical diseases that are rare in the U.S.</p> <p>No matter the reason for travel — vacation, business, studying abroad, visiting friends or relatives or medical tourism — always be prepared, and take steps to ensure your health and safety.</p> <p><em>Raj Palraj, M.B.B.S., M.D.</em><em>, is an <a href="/services-and-treatments/infectious-diseases" target="_self" title="Opens in same window.">infectious diseases</a> specialist in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em> </p><img src="/-/media/national-files/images/hometown-health/2024/eating-outdoors-while-traveling.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CDC54E373085C7AB63234E3E1B2CCC9E" alt="Eating outdoors while traveling" width="660" height="370" DisableNVelocity="true" />Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Dawn Haller4/11/2023Hair loss is a common side effect of chemotherapy, and can contribute to stress and anxiety. However, scalp cooling therapy helps many patients keep most of their hair.Using cold cap to prevent hair loss during cancer<p>Chemotherapy often is prescribed to treat many forms of cancer. It kills cancer cells, can make a tumor smaller before surgery and helps other treatments work better. </p> <p>Not only does chemotherapy kill cancer cells, but it also slows down or kills healthy cells that grow and divide quickly. This includes the cells that cause hair to grow, so hair loss is one of the common side effects of chemotherapy. Losing hair can significantly contribute to a patient's stress and anxiety. However, a treatment called scalp cooling therapy is helping many patients keep most of their hair.</p> <p>Hair loss may seem like a small price to pay in exchange for chemotherapy aimed at treating cancer or preventing it from returning. But for some patients, hair loss damages their self-image and serves as a constant reminder of the disease. Scalp cooling therapy helps protect a patient's privacy by reducing the visible effects of cancer treatment, and can improve patients' self-esteem and attitude toward treatment.</p> <p>Scalp cooling therapy uses a Food and Drug Administration-approved cooling cap that covers the patient's hair and has cold liquid circulating through it. The cap is connected to a computer that maintains the temperature of the liquid at around 32 degrees Fahrenheit. The cap has a covering that keeps it in place and the temperature constant. </p> <img height="356" alt="Cold cap therapy" width="300" src="/-/media/national-files/images/hometown-health/2023/cold-cap-therapy.jpg?sc_lang=en&hash=7FA4E80EFAD992F8A70131408F1A8A70" /> <p>Scalp cooling reduces the damage that chemotherapy causes to hair follicles. When cooled, blood vessels in the scalp constrict, reducing blood flow to hair follicles. This restricts the amount of chemotherapy medication that enters hair follicle cells.</p> <p>Usually, patients wear the cap for 30 minutes before their chemotherapy treatments, throughout the chemotherapy session and for 90 to 120 minutes afterward. A study conducted on women using the cooling caps while undergoing chemotherapy for breast cancer showed that 66% lost 50% or less of their hair. This was compared to women who didn't use the caps, with all women in that group losing more than 50% of their hair.</p> <p>Side effects of scalp cooling therapy are minor and may include chills, headaches, scalp irritation, and neck and shoulder discomfort.</p> <p>Talk with your <a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">oncologist</a> about using scalp cooling therapy to preserve your hair during chemotherapy treatments. </p> <p> Your health care team can help you find information about resources to cover the cost of scalp cooling therapy. The therapy is offered free of charge to patients in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a> and <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota, thanks to philanthropic sources, including the Fairmont Community Hospital Foundation.</p> <p><em><a href="/providers/amrit-singh-mbbs">Amrit Singh, M.B.B.S.</a>, is an <a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">oncologist</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a>, <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a> and <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li> Benign blood conditions like anemia and thrombocytopenia</li> <li>Breast cancer </li> <li>Colon cancer </li> <li>Head and neck cancers</li> <li>Lung cancer </li> <li> Lymphomas</li> </ul>M.B.B.S.<p>My practice provides the latest, personalized and evidence-based care for all types of cancer and diseases of the blood and blood-forming organs. I place myself in my patients' shoes and empower them to share in decision-making. I will discuss options in depth, yet in simple, everyday terms they can understand.</p> <p>I am here because of my patients and I work hard, with empathy, to ensure that no stone is left unturned in the care they receive.</p><p><strong>Education</strong></p> <ul> <li>Armed Forces Medical College, India</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Brookdale University Hospital and Medical Center</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Brookdale University Hospital and Medical Center</li> </ul> <p><strong>Certifications</strong> </p> <ul> <li>Internal Medicine, American Board of Internal Medicine</li> <li>Hematology, American Board of Internal Medicine</li> <li>Medical Oncology, American Board of Internal Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Medical Association</li> <li>American Society of Clinical Oncology </li> <li>American Society of Hematology</li> <li>Minnesota Medical Association </li> <li>Minnesota Society of Clinical Oncology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Medical Oncology, Mayo Clinic College of Medicine and Science</li> </ul>Singh<img src="/-/media/shared-files/images/medical-professionals/full/mankato/amrit-singh-md.jpg?h=200&iar=0&w=200&sc_lang=en&hash=E1CF77833B1263B4A148D8FE42FE02B5" alt="Amrit Singh MD" width="200" height="200" DisableNVelocity="true" />Amrit <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15666824Amrit Singh, M.B.B.S.1{BCFC3BDC-CF55-458E-A41C-9360527B6CCC}|{0DD9D3C9-86C5-47FC-A2CF-8AEEA4717B70}|{7C7741C5-CC6B-4EEB-92CD-A20D529F4D9F}<img src="/-/media/national-files/images/hometown-health/2023/hands-braiding-long-hair.jpg?h=370&iar=0&w=660&sc_lang=en&hash=582101D2A1E68874DA3BE5D2A4CB9CC8" alt="Hands braiding long hair" width="660" height="370" DisableNVelocity="true" />Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Colorectal HealthGet screening and treatment for colorectal cancer symptoms, and learn about risk factors and prevention strategies.Lung CancerLung cancer is a type of cancer that begins in the lungs. It is the leading cause of cancer deaths in the U.S., among both men and women. Lung cancer claims more lives each year than do colon, prostate, ovarian and breast cancers combined. <br/><br/>Prostate HealthProstate cancer is the most common cancer diagnosed in men. You may have friends or family members who have been diagnosed with prostate cancer, and this may make you wonder about what you can do for prostate cancer prevention.Skin CancerSkin cancer — the abnormal growth of skin cells — most often develops on skin exposed to the sun. But this common form of cancer can also occur on areas of your skin not ordinarily exposed to sunlight.Dawn Haller6/17/2019Do you find it difficult to exercise because of reduced mobility, pain or balance issues? Aquatic exercise is a fun, effective way to focus on fitness in a gravity-reduced environment. Here are five things you need to know before you begin.Aquatic exercise: Healthy, easy on the body<img height="370" alt="Two people doing aquatic exercise" width="660" src="/-/media/national-files/images/hometown-health/2019/two-people-doing-aquatic-pt.jpg?sc_lang=en&hash=6EF08EBFD53501819B66053BC02D9FC9" /> <p>Most of us know that regular exercise has a number of important health benefits, including weight management and improvement in cardiovascular health and sleep quality. However, many people struggle with common forms of exercise, such as walking, running and weight-training due to pain, mobility issues or fear of falling.</p> <p>Aquatic exercise is a fun way to focus on fitness in a gravity-reduced environment. The buoyancy of water is easier on the body and provides support for people with weakness, balance problems or pain. Additionally, the viscosity of water slows movement and provides resistance during exercise, making aquatic exercise a great workout.</p> <h2>Here are five things you need to know before jumping into the pool:</h2> <h3>1. Aquatic exercise is versatile.</h3> <p>Exercise in an aquatic environment offers numerous options and techniques for almost all levels of physical ability. Exercise can be as basic as walking in the water to more high-level aerobic activities, such as deep-water running or swimming. Standing exercises often are performed in water that is waist to chest deep. These exercises can focus on improving range of motion/flexibility, balance and strength. Resistance training can be amped up by simply increasing the speed of movement or adding equipment, such as mitts, paddles, noodles or bands, to increase drag.</p> <h3>2. You don’t need to know how to swim.</h3> <p>Having a basic knowledge of swimming or water safety is a good idea for anyone who is around water, but this form of aquatic exercise doesn't necessarily involve swimming. The shallow end of any pool or lake will do, and you need only be able to stand in water for many of the movements.</p> <h3>3. Water temperature is important.</h3> <p>Aquatic exercise in lower water temperatures (82–88 degrees Fahrenheit) generally is best for higher-level intensity exercise or people who are prone to overheating, such as those who are pregnant, obese or have multiple sclerosis. Aquatic exercise in warmer temperatures (84–92 degrees Fahrenheit) is better for people with arthritis, fibromyalgia or pain, as well as those who are frail.</p> <h3>4. Be cognizant of your abilities.</h3> <p>With the increased ease of exercise in water, people often can tolerate longer exercise sessions. As a result, these sessions can be more intense, with larger ranges of motion. You should be aware of the potential of overstressing your body. You may be more fatigued than you were expecting following an aquatic exercise session.</p> <h3>5. Consider group exercises to mix it up.</h3> <p>Group aquatic exercise classes are a great way to socialize, build connections, find support, increase accountability and stay motivated to continue exercising. Classes often are led by instructors who have special training in exercising in an aquatic environment. The instructors are able to offer suggestions to adjust exercises for individual participants, if needed.</p> <p><em><a href="/providers/kimberly-olsen-pt" target="_self" title="Opens in same window.">Kimberly Olsen</a> is a <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapist</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Aquatic therapy  </li> <li>Orthopedic medicine</li> <li>Sports medicine</li> <li>Vestibular</li> </ul>P.T.<p>I am passionate about helping patients achieve their goals of returning to work, daily activities and recreational activities. My specialty areas include aquatic therapy, vestibular therapy, and orthopedic and sports rehab.</p> <p>In my free time, I enjoy spending time with my family, biking on the trails around Mankato and Minnesota, walking my dog, and gardening.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Physical Therapy, Mayo Clinic School of Health Sciences</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Credentialed Clinical Instructor, American Physical Therapy Association</li> <li>Minnesota Board of Physical Therapy</li> </ul>Olsen<img src="/-/media/shared-files/images/medical-professionals/full/mankato/kimberly-olsen-pt.jpg?h=280&iar=0&w=280&sc_lang=en&hash=9FAAE935455429C0A4D51A0D93745BC0" alt="Kimberly Olsen PT" width="280" height="280" DisableNVelocity="true" />{FEA2DE2C-F235-4D61-A2E6-901AD650C612}Kimberly<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>11913177Kimberly Olsen PT1{DEF55970-853F-4E96-9A4D-3413874FF059}|{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2019/two-people-doing-aquatic-pt.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1E3D38B0A58AC385C7E5938ACED6E44A" alt="Two people doing aquatic PT" width="660" height="370" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Dawn Haller6/14/2019<p>“Oh my aching back!” If your back pain is caused by structural issues and not muscle or ligament strain, find out what spinal fusion is and how you can benefit.</p>What is a spinal fusion, and does it work?<img height="370" alt="Woman walking dog" width="660" src="/-/media/national-files/images/hometown-health/2019/woman-walking-dog.jpg?sc_lang=en&hash=7AC1ADE9A9595AFA0DFFF5E27EFD5E9B" /> <p>“Oh my aching back!” Have you heard this before? Up to 80 percent of adults have back pain at some point in life, and all are seeking relief. Most people with back pain will get relief from nonsurgical interventions, such as heat, ice, exercise and time. This is because their pain is a result of a muscle or ligament strain.</p> <p>However, the pain that some people experience is the result of structural issues with their spines, and those individuals can benefit greatly from a surgical intervention on their spine.</p> <h4>SPINAL FUSION EXPLAINED</h4> <p>A spinal fusion is a common type of complex spinal surgery that can help with chronic back pain in certain situations. These include correcting instability or deformity in the person’s spine. Spinal fusion also is used to treat some degenerative conditions and spinal fractures.</p> <p>During the procedure, your surgeon places bone or a bonelike material within different spaces between two or more spinal vertebrae which will cause these vertebrae to grow together, or fuse, over time. The bone graft may come from a bone bank or your own body, typically your pelvis. Metal plates, screws and/or rods are used to hold the vertebrae together as a single solid unit while the bones heal. Your surgeon also may remove a portion of your back structure to reduce pressure on the nerve(s) causing pain.</p> <h4>SPINAL FUSION CONSIDERATIONS</h4> <p>Spinal fusion generally is a safe procedure. As with any surgery, however, spinal fusion carries the potential risk of complications. Additionally, it is important to consider the pros and cons with this surgery because it immobilizes parts of your spine permanently and changes the way your spine can move. Most of my patients report that their lives have not been significantly impacted by this loss of mobility, and quality of life actually is enhanced due to the reduction of pain.</p> <p>Even when spinal fusion provides symptom relief, it does not prevent you from developing more back pain in the future. Most of the degenerative conditions in the spine are caused by arthritis, and surgery will not cure your body of that disease. Additionally, fusion of vertebrae can place additional stress and strain on the vertebrae above and below the fused portion, and may increase the rate at which those areas of your spine degenerate, which is called adjacent segment disease.</p> <h4>SPINAL FUSION RECOVERY</h4> <p>If you have a spinal fusion procedure, you can expect to remain in the hospital one to three nights on average, but will be encouraged to begin walking the day after surgery. Physical therapy will begin about six weeks after surgery. You also will have lifting restrictions immediately after the procedure and have a 50-pound weight-lifting restriction for the rest of your life to try to minimize the strain on the spine and reduce the chance of an adjacent segment problem.</p> <p>It is important not to attempt to rush your recovery as the bone graft requires time to heal and immobilize the portion of your spine. Nicotine impedes bone growth and the healing process, so you will need to stop using tobacco or nicotine for six weeks before surgery and at least one year after surgery. Better yet, stop smoking completely.</p> <p><em><a href="/providers/tk-schiefer-md" target="_self" title="Opens in same window.">T.K. Schiefer, M.D.</a>, is a <a href="/services-and-treatments/neurosurgery" target="_self" title="Opens in same window.">neurosurgeon</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Herniated discs</li> <li>Spinal deformity</li> <li>Spinal stenosis, also known as narrowing of the spinal canal</li> <li>Spondylolisthesis, also known as slipped vertebrae</li> <li>Traumatic brain injuries</li> <li>Traumatic spine injuries, such as fractures and spinal cord injury</li> <li>Tumors, spinal and brain</li> </ul>M.D. <p>I view the doctor-patient relationship as a partnership. We will work together to find solutions to treat your condition and improve your quality of life. </p> <p>Since we are working together, it is very important we are on the same page and develop a plan as a team. To help facilitate this, first, I will ask you questions to get details about what is going on. Second, I usually perform a neurological examination pertinent to your problem. Third, we typically review your imaging studies together to better understand the problem. Finally, we have an open and honest discussion about possible solutions and treatments, both surgical and non-surgical. </p> <p>Sometimes non-surgical treatments may be the best option. I only offer and recommend a surgery if I feel it is in your best interest and something I would recommend to one of my own family members. I also try to avoid “doctor jargon” and explain things so they are straight forward and easy to understand. I look forward to partnering together in your neurosurgical care. </p> <p>I am a husband and father of four children. I am very active in my church community and enjoy serving others. I am an Eagle Scout and worked as scoutmaster for my sons' troop for many years. I enjoy traveling, backpacking, being outdoors, staying physically fit and personal finance/investing.</p> <p><strong>Education</strong></p> <ul> <li>Mayo Clinic Alix School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Preliminary Surgery, Mayo Clinic College of Medicine and Science</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Neurologic Surgery, Mayo Clinic College of Medicine and Science</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Neurological Surgery</li> <li>Certificate in Clinical and Translational Science, Mayo Graduate School</li> <li>Silver Level Certification, Mayo Clinic Quality Academy</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Neurological Surgeons</li> <li>Congress of Neurological Surgeons</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Neurosurgery, Mayo Clinic College of Medicine and Science</li> </ul> Schiefer<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/tk-schiefer-md.jpg?h=200&iar=0&w=200&sc_lang=en&hash=5328718020A2786933F34ECF5D6846CB" alt="T.K. Schiefer, M.D." width="200" height="200" DisableNVelocity="true" /> <ul> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/25545552/" target="_blank" title="Opens in new window">In-hospital neurologic deterioration following fractures of the ankylosed spine: a single-institution experience</a>, May 2015.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/24476904/" target="_blank" title="Opens in new window">Significance of cochlear dose in the radiosurgical treatment of vestibular schwannoma: controversies and unanswered questions</a>, May 2014.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/22084629/" target="_blank" title="Opens in new window">Moving forward: advances in the treatment of movement disorders with deep brain stimulation</a>, November 2011.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/19929340/" target="_blank" title="Opens in new window">Importance of the vasculature in cyst formation after spinal cord injury</a>, October 2009.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/18423548/" target="_blank" title="Opens in new window">Epidermoids of the cerebellopontine angle: a 20-year experience</a>, December 2008.</li> </ul> {000BB0CC-A7F9-4570-B165-7B3E176167E9}T.K.<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14270005T.K. Schiefer, M.D. 1{4EA2A40E-3721-48EC-AFC9-E6D0E13BCDEC}|{993AF103-0FE1-4CF2-9F2A-3D064CDA9F32}<img src="/-/media/national-files/images/hometown-health/2019/woman-walking-dog.jpg?h=370&iar=0&w=660&sc_lang=en&hash=DCAF3D593AA43ECEDAF7099B7687DBF5" alt="Woman walking dog" width="660" height="370" DisableNVelocity="true" />NeurosurgeryNeurosurgery treats disorders that impact any part of the nervous system, which may include the brain, spine or peripheral nerves. Conditions treated range from life-threatening brain tumors, to disorders impacting quality of life, such as back pain and carpel tunnel syndrome.Dawn Haller6/13/2019A nibble here and a bite there can quickly add up to a 1,000 or more extra daily calories. Read how easily it can happen.Keep track of bite, lick and taste calories<img height="370" alt="Young woman tasting cooking" width="660" src="/-/media/national-files/images/hometown-health/2019/young-woman-tasting-cooking.jpg?sc_lang=en&hash=87B7D2286A6777E77B39FB8EEB47C0BB" /> <p>Here’s a story about how easy it is to consume more calories than you expect to through extra bites, licks and tastes of food — or what I refer to as BLTs:</p> <ul> <li>While having your usual serving of cereal in the morning, there is a little left in the box — too much to throw and not enough to save. So you dump it in your bowl. (50 calories)</li> <li>Someone at work baked cookies and brought a plate to share. You say to yourself, “I’ll just have a small one. After all, I don’t want to hurt her feelings.” (100 calories)</li> <li>After several trips past your co-worker’s desk, you finally take just one chocolate candy. You think, “It’s only one, and they are so cute!” (25 calories)</li> <li>You eat your usual lunch and think afterwards, “Something sweet sounds good. I’ll see if there are any cookies left. They are so small.” (100 calories)</li> <li>It’s midafternoon, and you are getting sluggish. A couple of chocolate candies would be far better than going down to the vending machine. (50 calories)</li> <li>Before you can go home, you need to stop at the grocery store. You are so hungry you decide to buy a small pack of almonds. You think it will hold you over until you can eat your dinner, and almonds are healthy. (250 calories)</li> <li>While making chili at home, you check to see if it is seasoned properly. You taste (30 calories), season, taste (30 calories), season, taste (30 calories). Now it’s just right. (90 calories)</li> <li>It’s the evening and after all the chaos of your after-supper activities and chores. The kids are in bed, and now you can finally relax. Ice cream sounds really good — but not too much. One cup should be good. (500 calories)</li> </ul> <p>How much of your daily calorie budget did you spend on all these BLTs? You had 1,165 extra calories on top of your usual eating plan.</p> <p>Keeping track of all foods you eat can help you stay mindful of what you are actually eating. Learn how with a <a href="/-/media/local-files/eau-claire/documents/medical-services/weight-management/mayo-clinic-diet-record-tracker.pdf?sc_lang=en&hash=FAF5A394467C967CD4617BCE518CAFDC" target="_blank" title="Opens in a new window.">diet tracker</a>.</p> <p>Find additional <a href="/healthy-weight" target="_self" title="Opens in same window.">healthy weight resources</a>, and read our <a href="https://mayoclinichealthsystem.org/hometown-health?topic=Weight%20Loss%20and%20Bariatric%20Surgery" target="_self" title="Opens in same window.">blogs about weight management</a> to help you reach your goals.</p> <p><em><a href="/providers/rhonda-jenson" target="_self" title="Opens in same window.">Rhonda Jenson</a> is an educator in <a href="/services-and-treatments/weight-management" target="_self" title="Opens in same window.">Weight Management Services</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Lifestyle and behavior changes</li> <li>Nutrition</li> <li>Weight management</li> </ul>I am a weight management educator. I help patients with behavior, lifestyle and nutrition changes to help them get to and maintain a healthy weight.<p><strong>Education </strong></p> <ul> <li>Vocational Rehabilitation, University of Wisconsin-Stout</li> </ul>Jenson<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/rhonda-jenson.JPG?h=280&iar=0&w=280&sc_lang=en&hash=65B478A03A514D221E16B99AB77490D3" alt="Rhonda Jenson" width="280" height="280" DisableNVelocity="true" />Rhonda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13783599Rhonda Jenson1{94B2E140-AEF8-44BA-B6A9-4538B77501BC}<img src="/-/media/national-files/images/hometown-health/2019/young-woman-tasting-cooking.jpg?h=370&iar=0&w=660&sc_lang=en&hash=50A74E24E299FFAA5E7F72972B2CA7D2" alt="Young woman tasting while cooking" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller3/17/2022Laughing during labor? Nitrous oxide, or laughing gas, won’t cause hysterical laughing during labor. Learn more about this childbirth pain relief option.5 FAQ about laughing gas for pain relief during labor, delivery<p>When you think of laughing gas, the first image that comes to mind likely is someone hysterically laughing. Nitrous oxide, also known as laughing gas, has been making a comeback as a pain-relief option for women during childbirth. While the option is safe for most women, many rumors surround its use.</p> <h3>Here are the answers to 5 common questions about nitrous oxide as a pain relief option for labor:</h3> <h4>1. Why are more women turning to laughing gas for managing childbirth pain?</h4> <p>Women want more options for managing pain during labor and delivery. Nitrous oxide is self-administered, so you feel more control over pain relief.</p> <p>Nitrous oxide does not limit mobility, slow labor or cause significant risk to the baby. It has a quick onset after it is inhaled and leaves the system quickly once its use is discontinued.</p> <p>Nitrous oxide will not eliminate pain, but it can dull pain and lessen anxiety. It's a good option for women who are prone to anxiety or want the ability to move around during labor.</p> <h4>2. Does laughing gas make you laugh like crazy? </h4> <p>Contrary to its name, laughing gas does not make you laugh like crazy. The gas slows the nervous system, which makes you feel less inhibited. It also can create a sense of well-being or euphoria. This combination can make you feel gigglier than usually, but most don't laugh hysterically.</p> <p>Nitrous oxide may make you feel groggy or nauseous, but those potential side effects usually go away within a few minutes.</p> <h4>3. What are some of the benefits of using laughing gas over other pain relief methods?</h4> <p>Laughing gas is the least expensive pain relief option available and has little effect on the baby. It can be used continuously, and it allows you to walk during labor.</p> <p>Laughing gas also is less invasive than an epidural. If you choose a different pain management option, nitrous oxide can be stopped at any time.</p> <p>You can safely breastfeed after delivery even if you used laughing gas.</p> <h4>4. Who benefits from using laughing gas?</h4> <p>Laughing gas is a good option if you tend to feel anxious. If you have been diagnosed with anxiety, are nervous around needles, scared of being in hospitals or have a hard time relaxing and releasing tension, it may be for you.</p> <p>It also is an option to consider if you wanted to avoid an epidural and narcotic pain medication, or it's too early or late for an epidural.</p> <h4>5. How is laughing gas administered?</h4> <p>You give yourself laughing gas by holding a small mask to your mouth to inhale the gas. It takes effect within a minute. Once the mask is removed, the effects of nitrous oxide quickly wear off. Some women prefer to use nitrous oxide during contractions, and others prefer to use it to help relax between contractions. Your health care team will teach you how to use it.</p> <p>Nitrous oxide is a good option if you are looking for a noninvasive pain reliever that you can control. Knowing the available options will help you choose an effective pain relief method for labor and delivery.</p> <p>Learn more about <a href="/hometown-health/speaking-of-health/easing-labor-pain-with-inhaled-nitrous-oxide" target="_self" title="Opens in same window.">easing pain with nitrous oxide</a> and the <a href="/hometown-health/speaking-of-health/the-importance-of-a-birth-plan" target="_self" title="Opens in same window.">importance of having a birth plan</a>.</p> <p><em><a href="/providers/christina-spencer-do" target="_self" title="Opens in same window.">Christina Spencer, D.O.</a>, is an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Robotic surgery</li> </ul>D.O.<p>Patients can expect to have my full attention during their visit, and know that we will work together to come up with a treatment plan that fits their needs.</p> <p>In my spare time, I enjoy hiking, biking, travel and soccer.</p><p><strong>Education</strong></p> <ul> <li>A.T. Still University School of Osteopathic Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Obstetrics and Gynecology, Good Samaritan Hospital Medical Center</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Gynecologic Laparoscopists</li> <li>American College of Obstetrics and Gynecology</li> <li>American Institute of Ultrasound in Medicine</li> <li>American Society for Colposcopy and Cervical Pathology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Obstetrics and Gynecology, Mayo Clinic College of Medicine and Science</li> </ul> <p> </p>Spencer<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/christina-spencer-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=0027F4F75C2C8D4E96C042649FCD17C1" alt="Christina Spencer, D.O." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.gynecologiconcology-online.net/article/S0090-8258(20)31786-8/fulltext" target="_blank" title="Opens in a new window.">Outcomes of MSI high advanced stage endometrial cancer treated with chemotherapy and radiation versus chemotherapy alone</a>, October 2020</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00006250-202005001-00312&D=ovft&PDF=y" target="_blank" title="Opens in a new window.">Multimodality therapy associated with improved outcomes in patients with MSI-high advanced endometrial carcinoma</a>, April 2020</li> </ul>Christina<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30080417Christina Spencer, D.O.1{54693F31-87AF-4B21-91DB-1DEC1E21F878}|{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}<img src="/-/media/national-files/images/hometown-health/2022/pregnant-woman-holding-belly.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BAFAE34ED1F36DF37D19DDDE936309E7" alt="Pregnant woman holding belly" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller6/5/2019As an athletic trainer, Kiersten Schmidt conducts baseline concussion screenings, evaluates injuries during and after games, and much more. Read about her work with the Mankato MoonDogs and other teams.Athletic trainer provides sports medicine care<img height="370" alt="Athletic trainer taping wrist" width="660" src="/-/media/national-files/images/hometown-health/2019/athletic-trainer-taping-wrist.jpg?sc_lang=en&hash=B950B64E63BB9BDCCD5D0D0A32791CAA" /> <p>A few hours before the Mankato MoonDogs home opener in Mankato, Minnesota, team newcomer Sky-Lar Culver found Kiersten Schmidt in the dugout.</p> <p>“Can you tape up my wrist?” Sky-Lar asks.</p> <p>As an athletic trainer in the <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">Orthopedics</a> and <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">Sports Medicine</a> Department at Mayo Clinic Health System in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Kiersten does a lot of this type of care for the amateur baseball team players. She also keeps a critical eye on the athletes during games, watching for injuries.</p> <h4>BASELINE CONCUSSION TESTING</h4> <p>With the onset of the new season this year, Kiersten’s scope of care broadened. She conducted baseline concussion testing for the first time. The preseason exam is used to assess athletes’ balance and brain function, including memory, concentration and problem-solving skills. The baseline tests can be compared with results from a similar exam conducted if an athlete is suspected of having sustained a concussion.</p> <p>“I thought it was important we do this,” says Kiersten, noting that concussions are not a common occurrence. “When we have a little bit better background on the athlete, we can truly assess where they’re at with their concussions. We’re not playing a guessing game when they can return to play.”</p> <p>This is Kiersten’s fifth year working with the MoonDogs — a team she worked with prior to joining Mayo Clinic Health System. She says she’s always excited for the start of a new season.</p> <p>“I love working with these elite athletes and getting to know their back story since they come to Mankato from all over the country,” she says. “I enjoy every minute.”</p> <p>Kiersten provides coverage at all the home games for home and away teams. Athletic trainers also provide care for youth and professional teams.</p> <p>“I am extremely excited to expand our sports medicine services and provide care to professional athletes,” Kiersten says.</p> <h4>A TYPICAL DAY AT THE GAME</h4> <p>“On a typical day, I normally get to the field early while the teams are taking batting practice,” Kiersten says. “During this time, I can complete any evaluations for injuries that may have happened the night before by putting the players through a series of tests. I can also watch them while batting and playing catch to determine if they are able to perform or if they should sit out for the game.”</p> <p>Before the games, Kiersten also helps get athletes ready by performing any stretches or treatment needed. During the games, Kiersten responds to any injuries, provides treatment and cheers the team on from the sidelines.</p> <p>“I’m at the field in case any of the athletes get injured or a medical emergency happens,” Kiersten says. “I can evaluate the injury to determine if the athlete is able to be treated on-site or if they should be referred to a physician, such as our sports medicine physicians. If there is a medical emergency, I can manage the situation until emergency medical personnel arrive, and the athlete can be transported.”</p> <h4>LEARN MORE</h4> <ul> <li><a href="/hometown-health/speaking-of-health/the-real-impact-of-a-concussion" target="_self" title="Opens in same window.">The real impact of a concussion</a></li> <li><a href="/hometown-health" target="_self" title="Opens in same window.">Collaboration returns girl to ice for tournament play</a></li> <li><a href="/hometown-health/speaking-of-health/top-5-sports-medicine-faqs" target="_self" title="Opens in same window.">Top 5 sports medicine FAQs</a></li> </ul><img src="/-/media/national-files/images/hometown-health/2019/athletic-trainer-taping-wrist.jpg?h=370&iar=0&w=660&sc_lang=en&hash=97D8199B0654F456E501C193C44EF10F" alt="Athletic trainer taping wrist" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller6/3/2019If you have wrinkles or acne scars, a skin needling may be the solution for you. As microinjuries from needling heal, the body produces capillaries, collagen and elastin that reduce fine lines, wrinkles and acne scars.Skin needling procedure uses body’s natural healing process<img alt="Middle-age woman hands on face" src="/-/media/national-files/images/hometown-health/2019/middle-age-woman-hands-on-face.jpg?h=370&w=660&sc_lang=en&hash=837EF3AD58305E3C3C027760FC3538C4" style="height: 370px; width: 660px;" /> <p>Do you have wrinkles or acne scars that you just don't like? A skin needling procedure may be the solution for you.</p> <p>During the procedure, a <a href="/services-and-treatments/dermatology" target="_self" title="Opens in same window.">dermatologist</a> punctures the skin using a device that has fine surgical needles, creating controlled microinjuries. As these injuries heal, the body produces capillaries, collagen and elastin that reduce fine lines, wrinkles and acne scars. You also may hear the procedure called collagen induction therapy (CIT) or percutaneous collagen induction (PCI).</p> <p>This procedure can benefit virtually any adult, and is safe for all skin colors and types. While you may be able to find derma rollers online or at the drugstore, they won’t deliver the same effects as a professional. Devices from these sources can have contact with the skin at several different angles, causing more damage to the skin. Clinicians can customize the procedure to your needs with adjustable needle lengths. Needle cartridges are disposed of after the procedure.</p> <p>Each session takes 30 to 60 minutes. Depending on the area size and condition of the skin, you may need multiple sessions. Most people have between one to three sessions, but it may take more to get the desired results. Sessions are scheduled four to six weeks apart to allow the skin to heal.</p> <h2>Here’s how a typical skin needling procedure works:</h2> <ol> <li>You will have a consultation appointment before your first session to talk about the procedure, healing process and proper treatment to address your skin concerns.</li> <li>At your microneedling appointment, the clinician will cleanse your skin and apply a numbing cream to the area being treated. You may feel a small amount of discomfort during the procedure, but the cream helps to minimize pain.</li> <li>The dermatologist will use the tool to create microinjuries on the treated area.</li> <li>You may experience pinkness and skin tightness similar to sunburn, but there is no downtime after the procedure.</li> </ol> <p>Talk with your dermatologist about microneedling to determine the best treatment plan for you and guide you through each session so you can achieve your desired results.<span style="color: #131313; font-family: 'Open Sans', Arial, sans-serif;"> </span></p> <p><em><a href="/providers/patrice-hicks-md" target="_self" title="Opens in same window.">Patrice Hicks, M.D.</a>, is a <a href="/services-and-treatments/dermatology" target="_self" title="Opens in same window.">dermatologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>University of Minnesota School of Medicine</li> </ul> <p><strong>Internship/Residency</strong></p> <ul> <li>University of Minnesota</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Cryolipolysis, also called CoolSculpt or CoolSculpting</li> <li>Dermatology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Dermatology, Mayo Clinic College of Medicine and Science</li> </ul>Hicks<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/patrice-hicks-md.jpg?h=200&iar=0&w=200&sc_lang=en&hash=84C7DF035B69D8140897F8DA30E0F76E" alt="Patrice Hicks MD" width="200" height="200" DisableNVelocity="true" />Patrice<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13830112Patrice Hicks, M.D.1<img src="/-/media/national-files/images/hometown-health/2019/middle-age-woman-hands-on-face.jpg?h=370&iar=0&w=660&sc_lang=en&hash=60E75B1BBBADDBB26E0C5408C44E1739" alt="Middle-age woman hands on face" width="660" height="370" DisableNVelocity="true" />Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Dawn Haller7/31/2019When medication is prescribed by a doctor and taken correctly, it can help you with day-to-day life. But did you know that you also should take precautions with over-the-counter medications?Over-the-counter, prescription medication safety<p>You want to begin taking a <a href="/services-and-treatments/medication-therapy-management" target="_self" title="Opens in same window.">medication</a>, but how do you know if it is safe? When prescribed by a doctor and taken correctly, your medication can help you with day-to-day life. Your doctor will decide the right prescription medication for you based on your diagnosis, biology and family medical history. However, judging whether or not an over-the-counter medication is safe for you can be challenging. Consult with your doctor or pharmacist before taking any medication to discuss dosage, side effects and correct usage.</p> <h4>Use these online databases to research medications, supplements and herbs before taking them:</h4> <ul> <li>Check the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/drugs-supplements" target="_blank" title="Opens in a new window.">Mayo Clinic drug and supplement database</a>. You can search for information about over-the-counter and prescription drugs and supplements.</li> <li>If you’re curious about side effects and warnings, search for drugs, herbs and supplements on the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://medlineplus.gov/druginformation.html" target="_blank" title="Opens in a new window.">MedlinePlus</a> database.</li> <li>The FDA has resources to help you find more information about medications, such as a medication guide, drug safety by name and function, disposal guides and a description of prescription drug labels.</li> </ul> <h4>For all medications, supplements and herbs, follow these six tips:</h4> <ol> <li>Always take your medications exactly as directed by your doctor.</li> <li>Be open with your doctor about all medications you are taking, even over-the-counter medications. Some ingredients become dangerous when mixed together. You also may be taking two medications that contain the same ingredient, which could be harmful if too much is taken.</li> <li>Do not take medication from someone else or share your medication with others.</li> <li>Talk to your pharmacist about potential side effects or signs of an allergic reaction.</li> <li>Make sure you are taking the correct dose. Accurately measure medications with an oral syringe, measuring spoon or dose cup. Do not split pills unless your doctor or pharmacist says it is safe. Some pills are coated to be long lasting or to protect the stomach.</li> <li>If possible, use the same pharmacy for all of your prescriptions. They may be able to provide you with a list of all your medications.</li> </ol> <p>Medications are crucial for many people because they can help you perform normal activities you may otherwise find difficult. Always follow your doctor’s and pharmacist’s directions, research your medication and take some extra precautions to ensure your safety and the safety of those around you.</p> <p><em>Troy Taylor is a registered <a href="/services-and-treatments/pharmacy" target="_self" title="Opens in same window.">pharmacist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2019/prescription-bottle-emptying-capsules-into-hand.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0587EEC2E9A21F3655D4667EE756BFBA" alt="Prescription bottle emptying capsules into hand" width="660" height="370" DisableNVelocity="true" />Medication ManagementNearly 70% of Americans take at least one prescription drug, and more than half take two.SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.AgingLife expectancy is 75 for males and 80 for females according to the National Center for Health Statistics. We'll help you keep you informed about potential issues with aging, and steps you can take to maintain your health and keep active.Dawn Haller7/24/2020It’s summer, and the warmer weather tends to influence our dining habits. Whether you are dining out or grilling at home, here are 8 healthy reminders.8 healthy tips for summer dining<p>It’s summer, and the warmer weather tends to influence people’s dining habits by eating out and attending celebrations and events more frequently. In fact, some reports show that nearly half of consumers eat out more in the summer — often on a weekly basis.</p> <h3>Whether you are dining out or grilling at home, here are 8 healthy reminders:</h3> <h4>1. Use portion control.</h4> <p>Healthy eating does not imply cutting out all of your favorite foods, but it doesn’t mean you can eat whatever you want. For those few unhealthy items that you can’t live without, consider moderation and stick to one serving a few times a week.</p> <h4>2. Make a healthy plate.</h4> <p>Whether you are attending a graduation party or eating at the cabin, make a healthy plate. Balance your plate with fruits, vegetables, protein and whole grains. Follow the portion and proportion guidelines from the Department of Agriculture, which recommends half of your plate be filled with fruits and vegetables, and the other half with grains, protein and dairy.</p> <h4>3. Read labels.</h4> <p>Be sure to read the nutrition facts label on food packages, or read the nutritional information on the menu carefully, noting how many total calories are in your serving. On average, one meal should range between 500–700 calories for a healthy adult. The breakfast meal usually is lighter in calories.</p> <h4>4. Dine and shop smart.</h4> <p>Even when you are dining out, remember the plate guidelines noted above. While french fries technically may be a vegetable, they aren’t considered to be healthy. Shop the perimeter of the grocery store, and visit your local farmer’s market for fresh, low-calorie produce.</p> <h4>5. Skip the salt, cut the fat.</h4> <p>When grilling, choose lean, unprocessed meats. And, when cooking, choose unsaturated fats and use less sodium. Experiment with herbs, spices and vinegars to add flavor.</p> <h4>6. Be cautious of fad diets.</h4> <p>Plenty of diets promise results that sound too good to be true — and they probably are. Get the facts, do your research or ask your dietitian before considering a fad diet.</p> <h4>7. Snack smart.</h4> <p>Those morning pastries, afternoon cookies and evening desserts add up. Choose fruit, low-fat yogurt, whole-grain items, or veggies and dip when looking for a snack. Fresh, in-season fruit can be a great snack, too.</p> <h4>8. Hydrate, hydrate, hydrate. </h4> <p>While it’s important to stay hydrated year-round, summer activities can mean increased water loss through sweat and evaporation. Pay attention to staying hydrated and what you’re drinking. Because calories from beverages can add up quickly, be sure to choose zero-calorie or low-calorie beverages. And with so many beverages on the market, remember fruit-infused or plain water is still one of the best and lowest-calorie ways to hydrate your body.</p> <p><em>Anne Harguth is a <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">registered dietitian</a> in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2019/salad-with-steak-corn-and-tomatoes.jpg?h=370&iar=0&w=660&sc_lang=en&hash=ECD8F3B17E7042A3D8F17BA4B45B3737" alt="Salad with steak corn and tomatoes" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller7/25/2019Looking to treat yourself? Try one of these 20 reward ideas unrelated to food to keep your diet on track without sabotaging a healthy lifestyle.Don't sabotage a healthy lifestyle when feeling rogue: 20 reward ideas unrelated to food<p>“I worked out today, so I deserve pizza.”</p> <p>“Work has me stressed out, and chocolate helps me relax.”</p> <p>“I am good all week so the weekends are my cheat days.”</p> <p>Any of these sound familiar?</p> <p>It’s not uncommon for people to want to treat themselves with an unhealthy choice after they have started a new healthy lifestyle plan. This could be because they feel that they have worked hard and deserve a treat or view these treats as a way to deal with life’s stresses. For some people, their brains fight back in the attempt to return to what was normal before. For others, poor choices become appealing after a long period of healthy choices and gives the person a feeling of going rouge or being naughty. Unfortunately, this type of behavior sabotages their progress.</p> <p>An occasional treat is fine, especially if you wish to celebrate a milestone on your health journey. Treats can keep you motivated and working toward your goal. There are many healthy rewards unrelated to food that will not negatively affect your health.</p> <h4>Try one or more of these 20 activities to reward yourself and celebrate milestones, while avoiding self-sabotaging your new healthy lifestyle:</h4> <ol> <li>Experiment with a new hair style or color.</li> <li>Try an edgy nail polish color on your fingers or toes.</li> <li>Wear colorful or crazy socks to work.</li> <li>Try a new physical activity with a family member or friend, such as rock climbing, kayaking, kickboxing or dance lessons.</li> <li>Fashion a temporary tattoo.</li> <li>Nurture yourself with a candlelight bubble bath.</li> <li>Schedule some “me time” on your calendar.</li> <li>Participate in an interactive dinner theater.</li> <li>Take a long ride in the country on a motorcycle or bicycle.</li> <li>Splurge on a new exercise outfit.</li> <li>Take a vacation day from work.</li> <li>Treat yourself to a massage.</li> <li>Hire someone to clean your house.</li> <li>Buy a lottery or raffle ticket.</li> <li>Visit a library or bookstore.</li> <li>Buy yourself flowers.</li> <li>Purchase a new water bottle or lunch bag.</li> <li>Laugh it up at a comedy show.</li> <li>Crack open a coloring book and get creative.</li> <li>Invite your friends over and catch up.</li> </ol> <p><em>Angie Kindschy is a registered nurse in <a href="/services-and-treatments/bariatric-surgery" target="_self" title="Opens in same window.">Bariatric Surgery</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em> </p><img src="/-/media/national-files/images/hometown-health/2019/pink-keds-and-striped-stockings.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C6EFF98564715BA5D3F52C7F048FA07D" alt="Pink Keds and striped stockings" width="660" height="370" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller7/30/2019Many aspects impact your mental and emotional health, including worry, mood, sleep, stress, relationships and alcohol consumption. Take a few minutes to answer nine questions that will help evaluate your wellness.Assess your mental and emotional health<img src="/-/media/national-files/images/hometown-health/2019/two-people-holding-up-jigsaw-puzzle-head.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E3E554667949A132F012D70861E6A0A3" alt="Two people holding up jigsaw puzzle head" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Get Tools to Live Your HealthiestIt’s never too early — or too late — to plan ahead for health. By making preventive care for you and your family a healthy habit, you’ll help improve your well-being. Be sure to connect with your healthcare provider to discuss any further questions that you may have about your health.Dawn Haller8/20/2019<p>Grief often means change and loss for the way things were. If you have experienced the death of a loved one, this is the hardest kind of grief and change to work through.</p>Seeking support when grieving<p>Those who are grieving are more than just aware of their grief day to day; it quite often takes over their lives in an overwhelming way. They find themselves changed — not just their lives and the people in it or not in it anymore — but they are themselves changed and do not look at things in quite the same way.</p> <p>Throughout my career as a bereavement counselor, marriage and family therapist, pastor and chaplain, it has become abundantly clear to me just how much grief and loss there is all around us, every day. It has also made me cherish time with my own loved ones more because of the stories I hear all the time about loss and the crushing heartbreak that comes with it.</p> <p>If you are grieving, try a new way to support yourself in your grief. Reach out for support from someone or someplace where you haven't looked before.</p> <p>If you are not grieving, but you know someone who is, think about ways that you can further support them. Encourage them to seek out support, as well. Just being with someone in grief sometimes is the best support you can give — letting them lead and guide the conversation or the silence as it unfolds.</p> <p>Even if you don't know anyone who is grieving and loss has not yet been a part of your life, you can always contact a bereavement service and gather some information to help yourself or those around you when a loss does occur.</p> <p>Support comes from each other, and we are all here to support and uphold one another in times of joy — and in times of sorrow.</p> <p>Rabbi Harold Kushner, author of "When Bad Things Happen to Good People," says when bad things happen, others are there "to hug us and hold our hands and dry our tears so that we don't feel abandoned." We are here for each other.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2019/dandelions-white-fluff-seeds.jpg?h=370&iar=0&w=660&sc_lang=en&hash=78241E366A3A36E379723EEE663ACF67" alt="Dandelions white fluff seeds" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.GriefGrief is the natural reaction to loss. It will be unique to you, depending on your own personality and circumstances.Dawn Haller7/6/2023Some fear of cancer recurring is normal, but excessive fear can decrease your quality of life. Here's how you can manage your fear.Living in fear: Cancer recurrence<p>Fear of cancer recurring, or the reappearance of prior cancer, is one of the biggest concerns following cancer treatment. If you have had cancer, it's natural to worry about it coming back. Some fear of recurrence is normal, but excessive fear can lead to decreased quality of life.</p> <p>People with significant cancer-recurrence fear may experience problems sleeping and eating, have difficulty concentrating and making decisions, and withdraw from participating in activities that once provided joy and fulfillment. Increased physical problems, distress and risk of post-traumatic stress disorder also may happen.</p> <h2>Fortunately, there are several ways you can manage the fear of cancer recurrence. Try these tips:</h2> <ul> <li><strong>Talk to your health care team about your fears.</strong><br /> They can help put your worries into perspective.</li> <li><strong>Be proactive and well-informed.</strong><br /> Most cancers have a predictable pattern of recurrence. Talk with your health care team, who can tell you about the chances of cancer recurrence and the symptoms to look for. Ask about steps you can take to reduce your risk of recurrence. Sometimes focusing on what actions you can take can help you manage and move past your fears.</li> <li><strong>Name your fears.</strong><br /> Is it more than just the fear of cancer coming back? Are you afraid of pain? Are you afraid of the outcome and what it means for your family? Identifying the fear will help you determine the steps to cope with and manage it.</li> <li><strong>Get emotional support.</strong><br /> Share your fears with a family member, friend, counselor or support group. Talking to someone helps lessen the loneliness that accompanies fear.</li> <li><strong>Find a coping method.</strong><br /> Distraction is an excellent coping method because it will take your mind off of your fear. Distraction can take many forms from starting an exercise program to finding a creative outlet, such as painting, listening to music or journaling. Another option is trying <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.nccih.nih.gov/health/qigong-what-you-need-to-know" target="_blank" title="Opens in a new window.">qi gong</a>, which is a breathing technique combined with meditation. Studies suggest qi gong may help with cancer fatigue and benefit the immune system.</li> <li><strong>Become an advocate for others with cancer.</strong><br /> Other people also struggle with fear of cancer recurrence. Share these tips and how you used them to help others manage fear.</li> </ul> <p>Don't live in fear or let the worry and stress of cancer recurrence overwhelm you. Talk to your health care team, who can help you identify ways to manage the fear and other accompanying emotions.</p> <h2>Next steps:</h2> <ul> <li>Discover the <a href="/hometown-health/speaking-of-health/keep-moving-the-importance-of-exercise-in-cancer-survivorship" target="_self" title="Opens in same window.">benefits of an exercise routine after cancer</a>.</li> <li><a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">Find a cancer specialist</a> near you.</li> <li>Gather <a href="/hometown-health/speaking-of-health/emotional-recovery-after-cancer-treatment" target="_self" title="Opens in same window.">tips for emotionally recovering after cancer</a>.</li> <li>Learn about the <a href="/hometown-health/speaking-of-health/the-importance-of-a-cancer-survivorship-care-plan" target="_self" title="Opens in same window.">importance of a survivorship plan</a>.</li> </ul> <p><em><a href="/providers/kaye-sturz-np" target="_self" title="Opens in same window.">Kaye Sturz</a> is a nurse practitioner in <a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">Oncology</a> in <a href="/locations/barron" target="_self" title="Opens in same window.">Barron</a> and <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Symptom management in patients undergoing cancer treatment</li> </ul>N.P.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Nursing, University of Wisconsin-Eau Claire</li> <li>Master's degree, Nursing, University of Utah</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Adult Nurse Practitioner, American Nurses Credentialing Center</li> <li>Advanced Oncology Certified Nurse, Oncology Nursing Certification Corporation</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Oncology, Mayo Clinic College of Medicine and Science</li> </ul>Sturz<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/kaye-sturz-np.jpg?h=280&iar=0&w=280&sc_lang=en&hash=284244307377E45F8F32C9628894A3E3" alt="Kaye Sturz, N.P." width="280" height="280" DisableNVelocity="true" />{F24183E4-E12B-4952-AEE0-0180C2798AEE}Kaye<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14571617Kaye Sturz, N.P.1{BCFC3BDC-CF55-458E-A41C-9360527B6CCC}|{0DD9D3C9-86C5-47FC-A2CF-8AEEA4717B70}<img src="/-/media/national-files/images/hometown-health/2019/paint-brush-on-canvas-frame.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E4C6DB8D65AA0D02610C1AE14E438E06" alt="paint brush on canvas frame" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Dawn Haller10/14/2025Most Americans eat a diet rich in heavily processed foods packed with fat, sugar, sodium, chemicals, preservatives, food dyes and other additives. Learn how and why clean eating can be a healthy way of living.Clean eating: What does that mean?<p>There are a lot of variations to clean eating; but, basically, it refers to eating foods that are as close as possible to their natural state. This encourages us to make our meals from scratch to make them as “clean” as possible.<span>  </span></p> <p>The main reason to take on clean eating is the health benefits of consuming foods rich in nutrient content directly from the earth that have not been overly processed. Most Americans eat a diet rich in heavily processed foods which have been made from synthetic ingredients, and packed with fat, sugar, sodium, chemicals, preservatives, food dyes and other additives your body doesn’t quite know what to do with. These additional items may be detrimental to your overall health and well-being.<span>  </span></p> <p>Clean eating nourishes your body with healthy and nutrient-dense foods. Clean foods fill your body with plentiful vitamins and minerals, high-quality protein and healthy fats, which improve heart and brain health, assist with weight management, build a stronger immune system and increase energy levels, among other benefits. Foods in their natural state are more flavorful. </p> <p>It may be daunting to consider eating a clean diet, but the benefits might far outweigh any concerns you may have when attempting to eat clean. </p> <h4>These items are examples of what might be considered in a clean diet:</h4> <ul> <li><strong>Fresh fruit</strong><br /> Apples, bananas, blueberries, grapes, oranges, strawberries, 100% fruit juice</li> <li><strong>Vegetables</strong><br /> Avocados, broccoli, Brussels sprouts, cabbage, carrots, cauliflower, corn, green beans, lettuce, mushrooms, onion, peppers, salsa, sweet potatoes, tomatoes</li> <li><strong>Lean meats/protein</strong><br /> Dried beans, eggs from grass-fed chickens, fresh fish, grass-fed chickens, plain nut butters (no sugar added), unflavored nuts </li> <li><strong>Grain (cereal) foods</strong><br /> Those made with whole grains, air-popped popcorn, oats, brown rice, whole-wheat pasta</li> <li><strong>Dairy products</strong><br /> Cheese, milk, plain yogurt, unsweetened nondairy milks</li> </ul> <p>Drinks and desserts can be a big source of added sugar. Look for unsweetened tea and coffee, water and seltzer. Consider making treats at home with less sugar or with honey, and with fruit and whole grains.</p> <p>As you look over the items listed, imagine where they came from in their original state. Eating those items as fresh as possible without being overly processed is clean eating. Of course, how clean your diet is, is up to you.</p> <p>Find additional <a href="/healthy-weight" target="_self" title="Opens in same window.">healthy weight resources</a> and read our <a href="https://mayoclinichealthsystem.org/hometown-health?topic=Weight%20Loss%20and%20Bariatric%20Surgery" target="_self" title="Opens in same window.">blogs about weight management</a> that can help you reach your goals.</p> <p><em>By Mayo Clinic Health System staff. </em></p><img src="/-/media/national-files/images/hometown-health/2019/basket-of-vegetables.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CCEEF5CA0CD09BFE17E54D0A0CDC00DE" alt="Basket of vegetables" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller9/5/2019Do your eyes make you look tired? Learn about options to help you appear more refreshed and awake.How do I make my eyes look less tired?<p><span>One of the most common questions I hear from patients is, "How can I look less tired?" Specifically, "How do I make my eyes look less tired?" There are parts around your eye that may contribute to you looking tired: the eyelid area above your eyes and the area below your eyes.</span></p> <h3>Upper eyelid area</h3> <p>The skin around the eye is the thinnest skin on the body. As you age, your eyelids stretch and the muscles supporting them may weaken. This can leave extra, unwanted skin that looks baggy and tired.</p> <p>This excess skin can be treated with an outpatient procedure called a <a href="/services-and-treatments/plastic-and-reconstructive-surgery" target="_self" title="Opens in same window">blepharoplasty</a> or eyelid lift. An incision is made in the natural fold of your eye, and the excess skin is removed. This procedure gives a rested appearance and can improve your visual field, making things appear brighter and your eyes feel more open.</p> <p>The upper lid eye lift sometimes can be combined with a <a href="/services-and-treatments/plastic-and-reconstructive-surgery" target="_self" title="Opens in same window">brow or forehead lift</a>, or <a href="/services-and-treatments/plastic-and-reconstructive-surgery" target="_self" title="Opens in same window">Botox injections</a>, to give further improved results.</p> <h3>Lower eyelid area</h3> <p>Puffiness of the lower eyelid can make you look tired or unrested. As you age, the thin wall of your eyelid can weaken, and fat from the lower eyelid pushes forward. The surgery to correct this is called a lower lid blepharoplasty.</p> <p>During the procedure, an incision is made inside the lower lid and excess fat is removed. This procedure leaves little or no visible scar and typically produces excellent results. In addition, <a href="/services-and-treatments/plastic-and-reconstructive-surgery" target="_self" title="Opens in same window">laser skin resurfacing</a> can be used to improve lower eyelid skin and rejuvenate your natural collagen. After the procedure, you'll notice a more youthful, rested appearance.</p> <h4>Surgical considerations</h4> <p>If you choose to have upper and lower blepharoplasty, the procedure typically lasts about 60 to 90 minutes.</p> <p>After surgery, it's common to have some bruising and swelling, but many patients are surprised that there is minimal discomfort, even immediately after surgery. Some insurance plans cover all or part of an upper lid blepharoplasty procedure.</p> <p>Talk to your doctor about your surgical risks. Also, fully understanding what's involved in blepharoplasty, and weighing the benefits and risks can help you decide if these procedures are a good option.</p> <h4>Watch this video to learn more about what to expect with an eyelid lift:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/C4O5r1rYChs" title="What to expect with an eyelid lift" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p><strong>Read more blogs about <a href="https://mayoclinichealthsystem.org/hometown-health?topic=Plastic%20and%20Reconstructive%20Surgery" target="_self" title="Opens in same window.">plastic and reconstructive surgery</a>.</strong></p> <p><em><a href="/providers/yvonne-pierpont-md" target="_self" title="Opens in same window">Yvonne Pierpont, M.D.</a></em><em>, is a plastic surgeon in <a href="/services-and-treatments/plastic-and-reconstructive-surgery" target="_self" title="Opens in same window.">Plastic & Reconstructive Surgery</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Arm lifts (brachioplasty)</li> <li>Body contouring</li> <li>Body lifts</li> <li>Breast augmentation</li> <li>Breast cancer</li> <li>Breast reduction</li> <li>Eyelid lift or eyelid surgery (blepharoplasty)</li> <li>Mastectomy </li> <li>Oculoplastics</li> <li>Skin cancer and reconstruction</li> <li>Skin removal surgery</li> <li>Thigh lifts</li> <li>Tummy tucks (abdominoplasty)</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Maryland School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Plastic Surgery, University of South Florida</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Facial Plastic and Breast and Body Surgery, Clevens Face and Body Specialists</li> <li>Research, University of South Florida</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Plastic Surgery </li> </ul> <p><strong>Membership</strong></p> <ul> <li>Wisconsin Medical Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Plastic Surgery, Mayo Clinic College of Medicine and Science</li> </ul>Pierpont<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/yvonne-pierpont-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=31D9B46DB7EACA47CE4C2E20F1944E0F" alt="Yvonne Pierpont, M.D." width="280" height="280" DisableNVelocity="true" />Yvonne<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20840870Yvonne Pierpont, M.D.1{3D1714E2-ECE8-4D0A-98A0-A4318C6DA2C3}<img src="/-/media/national-files/images/hometown-health/2019/older-woman-with-white-hair.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D60F01FC7A9EB6449E9479D0BFAD8758" alt="Older woman with white hair" width="660" height="370" DisableNVelocity="true" />Plastic and Reconstructive SurgeryPlastic and reconstructive surgery provides services that not only include cosmetic or aesthetic surgery, but also surgical repair of congenital deformities, laser surgery, postsurgical reconstruction, such as breast, head and neck defects, and microsurgery.Dawn Haller9/26/2019Running is one of the world's most popular sports, hobbies and ways of staying fit. But it can lead to the occasional injury. Get tips from a physical therapist for a successful run.6 tips for a successful run<p>Running is one of the world's most popular sports, hobbies and ways of staying fit. However, running also can lead to the occasional injury. At some point, whether it's a 5K, 10K or marathon, runners of all levels tend to cross this familiar bump in the road.</p> <p>As a physical therapist for Mayo Clinic Health System, I treat all types of runners, from ultramarathoners to novices. With a doctorate in physical therapy, I'm an expert in motion, and have been trained to treat and prevent injuries in many athletes, particularly runners. I truly enjoy helping people cross that finish line. With the start of the Mankato Marathon — one of Minnesota's most beautiful marathons — quickly approaching, many people ask me what it takes to succeed during their run.</p> <p>One of the most common barriers to success — or crossing that finish line — is injury. One can encounter a number of injuries in preparing for a marathon. Runner's knee, plantar fasciitis (foot pain) and stress fractures in the foot all are common ailments many runners find themselves struggling with leading up to a race. Therefore, the best approach to ensure success for your upcoming run is to avoid injury.</p> <p>Here's how:</p> <h4>1. Preparing for your run</h4> <p>There's no secret to preparing for your run. Preventing injury is as simple as preparing ahead of time. Just like taking an exam, it's necessary to prepare by studying, getting adequate sleep and eating properly. </p> <p>The most important step in preparing for running and competing in races is planning ahead. This is particularly true for longer distances, such as marathons. For these events, planning months ahead is necessary. Adhering to running programs that gradually progress running distances and allow for appropriate days of rest will progressively prepare your body's joints and tissues, allowing it to adapt and rebuild over time. </p> <p>Often, people will overtrain and find themselves having to stop training or even backing out of a race. Starting gradually, instead of jumping into large distances, prevents joint or tissue overload. Once you begin your program, increasing mileage 10% weekly is a safe progression.</p> <h4>2. Stay strong.</h4> <p>Strength training is another key element in preparation for running. We often have weakness in various areas in our body that can lead to asymmetry or faulty running mechanics. This often is observed in the core and hip musculature. Strength training will address these faults and imbalances, preventing undue stress on weak tissues.</p> <h4>3. Choose a shoe that works for you.</h4> <p>Footwear is a topic that I cover with almost every runner who I work with. While there's no perfect shoe for everyone, finding the right fit and type of shoe is necessary for success. If you have flat feet, arch supports or more sturdy shoes can help prevent excessive stress to your joints. Some people do well with more flexible shoes, and some do not. Find what works best for you and go with it. Also remember that, like the treads of a vehicle's tire, your shoes can and will wear out with use. Make sure to keep an eye on the integrity of your shoes to prevent injury. Shoes typically last around 300–400 miles before needing to be replaced.</p> <h4>4. Use proper technique for efficiency.</h4> <p>The most successful runners often are the most efficient runners. Using the best technique for running will help you run more efficiently for longer and with less stress to your body. This is best done by monitoring your stride length and cadence. Recommended cadence is greater than 170 steps per minute. Instead of taking longer strides, increase your cadence. Taking longer strides requires more energy expenditure.</p> <h4>5. Rest up.</h4> <p>Most runners don't take into account their own recovery. Running taxes the body significantly, breaking down various parts of our body — and the body always is in the process of rebuilding. For the body to recover successfully, it's necessary to get adequate amounts of sleep; eat a well-balanced diet that is high in carbohydrates, low in fat and contains sufficient protein; and drink plenty of water.</p> <h4>6. Treat a running injury.</h4> <p>Preparation is the key to success. However, what if an injury was to occur? The PRICE method, which stands for protect, rest, ice, compress and elevate, is a great start. Depending on the severity of the injury, this alone may be enough. The most difficult task is taking the time needed to rest, especially when the excitement for an upcoming race is rising. Running or limping on an injured foot or knee is only going to prolong your symptoms or worsen them. If pain lingers for greater than one to two weeks, speaking with your health care provider or a physical therapist can help get you back to running all the way through the finish line.</p> <p><em><a href="/providers/jordan-moen-dpt" target="_self" title="Opens in same window.">Jordan Moen, D.P.T.</a>, is a <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapist</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Injury prevention</li> <li>Orthopedics</li> <li>Spine care</li> <li>Sports medicine</li> </ul>D.P.T.<p>I provide personalized care, specific to each patient’s needs, utilizing approaches and techniques supported by up-to-date and cutting-edge research. Getting to know my patients well allows me to provide positive results as well as an enjoyable experience. I enjoy interacting with patients, getting to know them and their stories.</p> <p>I grew up in a small town in Minnesota. I have participated in sports nearly my whole life. I am married and have two children who keep me on my toes and entertained and always busy. I am also a die-hard Vikings fan.</p><p><strong>Education</strong></p> <ul> <li>Doctor of Physical Therapy, University of Minnesota</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Certified Orthopedic Clinical Specialist</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Physical Therapy, Mayo Clinic College of Medicine and Science</li> </ul>Moen<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jordan-moen.jpg?h=280&iar=0&w=280&sc_lang=en&hash=5DC1BDE898CC87D4B7C7263F7270B861" alt="Jordan Moen" width="280" height="280" DisableNVelocity="true" />{4981A277-40C7-4276-8A69-F497BEB1C905}Jordan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14537541Jordan Moen, D.P.T.1{DEF55970-853F-4E96-9A4D-3413874FF059}|{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2019/running-shoes-on-paved-trail.jpg?h=370&iar=0&w=660&sc_lang=en&hash=ACB43F2209B18EE7402740684C3982E2" alt="Running shoes on paved trail" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Dawn Haller9/22/2019Good posture can affect how you feel and move throughout your life. Get tips on how to improve your posture today.Do you have good posture?<p>Modern life seems to be conspiring against your better habits. You want to stand tall and sit up straight. But cellphones draw your eyes down, curving your neck.</p> <p>At work, many spend their days staring at a computer, slouching rather than sitting at attention. Those habits can strain muscles and joints, causing body pain.</p> <p>“Good posture is not just about the way you look,” says <a href="/providers/andrew-jagim-phd" target="_self" title="Opens in same window.">Andrew Jagim, Ph.D.</a>, director of <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">Sports Medicine</a> Research at Mayo Clinic Health System in <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin. “It can have an effect on how you feel in addition to impacting certain movement abilities over time.”</p> <h4>Find your healthy posture</h4> <p>Dr. Jagim shares this technique for finding your healthy posture: stand up against a wall with your upper back, shoulders and bottom touching the wall. Your feet should be a couple of inches away from the wall. Step away from the wall and maintain that position. “It will get easier over time as your muscles strengthen,” Dr. Jagim says.</p> <h4>Sitting strategies</h4> <p>Frequent standing is one of the easiest ways to protect against the harms of sitting. <span style="color: #333333;">“</span>If you work at a desk, try to get up at least once an hour,<span style="color: #333333;">”</span> Dr. Jagim says.<span style="color: #333333;"> “</span>Walk to talk to a colleague or get a drink of water. While you're up, take a minute to focus on your posture and do a few light stretches.<span style="color: #333333;">”</span></p> <p>Dr. Jagim recommends that your desk is set up to support proper body alignment.</p> <p>Check that:</p> <ul> <li>Your keyboard is at elbow height, so your hands can rest on the desk.</li> <li>Your computer screen or laptop is at eye level.</li> <li>Your chair's height allows your feet touch the ground.</li> </ul> <h4>Cellphone tips</h4> <p>Dr. Jagim says that when you're looking at your cellphone, you should hold it at eye level. <span style="color: #333333;">“</span>That way, you're not bending forward and straining your neck,<span style="color: #333333;">”</span> he says.</p> <h4>Read more about posture:</h4> <ul> <li>View a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/adult-health/multimedia/back-pain/sls-20076817" target="_blank" title="Opens in a new window.">slideshow on how to prevent back pain with good posture</a>.</li> <li>Learn ways to <a href="/topics/move-more" target="_self" title="Opens in same window.">get and stay physically fit</a>.</li> <li>Get <a href="/topics/tools-for-health" target="_self" title="Opens in same window.">tools to live your healthiest</a>.</li> </ul><img src="/-/media/national-files/images/hometown-health/2019/hand-holding-lower-back-sitting-on-chair.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C2BA64D4F6528337820B561C70336DA9" alt="Hand holding lower back sitting on chair" width="660" height="370" DisableNVelocity="true" />Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.NeurosurgeryNeurosurgery treats disorders that impact any part of the nervous system, which may include the brain, spine or peripheral nerves. Conditions treated range from life-threatening brain tumors, to disorders impacting quality of life, such as back pain and carpel tunnel syndrome.Dawn Haller8/25/2023Whether they're pounding, pulsing or piercing, headaches are a pain. Learn about headache types, common treatments and prevention.Oh, my aching head: Tips for headache relief <p>Whether they're pounding, pulsing or piercing, headaches are a pain. They can slow you down or even bring you to a complete stop.</p> <p>There are several types of headaches, and knowing your type can be the first step in effectively treating it. Also, good health habits are important in preventing or minimizing your headache risk.</p> <h2>Know your headache type</h2> <p>Not all headaches are the same. It's important to identify the type of headache you're experiencing to pick the right treatment and possibly prevent them in the future.</p> <h3>The most common headache types are:</h3> <ul> <li><a href="https://www.mayoclinic.org/diseases-conditions/tension-headache/symptoms-causes/syc-20353977" target="_blank" title="Opens in a new window."><strong>Tension</strong><br /> </a>These are the most common headaches and cause dull and achy pain. They may include a sensation of tightness or pressure across your forehead or on the sides and back of your head. Stress, neck pain, missed meals, dehydration and other factors can bring them on. </li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/syc-20360201" target="_blank" title="Opens in a new window."><strong>Migraine</strong></a><br /> These headaches cause severe, throbbing pain, usually on one side of the head. They're often accompanied by nausea, vomiting or increased sensitivity to light and sound. The pain may worsen with increased activity. Untreated, a migraine can last up to three days.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/cluster-headache/symptoms-causes/syc-20352080" target="_blank" title="Opens in a new window."><strong>Cluster</strong></a><br /> These severe headaches are rare and can occur on and off for weeks at a time. The pain often is focused around one eye or side of the head. Cluster headaches begin quickly and reach maximum intensity in minutes. Then, they stop for a period — months or even years — before striking again.</li> </ul> <p>Often, identifying headache types is challenging. You may have a less-common type of headache. Your healthcare team can help determine if your headache is a primary headache not caused by another medical condition, or a secondary headache, which is caused by an underlying health condition.</p> <h2>Common headache treatments</h2> <p>There's no one-size-fits-all treatment for headaches, since each type may have different approaches, and each person responds to treatment differently. It may take some experimenting to find out what works for you.</p> <h3>Some treatments include:</h3> <ul> <li><strong>Over-the-counter pain relievers</strong><br /> Aspirin, ibuprofen and acetaminophen may do the trick for tension headaches and migraines. However, it's important to use these in moderation as persistent use can lead to medication overuse headaches, also called rebound headaches.</li> <li><strong>Prescription medications</strong><br /> Several prescription medications can be used to treat migraines and the accompanying nausea. Some medicines can be taken to prevent migraines. Some of these medications also work on cluster headaches.</li> <li><strong>Oxygen</strong><br /> Breathing pure oxygen effectively treats cluster headaches for many people.</li> </ul> <p>While common treatments work for most people, some may not find adequate relief and must pursue other treatment options like injections or nerve stimulation. Talk with a healthcare professional that specializes in headache medicine.</p> <h2>Headache prevention</h2> <p>Many lifestyle factors can affect the likelihood of developing tension headaches and migraines. Managing those factors not only can help you avoid pain but also have other health benefits.</p> <h3>Try these prevention strategies to reduce your headache risk: </h3> <ul> <li><strong>Exercise.</strong><br /> Aerobic exercise releases tension and stress that can contribute to developing headaches.</li> <li><strong>Get enough sleep.</strong><br /> Aim for enough sleep — seven to nine hours for adults — and try to go to bed and get up at the same time each day.</li> <li><strong>Limit caffeine and alcohol.</strong><br /> Too much caffeine and alcohol can cause headaches.</li> <li><strong>Know your food triggers.</strong><br /> Certain foods, such as chocolate, aged cheese, processed meats and foods containing gluten, may trigger migraines.</li> <li><strong>Stress less.</strong><br /> Find healthy ways to manage the stress in your life. That may mean scheduling time with friends, taking a yoga class or setting healthy boundaries.</li> </ul> <p>Chronic headaches can be extremely distressing. It's exhausting to live with pain. Talk with your healthcare team about treatment options that can make a difference.</p> <h2>Next steps:</h2> <ul> <li>Download a <a href="/-/media/national-files/documents/hometown-health/2019/headache-diary.pdf?sc_lang=en&hash=4AEEAAAB5E6EA9A27F7F43A11D5B40F1" target="_blank" title="Opens in a new window.">headache diary</a> to share with your healthcare team.</li> <li>Read a <a href="/hometown-health/speaking-of-health/common-questions-about-headaches" target="_self" title="Opens in same window.">Q&A about headaches</a>.</li> <li>Discover <a href="/hometown-health/speaking-of-health/6-tips-for-headache-relief" target="_self" title="Opens in same window.">six tips for headache relief</a>.</li> <li>Get the <a href="/hometown-health/speaking-of-health/headache-medication-get-the-facts" target="_self" title="Opens in same window.">facts about headache medication</a>.</li> <li>Find out how <a href="/hometown-health/speaking-of-health/botox-as-a-treatment-for-chronic-migraines" target="_self" title="Opens in same window.">Botox is used as a treatment for chronic migraines</a>.</li> </ul> <p><a href="/providers/brian-burroughs-pac" target="_self" title="Opens in same window."><em>Brian Burroughs</em></a><em> is a physician assistant in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a>, with special interest in headache treatment, in <a href="/locations/red-wing" target="_self" title="Opens in same window.">Red Wing</a>, Minnesota.</em></p><ul> <li>Community health and wellness</li> <li>Diabetes</li> <li>Headaches</li> <li>Hypertension</li> <li>Nutrition</li> <li>Psychiatry</li> </ul>P.A.-C.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Biology and Nutrition, St. John’s University</li> <li>Master's degree, Physician Assistant Studies, DeSales University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Added Qualification in Headache Medicine</li> <li>Board Certified - Advanced Diabetes Management</li> <li>Certified Diabetes Care and Education Specialist</li> <li>Certified Hypertension Clinician</li> <li>Physician Assistant, National Commission on Certification of Physician Assistants</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Physician Assistants</li> <li>American College of Physicians</li> <li>Association of Diabetes Care and Education Specialists</li> <li>Minnesota Academy of Physician Assistants</li> <li>National Headache Foundation</li> <li>National Lipid Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Burroughs<img src="/-/media/shared-files/images/medical-professionals/full/red-wing/brian-burroughs-pajpg.jpg?h=280&iar=0&w=280&sc_lang=en&hash=6E3ED7F75144592AF7CC4BD3FB1400C4" alt="Brian Burroughs, P.A.-C." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://journals.sagepub.com/doi/10.1177/2633559X231173946" target="_blank" title="Opens in new window.">Approach to screening for depression in persons with diabetes</a>, May 2023.</li> </ul>Brian<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21656568Brian Burroughs, P.A.-C.1<img src="/-/media/national-files/images/hometown-health/2023/pinching-upper-nose-eyes-closed.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A290FE8B60B2BB9069BFD40C39285D9F" alt="Pinching upper nose, eyes closed" width="660" height="370" DisableNVelocity="true" />HeadacheHeadache is pain in any region of the head that feels like a sharp pain, throbbing sensation or dull ache. It may develop gradually or suddenly, and last for minutes or days.Dawn Haller2/18/2022An inguinal hernia isn't necessarily dangerous, but it doesn't improve on its own and can lead to life-threatening complications. Learn about the two general types of treatment options for this common condition.Treatment options for inguinal hernia repair<p>An <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/inguinal-hernia/symptoms-causes/syc-20351547" target="_blank" title="Opens in a new window.">inguinal hernia</a> occurs when tissue, such as part of the intestine, protrudes through a weak spot in the lower abdominal muscles. The resulting bulge can be painful. Over time, this bulge can increase in size, leading to potentially serious complications.</p> <p>Inguinal hernias generally start as a lump or bulge in the groin region. They can change in size with activity and usually will pop out during strenuous activity or lifting. These hernias usually can be able pushed back in, or reduced, but can require lying down flat to accomplish this.</p> <p>Inguinal hernias can progress to discomfort, ranging from a dull ache to sharp, stabbing pain.</p> <p>An inguinal hernia isn't necessarily dangerous, but it most likely will not improve on its own. And it can lead to serious complications requiring emergent surgery. Your health care professional is likely to recommend surgery to fix an inguinal hernia that's painful or enlarging. If your hernia does not cause any symptoms, it is safe to observe and not surgically repair it. Inguinal hernia repair is a common surgical procedure.</p> <p>If hernias are left untreated with no symptoms, 75% of patients will develop some sort of symptoms in the future.</p> <h3>The two general types of hernia operations are:</h3> <h4>Robotic-assisted/laparoscopic repair</h4> <p>Robotic-assisted or laparoscopic repair is a minimally invasive procedure that requires general anesthesia. In this procedure, the surgeon operates through several small incisions in your abdomen. A small tube equipped with a tiny camera, called a laparoscope, is inserted into one incision. Guided by the camera, the surgeon inserts tiny instruments through other incisions to repair the hernia using synthetic mesh.</p> <p>The main advantages of robotic or laparoscopic hernia repair are lower risk of infection, less postoperative pain, and quicker return to work or normal activities. These advantages are amplified for patients with hernias on both sides of their abdomens or recurrent inguinal hernias.</p> <p>Robotic-assisted or laparoscopic repair allows the surgeon to avoid scar tissue from an earlier hernia repair, so it might be a good choice for people whose hernias recur after open hernia surgery.</p> <h4>Open hernia repair</h4> <p>In open hernia repair, the surgeon makes an incision in your groin and pushes the protruding tissue back into your abdomen. The surgeon then sews the weakened area, often reinforcing it with a synthetic mesh. Then the opening is closed with stitches, staples or surgical glue.</p> <p>This procedure is performed under local anesthesia and sedation, or general anesthesia. This is a good option for patients who have a high risk of complications due to general anesthesia.</p> <p>After surgery, you'll be encouraged to move as soon as possible, but it might be several weeks before you're able to resume normal activities.</p> <h4>Learn more about hernias and surgery:</h4> <ul> <li>What you need to know when <a href="/hometown-health/speaking-of-health/preparing-for-surgery-what-you-need-to-know" target="_self" title="Opens in same window.">preparing for surgery</a></li> <li><a href="/hometown-health/speaking-of-health/are-you-at-risk-for-an-inguinal-hernia" target="_self" title="Opens in same window.">Hernia prevention tips</a></li> </ul> <p><em><a href="/providers/christopher-johnson-md" target="_self" title="Opens in same window.">Christopher C. Johnson, M.D.</a>, is a <a href="/services-and-treatments/surgery" target="_self" title="Opens in same window.">general surgeon</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/menomonie" target="_self" title="Opens in same window.">Menomonie,</a> Wisconsin.</em></p><ul> <li>Acute care and trauma surgery</li> <li>Benign breast conditions</li> <li>Breast cancer</li> <li>Colon and rectal surgery</li> <li>Colonoscopy and upper endoscopy</li> <li>Gallbladder conditions</li> <li>Hernia surgery</li> <li>Melanoma and skin cancers</li> <li>Perianal conditions, including hemorrhoids, fissure, abscess, pilonidal</li> <li>Robotic colorectal surgery</li> <li>Robotic hernia surgery</li> </ul>M.D.<p>I practice evidence-based medicine with a personal approach to each individual patient's needs.</p> <p>I grew up in northwest Wisconsin and feel privileged to provide care to the patients near my home. I enjoy spending quality time with my family and getting outside as much as possible. My hobbies include skiing, hunting, cycling and golfing. I also love Wisconsin sports, specifically the Badgers and Packers — On Wisconsin and Go Pack Go!</p><p><strong>Medical School</strong></p> <ul> <li>University of Wisconsin School of Medicine & Public Health</li> </ul> <p><strong>Residency</strong></p> <ul> <li>General Surgery, Bassett Medical Center</li> </ul> <p><strong>Certification</strong></p> <ul> <li>General Surgery, American Board of Surgery</li> <li>Robotic Surgery, Intuitive Surgical</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Surgery, Mayo Clinic College of Medicine and Science</li> </ul>Johnson<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/christopher-johnson-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=BDB320E86445515FBB88359805508E5C" alt="Christopher Johnson, M.D." width="280" height="280" DisableNVelocity="true" />{4D10EA22-E021-46A2-A00F-CA8C4186196A}Christopher<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16382951Christopher Johnson, M.D.1{CE631A85-B409-4C11-907C-39868E49E636}<img src="/-/media/national-files/images/hometown-health/2022/watering-plant-with-green-can.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D6F0E7A63D9D9184EB0F6CDE3959141D" alt="Watering plant with green can" width="660" height="370" DisableNVelocity="true" />SurgeryHaving surgery is a major event in your life. We know this and make every effort to keep you as comfortable as possible, focusing on you as an individual. Our surgeons and staff work as a coordinated team treating a wide variety of illnesses ranging from simple to complex. We offer comprehensive, advanced care and service to every patient.Dawn Haller10/15/2019For many, fall means hunting season, which can pose dangers and send hunters to the hospital or worse. Hunters should ensure they're educated about their surroundings and remember these 11 tips.11 tips for keeping safe during hunting season<p>Being outdoors in the autumn can be a great way to get fresh air and exercise. For many, fall also means hunting season which can pose dangers, sending hunters to the hospital or worse. Heart attacks, injured backs and broken bones are among the most common medical emergencies in hunting.</p> <p>I am a hunter and always need to remind myself to lead by example when I'm in the woods. Hunting can be a sport for all to enjoy. But we need to make sure that time outdoors isn't spoiled by some unfortunate accident.</p> <p>Hunters should make sure they are properly educated about their surroundings and remember these tips:</p> <h4>1. Watch for heart attack warning signs.</h4> <p>One study of middle-aged male deer hunters found that the activities inherent to hunting — walking over rough terrain, shooting an animal and dragging its carcass, for example — significantly increased their heart rates. Although opinion varies, many health care providers caution that exercising at more than 85% of a person's maximum heart rate increases the risk of <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/heart-attack/symptoms-causes/syc-20373106" target="_blank" title="Opens in a new window.">heart attack</a>. Hunters unaccustomed to the strenuous hikes involved should take several breaks to rests.</p> <h4>2. Know that falls tend to be the most common cause of injuries.</h4> <p>Falls often happen when a hunter is up a tree and startled by animals there. Pay attention to your surroundings at all times.</p> <h4>3. Always check equipment and stands, and use safety belts to prevent falls.</h4> <p>Avoid permanent tree stands, as they are more likely to deteriorate. The average fall from a tree stand is about 15 feet. Injuries suffered from those heights can cause broken bones, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/spinal-cord-injury/symptoms-causes/syc-20377890" target="_blank" title="Opens in a new window.">paralysis</a> or death.</p> <h4>4. Avoid alcohol.</h4> <p>Hunters are more susceptible to injuries, including <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/first-aid/first-aid-frostbite/basics/art-20056653" target="_blank" title="Opens in a new window.">frostbite</a> and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/first-aid/first-aid-hypothermia/basics/art-20056624" target="_blank" title="Opens in a new window.">hypothermia</a>, if they've been drinking.</p> <h4>5. Let family members know where you'll be hunting, and take two-way radios or loud whistles along in case help is needed.</h4> <p>A surprisingly large number of hunting accidents involve family members and friends who have gone out together, but they do not remember or know where their party has gone.</p> <h4>6. Learn some basic first aid before heading into the woods.</h4> <p>Basic <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/first-aid/first-aid-kits/basics/art-20056673" target="_blank" title="Opens in a new window.">first aid</a> that you should know includes how to administer hands-only <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/first-aid/first-aid-cpr/basics/art-20056600" target="_blank" title="Opens in a new window.">CPR</a>, which consists of <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/first-aid/first-aid-cpr/basics/art-20056600" target="_blank" title="Opens in a new window.">chest compressions</a>, should a hunting partner have a heart attack.</p> <p>I also recommend following these basic rules of safe firearms handling from the Minnesota Department of Natural Resources:</p> <h4>1. Treat every firearm as if it is loaded.</h4> <p>Never assume a firearm is unloaded. Place your finger on the trigger only when you're ready to shoot.</p> <h4>2. Always control the muzzle.</h4> <p>Keep your muzzle pointed in a safe direction, and remember that wherever the muzzle points is in the crosshairs. Don't overlook the possibility of a ricochet.</p> <h4>3. Be sure of your target.</h4> <p>You're responsible for knowing what's in front of your target, near your target and beyond your target. If you aren't certain about any of the three, don't take the shot.</p> <h4>4. Wear protective gear.</h4> <p>Hunters' eyes and ears are vulnerable to a number of potential hazards while hunting, so it's important to protect them. Firearms create a high-decibel sound that can damage hearing. The firearm also discharges small particles of the projectile, burning gas and other residue that can damage your eyes. Always wear safety glasses and ear protection.</p> <h4>5. Don't forget the blaze orange.</h4> <p>Blaze orange has made hunting safer. Spotting a hunter wearing camouflage is hard, but wearing blaze orange makes you visible to others hunting in the area.</p> <p><a href="/providers/eric-grube-do" target="_self" title="Opens in same window."><em>Eric Grube, D.O.</em></a><em>, is an <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">Emergency Medicine</a> physician in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p>D.O.<p><strong>Education</strong></p> <ul> <li>Des Moines University College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Emergency Medicine, Ohio University College of Osteopathic Medicine/Doctors Hospital</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Diplomate, American Osteopathic Board of Emergency Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Emergency Physicians</li> <li>American College of Osteopathic Emergency Physicians</li> <li>American Osteopathic Association</li> <li>Emergency Medicine Residency Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Emergency Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Grube<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/eric-grube-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=675A018230C252FDE2233C6BC7E1120D" alt="Eric Grube DO" width="280" height="280" DisableNVelocity="true" />Eric<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>10035150Eric Grube, D.O.1{FB3BB67A-14FA-4DDE-B183-F85C42E0B255}<img src="/-/media/national-files/images/hometown-health/2019/hunter-silouette.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6A05F8BD50A880C34F2E274B52204D4A" alt="Hunter silouette" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Dawn Haller10/3/2019A healthy diet is essential for everyone, but it's vital for people who have chronic kidney disease. Learn about the five things you need to watch for in your diet.5 nutrition tips for chronic kidney disease<p>A healthy diet is essential for everyone, but it is vital for people who have chronic kidney disease.</p> <p>Chronic kidney disease affects an estimated 37 million people in the U.S., according to the National Kidney Foundation. Chronic kidney disease means your kidneys are damaged and losing the ability to keep you healthy.</p> <p>Diet and nutrition may help manage and, potentially, slow the disease. Other key factors to slowing the progression include managing diabetes and controlling blood pressure, which are the leading causes of kidney failure.</p> <p>A kidney-friendly meal plan focuses on the amount of certain nutrients that you should take in. Work with your dietitian to make a meal plan that meets your individual needs.</p> <h4>Dietary restrictions associated with chronic kidney disease include:</h4> <h4>1. Protein</h4> <p>It’s important to get the right amount of protein. Needs are based on height, weight and overall health. Protein is necessary for wound healing, enzyme and hormone production, and immune function. Byproducts of protein degradation no longer can be cleared as well by damaged kidneys, so protein is limited to decrease buildup of waste products. Try to keep portions of meat to the size of a deck of cards.</p> <h4>2. Sodium</h4> <p>Sodium can increase fluid retention and blood pressure, making your heart and lungs work harder. You may think if you aren't adding salt to your food that your sodium intake is low. However, more than 70% of sodium in the average American's diet already is in the foods we buy, such as grains, meat, soups, sandwiches and restaurant meals. A low-sodium diet may include 1,500–2,000 milligrams of sodium per day. Try to keep each meal under 600 milligrams. Remember that salt is an acquired taste. Give your taste buds six to eight weeks to adjust to a lower-sodium diet.</p> <h4>3. Potassium</h4> <p>Potassium is a mineral found in many foods. Your body needs potassium to make your muscles work, but too much potassium can be dangerous. If your kidneys aren't working well, they no longer can balance the minerals in your blood. This can lead to a buildup of potassium and phosphorus in your blood. High or low potassium levels affect the ways that your muscles work. Major sources of potassium include potatoes, tomatoes, melons, oranges and orange juice, bananas, dairy products and salt substitutes that contain potassium, such as Morton Lite Salt or No Salt. Try to limit or avoid these high sources of potassium if the potassium in your blood is elevated.</p> <h4>4. Phosphorus</h4> <p>Healthy kidneys keep the correct amount of phosphorus in your body. When your kidneys are not working well, phosphorus can build up in your blood. Foods highest in phosphorus are convenience or fast foods, processed cheese, packaged foods and many colas. Check the ingredients in the products that you use for words with "phos" in them. Examples may be calcium phosphate, phosphoric acid and hexametaphosphate. You also may need to limit foods with natural phosphorus, such as dairy, nuts and whole grains.</p> <h4>5. Calcium</h4> <p>Calcium is another mineral affected by kidney disease. Calcium helps keep your bones strong, but if you get too much, it can leave calcium deposits in your blood vessels. If your calcium levels are elevated, avoid calcium-fortified foods. Also, tell your health care provider if you take calcium supplements.</p> <p>Following a kidney-friendly diet can seem overwhelming and a bit restrictive at times. However, avoiding or limiting certain foods in your diet may help decrease the accumulation of waste products in the blood, improve kidney function and prevent further damage. A dietitian can help you design a kidney-friendly diet that is specific to your needs.</p> <p><em><a href="/providers/kristi-wempen-rdn" target="_self" title="Opens in same window.">Kristi Wempen</a> is a registered <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">dietitian-nutritionist</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Chronic kidney disease</li> <li>General health and wellness</li> <li>Weight management</li> </ul>RDN, LD<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Minnesota State University-Mankato</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Iowa State University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration</li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul> <p><strong>Membership</strong></p> <ul> <li>Academy of Nutrition and Dietetics</li> </ul>Wempen<img src="/-/media/shared-files/images/medical-professionals/full/mankato/kristi-wempen-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=BB7EFDC16603EA67B00B7CD0DBD528E1" alt="Kristi Wempen RDN" width="280" height="280" DisableNVelocity="true" />Kristi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14834341Kristi Wempen, R.D.N.1{2BEE5070-65FF-4406-9E59-103E06C5A535}<img src="/-/media/national-files/images/hometown-health/2019/couple-preparing-a-recipe.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1593D9BFA4A7FCFA062F847CCB9013D8" alt="Couple preparing a recipe" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Kidney HealthYour kidneys are responsible for filtering waste and excess fluids from your body. So when kidney functionality decreases, harmful amounts of fluid and waste can build up in your body. In most cases, you can prevent or manage kidney issues by making healthy, kidney-conscious decisions.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller10/7/2019Inguinal hernias are the most common type and can be quite painful. Learn who is most at risk of developing a hernia and how to prevent one.Are you at risk for an inguinal hernia?<p>An <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/inguinal-hernia/symptoms-causes/syc-20351547" target="_blank" title="Opens in a new window.">inguinal hernia</a> occurs when tissue, such as part of the intestine, protrudes through a weak spot in the lower abdominal muscles — typically in the groin. The resulting bulge can be painful, and if the inguinal hernia doesn't improve on its own, it can lead to life-threatening complications.</p> <p>In many people, the abdominal wall weakness that leads to an inguinal hernia occurs at birth. Other inguinal hernias develop later in life when muscles weaken or deteriorate due to aging, strenuous physical activity or coughing that accompanies smoking.</p> <h4>Hernia risk factors</h4> <p>These risk factors contribute to the development of an inguinal hernia:</p> <ul> <li><strong>Being male</strong><br /> Men are eight times more likely to develop an inguinal hernia than women.</li> <li><strong>Being older</strong><br /> Muscles weaken as you age.</li> <li><strong>Family history</strong><br /> You have a close relative, such as a parent or sibling, who has the condition.</li> <li><strong>Chronic constipation</strong><br /> Constipation causes straining during bowel movements.</li> <li><strong>Premature birth and low birth weight</strong></li> <li><strong>Previous inguinal hernia or hernia repair</strong><br /> Even if your previous hernia occurred in childhood, you're at higher risk of developing another inguinal hernia.</li> </ul> <h4>Hernia prevention </h4> <p>You can't prevent the congenital defect that makes you susceptible to an inguinal hernia. You can, however, reduce strain on your abdominal muscles and tissues. To do so, you should:</p> <ul> <li><strong>Maintain a healthy weight.</strong><br /> Talk to your health care provider about the best exercise and diet plan for you.</li> <li><strong>Emphasize high-fiber foods.</strong><br /> Fruits, vegetables and whole grains contain fiber that can help prevent constipation and straining.</li> <li><strong>Lift heavy objects carefully or avoid heavy lifting.</strong><br /> If you must lift something heavy, always bend from your knees — not your waist.</li> <li><strong>Stop smoking.</strong><br /> Besides its role in many serious diseases, smoking often causes a chronic cough that can lead to or aggravate an inguinal hernia.</li> </ul> <h4>Learn more: </h4> <ul> <li>Read more about<a href="https://mayoclinichealthsystem.org/hometown-health?topic=Weight%20Loss%20and%20Bariatric%20Surgery" target="_self" title="Opens in same window."> maintaining a healthy weight</a>.</li> <li>Learn <a href="/hometown-health/speaking-of-health/preparing-for-surgery-what-you-need-to-know" target="_self" title="Opens in same window.">what you need to know when preparing for surgery</a></li> </ul> <p><em><a href="/providers/christopher-johnson-md" target="_self" title="Opens in same window.">Christopher Johnson, M.D.</a>, is a <a href="/services-and-treatments/surgery" target="_self" title="Opens in same window.">general surgeon</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/menomonie" target="_self" title="Opens in same window.">Menomonie</a>, Wisconsin.</em></p><ul> <li>Acute care and trauma surgery</li> <li>Benign breast conditions</li> <li>Breast cancer</li> <li>Colon and rectal surgery</li> <li>Colonoscopy and upper endoscopy</li> <li>Gallbladder conditions</li> <li>Hernia surgery</li> <li>Melanoma and skin cancers</li> <li>Perianal conditions, including hemorrhoids, fissure, abscess, pilonidal</li> <li>Robotic colorectal surgery</li> <li>Robotic hernia surgery</li> </ul>M.D.<p>I practice evidence-based medicine with a personal approach to each individual patient's needs.</p> <p>I grew up in northwest Wisconsin and feel privileged to provide care to the patients near my home. I enjoy spending quality time with my family and getting outside as much as possible. My hobbies include skiing, hunting, cycling and golfing. I also love Wisconsin sports, specifically the Badgers and Packers — On Wisconsin and Go Pack Go!</p><p><strong>Medical School</strong></p> <ul> <li>University of Wisconsin School of Medicine & Public Health</li> </ul> <p><strong>Residency</strong></p> <ul> <li>General Surgery, Bassett Medical Center</li> </ul> <p><strong>Certification</strong></p> <ul> <li>General Surgery, American Board of Surgery</li> <li>Robotic Surgery, Intuitive Surgical</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Surgery, Mayo Clinic College of Medicine and Science</li> </ul>Johnson<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/christopher-johnson-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=BDB320E86445515FBB88359805508E5C" alt="Christopher Johnson, M.D." width="280" height="280" DisableNVelocity="true" />{4D10EA22-E021-46A2-A00F-CA8C4186196A}Christopher<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16382951Christopher Johnson, M.D.1{CE631A85-B409-4C11-907C-39868E49E636}<img src="/-/media/national-files/images/hometown-health/2019/man-using-a-lat-bar-in-gym.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5FB8906FD9662E02F15F5BD1D64966E3" alt="Man using a lat bar in gym" width="660" height="370" DisableNVelocity="true" />Dawn Haller9/19/2022Most pelvic floor issues can be diagnosed and treated once identified as a concern. Find out what determines minor and major fecal incontinence and treatment options.Fecal incontinence: Does your underwear have more than a small brown streak?<p>Pelvic floor issues are much more common than you might think. Fecal incontinence affects 2% to 7% of the U.S. population, although this number may be much higher, as many people are reluctant to discuss this issue with their health care team.</p> <p>For some people, including children, fecal incontinence is a minor problem, limited to the occasional soiling of their underwear. For others, the condition can be devastating due to a complete lack of bowel control.</p> <h2>Fecal incontinence is categorized in two ways.</h2> <ul> <li><strong>Minor incontinence</strong><br /> Involuntary loss of gas or liquid stool is considered minor incontinence.</li> <li><strong>Major incontinence<br /> </strong>The involuntary loss of solid stool is major incontinence.</li> </ul> <p>Fecal incontinence can damage a person's self-confidence, leading to anxiety and social isolation. People with fecal incontinence should discuss their symptoms openly and honestly with their health care team. With treatment, symptoms can be lessened in most cases, and incontinence can often be cured entirely.</p> <h2>What are pelvic floor muscles?</h2> <p><a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/womens-health/multimedia/female-pelvic-floor-muscles/img-20006566?_ga=2.142196466.1113561599.1562098129-2041838957.1562098129" target="_blank" title="Opens in new window.">Pelvic floor muscles</a> are a group of muscles that make up the bottom of the pelvic region. The anal sphincters and pelvic muscles surround the end of the digestive tract. Together, these muscles and the puborectalis muscle ensure controlled movement of digestive tract contents.</p> <p>The pelvic floor muscles play an important role in continence by supporting the pelvic organs, stabilizing the pelvis and participating in sexual activity. They are like any other muscle in the body. They can be weak, stretched out, strong or tight. Generally, pelvic floor weakness and tension lead to pelvic muscle dysfunction. Weakness is a common cause of incontinence, and tension often leads to pelvic pain.</p> <p>The anal and rectal areas contain specialized muscles that regulate the proper passage of bowel movements. Normally, when stool enters the rectum, the anal sphincter muscle tightens to prevent the passage of stool at an inconvenient time. If this muscle is weak or does not contract in a timely way, incontinence occurs.</p> <h4>Fecal incontinence can be caused by:</h4> <ul> <li>Damage to the anal sphincters</li> <li>Neurologic causes</li> <li>Fecal impaction</li> <li>Diarrhea</li> <li>Decreased distensibility of the rectum</li> <li>Idiopathic incontinence, which is when the cause cannot be identified</li> </ul> <h2>Tests to determine cause of incontinence</h2> <p>The underlying cause of fecal incontinence can often be established with a combination of medical history, physical examination and diagnostic tests.</p> <p>A few types of tests can be performed to determine the root of the problem. Anorectal manometry, or anorectal motility test, is a common, noninvasive test. The safe, low-risk procedure evaluates patients with constipation or fecal incontinence. The test measures how strong the sphincter muscles in the rectal and anus are and whether they relax as they should while passing stool.</p> <p>During the procedure, a gastroenterologist analyzes pressures of the anal sphincter muscles, sensation in the rectum, and neural reflexes associated with regular bowel movements. Patients do not need to be sedated during the test. They may experience slight discomfort but no pain as the tube is inserted.</p> <p>After the tube is in place, the exposed end is attached to a machine that will record the pressure changes of muscle contractions and relaxation for 10–20 minutes.</p> <p>Other diagnostic tests include <a href="/hometown-health/speaking-of-health/benefits-of-sedation-free-colonoscopy" target="_self" title="Opens in same window.">colonoscopy</a>, <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/flexible-sigmoidoscopy/about/pac-20394189" target="_blank" title="Opens in a new window.">flexible sigmoidoscopy</a>, anoscopy, ultrasound, MRI or stool tests.</p> <h2>Is treatment available for fecal incontinence?</h2> <p>Because fecal incontinence can be distressing, it is important to take steps to manage it. You should discuss potential treatment options with your health care team.</p> <p>What you <a href="/-/media/national-files/documents/hometown-health/2019/good-bacteria-for-your-gut.pdf" target="_self" title="Opens in same window.">eat and drink</a> affects the consistency of your stools. If constipation is causing fecal incontinence, you should drink plenty of fluids and eat fiber-rich foods. </p> <p>If diarrhea contributes to the problem, high-fiber foods can add bulk to your stools and make them less watery. Fiber bulks the stool, making it softer and easier to pass regularly. It is recommended that adults consume 20–35 grams of fiber per day. Sources of fiber include fruits, vegetables and whole grains.</p> <p>You can try an over-the-counter fiber powder product to help bulk stools. Examples include Citrucel, Metamucil and Benefiber. Pill forms of fiber also are available. </p> <p>Consuming large amounts of fiber can cause abdominal bloating or gas. You can minimize this by starting with a small amount and slowly increasing until stools become softer and more frequent. Make sure you are drinking plenty of water when increasing your fiber intake. It is recommended adults drink eight 8-ounce glasses of water every day.</p> <p>Depending on the cause of fecal incontinence, medications such as anti-diarrheal, bulk laxatives or injectable bulking agents can be used. If constipation does not respond to medications, or if constipation has been present for multiple years, the problem may be related to pelvic floor dysfunction.</p> <p>Over-the-counter antidiarrheals reduce stool frequency. Loperamide (Imodium) also can increase the tightness of the anal sphincter muscles. It is important to let your health care team know if you are taking any over-the-counter antidiarrheals and to take the medication only as directed on the package.</p> <p>If you are struggling with fecal incontinence, it is important to avoid foods and drinks that may cause loose or more frequent stool, which can worsen fecal incontinence. This may include dairy products, spicy foods, fatty or greasy foods, caffeinated beverages, diet foods or drinks, sugar-free gum or candy, and alcohol. </p> <p>If you are experiencing significant rectal discomfort without being diagnosed with fissures or hemorrhoids, or if you experience more than a slight yellow leak of stool or a brown streak in your underwear, schedule a visit with your primary care provider or a gastroenterologist. </p> <h2>Exploring biofeedback</h2> <p>If muscle damage is causing fecal incontinence, your health care professional may recommend an exercise program and other therapies to restore muscle strength. Your clinician may refer you to a physical therapist specializing in pelvic floor dysfunction. Biofeedback uses <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/fecal-incontinence/care-at-mayo-clinic/mac-20351407" target="_blank" title="Opens in a new window.">anal manometry testing</a> and special exercises of the pelvic floor muscles to strengthen the muscles and improve sensation. </p> <p>Biofeedback is a technique that helps you focus on controlling your body's functions by receiving feedback from electrical sensors. Patients are taught how to strengthen pelvic floor muscles, sense when stool is ready to be released, and how to contract the muscles if having a bowel movement at a particular time is inconvenient.</p> <p>It is important to take steps to manage your symptoms. Treatment can improve your quality of life and raise your self-esteem.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/artist-painting-pottery.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A423A02DB257A06E5B7ABA2B2631E525" alt="Artist painting pottery" width="660" height="370" DisableNVelocity="true" />Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Dawn Haller5/19/2022Dietary supplements are popular among young athletes with nearly 60% reporting regular use. Get information about research efforts, and gather tips before giving supplements to your young athlete.Is it safe for my kid to take supplements?<p>It is no secret that dietary supplements are popular, as annual sales are estimated to surpass $200 billion over the next decade. Supplements have become particularly popular among young athletes, with nearly 60% reporting regular use.</p> <h2>Supplement research</h2> <p>Many questions surround the safety of dietary supplements for young athletes. Unfortunately, limited research data are available, so the short answer is that we are still learning about the safety and efficacy of dietary supplements for this population.</p> <h4>One reason this question is so difficult to answer is because:</h4> <ul> <li>Supplements come in many categories.</li> <li>They consist of varying ingredient profiles and doses.</li> <li>Supplements have varying manufacturing practices.</li> <li>Supplements are used for various purposes.</li> </ul> <p>As a result, there's no easy way to determine whether supplements in general are safe. More research is available for some supplements versus others. For example, creatine monohydrate is one of the most extensively researched supplements in many populations, from high-level athletes to pediatric muscular dystrophy patients to older adults with various concerns related to health and performance.</p> <p>More importantly, most of these studies have found little to no adverse events reported from supplementation. Similarly, no evidence indicates that consuming a protein supplement can be problematic or result in any harm to the young athlete.</p> <p>It's best for young athletes to choose a product that is labeled as 100% protein, meaning it contains only protein. This type of product is preferred over supplements labeled as "mass gainer," or other multi-ingredient weight gain or weight loss health product. These types of products contain other ingredients that are not appropriate for young athletes.</p> <p>Nothing is inherently superior about a protein supplement, compared to a whole-food source of protein, such as yogurt and lean meats. The supplement may serve as a more convenient option during training and or competition times, which can help the athlete meet their nutritional needs.</p> <p>In comparison, no scientific evidence demonstrates for or against the safety of pre-workout supplements in young athletes. However, it is important to note that these types of supplements are more commonly associated with adverse events, such as mislabeling and product contamination from illegal ingredients like stimulants or steroid analogues. It may be best for young athletes to avoid pre-workout supplements.</p> <p>The same could be said for energy drinks, as limited research is available regarding their safety in young athletes. Instead, athletes should focus on improving sleep habits to promote healthy lifestyle choices.</p> <p>Focus on eating regular and healthy food options, and maintaining hydration, reduce the need for an energy drink.</p> <p>It's important to know that although dietary supplements fall under the purview of the Food and Drug Administration, dietary supplement products are not regulated before they are released to the market. Companies do not have to demonstrate safety and efficacy in humans before the products are sold to consumers, as is the case with pharmaceuticals.</p> <h2>Best practices for supplements</h2> <h4>I recommend parents follow these tips if they decide to provide dietary supplements to their young athletes:</h4> <ul> <li>Choose a high-quality product or brand that has passed an independent quality assessment. These products will have a label or symbol on the package to denote third-party testing.</li> <li>Follow the instructions carefully.</li> <li>Check with the governing body that oversees your athlete's sport for a list of banned ingredients or performance-enhancing substances to avoid.</li> <li>Avoid taking multiple supplements with overlapping ingredients. This will help prevent your child from consuming excessive amounts of specific ingredients, such as caffeine, herbal extracts or vitamins that could be problematic over time.</li> <li>Avoid products with proprietary blends that do not provide a list of specific ingredients and amounts within the product.</li> <li>Avoid giving your athlete supplements or multivitamins designed for adults, as the daily requirements or tolerable upper limits may be lower in young athletes due to smaller body sizes.</li> <li>Talk with your health care provider or dietitian before your child takes supplements if your child has an underlying medical condition or is taking other medications.</li> </ul> <h2>Are supplements needed?</h2> <p>For young athletes, it's best to focus on minimally processed, whole-food sources of nutrients rather than relying on supplements for their nutritional needs. If your child still has identified nutritional deficiencies confirmed by labs or a dietitian, a dietary supplement could help fill the gap.</p> <p>Also, if your athlete is constantly on the go and does not have time to properly prepare snacks and meals, a protein shake, bar or sports drink may provide important nutrients at the right time. Proper fueling can optimize recovery and enhance training adaptations over time. Again, it is best to always choose high-quality products and consult with an expert prior to use.</p> <h2>Performance-enhancing drugs</h2> <p>It's important to note that dietary supplements and performance-enhancing drugs differ. Dietary supplements can legally be sold over the counter and have different regulatory standards compared to prescriptions or other controlled substances. However, supplements may or may not be allowed, depending on the sporting organization. In contrast, performance-enhancing drugs often are controlled substances, may be illegal to possess without a prescription and almost always are banned in sport.</p> <p><em><a href="/providers/andrew-jagim-phd" target="_blank" title="Opens in a new window.">Andrew Jagim, Ph.D.</a>, is an exercise physiologist, sports nutritionist, and certified strength and conditioning specialist in <a href="/services-and-treatments/sports-medicine" target="_blank" title="Opens in a new window.">Sports Medicine</a> physician in <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Examining how different nutrition and exercise interventions influence health and performance — this interest applies to both the general population in regards to improve a person’s quality of life and prevent chronic disease in addition to improving the performance ability of elite athletes</li> </ul>Ph.D.<p><strong>Education</strong></p> <ul> <li>Master's degree, Human Performance, University of Wisconsin – La Crosse</li> <li>Ph.D., Kinesiology – Exercise Physiology Texas A&M University, College Station</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>International Society of Sports Nutrition</li> <li>National Strength and Conditioning Association</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Sports Medicine</li> <li>International Society of Sports Nutrition</li> <li>National Strength and Conditioning Association</li> </ul>Jagim<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/andrew-jagim-phd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=AA07F8D241D507CF3C0C9F28FC00E465" alt="Andrew Jagim PhD" width="280" height="280" DisableNVelocity="true" /><p>Dr. Jagim has authored or collaborated on numerous scholarly publications related to sports medicine. His topics have included:</p> <ul> <li>diets and nutrition</li> <li>workouts and training regimens</li> <li>sports injuries and treatment programs</li> <li>use and affects of drugs and supplements in sports</li> </ul> <p>His research has been published in numerous journals including International Journal of Exercise Science, Journal of Sports Science, Journal of Strength and Conditioning Research, Frontiers in Nutrition, International Society of Sports Nutrition, Journal of Neurosurgery and the Clinical Journal of Sports Medicine.</p>Andrew<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20772289Andrew Jagim, Ph.D.1{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2022/young-person-on-tennis-court.jpg?h=370&iar=0&w=660&sc_lang=en&hash=422FBE5DC110285852BD2065F7F281D5" alt="Young person on tennis court holding tennis racket" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller11/14/2019Luna may not be a superhero but she's pretty close. Thanks to her warm brown eyes, big floppy ears and calming presence, she helps patients feel more comfortable and relaxed. Read about a day in the life of Luna.A day in the life of Luna — a facility dog<p>For some people, receiving news of a medical diagnosis can feel overwhelming and frightening. Spending a significant amount of time in and out of the hospital, meeting with physicians and receiving treatments may lead to feelings of disconnection from home. However, therapy and facility dogs at Mayo Clinic Health System help many patients feel more at ease during their visits.</p> <p>There are two different levels of training that dogs can complete to provide support for patients. Therapy dogs must pass testing criteria to ensure they can behave in various settings, and they often are used for comfort visits with patients. In contrast, a facility dog is a fully trained service dog that completes a two-year advanced training program and responds to over 40 commands. They are consistently reliable in public settings, and can work in environments with many distractions and still maintain focus on their work.</p> <p>Lunar III, known as Luna, is a full-time facility dog that works at Mayo Clinic Health System in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin. She also travels to clinics in <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, <a href="/locations/sparta" target="_self" title="Opens in same window.">Sparta</a> and <a href="/locations/tomah">Tomah</a>. Luna graduated from a specialized training program in Ohio. She is a Labrador retriever with light golden fur, warm brown eyes and big floppy ears.</p> <p>Luna’s daily tasks range from carrying a basket of chocolates through the hospital to providing comfort during treatments. She assists patients with exercise, motivation, positive distraction, opening and closing drawers or doors, retrieving items and pulling pediatric patients on scooter boards.</p> <p>At the start of each day in the clinic, Luna visits patients in <a href="/services-and-treatments/cardiovascular-rehabilitation-and-services" target="_self" title="Opens in same window.">Cardiac Rehabilitation</a>. She is assisted by her handler, Lisa Morgan, who is a supervisor in Rehabilitation Services.</p> <p>“As soon as she walks in the department, it’s clear that both patients and staff are friends with Luna,” explains Morgan. “The smiles on patients’ faces show that they know their canine friend is there to help. Most people call her by name and ask me if they can pet her.”</p> <p>During her next task in Cardiac Rehabilitation, Luna spends time with a patient receiving enhanced external counterpulsation (EECP), a treatment for angina, which is a type of chest pain. The patient has one-hour treatments five times a week for seven weeks. The frequency and duration of the treatments can get lonely and tiresome, but Luna helps ease negative emotions the patient may be feeling by allowing the patient to pet and talk to her.</p> <p>“Luna is a great comfort to patients receiving EECP treatments,” says Morgan. “It can be an uncomfortable process, and she provides much-needed distraction and relief.”</p> <p>Finally, Luna reaches the Cancer Center, where she provides emotional support and a calming presence.</p> <p>“Patients in the Cancer Center may have just received upsetting news or may be receiving treatment, but Luna’s presence seems to improve their spirits,” says Morgan. “They smile when Luna places her head on their lap, and they share stories about the pets they have at home.”</p> <p>Similar to her time in Cardiac Rehabilitation, her presence provides comfort and distraction during uncomfortable medical treatments.</p> <p>“Whether patients and staff know Luna or have just met her for the first time, it’s obvious that she brings light to any room she enters,” says Morgan. “She knows how to make patients’ experiences at Mayo Clinic Health System even more extraordinary.”</p> <h3>Learn more about pet therapy:</h3> <ul> <li>Meet <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://intheloop.mayoclinic.org/2019/01/10/piper-the-therapy-dog-with-three-legs-and-a-nose-for-healing/" target="_blank" title="Opens in a new window.">Piper, the therapy dog with three legs and a nose for healing</a>.</li> <li>Watch this video to see volunteers in action, including a pet therapy handler, and learn more about opportunities at Mayo Clinic Health System:</li> </ul> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/9nMpnFnmgdI" title="Volunteering" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p><img src="/-/media/national-files/images/hometown-health/2019/luna-pet-therapy-dog.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8FF2B2135766887AE1CE4B47C1D63CA5" alt="Luna the pet therapy dog" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller11/13/2019Physical medicine and rehabilitation is t<span>he growing specialty that </span>treats impairments affecting the brain, spinal cord, nerves, bones, joints, ligaments, tendons or muscles. A physiatrist answers some FAQ. What is physical medicine and rehabilitation?<p><em>By Mayo Clinic Health System staff</em></p> <p><a href="/services-and-treatments/physical-medicine-and-rehabilitation" target="_self" title="Opens in same window.">Physical medicine and rehabilitation</a> refers to the medical specialty that treats a variety of conditions, including impairments/disabilities affecting the brain, spinal cord, nerves, bones, joints, ligaments, tendons or muscles. With so many different conditions treated, it can become confusing when you're seeking care. Here are a few frequently asked questions that can help shed some light on this growing medical specialty.</p> <h4>What does a physical medicine and rehabilitation physician do?</h4> <p>Physical medicine and rehabilitation physicians — also known as physiatrists — emphasize prevention, diagnosis, treatment and rehabilitation of people disabled by disease, disorder or injury.</p> <h5>Goals of a physiatrist include:</h5> <ul> <li>Maximize independence with daily living activities</li> <li>Decrease pain</li> <li>Enhance performance/functionality to improve quality of life without surgical intervention</li> </ul> <p>Physical medicine and rehabilitation providers treat the whole person, not just the problem area. Physical medicine and rehabilitation often is called the quality of life profession because its goal is to enhance the body's performance.</p> <h4>Where do physical medicine and rehabilitation specialists practice?</h4> <p>Physical medicine and rehabilitation physicians practice in a variety of clinical settings, including outpatient clinics and inpatient facilities. They have a broad range of knowledge, including musculoskeletal (bones, muscles), neurology (nerves, nervous system) and rheumatology (joints, muscles, ligaments). Some physical medicine and rehabilitation physicians complete additional training in sports medicine, pediatrics, brain injury and pain medicine.</p> <h4>Who can see a physical medicine and rehabilitation provider?</h4> <h5>Physical medicine and rehabilitation specialists treat people of all ages, providing procedures and services, including:</h5> <ul> <li>Ultrasound-guided injections for improvement of pain and symptoms caused by <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/arthritis/symptoms-causes/syc-20350772" target="_blank" title="Opens in a new window."><span>arthritis</span></a><span>, </span><span><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/tendinitis/symptoms-causes/syc-20378243" target="_blank" title="Opens in a new window.">tendonitis</a> and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/bursitis/symptoms-causes/syc-20353242" target="_blank" title="Opens in a new window.">bursitis</a></span></li> <li>Guided injections of the spine to treat pain related to arthritis, sciatica and other conditions</li> </ul> <h5>Other common treatments provided or prescribed include:</h5> <ul> <li>Physical therapy</li> <li>Manual therapy</li> <li>Trigger point injections</li> <li>Complementary and alternative medical treatments, including acupuncture, yoga and massage</li> </ul> <h4>Can a physical medicine and rehabilitation physician prescribe medications?</h4> <p>Like other physicians, physical medicine and rehabilitation providers also prescribe medications for many issues, including muscle and nerve problems, attention and memory problems, and pain. Physical medicine and rehabilitation physicians also prescribe braces or splints to improve functionality along with other medical aids, including canes and walkers to enhance safety. Physical medicine and rehabilitation specialists are trained to utilize laboratory testing, X-rays, MRI or CT scans, electromyography (EMG), nerve conduction studies and psychological testing.</p> <h4>Why might I see a physical medicine and rehabilitation physician?</h4> <p>Outpatient physiatrists manage nonsurgical or nonoperative conditions, such as orthopedic/musculoskeletal injuries, including muscle strains/tears/sprains, and bursitis and tendonitis related to the shoulder, elbow, wrist/hand, hip, knee and foot or ankle. Other common conditions treated include arthritis, overuse injuries, neck or low back pain and nerve disorders, including carpal or tarsal tunnel.</p> <p>Physiatrists work with other medical providers, including orthopedic surgeons, neurosurgeons, neurologists, primary care providers, physical therapists, occupational therapists and speech therapists to help you get back to living your best life.</p><img src="/-/media/national-files/images/hometown-health/2019/physical-medicine-providers-working-with-patient.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A899B20AED8401E453D1026C60B0A8CA" alt="Physical Medicine providers working with patient" width="660" height="370" DisableNVelocity="true" />Rehabilitation TherapyRestoring movement and function to people injured or impaired by disease or injury.Dawn Haller6/14/2022One in 5 adolescents or teens experience a mental disorder each year. For girls, it can be especially challenging. Here's how to positively impact mental health in the girls in your life.5 things you need to know about mental health and girls<p>Mental health is important to your overall health, regardless of age or gender. Mental health symptoms can affect any community or family and should not be defined in just one way.</p> <p>Many young women and girls deal with a range of mental health conditions, including depression, anxiety, adjustment disorders, eating disorders and addictive behaviors. One in 5 children ages 6–17 experiences a mental disorder each year, according to the Centers for Disease Control and Prevention.</p> <h2>Here are 5 things to keep in mind when considering mental health in a teen girl in your life:</h2> <h4>1. Teach emotions.</h4> <p>Parents should start to tune in to their child's mental well-being from the day their child is born. Teach your child about emotions, what she can do when she has big feelings and model positive behavior.</p> <p>For example, you might say to your child: "I'm irritable today because I had a hard day at work. Let's read a book together because that would help me feel better." In this case, you are expressing what you're feeling, the reason you're feeling that way and demonstrating a positive way to handle your feelings.</p> <h4>2. Help with decision-making.</h4> <p>Mental health can affect a person's decision-making skills. When someone is anxious, overwhelmed, angry or sad, it can be hard to problem-solve or know what to do to feel better. That's why it's essential to have a general plan in mind before the big feelings happen.</p> <p>To construct a general plan, start by being aware of emotions and knowing that they're all OK. The easy emotions, such as being happy and excited, along with the hard emotions, such as being sad, angry or nervous, all are important. We wouldn't be human beings if we didn't have an array of emotions.</p> <p>It's necessary to have a plan for how to work through emotions when they happen. This could be talking with a friend or a trusted adult, listening to music, or performing physical activity like going for a run or a walk.</p> <h4>3. Watch for symptoms.</h4> <p>While mental illness can't be prevented in one way, helpful first steps are to be aware, and pay attention to emotions, thoughts and behaviors. Sometimes symptoms like depression and anxiety may manifest themselves in physical symptoms, such as headaches, muscle tension, or changes in sleeping or eating habits. This could be too much or too little sleeping or eating. Other symptoms can be withdrawal from friends and activities, significant tiredness or low energy, irritability, extreme mood changes of highs and lows, or excessive fears or worries.</p> <h4>4. Seek professional help.</h4> <p>Most mental illnesses don't improve on their own, and if left untreated, they can worsen over time and cause serious problems. Talk to your child's primary care provider or a mental health professional if you are concerned.</p> <p>In addition to mental health care, children should receive routine well-child checkups with their primary care providers to rule out any underlying health issues that may contribute to symptoms.</p> <p><strong>If you suspect suicide, call or text <a href="tel:988">988</a> for the 988 Suicide and Crisis Lifeline.</strong></p> It provides free, confidential support 24/7 for people in distress, and prevention and crisis resources. <p> </p> <h4>5. Take care of yourself.</h4> <p>Finally, take care of yourself. Get adequate sleep, eat healthy and find ways to be physically active. Encourage your daughter to do so, as well.</p> <p><em><a href="/providers/jessie-wolf-licsw" target="_self" title="Opens in same window.">Jessie Wolf</a> is a clinical social worker in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Adjustment disorders</li> <li>Adolescent and children’s behavioral health (ages 6-17)</li> <li>Anxiety disorders</li> <li>Attention-deficit/hyperactivity disorder (ADHD) assessment and treatment with adults and children (ages 6-17)</li> <li>Depressive disorders</li> <li>Grief and loss</li> </ul>L.I.C.S.W.<p>I see children six years of age through adulthood.</p><p><strong>Education </strong></p> <ul> <li>Master's degree, Social Work, Minnesota State University-Mankato</li> </ul> <p><strong>Internships</strong></p> <ul> <li>Hospice and Palliative Care, Mayo Clinic Health System-Mankato</li> <li>Nursing Home and Rehab Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>ADHD, Certified Clinical Services Provider </li> <li>Art of Traumatic Grief Counseling, Compassionate Bereavement Care</li> <li>Licensed Independent Clinical Social Worker</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Professional Society of ADHD and Related Disorders</li> <li>National Social Work Association</li> </ul> <p><strong>Academic Rank</strong></p> <ul> <li>Instructor in Social Work, Mayo Clinic College of Medicine and Science</li> </ul>Wolf<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jessie-wolf-licsw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B680201D1A0D763676AD889806D46E00" alt="Jessie Wolf LICSW" width="280" height="280" DisableNVelocity="true" />Jessie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14640821Jessie Wolf LICSW1{2B88C934-922C-4130-B661-197B59D83899}|{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2022/youth-with-red-streak-in-dark-hair.jpg?h=370&iar=0&w=660&sc_lang=en&hash=FD4F49CA98E5F07E10717493F1BCEA82" alt="Youth with red streak in dark hair" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Suicide PreventionSuicide is a major concern in the U.S. According to the Centers for Disease Control and Prevention, suicide was among the top nine leading causes of death for people ages 10–64 and the second leading cause of death for people ages 10–14 and 25–34. The positive news is that with the right information and willingness to reach out to someone in need, we all can help prevent suicide.<br /><br /><strong>If you are having suicidal thoughts, call the 988 Suicide and Crisis Lifeline at <a href="tel:988">988</a>, or chat at <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://988lifeline.org/" target="_blank" title="Opens in a new window.">988lifeline.org</a>.</strong>Dawn Haller9/9/2025All walking takes is you and a good pair of shoes. That's what makes it the most accessible form of exercise. Follow these tips for starting or maintaining a walking routine.5 tips for walking your way to better health<p>How often have you planned a new exercise routine? Each year, millions of people set resolutions to exercise more, driven by goals of improving their health, losing weight, keeping up with friends or kids, or maybe even addressing a new diagnosis. This often leads to complicated regimens, expensive equipment that ends up working better as a clothes rack — yes, I'm talking about that treadmill — or elaborate exercises.</p> <p>In reality, the best exercise is any exercise that's easily accessible, adaptable and something that you enjoy. Walking typically is the most accessible exercise and has multiple health benefits. But if dancing, kayaking or playing sports gives you more joy, then those are a better fit for you. The most important thing is being consistently active.</p> <h2>Why walking could work for you</h2> <p>Walking is a gentle, low-impact cardio exercise that can ease you into a higher level of fitness and health. It's safe and simple. Regular brisk walking can provide many of the same benefits as more vigorous exercises, such as jogging. For example, just 21 minutes of walking a day can reduce your risk of heart attack by 30%. Walking burns calories and trims the waistline, but it's also important for your lymphatic and immune systems.</p> <h3>Walking for fitness can help you:</h3> <ul> <li>Control your blood pressure.</li> <li>Lose or maintain weight.</li> <li>Improve balance and coordination.</li> <li>Increase core strength.</li> <li>Manage stress and improve mood by releasing endorphins.</li> <li>Manage your diabetes.</li> <li>Reduce the risk of a heart attack.</li> <li>Reduce the risk of developing <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/basics/definition/con-20031902" target="_blank" title="Opens in a new window.">Type 2 diabetes</a>.</li> <li>Stay strong and active.</li> </ul> <h3>Walking also has been shown to:</h3> <ul> <li>Improve sleep.</li> <li>Slow mental decline.</li> <li>Lower the risk of dementia.</li> <li>Reduce the risk of some cancers.</li> <li>Help you lead a longer life.</li> <li>Maintain independent living into older age.</li> </ul> <p>According to some estimates, it could save Americans over $100 billion per year in healthcare costs. On a community level, it's been shown that more people walking lowers crime rates and improves the local economy.</p> <h2>Tips for starting a walking routine</h2> <h3>Try these five tips to begin walking:</h3> <ul> <li><strong>Start slowly.</strong><br /> If you've been inactive, then start gently with five to 10 minutes at a steady pace, and build up your time and distance over a couple of weeks to months.</li> <li><strong>Set goals.</strong><br /> Set realistic goals for yourself, such as 20 to 40 minutes of walking five days a week.</li> <li><strong>Adjust your plan.</strong><br /> If you're taking a trip or working overtime, think of ways to incorporate short walks into your day to keep your plan on track.</li> <li><strong>Don't let the weather get you down.</strong><br /> If the weather isn't optimal, consider walking indoors, such as at local malls, exercise facilities and community centers.</li> <li><strong>Plan several different routes.</strong><br /> To keep you from getting bored, create several routes to choose from to add variety to your walking.</li> </ul> <p>Once you take that first step, you'll be on your way to an important destination: better health.</p> <h2>Tips to improve or maintain your walking routine</h2> <p>Already started? Fantastic. You've built walking into your regular routine.</p> <h3>To maintain or take this healthy habit to the next level, try these tips:</h3> <ul> <li><strong>Walk with family or friends.</strong><br /> Invite others. Not only will they help keep you accountable, but they'll also reap the benefits of a walking program. No humans available? Bring the dog or cat.</li> <li><strong>Be consistent.</strong><strong><br /> </strong>To help your walk become a habit, build it into your daily routine. Maybe it becomes part of your lunch break or something to do after dinner. Add your walk to your calendar, just as you do with other appointments. There will be days when you may need to adjust your walking schedule, but keep it as consistent as possible.</li> <li><strong>Spice it up.</strong><br /> Now comes the fun part of a walking program. Add small challenges to your routes or try some of these ideas: <ul> <li>Add a workout section with a set of lunges, squats or push-ups.</li> <li>Create a walking bingo game or mentally play the alphabet game by finding something along your route that begins with A, B, C.</li> <li>Walk like other animals.</li> <li>Try a new route to vary your scenery, as well as level of difficulty.</li> <li>Walk on grass or a dirt or gravel path instead of concrete.</li> <li>Vary your pace by speed-walking for short distances.</li> <li>Up the ante with resistance bands or weights.</li> <li>Listen to music, a podcast or guided meditation.</li> </ul> </li> <li><strong>Fuel your body and stay hydrated.</strong><br /> You don't need to go on a special diet. Instead, pay attention to how your body reacts to what, when and how much you <a href="/topics/nutrition" target="_self" title="Opens in same window.">eat</a>. Be mindful of <a href="/-/media/national-files/images/hometown-health/2018/tips-for-drinking-more-water.jpg" target="_self" title="Opens in same window.">hydration</a> and how your body responds. Small changes can make a world of difference.</li> <li><strong>Embrace apps or leave technology at home.</strong><br /> Your smartwatch may have started out as an accountability partner, pushing you to start that next walk. But wearable technology also can provide virtual badges as you reach certain goals, let you walk virtually with friends and even incorporate mindfulness. Or try a walk without technology. Listen to the sounds around you. Feel the cool breeze on your face. Take some time for just you.</li> </ul> <h2>Learn more about walking for health:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/expert-advice-on-finding-the-best-shoe-fit" target="_self" title="Opens in same window.">Get tips on selecting a good walking shoe</a>.</li> <li><a rel="noopener" href="https://newsnetwork.mayoclinic.org/discussion/get-walking-with-this-12-week-walking-schedule/" target="_blank" title="Opens in a new window.">Try this 12-week walking schedule</a>.</li> <li><a href="/hometown-health/speaking-of-health/taking-the-first-step-starting-restarting-an-exercise-program" target="_self" title="Opens in same window.">Taking the first step: Starting or restarting an exercise program</a>.</li> </ul> <p><em>By Mayo Clinic Health System staff. </em></p><img src="/-/media/national-files/images/hometown-health/2023/walking-dog-on-wooded-trail.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3C3B06DBA6BA9AD8E7765D4F6318240A" alt="Walking dog on wooded trail" width="660" height="370" DisableNVelocity="true" />Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Dawn Haller4/4/2024Did you know influenza is the most common, vaccine-preventable disease for travelers? Be a smart traveler, and talk to your healthcare team about flu vaccination before your trip.Foreign travel plans? What to know about influenza before you go<p>Do you have plans to travel internationally? When making international travel plans, your focus may be on your risk of getting exotic diseases. However, U.S. travelers also are at significant risk for many common, vaccine-preventable diseases, and that risk isn't limited to travel to developing countries.</p> <p>Influenza is the most common vaccine-preventable disease for travelers, primarily if they are traveling by airplane, taking a cruise or attending a mass gathering, such as the Hajj pilgrimage, the Times Square New Year's Eve celebration in New York City or the Super Bowl, reports the <a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5505480/" target="_blank" title="Opens in a new window.">Journal of Travel Medicine</a>.</p> <p>The influenza vaccine protects against complications associated with the virus and reduces the risk of hospitalization and death, according to the <a rel="noopener" href="https://www.cdc.gov/flu/prevention/?CDC_AAref_Val=https://www.cdc.gov/flu/prevent/prevention.htm" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention</a> (CDC). Even if you acquire this respiratory illness, symptoms are less severe if you are vaccinated.</p> <p>The influenza virus circulates year-round in tropical and subtropical regions, and in certain seasons in temperate countries. Regardless of the time of year, if you're visiting the tropics, you should be vaccinated for influenza before your trip.</p> <p>The risk of infection from the virus varies based on your age, underlying health conditions, travel destination and planned activities.</p> <p>A <a rel="noopener" href="https://www.mayoclinicproceedings.org/article/S0025-6196(19)30317-9/pdf" target="_blank" title="Opens in a new window.">Mayo Clinic review of vaccines for international travel</a> (PDF) suggests that travelers who were immunized with the current influenza vaccine formulation more than six months before their trip may consider revaccination because immunity declines. This may be most beneficial if your plans call for travel to areas with active circulating influenza virus or tropical regions. Receiving the influenza vaccine reduces the risk of an illness that could disrupt your travel plans.</p> <h2>Here's what to know about influenza before you travel:</h2> <ul> <li>The CDC recommends <a href="/hometown-health/featured-topic/dont-skip-your-flu-shot-this-year" target="_self" title="Opens in same window.">annual vaccination</a> for anyone 6 months and older.</li> <li>Get vaccinated at least two weeks before travel because vaccine immunity typically takes that long to develop. </li> <li>High-risk people, such as children, pregnant women, and those who are immunocompromised, living with HIV or have chronic underlying health conditions, should receive the vaccine before travel.</li> <li>It's crucial to be informed about the country you plan to visit to account for additional risks. For example, travelers going to China and Southeast Asia should avoid poultry markets and farms to decrease the risk of acquiring avian influenza. Current vaccines are ineffective against the virus.</li> <li>Travelers may want to discuss antiviral medication with their healthcare team as standby therapy.</li> <li>Washing your hands with soap and water or an alcohol-based hand sanitizer is one of the best things you can do to protect yourself from illness when you travel. <a href="/hometown-health/speaking-of-health/5-ws-of-healthy-hands" target="_self" title="Opens in same window.">Regular handwashing</a> reduces the risk of respiratory viruses and infections that can cause gastrointestinal illness, like norovirus</li> </ul> <h2>Learn more about staying healthy while traveling:</h2> <ul> <li> Find out <a href="/hometown-health/speaking-of-health/9-reasons-to-see-a-travel-medicine-specialist" target="_self" title="Opens in same window.">why seeing a travel medicine specialist is essential before international travel</a></li> <li>Get answers to <a href="/hometown-health/speaking-of-health/questions-about-vaccines-and-travel" target="_self" title="Opens in same window.">common questions about vaccines and travel</a>.</li> <li>Learn the <a href="/hometown-health/speaking-of-health/steps-to-prevent-norovirus" target="_self" title="Opens in same window.">steps to prevent norovirus</a>.</li> <li>Read about <a href="/services-and-treatments/infectious-diseases" target="_self" title="Opens in same window.">infectious diseases and local travel clinic services</a>.</li> </ul> <p><em><a href="/providers/jessica-sheehy-pac" target="_self" title="Opens in same window.">Jessica Sheehy</a> is a physician assistant in <a href="/services-and-treatments/infectious-diseases" target="_self" title="Opens in same window.">Infectious Diseases</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Antimicrobial stewardship</li> <li>Infectious disease</li> <li>Travel medicine</li> </ul>P.A.-C.<p>My goal is to help my patients understand what is happening in regard to their infection, and how it impacts them. When my patients are informed, they can fully participate in the development of a plan that will treat their infection.</p> <p>I have always had an interest in microbiology, and have a college minor in microbiology. Therefore, infectious diseases was a natural fit for my professional career. </p> <p>I love to travel and visit my friends and family in Montana as often as I can.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Physician Assistant Studies, Arcadia University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>National Commission on Certification of Physician Assistants</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Sheehy<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jessica-sheehy-pac.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4E5429A03BCFC322B550B0EC92C132BF" alt="Jessica Sheehy, P.A.-C., P.A." width="280" height="280" DisableNVelocity="true" />{645A5342-C9AE-4AD4-9114-2A0634580FC2}Jessica<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15739287Jessica Sheehy PAC1{C8A905E8-82D3-45FC-9669-A5F09F2EF6CA}<img src="/-/media/national-files/images/hometown-health/2024/group-dancing-outdoors.jpg?h=370&iar=0&w=660&sc_lang=en&hash=70098CAB846BCAA99BDA335AFAB187E0" alt="Group dancing outdoors" width="660" height="370" DisableNVelocity="true" />InfluenzaInfluenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza, commonly called the flu, is not the same as the stomach "flu" viruses that cause diarrhea and vomiting.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Dawn Haller11/28/2022The holidays can be a time of joy and also a time of grief for lost loved ones. Understanding how grief affects you can help provide a sense of empowerment to navigate the holiday season.Grief and loss throughout the holiday season<p>The holiday season can be especially challenging if you're dealing with the death of someone close to you. Whether it was a recent loss or one that occurred some time ago, feelings of grief can be heightened and may seem overwhelming during the holiday season.</p> <p>This is the time of year known for traditions and togetherness with family and friends, yet you may face challenges in how you celebrate and gather. Understanding <a href="/hometown-health/speaking-of-health/the-space-in-between-grief-and-growth" target="_self" title="Opens in same window.">how grief affects you</a>, having conversations about plans with those close to you, and finding ways to remember your loved ones can help restore a sense of balance through this time. These actions also can help you navigate through rough spots and find warmth in special, unexpected places.</p> <p>Grief and bereavement are universal, understandable human responses to loss, but how each person processes the various symptoms and reactions can vary greatly. Because each person is different, how and when those feelings surface will vary.</p> <p>There is no predictable timetable or pattern. While you may feel it on an emotional level or in your everyday behaviors and relationships, grief also has its physical effects, which are important to note. You might recognize that you tire more easily, have trouble eating or sleeping, or seem more susceptible to headaches and other illnesses. You might even notice that you have difficulty concentrating and a low tolerance level.</p> <p>These symptoms occur because the part of the brain responsible for emotion and stress is activated during the grieving process, so normal brain functioning is interrupted. Grief can change brain chemicals and hormonal functioning, and your immune system can be compromised.</p> <p>Pay close attention to your health and take good care of yourself while grieving. It's important to take it easy and be gentle with yourself. Try to <a href="/hometown-health/speaking-of-health/embrace-a-healthy-mindset-for-eating-no-matter-the-occasion" target="_self" title="Opens in same window.">eat healthy foods</a> and get enough rest. You're not imagining these reactions. They are real.</p> <p>If you're experiencing these feelings, it's a good idea to see your health care team to ensure that all is well and have added guidance during this difficult time.</p> <p>Some of what you're experiencing may include responses that don't feel socially acceptable. You might find that tears come easily in unexpected places or you can't cry — the tears just won't come. You might feel so down or exhausted that you have trouble just getting out of bed or off the sofa. You might realize that the coping responses you've developed might not be the healthiest.</p> <p>The important thing to remember is that you are a unique person. Honor your process, and acknowledge that this is how you respond and are attempting to cope. There is no right or wrong way to grieve. Try to go at your own pace.</p> <p>It may be beneficial to seek grief counseling or join a grief support group. Knowing that you're not alone can make a world of difference. Connecting with those who understand or are going through a similar situation can provide new perspectives, affirm that what you are going through is normal and offer much-needed support.</p> <p> You're grieving because you've loved, have been loved and continue to love. An important part of your healing this holiday season may be to embrace the love and memories you've shared with your loved ones.</p> <p>Sharing stories among family and friends, making favorite foods, looking at photographs of happy memories or other activities may help you find connection. Pay attention to whether this warms you or becomes too hot to touch. Let your feelings be your guide. Finding the path to navigate through all the <a href="/hometown-health/speaking-of-health/9-ways-to-make-your-holiday-season-jolly" target="_self" title="Opens in same window.">season's activities</a> may provide a sense of empowerment.</p> <p>Wishing you peace through the holiday season.</p> <p><em>Lisa DeSieno, is the Bereavement Services director in Eau Claire, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2022/child-hugging-grandparent.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6B9DC1F509CD51255DA3E8B323968F83" alt="Child hugging grandparent" width="660" height="370" DisableNVelocity="true" />GriefGrief is the natural reaction to loss. It will be unique to you, depending on your own personality and circumstances.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller12/18/2019With flu season in full swing, there's still time to get a flu shot. But if your child has an egg allergy, you may be wondering if it's safe to be vaccinated.Should my child with an egg allergy get the flu shot?<p>An egg allergy is the second most common food allergy in the U.S. after a milk allergy. Egg allergies affect about 1.3% of all children and 0.2% of all adults.</p> <h2>Some signs or symptoms of an egg allergy include:</h2> <ul> <li><a rel="noopener" href="https://acaai.org/allergies/types/skin-allergies/hives-urticaria" target="_blank" title="Opens in a new window.">Hives</a></li> <li>Shortness of breath</li> <li>Wheezing</li> <li>Repetitive cough</li> <li>Shock or circulatory collapse</li> <li>Tight, hoarse throat, or trouble swallowing</li> <li>Swelling of the tongue, affecting the ability to talk or breathe</li> <li>Vomiting or stomach cramps</li> <li>Weak pulse</li> <li>Pale or blue coloring of skin</li> <li>Dizziness or feeling faint</li> <li><a rel="noopener" href="https://acaai.org/allergies/anaphylaxis" target="_blank" title="Opens in a new window.">Anaphylaxis</a> —a potentially life-threatening reaction that can impair breathing and send the body into shock</li> </ul> <p>If your child has an egg allergy, the <span>Centers for Disease Control and Prevention (CDC) recommends flu vaccination. If your child has a severe allergic reaction to egg, your child should be vaccinated in a medical setting under the supervision of a healthcare provider who can recognize and manage severe allergic conditions.</span></p> <p>The risk of adverse reaction to flu vaccination in people with an egg allergy is low, with 10 cases of anaphylaxis in 7.4 million doses of the flu vaccine, according to the CDC. Most cases of anaphylaxis were not related to the egg protein present in the vaccine.</p> <p>However, if your child has had a previous severe allergic reaction to the flu vaccine, a flu vaccination is not recommended, according to the CDC.</p> <p>For those with no egg allergy, now is the time to get vaccinated against the flu — a contagious respiratory illness that can cause mild to severe disease. Serious outcomes of influenza infection can result in hospitalizations and in some cases, even death. Young children, the elderly and people with certain health conditions are at high risk for serious flu complications.</p> <p>The best way to prevent flu is by getting vaccinated each year.</p> <p><em><a href="/providers/adela-taylor-md" target="_self" title="Opens in same window.">Adela Taylor, M.D.</a>, is an <a href="/services-and-treatments/immunology" target="_self" title="Opens in same window.">allergist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/rice-lake" target="_self" title="Opens in same window.">Rice Lake</a>, Wisconsin.</em></p><ul> <li>Angioedema (welts below the skin)</li> <li>Atopic dermatitis</li> <li>Food allergies</li> <li>Medication allergy</li> <li>Pediatric asthma</li> <li>Urticaria (hives)</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Medical University of Warsaw</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Pediatric and Adolescent Medicine, Mayo Clinic School of Graduate Medical Education</li> <li>Pediatric Allergy and Immunology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Pediatric Allergy and Immunology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Allergy and Immunology, American Board of Allergy and Immunology</li> <li>Diplomate, American Board of Pediatrics</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Allergy, Asthma & Immunology</li> <li>Joint Council of Allergy, Asthma and immunology</li> <li>Wisconsin Medical Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Taylor<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/adela-taylor-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=FF6FA06FF41A37127EEE585DCA8A3F55" alt="Adela Taylor, M.D." width="280" height="280" DisableNVelocity="true" />{94F9636D-A44F-4A1B-BB6B-110B3CA6B06B}Adela<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>11922869Adela Taylor, M.D.1{9D6C5FE2-E6DA-4A63-9DD8-CE124BD4E4B7}<img src="/-/media/national-files/images/hometown-health/2019/egg-allergies-and-the-flu-shot.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1E0897A77D9774DFC40D13DE2F2D5117" alt="Egg Allergies and The Flu Shot" width="660" height="370" DisableNVelocity="true" />Allergy and AsthmaOur allergists provide care for your allergies, asthma and conditions that affect the immune system's ability to defend the body against foreign or abnormal cells. The main treatment goal is your satisfaction when your condition is under control and quality of life is improved.InfluenzaInfluenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza, commonly called the flu, is not the same as the stomach "flu" viruses that cause diarrhea and vomiting.Immunizations<p>Disease prevention is crucial to your health. Getting vaccinated is one of the best ways to maintain good health, and protect you and those you care about against infectious diseases. Vaccinations offer protection against serious diseases by stimulating the immune system to create antibodies against certain bacteria or viruses.</p><br/><p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/vaccine-guidance/art-20536857" target="_blank" title="Opens in a new window.">Get vaccine guidance from Mayo Clinic</a>, including benefits, safety, side effects and what to know about recommended vaccines for babies, children, teens, adults and during pregnancy. For recommended vaccines based on age, refer to the <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/adult" target="_blank" title="Opens in a new window.">adult</a> or <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/child" target="_blank" title="Opens in a new window.">child and adolescent</a> schedules.</p><br/><p>Review the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/coronavirus-covid-19/history-disease-outbreaks-vaccine-timeline" target="_blank" title="Opens in a new window.">history of infectious disease outbreaks and vaccines timeline</a> for information about major disease outbreaks, epidemics and pandemics, and the impact of vaccines and research.</p>Dawn Haller9/11/2020Cancer can affect more than physical health. The emotional side can affect the ability to cope and stick to a treatment plan. Get 7 tips on how to improve your emotional well-being as a cancer patient or caregiver.The emotional side of cancer: 7 tips<p>Adult cancer patients have unique physical health needs, but they also have unique emotional and mental health needs. </p> <p>The emotional side of cancer — things like dealing with the stress of a diagnosis, self-care during treatment, accessing financial and legal resources or locating support — all can affect a patient's ability to cope and stick to a treatment plan.</p> <p>To help meet these needs, social workers can help navigate resources that support and encourage families. For example, if a patient is having trouble finding a ride to medical appointments, a social worker can connect the patient to transportation resources.</p> <p>The patient can focus on healing if some of the stress and barriers getting to and from appointments are removed. Social workers are an important part of the care team who can coordinate services, educate, and listen to concerns during and after a hospital stay or during treatment.</p> <h3>Here are 7 tips to maintain or improve emotional well-being for cancer patients and caregivers:</h3> <h4>1. Talk to someone who is not a family member.</h4> <p>While it can seem overwhelming to meet with a clinical social worker, these experts are trained to help on a one-time, short-term or long-term basis. By allowing yourself the opportunity to talk to someone other than friends or family, you get a trusted person to talk to while allowing your family to be just family.</p> <h4>2. Continue with daily activities, but modify if necessary.</h4> <p>Modifying normal tasks, habits and activities is not failure — it's good self-care. Maybe you can't camp for a full week far away, but could you camp for a couple of days closer to home?</p> <h4>3. Plan ahead.</h4> <p>If you know you might need transportation or could benefit from a program, such as Meals on Wheels, do some research ahead of time or enlist the help of a friend who enjoys planning. Not only can this help you avoid a last-minute scramble, but also checking on community resources in advance can help you understand your choices, lower your stress, and give you peace of mind and some control at a time things around you may seem out of control.</p> <h4>4. Find support that works for you.</h4> <p>For some people, it's really important to connect with others going through the same thing. Support could be a monthly in-person group, a one-time class, or ongoing education about self-care, caregiving, nutrition or legal resources. For others, it may be important to explore short-term counseling with a clinical social worker.</p> <h4>5. Balance in-person and online support.</h4> <p>At certain times during treatment, there could be physical limitations or your immune system could be compromised, making an online community a good source of support. Remember that this may be helpful in the short term, but being social is key to emotional well-being.</p> <h4>6. Tap your community.</h4> <p>There are so many wonderful community resources that are here to help. Services can be practical, provide an emotional boost or offer opportunities for social interaction. A good place to start is the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.cancer.org/treatment/support-programs-and-services/resource-search.html" target="_blank" title="Opens in a new window.">American Cancer Society website</a>. Enter your ZIP code for a list of resources near you. The site also can connect caregivers.</p> <h4>7. Reach out.</h4> <p>Contacting a social worker at your local cancer center is always welcome. Remember, reaching out is a sign of strength, not weakness. Even though you may want to be independent asking for help is healthy.</p> <p><em><a href="/providers/sharon-dexheimer-licsw" target="_self" title="Opens in same window.">Sharon Dexheimer</a> is a licensed clinical social worker in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota, who specializes in working with <a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">cancer</a> patients and their loved ones.</em></p><ul> <li>Adjustment disorder </li> <li>Adults </li> <li>Anxiety </li> <li>Caregiver stress </li> <li>Depression </li> <li>Grief and Loss </li> <li>Oncology patients </li> </ul>L.I.C.S.W.<p>I like to use a strengths-based approach to providing care.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Social Work, University of St. Thomas</li> </ul> <p><strong>Internships</strong></p> <ul> <li>Hospice, Mayo Clinic Health System-Mankato</li> <li>Emergency Department, Mayo Clinic Health System-Mankato</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Certified Oncology Social Worker</li> <li>Licensed Independent Clinical Social Worker</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Association of Oncology Social Work</li> <li>National Association of Social Workers</li> </ul>Dexheimer<img src="/-/media/shared-files/images/medical-professionals/full/mankato/sharon-dexheimer-licsw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=694257FD0BB3D05A02ABDCBE87EF4262" alt="Sharon Dexheimer LICSW" width="280" height="280" DisableNVelocity="true" />Sharon<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15257258Sharon Dexheimer LICSW1{2B88C934-922C-4130-B661-197B59D83899}|{BCFC3BDC-CF55-458E-A41C-9360527B6CCC}|{C4130004-0F31-48C4-AC9F-A4350A75AB24}|{F26710D2-A52B-47C8-986C-0B3D1DA0A9D0}<img src="/-/media/national-files/images/hometown-health/2019/woman-with-close-hair-looking-in-mirror.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C21D2B5CFDD5793E5B7C76E7A0180973" alt="Woman with close hair looking in mirror" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.Lung CancerLung cancer is a type of cancer that begins in the lungs. It is the leading cause of cancer deaths in the U.S., among both men and women. Lung cancer claims more lives each year than do colon, prostate, ovarian and breast cancers combined. <br/><br/>Skin CancerSkin cancer — the abnormal growth of skin cells — most often develops on skin exposed to the sun. But this common form of cancer can also occur on areas of your skin not ordinarily exposed to sunlight.Prostate HealthProstate cancer is the most common cancer diagnosed in men. You may have friends or family members who have been diagnosed with prostate cancer, and this may make you wonder about what you can do for prostate cancer prevention.Colorectal HealthGet screening and treatment for colorectal cancer symptoms, and learn about risk factors and prevention strategies.Dawn Haller1/17/2020If achy joints have you feeling like the Tin Man, don't just chalk it up to getting older. Those aches and pains could signal something more serious, but treatable. No oil required.How to keep moving with arthritis<p>Creak, creak, creak. If achy joints have you feeling like the Tin Man, don't just chalk it up to getting older. Those aches and pains could signal something more serious. And treatable. No oil required.</p> <p>"Arthritis is a common cause of joint pain and stiffness," says <a href="/providers/jacob-ziegler-md" target="_self" title="Opens in same window.">Jacob Ziegler, M.D.</a>, an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgeon</a> at Mayo Clinic Health System in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota. "It affects millions of people, and you don't have to be as old as you might think to develop it. People of all ages have arthritis."</p> <h4>Two types of arthritis pain</h4> <p>There are two main types of arthritis: <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/osteoarthritis/symptoms-causes/syc-20351925" target="_blank" title="Opens in a new window.">osteoarthritis</a> and <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/symptoms-causes/syc-20353648" target="_blank" title="Opens in a new window."><span>rheumatoid arthritis</span></a>.</p> <p>"Osteoarthritis is most common and the one people are most familiar with," says <a href="/providers/robert-cates-do" target="_self" title="Opens in same window.">Robert Cates, D.O.</a>, an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgeon</a> at Mayo Clinic Health System in <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota. "It's caused by wear and tear of the cartilage in the joints."</p> <p>If that wear and tear gets bad enough, the cartilage can become so damaged that your bones rub against each other. That can be painful and limit your movement.</p> <p>The other common type of arthritis — rheumatoid — is an autoimmune disorder. Your body's immune system attacks itself, causing your joints to become inflamed and swollen. Eventually, your joints may become deformed.</p> <h4>Arthritis treatment options</h4> <p>"There are a number of treatments you can try to reduce pain and have more function," Dr. Ziegler says.</p> <p>Common treatments include medication, including over-the-counter pain relievers, such as acetaminophen and ibuprofen. Your health care provider may recommend prescription medications, depending on the type of arthritis and symptoms you're having. There also are medications that can be injected directly into your joints to relieve pain.</p> <p>All treatments have the same mission.</p> <p>"The goal of arthritis treatment is to improve function and reduce pain," Dr. Cates says.</p> <p>While arthritis may leave you feeling like taking it easy, gentle exercise may be just what the doctor ordered.</p> <p>"People might not feel like going to the gym when they are in pain," Dr. Ziegler says. "But regular exercise has a host of benefits for people who have arthritis. It really does help keep joints flexible. Typically, low-impact exercise is best tolerated. Things like pool exercises, bicycle or elliptical tend to keep you moving with less aggravation of the pain."</p> <p>Other benefits include strengthening the muscles around the joints, maintaining bone strength, and improving energy and mood. Low-impact activities, such as swimming and yoga, are good choices.</p> <p>Exercise also can help with weight loss and management. That's important because extra weight can stress your joints.</p> <p>Your diet also can play a role in managing pain.</p> <p>"What you eat can have an impact on how you feel," Dr. Cates says. "Avoid processed foods, carbohydrates and unhealthy fats when possible because these can contribute to inflammation. Instead, choose to eat more fruit, vegetables, whole grains and fish as part of a healthy diet."</p> <p>If your pain persists despite nonsurgical treatments, you may benefit from surgery. Options include joint fusion, repair or replacement.</p><img src="/-/media/national-files/images/hometown-health/2020/mature-couple-folded-hands-meditation.jpg?h=370&iar=0&w=660&sc_lang=en&hash=289E4B7B32C7DCE27183E538DBE56777" alt="Mature couple folded hands meditation" width="660" height="370" DisableNVelocity="true" />ArthritisArthritis is inflammation of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis.Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Pain ReliefApproximately 50 million people in the U.S. live with chronic pain. If you experience chronic pain, you're not alone. Learn about the ways to deal with painful disorders, from at-home solutions to drug treatments, injectable or implantable therapies to surgery.Dawn Haller1/9/2020Are you among the 60 million Americans who experience heartburn at least once a month? If left untreated, it can lead to Barrett's esophagus, which is associated with an increased risk for esophageal cancer. Learn about a screening option and tips for managing gastro reflux disease.Barrett's esophagus screening helps with early diagnosis of esophageal cancer<p>About 60 million Americans experience heartburn at least once a month, especially after a large or spicy meal. However, if your symptoms occur two or more times per week, you may have gastroesophageal reflux disease, or <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940" target="_blank" title="Opens in a new window.">GERD</a>. Symptoms can include heartburn, regurgitation and/or difficulty swallowing. Try these <a href="/hometown-health/speaking-of-health/take-the-burn-out-of-gerd" target="_self" title="Opens in same window.">tips to manage GERD</a>.</p> <p>If left untreated, GERD could lead to Barrett’s esophagus, in which the lining of the esophagus becomes stomach-like in response to abnormal acid exposure over a long period. Barrett's esophagus is associated with an increased risk of developing esophageal cancer, and, like most cancers, it is easier to treat if detected early. Your doctor may recommend that you be screened for Barrett's esophagus if you have long-standing GERD. </p> <h4>Factors increasing your risk for Barrett's esophagus include:</h4> <ul> <li>Experiencing chronic GERD</li> <li>Being a man</li> <li>Being 50+</li> <li>Being obese</li> <li>Being Caucasian</li> <li>Smoking</li> <li>Having a family history of Barrett’s</li> </ul> <p>To be screened for Barrett's esophagus, you will have a procedure called esophagogastroduodenoscopy, also known as an upper GI endoscopy or EGD. It is an outpatient procedure, which means you will go home after the procedure and not stay in the hospital overnight. During the procedure, a thin, flexible telescope is inserted through your mouth to inspect your esophagus, stomach and first part of the small bowel. Tissue samples, called biopsies, may be taken depending on what is found. </p> <p>An EGD typically takes less than 30 minutes. You will receive medication that decreases your level of consciousness causing short-term memory loss, so there usually is little or no recollection of the procedure. The medication also decreases levels of anxiety and keeps any discomfort to a minimum.</p> <p>If Barrett’s esophagus is found, your treatment plan will depend on biopsy results. You may be advised to undergo periodic EGDs, usually once every three years. Or you may need additional endoscopic treatments to eliminate the segment of Barrett’s. If there is no evidence of Barrett’s, another EGD typically is not necessary unless you experience additional symptoms.</p> <p><em>Jaime Zighelboim, M.D., is a <a href="/services-and-treatments/gastroenterology-and-hepatology" target="_self" title="Opens in same window.">gastroenterologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p> <img src="/-/media/national-files/images/hometown-health/2020/hand-on-throat-esophagus.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9F212A74BF3EDC0133FE01CDC2E20F2C" alt="Hand on throat esophagus" width="660" height="370" DisableNVelocity="true" />Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Dawn Haller1/15/2020Searching for reliable information about taking supplements during pregnancy can be confusing. Read this Q&A for advice on those you should and shouldn't take.Should women take supplements while pregnant?<p>It seems there's an endless amount of online information related to what supplements a woman should take when pregnant. As a result, searching for reliable information related to supplements during pregnancy can be difficult at best.</p> <h4>Here's a Q&A with some advice on which supplements you can use — and those you should avoid — during your pregnancy:</h4> <h4>Are dietary supplements OK during pregnancy?</h4> <p>It's recommended that women should not use dietary and herbal supplements during pregnancy. In addition, dietary and herbal supplements should be used with caution in women of reproductive age due to the risk of taking these supplements before knowledge of pregnancy.</p> <p>Unlike prescription drugs, dietary supplements are not reviewed by the U.S. Food and Drug Administration (FDA) for safety and effectiveness. As a result, they may contain contaminants, like metals, pesticides, chemicals or bacteria, which may pose risks for pregnancy. Also, most supplements are not thoroughly studied, which can lead to issues related to quality standards for ingredients and strength. For example, vinpocetine — an ingredient found in a number of dietary supplements, including those marketed for weight loss, enhanced memory, focus, mental acuity or increased energy — is not safe during pregnancy. Other commonly used supplements that may cause harm during pregnancy include melatonin and St. John's wort.</p> <h4>What about meal replacement shakes?</h4> <p>Women shouldn't consume nutritional shakes as meal replacement options during pregnancy, as they're considered supplements and are not approved by the FDA.</p> <p>Nutritional shakes may contain vitamins, herbs or other substances that have the potential to be harmful during pregnancy, and are difficult to identify on a label. Many supplement labels often read as herbal or proprietary blends. Also, because these shakes are considered supplements, there are similar quality, contamination, safety and efficacy concerns as with other dietary supplements.</p> <h4>What supplements are OK to take?</h4> <p>Folic acid supplementation is recommended for all women of reproductive age and who are pregnant, as it helps prevent neural tube defects or abnormalities, such as spina bifida. Ideally, women should take a daily folic acid supplement for at least one month before conception.</p> <p>Ginger has also been shown to be helpful for nausea and vomiting during pregnancy. The American College of Obstetricians and Gynecologists suggests using ginger capsules to treat nausea and vomiting during pregnancy.</p> <h4>What about vitamins during pregnancy?</h4> <p>A prenatal vitamin should be a sufficient source of vitamins during a woman's pregnancy. Talk to your health care provider about a prescription for a prenatal vitamin that is approved for use prior to getting pregnant and during pregnancy. Once pregnant, women should avoid taking more than twice the recommended dietary allowances of vitamins and minerals. Excessive intake of vitamins and minerals, such as iodine, can cause problems in pregnancy.</p> <p>Also, an excessive intake of vitamin A, defined as more than 10,000 IU of vitamin A per day, may be associated with fetal malformations of the bones, urinary tract or nervous system. As a result, women should not take additional vitamin A supplementation outside of what's in their prenatal vitamin.</p> <h4>In general, how can women be healthy during pregnancy?</h4> <p>Women who are pregnant should strive to eat a well-balanced diet that is high in vegetables and fruits, has lots of colors, and includes whole grains and lean meats. Finally, make sure to avoid highly processed foods and foods high in fats, such as fried and sugary foods.</p> <p>It's essential for women who are pregnant or who have the potential to become pregnant to let their health care provider know if they are taking any supplements, and discuss the risks and benefits of continuing them.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2020/pregnant-woman-looking-at-supplements.jpg?h=370&iar=0&w=660&sc_lang=en&hash=FE63148FF3BEE25D001015A3348165C5" alt="Pregnant woman looking at supplements" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller11/16/2023Acne can appear anywhere you have oil glands on your skin, including the back, face, stomach or chest. Learn about some factors that can lead to chest acne and what you can do to prevent or treat it.The facts about chest acne<p>Acne is a skin condition that nearly everyone deals with at some point in their lives.</p> <p>Acne can develop as whiteheads, blackheads or deeper pimple lesions that are caused by multiple factors, including: </p> <ul> <li>Bacteria</li> <li>Clogged pores or hair follicles</li> <li>Increased oil production</li> <li>Inflammation of the skin</li> <li>Overgrowth of cutibacterium acnes</li> </ul> <p>The unfortunate truth is that acne has no boundaries. It's more common for teenagers, but it can develop in people of all ages and equally affects people of all genders. Acne can appear anywhere you have oil glands in your skin, so it can be on your back, face, stomach, shoulders or chest.</p> <h2>Why does my chest have acne?</h2> <h3>Chest acne develops the same way as acne on other parts of your body, but some specific factors lead to the development of chest acne, including:</h3> <ul> <li>Excessive sweating followed by not cleansing promptly.</li> <li>Friction pressure on your skin from clothing and backpacks.</li> <li>Using skin care products that clog pores like lotions and creams that contain oil.</li> </ul> <h3>Other factors can make acne worse, including:</h3> <ul> <li><strong>Certain medications</strong><br /> Examples include corticosteroids, testosterone, lithium and some chemotherapy medications.</li> <li><strong>Hormones</strong><br /> Hormonal changes during puberty, pregnancy and midlife can cause your glands to produce more oil and lead to increased acne.</li> <li><strong>Stress</strong><br /> Stress doesn't cause acne, but stress can make your acne worse. When your body is under stress, it produces hormones called androgens. In the skin, androgens stimulate hair follicles and oil glands, leading to more inflammation and development of acne.</li> </ul> <p>You may have heard the myth that eating chocolate or greasy foods causes acne. Eating these foods has little to no effect on acne. If you suspect a particular food is triggering your acne, stop eating that food for some time to see if your acne improves.</p> <p>It's also a myth that chest acne is the result of poor hygiene. Dirty skin does not cause acne and using harsh soap or chemicals and rough scrubbing can actually make acne worse.</p> <h2>How can I treat my chest acne?</h2> <p>Consistent care for your skin is essential in treating acne. Many treatments are available for chest acne to help you avoid skin scars, make acne less noticeable and lower the emotional stress it causes. </p> <p>Use gentle cleansers and noncomedogenic creams so skin pores don't get clogged. Also, avoid coarse or rough body scrubs, which are traumatic to the skin and can worsen acne.</p> <h3>Over-the-counter creams, gels, lotions and body washes can provide some relief of mild inflammatory acne, including:</h3> <ul> <li><strong>Adapalene 0.1% gel</strong><br /> A retinoid product that works to stop pimples from forming under the skin's surface.</li> <li><strong>Benzoyl peroxide</strong><br /> Kills bacteria and comes in varying strength levels.</li> <li><strong>Salicylic acid</strong><br /> A common ingredient used to treat acne on top of the skin.</li> </ul> <p>When using a new product, start with a small amount and gradually increase the frequency of use over time. Be patient with results, as it may take up to eight weeks or more to see changes in your skin. </p> <p>Trying multiple treatment options can help you find the right solution, but acne can be persistent. Chest acne pimples and bumps may heal slowly. If over-the-counter products are not working, talk with your healthcare team about topical and oral medications that can help you manage your acne.</p> <p>If your children under 12 have acne, talk with their healthcare team about products and ingredients to treat acne that are safe for preadolescent children. </p> <p><em><a href="/providers/elizabeth-demaree-do" target="_self" title="Opens in same window.">Elizabeth Demaree, D.O.</a>, specialized in <a href="/services-and-treatments/dermatology" target="_self" title="Opens in same window.">dermatology</a> and <a href="/services-and-treatments/cosmetic-services" target="_self" title="Opens in same window.">cosmetic services </a>in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Acne</li> <li>Cosmetics — neurotoxin and fillers</li> <li>Eczema</li> <li>Hidradenitis suppurativa</li> <li>Moles</li> <li>Psoriasis</li> <li>Skin cancer</li> <li>Warts</li> </ul>D.O.<p>I believe in a friendly, down-to-earth approach to patient care, and take great joy in educating my patients and answering all questions.</p> <p>I am a South Dakota native who completed my medical training in Missouri before moving to the lovely state of Wisconsin. I spend my free time cooking, reading and playing with my two young children.</p><p><strong>Education</strong></p> <ul> <li>A.T.S.U. Kirksville College of Osteopathic Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Traditional Rotating Internship, Capital Region Medical Center</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Dermatology, Northeast Regional Medical Center</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Dermatology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Dermatology</li> <li>American Osteopathic College of Dermatology </li> </ul> <p> <strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Dermatology, Mayo Clinic College of Medicine and Science</li> </ul>Demaree<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/elizabeth-demaree-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7433C8F47B411169AECB297766035EE5" alt="Elizabeth Demaree, D.O." width="280" height="280" DisableNVelocity="true" />Elizabeth<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30082632Elizabeth Demaree, D.O.1{276FDCB2-F341-4C45-B04B-F71FB963B8CB}|{20D94572-B26A-4FB7-8C9D-7555CE785162}<img src="/-/media/national-files/images/hometown-health/2023/buttoning-top-button-on-shirt.jpg?h=370&iar=0&w=660&sc_lang=en&hash=860C2B3E1525BD2810DA8F89B74C0626" alt="Buttoning top button on shirt" width="660" height="370" DisableNVelocity="true" />Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Dawn Haller1/22/2020Brrr. Cold winter weather is upon us. Curl up with something warm and healthy this winter: cream of wild rice soup.Winter warmup: Cream of wild rice soup<p>Curl up with something warm and healthy this winter: cream of wild rice soup.</p> <p>"Wild rice is a nutrient-rich whole grain with a nutty flavor that is a good source of dietary fiber and contains more protein than other types of rice," says <a href="/providers/allyn-wergin-rdn" target="_self" title="Opens in same window.">Allyn Wergin</a>, a registered dietitian at Mayo Clinic Health System in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</p> <p>Using 1% milk and pureed beans in this recipe keeps the fat low, and amps up the flavor and texture.</p> <h3>Cream of wild rice soup</h3> <p>By Mayo Clinic<br /> Serves 4</p> <p>1/2 tablespoon canola oil<br /> 1 1/2 cups diced yellow onion<br /> 1 cup diced carrot<br /> 1 cup diced celery<br /> 2 cloves garlic, minced<br /> 1 1/2 cups chopped kale<br /> 1 tablespoon minced parsley<br /> 2 cups low-sodium vegetable stock<br /> 1 teaspoon fennel seeds, crushed<br /> 1 teaspoon ground black pepper<br /> 1 cup unsalted prepared white beans (or about half of a 15.5 ounce can of white beans, rinsed and drained)<br /> 2 cups 1% milk<br /> 1/2 cup wild rice, cooked</p> <p>In a pot over medium heat, add canola oil and sauté onion, carrot, celery and garlic until lightly brown. Stir in kale, parsley, stock and spices. Bring to a boil. In a blender, puree beans with milk. Add the bean mixture to the soup, bring to simmer and add rice. Cook for 30 minutes.</p> <p>Nutritional per two-cup serving: 236 calories; 4 g fat (1 g saturated fat; 0 g trans fat); 6 mg cholesterol; 180 mg sodium; 38 g carbohydrates; 7 g fiber; 0 g added sugars; 12 g protein.</p> <h3>More healthy food resources:</h3> <ul> <li>Get more <a href="/topics/eat-well" target="_self" title="Opens in same window.">information about healthy food</a>.</li> </ul> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2020/wild-rice-on-wooden-spoon.jpg?h=370&iar=0&w=660&sc_lang=en&hash=839FB0DD43315BEF422F0CC8FE9D69CC" alt="Wild rice on wooden spoon" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller1/23/2023When expanding your family, taking care of your body before and during pregnancy is important. Learn five steps you can take to reduce birth defects.5 steps you can take to help avoid birth defects<p>Every 4½ minutes in the U.S., a baby is born with a physical or biochemical abnormality present at birth that may be inherited or the result of environmental influence. This statistic shouldn't alarm future parents, but highlights the importance of taking care of your body before and during pregnancy.</p> <p>As the saying goes, an ounce of prevention is worth a pound of cure. Talk your health care team before and during pregnancy so you can work together for your best health.</p> <h2>While you can't prevent all birth defects, here are five steps to increase your chance of having a healthy baby:</h2> <h3>1. Take 400 micrograms of folic acid every day.</h3> <p><a rel="noopener" href="https://www.mayoclinic.org/drugs-supplements/folic-acid-oral-route-injection-route/description/drg-20063897?_ga=2.47005413.3590942.1579108161-1478281794.1579108161" target="_blank" title="Opens in a new window.">Folic acid</a> is the synthetic version of a vitamin B called folate, which is found naturally in certain foods, such as dark green vegetables, beans, peas and nuts. It is an essential component of prenatal vitamins.</p> <p>Folic acid is important because it can help prevent some major birth defects of the baby's brain and spine called neural tube defects. They are caused by improper formation of the spinal cord and tissues, called anencephaly. Hispanic women are more likely to have a child born with a neural tube defect, such as <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/spina-bifida/symptoms-causes/syc-20377860" target="_blank" title="Opens in a new window.">spina bifida</a>, compared to other ethnic groups.</p> <p>It's not possible for a woman wishing to become pregnant to get enough folic acid or folate through diet alone. For example, if a woman were to eat beef liver every day ― the food with the most folate ― it would provide to 210 micrograms of folate. That's less than the needed amount. So a prenatal vitamin or multivitamin with folic acid is crucial.</p> <h3>2. Talk with your health care team before stopping or starting medications.</h3> <p>There often are benefits to continuing treatment throughout pregnancy. You and your health care provider should weigh the pros and cons of all options, and discuss a treatment plan before pregnancy.</p> <h3>3. Remain up to date with all vaccines, including the influenza and COVID-19 vaccine and booster.</h3> <p>Getting the right vaccines, such as the influenza, and tetanus, diphtheria and acellular pertussis booster, or Tdap, at the right time during pregnancy can help keep you and your baby healthy.</p> <h3>4. Try to reach a healthy weight before you get pregnant.</h3> <p>Obesity increases the risk for several serious birth defects and other pregnancy complications.</p> <h3>5. Avoid harmful substances during pregnancy, such as alcohol, tobacco and other drugs.</h3> <p>There is no known safe amount of alcohol during pregnancy, and its exposure can cause major birth defects. Also, smoking during pregnancy can cause dangerous damage to the placenta and reach the baby's bloodstream. Finally, the opioid addiction epidemic hasn't helped either. Far too many babies in the nation have been delivered prematurely and with neonatal abstinence syndrome or have needed drug withdrawal treatments. It is best to avoid opioids or illegal drugs completely during pregnancy.</p> <p>Taking these preventive steps can go a long way to a healthy pregnancy for you and your child.</p> <h2>Learn more about immunizations, fertility and preparing for pregnancy:</h2> <ul> <li>Review the Centers for Disease Control and Prevention recommended <a rel="noopener" href="https://www.cdc.gov/vaccines/schedules/downloads/adult/adult-combined-schedule.pdf" target="_blank" title="Opens in a new window.">adult immunization schedule</a>.</li> <li>Discover <a href="/hometown-health/speaking-of-health/5-ways-to-prepare-before-starting-a-family" target="_self" title="Opens in same window.">five ways to prepare before starting a family</a>.</li> <li>Unravel <a href="/hometown-health/speaking-of-health/boxers-or-briefs-4-common-fertility-myths-debunked" target="_self" title="Opens in same window.">four common fertility myths</a>.</li> <li>Get <a href="/hometown-health/speaking-of-health/tips-to-improve-fertility" target="_self" title="Opens in same window.">tips to improve fertility for men and women</a>.</li> </ul> <p><a href="/providers/dennis-costakos-md" target="_self" title="Opens in same window."><em>Dennis Costakos, M.D.</em></a><em>, is a neonatologist in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Folic acid to prevent neural tube defects in minority populations as part of equity and inclusion</li> <li>Hyperbilirubinemia</li> <li>Newborn screening for biotinidase deficiency</li> <li>Predictive analytics</li> <li>Pulmonary surfactant and inter-hospital transfer</li> <li>Vitamin K and the newborn</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Dartmouth Medical School </li> </ul> <p><strong>Residency</strong></p> <ul> <li>Pediatrics, Mount Sinai Hospital</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Neonatal/Perinatal Medicine, New York Hospital/Cornell University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Neonatology, American Board of Pediatrics</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Pediatrics, Fellow in Neonatal-Perinatal Medicine and Epidemiology</li> <li>American Federation for Medical Research</li> <li>American Medical Association</li> <li>Society of Neuroscience </li> <li>Wisconsin Association for Perinatal care</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Pediatrics, Mayo Clinic College of Medicine and Science</li> </ul>Costakos<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/dennis-costakos-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=0A58CB05C01B2118F3FD82CC17315366" alt="Dennis Costakos MD" width="280" height="280" DisableNVelocity="true" /><p>See my publications at <a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/?term=costakos+dt" target="_blank" title="Opens in a new window">PubMed</a>.</p>Dennis<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12794287Dennis Costakos, M.D.1<img src="/-/media/national-files/images/hometown-health/2020/pregnant-woman-eating-salad.jpg?h=370&iar=0&w=660&sc_lang=en&hash=DED49090562C5BDDA747487A3E03C29B" alt="Pregnant woman eating salad" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller9/20/2022Did your mom warn you that going outside with wet hair will make you sick? Sorry, mom, but it's time for a fact check.Can wet hair make you sick?<p>Your mom may have warned you that going outside with wet hair will make you sick. But is this just a superstition or can damp hair outdoors make you ill?</p> <p>Sorry, mom, but the short answer is no.</p> <p>Wet hair in a cold environment can make you feel cold and uncomfortable. But it will not give you a cold.</p> <p>Viruses transmitted through bodily fluids cause colds, influenza and COVID-19. You need to come into contact with the fluids to be infected by the viruses. This usually happens when people who are sick sneeze, cough or blow their noses.</p> <p>Wet hair won't make you more attractive to viruses and doesn't increase your chances of getting sick.</p> <h2>Follow these six tips to protect you and your family from catching a cold:</h2> <h3>1. Wash your hands.</h3> <p>Clean your hands often with soap and water. If soap and water aren't available, use an alcohol-based hand sanitizer.</p> <h3>2. Disinfect your stuff.</h3> <p>Clean kitchen and bathroom countertops with disinfectant, especially when someone in your household has a cold.</p> <h3>3. Use tissues.</h3> <p>Sneeze and cough into tissues. Discard used tissues right away and then thoroughly wash your hands.</p> <h3>4. Don't share.</h3> <p>This is one time that it's best to keep to yourself. Don't share drinking glasses or utensils with other family members. Use your own glass or disposable cups when you or someone else is sick. Label the cup or glass with the name of the person with the cold.</p> <h3>5. Steer clear of people who are sick.</h3> <p>Practice social distancing by avoiding close contact with anyone who has a cold.</p> <h3>6. Take care of yourself.</h3> <p>Eat well, exercise, get enough sleep and manage stress levels to keep illness at bay.</p> <p>You can rest assured that if you go outside with wet hair you don't have an increased chance of getting sick. Wet hair in the colder months just causes temporary discomfort.</p> <p><a href="/providers/carmen-dargel-md" target="_self" title="Opens in same window."><em>Carmen Dargel, M.D.</em></a><em>, is a physician in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Pediatrics</li> <li>Women's health</li> </ul>M.D.<p>I enjoy providing care to families and patients of all ages. I will strive to actively listen to you and your concerns so we can use evidence-based medicine and shared decision-making to improve your overall health and well-being.</p> <p>Outside of work, I enjoy spending time with my family, reading, working out, walking our dog and traveling.</p><p><strong>Education </strong></p> <ul> <li>Medical College of Wisconsin</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Medicine, American Board of Family Medicine</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Academy of Family Physicians</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Dargel<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/carmen-dargel-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=D24FC6AAE7536C9A929EB152F450F673" alt="Carmen Dargel, M.D." width="280" height="280" DisableNVelocity="true" />Carmen<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14237989Carmen Dargel, M.D.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}|{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}<img src="/-/media/national-files/images/hometown-health/2022/back-of-student-wearing-backpack.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9B875E31145561A8491F13D5BB3B9EFB" alt="Back of student wearing backpack" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller2/24/2020Kids with ADHD sometimes struggle to play with others, and may have a hard time sharing and losing at games. Get tips to help your child with ADHD develop and practice social skills.Helping a child with ADHD develop social skills<p>The emotional maturity level of children with <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/adhd/symptoms-causes/syc-20350889" target="_blank" title="Opens in a new window.">attention deficit hyperactivity disorder (ADHD)</a> may be well below that of their counterparts without ADHD. This means that a 10-year-old with ADHD may behave more like a 7- or 8-year-old around their peers, struggle to play well with others, and have a hard time sharing and losing at games.</p> <p>While it’s important that children are involved in activities with others, many children with ADHD have a difficult time making and keeping friends. If a child isn't accepted by a peer group, this can make them feel isolated, which can be one of the most painful parts of having ADHD. While some parents isolate their children from participating in activities with others, it’s extremely important that kids with ADHD take part in social activities to help develop social skills.</p> <p>Children with ADHD often have a harder time monitoring their social behavior than other children. They don’t always know how to read social situations and others’ reactions. Parents play an important role in helping increase self-awareness in children with ADHD.</p> <h4>Follow these tips to help your child improve his or her social skills:</h4> <ul> <li>Provide immediate, frequent feedback about inappropriate behavior and social miscues. Children with ADHD have difficulty monitoring their social behavior, so they may need someone to provide guidance. Role-playing with your child is an effective way to simulate situations that your child may encounter. You also can point out facial expressions, scenarios and appropriate or inappropriate behavior in characters in books or on TV.</li> <li>Focus on a few areas that your child is struggling with, such as listening or showing interest in another child. Explain to your child social rules and behaviors that reflect these skills. Set goals that are achievable and specific. Goals can be as simple as saying hi to a friend at the grocery store.</li> <li>Schedule play dates with only one or two friends. This scenario usually is better for a child with ADHD than a play date with a large group of friends. Pair your child with children that are role models for good social skills.</li> <li>Reward improved social skills, and reinforce skills that need more work.</li> </ul> <p>One of the most effective ways to help your child develop social skills is to coach him or her in the moment and have your child participate in activities with their peers instead of isolating him or her from others. Practicing social skills with others is more effective than simply practicing in the office setting.</p> <h4>Help your child by learning more about:</h4> <ul> <li><a href="/hometown-health/speaking-of-health/fostering-resiliency-in-kids" target="_self" title="Opens in same window.">Fostering resiliency in kids</a></li> <li><a href="/hometown-health/speaking-of-health/back-to-school-tips-to-help-students-adjust" target="_self" title="Opens in same window.">Tips to help students adjust going back to school</a></li> <li><a href="/hometown-health/speaking-of-health/6-tips-to-reduce-childrens-screen-time" target="_self" title="Opens in same window.">6 tips for reducing screen time</a></li> <li><a href="/hometown-health/speaking-of-health/parenting-a-child-or-teen-with-adhd" target="_self" title="Opens in same window.">Parenting a child or teen with ADHD</a></li> </ul> <p><a href="/providers/janice-schreier-lcsw" target="_self" title="Opens in same window."><em>Janice Schreier</em></a><em> is a clinical therapist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin. </em></p><ul> <li>Anxiety</li> <li>Attention deficit hyperactivity disorder</li> <li>Bipolar disorders</li> <li>Chemical dependency</li> <li>Depression</li> <li>Eating disorders</li> <li>Facilitates social skills groups for adolescents with autism spectrum disorders</li> <li>Individual, family and group therapy</li> <li>Obsessive-compulsive disorders</li> <li>Post-traumatic stress disorder</li> <li>Reactive attachment disorder</li> <li>Trauma</li> <li>Treatment for children 7–17 and young adults</li> </ul>L.C.S.W.<p><strong>Education</strong></p> <ul> <li>Addiction Counseling, Viterbo University</li> <li>Bachelor's degree, Social Work, University of Wisconsin-La Crosse</li> <li>Master's degree, Social Work, University of Wisconsin-Milwaukee</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Autism Spectrum Disorders</li> <li>Licensed Clinical Social Worker, Substance Abuse Specialty</li> </ul>Schreier<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/janice-schreier-msw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=42215A8A31EDEE2903AC5F89E6D23B11" alt="Janice Schreier MSW" width="280" height="280" DisableNVelocity="true" />Janice<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15449963Janice Schreier, L.C.S.W.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2020/elementary-student-doing-homework.jpg?h=370&iar=0&w=660&sc_lang=en&hash=41C049CD0D6AB0E074290D66997834AC" alt="Elementary student doing homework" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller2/11/2020Most people know that Valentine's Day candy and chocolates contain extra sugar. But did you know it also is hiding in other foods you may not expect? Here's the not-so-sweet truth about added sugar in our diets and tips on how to cut back.The not-so-sweet truth of added sugars<p>You have yogurt and cereal for breakfast, a salad for lunch and make a stir-fry for dinner. You haven't had a sweet all day — or so you think. But chances are you've consumed countless grams of added sugar, which is hiding in many foods. </p> <p>There is added sugar in everything from breakfast cereal to salad dressings to prepared sauces. It can be shocking where you find it once you start reading labels, and all that added sugar adds a lot of negatives to your life.</p> <p>Consuming too much added sugar is a problem for many reasons, beginning with the number of extra calories it adds to your diet. The <a rel="noopener noreferrer" href="https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sugar/added-sugars" target="_blank" title="Opens in a new window.">American Heart Association</a> suggests that most women consume no more than 100 calories a day from added sugars and men consume no more than 150 calories a day of added sugars. That translates to about 6 teaspoons for women and 9 teaspoons for men. When you consider that 12 ounces of soda can have up to 10 teaspoons of sugar, it's easy to see how many Americans consume far more than what's recommended.</p> <p>Additionally, eating foods with added sugar fills you up so you have less room for nutritious food. And too much sugar increases your risk for a host of problems, including tooth decay, high triglycerides and diabetes.</p> <h2>Here are some tips for cutting back on added sugar in your diet:</h2> <ul> <li><strong>Read labels.</strong><br /> Knowledge can be a powerful tool when you're trying to change your habits, so reading labels to be more aware of how much sugar is in the foods you eat can help you make healthier choices.</li> <li><strong>Choose the right topping.</strong><br /> Top your cereal and oatmeal with fruit, cinnamon or nuts to add flavor, and skip the extra sugar.</li> <li><strong>Rethink your drink</strong>.<br /> Drink low-calorie or sugar-free drinks instead of soda or juice. Water is an even better choice.</li> <li><strong>Cut back on processed foods.</strong><br /> Most have added sugar. Instead, choose fruits, vegetables and other whole foods. </li> <li><strong>Swap flavors.</strong><br /> Ketchup, barbeque sauce and honey mustard all are high in added sugar. Instead, choose condiments such as fresh salsa or regular mustard.</li> <li><strong>Redo dessert.</strong><br /> Layer fruit and plain yogurt for a healthy sundae. Or make soft-serve "ice cream" by processing frozen banana slices in your food processor. </li> </ul> <p>It can be hard to cut back on sugar, but it's worth it. By making a few changes in your habits and diet, you can significantly affect your overall health.</p> <h2>How to read a Nutrition Facts label</h2> <img alt="Side-By-Side Comparison of the Old and New Nutrition Facts Label" style="height: 390px; width: 325px;" src="/-/media/national-files/images/hometown-health/2020/old-and-new-nutrition-facts-label.jpg?h=390&w=325&sc_lang=en&hash=DE76F8B949F2841096E703AC9588FA8F" /> <p>The Nutrition Facts label is required by the <a rel="noopener noreferrer" href="https://www.fda.gov/home" target="_blank" title="Opens in a new window.">Food and Drug Administration</a> on most packaged foods and beverages. The label provides detailed information about a food's nutrient content and recently was updated to make it easier for consumers to make informed food choices. The changes include:</p> <ul> <li>The font size was increased for calories, servings per container and the serving size information, making it easier to find and read.</li> <li>Products are required to list daily values of vitamin D, calcium, iron and potassium. </li> <li>Products are required to list added sugars in grams and as percent of daily value.</li> <li>The serving size must reflect the amounts of food and beverages that people are actually eating, not what they should be eating.</li> </ul> <h3>In this Mayo Clinic Minute, Angie Murad, a wellness dietitian with the Mayo Clinic Healthy Living Program, explains some of the key Nutrition Facts label changes:</h3> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/nXBeE1KhUKI" title="How to read the new nutrition labels" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <h2>Learn more about nutrition:</h2> <ul> <li>Read about <a rel="noopener noreferrer" href="https://www.fda.gov/food/food-labeling-nutrition/changes-nutrition-facts-label" target="_blank" title="Opens in a new window.">additional changes to the Nutrition Facts label</a><span style="text-decoration: none;">.</span></li> <li><a href="/hometown-health/speaking-of-health/clean-eating-what-does-that-mean" target="_self" title="Opens in same window.">Clean eating: What does that mean?</a></li> <li>Discover <a href="/hometown-health/speaking-of-health/14-common-food-package-claims" target="_self" title="Opens in same window.">14 common food package claims</a>.</li> </ul> <p><em><a href="/providers/allyn-wergin-rdn">Allyn Wergin</a> is a registered <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">dietitian</a> in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota. </em></p><ul> <li>Bariatric surgery</li> <li>Diabetes management</li> <li>Oncology</li> <li>Weight management</li> </ul>RDN<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, St. Catherine University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration </li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul>Mahowald<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/allyn-wergin-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=74F690ED261F537AA65B66929A3356D1" alt="Allie Mahowald, RDN" width="280" height="280" DisableNVelocity="true" />{9209F8EC-1016-41AA-985F-014D9B877417}Allie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15971546Allyn Mahowald, RDN1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2020/man-reading-ingredients-on-food-box.jpg?h=370&iar=0&w=660&sc_lang=en&hash=98D920E9E005F7595A8DF1756DB109D9" alt="Man reading ingredients on food box" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller4/12/2020The COVID-19 pandemic offers us the opportunity to give extra TLC to our spiritual lives. Get advice on how to get started on your spiritual checkup.Getting a spiritual checkup during the COVID-19 pandemic<p>A few years ago, I told my family care provider that I was here for my annual physical exam so I can go back at 'em for 3,000 more smiles. My physician instantly recognized the traditional car oil change schedule of 3,000 miles to smiles comparison.</p> <p>In the same way that a physical exam benefits our physical bodies, it is important to have a spiritual checkup on an annual basis, as well. Our spiritual lives need regular fine-tuning to work at optimal efficiency. </p> <p>While a physical exam helps to ward off serious illnesses, a spiritual checkup enables us to have better quality of life, helps with spiritual coping and secures overall peace in our lives.</p> <p> The COVID-19 pandemic offers us the opportunity to give extra TLC to our spiritual lives. As you consider a spiritual checkup, it is good to start with baseline data that gives you insights on changes you may wish to make. In our spiritual lives, symptoms that something is wrong may go unnoticed and affect our lives in negative ways. You may not see the urgency of the moment and do something to fix it.</p> <p>This article will examine practical ways of how you can fine-tune your spiritual life using a spiritual checkup. What an opportunity of taking a new spiritual journey ― and there are no COVID-19 pandemic restrictions for this journey.</p> <h2>Here are tips to get you started on your spiritual checkup:</h2> <h3>Make a commitment to the spiritual experience and stick to it.</h3> <p>In the sci-fi epic "Star Wars," the divine is pictured as a spiritual force that binds everyone together. One of the best examples of a spiritually healthy person in the franchise is Jedi Master Yoda. It is apparent to me that this character spent time growing in the spiritual force rather than neglecting his spiritual life. He saw the value of religious basis of the force and built his spiritual life by becoming one with the force.</p> <p>For you, this commitment could look like promising to do good works or praying daily to your deity. This is not a one-size-fits-all and it is different from one person to the next.</p> <h3>Start with something and use it as a springboard.</h3> <p>Someone once told me that every person has an unlimited capacity for spiritual growth. For this reason, the key is to start with something as the springboard for spiritual growth. This could be attending a spiritual retreat, getting involved in a study of a good spiritual book or many other activities.</p> <p>For me, this start began when I attended a discipleship course in the 1980s. I will always remember the outcomes that I experienced as a result of this experience. Like the derivative in calculus that tries to get closer and closer to a specific number, a diligent and vigilant-minded, faith-committed person will be devoted to their spiritual life and choose to make it a high priority.</p> <p>I see religion and spirituality as noncompeting entities so a person's path to either should not be judged. After all, the purity of the heart is the key ingredient. God has a way of communicating the truth to people who have made a commitment to serving the spiritual one.</p> <h3>Examine past failures for growth opportunities.</h3> <p>At various points along this commitment journey of faith, it may seem like you are spinning your wheels or taking five steps forward followed by four steps back. Personally, I feel I am getting closer and closer toward perfection or maturity when I fail. Often, we learn more from our failures than our successes in the spiritual realm.</p> <p>Your commitment moves you forward along the spiritual plain and you should look for results in the short and long terms. A good example is a jigsaw puzzle. It gets a little easier as more pieces fall into place. It doesn't just happen, but this can come in the form of acquiring new knowledge, attending religious activities and performing various service activities. With the COVID-19 pandemic, many activities must be completed virtually due to social distancing guidelines.</p> <h3>Set goals for spiritual development.</h3> <p>Yes, it is important to assess where you are now with your baseline spirituality. Maybe you made a commitment to do this in the past and you failed to continue the work, but it is never too late to get started again. However, setting a new goal moves you forward.</p> <p>The COVID-19 pandemic enables you to develop new goals because our regular routines have been shaken. Remember to measure your goals so that you can celebrate your successes later. Best wishes on the journey ahead.</p> <p><em>Chaplain William Creech is a clinically trained, board-certified chaplain in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2020/cosmos-space-spirituality.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F6C8E7BABF156EFEF434261C2708FBD2" alt="Cosmos space spirituality" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Stress ManagementGuidance to help you reduce and manage daily stress.Dawn Haller3/30/2020If you recently moved to a new office space, it's important for you to assess the ergonomics so you are comfortable while working. Here are five things you can do to keep productive.5 tips for setting up your home workspace<p>If you sit behind a desk for hours at a time, you're not doomed to a career of neck and back pain or sore wrists and fingers. Proper office ergonomics, including correct chair height, adequate equipment spacing and good desk posture, can help you and your joints stay comfortable at work. If you recently moved to a new office space, it's important that you assess these elements.</p> <h4>Here are five suggestions to keep you comfortable and productive while working:</h4> <img alt="Office ergonomics" src="/-/media/national-files/images/hometown-health/2020/office-ergonomics-illustration.jpg?h=359&w=350&sc_lang=en&hash=E92741CFDC23225B20804E6394B666AA" style="height: 359px; width: 350px; float: right; margin-bottom: 5px; margin-left: 5px;" /> <h4>1. Adjust your chair height.</h4> <p>You want your chair to be in a position that allows your feet to sit flat on the ground and your knees to be level with your hips. If need be, place a cushion in the small of your back while sitting in your chair. This helps with lumbar support.</p> <h4>2. Position your go-to items effectively.</h4> <p>You're often reaching for your phone, computer mouse or calculator, so keep these items in easily reachable positions.</p> <h4>3. Take care of your wrists.</h4> <p>Keep your wrists straight while typing. Also use a wrist rest for support.</p> <h4>4. Sit up straight.</h4> <p>While in front of your computer or at your desk, sit up straight and position your body in the center of your workstation.</p> <h4>5. Use a headset.</h4> <p>Wedging your phone between your shoulder and the side of your face while writing isn't good. Use a headset instead to reduce the strain on your body.</p> <p>Sitting at a desk all day can contribute to aches and pains. In addition to making sure your workstation is set up properly, it's also a good idea to change your position, and incorporate stretches and other physical activities into your workday. Here are some <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/office-stretches/art-20046041" target="_blank" title="Opens in a new window.">easy desk stretches</a> and <a href="/hometown-health/speaking-of-health/dont-just-sit-there-exercises-for-the-office" target="_self" title="Opens in same window.">office exercises</a> to try.</p> <p>Regardless if your work space is at home or an office, practicing good office ergonomics, varying how long you sit or stand for a given period of time, and adding stretches and movement to your routine can reduce strain, and keep your muscles and joints healthy.</p><img src="/-/media/national-files/images/hometown-health/2020/typing-on-keyboard-in-home-office.jpg?h=370&iar=0&w=660&sc_lang=en&hash=90B4D11508933B45A1F808807FAA99E6" alt="Typing on Keyboard in Home Office" width="660" height="370" DisableNVelocity="true" />Occupational MedicineBusiness success depends upon the productivity of the workforce. Occupational medicine helps businesses and organizations prevent and manage occupational and environmental injuries, illnesses and disabilities.Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller10/20/2023Fighting off the dreaded stomach "flu" isn't fun. This intestinal infection is marked by watery diarrhea, abdominal cramps, nausea or vomiting. Here are some tips for fueling your body when it hits.Best foods to eat when you have a stomach 'bug'<p>Viral gastroenteritis is an intestinal infection marked by watery diarrhea, abdominal cramps, nausea or vomiting, headache, muscle aches and sometimes fever. It's often called a stomach bug or the stomach flu, but it's not actually the flu or influenza, which is a respiratory illness. This infection often develops though contact with an infected person or by ingesting contaminated food or water.</p> <p>An upset stomach is a common symptom of a stomach bug, which can make eating sound unappealing, even though you may be hungry. Knowing what to eat is difficult because you don't know what will agree with your stomach.</p> <h2>Follow these tips for fueling your body when you have viral gastroenteritis:</h2> <ul> <li><strong>Let your stomach settle.</strong><br /> Avoid eating solid foods for a few hours. Instead, drink liquids like broths, teas, sodas or noncaffeinated sports drinks.</li> <li><strong>Hydrate.</strong><br /> Focus on drinking in small amounts of liquid frequently to stay hydrated.</li> <li><strong>Ease back into eating.</strong><br /> After you can tolerate drinking clear fluids, start eating smaller meals of bland, low-residual foods, such as mashed potatoes, plain noodles, crackers, toast, gelatin, bananas, rice and chicken.</li> <li><strong>Be cautious with medications.</strong><br /> It's best to use over-the-counter medications like ibuprofen sparingly as they can cause an upset stomach. Discuss your medications with your healthcare team to avoid any potential side effects. If your symptoms are severe, you may need to use an over-the-counter medication to help decrease diarrhea symptoms or an anti-nausea medicine to help you keep food and fluids down with vomiting.</li> </ul> <p>The main complication of a stomach bug is dehydration, which is a severe loss of water and essential salts and minerals. You can lower the risk of dehydration by drinking enough fluids to replace those lost from vomiting or diarrhea.</p> <p>Depending on the cause, viral gastroenteritis symptoms generally appear about one to three days after exposure. Symptoms can be mild or, at times, severe and last for a few days to a week.</p> <h2>When to see a healthcare professional</h2> <p>Although viral gastroenteritis is extremely common, it can usually be managed at home. Red flags or worrisome symptoms that would prompt a visit to your healthcare team are severe dehydration, not being able to keep fluids down, bloody stools, severe abdominal pain or when symptoms last longer than one week. Young children, older adults and people with compromised immune systems are more likely to have complications related to viral gastroenteritis.</p> <h2>Prevention</h2> <p>Good hand hygiene and proper food handling are essential to prevent you from getting sick and to limit the spread of viral gastroenteritis within a household, school, workplace and the community. Ensure you wash your hands with soap and water, especially after using the bathroom, before preparing food and eating. Stomach bugs most commonly are seen in the winter and spring, so it's important to be diligent, especially this time of year. </p> <p><em><a href="/providers/michelle-shelly-frischmann-cnp" target="_self" title="Opens in same window.">Shelly Frischmann</a></em><em> is a nurse practitioner in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Family medicine</li> </ul>C.N.P., A.P.N.P.<p>I take pleasure in providing primary care across the lifespan and enjoy that family medicine allows me to deliver preventive services, acute care and chronic disease management. </p> <p>I grew up in Rochester which influenced my desire to work for Mayo Clinic and provide care for members of my community.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Nursing, Winona State University</li> <li>Master's degree, Nursing, Winona State University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Nurse Practitioner, American Academy of Nurse Practitioners</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Frischmann<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/michelle-frischmann-cnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=04A9C247A745B696E9927AD9C15A341D" alt="Michelle Frischmann CNP APNP" width="280" height="280" DisableNVelocity="true" />Shelly<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>10461787Shelly Frischmann, C.N.P., A.P.N.P.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}|{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{986C767E-E5DE-43F5-957F-B4212DB8E384}<img src="/-/media/national-files/images/hometown-health/2023/chicken-noodle-soup.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4D41E5FE97A8DB0E6A989C5E116313C1" alt="Chicken noodle soup" width="660" height="370" DisableNVelocity="true" />Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller8/31/2023With someone in the U.S. receiving a blood product every two seconds, there is a constant need for red blood cells, platelets and plasma. Learn how the donation process works and why donating blood is vital.Blood donation: Simple, selfless act to save lives<p>It's not often you have the opportunity to do something simple that can save another person's life. But that's what occurs every time you donate blood. Every blood donation can help save or improve the lives of at least three people.</p> <p>Physician-scientists have built incredible, medications over the past years, but donated blood products continue to provide proteins and clotting factors different from anything manufactured in a lab or designed in a pharmacy. In many clinical situations, no suitable alternatives are available to replace blood products, which continue to be lifesaving and life-changing. There is no gray area about it — blood products save lives.</p> <h2>How the blood donation process works</h2> <p>The voluntary donation process is quick and easy. You can donate at a community blood center or local drive. You will be asked to complete a confidential medical history that includes questions about behaviors known to carry a higher risk of bloodborne infections. You also will undergo a brief physical exam that includes checking your blood pressure, pulse and temperature. A blood sample is taken from a finger prick and is used to check hemoglobin level, which is the oxygen-carrying component of your blood. You can donate blood if your hemoglobin concentration is within the typical range and all other screening requirements are met.</p> <p>If you're unsure if you're a candidate to donate blood, contact a local blood collection agency to determine eligibility.</p> <h3>The most common type of donation is about a pint of whole blood, which is separated into these three components:</h3> <ol> <li><strong>Red blood cells</strong><br /> This is the component of blood that you may think of because these cells give blood its distinctive red color. These are the cells that provide oxygen to your body's tissues. Red blood cells are used when a person is bleeding and needs blood replenished.</li> <li><strong>Platelets</strong><br /> They are used to prevent or stop active bleeding.</li> <li><strong>Plasma</strong><br /> This is the liquid portion of your blood. Plasma, which is full of clotting factors, is used to stop bleeding.</li> </ol> <h2>How blood products are used in healthcare</h2> <p>Blood products are used daily in healthcare as one of the most powerful, necessary interventions possible, with someone in the U.S. needed blood products every two seconds. This always will be true because there are so many reasons why people need blood, such as ensuring safety during surgery, and treating chronic diseases, such as kidney failure, anemia and cancer. Providing blood products to critically injured trauma patients saves lives daily and is particularly important for patients taking blood thinning medication, such as warfarin.</p> <p>Mayo Clinic Health System stocks blood products in all hospitals with an Emergency Department, including small, rural hospitals. Blood products also are stocked in the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/ambulance-service/air-ambulance/helicopter" target="_blank" title="Opens in a new window. ">Mayo One medical helicopter</a> at all times so patients who require transfusions can receive this lifesaving intervention right away.</p> <h2>Common concerns about donating blood</h2> <p>Less than 3% of eligible Americans are estimated to donate blood each year. That's a problem because the need for blood products remains constant.</p> <h3>There are three main reasons why people don't donate regularly:</h3> <ul> <li><strong>Infection</strong><br /> Some people are concerned that a donation will put them at risk for infection. A new sterile collection set, including the needle, is used for each donor. That means there is no risk of getting an infection or disease from needle use when donating blood.</li> <li><strong>Worsening medical conditions</strong><br /> Others worry that donating will wear them out or worsen an existing medical condition. Each person is screened and evaluated carefully to ensure they can donate blood safely. A typical donation is about one pint of blood, and your body has between 10 and 12 pints. Your body continually makes new blood products, and you have more than enough remaining after donating to transport nutrients and oxygen throughout your body and fight infection.</li> <li><strong>Needles</strong><br /> Some people are worried about seeing blood or needles during the donation, as these sights can cause uneasiness. You don't need to watch the needle being inserted or see any blood during the donation process. Many people bring mobile devices or books to keep their focus elsewhere during their donation time.</li> </ul> <p>Many healthcare facilities face critical shortages of blood products. Donating blood is one way you can become involved in your community and help patients in need of blood products. <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.redcross.org/give-blood.html" target="_blank" title="Opens in new window.">Find a blood drive in your area</a>.</p> <p><a href="/providers/allison-humes-pac" target="_self" title="Opens in same window."><em>Allison Humes</em></a><em> is a physician assistant in <a href="/services-and-treatments/hematology" target="_self" title="Opens in same window.">Hematology</a> and <a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">Oncology</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Breast cancer care</li> <li>Hematology (blood) care</li> <li>Medical oncology (cancer) care</li> </ul>P.A.-C.<p>I deliver modern, full-spectrum evidence-based care to adults with cancer (oncologic) and blood (hematologic) concerns. I work to empower patients with education and shared decision-making to ensure they are able to make informed decisions regarding their health care.</p> <p>I was born and raised in rural Iowa. I enjoy spending time outdoors and enjoying the beauty of nature that encompasses the Midwest. </p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Human Biology, Luther College</li> <li>Master's degree, Physician Assistant Studies, University of Dubuque</li> </ul> <p><strong>Certification</strong></p> <ul> <li>National Commission on Certification of Physician Assistants</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Academy of Physician Assistants </li> </ul>Humes<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/allison-humes-pac.jpg?h=280&iar=0&w=280&sc_lang=en&hash=FC94F9E1AE1A23C4702E124F2F974C97" alt="Allison Humes, P.A.-C." width="280" height="280" DisableNVelocity="true" />Allison<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30084434Allison Humes, P.A.-C.1{BCFC3BDC-CF55-458E-A41C-9360527B6CCC}<img src="/-/media/national-files/images/hometown-health/2023/two-people-smiling.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0A8A4CD2A90487EC38808F9A9F53514F" alt="Two people smiling" width="660" height="370" DisableNVelocity="true" />Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Dawn Haller3/10/2020Colorectal cancer is the third most commonly diagnosed cancer in the U.S., resulting in more than 40,000 deaths this year. Learn the common signs and symptoms.Colorectal cancer basics<p><a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/colon-cancer/symptoms-causes/syc-20353669" target="_blank" title="Opens in a new window.">Colorectal cancer</a> is the third most commonly diagnosed cancer in the U.S. Colorectal cancer will account for more than 40,000 deaths this year, according to the American Cancer Society. But there is reason for optimism, as cancer screenings, lifestyle changes and added awareness can decrease your risk for colorectal cancer.</p> <p>Colorectal cancer is a cancer that starts in the large intestine (colon) or rectum. It often begins as small noncancerous clumps of cells called <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/colon-polyps/symptoms-causes/syc-20352875" target="_blank" title="Opens in a new window.">polyps</a> that form on the inside of the colon. Over time, some of these polyps can increase in size, undergo cellular changes and eventually transform into colon cancer. Colorectal cancer screenings can detect the polyps early and prevent the disease from developing or spreading. One screening method is <a rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/colonoscopy/about/pac-20393569" target="_blank" title="Opens in a new window.">colonoscopy</a>, which can help identify these polyps and remove them. Learn <a href="/hometown-health/speaking-of-health/what-to-expect-before-and-during-a-colonoscopy" target="_self" title="Opens in same window.">what to expect before, during and after a colonoscopy</a></p> <h2>Signs and symptoms of colorectal cancer</h2> <p>The signs and symptoms for colorectal cancer can be embarrassing or uncomfortable to talk about with other people, including your health care provider. But if noticed early, that conversation potentially could save your life. <a href="/hometown-health/speaking-of-health/understanding-your-colon-cancer-screening-options" target="_self" title="Opens in same window.">Talk to your doctor about your colon cancer screening options</a>.</p> <h3>The most common symptoms of colorectal cancer include:</h3> <ul> <li>A persistent change in your bowel habits, including diarrhea or constipation, or a change in stool consistency</li> <li>Rectal bleeding or blood in your stool</li> <li>Persistent abdominal discomfort, such as cramps, gas or pain</li> <li>A feeling that your bowel doesn't empty completely</li> <li>Weakness or fatigue</li> <li>Unexplained weight loss</li> </ul> <p>I often hear from patients that they are not experiencing any colorectal cancer symptoms, so they decide to delay the screening for the disease. Unfortunately, many people with colon cancer experience no symptoms at all in the early stages of the disease. By the time pain, bleeding and changes in bowel habits occur, the cancer may not be curable. Be sure to talk with your health care provider about your risk factors and recommended screening schedule. <a href="/hometown-health/speaking-of-health/reducing-your-risk-for-colon-cancer" target="_self" title="Opens in same window.">Understand your risk for colorectal cancer</a>.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2020/colon-cancer-3rd-most-common.jpg?h=370&iar=0&w=660&sc_lang=en&hash=964478F2684B1EC5A9D46B21E170BE9C" alt="Colon cancer is the third most common cancer in the U.S." width="660" height="370" DisableNVelocity="true" />Colorectal HealthGet screening and treatment for colorectal cancer symptoms, and learn about risk factors and prevention strategies.Dawn Haller3/11/2020Are you affected by joint pain? Find out how injection therapy can help relieve your pain without surgery.Injection therapy for nonoperative joint pain relief<p>Joint pain affects people of all ages. However, it can become even more common the older we get. While surgery can be a solution for many issues related to a shoulder, hip or knee, it’s always best to first look at nonoperative options when seeking relief for your joint pain.</p> <h4>Common joint pain issues</h4> <p>Joint pain issues of the elbows, feet and ankles, hips, knees, shoulders, and wrists and hands are commonly treated. These issues often occur due to problems in the joint or the surrounding bone, muscle, tendon, ligaments and nerves.</p> <h4>Injection treatment for all ages</h4> <p>Physiatrists treat musculoskeletal injuries in patients of all ages and activity level, including adolescent athletes, weekend warriors, and seniors with aches and pains. Treatment includes comprehensive nonsurgical care for musculoskeletal injuries involving:</p> <ul> <li>Diagnostic ultrasound and ultrasound-guided interventions</li> <li>Exercise and return-to-play recommendations</li> <li>Oral medications and supplements</li> <li>Physical therapy</li> <li>Topical medications</li> </ul> <p>Interventions include injections that can help relieve pain for disorders such as <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/osteoarthritis/symptoms-causes/syc-20351925" target="_blank" title="Opens in a new window.">osteoarthritis</a>, tendinopathy and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/tendinitis/symptoms-causes/syc-20378243" target="_blank" title="Opens in a new window.">tendinitis</a>, and overuse injuries. While steroid (cortisone) injections in pediatric patients are not routinely recommended or performed, there are many other therapeutic interventions for children with musculoskeletal injuries, including guided physical therapy, and modalities and bracing, as well as oral and topical medications.</p> <h4>Injection therapy can help joint pain</h4> <p>Injections have long been offered for pain control in musculoskeletal and sports disorders. Historically, injections were performed using landmarks on the body and simply touching a painful structure to determine the correct location and area of pain to deliver the medication.</p> <p>Today, with advanced technology, ultrasound allows us to visualize and diagnose an area of injury in the clinic and, when indicated, perform a guided intervention to help people with their symptoms. Ultrasound also helps avoid injury to nearby tissues, including blood vessels and nerves. Injections can reduce local inflammation, help lubricate joints and improve people's pain to get them back to doing the things that they love.</p> <h4>How quickly does injection treatment work?</h4> <p>How quickly someone may notice a difference from an injection depends on what the underlying problem is, and what intervention or injection was performed. Steroid injections usually exert their maximum effect over two weeks, whereas <a rel="noopener noreferrer" href="https://www.mayoclinic.org/drugs-supplements/hyaluronic-acid-injection-route/description/drg-20074557" target="_blank" title="Opens in a new window.">viscosupplement injections</a> that work by acting like a lubricant and shock absorber in the joints can take four to six weeks for full effect. Regenerative medicine injections, including platelet-rich plasma, can take even longer, with approximately two to three months before becoming fully effective.</p> <h4>How long does injection treatment last?</h4> <p>Therapeutic benefits from ultrasound-guided procedures vary by what part of the body is being injected and what medication is used. For example, the response to a cortisone injection can last between weeks to months, while viscosupplement injection for knee osteoarthritis has been shown to improve symptoms for approximately six months.</p> <p>Response to a specific injection also varies from person to person, with some patients receiving longer-term relief than typical and some patients receiving less relief. Unfortunately, we cannot always predict exactly how long or to what degree each patient will benefit. As injections offer good, but temporary, relief of symptoms, it's also important to correct the underlying cause of the symptoms. I always recommend a therapeutic exercise program and, potentially, bracing to go along with injections. This allows me to correct the abnormal motion pattern, weakness or repetitive stress in the area of pain.</p> <h4>Is injection treatment painful?</h4> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/ultrasound/about/pac-20395177" target="_blank" title="Opens in a new window.">Ultrasound-guided interventions</a>, including injections, can be painful during the procedure. Ultrasound is used to limit the amount of tissue trauma during the injection. Anesthetic, or numbing medication, also is used during interventions to limit the amount of discomfort associated with the procedure. Some patients may experience discomfort at the injection site for one to two days after an injection once the anesthetic has worn off, though this generally is well-managed with ice and over-the-counter pain medications.</p> <h4>How happy are patients after injection treatment?</h4> <p>When a correct diagnosis and intervention plan has been made, most patients experience significant pain relief for varying amounts of time after an ultrasound-guided intervention. While patients who undergo procedures do not always respond to the therapy, it’s rare that a patient’s symptoms worsened after injection and other ultrasound interventions.</p> <p>The main goal of performing an ultrasound-guided intervention is to get patients back to doing the things that they enjoy. When we are successful, patients are quite happy after treatment</p> <p><em><a href="/providers/wade-johnson-do" target="_self" title="Opens in same window.">Wade Johnson, D.O.</a>, is a <a href="/services-and-treatments/physical-medicine-and-rehabilitation" target="_self" title="Opens in same window.">physical medicine and rehabilitation</a> and <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">sports medicine</a> physician in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Concussion identification and management</li> <li>Diagnostic and interventional ultrasound for joint, tendon, muscle, and ligament injuries</li> <li>Injury prevention and return to play </li> <li>Regenerative Medicine</li> <li>Exercise Medicine</li> </ul>D.O. <p>I like to form a team with my patients and work together to improve their function and pain with a goal of getting them back to the activities they enjoy. I prefer to pursue active therapies in addition to medications and interventions to accomplish this and believe in the importance of exercise and activity as a therapeutic modality. I utilize ultrasound guidance to perform many of my therapeutic interventions and can deliver therapies to treat joint, tendon, muscle, and ligament injuries with precision.</p> <p>When I am not working, I enjoy spending time with my family, being active outdoors and I am often found on the sidelines with my children’s sports. I competed in multiple sports growing up and still take the field or ice whenever I get the chance. I am an avid hockey, baseball and soccer fan and am waiting for the Twins and Wild to bring home a championship.</p><p><strong>Education</strong></p> <ul> <li>Touro College of Osteopathic Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Westchester Medical Center</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Rehabilitation Medicine, New York Presbyterian Hospital</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Primary Care Sports Medicine, Mayo Clinic Square</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Physical Medicine and Rehabilitation</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Physical Medicine and Rehabilitation</li> <li>American Medical Society for Sports Medicine</li> <li>Association of Academic Physiatrists</li> <li>Mayo Fellows Association</li> <li>Sigma Sigma Phi</li> </ul> <p><strong>Academic Appointment</strong> </p> <ul> <li>Instructor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Johnson<img src="/-/media/shared-files/images/medical-professionals/full/mankato/wade-johnson-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=430D14C9D525CA07C6B2670AE76C9F83" alt="Wade Johnson DO" width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Winter+Adaptive+Sports+Participation%2C+Injuries%2C+and+Equipment" target="_blank" title="Opens in new window. ">Winter Adaptive Sports Participation, Injuries, and Equipment</a>, June 2019.</li> </ul>{F12ACCCD-B5BB-4D75-AB87-5C4182A9239F}Wade<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20970170Wade Johnson, D.O.1{4EA2A40E-3721-48EC-AFC9-E6D0E13BCDEC}<img src="/-/media/national-files/images/hometown-health/2020/man-hands-holding-sore-knee.jpg?h=370&iar=0&w=660&sc_lang=en&hash=DF445FFD2016F2E27BA3D7106D90A282" alt="Man hands holding sore knee" width="660" height="370" DisableNVelocity="true" />Rehabilitation TherapyRestoring movement and function to people injured or impaired by disease or injury.Pain ReliefApproximately 50 million people in the U.S. live with chronic pain. If you experience chronic pain, you're not alone. Learn about the ways to deal with painful disorders, from at-home solutions to drug treatments, injectable or implantable therapies to surgery.Dawn Haller3/13/2023While the exact cause of colorectal cancer remains unknown, there are proven risk factors for the disease. Learn about colorectal cancer screening options and what you can do to reduce your risk.Reducing your risk for colorectal cancer<p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/colon-cancer/symptoms-causes/syc-20353669" target="_blank" title="Opens in a new window.">Colorectal cancer</a> is cancer of the large intestine (colon) or the rectum. Following your health care team's recommended screening schedule is the best way to reduce your risk of developing colorectal cancer. This may include a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/colonoscopy/about/pac-20393569" target="_blank" title="Opens in a new window.">colonoscopy</a> or other screening methods, beginning at age 45.</p> <p>Although most cases of colorectal cancer occur in people over 50, initiating screening at 45 balances the benefits of detection and prevention with the potential risk of screening. The American Cancer Society lowered the recommended age to start screening to 45 after research showed that new cases of colorectal cancer are occurring at an increasing rate among younger adults. However, people with an increased risk should get screened sooner.</p> <p>Talk to your health care team about your <a href="/hometown-health/speaking-of-health/understanding-your-colon-cancer-screening-options" target="_self" title="Opens in same window.">colorectal cancer screening options</a>. Learn <a href="/hometown-health/speaking-of-health/what-to-expect-before-and-during-a-colonoscopy" target="_self" title="Opens in same window.">what to expect before, during and after a colonoscopy</a>.</p> <h2>Colorectal cancer risk factors</h2> <p>While the exact cause of colorectal cancer remains unknown, there are proven risk factors for the disease. You can make lifestyle changes to avoid certain risks, but there are some that you cannot prevent.</p> <h3>Unavoidable colorectal cancer risk factors include:</h3> <ul> <li>Family history of colon cancer</li> <li>Inflammatory intestinal conditions, such as ulcerative colitis or Crohn's disease</li> <li>Older age</li> <li>Personal or family history of <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/colon-polyps/symptoms-causes/syc-20352875" target="_blank" title="Opens in a new window.">colon polyps</a></li> <li>Race — African Americans are at greater risk</li> </ul> <h3>Avoidable colorectal risk factors include:</h3> <ul> <li><strong>Drinking alcohol in excess</strong><br /> Heavy alcohol consumption can increase your risk of colorectal cancer.</li> <li><strong>Lack of exercise</strong><br /> If you're inactive, you're more likely to develop colorectal cancer. Exercising regularly may reduce your risk of colorectal cancer.</li> <li><strong>Obesity</strong><br /> People who are obese have an increased risk of developing and dying from colorectal cancer.</li> <li><strong>Smoking</strong><br /> People who smoke cigarettes are at an increased risk of colorectal cancer.</li> <li><strong>Unhealthy diet</strong><br /> Colorectal cancer may be associated with a diet low in fiber and high in calories and fat.</li> </ul> <p>Notably, most colorectal cancer is found in people without a family history of the cancer. Those with a family history have an increased risk of developing the disease, but it's not the only risk factor that should be considered when assessing a person' risk. <a href="/-/media/national-files/documents/hometown-health/2019/colon-risk-assessment.pdf?sc_lang=en&hash=A50D8C774CF207A0976E7CD6829BF474" target="_blank" title="Opens in a new window.">Take a colon cancer risk quiz</a>.</p> <h2>Colorectal cancer prevention</h2> <h3>You can help reduce your risk of colorectal cancer if you:</h3> <ul> <li><strong>Eat your veggies and healthy fats.<br /> </strong>Research has shown that the Western diet correlates to higher colorectal cancer rates. People who eat high-fiber diets are less likely to develop the disease. Fruits, vegetables and whole grains contain vitamins, minerals, fiber and antioxidants, which may play a role in cancer prevention. Choose a variety of fruits and vegetables to get an array of vitamins and nutrients.</li> <li><strong>Get moving.<br /> </strong>You know exercise benefits your heart and can help you maintain your weight. It also may lower your risk of developing some types of cancer, including colorectal cancer. Aim for 30 minutes of moderate exercise on most days of the week.</li> <li><strong>Watch your weight.<br /> </strong>Carrying extra pounds increases your risk of colorectal cancer, and cancers of the breast (in postmenopausal women), rectum, esophagus, pancreas and kidney, among others, according to the American Cancer Society. Talk to your health care team if you need help losing weight.</li> <li><strong>Limit alcohol and don't smoke.<br /> </strong>If you choose to drink alcohol, do so moderately. That means no more than one drink a day for women or two drinks a day for men. And if you smoke, quit. Your provider can offer tips or refer you to a program to help you stop.</li> </ul> <p>Learn the <a href="/hometown-health/speaking-of-health/colorectal-cancer-basics" target="_self" title="Opens in same window.">basics of colorectal cancer</a> and <a href="/hometown-health/speaking-of-health/5-things-you-can-do-to-keep-your-colon-healthy" target="_self" title="Opens in same window.">five things you can do to keep your colon healthy</a>.</p> <p><em><a href="/providers/amrit-singh-mbbs" target="_self" title="Opens in same window.">Amrit Singh, M.B.B.S.</a>, is a <a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">medical oncologist</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a><em>, </em><a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a><em> and </em><a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a><em>, Minnesota.</em></em></p><ul> <li> Benign blood conditions like anemia and thrombocytopenia</li> <li>Breast cancer </li> <li>Colon cancer </li> <li>Head and neck cancers</li> <li>Lung cancer </li> <li> Lymphomas</li> </ul>M.B.B.S.<p>My practice provides the latest, personalized and evidence-based care for all types of cancer and diseases of the blood and blood-forming organs. I place myself in my patients' shoes and empower them to share in decision-making. I will discuss options in depth, yet in simple, everyday terms they can understand.</p> <p>I am here because of my patients and I work hard, with empathy, to ensure that no stone is left unturned in the care they receive.</p><p><strong>Education</strong></p> <ul> <li>Armed Forces Medical College, India</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Brookdale University Hospital and Medical Center</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Brookdale University Hospital and Medical Center</li> </ul> <p><strong>Certifications</strong> </p> <ul> <li>Internal Medicine, American Board of Internal Medicine</li> <li>Hematology, American Board of Internal Medicine</li> <li>Medical Oncology, American Board of Internal Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Medical Association</li> <li>American Society of Clinical Oncology </li> <li>American Society of Hematology</li> <li>Minnesota Medical Association </li> <li>Minnesota Society of Clinical Oncology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Medical Oncology, Mayo Clinic College of Medicine and Science</li> </ul>Singh<img src="/-/media/shared-files/images/medical-professionals/full/mankato/amrit-singh-md.jpg?h=200&iar=0&w=200&sc_lang=en&hash=E1CF77833B1263B4A148D8FE42FE02B5" alt="Amrit Singh MD" width="200" height="200" DisableNVelocity="true" />Amrit <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15666824Amrit Singh, M.B.B.S.1{BCFC3BDC-CF55-458E-A41C-9360527B6CCC}|{0DD9D3C9-86C5-47FC-A2CF-8AEEA4717B70}|{7C7741C5-CC6B-4EEB-92CD-A20D529F4D9F}<img src="/-/media/national-files/images/hometown-health/2023/celery-and-carrots-cooking-in-pan.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7DCCB31200A6EFE88A18E820355296AD" alt="Celery and carrots cooking in pan" width="660" height="370" DisableNVelocity="true" />Colorectal HealthGet screening and treatment for colorectal cancer symptoms, and learn about risk factors and prevention strategies.CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Dawn Haller4/7/2020Taking care of yourself is important so you are equipped to help your family through this time. Here are some tips.Self-care tips during the COVID-19 pandemic<p>The COVID-19 pandemic can feel overwhelming due to new information, long work hours, and caring for your family and yourself. It's important to pause for a moment and collect your thoughts, as worldwide pandemics can be taxing. Remaining calm can help.</p> <p>It is normal to feel stressed or overwhelmed during uncertain times. Emotions in response to uncertainty may include anxiety, fear, anger and sadness. You also could feel helpless, discouraged and, occasionally, out of control. Physical responses may include headache, muscle tension, fatigue and sleeplessness.</p> <p>Taking care of yourself is important so you are equipped to help your family through this time.</p> <h2>Here are a few tips you can use to take care of yourself:</h2> <h3>Physical health:</h3> <ul> <li>Fuel your body by eating a healthy, well-balanced diet and drinking plenty of water.</li> <li>Aim to get seven to eight hours of sleep each night.</li> <li>Exercise every day.</li> <li>Take deep breaths and stretch often.</li> <li>Avoid risky or destructive behaviors, such as abusing alcohol or drugs, excessive gambling or ignoring public health recommendations.</li> <li>Spend time outside, such as going for a walk in the park, but follow social distancing guidelines.</li> </ul> <h3>Mental health:</h3> <ul> <li>Set and maintain a routine at home.</li> <li>Focus on things you can control.</li> <li>Use technology to maintain social connections with your loved ones. Consider a regular check-in schedule to give you something to look forward to.</li> <li>Focus your thoughts on the present and things to be grateful for today.</li> <li>Listen to music or read books.</li> <li>Consume reliable news sources that report facts, and avoid media that sensationalizes emotions. Limit your exposure or take a break from news and social media if you find that it makes you anxious.</li> <li>Lean on your personal beliefs and faith for support.</li> <li>Look for ways to help your community, such as blood donations, checking on older people in your neighborhood, or donating supplies or money to local organizations.</li> <li>Acknowledge and appreciate what others are doing to help you and your community.</li> </ul> <h2>Symptoms to watch for</h2> <p>If any of the these things become persistent or interfere with daily functioning and are outside the norm for the COVID-19 pandemic, contact your provider for help and guidance:</p> <ul> <li>Trouble focusing on daily activities</li> <li>Anxiety that turns into feelings of being out of control</li> <li>Strong feelings that interfere with daily activities</li> <li>Having emotions that become difficult to manage</li> <li>Feelings of hopelessness or helplessness</li> </ul> <p>Get <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/kids-coping-with-the-covid-19-pandemic/" target="_blank" title="Opens in a new window.">strategies to help kids cope with COVID-19</a>.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2020/happy-woman-sitting-on-log-fence.jpg?h=370&iar=0&w=660&hash=DF2932BC131BC2C70934899EC42A298B" alt="Happy woman sitting on log fence" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.AnxietyFeelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. Symptoms may start during childhood or the teen years and continue into adulthood. We have the experts who can help diagnose and treat anxiety concerns.Back to SchoolDawn Haller3/25/2020Finding colon cancer at its earliest stage provides the greatest chance for a cure. That's why health care providers now recommend colon cancer screenings beginning at age 45. Learn about your options.Understanding your colon cancer screening options<p>Health care providers recommend certain screening tests for healthy people to look for signs of <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/colon-cancer/symptoms-causes/syc-20353669" target="_blank" title="Opens in a new window.">colon cancer</a> or precancerous <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/colon-polyps/symptoms-causes/syc-20352875" target="_blank" title="Opens in a new window.">colon polyps</a>. Finding colon cancer at its earliest stage provides the greatest chance for a cure. Screening has been shown to reduce your risk of dying of colon cancer. For people with average risk, screening begins around age 45. However, people with an increased risk should be screened sooner. </p> <p>You have options for which colon cancer screening test is best for your individual needs. Each has benefits and drawbacks. It's important that you talk with your health care provider about which is best for you. </p> <p>Let's review each option.</p> <h4>Colonoscopy</h4> <p>During a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/colonoscopy/about/pac-20393569" target="_blank" title="Opens in a new window.">colonoscopy</a>, a long, flexible tube called a colonoscope is interested into your rectum. A tiny video camera at the tip of the tube allows the doctor to view the inside of the entire colon and rectum. During a colonoscopy, the doctor also can collect tissue samples and remove <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/colon-polyps/symptoms-causes/syc-20352875" target="_blank" title="Opens in a new window.">polyps</a> through the scope. Colonoscopy is considered the gold standard for colon cancer screening, and there are few risks associated with the procedure. When sedation is used, patients have little or no recollection of the exam. </p> <h4>Watch a video on how a colonoscopy is performed:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/_mGLYnyGeHk" title="Keeping patients comfortable during a colonoscopy" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p>Colonoscopies have a poor reputation for having an uncomfortable preparation phase. However, several options can make this process tolerable. Be sure to talk with your provider about which options are best for you and your situation. Learn more about <a href="/hometown-health/speaking-of-health/what-to-expect-before-and-during-a-colonoscopy" target="_self" title="Opens in same window.">what to expect before, during and after a colonoscopy</a>.</p> <h4>Cologuard DNA stool test</h4> <p>One newer method of detection is a stool DNA test called Cologuard. This test offers people 50 and older who are at average risk for colorectal cancer an easy-to-use screening test that they can complete in the privacy of their own home. A sample of your stool will be taken to look for blood or DNA changes in cells that suggest the presence of colorectal cancer or precancerous conditions. </p> <p>This test is safe and poses no risk. However, it is less sensitive than colonoscopy at finding precancerous polyps. One or 2 of every 20 people who undergo stool DNA testing will have a positive result, but no cancer or polyps will be found during a follow-up colonoscopy. Read <a href="/hometown-health/speaking-of-health/5-questions-about-stool-dna-tests-for-colon-cancer" target="_self" title="Opens in same window.">FAQ about the stool DNA test</a>.</p> <h4>Watch a video about DNA stool testing:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/KmjaD0LfuRk" title="DNA stool test recommended" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p><strong>Learn the <a href="/hometown-health/speaking-of-health/colorectal-cancer-basics" target="_self" title="Opens in same window.">basics of colorectal cancer</a> and <a href="/hometown-health/speaking-of-health/5-things-you-can-do-to-keep-your-colon-healthy" target="_self" title="Opens in same window.">5 things you can do to keep your colon healthy</a>.</strong></p> <p><a href="/providers/daisy-batista-md" target="_self" title="Opens in same window."><em>Daisy Batista, M.D.</em></a><em>, is <a href="/services-and-treatments/gastroenterology-and-hepatology" target="_self" title="Opens in same window.">gastroenterologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Diagnostic and therapeutic endoscopy</li> <li>Management of advanced inflammatory bowel disease and Crohn's disease</li> </ul>M.D.<p>My area of expertise is in the care of patients with inflammatory bowel disease, such as ulcerative colitis and Crohn's disease. I also see patients with a variety of general gastrointestinal (GI) complaints, such as diarrhea, constipation and reflux.</p> <p>I enjoy teaching patients about their disease as a tool to empower them to make decisions that would help them get relief of their symptoms and achieve the highest quality of life possible.</p><p><strong>Education</strong></p> <ul> <li>University of Chicago, Pritzker School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Massachusetts General Hospital</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Massachusetts General Hospital</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Gastroenterology, University of Florida, Shands University Hospital</li> <li>Advanced Inflammatory Bowel Disease, Mayo Clinic</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Gastroenterology, American Board of Gastroenterology</li> <li>Hepatology, American Board of Internal Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Gastroenterology</li> <li>American Gastroenterology Association</li> <li>American Society of Gastrointestinal Endoscopy</li> <li>Crohn's and Colitis Foundation of America</li> </ul>Batista<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/daisy-batista-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4A32C6488B16AA601137C0EACEFA17E6" alt="Daisy Batista, M.D." width="280" height="280" DisableNVelocity="true" />Daisy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15833224Daisy Batista, M.D.1{CDA27FD1-23E5-4D31-BD85-567A48B862F7}|{63CBB755-37F9-4058-9120-6CD50C94BD16}|{164A5F93-090D-40B1-B93B-7C91986AE546}<img src="/-/media/national-files/images/hometown-health/2020/colon-cancer-screening-45-and-older.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EA03B98CB6D06D97EDDEFE47A68B720E" alt="45 or older? Talk with your doctor about colon cancer screening." width="660" height="370" DisableNVelocity="true" />Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Colorectal HealthGet screening and treatment for colorectal cancer symptoms, and learn about risk factors and prevention strategies.Dawn Haller4/5/2020Change is constant, but not always easy — especially the recent monumental changes due to the COVID-19 pandemic. Learn how to manage these changes and build your spiritual life.Building your spiritual life during changes brought about by the COVID-19 pandemic<p>Change is one constant in our lives, but that doesn't make it easy. The late singer Kenny Rogers used to sing a song with lyrics that said: "Life was so much easier 20 years ago." Some businesses cater to life in a simpler time in their marketing messages. In the movie "Sarah: Plain and Tall: Winter's End," you can see Model T cars riding on the same roads as horse-and-buggy carriages, along with the installation of a telephone in a traditional home.</p> <p>Now society is in the midst of monumental change once again. How will we respond?</p> <h4>Here is my advice on how to build your spiritual life during this time of change:</h4> <h4>Just do it.</h4> <p>Nike has the slogan "Just Do It," and this is good advice during this crisis. The first thing to do is to do something in such an unprecedented time. During this COVID response, my team was reminded "Don't waste a crisis." That is, find something to do.</p> <p>As we are called to be idle at home, it is important that we use this time to think about our lives and how we might do things differently. An idle mind mentality could lead to occurrences of being anxious and depressed. Doing something can heighten your spiritual energy if you view it as worthwhile, value-added work, rather than the completion of tasks. Put another way, concentrate on where the divine longs for you to serve, and that will be the most effective work you can do.</p> <h4>Strive to live out a fulfilled spiritual life.</h4> <p>COVID-19 is causing many of us to think about how we are spending our time. Previously, much of our lives had been consumed by multiple activities. We are social, busy human beings by nature, so this time alone is like a new novel for all of us. One wonders if social distancing might become the new normal, so scheduling time for spiritual life-building can become part of the change of filling the void of loneliness. Concentrate on tasks and items that bring fulfillment, and increase joy and peace ― particularly those that grow your spiritual life ― rather than merely doing activities to fill the time.</p> <h4>View the COVID-19 pandemic as an opportunity, rather than just a challenge.</h4> <p>While the COVID-19 pandemic is a mammoth challenge, filled with added stress and loneliness, the existential part of change itself is an equal stressor amid all specific stressors. Once again, I go back to the adage of "Don't waste a good crisis." Herein is the glass half-full versus glass half-empty of changing one's perspective. Another adage goes "A person's perception is his/her reality." Sometimes change can be tilted toward a silver lining and that things aren't as bad as they seem to be. One way to be prepared for the best- or worst-case scenarios is to see the opportunities amid the challenges. A story was once told of a famous inventor whose laboratory blew up. But when asked about the bad in the situation, it was said that he replied, "Good, all my mistakes have been erased." If COVID-19 is seen as an opportunity, then look for the opportunities that may come to you.</p> <h4>Look for the good that you can do to help others.</h4> <p>Think about small acts you can do to brighten someone else's day. Every drop of water makes an ocean when added together. Think your local context. Think donations to shelters. Think of playing games or music with neighbors from a distance.</p> <h4>Watch for ways to grow and learn.</h4> <p>During this time, some families are joining faith services through online streaming and others are attending drive-in services. While not as effective as face-to-face services, these alternatives are giving faith communities and attendees new ways to be involved in worship. We could use some outside-the-box thinking, and a crisis might afford that opportunity.</p> <h4>Consider the ways that you use your time alone.</h4> <p>Now is the time to stay focused on the spiritual disciplines in our lives, such as prayer and meditation, because these disciplines apply to many faiths. Prayer is the way to connect to the deity, and this time of distancing one's self from people and events gives you an opportunity to focus more on the spiritual deity that may be the most important aspect of your life.</p> <p><em>Chaplain William Creech is a clinically trained, board-certified chaplain in <a href="/locations/mankato">Mankato</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2020/looking-out-window.jpg?h=370&iar=0&w=660&sc_lang=en&hash=020098A0968A7151456E03BE2E1A3ECD" alt="Looking out window" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Karen Sperl2/8/2024Racing heart, trembling body and scattered mind. Anxiety is common and can overtake your emotions and life. Discover practical strategies to build resiliency when faced with your anxiety triggers.Building resilience: 9 ways to tame anxiety <p>Anxiety is a common and uncomfortable struggle for many people. The tendency to have anxiety comes from your genetics, your sense of security (or lack of it), the role modeling you received as a child, and, of course, the big and challenging events that happen throughout your life. </p> <p>Everyone has a point, no matter how resilient you are, where anxiety can overtake your emotions and life. Social fears, physical health issues, financial issues, loneliness, relationship issues, pandemics and world affairs can collectively affect you to the point where you feel anxious. </p> <p>Anxiety and fear are natural protectors. The fight-or-flight response they trigger motivates you to run, fight or possibly freeze to escape the danger. This response has kept humans alive for all of our history despite many risks in the world. It can become an issue, however, when you're not in physical danger, but your <a href="/hometown-health/speaking-of-health/anxiety-disorders-is-it-really-all-in-your-head">mental or emotional stress</a> still triggers that fight-or-flight response. </p> <h2>Symptoms of anxiety </h2> <p>Anxiety affects you physically, along with your thoughts and actions. When you face physical danger, anxiety is designed to help you focus on the threat so you know where the danger is coming from and then respond in ways that help fight it or escape from it. </p> <p>Anxiety helps build the energy to fight or run from danger quickly. While that may be a helpful instinct, it may cause uncomfortable physical symptoms such as a racing heart, inability to concentrate, shakiness, sweating or difficulty swallowing. These symptoms may not feel good, but they aren't dangerous in the short term. </p> <p>Anxiety can cause a sense of impending doom or helplessness, which can provoke more anxiety and induce a vicious circle of thoughts, actions and physical symptoms. Feeling tense, irritable and impatient can be a part of anxiety. People may pace, space out or feel like they're spinning their wheels and not getting anything done. </p> <h2>Building resiliency, reducing anxiety </h2> <p>Here are nine tips to build up your resilience when faced with anxious times: </p> <ol> <li><strong>Gather information.</strong> <br> Knowledge of the threat, concerns, fears or issues can reduce anxiety. <a href="/hometown-health/speaking-of-health/cognitive-overload">Gather accurate, factual information</a> from trusted sources to better understand the source of your anxiety and help with problem-solving to gain a greater sense of control. </li> <li><strong>Establish a new routine.</strong> <br> Routine and structure can be helpful and calming. Mindfully create a daily and weekly flow of events, such as starting your morning with a relaxing cup of coffee or tea and breakfast. <br> A routine of practical and enjoyable tasks may include: <ol> <li>Making a list of projects you want to accomplish. </li> <li>Reading inspirational writings.</li> <li>Writing in a journal to express your thoughts, hopes, emotions and concerns.</li> <li>Scheduling time for physical activities or hobbies. </li> </ol> </li> <li><strong>Stay connected.</strong> <br> Reaching out to loved ones is essential, whether through phone calls, texting, emailing, video calls or in person. Consider hosting gatherings with your friends and loved ones. Keep it to a small gathering if that's more comfortable for you. <a href="/hometown-health/featured-topic/brushing-off-the-social-rust">Human connection can lower stress</a> and anxiety levels and build camaraderie. Helping others and volunteering for a cause can give you purpose and help you feel more fulfilled and less anxious. </li> <li><strong>Practice self-care habits.</strong> <br> Take a few moments to care for yourself each day, such as soaking in a soothing bath, listening to calming or upbeat music, getting plenty of sleep, and eating regular, balanced, nutritious meals and snacks. These habits can help whether you work from home or outside the home.</li> <li><strong>Look for the good.</strong> <br> Acknowledge and accept that the good and bad often exist next to each other. A person can be sad about one thing but aware that there's goodness and happiness in the same moment for another thing. Intentionally look for those good things. Our thoughts can grow and feed on each other, so it can help to purposefully think hopeful, realistic and<a href="/hometown-health/speaking-of-health/managing-high-functioning-anxiety"> solution-focused thoughts</a>. Look for the beauty amid the difficulties in life. </li> <li><strong>Exercise.</strong> <br> Regular exercise and movement help release the built-up fight-or-flight energy. Exercise also releases endorphins, which are feel-good chemicals in the brain. Using bigger muscle movements can help release more of this energy so you feel calmer. Try jumping jacks, push-ups, walking, running, dancing, chopping wood, swimming or <a href="/hometown-health/speaking-of-health/no-matter-your-age-or-skill-level-its-never-too-late-to-start-weight-training">lifting weights</a>. Even cleaning the house or moving heavy boxes are good big-muscle exercises. Stretching and yoga also can help reduce stress. </li> <li><strong>Meditate.</strong> <br> Meditation, mindfulness and breathing exercises are good ways to release stress. Now is an excellent time to learn and incorporate these approaches into your life until they become daily habits.</li> <li><strong>Reflect.</strong> <br> Take time to reflect on what is truly important. Explore your worldview, spirituality and belief system. Find meaning in your life. Identify what you're grateful for and express gratitude. </li> <li><strong>Reach out.</strong> <br> You aren't alone. If you feel alone, don't be silent. Instead, <a href="/hometown-health/speaking-of-health/overcoming-loneliness">reach out to a friend</a> or healthcare professional. Attend a support group that addresses your area of struggle. Communicating your hopes and fears and listening to others divides the burden and increases the connection. This can decrease your sense of anxiety. </li> </ol> <p><em>Linda Hubbard is a psychotherapist in <a href="/services-and-treatments/psychiatry-and-psychology">Psychiatry & Psychology</a> in <a href="/locations/eau-claire">Eau Claire</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2024/adult-petting-black-lab-dog.jpg?h=370&iar=0&w=660&sc_lang=en&hash=30FE1E8D5BB3A265C0352D2EDFAE6ED4" alt="Adult petting black lab dog" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.AnxietyFeelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. Symptoms may start during childhood or the teen years and continue into adulthood. We have the experts who can help diagnose and treat anxiety concerns.Dawn Haller4/11/2020With many people under orders to remain at home, there are concerns about increased risk for domestic violence. Having a plan is important. Consider these tips to stay safe.Abuse at home: Safety planning during the COVID-19 pandemic<p>If you or a loved one is in an abusive situation, safety planning is extremely important. Many people are under orders to remain at home due to the COVID-19 pandemic, so there are concerns about increased risk for domestic violence.</p> <p>At any time, some people may find themselves in circumstances where they<span style="color: red;"> </span>feel there is no way out due to financial burdens or emotional stress. This could be heightened due to the pandemic.</p> <p>There are services to help and support people affected by domestic violence or sexual assault. Learn about your community's local resources to help you remain safe and explore options. In addition, emergency departments and clinics in your area continue to provide care and support during the pandemic.</p> <h4>Consider these actions to create a plan — an important part of remaining safe:</h4> <ul> <li>Reach out to your local domestic violence agency or the <a rel="noopener" href="https://www.thehotline.org/2020/03/13/staying-safe-during-covid-19/" target="_blank" title="Opens in a new window.">National Domestic Violence Hotline</a><span>.</span> These organizations have additional information for staying safe during the COVID-19 pandemic.</li> <li>Remain in contact with people who are supportive, such as a friend, advocate or family member.</li> <li>Designate a safe space and a way to call emergency services. An old cellphone can be used to call 911 in an emergency.</li> <li>Pack a bag if you need to quickly leave and stay with a family member or friend. In addition to clothing, don't forget to include important documents, medications and other necessary items.</li> </ul> <p>Many local courthouses have adjusted hours of operation or are rescheduling hearings. Visit <a rel="noopener" href="https://www.womenslaw.org/" target="_blank" title="Opens in a new window.">WomensLaw.org</a> to learn how to access court information and determine if there are changes to pending hearings or court dates during the pandemic.</p> <h4>How to help others</h4> <p>In abusive relationships, victim isolation is a way to maintain power and control over someone. Reach out virtually if you know someone who is in an abusive situation. Be supportive, listen and do not judge his or her situation. </p> <p><em>Amanda Kubista Owen is a social worker in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2020/living-room-in-low-light.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A067296E02FD4B082071EE55FC23DE53" alt="living room in low light" width="660" height="370" DisableNVelocity="true" />Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Dawn Haller4/28/2020Has the stress level risen in your home? Here are 3 spiritual health tips you can try to lower anxiety levels in your family.COVID-19 and spiritual life: Controlling anxiousness in your family<p>You may feel that the stress level in your home has been raised since the COVID-19 pandemic began. Changes in routine have led to the removal of usual support systems that help our families with their mental and spiritual framework. This may include faith and religious community groups, faith formation confirmation and other programs, after-school activities, clubs and school. Thankfully, spirituality and religion offers help for dealing with anxiousness during crises like COVID-19.</p> <p>The hope for a quick resolution of COVID-19 may be a little idealistic, yet parents can combat anxiousness in the family by bolstering some resemblance of the ordinary, normal life. Remember that an event doesn't necessarily equal a crisis. COVID-19 is a stress-filled event for many, and it is filled with challenges. These challenges should not be under- or overestimated, but we can take steps to lessen the impact so it doesn't become a crisis.</p> <p>People under stress have normal reactions to an abnormal event. This includes feeling anxious when an event feels unpredictable. While COVID-19 is an abnormal event, it is an event we will eventually get through, and, as my particular faith likes to say with regard to God, "We are more than conquerors."</p> <h4>Here are 3 spiritual health tips you can try to lower anxiety levels in your family:</h4> <h4>1. Model good coping behaviors.</h4> <p>While we all are anxious in some ways, we can be less anxious by working on our own anxiety. For some, this might include taking medications, doing exercise, or getting involved in mindfulness or similar activities. Whatever you do for coping, it potentially will benefit your family since they are influenced by your aura of calm.</p> <p>A friend used to say to me: "You know, chaplain, when we see you and your colleagues come around, we don't think things are quite as bad." How true that is for all of us. We can be anxious, yet control our anxiety. Part of the benefit could be lowered stress levels and increased physical well-being with our immune system. One of my favorite movies, "The Bishop's Wife," has a scene where a character is about to enter a meeting filled with conflict. You can hear the shouting on the other side of the doors. She could hear the group inside criticizing her husband. However, prior to opening the doors, she stopped and centered herself for a moment. Then she proceeded in with guarded, but cautious, optimism. This action was able to lower the negativity of the environment. In the same way, it helps us to come to stop, gather our thoughts and take a deep breath in the moment. It can make a big difference.</p> <p>Music, massage and spiritual direction also are just a few other options to help you so you can help your family better cope with COVID-19 anxiousness.</p> <h4>2. Answer questions over dinner.</h4> <p>One of the best questions I like to ask during dinners is: "What are three good things that happened today or this week?" The responses often are one-line zingers filled with laughter. The point is to celebrate the good. A former colleague used to begin each leadership meeting with this question, and it set the tone for the entire meeting.</p> <p>It is easy to start and keep on filling a home with negative energy, whereas a positive beginning produces an atmosphere of getting started on the proverbial right foot. Our families can help by being involved as leaders in these discussions. Other suggestions include playing a board game, going for a ride in the country or taking a walk.</p> <p>We can continue to connect with others in unique and safe ways. A recent news story showed how a son visited with his father at a nursing home using his phone and looking at each other through the window. In another story, two people played a game together from their apartment balconies. Model how you can creatively connect with people, because we do need each other and these safe interactions can be learning experiences for better coping.</p> <h4>3. Carry forward lessons learned during COVID-19.</h4> <p>Most of us remember where we were during tragic national events, such as 9/11 or the space shuttle Challenger exploding. COVID-19 will be remembered for a long time, and how we coped with it will be etched into our memory.</p> <p>Your family may be feeling a lot of anxiety right now, but reflect on what you can learn in this crisis for present and future coping. Think about how you can preserve these skills and how you can use it to strengthen family relationships. Remember the Etch a Sketch toy? May we not shake this crisis off like an Etch a Sketch drawing after this crisis is over.</p> <p>We will make it through this. In the words of a "Star Trek" admiral as he lead his fleet of ships against the enemy aliens seeking to invade Earth, I say to you likewise: "To us all."</p> <p><em>William Creech is a clinically-trained, board-certified chaplain in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2020/family-of-5-eating-dinner-laughing.jpg?h=370&iar=0&w=660&sc_lang=en&hash=ADA838EB5E11C91EB3D51940451CCF37" alt="Family of 5 eating dinner laughing" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),AnxietyFeelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. Symptoms may start during childhood or the teen years and continue into adulthood. We have the experts who can help diagnose and treat anxiety concerns.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Back to SchoolParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Dawn Haller4/17/2020While there may be more uncertainty in life right now, there still are blessings in each day. Here is encouragement to embrace each day and recognize new opportunities in the quietness.COVID-19 and spiritual life: Living one day at a time<p>During the COVID-19 pandemic, all of us have been lifted into a new way of living our day. Many of us who were so busy before have been slowed by an extremely small organism with a huge amount of power.</p> <p>As we work to figure out how to reorganize our life, each day presents a new set of rules and changes that may give us a reason to pause. There is more uncertainty and a feeling of being out of control.</p> <p>And yet, each day is unique. There still are blessings in each day, like the sun rising, birds singing, the birth of a new baby and snow turning to rain to provide water for spring plants.</p> <p>People are helping people. Many are reintroducing themselves to the most precious unit of family. Others are talking to people they have not visited in months.</p> <p>It's what we could term a rebirth or renewal. It is a discovery for many that each day is precious and finite. It is a sequestered chance to slow down.</p> <p>These times have given many of us a different lens with which to see the world and realize that each day is precious. Time that was once taken for granted now is seriously reconsidered. There now are rules and cautions that affect us all.</p> <h4>Change your focus</h4> <p>One way to forge ahead with a clearer mental capacity is to focus on the current day ahead ― not all of the days to come. Viewing our time as a single day gives us a chance to absorb and manage the daily demands. As the world continues to slow down, we can assess how the moments reflect the delicate balance of who we are. Our days take on a different meaning.</p> <p>When we focus on the past day and what was, there is a feeling of powerlessness with what we may not have accomplished. We could feel depressed and frustrated.</p> <p>When we focus on too many days ahead, it is a formula for becoming overwhelmed and making decisions with little information or in an untimely manner. Again, frustration and anxiety can occur. Thoughts of the unknown can bring emotional turmoil and uncertainty of how we will maintain or adapt to the new.</p> <p>When we live one day at a time, we put energy into knowing that a divine force guides us. We can breathe and reason, and manage our lives in a more orderly fashion. This is the day that has been made for us, and we can choose how we will be within that day. We can take time to see the blessings and recognize new opportunities in the quietness.</p> <p>We can live intentionally, knowing that our mercies are new each day and that our needs will be met. Being spiritually intent gives hope. We can be a light to others who need hope. We can offer support to those who are depressed or fearful.</p> <p>Our stress lowers when we give our days ahead to a spiritual presence that will be with us ― one that never leaves. Leaning into one's faith allows room for building a stronger sense of peace.<br /> Rediscovering who you are, and knowing that you have been given gifts and talents that can be used, gives purpose. Find that purpose, give it strength one day at a time, and discover a spiritual awakening and divine love that will overpower any real or imagined quarantine we will experience.</p> <p>Take advantage of this unique time away from the daily routine. Glean the wisdom of connecting with your spiritual source in prayer and meditation. See blessings that were previously unseen and know that mercies are new each day.</p> <p><em>Chaplain Shar Burgess, is a board-eligible, clinically-trained chaplain in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a> and <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2020/beads-of-water-on-blades-of-grass.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EAA84D5AE924988EA2CF03143288BF60" alt="Beads of water on blades of grass" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Dawn Haller4/22/2020For those at higher risk of getting fatally sick ― like Jerome Determan, a cancer patient ― receiving care at home through video appointments is the right option, especially during social distancing. Learn how getting connected to his care team was easier than he thought possible.Video visits keep homebound patients connected to care<p>Jerome Determan isn't one to back down from a challenge. When he was diagnosed with <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/multiple-myeloma/symptoms-causes/syc-20353378" target="_blank" title="Opens in a new window.">multiple myeloma</a> in 2009, he was told that he may only live for another three years.</p> <p>Eleven years later, he's still here.</p> <p> "I feel just fine," says Jerome, 88, of Fairmont, Minnesota.</p> <p>Having yet to achieve remission, Jerome is still undergoing treatment for his cancer, and he's doing so in a world that poses a more acute threat to his health, given the COVID-19 pandemic. While he still must seek on-site infusion treatments at <a href="/locations/fairmont" target="_self" title="Opens in same window.">Mayo Clinic Health System in Fairmont</a>, some of his appointments can be conducted remotely through <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/how-video-appointments-are-changing-the-way-mayo-clinic-patients-receive-care/" target="_blank" title="Opens in a new window.">video visits</a>. </p> <p>In response to the pandemic, Mayo Clinic Health System quickly rolled out widespread use of video visits across various departments to ensure patients could safely stay at home while still being connected to their health care providers.</p> <h4>Patients willing to use technology to get care they need</h4> <p>"We have very much appreciated our patients' willingness to try the technology so we can continue to provide them with quality care in their homes," says <a href="/providers/amrit-singh-mbbs" target="_self" title="Opens in same window.">Amrit Singh, M.B.B.S.</a>, a Mayo Clinic Health System medical oncologist. "We've been so pleased with how smoothly the process has gone and how many patients we've been able to serve so far. We want to encourage many more patients to schedule these visits for any health care needs that don't require a physical exam during this period when it's safer to shelter in place." </p> <p>Telehealth has been used for years across Mayo, including on rural medical campuses, to connect patients with specialists at Mayo Clinic in Rochester, among other locations. But COVID-19 required a hastening of widespread use, meaning thousands of patients like Jerome are experiencing it for the first time this spring.</p> <p>"Our concern at first was acquainting patients with the technology," says Tracy Culbertson, a nurse manager in <a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">Oncology</a> at <a href="/locations/mankato" target="_self" title="Opens in same window.">Mayo Clinic Health System in Mankato, Minnesota</a>." In Oncology, we work in large part with an older population, and not all of them have access to computers. But a lot of people have had family members who can help. Or if they have a computer and can log in to their Patient Online Services account, and click the link that says, 'Click here to start visit,' then a member of the Mayo Clinic Center for Connected Care team appears on the screen and walks the patient through the process of ensuring the sound and video are working properly. They make it very simple."</p> <h4>You don't have to be tech savvy to take advantage of online care</h4> <p>When a doctor's visit on the computer first came up, Jerome thought, "Well, I'm computer illiterate." But thankfully his wife, Donna Determan, is not. She has a computer and an iPad, and she got her husband all set up for his first video visit. The visits only require a device and an internet connection. No software needs to be downloaded.</p> <p>"I've used Skype, and it's very similar," says Donna. "I got it on the computer, and everything went fine. Someone (a Center for Connected Care person) walks you right through it. It went really smooth."</p> <p>Jerome agreed. In fact, he was so impressed with how smoothly and quickly the visit went, he hopes they continue using it after the COVID-19 pandemic. There have been trips he and Donna have made to Rochester for checkups that don't involve a physical exam, and he thinks video visits would be a big timesaver. </p> <p>"In this day and age, if there's new technology that will make things better for you and me, then let's do it," says Jerome. "If we all kept using the same stuff we were born with, we'd all be driving horses and buggies. Let's progress with the world."</p> <h4>Care starts with a Patient Online Services account</h4> <p>Patients need to have a Patient Online Services account to take advantage of video visits. They can inquire about setting up an account when calling to make an appointment. </p> <p>Appointments for video visits are required. Patients are asked to log in to their account 15 minutes before their appointment. Their provider will log in at the scheduled visit time, and the session will begin.</p> <p>"One of the many great features of this type of visit is that the provider has the option to share his or her screen with the patient, and the patient can actually see scans or test results on their own computer screen," says Tracy. "They can show the patient a list of their medications to make sure they're all correct. It's a really nice visual."</p> <p>Tracy says many patients have been apprehensive to try a video visit, but once completed, they've realized how easy and convenient the technology is. </p> <p>"They express gratitude for keeping them safe at home," says Tracy.</p> <h4>These videos explain how to connect to Mayo Clinic for scheduled video appointments:</h4> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/0yO5KShM8Cc" title="Using Mayo Clinic App for video appointments" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe> </p> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/_cYczRSz4V8" title="Connecting to your video appointment" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <h4>Learn more:</h4> <li>Get <a href="/hometown-health/featured-topic/6-tips-for-making-the-most-of-your-video-appointment" target="_self" title="Opens in same window.">6 tips for make the most of your health care video appointment</a>.</li> <li>Find <a href="/hometown-health/featured-topic/faq-video-appointments-and-your-security" target="_self" title="Opens in same window.">answers to your questions about whether video visits are a secure way of communicating with your provider</a>.</li> <li>Find out how you can <a href="/hometown-health/featured-topic/connect-to-the-care-you-need-with-patient-online-services" target="_self" title="Opens in same window.">connect to the care you need with a Patient Online Services account</a>.</li><img src="/-/media/national-files/images/hometown-health/2020/video-health-care-visit.jpg?h=370&iar=0&w=660&sc_lang=en&hash=85630856471FFC86E4CD8C0E918A8898" alt="Video health care visit" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Patient PortalStaying engaged in your healthcare is important. The patient portal is a free, secure and convenient online resource that connects you to your healthcare team and helps you manage your health from the comfort of your home or anywhere else.CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Dawn Haller5/15/2020Curious children are more likely to learn and retain information, and stay involved and do better in school. Get 8 tips to nurture and develop children's curiosity, and have fun exploring with your family.8 tips to develop children's curiosity<p>"Think left and think right and think low and think high. Oh, the thinks you can think up if only you try!" ― Dr. Seuss</p> <p>Children are naturally curious and seem to want to know everything about the world around them. Giving children the opportunity to be curious and explore their environment is important for their development and well-being. Curious children are more likely to learn and retain information, and stay involved and do better in school.</p> <h3>Here are 8 tips to nurture and develop children's curiosity:</h3> <h4>1. Show them the world.</h4> <p>Traveling, go camping, go to a museum or show them another culture.</p> <h4>2. Spend time together as a family.</h4> <p>Go for a walk, bake a cake, or go to the park or zoo.</p> <h4>3. Encourage friends and family to give experiences rather than gifts.</h4> <p>Kids remember experience, the excitement they felt in planning and the happiness afterward. Memories can last a lifetime.</p> <h4>4. Wonder aloud.</h4> <p>Say out loud, "I wonder why the leaves on the trees are green?"</p> <h4>5. Encourage natural interest.</h4> <p>If children are interested in an activity, give them opportunities to do that activity.</p> <h4>6. Ask open-ended questions.</h4> <p>Use words like who, what, when, where, why and how.</p> <h4>7. Prompt thinking.</h4> <p>When your children have a question, ask for their thoughts first before answering.</p> <h4>8. Let kids be kids.</h4> <p>Unstructured play is a great way to nurture and develop your children's curiosity and sense of discovery.</p> <p>By allowing your children to be curious and explore, you teach them confidence and appreciation. You also show them the world and teach them the value of experiences over things. Explore with your children, get outdoors, and learn about the world around you. Curiosity will always open doors, and lead down new and exciting paths full of adventure and learning.</p> <p>Learn more about <a href="/topics/childrens-health-pediatrics" target="_self" title="Opens in same window.">children's health on our blog</a>, including <a href="/hometown-health/speaking-of-health/play-its-good-for-your-familys-health" target="_self" title="Opens in same window.">tips on play for your family's health</a>.</p> <p><em><a href="/providers/melanie-busch-np" target="_self" title="Opens in same window.">Melanie Busch</a> is a nurse practitioner in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em></p><ul> <li>Disease Prevention</li> <li>Family Planning</li> <li>Health Promotion</li> <li>Women’s Health</li> </ul>APRN, C.N.P.<p><strong>Education</strong></p> <ul> <li>Master of Science, Family Nurse Practitioner, Walden University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Family Nurse Practitioner, American Association of Nurse Practitioners</li> <li>Trauma Nurse Core Course Provider, Emergency Nurses Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Busch<img src="/-/media/shared-files/images/medical-professionals/full/owatonna/melanie-busch-np.jpg?h=280&iar=0&w=280&sc_lang=en&hash=1661433174F4D34FA4BD2B6A2379F710" alt="Melanie Busch CNP" width="280" height="280" DisableNVelocity="true" />Melanie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15136728Melanie Busch CNP1{B3F96F77-F93E-41A4-AE4E-603045CDB443}<img src="/-/media/national-files/images/hometown-health/2020/boy-and-girl-with-magnifying-glass-illustration.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BCB246266D0E29422190A94930246D11" alt="Boy and girl with magnifying glass illustration" width="660" height="370" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Child DevelopmentWe all want our children to grow up happy and healthy. The reality is most all of them do — but at vastly different rates. Experts across Mayo Clinic Health System see thousands of children each year, and have the experience and resources to know what is normal and what may be cause for closer observation. This includes not only physical and motor skills development, but psychological and social skill advancement.Back to SchoolDawn Haller5/4/2020COVID-19 is a respiratory disease, but it can place additional stress on your heart. Learn about the effects on cardiovascular disease, and get prevention tips.COVID-19 and heart disease: What you need to know<p>COVID-19 is a respiratory disease and can severely affect the lungs of a minority of people infected. However, all of the organs in your body work together and can be affected by this disease. COVID-19 places additional strain on your heart and circulatory system because of the stress, inflammation and impaired oxygen levels. Unfortunately, for some people, the totality of these injuries could lead to multiorgan failure and death.</p> <h2>Effects of COVID-19 on cardiovascular disease</h2> <p>Although COVID-19 primarily is a respiratory illness, it can cause inflammation of the heart muscle and blood vessels. This means that people with underlying cardiac disease are at higher risk for decompensation, which is the deterioration of the heart structures.</p> <p>During this pandemic, up to 20% of people with serious COVID-19 symptoms have been shown to have cardiac injury. This has been associated with poor prognoses, including a high risk of needing mechanical ventilation or death.</p> <p>In addition, inflammation of the heart muscles and multiorgan stress can cause other cardiac-related conditions, including blood clots (thrombosis), heart attacks and heart rhythm abnormalities (arrhythmias).</p> <h2>Prevention tips</h2> <p>Similar to other health conditions or advanced age, people with cardiovascular disease should take special precautions to avoid exposure to COVID-19, including:</p> <ul> <li><strong>Wear a mask.</strong> <br /> This action primarily protects others by reducing the spread if you are an asymptomatic carrier — someone who is infected with the virus but currently not experiencing symptoms. Most often, symptoms develop within four to five days, but it could take 13 days from exposure.</li> <li><strong>Avoid touching your face.</strong></li> <li><strong>Wash your hands with soap often.</strong> <br /> Wash for at least 20 seconds, and pay special attention to the back of your hands, finger creases and thumbs.</li> <li><strong>Follow social distancing guidelines.</strong> <br /> This includes staying home and maintaining a 6-foot distance from you and others while in public.</li> </ul> <p>In addition to trying to prevent exposure to the COVID-19 virus, it's important that people with cardiovascular disease continue to practice healthy habits during this time.</p> <h3>Continue to follow your provider's recommendations, which may include:</h3> <ul> <li>Eating a healthy diet</li> <li>Exercising often</li> <li>Getting plenty of sleep</li> <li>Virtually connecting with others for social support</li> <li>Taking medications as prescribed</li> <li>Avoiding unhelpful behaviors as a reaction to stress or anxiety, such as alcohol, drugs, eating empty calories or gambling</li> </ul> <h2>Seeking heart disease care</h2> <p>Cardiovascular disease remains the No. 1 cause of death in the U.S., and fear of the COVID-19 virus should not prevent you from seeking the care you need for new or unusual symptoms. Hospitals and providers remain available and can protect you from virus exposure within the hospital.</p> <p>If you are unwell, do not be afraid to contact your provider by phone. If you need emergency care, you should call 911 and come to the Emergency Department right away.</p> <p><em><a href="/providers/d-fearghas-ocochlain-md" target="_self" title="Opens in same window.">D. Fearghas O'Cochlain, M.D.</a>, is a <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Cardiac imaging</li> <li>Clinical cardiology</li> <li>Heart failure</li> <li>Interventional cardiology (angioplasty)</li> <li> Peripheral vascular disease</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University College Galway Medical School</li> </ul> <p><strong>Internships</strong></p> <ul> <li>General Surgery, Letterkenny General Hospital</li> <li>Internal Medicine, University College Hospital</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Cardiovascular Diseases, Mayo Clinic School of Graduate Medical Education</li> <li>Interventional Cardiology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Internal Medicine, American Board of Internal Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Cardiology</li> <li>American Society of Echocardiography</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul>O'Cochlain<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/d-fearghas-ocochlain-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=BCF67E0035A61997063B2785E07388F9" alt="Deaglan Fearghas O'Cochlain, M.D." width="280" height="280" DisableNVelocity="true" />{565C4EC2-25E8-4848-A318-DFE4E56D4483}D. Fearghas<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13307002D. Fearghas OCochlain, M.D.1{676428F6-179A-4C9B-9B23-5F1E40032A38}<img src="/-/media/national-files/images/hometown-health/2020/mature-couple-smiling-looking-at-each-other.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B23F0549ADEDE90629E1BE5020E7354F" alt="Mature couple smiling and looking at each other" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller5/20/2020The "what comes next" question is important in our society today as we deal with the COVID-19 pandemic. So what do we do now? Here are three ways we can choose to deal with dubious times.COVID-19 and spiritual life: What do we do now?<p>In the sci-fi epic "Star Wars," a young Jedi, Luke Skywalker, not yet trained in the use of the force, along with his sister, Leia Organa, are fleeing from a storm trooper legion. They go through a large, seemingly impenetrable door. Young Luke instantly and instinctively shoots at the door controls to keep it closed. Yet the controls ruined their opportunity to simply walk across an extended bridge that the now blown-out controls operated.</p> <p>It was a mistake, but it is one that any of us could have made if we were characters in the movie. As the enemy slowly raises the door and Leia asks, "What do we do now?" Luke realizes his mistake and explains, "Well, I can't extend the bridge because I blasted the control mechanism that extends the bridge."</p> <p>The "what comes next" question is important in the movie and in our society today as we deal with the COVID-19 pandemic. Some of you might be wondering in the midst of this quagmire, "What are we going to do next?"</p> <h3>So what do we do now? Here are three ways we can choose to deal with dubious times:</h3> <h4>1. Stay calm and be confident.</h4> <p>Luke's actions impressed me because he didn't go out of control. And Leia was glad she had a confident colleague with her. Luke may have been an untrained Jedi, but he was stronger than even he thought he was in this crisis. Amid the crisis, Luke was, as the old adage goes, as "cool as a cucumber."</p> <p>Another example is two world leaders from decades ago coming together to discuss a world crisis and their countries' involvement. When one leader asked with anxiousness in his voice about whether this was the right decision or not, the other one said, "Now is not the time to get wobbly."</p> <p>During this time, we need people to be calm, cool and collected. Cooler heads will rule the day. Why was Luke calm? It was because he had the force behind him. In your life, you also have your spiritual life that brings you strength. In my faith tradition, there are sacred words that read, "Be still and know that I am God." All faiths have sacred words that provide centering and grounding.</p> <h4>2. Do what you can during COVID-19.</h4> <p>Many of us are asking, "What do we do now to help others during the COVID-19 pandemic?" And you may be struggling with this. You may feel afraid or feel anxious for your family. You may not know what to do because there are too many options. You can't see the proverbial forest for the trees. Wherever you are in your present spiritual place, don't feel guilty about having these feelings. Life is full of uncertainty now, so try not to feel guilty about taking care of yourself, because you are special to the Creator. You are a kind and giving person, and you will know what to do when the time comes.</p> <p>In the "Star Wars" example, Luke always seemed to have the right tool for the situation, including a rope so he and Leia could swing to safety. In the context of COVID-19, there are things you can do and things you shouldn't do. Getting educated on what is needed during the COVID-19 pandemic response is helpful, and much can be applicable to many. Pick and choose what you need to use. Don't worry about what you can't do, but instead focus on the good that you can do and be safe while doing it.</p> <h4>3. Trust God in whatever name God is for you to help you.</h4> <p>Using the "Star Wars" example again, after Luke destroys the enemy, he hears a voice that states, "Luke, the force will be with you always." Furthermore, this also is true of the spiritual relationship that we have with God or our Divine.</p> <p>In my life, I have felt my Master hold my hand through it all ― whether it was in the loss of my first wife and two children, and so much more. I have always been able to count on my spiritual life to give me strength. Now this is not to say that bad things won't happen in our lives, because they will. But I like to say that my Master is holding my hand as I go through it.</p> <p>Keep the faith and this, too, shall pass. As a wise prophet once said, "We will mount up wings like eagles, and we will walk and not be weary or be faint." So what do we do now? Keep the faith and keep on keeping on.</p> <p><em>William Creech is a clinically-trained, board-certified chaplain in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2020/head-bowed-with-hands-folded.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A45FE67B3B7C0585511F32A0C271982F" alt="Head bowed with hands folded" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.AnxietyFeelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. Symptoms may start during childhood or the teen years and continue into adulthood. We have the experts who can help diagnose and treat anxiety concerns.Dawn Haller4/19/2024When challenging events in life are continual, you can find yourself feeling emotional exhaustion. Learn how to sort through the causes and symptoms to regain a sense of well-being.Emotional exhaustion: When your feelings feel overwhelming<p>Turning on the news or opening a newspaper to see local and world events can bring out strong emotions and stressors. In addition to the social unrest happening around the world, you may face personal challenges from a high-pressure job, financial stress or poverty, <a href="/hometown-health/featured-topic/caregiving-self-care-during-beyond-the-covid-19-pandemic" target="_self" title="Opens in same window.">being a caregiver</a>, parenting, grieving the death of a family member or friend, or a chronic illness.</p> <p>You may wonder what's next or what else you can endure. With the sense of relentless struggles, you may begin to feel unwell and irritable, and struggle to concentrate and lack motivation. You may not even know what is causing these feelings. You can feel trapped or stuck. You're emotionally exhausted.</p> <h2>What is emotional exhaustion?</h2> <p>When stress from adverse or challenging events in life occur continually, you can find yourself in a state of feeling emotionally worn out and drained. This is called emotional exhaustion. For most people, emotional exhaustion tends to build up slowly over time. Emotional exhaustion includes emotional, physical and performance symptoms.</p> <h3>Emotional symptoms include:</h3> <ul> <li>Anxiety</li> <li>Apathy</li> <li><a href="/hometown-health/speaking-of-health/could-you-be-depressed" target="_self" title="Opens in same window.">Depression</a></li> <li>Feeling hopeless</li> <li>Feeling powerless or trapped</li> <li>Irritability</li> <li>Lack of focus or forgetfulness</li> <li>Lack of motivation</li> <li>Negative thinking</li> <li>Nervousness</li> <li>Tearfulness</li> </ul> <h3>Physical symptoms include:</h3> <ul> <li>Fatigue</li> <li><a href="/hometown-health/speaking-of-health/common-questions-about-headaches" target="_self" title="Opens in same window.">Headaches</a></li> <li>Lack of appetite</li> <li>Nausea or upset stomach</li> <li>Poor sleep</li> <li>Sore muscles or muscle tension</li> </ul> <h3>Performance symptoms include:</h3> <ul> <li>Difficulty completing daily tasks for responsibilities</li> <li>Failing to meet deadlines</li> <li>Increased absences</li> <li>Isolation or avoidance</li> <li>Lower workplace commitment </li> <li>Performing work duties more slowly </li> </ul> <h2>How is emotional exhaustion treated?</h2> <p>You can address emotional exhaustion by recognizing the stressors you're able to minimize or eliminate. When you're unable to change a stressor because it's out of your control, it's crucial to focus on the present moment. In the present, many neutral or positive events are occurring. When you focus on these types of events, it gives perspective about what's happening around you. This allows you to shift your focus away from the stressors.</p> <p>Your body often interprets stress as a threat to survival. When this happens, your brain releases stress hormones throughout your body, further contributing to your experience of emotional exhaustion. When you're able to focus on small neutral or positive events, your brain learns that the threat is not as dire as it may first seem. The amount of stress hormone released is decreased, and you're able to feel more emotionally balanced.</p> <h3>Other strategies to reduce emotional exhaustion include:</h3> <ul> <li>Eating a healthy, balanced diet </li> <li>Eliminating or minimizing the stressor when possible</li> <li>Exercising</li> <li>Getting adequate sleep</li> <li>Identifying and challenging unhelpful thoughts and replacing them with balanced thoughts</li> <li><a href="/hometown-health/speaking-of-health/mindfulness-meditation-improve-your-quality-of-life" target="_self" title="Opens in same window.">Practicing mindfulness</a> to engage in the present moment</li> </ul> <p>Talk with a <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">mental health professional</a> if you have signs of emotional exhaustion. They can help you sort through the causes and symptoms you're experiencing to determine a plan that will help you regain a sense of well-being.</p> <h2>Read more about self-care and coping:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/finding-joy-throughout-life" target="_self" title="Opens in same window.">Finding joy in every phase of life</a></li> <li><a href="/hometown-health/speaking-of-health/tips-to-help-ease-anxiety" target="_self" title="Opens in same window.">5, 4, 3, 2, 1: Countdown to take control of anxiety</a></li> <li><a href="/hometown-health/speaking-of-health/5-tips-to-manage-stress" target="_self" title="Opens in same window.">5 tips to manage stress</a> </li> <li><a href="/hometown-health/speaking-of-health/discovering-calm-in-the-chaos" target="_self" title="Opens in same window.">Discovering calm in the chaos</a></li> <li><a href="/hometown-health/speaking-of-health/can-expressing-gratitude-improve-health" target="_self" title="Opens in same window.">Can expressing gratitude improve your mental, physical health?</a></li> </ul> <p><a href="/providers/jolene-hanson-licsw" target="_self" title="Opens in same window."><em>Jolene Hanson</em></a><em> is a clinical social worker in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/mankato">Mankato</a>, Minnesota.</em></p><p>Children ages six through adult:</p> <ul> <li>Adjustment disorders</li> <li>Anxiety disorders</li> <li>Obsessive-compulsive disorders</li> <li>Phobias</li> <li>Posttraumatic stress disorder</li> <li>Trauma-related disorders</li> </ul>L.I.C.S.W.<p>I have been practicing in the mental health field for over 15 years. My work is a collaborative approach with the patient to determine goals for treatment and ways to achieve these goals. I am passionate about my practice and continue to strive for the best patient care possible through on-going education, attentive listening and empathetic communication.</p> <p>In my free time, I enjoy being outdoors with my family along with running and playing volleyball.</p><p><strong>Education</strong></p> <ul> <li>Master’s degree, Social Work, Minnesota State University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Clinical Social Work, Mayo Clinic Health System</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Certified in Cognitive Processing Therapy</li> <li>Certified in Trauma-focused Cognitive Behavioral Therapy</li> <li>Trained in Eye Movement Desensitization and Reprocessing (EMDR)</li> <li>License Independent Clinical Social Worker, State of Minnesota</li> </ul> <p><strong>Membership</strong></p> <ul> <li>EMDR International Association </li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor of Social Work, Mayo Clinic College of Medicine and Science</li> </ul>Hanson<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jolene-hanson-licsw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7483CB6D0C345431B3BDB2662F609078" alt="Jolene Hanson LICSW" width="280" height="280" DisableNVelocity="true" />Jolene<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15448835Jolene Hanson, L.I.C.S.W.1<img src="/-/media/national-files/images/hometown-health/2024/holding-dog-outdoors.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6C3CEF5FBC63F6CFD1AB7F1B07BEA41C" alt="Holding dog outdoors" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller9/14/2023Have you ever awoken to discover a red, painful lump near the edge of your eyelid? Here's how to treat a stye and when you should see a healthcare professional.Eye pain: Taking the sting out of a stye<p>Have you ever awoken to discover a red, painful lump near the edge of your eyelid? This lump, which may look like a pimple or boil filled with pus, is called a stye.</p> <p>A stye usually forms on the outside of the eyelid but also could form on the inner part of the eyelid. It often is painful, causes your eyelid to swell and leads to significant concern.</p> <h2>What is a stye?</h2> <p>A stye, also called a hordeolum, is the bacterial infection in one or more small glands of the eyelids. Some sties form on the inside of the eyelid and are called internal hordeolum. Meibomian glands in your eyelids naturally release an oil essential to the tears in your eyes. If these glands become blocked, bacteria can grow. Eyelids have naturally occurring bacteria to keep the eyes healthy. A stye can form if you have an overgrowth of bacteria at the same time as blocked glands.</p> <p>Sties are quite common and affect people of all ages, regardless of sex. People who have dry eyes or eyelid disease are more prone to sties. Other risk factors include wearing contact lenses or using expired makeup.</p> <h2>What is the treatment for a stye?</h2> <p>In most cases, a small sty doesn't require specific treatment and will away on its own within a week. Applying a warm washcloth on your closed eyelid for five to 10 minutes several times a day can help with pain and swelling, as well as allowing those blocked glands to better express.</p> <p>Take care to keep your eye area clean, and don't use contact lenses or makeup during this time. Wash your hands often when touching the area around your eye. Don't try to pop or squeeze the pus from a stye. Doing so can cause the infection to spread or worsen scar formation.</p> <h2>When is a stye cause for concern?</h2> <p>Most sties go away without treatment or evaluation. However, if you have recurring, or medium or large sties, you may need further evaluation and treatment by a healthcare professional.</p> <p>If you have redness and swelling that involve the entire eyelid or extend into your cheek or other parts of you face, you should seek urgent medical attention.</p> <p><em><a href="/providers/nitika-arora-mbbs" target="_self" title="Opens in same window.">Nitika Arora, M.B.B.S.</a>, is an <a href="/services-and-treatments/ophthalmology" target="_self" title="Opens in same window.">ophthalmologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p>M.B.B.S.<p><strong>Education</strong></p> <ul> <li>Kasturba Medical College</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>RML Hospital</li> <li>University of Illinois College of Medicine</li> <li>Ophthalmology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Research, Mayo Clinic School of Graduate Medical Education</li> <li>Glaucoma, Mayo Clinic School of Graduate Medical Education</li> </ul> <div><strong>Memberships</strong></div> <ul> <li>American Academy of Ophthalmology</li> <li>American Glaucoma Society</li> <li>Women in Ophthalmology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Ophthalmology, Mayo Clinic College of Medicine and Science</li> </ul>Arora<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/nitika-arora-mbbs.jpg?h=280&iar=0&w=280&sc_lang=en&hash=9675C67908761C784DE1E007AA073959" alt="Nitika Arora, M.B.B.S." width="280" height="280" DisableNVelocity="true" />{14B42962-0BAD-44FB-8670-D80CDFEE2C79}Nitika<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15500586Nitika Arora, M.B.B.S.1{C5680DDD-C649-4B63-AFCC-B52A244736B7}<img src="/-/media/national-files/images/hometown-health/2022/checking-eye-in-mirror.jpg?h=370&iar=0&w=660&sc_lang=en&hash=AC4286F229944AF6303C41776751880F" alt="Checking eye in mirror" width="660" height="370" DisableNVelocity="true" />Eye HealthYour eyes are responsible for providing you with vision, perhaps the most important of the senses. However, the eye is a delicate and complicated structure that needs protection. The ugly truth is that eye injuries can happen at any time and place.Michele Halterman7/25/2023When the weather forecast calls for hot and humid days ahead, follow these steps to keep cool and prevent heatstroke.When temps rise, remember these heatstroke prevention tips<p>Time outdoors is time well spent throughout the year, but it's especially enjoyable during the summer. Hiking, fishing, boating and other warm-weather activities can renew your appreciation for nature. They also are good for physical and mental health.</p> <p>Summer can bring hot temperatures, and working or playing in the heat can be dangerous. As you head out this summer, remember to take precautionary measures to prevent heat-related injuries when you're far from climate-controlled environments.</p> <p>Sometimes when people are having fun outside in the summer, they don't realize they're becoming overheated. If the condition reaches the level of <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/heat-stroke/symptoms-causes/syc-20353581" target="_blank" title="Opens in a new window">heatstroke</a>, it's serious and immediate medical attention is needed.</p> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/heat-exhaustion/symptoms-causes/syc-20373250" target="_blank" title="Opens in a new window"></a><a href="https://www.mayoclinic.org/diseases-conditions/heat-exhaustion/symptoms-causes/syc-20373250" target="_blank" title="Opens in a new window">Heat exhaustion</a> often precedes heatstroke. The signs of heat exhaustion include cool, moist skin with goose bumps when in the heat, heavy sweating, faintness, dizziness, fatigue, rapid pulse, headache and nausea. Without prompt treatment, heat exhaustion can lead to heatstroke, a life-threatening condition. Heatstroke occurs when the body reaches a temperature of 104 degrees or higher, and symptoms can include confusion, altered speech, nausea or vomiting, rapid breathing and a racing heartbeat, among other symptoms.</p> <p>The good news is that you can prevent heat exhaustion and heat stroke.</p> <h2>Take these steps to prevent heatstroke during hot weather:</h2> <ul> <li><strong>Wear loose-fitting, lightweight clothing.</strong><br /> Wearing excess clothing or clothing that fits tightly won't allow your body to cool properly.</li> <li><strong>Protect against sunburn.</strong><br /> Sunburn affects your body's ability to cool itself, so protect yourself outdoors with a wide-brimmed hat and sunglasses and use a broad-spectrum sunscreen with a sun protection factor, or SPF, of at least 30. Apply sunscreen generously and reapply every two hours, or more often if you're swimming or sweating.</li> <li><strong>Drink plenty of fluids.</strong><br /> Staying hydrated will help your body sweat and maintain an average body temperature.</li> <li><strong>Take extra precautions with certain medications.</strong><br /> Ask your health care team your medications can affect your body's ability to stay hydrated and dissipate heat.</li> <li><strong>Never leave anyone in a parked car.</strong><br /> This is a common cause of heat-related deaths in children. When parked in the sun, the temperature in your car can rise 20 degrees F in 10 minutes. It's unsafe to leave a person or pet in a parked car in warm or hot weather, even if the windows are cracked or the car is in the shade. Keep your car locked to prevent a child from getting inside when it is parked.</li> <li><strong>Take it easy during the hottest parts of the day.</strong><br /> If you can't avoid strenuous activity in hot weather, drink fluids and rest frequently in a cool spot. Try to schedule exercise or physical labor for cooler parts of the day, such as early morning or evening.</li> <li><strong>Get acclimated.</strong><br /> It can take several weeks for your body to adjust to hot weather. Limit time spent working or exercising in the heat until you're conditioned to it. People not used to hot weather are especially susceptible to heat-related illnesses.</li> <li><strong>Be cautious if you're at increased risk.</strong><br /> If you take medications or have a condition that increases your risk of heat-related problems, avoid the heat and act quickly if you notice symptoms of overheating. If you participate in a strenuous sporting event or activity in hot weather, make sure medical services are available in case of a heat emergency.</li> </ul> <p>Heatstroke requires emergency treatment. Left untreated, it can quickly damage your brain, heart, kidneys and muscles. The damage worsens the longer treatment is delayed, increasing your risk of serious complications or death.</p> <p><em><a href="/providers/stephen-stacey-do" target="_self" title="Opens in same window.">Stephen Stacey, D.O.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Helping youth and adults overcome barriers that keep them from being active</li> <li>Holistic medicine for chronic pain</li> <li>Osteopathic manual medicine</li> </ul>D.O.<p>I am the director of osteopathic education for the Mayo Clinic Family Medicine Residency program in La Crosse.</p> <p>I practice comprehensive, whole-person care for patients throughout their lifecycle. I also specialize in osteopathic manual medicine and holistic treatment of patients who suffer from chronic pain. I especially love helping youth and adults overcome barriers that keep them from being active.</p> <p>I have served as a battalion and flight surgeon in the U.S. Army. While in the Army, I deployed to Poland and Ukraine where I helped train our NATO allies in battlefield trauma care.</p> <p>In my free time, I enjoy trail running, mountain biking, cross-country skiing, and spending time with my wife and five children.</p> <p><strong>Education</strong></p> <ul> <li>Kirksville College of Osteopathic Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Madigan Army Medical Center</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Peak Vista Community Health Centers</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American College of Osteopathic Family Physicians</li> <li>American Osteopathic Association</li> <li>North American Primary Care Research Group</li> <li>Society of Teachers of Family Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Stacey<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/stephen-stacey-do.jpg?h=559&iar=0&w=559&sc_lang=en&hash=EE5206E176694210ACFC3D4307B4E16D" alt="Stephen Stacey, D.O." width="559" height="559" DisableNVelocity="true" />Stephen<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21340552Stephen Stacey, D.O.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}<img src="/-/media/national-files/images/hometown-health/2022/drinking-bottled-water-wearing-earbuds.jpg?h=370&iar=0&w=660&sc_lang=en&hash=54741A568E777DB455A66848F14F2764" alt="Drinking bottled water, wearing earbuds" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Dawn Haller8/11/2020"You are what you eat." This is true when considering foods that impact heart health. Here are four tips for incorporating foods in your diet that are heart-healthy and delicious.4 key elements of a heart-healthy diet<p>You may have heard the phrase "you are what you eat." This is true when considering the affect that the foods we eat have on our heart health. Foods high in saturated fats or sodium can lead to obesity, high blood pressure or high cholesterol — all risk factors for heart disease.</p> <h2>Here are four tips I give my patients who are trying to eat a more heart-healthy diet:</h2> <h3>1. Eat more vegetables and fruits.</h3> <p>Vegetables and fruits are good sources of vitamins and minerals. They also are low in calories, rich in dietary fiber and contain substances that may help prevent cardiovascular disease. Eating more fruits and vegetables may help you cut back on higher-calorie foods, such as meat, cheese and snack foods.</p> <h3>2. Select whole grains.</h3> <p>Whole grains are good sources of fiber and other nutrients that play a role in regulating blood pressure and heart health. You can increase the amount of whole grains in a heart-healthy diet by making simple substitutions for refined grain products. Or be adventuresome and try a new whole grain, such as whole-grain farro, quinoa or barley.</p> <h3>3. Limit unhealthy fats.</h3> <p>Limiting how much saturated and trans fats you eat is an important step to reduce your blood cholesterol and lower your risk of coronary artery disease. A high blood cholesterol level can lead to a buildup of plaques in your arteries, called atherosclerosis, which can increase your risk of heart attack and stroke.</p> <h3>4. Choose low-fat protein sources.</h3> <p>Lean meat, poultry and fish, low-fat dairy products and eggs are some of your best sources of protein. Certain types of fish are rich in omega-3 fatty acids, which can lower blood fats called triglycerides. Finally, legumes, like beans, peas and lentils, also are good sources of protein, and contain less fat and no cholesterol, making them good substitutes for meat.</p> <p>Incorporate these foods into your diet, and you'll find that heart-healthy eating is both doable and enjoyable. With planning and a few simple substitutions, you can eat with your heart in mind.</p> <p><em><a href="/providers/brodie-marthaler-md" target="_self" title="Opens in same window.">Brodie Marthaler, M.D.</a>, is a <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Cardiac MRI</li> <li>Cardiovascular CT</li> <li>Echocardiography</li> <li>Nuclear cardiology</li> <li>Preventive cardiology</li> </ul>M.D.<p>Mayo Clinic Health System is the perfect blend of a community-based practice, and a large health care system that develops and uses the latest, cutting-edge tools and expertise in medicine. I grew up in Wisconsin, and am looking forward to establishing my practice, giving back to the community and establishing connections with patients.</p> <p>In my free time, I enjoy cooking, playing golf and reading historical books.</p><p><strong>Medical School</strong></p> <ul> <li>Medical College of Wisconsin, Milwaukee</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, University of Iowa, Iowa City</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Cardiovascular Medicine, University of Iowa, Iowa City</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Internal Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Cardiology</li> <li>American College of Physicians</li> <li>American Society of Echocardiography</li> <li>Society for Cardiovascular Computed Tomography</li> </ul> <p><strong>Additional Cardiology Outreach</strong><br /> Ascension | Saint Elizabeth’s Medical Center<br /> 1200 Grant Blvd. W.<br /> Wabasha, MN<br /> 715-838-6320</p>Marthaler<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/brodie-marthaler-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=12040CBBA2D7352C5BAC64B0A315B718" alt="Brodie Marthaler, M.D." width="280" height="280" DisableNVelocity="true" />{129285BA-4E5E-4EFC-9070-DBC94610FDED}Brodie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15894355Brodie Marthaler, M.D.1{676428F6-179A-4C9B-9B23-5F1E40032A38}<img src="/-/media/national-files/images/hometown-health/2020/family-preparing-heart-healthy-meal.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E5D9DA0F089F119C2AB5501950D6A86D" alt="Family preparing heart healthy meal" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller10/6/2022Anger is a normal emotion, but uncontrolled anger can take a toll on your relationships. These tips can help you regain control. 7 anger management tips to prevent relationship damage<p>Do you fume when someone cuts you off in traffic? Does your blood pressure rocket when your child refuses to cooperate? Do you lash out quickly and later regret so doing? If so, you're not alone. Everyone experiences anger from time to time.</p> <p>Anger is a normal and even healthy emotion. Like all emotions, it gives us insight into how we just perceived an event. But it's important to deal with it in a positive way. Uncontrolled anger can take a toll on your health and relationships.</p> <h2>If you're often feeling angry, or if those feeling are causing problems at home or at work, here are seven tips to help you regain control:</h2> <h3>1. Think before you speak.</h3> <p>One of the best tactics is to take a pause before reacting. If your heart is pounding and you feel like yelling at your friend, family member or the guy who just pulled in front of you in traffic, stop. Take a breath. Count to 10. Do whatever it takes to avoid lashing out and saying or doing something you'll regret.</p> <h3>2. Once you're calm, state what upset you.</h3> <p>What is the more correct feeling in response to what happened? Identify the deeper feeling. Maybe you feel unimportant because your spouse didn't help clean up the kitchen after you made dinner. Or you feel used because your son borrowed your car and returned it with a nearly empty gas tank — again. Address the circumstance and person clearly and directly, using an "I" statement. For example, say, "I'm upset that you left me without enough gas to get to work" or "I resent it when I work to prepare a meal and you don't help clean up afterward."</p> <h3>3. Use humor to release tension.</h3> <p>Lightening up can help diffuse tension. Use humor to help you face what's making you angry. Laugh at yourself for unrealistic expectations you have for how things should go. Laugh at yourself but avoid sarcasm. It often aims to hurt others to make a point about how you are feeling. Don't be passive-aggressive either.</p> <h3>4. Take a timeout.</h3> <p>Timeouts aren't just for kids. Being self-aware about your energy level is helpful so you can take care of your needs and be the best you can be. Give yourself short breaks during times of the day that tend to be stressful. A few moments of quiet time might help you feel better prepared to handle what's ahead without getting irritated or angry.</p> <h3>5. Get exercise.</h3> <p>Physical activity can help reduce stress that can cause you to become angry. Exercise is often prescribed to improve mood. The endorphins produced from physical exertion are natural pick-me-ups and stress reducers. If you feel your anger escalating, go for a brisk walk or run, or spend some time doing other enjoyable physical activities.</p> <h3>6. Practice relaxation skills.</h3> <p>Using any, or all, of your six senses to provide relaxing input can improve calmness. Practice deep-breathing exercises, get a warm drink, smell some pleasant scents, go outside and feel the crisp air, stretch your muscles, imagine a relaxing scene, listen to calming music or repeat a calming word or phrase, such as "Take it easy." Yoga and meditation also are good tools to use to help you stay calm. When you're taking care of yourself, it's easier to deal with the challenges life throws your way.</p> <h3>7. Don't hold a grudge.</h3> <p>Forgiveness is a powerful tool. Holding on to the offenses of others and hoping they will feel your pain or repay you for their error only affects you. If you allow anger and other negative feelings to crowd out positive feelings, you might find yourself swallowed up by your own bitterness or sense of injustice. But if you can forgive someone who hurt you (i.e., write the debt owed you to zero) you release the weight and are no longer bogged down and hoping for "pay-back."</p> <p>Learning to control anger is a challenge at times for everyone. If changes like these aren't enough to help you control your anger, reach out to a mental health specialist for support. Seek help for anger issues if your anger seems out of control, causes you to do things you regret or hurts those around you.</p> <p><em><a href="/providers/richard-oswald-lpc" target="_self" title="Opens in same window.">Rich Oswald</a> is a psychotherapist in </em><em><a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry and Psychology</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/menomonie" target="_self" title="Opens in same window.">Menomonie</a>, Wisconsin.</em></p><ul> <li>Addicted family member</li> <li>Anxiety</li> <li>Bi-polar disorder</li> <li>Boundaries</li> <li>Career issues</li> <li>Conflict resolution</li> <li>Grief</li> <li>Healing abuse issues (emotional, mental, spiritual)</li> <li>Healing trauma issues</li> <li>Identity</li> <li>Life direction</li> <li>Low self-esteem</li> <li>Marital counseling (affair recovery, communication, conflict, parenting concerns, sexual issues)</li> <li>Relationship problems</li> <li>Sexual issues</li> <li>Spiritual/faith concerns</li> </ul>L.P.C.<p>Deep and lasting change is my goal while acknowledging short term changes are the steps in the journey. I view therapy as the opportunity to come alongside you during your journey to help you heal and grow, to live truer to who you are and make the healthiest decisions you can. I address both immediate issues and long-term patterns of thought, behavior and relating.</p> <p>I utilize a Christian worldview to understand people’s value, motivations, challenges and needs but work with people of all faiths. I use my education and experiences in engineering and carpentry work to provide practical and relatable illustrations.</p> <p>I grew up in Eastern Pennsylvania, learning to work on cars in my dad's mechanic shop. I had good times riding bikes and motorcycles, fishing, boating and building and driving RC Cars. After college and various jobs, I realized I was good with people and wanted to become a counselor.</p> <p>During my life journey, I became aware of my own mental disorders and addressed them in therapy. I spent 22 years in Atlanta, Georgia, with 19 of them working in counseling and running my own handyman business. However, I missed the snow of the North, so Wisconsin became my family's new home. I am married and have four daughters. I love being outside, riding motorcycles, fixing things, learning new things and meeting new people.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Mechanical Engineering, Penn State University</li> <li>Master's degree, Mechanical Engineering, Penn State University</li> <li>Master's degree, Professional Counseling, Richmont Graduate University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Outpatient Counseling, Mount Paran North Church</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Certified Professional Counseling Supervisor</li> <li>Certified Trauma Resolutions Therapist</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Christian Counselors</li> <li>Professional Counseling Association of Georgia</li> <li>Professional Counseling Association of Wisconsin</li> </ul>Oswald<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/richard-oswald-lpc.jpg?h=280&iar=0&w=280&sc_lang=en&hash=07E6DC8C4784E3E146B16A66D64F1E4F" alt="Richard Oswald LPC" width="280" height="280" DisableNVelocity="true" />Rich<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30181503Richard Oswald, L.P.C.1<img src="/-/media/national-files/images/hometown-health/2022/eyes-closed-glasses-airpod.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0918CCD77AF93AAD7BDF0CF0666A77A9" alt="Eyes closed, wearing glasses. using airpods" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller2/23/2022You may think you know why varicose veins develop, who's most at risk or the best treatment. Here's the truth behind 6 common varicose vein myths.6 varicose vein myths debunked<p>Varicose veins are twisted, enlarged and bulging veins that most commonly affect your legs. Nobody wants to develop these blue or purple, and sometimes painful, veins. Unfortunately, about half of adults do at some point in their lives. </p> <p>Varicose veins form when internal valves break down and allow blood to flow in the wrong direction down the leg and pool within the veins. This causes the vein to stretch and dilate, leading to swelling, aching and pain. To make matters worse, veins often can bulge more and more to hold the increasing amount of blood, which results in even more persistent discomfort.</p> <p>Many people think they know why varicose veins develop, who is most at risk or the best way to treat them.</p> <h3>Here's the truth behind 6 common varicose vein myths:</h3> <h4>Myth 1: Only women get varicose veins.</h4> <p>Women are more likely to develop the condition. Hormonal changes due to pregnancy or menopause may be a factor because hormones tend to relax vein walls. However, men are not immune to varicose veins, with as many as 45% of men developing them at some point. The No. 1 predictor is family history. If your mother or grandfather had varicose veins, you are more likely to develop them, regardless of whether you're male or female.</p> <h4>Myth 2: Varicose veins are an inevitable symptom of aging.</h4> <p>Not every person over a certain age develops varicose veins, and there are ways to prevent them. It is true that the risk of varicose veins increases with age as aging causes wear and tear on the valves in your veins that regulate blood flow.</p> <h4>Myth 3: Crossing your legs causes varicose veins.</h4> <p>Crossing your legs or wearing tight pants doesn't cause varicose veins. External pressure on your veins, like crossing your legs, is minimal and doesn't exert enough force to damage your veins. However, depending on the duration and location of the pressure, it can exacerbate the symptoms of varicose veins. Also, if you remain in the same position for long periods of time, it is more difficult for your blood to flow properly.</p> <p>Try to alternate between sitting and standing to move blood in your legs. Exercise and using the muscles in your legs can return blood from your legs to your core and improve symptoms of varicose veins.</p> <h4>Myth 4: Pregnancy causes varicose veins.</h4> <p>During pregnancy, the volume of blood in your body increases. While this change supports the growing fetus, it also can produce an unfortunate side effect: enlarged veins in your legs. Hormonal changes during pregnancy also may play a role.</p> <p>For most women, this is a temporary condition, and their veins return to their previous size after delivery.</p> <h4>Myth 5: Varicose veins are a cosmetic issue.</h4> <p>Varicose veins are not simply a cosmetic issue. At best, they are a cosmetic concern with few symptoms. More commonly, they lead to painfully swollen, aching and tired legs that worsen with even a minimal amount of exercise or standing. At worst, they indicate a progressive disease process called chronic venous insufficiency, which causes poor wound healing, ulcers and, in the most severe cases, can lead to amputation. Your health care provider should evaluate all varicose veins, especially symptomatic ones.</p> <h4>Myth 6: Varicose vein treatment is painful.</h4> <p>You may have heard stories about treatments in the past that included vein stripping or other invasive procedures. These painful treatments often had scarring and a longer recovery time. Technology has advanced, and many minimally invasive treatment options are available that can make a difference.</p> <p>Radiofrequency or laser ablation surgeries produce good results with little downtime. In these treatments, heat or light is used to damage the inside of the vein, ultimately causing it to collapse and fade away. Another option is sclerotherapy, which injects a solution that causes the vein to collapse. The process of destroying the veins begins immediately. Most people see full results in about two months with minor discomfort and no downtime.</p> <p>Many treatment options are available, so the first step is to decide that you want to treat this issue. Talk with your health care professional about vein issues you're experiencing.</p> <p><em><em>By Mayo Clinic Health System staff.</em></em></p><img src="/-/media/national-files/images/hometown-health/2022/hands-clasping-knee.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3E0C35DC2CD805E27FC07894805FF05A" alt="Hands clasping knee" width="660" height="370" DisableNVelocity="true" />SurgeryHaving surgery is a major event in your life. We know this and make every effort to keep you as comfortable as possible, focusing on you as an individual. Our surgeons and staff work as a coordinated team treating a wide variety of illnesses ranging from simple to complex. We offer comprehensive, advanced care and service to every patient.Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Dawn Haller9/3/2020You're not alone if you're unsure if you should go to the Emergency Department or Urgent Care for an accident or illness. Learn about the differences so you're prepared next time the unexpected happens.Emergency vs. Urgent Care: What's the difference? <p>It's Saturday morning and your child fell while playing in the backyard. He can't put any weight on his rapidly swelling ankle, and he is sweating and crying in pain. Should you head to the Emergency Department or Urgent Care?</p> <p>If you have been in a similar situation and wondered which option is better, you are not alone. Although Mayo Clinic Health System has offered Urgent Care for more than 20 years, many people are confused about when to use it.</p> <h2>Here are a few differences between Emergency Departments and Urgent Care clinics:</h2> <h3>Severity of health problems</h3> <p>An Emergency Department treats life- or limb-threatening health conditions in people of all ages. It is the best option when you require immediate medical attention.</p> <p>Urgent Care is the middle ground between your primary care provider and the Emergency Department. If you have a minor illness or injury that can't wait until tomorrow, Urgent Care is the way to go. Also, it is a good option if you have illnesses or injuries without other symptoms, or if you do not have other underlying health conditions. For example, an earache can easily be treated in Urgent Care. However, if it is accompanied by a high fever (104 F or higher), or you have a history of cancer or are on immune-suppressing medication, it is important to have it checked out in the Emergency Department. </p> <h3>Hours and staff</h3> <p>Emergency Departments are staffed 24/7 with physicians, physician assistants, nurse practitioners and nurses trained in delivering emergency care. The team has quick access to expert providers in advanced specialties such as Cardiology, Neurology and Orthopedics. Emergency Departments also have the imaging and laboratory resources needed to diagnose and deliver care for severe and life-threatening situations.</p> <p>Typically, Urgent Care clinics are staffed with physician assistants, nurse practitioners and nurses. Although, some Urgent Care clinics have physicians on staff as well. Urgent Care providers can order basic labs and imaging tests, such as X-rays, to help them provide diagnoses and develop treatment plans. Urgent Care clinics have set hours and an established list of conditions treated. As a result, Urgent Care clinics often are less expensive and have shorter wait times than Emergency Departments.</p> <h3>Here are examples of types of conditions treated in Urgent Care clinics and Emergency Departments:</h3> <h4>Urgent Care clinic:</h4> <ul> <li>Back or muscle pain</li> <li>Bronchitis </li> <li>Cuts and minor burns</li> <li>Diarrhea </li> <li>Earache</li> <li>Skin conditions</li> <li>Sprains or joint pain</li> <li>Upper respiratory infection </li> <li>Urinary tract infections</li> <li>Vomiting </li> </ul> <h4>Emergency Department:</h4> <ul> <li>Chest pain or pressure</li> <li>Compound fracture (bone that protrudes through the skin)</li> <li>Head injuries</li> <li>Pneumonia</li> <li>Seizures</li> <li>Severe abdominal pain</li> <li>Shortness of breath </li> <li>Sudden, severe headache, or paralysis or weakness</li> <li>Uncontrolled bleeding </li> </ul> <p>Always call 911 and don't drive yourself to the Emergency Department if you are having difficulty breathing, shortness of breath, a life or limb injury, or signs of stroke or heart attack.</p> <p>Learn about your <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://mcforms.mayo.edu/mc4400-mc4499/mc4484-353.pdf" target="_blank" title="Opens in a new window.">options for same-day care</a>.</p> <p><em><a href="/providers/graham-king-md" target="_self" title="Opens in same window.">Graham King, M.D.</a></em><em>, is a </em><em><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></em><em> physician in </em><em><a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a></em><em>, Minnesota.</em></p><ul> <li>Community fitness outreach programs</li> </ul>M.D.<p>I enjoy caring for the health needs of families from prenatal care and pediatrics to adult medicine, and specialize in women's health and reproductive health. I focus on listening and hearing my patients, and forming partnerships with them in delivering their care.</p> <p>I am married to an elementary school teacher with four energetic boys who are active in community, school and sports. I enjoy playing guitar and piano, writing educational blogs and practicing healthful living. </p> <p>I am an 80s rock superfan and love going to concerts with my family and friends. I also enjoy Vikings, Twins, Wild and Maverick sports.</p><p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Mercy Hospital</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Sutter Health Family Medicine Residency Program</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Family Medicine</li> <li>Mayo Clinic Quality Fellow, Bronze Level</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Medical Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>King<img src="/-/media/shared-files/images/medical-professionals/full/mankato/graham-king-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=78048D61A3A60EF1DF00C06F2F6CCBEE" alt="Graham King MD" width="280" height="280" DisableNVelocity="true" />{46521252-3F34-48F2-80D2-338AA6DD4C22}Graham<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14899019Graham King, M.D.1<img src="/-/media/national-files/images/hometown-health/2020/emergency-and-urgent-care.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EABD8F7ED3A8BFA89F154E49C239C7ED" alt="Emergency and Urgent Care" width="660" height="370" DisableNVelocity="true" />Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Dawn Haller1/3/2025HoLEP is a minimally invasive laser procedure to treat an enlarged prostate. Learn about its benefits, including fast recovery and no hospital stay.Laser-based prostate procedure treats BPH<p>Advancements in surgical technologies continue to make procedures safer by reducing operative and overall recovery time.</p> <p>One such urological procedure proven to have both short- and long-term benefits is the holmium laser enucleation of the prostate or HoLEP. This minimally invasive procedure is currently being performed at <a href="/locations/mankato" target="_self" title="Opens in same window.">Mayo Clinic Health System in Mankato</a>, one of only two organizations that offer the procedure in Minnesota.</p> <h4>HoLEP procedure</h4> <p>HoLEP is a treatment option for obstructive urinary tract symptoms due to an enlarged prostate — a condition known as benign prostate hyperplasia or BPH. The procedure uses a specialized scope and laser to remove tissue that is blocking urinary flow through the urethra. The tissue is excised in two or three pieces that easily can be removed through the urethra.</p> <p>Unlike similar prostate surgical procedures performed for prostates, HoLEP does not require any abdominal incisions. The result is faster recovery and avoidance of inpatient hospitalization for monitoring.</p> <h4>HoLEP benefits</h4> <p>The biggest advantage to choosing HoLEP is its minimally invasive nature — meaning a lower risk of complications, symptom relief and shortened recovery time. Often (85% of the time), the urinary catheter can be removed within 24 hours of the procedure, compared to 5-7 days with other techniques. Many patients can resume normal daily activities within a few days.</p> <p>Long term, HoLEP greatly improves the health and quality of life of patients. For patients in complete urinary retention, which requires catheters to keep the bladder empty and decompressed, this is one of the best options. Without surgical intervention, patients with complete urinary retention require long-term forms of catheterization to prevent infectious complications and deteriorations in kidney function. The procedure allows the patients to urinate again, immediately eliminating the need for a catheter.</p> <p>Talk with your primary care provider and make an appointment if you are having trouble urinating and are looking for treatment strategies.</p> <h4>Read more about prostate and men's health:</h4> <ul> <li><a href="/hometown-health/speaking-of-health/5-facts-about-prostate-specific-antigen-psa-tests" target="_self" title="Opens in same window.">Get 5 facts about prostate specific antigen (PSA) tests</a>.</li> <li><a href="/hometown-health/speaking-of-health/mens-health-checkups-and-screenings-are-key" target="_self" title="Opens in same window.">Learn why checkups and screenings are important for men</a>.</li> <li>Learn about prostate cancer risks and treatment.</li> </ul> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2020/grey-haired-man-on-laptop-having-breakfast.jpg?h=370&iar=0&w=660&sc_lang=en&hash=33DC5889B5F4EEF117C154ECCC4C30F2" alt="Grey haired man on laptop having breakfast" width="660" height="370" DisableNVelocity="true" />Prostate HealthProstate cancer is the most common cancer diagnosed in men. You may have friends or family members who have been diagnosed with prostate cancer, and this may make you wonder about what you can do for prostate cancer prevention.Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Dawn Haller10/4/2021Put up your best defense by scheduling a flu vaccination through the online patient port or the Mayo Clinic App — it's convenient. Select the date, time and location that's best for you.Schedule flu vaccinations through patient portal, Mayo Clinic App<p>It's time to schedule flu vaccination appointments.</p> <p>It's easy if you are a Mayo Clinic Health System patient. You can schedule these appointments using the patient portal or the Mayo Clinic App. This option is available for all patients 6 months and older.</p> <p>If you are a parent or guardian, you can schedule for a child 12 years or younger using the child's account. If you need to create this account, you can select the child's name and use the "Add Account" feature. If your child is between 13 and 17, he or she will need to have his or her own account to schedule a flu vaccination appointment.</p> <p>If you prefer, you can request an appointment by calling your primary care provider's office.</p> <h2>Scheduling on the web</h2> <h3>Once you have logged in to your portal account, you should:</h3> <ul> <li>Go to "Appointments and Admissions."</li> <li>Select the "New Appointment" tab.</li> <li>Select the "Flu Immunization" button.</li> </ul> <p>Possible times, dates and locations for the appointment will appear, and you can schedule your appointment by following the online prompts. Finalize your appointment by selecting "Schedule Now."</p> <h2>Scheduling on the Mayo Clinic App</h2> <h3>When using the Mayo Clinic app, you should: </h3> <ul> <li>Select "Appointments."</li> <li>Select "Request Appointment Now."</li> <li>Select the "Flu Immunization" button.</li> </ul> <p>Possible times, dates and locations for the appointment will appear, and you can schedule your appointment by following the online prompts. Finalize your appointment by selecting "Schedule Now."</p> <h3>Final steps</h3> <p>Whether you're using the portal on the web or Mayo Clinic app, you will be able to verify the information that you provided before you scheduled your appointment. Once your appointment is scheduled, it will appear in the portal and on the Patient Appointment Guide as a scheduled appointment.</p> <h2>Benefits of online scheduling</h2> <p>Online scheduling lets you choose your preferred appointment times from a range of options. By seeing the scheduling options available, you can take your time to pick the most convenient appointment time, date and location. You can schedule your appointment from home or after business hours, or while at work, shopping or running other errands.</p> <p>You may find it convenient to schedule the appointment on a day you are already at Mayo Clinic Health System for another reason. You will need to make sure you include enough time to get to all of your appointments and not schedule appointments too near each other.</p> <p>You also can schedule appointments for other family members if you have caregiver access to portal accounts for those family members.</p> <h3>Watch this video to learn how to use the patient portal to schedule an appointment:</h3> <iframe id="kaltura_player" src="https://cdnapisec.kaltura.com/p/1825021/sp/182502100/embedIframeJs/uiconf_id/29327221/partner_id/1825021?iframeembed=true&playerId=kaltura_player&entry_id=1_zgic8ew5&flashvars[streamerType]=auto&flashvars[localizationCode]=en&flashvars[leadWithHTML5]=true&flashvars[sideBarContainer.plugin]=true&flashvars[sideBarContainer.position]=left&flashvars[sideBarContainer.clickToClose]=true&flashvars[chapters.plugin]=true&flashvars[chapters.layout]=vertical&flashvars[chapters.thumbnailRotator]=false&flashvars[streamSelector.plugin]=true&flashvars[EmbedPlayer.SpinnerTarget]=videoHolder&flashvars[dualScreen.plugin]=true&flashvars[hotspots.plugin]=1&flashvars[Kaltura.addCrossoriginToIframe]=true&&wid=1_r0kke1zj" width="400" height="285" allow="autoplay *; fullscreen *; encrypted-media *" sandbox="allow-forms allow-same-origin allow-scripts allow-top-navigation allow-pointer-lock allow-popups allow-modals allow-orientation-lock allow-popups-to-escape-sandbox allow-presentation allow-top-navigation-by-user-activation" frameborder="0" title="Kaltura Player"></iframe> <p> </p> <h2>Creating a patient portal account</h2> <p>You can easily <a href="/patient-online-services" target="_self" title="Opens in same window.">create an account</a> if you don't have one. Click on "Create your account." You also can download the Mayo Clinic App from the Apple and Google Play app stores.</p><img src="/-/media/national-files/images/hometown-health/2020/online-scheduling-with-a-laptop.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E380387D4CED8EB1FBF946BF9D4C28C5" alt="Online scheduling with a laptop" width="660" height="370" DisableNVelocity="true" />InfluenzaInfluenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza, commonly called the flu, is not the same as the stomach "flu" viruses that cause diarrhea and vomiting.Patient PortalStaying engaged in your healthcare is important. The patient portal is a free, secure and convenient online resource that connects you to your healthcare team and helps you manage your health from the comfort of your home or anywhere else.Immunizations<p>Disease prevention is crucial to your health. Getting vaccinated is one of the best ways to maintain good health, and protect you and those you care about against infectious diseases. Vaccinations offer protection against serious diseases by stimulating the immune system to create antibodies against certain bacteria or viruses.</p><br/><p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/vaccine-guidance/art-20536857" target="_blank" title="Opens in a new window.">Get vaccine guidance from Mayo Clinic</a>, including benefits, safety, side effects and what to know about recommended vaccines for babies, children, teens, adults and during pregnancy. For recommended vaccines based on age, refer to the <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/adult" target="_blank" title="Opens in a new window.">adult</a> or <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/child" target="_blank" title="Opens in a new window.">child and adolescent</a> schedules.</p><br/><p>Review the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/coronavirus-covid-19/history-disease-outbreaks-vaccine-timeline" target="_blank" title="Opens in a new window.">history of infectious disease outbreaks and vaccines timeline</a> for information about major disease outbreaks, epidemics and pandemics, and the impact of vaccines and research.</p>Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller10/14/2020Do you recall the good feelings you have when you hear an old favorite song? Explore the ways you can use music to help you heal and be well during challenging times.4 tips for making music good medicine<p>Music has been a part of humanity for as long as humanity has existed. Archeologists have unearthed relatively complex bone instruments greater than 40,000 years old. Certainly, human ancestors likely were making music in more rudimentary ways even before this. It is no surprise then that music is so fundamental to development as humans and their continued psychological well-being.</p> <p>There's no doubt the COVID-19 quarantine and the difficulties people all have experienced recently have taken a toll on mental health. Music is one tool to use ease the strain on your mental health, and help you to recover in the future.</p> <p>No one can tell a person exactly how to enjoy music. This is because music preferences are as unique as each person.</p> <p>Music therapy is field of medicine where music is used to treat various conditions, much as a physical therapist might treat a patient. You can use some of their techniques to inspire your own healing and manage your mental health. These techniques are wide ranging. No matter your preferences for music, you can make activities like these work for you.</p> <h2>Here are 4 tips to use music to help you heal and be well:</h2> <h3>1. Be creative with music.</h3> <p>Performing music often is more powerful than listening. If you have the skill, you should try to perform music. You don't need to be a classically trained musician, and you don't need an audience. Sure, you can sit down and play the piano, but belting out a tune in the shower or in your car likely is just as helpful. Whistling is performing music, too. Getting a group of people together, using social distancing, to play kazoos, rarely ends without laughter, which also is powerful medicine. However you do it, find a way to make music.</p> <h3>2. Build and strengthen bonds with music.</h3> <p>Music has always been a social bonding activity. If you aren't comfortable making your own music, you can make listening more powerful by listening together. With quarantine, this takes creativity. Try listening to a song together on Facetime with a friend or playing music that you and a neighbor enjoy. If you and another person have a song that you share as your special song, call him or her ― or send him or her the song to listen to ― and then call and talk when the song is done. If you are quarantined together, listen together.</p> <h3>3. Improve mood with music.</h3> <p>Music often is linked to some of our deepest and most resilient memories and emotions. If you are feeling down, think back to music you listened to during a happier time. Often this is music from your youth. Whatever this music is, listen to it, and it may lighten the mood. </p> <h3>4. Move to music.</h3> <p>In many cultures, music and dance are closely linked, so much so that one seems incomplete without the other. So listen or perform music and dance. Do it with a partner if you can, but alone will do, and you don't need an audience for this either. We all need to move more than we do, even in normal times. While stuck in quarantine, this is doubly true, and evidence shows that exercise also improves mental health. There are many ways ― and no wrong way ― to move with music. Many places are offering things like online movement and dance classes, and other ways to move to music and connect to people online. You don't need anything fancy. If you can find a way to hear music and move your body to it, then do it.</p> <p>There are many other ways to fit music into your lives. Let my suggestions be motivation for your own creativity. Music has always been a refuge for people during the most difficult times, and it can certainly help during the COVID-19 pandemic.</p> <p>So sing, dance, play and connect to make each day a little better.</p> <p>Get more <a href="/topics/covid-19" target="_self" title="Opens in same window.">tips on managing COVID-19</a> and <a href="/topics/behavioral-health" target="_self" title="Opens in same window.">mental health</a>.</p><img src="/-/media/national-files/images/hometown-health/2023/guitarist-playing-with-people-clapping.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F62322AA8FC558F43E1C1F286D13D0FB" alt="Guitarist playing with people clapping" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Dawn Haller10/12/2020Many people ask whether caffeine can treat or trigger a headache. Learn how your morning cup of joe actually can do both.Does caffeine treat or trigger headaches?<p>Many people ask whether caffeine can treat or trigger a headache. The answer is that caffeine can do both.</p> <h2>Caffeine can provide relief for a headache.</h2> <p>During a headache, blood vessels swell, tighten or go through other changes, causing an increase in blood flow around the brain. This increased blood flow pressures surrounding nerves, which send pain messages to the brain. This brings on the headache.</p> <p>Caffeine has vasoconstrictive properties, meaning that blood vessels narrow to restrict blood flow, thereby alleviating the pain. Also, when caffeine is taken in combination with pain medicines, such as aspirin, ibuprofen or acetaminophen, it increases the absorption and strength of the medication to provide faster relief.</p> <h2>Caffeine can trigger a headache.</h2> <p>When caffeine is consumed regularly, the body becomes dependent on its effects. And because caffeine narrows the blood vessels that surround the brain, when consumption is stopped, the blood vessels enlarge. This causes an increase in blood flow around the brain and pressures surrounding nerves. This can then trigger what is known as a caffeine withdrawal headache. These headaches can last for a couple of weeks because it takes the body a while to adjust to not having caffeine in its system.</p> <h2>What should you do?</h2> <p>Pay attention to how much caffeine you consume and how it affects you. Keep track of when your headaches occur and what seems to help or hinder them. If you have frequent headaches, consider slowly reducing your caffeine intake and consuming it in moderation.</p> <p><em><a href="/providers/kelli-tornstrom-cnp-apnp" target="_self" title="Opens in same window.">Kelli Tornstrom</a> is a nurse practitioner in <a href="/services-and-treatments/neurology" target="_self" title="Opens in same window.">Neurology</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p>C.N.P., A.P.N.P.<p><strong>Education</strong></p> <ul> <li>Master's degree, Nursing, Winona State University via Mayo School of Health Science Clinical Residency Program</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Nurses Credentialing Center as an Adult Gerontological Acute Care Nurse Practitioner </li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Nurse Practitioners</li> <li>American Nurses Association</li> <li>American Academy of Neurologic Nurses</li> <li>American Heart/Stroke Association</li> <li>Sigma Theta Tau International, Kappa Mu Chapter</li> </ul>Tornstrom<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/kelli-tornstrom-cnp-apnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=34D4C89D7DFE89811028AD0FB23FEA58" alt="Kelli Tornstrom, C.N.P., A.P.N.P." width="280" height="280" title="Kelli Tornstrom, C.N.P., A.P.N.P." DisableNVelocity="true" />Kelli<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13191047Kelli Tornstrom, C.N.P., A.P.N.P.1<img src="/-/media/national-files/images/hometown-health/2020/cup-of-coffee-on-coffee-beans.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3D7BA2CDF5BF9E24E27C595745CB99F0" alt="Cup of coffee on coffee beans" width="660" height="370" DisableNVelocity="true" />HeadacheHeadache is pain in any region of the head that feels like a sharp pain, throbbing sensation or dull ache. It may develop gradually or suddenly, and last for minutes or days.Dawn Haller10/29/2020Alcohol sales are up since the start of the COVID-19 pandemic. So if you're reaching for a bottle of wine at the end of the day, how much is too much? Find outHow COVID-19 has changed alcohol use<p>Life has changed dramatically since March when communities began enacting stay-at-home orders to slow the spread of COVID-19. As many restaurants and bars closed, at-home alcohol sales increased, according to data compiled by The Nielsen Company (US) LLC.</p> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/karpyak-victor-m-m-d-ph-d/bio-20054628?mc_id=us&utm_source=newsnetwork&utm_medium=l&utm_content=content&utm_campaign=mayoclinic&geo=national&placementsite=enterprise&cauid=100721&_ga=2.250347974.1145733928.1598371880-2046122319.1596555926" target="_blank" title="Opens in a new window.">Victor Karpyak, M.D., Ph.D.</a>, a Mayo Clinic psychiatrist and addiction researcher, says using alcohol to celebrate or relieve stress is an age-old human trait, but <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/symptoms-causes/syc-20369243" target="_blank" title="Opens in a new window.">overusing alcohol</a> as a coping mechanism during these difficult times has consequences.</p> <h4>Motives for drinking</h4> <p>People may choose to drink for many reasons, but overall motives tend to fall into two main categories: enhance positive feelings or suppress negative feelings. During the COVID-19 pandemic, both motives can play a role in drinking more than usual.</p> <p>"First is related to the stress of dealing with the restrictions of COVID. We have a natural desire to be with friends or visit attractions, or just to get out of your house," says Dr. Karpyak.</p> <p> Drinking suppresses these negative emotions of missing activities or loved ones, and overall feelings of loneliness.</p> <p>The second motive to drink alcohol during this time is that "people are trying to achieve something that has positive connotation during this time," says Dr. Karpyak. People may drink more to enhance the feelings associated with the positive news or artificially create positive feelings.</p> <p>There are gender differences in drinking motives, as well. Men are more likely to drink alcohol to enhance positive feelings, while women are more likely to drink to suppress negative feelings, according to Dr. Karpyak.</p> <h4>Drinking levels</h4> <p>The <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.niaaa.nih.gov/" target="_blank" title="Opens in a new window.">National Institute on Alcohol Abuse and Alcoholism</a> defines moderate drinking as up to one drink per day for women and up to two drinks per day for men. And the overall current <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/Is-your-drinking-pattern-risky/Drinking-Levels.aspx" target="_blank" title="Opens in a new window.">recommendations</a> are no more than 14 drinks per week and no more than four drinks per occasion for men, and no more than seven drinks per week and no more than three drinks per occasion for women.</p> <p>"If it becomes three or four drinks today, and it is, again, three or four drinks tomorrow, then very easily we start to hit above the weeklong threshold. And this is what needs to be an alarming sign," says Dr. Karpyak.</p> <h4>Warning signs</h4> <p>An escalating pattern of drinking may be a potential sign of alcohol abuse and development of addiction, which affects relationships and the body.</p> <h5>Here are common warning signs according to Dr. Karpyak:</h5> <ul> <li>Increased frequency in drinking alcohol</li> <li>Increased alcohol consumption</li> <li>Use despite concerns expressed by others</li> <li>Use despite negative consequences on social or other areas of functioning</li> <li>Use despite behavioral problems, such as acting inappropriately, or putting yourself or others into dangerous situations</li> </ul> <p>The COVID-19 pandemic has changed some social behavior expectations as many traditional in-person social activities have been canceled or limited. "This gives some people a sense that drinking at home is OK, while in other circumstances, these people would have been concerned or received negative feedback due to consequences of their drinking," says Dr. Karpyak. This can lead to some people drinking more than they would have previously.</p> <h4>How to help</h4> <p>If you are concerned about your drinking or a loved one's drinking during the pandemic, there are some things you or your loved one can do:</p> <ul> <li><strong>Get active.</strong><br /> To avoid relying on alcohol to relive pressure, find ways to occupy your mind and time in a productive way, such as exercising, practicing hobbies, or talking with friends and family. "Don't rely on passive entertainment like watching TV," says Dr. Karkyak. "Keep different healthy activities until you find something that is enjoyable." Seek out healthier alternatives for <a href="/hometown-health/speaking-of-health/5-tips-to-manage-stress" target="_self" title="Opens in same window.">managing stress and anxiety</a>.</li> <li><strong>Assess your habits and symptoms</strong>.<br /> Dr. Karpyak recommends online self-assessment tools created by the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.niaaa.nih.gov/" target="_blank" title="Opens in a new window.">National Institute on Alcohol Abuse and Alcoholism</a> to help you determine if the drinking is escalating, and causing distress or harm.</li> <li><strong>Share your concerns</strong>.<br /> Have an honest, clear and direct conversation with your loved one. "Use specifics, facts and evidence to bring this concern to his or her attention," says Dr. Karpyak. "Don't be judgmental. Stick to the facts." If you don't have a trusting relationship with the person using, invite another person who is respected and trusted to address the concern."</li> <li><strong>Talk with a primary care provider.</strong><br /> "Many people carry trust in their primary care providers, and they have knowledge and tools to assess for presence of alcohol abuse, such as tests that detect changes in liver function or increased size in red blood cells," say Dr. Karpyak. "They can deliver this message in a nonjudgmental way based on the facts and facilitate referral for specialist evaluation, if necessary."</li> </ul> <p>If you or a loved one is struggling with alcohol use, do not hesitate to reach out for help during the COVID-19 pandemic.</p><img src="/-/media/national-files/images/hometown-health/2020/hand-holding-alcoholic-drink.jpg?h=370&iar=0&w=660&sc_lang=en&hash=85D0F18B3A83238C173DA8BD4751DE9A" alt="Hand holding alcoholic drink" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller10/12/2022Now more than ever, it's important to schedule flu vaccinations for your entire family. You can help prepare your children for getting a shot with these tips.Preparing kids for a flu shot: Tips to help parents<p>Cold and flu season is approaching, and that means it's time for <a href="/hometown-health/featured-topic/dont-skip-your-flu-shot-this-year" target="_self" title="Opens in same window.">flu shots</a>.</p> <p>The Centers for Disease Control and Prevention and the American Academy of Pediatrics recommend flu shots for children 6 months and older to protect themselves and their friends and family from the flu. There are two options available — a shot or nasal mist — that your family can use to prevent complications from the flu, such as pneumonia and bronchiolitis.</p> <p>The flu shot is safe to administer to your child. It does not cause the flu, but side effects can occur during the first one to two days, including mild soreness where the shot was administered and a mild fever or aching.</p> <p>The virus can be found in your child's nose and throat, and it can be transmitted by anyone. It can spread by kissing, touching and holding the hands of other infected people. The germs can stay on surfaces for many hours, or spread through the air when a person coughs or sneezes.</p> <p>The flu can change from year to year. Therefore, people do not stay immunized for more than a season. It's important to <a href="/hometown-health/speaking-of-health/expect-a-different-flu-season" target="_self" title="Opens in same window.">get the flu shot each year</a> to stay vaccinated for each flu season, which runs from November to April. The flu shot is the most effective means of preventing the flu and its complications.</p> <h2>Honesty and distraction can help</h2> <p>I recommend being honest with your child that an appointment will include a shot. This can be scary for a child, but children do best when they know what to expect. The nurses in the clinic have different options to help with discomfort, including a bee-shaped device that vibrates to distract your child and an ice pack for numbing skin. Other options include a topical anesthetic spray, numbing cream and oral sugar solution for infants.</p> <p>In addition to being honest with kids about needing a shot, bringing something to distract your child may help, such as a favorite video you can pull up on your phone.</p> <p>While I don't always recommend a treat after a flu shot appointment, depending on the child's age, an incentive — like ice cream after an appointment — can work.</p> <p>Our nursing staff is skilled at making kids feel secure and having parents as part of the process. Children will have forgotten all about it within a couple of hours of this little poke.</p> <h2>When is flu season?</h2> <p>Traditionally, flu season peaks in February, with December and March being the second and third most common peak months, respectively. This is why it often feels like flu season drags on, and many people continue to catch and spread the flu.</p> <p>Healthy kids can bounce back faster than adults, but kids in day care or school often get sick more often. While this may build their immune system, it can be hard on families.</p> <p>To stay as healthy as possible, I recommend that families maintain healthy habits, including hand-washing, getting plenty of sleep and eating well — in addition to the flu shot — to help prevent getting sick. This is especially important for specific populations, including infants and young children, pregnant women, the elderly and those with compromised immune systems, such as those treated with chemotherapy or an organ transplant. These groups are at higher risk for flu-related complications.</p> <p>There is no reason not to get the flu shot unless your provider recommends against it. Otherwise, the benefits of the flu shot far outweigh the risk of serious illness.</p> <h2>To avoid the flu:</h2> <ul> <li>Wash your hands and teach your kids to do the same. Wash hands thoroughly and frequently with warm water and soap. Do this before leaving the bathroom, eating or touching your face. A good rule of thumb is to wash hands for 20 seconds — about as long as it takes to sing the ABCs. Learn how to <a href="/hometown-health/speaking-of-health/clean-up-your-hand-washing-skills" target="_self" title="Opens in same window.">clean up your hand-washing skills</a>.</li> <li>Cover your cough with the crook of your elbow, and teach your kids to do the same.</li> <li>Stay home from work or school if you're ill.</li> <li><a href="/hometown-health/speaking-of-health/the-facts-about-vaccinations" target="_self" title="Opens in same window.">Keep vaccines current for your family</a>.</li> </ul> <p>Learn more about <a href="/topics/influenza" target="_self" title="Opens in same window.">flu prevention and treatment</a>.</p> <p><em><a href="/providers/jennifer-johnson-do" target="_self" title="Opens in same window.">Jennifer S. Johnson, D.O.</a>, is a physician in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Obesity management</li> <li>Preventive medicine</li> </ul>D.O.<p>I practice a whole-person approach to medicine, focusing on helping patients achieve health across their lifespan. </p> <p>I grew up in Kansas, and have lived in the Mankato area since 2005. I'm married, have four kids and a dog. When I'm not working, I enjoy cooking and spending time with family.</p><p><strong>Education</strong></p> <ul> <li>Kansas City University Osteopathic Medical School  </li> </ul> <p><strong>Internship</strong></p> <ul> <li>University of Minnesota-Mankato</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, University of Minnesota-Mankato</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Diplomate, American Board of Obesity Medicine</li> <li>Family Practice, American Board of Osteopathic Family Physicians</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Osteopathic Family Physicians</li> <li>American Osteopathic Association </li> <li>Minnesota Medical Association </li> <li>Minnesota Osteopathic Medical Society </li> <li>Obesity Medical Association</li> </ul> <p><strong>Academic Appointments</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Johnson<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jennifer-johnson-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=873658AFB998B5C1BD351A8B228A734B" alt="Jennifer Johnson DO" width="280" height="280" DisableNVelocity="true" />{876CA4AF-3CF4-4F4D-8D4B-5C3EBAEDB74F}Jennifer<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14617781Jennifer Johnson, D.O.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{94B2E140-AEF8-44BA-B6A9-4538B77501BC}|{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}<img src="/-/media/national-files/images/hometown-health/2023/parent-holding-child-with-fall-leaf.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C2CD17BE2D45BC8906D0548D2FFD43DE" alt="Parent holding child with fall leaf" width="660" height="370" DisableNVelocity="true" />InfluenzaInfluenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza, commonly called the flu, is not the same as the stomach "flu" viruses that cause diarrhea and vomiting.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller10/27/2020Surgery often is part of breast cancer treatment plans. Learn about the two main surgical procedures and the reasons why your surgeon may recommend one options over the other for you.Surgical options to remove breast cancer<p>For people diagnosed with breast cancer, surgery will likely be a part of treatment. Breast cancer surgery will remove the tumor and any surrounding area that may be affected. Successful removal of the cancerous tumor during surgery lowers the chance of it spreading and recurring. Breast cancer surgery also can be used in combination with other treatments, such as chemotherapy, endocrine therapy and radiation therapy.</p> <h2>There are two main surgical procedures for breast cancer ― either of which may include removing some lymph nodes:</h2> <h3>Lumpectomy</h3> <p>Lumpectomy is a surgical procedure that removes the cancer or other abnormal tissue from the breast. In this procedure, only a portion of the breast is removed, and a small amount of normal tissue around the lump also is taken to ensure the cancer and any other abnormal tissue is removed. Lumpectomy is also called breast-conserving surgery and is an option to consider if you want to preserve your breast, and it's recommended if the cancer is believed to be small and at an early stage. </p> <h3>Mastectomy</h3> <p>Mastectomy is a surgical procedure that removes the breast. A unilateral mastectomy removes one breast and a bilateral mastectomy removes both breasts.</p> <h4>A mastectomy is recommended if:</h4> <ul> <li>Lumpectomy is not an option or if you had a lumpectomy and the cancer is still present.</li> <li>The tumor is large relative to the size of the overall breast.</li> <li>There are two or more tumors in separate areas of the breast.</li> <li>A breast biopsy identified malignant-appearing calcium deposits throughout the breast.</li> <li>The cancer has returned after completing radiation treatment to the breast.</li> <li>You are pregnant and radiation creates a significant risk to your unborn child.</li> <li>A gene mutation gives you a high risk of developing a second cancer in the breast.</li> <li>You have a connective tissue disease, such as scleroderma or lupus, and will have difficulty tolerating the side effects of radiation.</li> </ul> <p>A newer mastectomy technique, called skin-sparing mastectomy or nipple-sparing mastectomy, can preserve breast skin and allow for a more natural breast appearance following the surgical procedure. Breast reconstruction — surgery to rebuild shape and size to the breast — may be performed at the same time as the mastectomy or later in a separate procedure. New techniques, called oncoplastic surgeries, also can enhance the cosmetic appearance of the breast after surgery.</p> <h3>In this video, Rebekkah Frunzac, M.D., explains how the right surgical approach can minimize scars — and reminders — of your surgery:</h3> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/fHD0krt1z6U" title="Ask Mayo Clinic Health System – Breast Cancer Surgery Cosmetic Options" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <h2>Sentinel lymph node biopsy</h2> <p>Depending on the stage of the breast cancer, the surgeon may recommend doing a sentinel lymph node biopsy during the surgery. Sentinel lymph node biopsy is a common procedure used to evaluate breast cancer to determine if the cancer has spread from the primary tumor location into the lymphatic system.</p> <p>Sentinel nodes are the first few lymph nodes into which a tumor drains. During a sentinel lymph node biopsy, a tracer material is injected to help the surgeon locate the sentinel nodes during the surgery. Once located, they are removed and analyzed in a laboratory. If the sentinel nodes are free of cancer, then it is unlikely the cancer has spread and the removal of additional lymph nodes is not necessary. If the biopsy shows cancer, the physician may recommend removing additional lymph nodes.</p> <p>Determining which surgical procedure is best for you will depend on several factors, including the type of cancer, size and stage of the cancer, and your personal preference. Discuss these factors with your physician to choose the best option for you.</p> <p><a href="/providers/m-kathleen-christian-md" target="_self" title="Opens in same window."><em>M. Kathleen Christian, M.D.</em></a><em>, is a <a href="/services-and-treatments/surgery" target="_self" title="Opens in same window.">surgeon</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Atypical hyperplasia of the breast</li> <li>Breast cancer surgery</li> <li>Breast cysts and lumps</li> <li>Breast duct excision</li> <li>Breast fibroadenoma</li> <li>Breast surgery</li> <li>BRCA gene mutation</li> <li>Ductal carcinoma in situ</li> <li>Gynecomastia (enlarged breasts in men)</li> <li>Male breast cancer</li> <li>Mastectomy</li> <li>Oncoplastic breast surgery</li> <li>Nipple-sparing mastectomy</li> <li>Sentinel lymph node surgery</li> </ul>M.D.<p>I approach each patients concerns with compassion and understanding. Currently, I am a surveyor for the Commission on Cancer and the National Accreditation Program for Breast Centers. This experience with breast cancer care, coupled with the ever-changing advances in medicine, encourages open dialogue between myself and my patients to discuss the best treatment options and a plan moving forward that meets their needs. The surgical team and I deliver care that is based on new and proven techniques backed by research. Our team prides itself on ensuring our patients have quick, easy access to care, and each and every patient receives individualized, focused care leveraging Mayo Clinic's multidisciplinary breast cancer experts.</p> <p>I enjoy spending time with my family in the Coulee Region. I also am an avid bicycler who enjoys the scenic country roads.</p><p><strong>Medical School</strong></p> <ul> <li>University of Kansas Medical School in Wichita</li> </ul> <p><strong>Residency</strong></p> <ul> <li>University of Kansas Medical School in Wichita</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Surgery</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Board of Surgery</li> <li>American College of Surgeons</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Surgery, Mayo Clinic College of Medicine and Science</li> </ul>Christian<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/m-kathleen-christian-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=EFE38D07DF5E7E2D40BE10B08A82E13D" alt="M Kathleen Christian MD" width="280" height="280" DisableNVelocity="true" />{CE7D8545-C15E-4F9C-B392-D9D91D9C6695}M. Kathleen<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>11213574M. Kathleen Christian, M.D.1{0DD9D3C9-86C5-47FC-A2CF-8AEEA4717B70}<img src="/-/media/national-files/images/hometown-health/2020/provider-discussing-breast-cancer-surgical-options.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2F94A42044D77BDA1C77C63311CB0787" alt="Provider discussing breast cancer surgical options" width="660" height="370" DisableNVelocity="true" />Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.SurgeryHaving surgery is a major event in your life. We know this and make every effort to keep you as comfortable as possible, focusing on you as an individual. Our surgeons and staff work as a coordinated team treating a wide variety of illnesses ranging from simple to complex. We offer comprehensive, advanced care and service to every patient.Dawn Haller11/24/2020The joys and stresses of the holidays can lead to overeating. Get seven tips to help you can enjoy your special treats in a healthier way.7 tips for reining in holiday overeating<p>The holidays are a time of celebration, and the foods served during this time can remind us of happy memories and lost loved ones. As a dietitian, I believe in good food and enjoying your holiday experiences. It can be a difficult time if you are on a diet or trying to follow a healthy diet. Coupled with holiday stress and high-calorie foods, it can be difficult to avoid unwanted holiday weight.</p> <p>All is not lost.</p> <h2>Here are 7 things you can do to enjoy your holiday treats in a healthier way:</h2> <h3>1. Don't skip meals.</h3> <p>Skipping meals may seem like a good way to reduce the amount of calories you consume, but is likely to make you eat more food faster when you finally do eat. Make sure to keep your regular meal schedule so your body can trust you to provide.</p> <h3>2. Fill your plate with colors.</h3> <p>Aim to cover half of your plate with colorful, festive fruits and vegetables. This will increase the nutritional value of your meal, help you feel full quickly and decrease the number of calories you consume.</p> <h3>3. Eat slowly, and savor your food.</h3> <p>Don't be too quick to scarf down your food. Learn to savor every bite. Try using every few minutes to focus on a different aspect of your meal. Using all the senses will help you not only enjoy your food more thoroughly, but also extend the time it takes to eat.</p> <h3>4. Appreciate special treats.</h3> <p>Many celebrations occur only once a year and are accompanied with foods that are not available other times of the year. Pick one or two foods that are special for you and take your time to savor those foods. Having a special treat once a year will not make or break your weight, so enjoy a few but skip the rest.</p> <h3>5. Choose drinks wisely.</h3> <p>Many holiday drinks are high in calories or sugar, and it's easy to have multiple drinks without thinking. Stick with low- or no-calorie drinks like water, tea or sparkling water, and reserve your calories for the foods you enjoy instead.</p> <h3>6. Listen to your body's fullness signals.</h3> <p>Pay close attention to how you feel while eating. Eating until we are full does not mean eating until we are sick. Choose to slow down and stop eating when you feel you are getting full. This may even mean waiting a few minutes to see how you feel before finishing your plate or getting second helpings.</p> <h3>7. Pick a holiday food mantra.</h3> <h4>When you are tempted to keep eating simply because the holiday foods are special and taste so good, use these mantras to help:</h4> <ul> <li>I can make this food again anytime I want.</li> <li>The leftovers will be delicious.</li> <li>I choose to enjoy this meal, and I look forward to the same treats next year.</li> </ul> <p>Find additional <a href="/topics/weight-loss-and-bariatric-surgery" target="_self" title="Opens in same window.">healthy weight resources</a> to help you reach your goals.</p> <p><em>By Mayo Clinic Health System staff. </em></p><img src="/-/media/national-files/images/hometown-health/2020/thanksgiving-meal.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3AA832DDF4C0560755A57B903A39282C" alt="Thanksgiving meal with turkey, Brussel sprouts and apple pie" width="660" height="370" title="Thanksgiving meal with turkey, Brussel sprouts and apple pie" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller11/1/2023The average adult consumes more than 4,000 calories during a holiday meal. If you follow a low-cholesterol diet, you still can enjoy foods you love. Here’s how to wisely plan your food choices.Follow a cholesterol-lowering diet during the holidays<p>You may be adding annual celebrations to your calendar this time of the year, and many of those gatherings include delicious foods. Holiday encourage events tend to encourage people to overindulge in holiday goodies that often are high in calories and fat. This is because some foods are only served during the holidays, and you want to experience the tastes and memories associated with holiday favorites.</p> <p>However, what you eat and drink affects your health. This includes your cholesterol and triglyceride levels. If you have a high amount of cholesterol in your blood, your healthcare team may recommend following a cholesterol-lowering diet. <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/symptoms-causes/syc-20350800" target="_blank" title="Opens in a new window.">High cholesterol</a> could cause your heart arteries to harden, a condition called <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/arteriosclerosis-atherosclerosis/symptoms-causes/syc-20350569" target="_blank" title="Opens in a new window.">atherosclerosis</a>, which could lead to <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/syc-20350613" target="_blank" title="Opens in a new window.">coronary artery disease</a>. In addition, hardened arteries may allow a coating called plaque to build up and partially block your arteries. Blocked arteries can lead to low blood flow in the heart and chest pain.</p> <h2>What are triglycerides and cholesterol?</h2> <p>Triglycerides and cholesterol are types of fat, or lipids, which circulate in your blood. Triglycerides store unused calories and provide your body with energy. Cholesterol is used to build cells and certain hormones.</p> <p>Cholesterol is made mainly by the liver. It also can enter your body in the foods you eat that contain animal fat. Foods that come from animals or contain animal fat include meat, egg yolks, lard and dairy products. The type and amount of fat you eat can influence how much cholesterol your body makes. </p> <p>Your body makes <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/triglycerides/art-20048186" target="_blank" title="Opens in a new window.">triglycerides</a> from excess calories, regardless of the calorie source, such as fat, protein or carbohydrates. Triglycerides also are made from excess sugar and alcohol. High triglyceride levels are a risk factor for heart disease.</p> <h2>Lifestyle choices for improving your levels</h2> <h3>Your healthcare team may recommend some of these lifestyle changes to improve your blood cholesterol levels and lower your triglyceride level:</h3> <ul> <li><strong>Eat a plant-based diet.</strong><br /> Eat more high-fiber foods from plants. Choose 100% whole grains, whole fruits and vegetables.</li> <li><strong>Exercise regularly.</strong></li> <li><strong>Get to and stay at a healthy body weight. </strong></li> <li><strong>Limit or avoid trans fats.</strong><br /> Trans fats can raise blood cholesterol.</li> <li><strong>Limit your intake of high-cholesterol foods.</strong><br /> Reduce consumption of foods like egg yolks, organ meats, animal fat and high-fat dairy.</li> <li><strong>Lower your total fat intake.</strong><br /> All oils and fats are high in calories.</li> <li><strong>Lower your saturated fat intake.</strong><br /> Saturated fat can raise blood cholesterol.</li> <li><strong>Replace saturated fats with unsaturated fats.</strong><br /> Unsaturated fats can lower your blood cholesterol levels. Monounsaturated fats are preferred. Polyunsaturated fats are OK.</li> </ul> <h2>Enjoying the holidays</h2> <p><strong> </strong></p> <p>The average adult will consume more than 4,000 calories during Thanksgiving, including many high-fat items that don't align well with a cholesterol-lowering diet. You can still enjoy the foods you love during the holidays, but you can prioritize and plan to spend your calories and fat intake wisely.</p> <p>For example, if stuffing with gravy is your favorite, then cut out green bean casserole or white dinner rolls. In addition, you can celebrate the holiday in a healthier way and lower the effect on your cholesterol by making ingredient substitutions. Your meal still can be bountiful and delicious but lower in calories and fat. </p> <p> </p> <h3>Consider these better choices and what to avoid:</h3> <table class="telerik-reTable-2"> <tbody> <tr class="telerik-reTableHeaderRow-2"> <td class="telerik-reTableHeaderEvenCol-2"><strong>Better Choices</strong></td> <td class="telerik-reTableHeaderOddCol-2"><strong>Avoid</strong></td> </tr> <tr class="telerik-reTableOddRow-2"> <td class="telerik-reTableEvenCol-2">Whole-grain bread</td> <td class="telerik-reTableOddCol-2">Commercial quick breads, such as croissants, canned refrigerated biscuits, pastries and sweet rolls</td> </tr> <tr class="telerik-reTableEvenRow-2"> <td class="telerik-reTableEvenCol-2">Plain fresh or frozen vegetables</td> <td class="telerik-reTableOddCol-2">Vegetables with butter, cream or sauces</td> </tr> <tr class="telerik-reTableOddRow-2"> <td class="telerik-reTableEvenCol-2">Whole fruits</td> <td class="telerik-reTableOddCol-2">Fruits with cream, sauces and dip</td> </tr> <tr class="telerik-reTableEvenRow-2"> <td class="telerik-reTableEvenCol-2">White turkey meat without skin</td> <td class="telerik-reTableOddCol-2">Dark turkey meat with skin on</td> </tr> <tr class="telerik-reTableOddRow-2"> <td class="telerik-reTableEvenCol-2">Fresh cranberry sauce</td> <td class="telerik-reTableOddCol-2">Canned cranberry sauce</td> </tr> <tr class="telerik-reTableEvenRow-2"> <td class="telerik-reTableEvenCol-2">Gravy made from turkey or chicken stock</td> <td class="telerik-reTableOddCol-2">Gravy made from cream or fat drippings</td> </tr> <tr class="telerik-reTableOddRow-2"> <td class="telerik-reTableEvenCol-2">Margarine with liquid oil listed as the first ingredient, such as soybean or canola oil</td> <td class="telerik-reTableOddCol-2">Butter</td> </tr> <tr class="telerik-reTableEvenRow-2"> <td class="telerik-reTableEvenCol-2">Baked goods made with nonfat yogurt or applesauce</td> <td class="telerik-reTableOddCol-2">Baked goods made with saturated fats, such as shortening, coconut oil or stick margarine</td> </tr> <tr class="telerik-reTableOddRow-2"> <td class="telerik-reTableEvenCol-2">Reduced-calorie or fat-free salad dressing</td> <td class="telerik-reTableOddCol-2">Regular salad dressing</td> </tr> <tr class="telerik-reTableEvenRow-2"> <td class="telerik-reTableEvenCol-2">Nonfat frozen yogurt</td> <td class="telerik-reTableOddCol-2">Regular ice cream</td> </tr> <tr class="telerik-reTableOddRow-2"> <td class="telerik-reTableEvenCol-2">Carbonated or flavored water (sugar-free)</td> <td class="telerik-reTableOddCol-2">Sports or soft drinks</td> </tr> <tr class="telerik-reTableEvenRow-2"> <td class="telerik-reTableEvenCol-2">Skin or low-fat (1%) milk</td> <td class="telerik-reTableOddCol-2">Whole or reduced-fat (2%) milk</td> </tr> </tbody> </table> <style type="text/css" id="telerik-reTable-2"> .telerik-reTable-2 strong, .telerik-reTable-2 b { color: #ffffff; font-family: "Open Sans", arial, "sans-serif"; font-weight: 600; } .telerik-reTable-2 { border-collapse: collapse; border: solid 0px; font-family: Tahoma; } .telerik-reTable-2 tr.telerik-reTableHeaderRow-2 { border-width: 1.0pt 1.0pt 3.0pt 1.0pt; margin-top: 0in; margin-right: 0in; margin-bottom: 10.0pt; margin-left: 0in; line-height: 115%; font-size: 11.0pt; font-family: "Calibri", "sans-serif"; width: 119.7pt; border: solid white 1.0pt; border-bottom: solid white 3.0pt; background: #4F81BD; padding: 0in 5.4pt 0in 5.4pt; color: #FFFFFF; } .telerik-reTable-2 td.telerik-reTableHeaderFirstCol-2 { border-width: 1.0pt 1.0pt 3.0pt 1.0pt; border: solid white 1.0pt; border-bottom: solid white 3.0pt; padding: 0in 5.4pt 0in 5.4pt; color: #FFFFFF; } .telerik-reTable-2 td.telerik-reTableHeaderLastCol-2 { border-width: 1.0pt 1.0pt 3.0pt 1.0pt; border: solid white 1.0pt; border-bottom: solid white 3.0pt; padding: 0in 5.4pt 0in 5.4pt; color: #FFFFFF; } .telerik-reTable-2 td.telerik-reTableHeaderOddCol-2 { border-width: 1.0pt 1.0pt 3.0pt 1.0pt; border: solid white 1.0pt; border-bottom: solid white 3.0pt; padding: 0in 5.4pt 0in 5.4pt; } .telerik-reTable-2 td.telerik-reTableHeaderEvenCol-2 { border-width: 1.0pt 1.0pt 3.0pt 1.0pt; border: solid white 1.0pt; border-bottom: solid white 3.0pt; padding: 0in 5.4pt 0in 5.4pt; } .telerik-reTable-2 tr.telerik-reTableOddRow-2 { color: #666666; background-color: #F2F3F4; font-size: 10pt; vertical-align: top; } .telerik-reTable-2 tr.telerik-reTableEvenRow-2 { color: #666666; background-color: #E7EBF7; font-size: 10pt; vertical-align: top; } .telerik-reTable-2 td.telerik-reTableFirstCol-2 { margin-top: 0in; margin-right: 0in; margin-bottom: 10.0pt; margin-left: 0in; line-height: 115%; font-size: 11.0pt; font-family: "Calibri", "sans-serif"; width: 119.7pt; border-top: none; border-left: solid white 1.0pt; border-bottom: none; border-right: solid white 3.0pt; background: #4F81BD; padding: 0in 5.4pt 0in 5.4pt; color: #FFFFFF; } .telerik-reTable-2 td.telerik-reTableLastCol-2 { padding: 0in 5.4pt 0in 5.4pt; } .telerik-reTable-2 td.telerik-reTableOddCol-2 { padding: 0in 5.4pt 0in 5.4pt; } .telerik-reTable-2 td.telerik-reTableEvenCol-2 { padding: 0in 5.4pt 0in 5.4pt; } .telerik-reTable-2 tr.telerik-reTableFooterRow-2 { color: #666666; background-color: #FFFFFF; font-size: 10pt; vertical-align: top; padding: 0in 5.4pt 0in 5.4pt; } .telerik-reTable-2 td.telerik-reTableFooterFirstCol-2 { margin-top: 0in; margin-right: 0in; margin-bottom: 10.0pt; margin-left: 0in; line-height: 115%; font-size: 11.0pt; font-family: "Calibri", "sans-serif"; width: 119.7pt; border-top: none; border-left: solid white 1.0pt; border-bottom: none; border-right: solid white 3.0pt; background: #4F81BD; padding: 0in 5.4pt 0in 5.4pt; color: #FFFFFF; } .telerik-reTable-2 td.telerik-reTableFooterLastCol-2 { padding: 0in 5.4pt 0in 5.4pt; } .telerik-reTable-2 td.telerik-reTableFooterOddCol-2 { padding: 0in 5.4pt 0in 5.4pt; } .telerik-reTable-2 td.telerik-reTableFooterEvenCol-2 { padding: 0in 5.4pt 0in 5.4pt; } </style> <p> </p> <p><em><a href="/providers/ripu-singh-md" target="_self" title="Opens in same window.">Ripu Singh, M.D.</a></em><em>, is a <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiologist</a> in </em><em><a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a></em><em> and </em><em><a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a></em><em>, Minnesota.</em></p><ul> <li>Coronary interventions</li> <li>Peripheral vascular interventions</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Government Medical College</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Cardiovascular Diseases, Mayo Clinic School of Graduate Medical Education</li> <li>Interventional Cardiology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Cardiovascular Diseases and Interventional Cardiology, American Board of Internal Medicine</li> <li>Certification Board of Nuclear Cardiology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Singh<img src="/-/media/shared-files/images/medical-professionals/full/mankato/ripu-singh-md.jpg?h=200&iar=0&w=200&hash=FBAF8064D8820080D862E2166101449E" alt="Ripu Singh MD" width="200" height="200" DisableNVelocity="true" />Ripu<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12673552Ripu Singh, M.D.1<img src="/-/media/national-files/images/hometown-health/2023/thanksgiving-meal.jpg?h=370&iar=0&w=660&sc_lang=en&hash=395207AF0974C03270BA9CCF3614AC3E" alt="Thanksgiving meal" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller1/30/2023Unsure if you have flu or COVID-19? Symptoms can be similar. Find out what to do, and how to self-manage symptoms.What should you do if you have COVID-19 or flu?<p>Most people who get COVID-19 or flu can treat themselves at home and often don't need to see a health care provider.</p> <p>However, if you have COVID-19 or flu-like symptoms, especially if you are at risk of complications, you are encouraged to get tested. That's because COVID-19 and the flu have similar symptoms. </p> <p>You also can be infected with COVID-19 and another respiratory illness at the same time, which is why you can be tested for more than one illness during one appointment at Mayo Clinic Health System.</p> <h2>Common signs and symptoms for COVID-19 and flu include:</h2> <ul> <li>Fever</li> <li>Muscle aches</li> <li>Chills and sweats</li> <li>Shortness of breath or difficulty breathing</li> <li>Dry, persistent cough</li> <li>Tiredness and weakness</li> <li>Runny or stuffy nose</li> <li>Sore throat</li> <li>Headache</li> <li>Vomiting, nausea or diarrhea</li> </ul> <p>Other symptoms of COVID-19 may include a loss of taste or smell and chest pain.</p> <h2>COVID-19 test self-reporting tool</h2> <p>Using a patient portal questionnaire, you can share the results of non-Mayo or at-home COVID-19 tests with your Mayo Clinic Health System care team. With the questionnaire, the Mayo health care team can more promptly complete their assessment to determine if you're eligible for COVID-19 therapy.</p> <p>Find the questionnaire in the COVID-19 section of the patient portal. Click on "COVID-19 Test Results & Vaccine Records," and enter information in the self-tests area.</p> <h2>Whether you have flu or COVID-19 with mild symptoms, there are ways you can manage your symptoms at home:</h2> <ul> <li><strong>Hydrate.</strong><br /> Be sure to drink plenty of liquids, such as water, juice and warm soups, to prevent dehydration. Avoid sugary drinks.</li> <li><strong>Rest.</strong><br /> Catch up on your sleep to help your immune system fight off the infection.</li> <li><strong>Medicate.</strong><br /> Generally, you'll need nothing more than bed rest and fluids. You also may consider an over-the-counter pain reliever to reduce some of the aches associated with flu. If you are infected with flu, your health care provider may prescribe an antiviral medication. If taken soon after you notice symptoms, the medication may shorten your illness by a day or so and help prevent serious complications. If you are infected with COVID-19, you may meet criteria to receive COVID-19 therapeutics.</li> </ul> <h2>When to seek medical care</h2> <p>If your symptoms worsen or fail to improve after three days, contact your health care team. If you have a fever for more than three days or the fever returns after going away, you have worsening shortness of breath or other concerning symptoms, seek medical care.</p> <h3>It's important to take these measures to ensure the viruses don't spread to others around you:</h3> <ul> <li><strong>Wash your hands.</strong><br /> Thorough and frequent hand-washing or cleaning hands using an alcohol-based sanitizer are effective ways to prevent the spread of germs.</li> <li><strong>Contain your coughs and sneezes.</strong><br /> Cover your mouth or nose when you sneeze or cough, and wash your hands after. To avoid contaminating your hands, cough or sneeze into a tissue or into the inner crook of your elbow.</li> <li><strong>Avoid groups of people.</strong><br /> Avoiding groups of people may reduce your chances of infection and spreading to others. If you're sick with the flu, stay home for at least 24 hours after your fever subsides to lessen your chance of infecting others.</li> <li><strong>Wear a mask and practice social distancing.</strong><br /> If you must leave your home, such as to get medication, wear a mask and maintain at least a 6-foot span between you and others.</li> </ul> <p>Once you no longer are infectious, it's important to get vaccinated for COVID-19 and flu. And you can get both shots at the same time. Call your primary care provider, or self-schedule using the Mayo Clinic App or <a href="/patient-online-services" target="_self" title="Opens in same window.">patient portal</a>. A flu shot is recommended for all patients 6 months and older. A COVID-19 vaccination is available for patients 6 months and older.<span style="font-family: 'Open Sans', Arial, sans-serif; color: #131313;"></span></p> <p><em><a href="/providers/muhanad-mohamed-mbbs">Muhanad Mohamed, M.B.B.S.</a>, is an <a href="/services-and-treatments/infectious-diseases" target="_self" title="Opens in same window.">Infectious Diseases</a> physician in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Antimicrobial-resistant bacteria</li> <li>HIV</li> <li>Tropical infectious diseases</li> </ul>M.B.B.S., M.D.<p>In my free time, I enjoy playing soccer with my son, and spending time with family and friends.</p><p><strong>Education</strong></p> <ul> <li>University of Khartoum-Sudan</li> <li>Master of Public Health, University of Minnesota</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Flushing Hospital Medical Center</li> </ul> <p> <strong>Fellowship</strong></p> <ul> <li>Infectious Disease, University of Minnesota</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Internal Medicine, American Board of Internal Medicine </li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Diplomate, American Board of Internal Medicine</li> <li>Member, American College of Physicians</li> <li>Member, Infectious Disease Society of America</li> </ul>Mohamed<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/muhanad-mohamed-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=E8DAAC5AD489945F614D262645BB097C" alt="Muhanad Mohamed, M.D." width="280" height="280" DisableNVelocity="true" />{62FF82AF-675F-49AF-A187-5FC74A60214B}Muhanad<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20722524Muhanad Mohamed, M.B.B.S., M.D.1{C8A905E8-82D3-45FC-9669-A5F09F2EF6CA}<img src="/-/media/national-files/images/hometown-health/2021/self-care-while-sick.jpg?h=370&iar=0&w=660&sc_lang=en&hash=639ED7F285D354766F2A5EB6A66FA671" alt="Person feeling sick, drinking beverage, holding tissue" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),InfluenzaInfluenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza, commonly called the flu, is not the same as the stomach "flu" viruses that cause diarrhea and vomiting.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Immunizations<p>Disease prevention is crucial to your health. Getting vaccinated is one of the best ways to maintain good health, and protect you and those you care about against infectious diseases. Vaccinations offer protection against serious diseases by stimulating the immune system to create antibodies against certain bacteria or viruses.</p><br/><p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/vaccine-guidance/art-20536857" target="_blank" title="Opens in a new window.">Get vaccine guidance from Mayo Clinic</a>, including benefits, safety, side effects and what to know about recommended vaccines for babies, children, teens, adults and during pregnancy. For recommended vaccines based on age, refer to the <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/adult" target="_blank" title="Opens in a new window.">adult</a> or <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/child" target="_blank" title="Opens in a new window.">child and adolescent</a> schedules.</p><br/><p>Review the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/coronavirus-covid-19/history-disease-outbreaks-vaccine-timeline" target="_blank" title="Opens in a new window.">history of infectious disease outbreaks and vaccines timeline</a> for information about major disease outbreaks, epidemics and pandemics, and the impact of vaccines and research.</p>Dawn Haller12/21/2020Despite the benefits of vasectomy, some myths may be holding you or your partner back. Get the truth about the simple procedure.4 common vasectomy myths debunked<p><a rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/vasectomy/about/pac-20384580" target="_blank" title="Opens in a new window.">Vasectomy</a> is a common office procedure for men, with about a half-million vasectomies performed each year. Although there are avenues for reversal, it's primarily considered a form of permanent birth control. As a result of its permanence, many men have questions or concerns before deciding on a vasectomy.</p> <h4>To help you make an informed decision, it's important to debunk some common vasectomy myths:</h4> <h5>Myth: A vasectomy will affect your sexual performance.</h5> <p><strong>Truth:</strong> A vasectomy will not affect libido, or sexual drive, or your testosterone. The purpose of the procedure is to prevent semen travel, which in turn prevents pregnancy. Men have even reported higher sexual satisfaction after a vasectomy.</p> <h5>Myth: A vasectomy will permanently damage your sexual organs.</h5> <p><strong>Truth:</strong> The procedure is directed toward a tube called the vas deferens. The procedure does not involve any other sexual organ or tissue. It is only in extremely rare cases that an injury to the blood supply can lead to the loss of a testicle, which is why it is important to ensure your physician is experienced and skilled.</p> <h5>Myth: A vasectomy will increase your risk of certain cancers or heart disease.</h5> <p><strong>Truth:</strong> There has been no proven link between this procedure and increased risk of cancers or heart disease.</p> <h5>Myth: A vasectomy will cause severe pain.</h5> <p><strong>Truth:</strong> You may feel minor discomfort similar to pulling or tugging during the procedure. Severe pain is extremely rare. After the procedure, localized aching is expected for a few days. Physicians trained to perform vasectomies are well-practiced in providing numbing medication during the procedure. Pain control strategies and medications also are discussed as part of the counseling appointment prior to the procedure appointment.</p> <p>The bottom line: Vasectomy is one of the safest, most effective and most reliable form of permanent birth control.</p> <p>Talk to your <a href="/providers" target="_self" title="Opens in same window.">primary care provider</a> if you are considering a vasectomy. He or she will be happy to answer your questions about this important aspect of your sexual health.</p> <p><em><a href="/providers/trevor-rich-md" target="_self" title="Opens in same window.">Trevor Rich, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/mondovi" target="_self" title="Opens in same window.">Mondovi</a>, Wisconsin.</em></p><ul> <li>Academic medicine and community health education</li> <li>Community nutritional health and preventive wellness</li> <li>Critical access rural clinic and hospital care <ul> <li>Vasectomy counseling and referral service</li> <li>Contraceptive counseling and referral service, OCP prescription management</li> <li>Preconception care & planning, prenatal referral service</li> <li>Wound care and wound management</li> </ul> </li> <li>Rural athletic support</li> <li>Skilled nursing facility medical directorship</li> </ul>M.D.<p>I view my delivery of care to be shared. My role, above all else, is to be a source of evidence-based counseling, such that all my patients feel comfortable with their informed decisions about their health. Patients can expect my undivided attention and eagerness to clarify their questions.</p> <p>I’m a humble family man, who finds purpose in serving my community and neighbors.</p><p><strong>Education</strong></p> <ul> <li>Medical College of Wisconsin-Milwaukee</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Mayo Clinic Family Medicine Residency, Eau Claire</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Clozapine REMS Program</li> <li>MAT, Suboxone Waiver</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians </li> <li>Mayo Clinic Alumni Association</li> <li>Society of Teachers of Family Medicine</li> <li>The National Guard Association of the United States</li> <li>Wisconsin Academy of Family Physicians</li> <li>Wisconsin Medical Society</li> <li>Wisconsin National Guard Association, Inc.</li> </ul>Rich<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/trevor-rich-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=C35BEC1720C4B1DC110D068E43EFF155" alt="Trevor Rich, M.D." width="280" height="280" DisableNVelocity="true" />{DEC439E2-74BD-46D1-94B9-DB111539B3A8}Trevor<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20654405Family Medicine - Trevor Rich MD1{986C767E-E5DE-43F5-957F-B4212DB8E384}|{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}<img src="/-/media/national-files/images/hometown-health/2020/smiling-couple-looking-at-each-other.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2F32456C5D869737D5539C0F82C501BD" alt="Smiling couple looking at each other" width="660" height="370" DisableNVelocity="true" />Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Dawn Haller5/26/2023Chronic pain affects 3 out of 10 people in the U.S. While there is no single cure, a team approach for medical management, movement therapy and learning specific coping strategies can help.Pathways through persistent pain: Tips for managing chronic pain<p>Living with chronic, persistent pain is a fact of life for 3 out of 10 people in the U.S. Chronic pain can develop in various ways, including from injury or illnesses. When pain lasts beyond three to six months, treatment focuses on the central nervous system, which includes the brain and spinal cord. </p> <h2>Pain pathways</h2> <p>Chronic pain can be difficult to pinpoint due to a process called central sensitization. </p> <p>Think of a city with just one highway leading into it. Now imagine that as the city grows, multiple highways are built leading in and out of the city. Similarly with pain, as symptoms develop and expand, it's hard to pinpoint the location of the problem due to the multiple pathways involved.</p> <img height="100%" alt="Pain pathways illustration" width="100%" src="/-/media/national-files/images/hometown-health/2023/pain-pathways-illustration.jpg?sc_lang=en&hash=6A6B8BE07CF75A331AB2FB4021B7A0B5" /> <p>How you act and think in response to pain interacts with the central sensitization process.</p> <h3>Certain factors can magnify the experience of pain, including: </h3> <ul> <li>Stressful life experiences</li> <li>Mental health issues, including depression, anxiety and social isolation</li> <li>Decreased ability to do the things you enjoy doing</li> <li>Overexertion or underexertion </li> </ul> <p>No diagnostic test can show your pain level. It's a subjective, individual experience. Your health care team may ask you to rate your pain level on a scale of 0–10 to help evaluate and document your symptoms.</p> <h2>Coping strategies</h2> <p>There is no single cure for chronic pain. It takes a team approach and involves medical management, movement therapy and learning specific coping strategies.</p> <h3>Let's review some of those strategies:</h3> <ul> <li><strong>Practice breathing exercises.</strong><br /> Inhale slowly through the nose, allow your lungs and belly to expand, then exhale slowly through your mouth and nose.</li> <li><strong>Get moving.</strong><br /> Work with a physical or occupational therapist on appropriate <a href="/hometown-health/speaking-of-health/no-matter-your-age-or-skill-level-its-never-too-late-to-start-weight-training" target="_self" title="Opens in same window.">exercises</a> to gradually retrain your body. Incorporate a gentle stretching program into your routine, such as <a href="/hometown-health/speaking-of-health/yoga-therapy-relieve-pain-manage-stress" target="_self" title="Opens in same window.">yoga</a> or tai chi.</li> <li><strong>Participate in meaningful activities.</strong><br /> The body's natural, feel-good chemicals, called endorphins, are activated by exercise, relaxation techniques and enjoyable experiences. Set aside time each day for a simple activity that is calming or brings you joy.</li> <li><strong>Engage in mindfulness.</strong><br /> Meditation does not have to be fancy or complicated. Allow yourself to <a href="/hometown-health/speaking-of-health/use-mindfulness-to-improve-well-being" target="_self" title="Opens in same window.">focus on the present</a> moment, letting go of any interpretation or judgment. To start, try paying attention to one sensory input at a time, such as hearing or vision.</li> <li><strong>Use moderation and pacing.</strong><br /> Set realistic goals and start by doing one-third of what you think you can do. For more difficult tasks, try setting a timer to remind yourself to take a break.</li> <li><strong>Practice good sleep habits.</strong><br /> Establish regular bed and wake times. Use your bed for <a href="/hometown-health/speaking-of-health/5-ways-to-get-better-sleep" target="_self" title="Opens in same window.">sleep</a> and sex only. Do not spend your day there.</li> <li><strong>Eliminate unhelpful substances.</strong><br /> Smoking restricts blood flow, which prevents healing. Alcohol creates nerve damage over time.</li> <li><strong>Treat related conditions.</strong><br /> Cognitive behavioral therapy with a licensed mental health professional helps decrease symptoms of depression, anxiety, and other mental and physical health concerns.</li> <li><strong>Stay connected to your support system</strong><br /> While it's important to take time for yourself, having family and friends that care about you is important. Although you may want to be left alone during bouts of chronic pain, lean in to support from others.</li> </ul> <p>These self-management tools, along with the appropriate use of over-the-counter and prescription medications, can help reduce the effects of persistent pain.</p> <p>If you have difficulty with pain, speak with your health care team regarding a comprehensive pain treatment plan to help put you back in control of your life.</p> <p>Read more about managing <a href="/topics/back-pain" target="_self" title="Opens in same window.">back pain</a> and <a href="/topics/stress-management" target="_self" title="Opens in same window.">stress</a>, and <a href="/topics/exercise-and-fitness">staying active</a>.</p> <p><a href="/providers/monica-foster-phd" target="_self" title="Opens in same window."><em>Monica Foster, Ph.D.</em></a><em>, is a psychologist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin. </em></p><ul> <li>Chronic pain and illness</li> <li>Insomnia and sleep disorders</li> <li>Smoking cessation</li> <li>Weight management</li> </ul>Ph.D.<p>As a clinical health psychologist, I work at the intersection of mental and physical health. What affects the mind has an impact on the body and vice versa. My approach is holistic and evidenced-based, and I listen to my patient's stories with compassion, seeking to understand the unique circumstances that have brought them to my office. I also recognize that many of my patients, who are trying to manage chronic pain or illness, need a sense of hope, and I work to help them find those possibilities.</p> <p>I grew up in Southern California and have lived in Northern Colorado for four years prior to moving to this area. I enjoy time with my family, time with my dogs, and trying new things. I recently took up cross-country skiing and am looking forward to learning how to play pickleball. I also enjoy stand-up paddleboarding and dancing. Reading and photography are my more relaxing hobbies.</p><p><strong>Education</strong></p> <ul> <li>University of Mississippi School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li> Clinical Psychology, Veterans Affairs Medical Center</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Behavioral Medicine, Kaiser Permanente</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Lifestyle Medicine</li> <li>Association of Behavioral and Cognitive Therapy</li> <li>Health Psychology, American Psychological Association</li> <li>Rehabilitation Psychology, American Psychological Association</li> </ul>Foster<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/monica-foster-phd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=D6B9218B2338D32DDE18DBBB9504E925" alt="Monica Foster, Ph.D." width="280" height="280" DisableNVelocity="true" />Monica<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30237684Monica Foster PhD1{94B2E140-AEF8-44BA-B6A9-4538B77501BC}|{EAC4F099-8A2B-4C7A-8911-5AF0769EADA7}|{B98A8ABA-9382-4804-A585-EA5B53B1D179}|{1903C77E-B711-48A8-9BB1-1CB5B9B8DD8E}|{C0BE921F-E11C-4DE7-A6CD-37511AB9685B}<img src="/-/media/national-files/images/hometown-health/2023/person-holding-wrist-with-hand.jpg?h=370&iar=0&w=660&sc_lang=en&hash=286D3C1AFA86D8CDCD5D0CFDF525551A" alt="Person holding wrist with hand" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.Pain ReliefApproximately 50 million people in the U.S. live with chronic pain. If you experience chronic pain, you're not alone. Learn about the ways to deal with painful disorders, from at-home solutions to drug treatments, injectable or implantable therapies to surgery.Dawn Haller12/21/2020Winter delivers a double whammy of cold temperatures and holiday stress. Instead of reaching for comfort food to cope, try these 8 tips for maintaining a healthy weight.8 tips to maintain weight during winter holidays<p>Midwest winters deliver a double whammy of negative windchill and holiday stress, causing even those who are strong-willed to reach for comfort food. But don't give up. It is possible to maintain your weight during holidays with some planning.</p> <h4>Give yourself the gift of health this holiday season by following these 8 tips:</h4> <h5>1. Stay active.</h5> <p>Your best intentions to forgo just one more holiday cookie quickly fall to the wayside; yet, the bathroom scale can't be ignored for long. Regular exercise is fundamental to maintaining a healthy weight, but motivation can be lacking when holiday indulgences beckon. The key is to choose and incorporate fun aerobic activities into our holiday plans, such as ice skating or sledding with your family. If you prefer a warm fire to the cold winds, there are plenty of indoor physical activities options, including exercising using cardiovascular equipment, exercise-based video games or DVDs.</p> <h5>2. Eat a balanced diet.</h5> <p>Ensure a healthy lifestyle by combining regular exercise with a balanced diet, even during the holidays. Make sure you have fresh fruits and vegetables available for snacking, and toss out or limit the treats in your pantry that are high in cholesterol, fat, salt or sugar. Your friends and family may wonder why you have so much energy, and soon they'll also be on the healthy bandwagon.</p> <h5>3. Seek complex carbohydrates.</h5> <p>Carbohydrates get a poor rap, but not all are bad. Avoid processed and refined carbohydrates, like cookies, soft drinks and white bread. Those are known as simple carbs and can increase your insulin levels and lead to excess pounds. In contrast, seek complex carbohydrates, also known as good or complex carbs, during the holidays. These are a great source of fiber, which is essential for maintaining healthy cholesterol and blood sugar levels, as well as aiding with regular bowel movements.<span style="color: green;"> </span>Examples of complex carbohydrates include whole-grain pastas and breads, brown rice, fruits, vegetables and legumes.</p> <h5>4. Jettison the juice.</h5> <p>The truth is that most juices contain added sugar and provide unnecessary calories to your diet. Adults and children benefit more from fresh fruits and vegetables, which offer natural goodness to satisfy a sweet tooth. Reconsider fruit smoothies, too, as they may have 300 to 500 calories per serving. You may want to choose satisfying fruit that is high in fiber instead and save those calories for a special splurge later.</p> <h5>5. Make time for breakfast.</h5> <p>A balanced breakfast is an integral part of any daily diet. For kids, breakfast is necessary to provide energy for the brain and body. Skipping breakfast, or any meal for that matter, doesn't help adults either. Research has shown that people who eat healthy foods frequently during the day have a higher metabolism and better appetite control.</p> <h5>6. Don't skimp on calcium.</h5> <p>Calcium is essential to bone health and heart function. Milk and other dairy products are great sources of calcium, as well as potassium and other vitamins and minerals necessary for overall health. Many low-fat or fat-free dairy products, along with fortified nondairy alternatives, are on the market. <span style="color: black;">However, </span>some low-fat dairy products, such as dessert-flavored yogurts, may have significant amounts of added sugar and calories. If you are watching your sugar or carbohydrate intake for weight reduction, select lower-fat Greek yogurt instead. Typically, this option offers lower sugar content with up to twice the protein. That's an easy, healthy swap.</p> <h5>7. Mix up your protein options.</h5> <p>Protein is a key part of any diet. It can help keep you feel full, build muscle and help your body repair cells. But don't limit your protein choices to only red meat. During the holidays, you can choose from a variety of low-fat protein foods, including seafood, lean poultry, eggs, beans, peas, soy products, nuts and seeds. Making chili with more beans and less meat is a great way to incorporate beans into your diet on a cold evening.</p> <h5>8. When in doubt, ask an expert.</h5> <p>Before you start a new exercise or nutrition program, it's always a good idea to schedule an appointment with your local health care team. A registered dietitian can provide nutritional guidance to address your individual needs.</p> <p><em>Anne Harguth is a registered <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">dietitian nutritionist</a> in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2020/healthy-bowl-of-food.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B2D012BB94C899E2EAF2E93DD1A47772" alt="Healthy bowl of food" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller12/7/2020If you or your child suffers from ADHD, anxiety or depression, it can be trial and error to find the right medicine. Learn how pharmacogenomic testing can get the right drug for the right patient at the right dose.Pharmacogenomics: Getting the right drug<p>One of the hardest things for me in my practice is determining which medication would be the best choice for a patient. There often isn't a precise equation that can inform me which medication is the right choice.</p> <p>Trying to be as conscientious as I can be, I do wonder, "Did I choose the best option for my patient?" I remember my professors from medical school telling me there is an art and a science to medicine, and that it is not black and white. However, science advances, and one of the benefits of this is <a rel="noopener" href="https://www.mayo.edu/research/centers-programs/center-individualized-medicine/patient-care/pharmacogenomics" target="_blank" title="Opens in a new window.">pharmacogenomic testing</a>.</p> <h2>How pharmacogenomic testing is performed</h2> <p>Pharmacogenomic testing at Mayo Clinic is performed by collecting a swab of your cheek. The test looks at your DNA for a number of different genes that code proteins that influence how medications are processed in the liver or at enzymes that influence how your body processes medications. A report is generated, and with the help of a clinical pharmacist, your health care team can consider that when choosing medications.</p> <p>There can be a gap between what your health care team thinks a medication can do for you and what it does, even if you take it according to your provider's directions. Sometimes this gap can be explained by how your body processes that drug. It can build up or never really reach effective levels, depending on your genetic composition.</p> <h2>Where pharmacogenomic testing can help</h2> <p>I find pharmacogenomic testing can help determine the best medications for <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/adult-adhd/symptoms-causes/syc-20350878" target="_blank" title="Opens in a new window.">attention deficit hyperactivity disorder</a>, especially in children, as well as <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961" target="_blank" title="Opens in a new window.">anxiety</a> and <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007" target="_blank" title="Opens in a new window.">depression</a>.</p> <p>By ordering pharmacogenomic testing, your provider can determine if a medicine isn't right for you before prescribing it. Why take a medicine that isn't likely to be effective or will cause side effects? Why start a child on a medicine, like a stimulant, when there isn't evidence that it will be more effective than other alternatives?</p> <p>There are other areas where I have found it beneficial to use pharmacogenomic testing for my patients. These include optimizing treatment of acid reflux, as some people churn through the usual medications much quicker. Therefore, we can adjust the dosing frequency. I also have seen the benefit when treating heart conditions by knowing which prescriptions will get appropriately processed.</p> <p>Every time I have ordered pharmacogenomic testing, I have seen a clinically significant variant in a gene that could affect my treatment choices. In a large study population, the rate of clinically significant variants in at least one test was over 90%. If I can avoid trial and error, reduce your rate of side effects, help get a medication that is more likely to be effective or potentially get you feeling better sooner, then that is worth doing.</p> <p><em><a href="/providers/troy-benson-md" target="_self" title="Opens in same window.">Troy Benson, M.D.</a> is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><ul> <li>Integrating new technologies when appropriate to practice</li> <li>Rural medicine and the close relationship it builds with patients and community</li> <li>Optimization of health to prevent illness</li> <li>Vaccinations as an important part of overall health</li> </ul>M.D.<p>I view my delivery of care in multiple ways:</p> <ul> <li> I try to do my best to value your trust in me and value your resources.</li> <li>I don't believe in telling you what you need to do — I will provide you with information so you can make the best choice.</li> </ul> <p>On a personal note, I grew up on a farm in West Central Minnesota. I now live near Waseca with my wife and children. In my spare time, I like to read, enjoy Mediterranean food and get out in the fresh Minnesota air.</p><p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>University of Minnesota Mankato Family Residency</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Benson<img src="/-/media/shared-files/images/medical-professionals/full/mankato/troy-benson-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=41000627DB1DA9D0C1982B710F6A6AFB" alt="Troy Benson MD" width="280" height="280" DisableNVelocity="true" />{BFA1DE9B-0A97-41E3-8BF9-35440B5EDE22}Troy <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15590062Troy Benson, M.D.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}<img src="/-/media/national-files/images/hometown-health/2020/medications-above-pill-bottle.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CE7C2809DB436EB2F713B822DE606F6F" alt="Medications above pill bottle" width="660" height="370" DisableNVelocity="true" />Medication ManagementNearly 70% of Americans take at least one prescription drug, and more than half take two.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller10/20/2021Intrauterine devices (IUDs) are the most commonly used long-acting reversible contraception method worldwide. Here are answers to 5 common questions about them.Troubleshooting your IUD<p>Intrauterine devices (IUDs) are the most commonly used long-acting reversible contraception method worldwide. The device is a T-shaped plastic frame that's inserted into the uterus, where it either releases a type of the hormone progestin (hormonal IUD) or produces an inflammatory reaction that is toxic to sperm and eggs, preventing pregnancy (copper IUD).</p> <p>They provide a nonsurgical option for pregnancy prevention that is almost as effective as surgical sterilization. Today's IUDs are highly efficient, safe, easy to use and cost-effective.</p> <h3>Here are 5 FAQ about issues related to using IUDs:</h3> <h4>1. What if the IUD moves?</h4> <p>It is uncommon for an IUD to move. If an IUD moves, it could result in some increased menstrual cramping or change in menstrual bleeding. There also is a small possibility that it could result in some discomfort during intercourse. If these symptoms occur, you should be evaluated by your health care provider.</p> <h4>2. What if the IUD comes out?</h4> <p>The risk of IUD expulsion is 3–6% for levonorgestrel IUD and 3–10% for copper IUD. If your IUD comes out, you should see your health care provider to discuss replacement versus changing to another form of contraception.</p> <h4>3. What if I do not have my period for a long time and then suddenly I have my period again?</h4> <p>Approximately half of women with a hormonal IUD will stop having their menstrual cycles. It is common for some women to have irregular, light menstruation with a hormonal IUD. If you have not had a menses for a prolonged period of time and then suddenly you resume your menses, you should see your health care provider.</p> <h4>4. What if I can't find the IUD strings?</h4> <p>You should check your IUD strings regularly. It is common for IUD strings to get pulled up inside the uterine cavity, and this is the most common cause for not being able to feel the IUD strings. If you cannot feel the IUD strings after several attempts, you should be evaluated by your health care provider.</p> <h4>5. Can I remove the IUD by myself?</h4> <p>You are unlikely to cause harm if you try to remove an IUD by yourself, but only about 20% of women who try to remove their IUDs at home are successful. The biggest factor in success is the length of the IUD strings with longer strings making the process easier and shorter making it more difficult. If you are unable to feel the strings or get traction, you are unlikely to successfully remove your IUD. Talk with your health care provider if you have questions or are considering removing your IUD.</p> <p>Remember that IUDs are intended to remain in place up to five years, so it is unlikely that you need to remove it yourself unless you want to become pregnant.</p> <p><em><a href="/providers/okechukwu-osuebi-md" target="_self" title="Opens in same window.">Okey Osuebi, M.B.B.S.</a>, is an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a>, Minnesota.</em></p><ul> <li>Fertility</li> <li>Hysterectomy</li> <li>Hysteroscopy</li> <li>Minimally invasive surgery</li> <li>Obstetrical care</li> <li>Preconception counseling</li> <li>Vulvar diseases</li> <li>Women's health</li> </ul>M.D.<p>My guiding philosophy is the need of the patient comes first. I strongly believe in patient-centered care that aims to provide the best care through collaborative efforts with the patient being an integral part of the decision making process. Patient education is an integral part of my practice.</p> <p>I enjoy travelling, discovering and learning about new places and cultures, being outdoors and reading.</p><p><strong>Education</strong></p> <ul> <li>University of Nigeria College of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Obstetrics-Gynecology, Howard University Hospital</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Obstetrics and Gynecology, American Board of Obstetrics and Gynecology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Obstetricians and Gynecologists</li> <li>Fellow, American Board of Obstetrics and Gynecology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Obstetrics and Gynecology, Mayo Clinic School of Medicine and Science</li> </ul>Osuebi<img src="/-/media/shared-files/images/medical-professionals/full/fairmont/okechukwu-osuebi-md.jpg?h=280&iar=0&w=280&hash=4F2C4FB876EE0180B8F0A9CDABEE140A" alt="Okechukwu Oseubi M.D." width="280" height="280" DisableNVelocity="true" />{565FE410-796E-4B7A-A005-C8951C6BAF2A}Okechukwu<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15593614Okechukwu Osuebi, M.D.1{54693F31-87AF-4B21-91DB-1DEC1E21F878}|{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}<img src="/-/media/national-files/images/hometown-health/2020/window-reflection-gazing-outside.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F1A26C1CC07CD9E7C769B0B493C23C75" alt="Woman's reflection on window as she is gazing outside" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller8/29/2023Vaccines have prevented millions of cases of infectious diseases like smallpox, polio and measles. Read why vaccines are the best defense against certain diseases, and get answers to common questions.Vaccine safety: Answers to 6 common questions<p>Vaccines have been used for decades to protect people against preventable infectious diseases like smallpox, polio, measles and whooping cough. The Centers for Disease Control and Prevention (CDC) estimates that 472 million illnesses were prevented through the vaccination of children born between 1994 and 2021.</p> <p>While vaccines are the best defense against certain diseases, you may have questions about vaccines and vaccine safety.</p> <h2>Here are answers to six common questions about vaccines:</h2> <h3>1. What are vaccines?</h3> <p>Vaccines help your immune system fight infections faster and more effectively. They are made of small amounts of weak or dead germs. When you get a vaccine, it sparks your natural immune response, helping your body fight off and remember the germ so it can attack it if the germ invades again. Vaccines provide long-lasting immunity to serious diseases without the risk of serious illness.</p> <h3>2. Do vaccines work?</h3> <p>Before a vaccine is recommended for use in the U.S., the Food and Drug Administration (FDA) ensures it works and is safe.</p> <p>Since vaccines were invented, the number of people who get sick or die from vaccine-preventable diseases has dropped significantly. Childhood illnesses and deaths in the U.S. also have decreased significantly due to vaccines given in childhood.</p> <h3>3. Are vaccines safe?</h3> <p>All vaccines must be approved for licensing by the FDA before they can be used. FDA regulations for the development of vaccines help ensure their safety, purity, potency and effectiveness. Before a vaccine can be approved, highly trained FDA scientists and doctors evaluate the results of studies on the safety and effectiveness of the vaccine, and inspect vaccine manufacturing sites. These evaluations follow extensive testing by a vaccine's manufacturer.</p> <p>The FDA also requires that vaccines undergo three phases of clinical trials with human subjects before they can be licensed for use. After the vaccine is licensed, the FDA and CDC continue monitoring it for safety.</p> <p>The U.S. has the safest vaccine supply in its history, according to the CDC. Its long-standing vaccine safety system ensures vaccines are as safe as possible. <a rel="noopener" href="https://nam12.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cdc.gov%2Fvaccine-safety-systems%2Fabout%2Fmonitoring.html&data=05%7C02%7CHaller.Dawn%40mayo.edu%7C8fe33770fe144b1860b908dd0810fe6f%7Ca25fff9c3f634fb29a8ad9bdd0321f9a%7C0%7C0%7C638675591263163916%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=Cd97GBNZmU5UjVDLnzU6V%2FBNVN5VdYKtmA23dUIzQBo%3D&reserved=0" target="_blank" title="Opens in a new window.">Learn more about how the vaccine safety process works</a>.</p> <h3>4. Is natural immunity better than vaccination?</h3> <p>A natural infection might provide better immunity than vaccination, but serious risks exist. For example, a natural chickenpox, or varicella, infection could lead to pneumonia or encephalitis, a serious brain infection. A natural polio infection could cause permanent paralysis. A natural mumps infection could lead to deafness. A natural chickenpox or measles infection in a pregnant woman could lead to the development of serious congenital disabilities in her unborn baby or even to a miscarriage. Vaccination can help prevent these diseases and potentially severe complications.</p> <h3>5. Who do vaccines protect?</h3> <p>Vaccines don't just protect you. They also protect the people around you.</p> <p>Germs can quickly travel through a community and make many people sick. If enough people get sick, it can lead to an outbreak or a pandemic. But when enough people are vaccinated against a disease, the germs can't travel as easily from person to person, and the entire community is less likely to get the disease.</p> <p>That means even people who can't get vaccinated, such as those with weak or failing immune systems, will have some protection from getting sick. And there's less chance of an outbreak or pandemic because it's harder for the disease to spread.</p> <p>For example, measles spreads through the air when a person infected with the disease coughs or sneezes. According to the CDC, measles is highly contagious, and 9 out of 10 people exposed to an infected person could become infected if not protected through vaccination.</p> <h3>6. Do vaccines have side effects?</h3> <p>While vaccines can cause side effects, most are rare, mild and short-lived. In rare cases, a vaccine can cause a serious problem, such as a severe allergic reaction. Via the Vaccine Adverse Event Reporting System, the CDC and FDA track serious reactions and events related to vaccines. This is a national early-warning system to detect possible vaccine safety issues in the U.S. Anyone can report an event to the Vaccine Adverse Event Reporting System, including patients and healthcare professionals. This information is used to ensure vaccine safety in the U.S.</p> <p>Talk to your healthcare team if you have questions or concerns about vaccines.</p> <p><em>Lisa Hayes, M.D., is a physician in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2023/parent-clipping-bike-helmet-on-child.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D6303984966449AF4BE06E485174B16E" alt="Parent clipping bike helmet on child" width="660" height="370" DisableNVelocity="true" />Immunizations<p>Disease prevention is crucial to your health. Getting vaccinated is one of the best ways to maintain good health, and protect you and those you care about against infectious diseases. Vaccinations offer protection against serious diseases by stimulating the immune system to create antibodies against certain bacteria or viruses.</p><br/><p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/vaccine-guidance/art-20536857" target="_blank" title="Opens in a new window.">Get vaccine guidance from Mayo Clinic</a>, including benefits, safety, side effects and what to know about recommended vaccines for babies, children, teens, adults and during pregnancy. For recommended vaccines based on age, refer to the <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/adult" target="_blank" title="Opens in a new window.">adult</a> or <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/child" target="_blank" title="Opens in a new window.">child and adolescent</a> schedules.</p><br/><p>Review the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/coronavirus-covid-19/history-disease-outbreaks-vaccine-timeline" target="_blank" title="Opens in a new window.">history of infectious disease outbreaks and vaccines timeline</a> for information about major disease outbreaks, epidemics and pandemics, and the impact of vaccines and research.</p>Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller1/19/2021Short-term bouts of dizziness or vertigo affect about one-third of Americans. Learn about the causes and 5 common misconceptions of these sensations.5 common misconceptions about vertigo, dizziness<p>Many adults have experienced dizziness. It could have occurred after standing up too quickly, after a carnival ride, after taking a medication or during a migraine. Many body systems, including your muscles, bones, joints, eyes and the inner ear, must work normally for you to have normal balance. When these systems aren't functioning well, you can experience balance problems.</p> <p>About one-third of Americans <span style="color: #333333;">at some point</span> experience short-term bouts of feeling foggy, unsteady and lightheaded or feeling a spinning sensation. However, if these sensations recur or affect your life, it is time to talk with your health care provider.</p> <h4>Vertigo vs. dizziness</h4> <p>First, it is important to outline the differences between vertigo and dizziness. While these words are often used interchangeably, they describe different sensations. Dizziness is the feeling of being lightheaded, foggy or unsteady. Vertigo, which is less common than dizziness, is an overall spinning sensation.</p> <h4>Causes of vertigo and dizziness</h4> <p>Several conditions can cause balance problems, and these problems are usually related to a specific sign or symptom. Your health care team can identify the causes of your symptoms.</p> <p>The most common cause of vertigo is when calcium crystals in your inner ear become dislodged from their normal position. This is called benign paroxysmal positional vertigo. Other causes of vertigo include inflammation of the nerves in your inner ear, migraine, head injury, Meniere's disease, noncancerous tumor or motion sickness.</p> <p>Often, the feelings of faintness or lightheadedness are caused by a significant drop in blood pressure, such as if you stand or sit up too quickly. Cardiovascular disease is another common cause.</p> <p>Joint, muscle or vision problems, or nerve damage to your legs, frequently cause feelings of unsteadiness. Other causes could include medications you take, abnormalities in your inner ear or a neurological condition, such as Parkinson's disease.</p> <p>Finally, dizziness can be caused by medications, abnormalities in your inner ear or psychiatric disorders. It also can occur if you are hyperventilating or breathing rapidly.</p> <h4>Common misconceptions</h4> <h5> These conditions often are misunderstood. Here are some common misconceptions about vertigo and dizziness:</h5> <ol> <li><strong>Dizziness is always related to ear crystals.</strong><br /> While benign paroxysmal positional vertigo is a common cause of vertigo, it is not associated with symptoms of dizziness. There are many other potential reasons for spells of dizziness.</li> <li><strong>Home remedies, like performing the </strong><a rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/canalith-repositioning-procedure/about/pac-20393315" target="_blank" title="Opens in a new window."><strong>canalith repositioning procedure</strong></a><strong> or flushing your ears, will fix the problem.</strong><br /> Not only can this be harmful, it can cause more problems. Attempting to reposition crystals without instruction from your health care provider can cause the crystals to be moved incorrectly. There have been instances where patients have given themselves a concussion during the process or damaged their eardrums from flushing liquid into their ears.</li> <li><strong>Dizziness is all in your head.</strong><br /> Unfortunately, some people are told that their symptoms of dizziness or vertigo are not real or a result of mental illness. They are given advice to ignore it, and it will go away. Long-term dizziness and vertigo should not be ignored. Rather, a health care provider should treat these conditions.</li> <li><strong>Antihistamines, such as meclizine, solve dizziness.</strong><br /> Meclizine is used to prevent and control nausea, vomiting and dizziness caused by motion sickness. It works to block the signals to the brain that cause these symptoms. However, if you have recurring vertigo or dizziness, taking antihistamines is not a good long-term solution. Meclizine can make you feel drowsy, which results in many people falling asleep until the episodes are over. In this situation, the medication is covering the symptoms, but it is not treating the condition.</li> <li><strong>You just need to deal with this because there are no long-term treatment options.</strong><br /> Recurring vertigo or dizziness can significantly affect your life, such as missing social activities, or disrupting your abilities to drive or work. There is hope. Work with your health care team to identify the correct treatment option for you.</li> </ol> <p>If you experience sudden vertigo with a decrease in hearing or ringing in your ear, seek emergency medical treatment. These are symptoms of sensorineural hearing loss, an inflammatory disorder probably caused by a virus that affect the nerves in the balance and hearing portions of your inner ear.</p> <p><em><a href="/providers/mindy-zenke-dnp" target="_self" title="Opens in same window.">Mindy Zenke</a> is a nurse practitioner in <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">Ear, Nose & Throat</a> (ENT/Otorhinolaryngology) in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, <a href="/locations/sparta" target="_self" title="Opens in same window.">Sparta</a> and <a href="/locations/tomah" target="_self" title="Opens in same window.">Tomah</a>, Wisconsin.</em></p><ul> <li>Chronic ear disease</li> <li>Chronic sinusitis</li> <li>Ear tubes/tympanostomy tubes</li> <li>Head and neck cancer (lip, mouth, tonsil, throat, voice)</li> <li>Hearing loss</li> <li>Nasal polyps</li> <li>Nose and sinus disease</li> <li>Salivary gland/parotid</li> <li>Tonsillectomy and adenoidectomy</li> </ul>CNS, D.N.P., A.P.N.P.<p>I deliver individualized care to each of my patients and try to build a positive relationship with each of them, listening to their individual concerns. I run a specialized dizziness clinic where my goal is to identify potential causes, triggers and improve outcomes and quality of life for these patients.</p> <p>I live with three of my children and have one grown son in college. I enjoy watching my children play football, hockey and baseball for Aquinas, and watching my daughter dance for Nicole’s School of Dance and gymnastics at PEG.</p><p><strong>Education</strong></p> <ul> <li>Doctorate of Nursing Practice, Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Adult Clinical Nurse Specialist</li> <li>Advanced Practice Nurse Prescriber</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Otorhinolaryngology, Mayo Clinic College of Medicine and Science</li> </ul>Zenke<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/mindy-zenke-cns-apnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=98EBE83DD10C3358E147F35238FB2ECA" alt="MIndy Zenke, CNS, A.P.N.P." width="280" height="280" DisableNVelocity="true" />Mindy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14774160Mindy Zenke, CNS, D.N.P., A.P.N.P.1{18E5E65E-45C8-4C48-BD32-A914794E2AA4}<img src="/-/media/national-files/images/hometown-health/2021/spinning-bleary-upward-view-of-trees.jpg?h=370&iar=0&w=660&sc_lang=en&hash=87896553D51E802029FE38B7ACB8174D" alt="Spinning, bleary upward view of trees and sky" width="660" height="370" DisableNVelocity="true" />Ear HealthAn audiologist specializes in evaluating and treating people of all ages with hearing loss, dizziness and balance disorders. Specialty audiology consultation is available for assessment and treatment of hearing loss, tinnitus, dizziness and balance disorders.Dawn Haller4/15/2022The best time to make an advance care plan is now. Starting a conversation about advance health care planning can be challenging, but it’s important. Here's what you need to know to get started.Now is the right time for advance directives<p>The best time to make an advance care plan is now. The COVID-19 pandemic has shown that the future can change in a second and highlighted the importance of having plans in place to navigate the unknown. One of the best ways to document your plans is through an advance directive.</p> <h2>What is an advance directive?</h2> <p>An advance directive is a legal form that tells your health care teams what kind of care you want if you are too ill to express yourself. Anyone over 18, regardless of state of health, can complete an advance directive.</p> <p>One type of advance directive, a power of attorney for health care, is preferred because it makes your care wishes known and designates a person to make decisions for you if you are unable to speak for yourself. In some states, this responsibly automatically is given to family members. In other states, like Wisconsin, it is not automatically assigned. The person you appoint is called your health care agent.</p> <p>A power of attorney for health care form gives your designated health care agent the right to make decisions on your behalf. Without the form, even a spouse may need to attain legal guardianship to make health care decisions for a loved one. Going through the legal system adds time and money to an already stressful situation. This form does not allow your health care agent to make business or financial decisions on your behalf, and it does not allow for specific decisions about your mental health.</p> <h2>Who can be your health care agent?</h2> <p>Picking a health care agent is important. Your health care agent's role is to work with your medical team and act on the wishes you outlined in your advance directive.</p> <p>Your health care agent can be anyone, and this choice is not limited to your family members. Also, your health care agent does not need to live near you. Health care organizations connect with people across the country over the telephone or using videoconference technology every day. The most important part is to select a health care agent who you trust to follow your outlined wishes.</p> <h2>Why is now a good time to complete an advance directive?</h2> <p>Since the start of the pandemic, the number of young, healthy adults interested in completing the necessary paperwork for an advance directive has increased. Most people know someone who contracted the virus, and many people know others who were hospitalized or died from the virus.</p> <p>The first step is to talk with your primary care provider who can direct you to the right resource at your clinic. Social workers and advance care planning facilitators are available to discuss the process with you over the telephone or in person at the clinic.</p> <p>Each advance directive document must be signed by two witnesses. There are multiple ways to legally secure the necessary witness signatures.</p> <p>Starting a conversation about advance health care planning can be challenging. Yet you may find that your loved ones are more open to the conversation now than they were a year ago. You can free your loved ones of any feelings of guilt or eliminate any confusion during an emergency by having these conversations and your advance directive in place.</p> <p><em>Gina Zumach is a social worker in <a href="/locations/la-crosse">La Crosse</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2022/middle-aged-person-backpacking.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F915FE1DD0434A183F6B6618668D7B21" alt="Middle aged person backpacking" width="660" height="370" DisableNVelocity="true" />AgingLife expectancy is 75 for males and 80 for females according to the National Center for Health Statistics. We'll help you keep you informed about potential issues with aging, and steps you can take to maintain your health and keep active.HospiceThe Hospice program believes that the highest quality of living is achieved when the family unit and Hospice team together offer hope, opportunity, support, presence, individualized care, comfort and encouragement.<br/><br/>Palliative CarePalliative care offers pain and symptom management, and emotional and spiritual support when you face a chronic, debilitating or life-threatening illness.Dawn Haller7/6/2023Your lungs work hard. Having clean air helps prevent illness and reduces the transmission of airborne viruses. Here are some ideas for improving the air quality in your home.Cleaner air: Another layer of protection from airborne particles<p>It's important to consider the quality of the air you and your family breathe every day. Proper air ventilation and filtration in your home may help prevent illness, reduce transmission of viruses, such as COVID-19 or influenza, and help alleviate symptoms of seasonal allergies. </p> <p>These actions alone are not enough to protect you and your family from all viruses. But they can serve as additional layers of protection.</p> <h2>So how do you improve the air quality in your home? Here are some ideas:</h2> <h3>Increase ventilation with outside air.</h3> <p>Generally, the more that indoor and outside air exchanges, the cleaner it is. This exchange lowers the risk of transmitting airborne viruses.</p> <h4>Ways you can increase ventilation include:</h4> <ul> <li>Opening windows or doors at opposite sides of the home, and keeping interior doors open as long as the weather allows to promote cross-ventilation.</li> <li>Operating a window air conditioner fan with an outdoor air intake vent.</li> <li>Running a bathroom fan intermittently or continuously.</li> <li>Opening the outside air intake of your heating, ventilation and air conditioning system.</li> <li>Using indoor fans to circulate air in the home.</li> </ul> <h3>Keep your home free of dust and debris.</h3> <p>Household dust, dirt and other allergens like pet hair can affect indoor air quality. Keep surfaces clean by:</p> <ul> <li>Vacuuming carpet and rugs frequently.</li> <li>Dusting hard surfaces.</li> <li>Regularly cleaning soft surfaces, such as bedding and drapery.</li> </ul> <h3>Use HEPA filters.</h3> <p>While keeping windows open is one way to promote cleaner air, people who have a lung disease, such as asthma, or are prone to seasonal allergies, may need to keep windows closed to prevent particles that could trigger their symptoms from entering their home. Using air filters that remove small particles, such as high-efficiency particulate air, or HEPA, filters, decrease contaminants in the air. The most common household appliances that use HEPA filters are portable air purifiers; vacuum cleaners; and heating, ventilation and air conditioning systems, such as furnaces.</p> <p>Appliances that use HEPA filters only work when they are on, so you may need to run the fan on your furnace continuously or for longer periods of time. Remember that these filters need to be cleaned or replaced regularly to work effectively. Check the manufacturer's instructions.</p> <h3>Use an air purifier.</h3> <p>When used properly, air purifiers can reduce contaminants in your air. However, they are designed to filter the air in a single room and not provide whole-house coverage.</p> <h4>Here are some tips on how to use a portable air purifier:</h4> <ul> <li>Place the air purifier where you spend the most time or where vulnerable people spend the most time.</li> <li>To reduce risks of airborne transmission of viruses, direct the airflow of the air cleaner so that it doesn't blow directly from one person to another.</li> </ul> <p>Increasing the ventilation and filtration of your home to improve the quality of the air is another layer of protection against airborne particles, including those carrying COVID-19, influenza or pollen. You should combine these strategies with other preventive measures, such as frequent hand-washing and staying up to date of vaccinations, to protect yourself and your family. </p> <p><em><a href="/providers/paul-horvath-md" target="_self" title="Opens in same window.">Paul Horvath, M.D.</a>, is an <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">Emergency Medicine</a> physician in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/menomonie" target="_self" title="Opens in same window.">Menomonie</a>, Wisconsin.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>University of Wisconsin Medical School-Madison</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Kalamazoo Center for Medical Studies</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Emergency Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Emergency Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Horvath<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/paul-horvath-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=6D9F9FFCF71AD564DF6A3FD125A4F235" alt="Paul Horvath, M.D." width="280" height="280" DisableNVelocity="true" />Paul<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13467174Paul Horvath, M.D.1<img src="/-/media/national-files/images/hometown-health/2023/air-purifier.jpg?h=370&iar=0&w=660&sc_lang=en&hash=83D0BEB810658431479FA7FE340D5EBF" alt="Air purifier" width="660" height="370" DisableNVelocity="true" />Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.BreathingMost cases of shortness of breath are due to heart or lung conditions. Your heart and lungs are involved in transporting oxygen to your tissues and removing carbon dioxide, and problems with either of these processes affect your breathing.Dawn Haller1/8/2021Osteopathic medicine is a growing branch of medicine. Learn more about this whole-person approach to identifying and treating the cause of illness.Q&A: Osteopathic medicine<p>Americans have relied on osteopathic medicine for more than 145 years. The number of osteopathic physicians is on the rise and that number is projected to keep climbing, according to the American Osteopathic Association.</p> <p>Stephen Stacey, D.O., director of osteopathic education for the <a rel="noopener" href="https://college.mayo.edu/academics/residencies-and-fellowships/family-medicine-residency-la-crosse-wisconsin/" target="_blank" title="Opens in a new window.">Mayo Clinic Family Medicine Residency program</a> and a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician at <a href="/locations/la-crosse" target="_self" title="Opens in same window.">Mayo Clinic Health System in La Crosse</a>, Wisconsin, answers common questions about this branch of medicine.</p> <h2>What does D.O. mean?</h2> <p>D.O. is the official designation of a doctor of osteopathic medicine who has attended and graduated from a U.S. osteopathic medical school.</p> <h2>Is an osteopathic physician a fully licensed physician?</h2> <p>Yes. Osteopathic physicians must pass state boards and exams, and be licensed to practice in all areas of medicine, just like a doctor of medicine (M.D.). Residency programs accept graduates of doctor of osteopathic medicine and doctor of medicine programs.</p> <p>Osteopathic physicians practice in all specialties of medicine, ranging from emergency medicine and cardiovascular surgery to psychiatry and family medicine. You or somebody you know has probably been treated by an osteopathic physician without realizing it.</p> <h2>What is unique about the osteopathic physician specialty?</h2> <p>The philosophy of osteopathic medicine focuses on a whole-person approach to identifying and treating the cause of illness, not just the symptoms.</p> <h3>Several key principles include:</h3> <ul> <li>The body acts as a whole unit, not a collection of separate parts.</li> <li>Structure and function are interrelated. This means that if there is a problem in one part of the body's structure, it can affect the function in that area and possibly other areas. The reverse also is true.</li> <li>The body has an innate ability to heal itself.</li> </ul> <p>Osteopathic physicians work in partnership with you, considering how lifestyle and community affect your well-being and working to break down barriers to good health.</p> <h2>What type of special training do osteopathic physicians receive?</h2> <p>Osteopathic physicians are trained to use a hands-on approach called osteopathic manipulative medicine, or OMM, to promote health and healing. Doctor of osteopathic medicine programs require approximately 200 additional hours of training in these therapeutic manual techniques.</p> <h2>What is osteopathic manipulative medicine?</h2> <p>Osteopathic manipulative medicine is a distinctive system of hands-on diagnosis and treatment that focuses on the body's interconnected system of nerves, muscles and bones. These techniques typically involve using pressure and resistance to work with muscles, connective tissues and joints. The techniques help restore motion, alleviate pain and support the body's structure to help it function more efficiently. Treatment plans are tailored to each patient.</p> <h2>What conditions can be treated with osteopathic manipulative medicine?</h2> <p>Osteopathic manipulative medicine benefits patients of all ages. Some common conditions treated include muscle pain, back or neck pain, shoulder pain, nerve entrapment, <a rel="noopener" href="https://www.mayoclinic.org/symptoms/headache/basics/definition/sym-20050800" target="_blank" title="Opens in a new window.">headaches</a>, <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/colic/symptoms-causes/syc-20371074" target="_blank" title="Opens in a new window.">infant colic</a>, <a rel="noopener" href="https://www.mayoclinic.org/symptoms/pelvic-pain/basics/definition/sym-20050898" target="_blank" title="Opens in a new window.">pelvic pain</a>, pregnancy issues, <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/scoliosis/symptoms-causes/syc-20350716" target="_blank" title="Opens in a new window.">scoliosis</a>, fibromyalgia and torticollis (twisted neck). The techniques used can provide patients an alternative to medications, including opioids or invasive surgical interventions.</p> <h2>How can I get care?</h2> <p>Schedule an appointment with one of our <a href="https://www.mayoclinichealthsystem.org/search-results?term=D.O." target="_self" title="Opens in same window.">osteopathic physicians</a> at your <a href="/locations" target="_self" title="Opens in same window.">local clinic</a>. Many osteopathic physicians provide osteopathic manipulative medicine to their own patients. Some may accept referrals from other physicians to treat patients using these techniques.</p> <p>As with any healthcare provider, it is important that you ask questions about how an osteopathic physician can meet your needs.</p><img src="/-/media/national-files/images/hometown-health/2021/blood-pressure-cuff-on-arm.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1FA2C8C8B7C3BF7B14734A5580EB4C34" alt="Blood pressure cuff on arm" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller1/5/2021Going back to work after maternity leave can be difficult. It's vital for you and your baby to feel supported. Get tips to help you physically and emotionally prepare.Returning to work after maternity leave: Tips, tricks to keep organized, decrease anxiety<p>Over 50% of women return to work after their maternity leave. Most women feel guilty about returning to work. Some return for financial reasons, and others return to maintain necessary skills. Either way, it is an emotional experience leaving baby behind. Moms can feel good knowing that studies have found no evidence that children experience harm when their mothers work outside the home.</p> <p>It is vital for women's mental and emotional health, and their relationship with baby, that they feel supported when returning to work.</p> <h3>Here are some helpful tips to help moms prepare physically and emotionally:</h3> <h4>Rally support from your employer.</h4> <p>All states have guidelines that outline how employers should support new mom's upon their return to work.</p> <h5>Check with your state's laws for details, but here are a few things to consider:</h5> <ul> <li>Employers should provide an adequate space for moms to pump. Many companies aren't aware of this requirement, so consider mentioning your plan to pump to your employer weeks to months in advance of your due date. This will allow your employer time to prepare a space. Bathrooms or bathroom stalls are not considered an adequate space. Employers should provide a conference room or other private space that can be reserved for breastfeeding moms.</li> <li>Employers should provide break times for pumping. Pumping can take about 10 to 15 minutes once you are used to using your breast pump. For some, it may take longer. Many women use their regular breaks and lunch break to pump. Some women come to work early or stay late to make up for the time needed to pump. Talk to your employer before your due date so you can agree on your approach.</li> <li>Touch base with your employer a few weeks before you return to ensure they are prepared for your time and space needs. Ask if you can visit so you can visualize and plan where you will be pumping.</li> </ul> <h4>Seek support from family and friends — and professionals.</h4> <p>It's important that you verbalize how you are feeling about returning to work.</p> <h5> Whether it is your partner, loved ones, friends, co-workers or health care providers, people want to help:</h5> <ul> <li><a href="/hometown-health/speaking-of-health/too-embarrassed-to-ask-i-just-had-a-baby-whats-wrong-with-my-moods" target="_self" title="Opens in same window.">Having a baby can cause changes in moods</a>. It's important to be as healthy as possible so you can provide the best care to your new baby. Talk to your provider if you think you may be experiencing <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617" target="_blank" title="Opens in a new window.">postpartum depression</a>.</li> <li>If you're having trouble with milk production or expressing milk, contact a <a href="/hometown-health/patient-stories/teamwork-helps-ensure-newborn-gets-strong--start-in-life" target="_self" title="Opens in same window.">lactation specialist</a>. They are waiting for your call and want you to be as successful as possible when you return to work.</li> <li>Consider joining a lactation group. It is helpful to connect with other women who are experiencing the same issues and concerns as you. They can give you ideas such as how to establish a feeding and pumping schedule.</li> </ul> <h4>Create a routine.</h4> <h5>Being organized can help reduce the stress you feel about returning to work:</h5> <ul> <li>Consider prepping the diaper bag for the baby and your bag for work the night before. Make sure pump supplies are cleaned, dried and packed. This will reduce the morning rush, which will help decrease anxiety.</li> <li>Do a dry run a few times the week before you return to work. Wake up and get ready for your day as if you were going to work. Be sure to note how much time you really need. As a part of the dry run, load the car and drive to the day care or grandma's house to time how long you will need to comfortably drop the baby off, including the extra kisses, and drive to work from there. Then add on some extra time for the unexpected mess or extended feeding. Most likely, it will take more time once baby arrives.</li> </ul> <h4>Monitor your breast milk supply.</h4> <h5>Your supply will go through some changes when you return to work:</h5> <ul> <li>You may notice a difference in your milk supply in the beginning because pumping is a big change from nursing your baby. Remember, your body will adjust to the new schedule.</li> <li>Bring a picture of your baby with you when you pump. Looking at your newborn's picture helps with milk letdown and helps you feel connected to your baby when you can't be together.</li> <li>Drink plenty of water to stay hydrated.</li> </ul> <p>Be patient, and give yourself grace. Allow yourself time to figure out what works and what doesn't. It will take a few weeks to get used to the new routine, but you've got this.</p> <p><em>By Mayo Clinic Health System staff. </em></p><img src="/-/media/national-files/images/hometown-health/2021/talking-on-cell-phone-outdoors.jpg?h=370&iar=0&w=660&sc_lang=en&hash=DA0F41D6DA972EA84B1E127681FEA957" alt="Talking on cell phone outdoors" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller1/29/2021Physical activity is good for people of all ages, especially seniors. Here are tips to keeping moving even during winter's cold, dark days.Ways for seniors to remain active during winter<p>Physical activity is good for people of all ages, especially seniors. It can reduce your risk of chronic health conditions, and improve your mood, strength and balance.</p> <p>Seniors should aim for 2½ hours of moderate-intensity exercise per week. Achieving this can be a challenge during the winter's cold, dark days. In addition, COVID-19 guidelines have led to more time spent at home and restricted access to some previously available indoor spaces.</p> <p>Even with these challenges, seniors can do many things to remain active during the winter.</p> <h2>Here are some tips to get you started:</h2> <h3>Find resources at a public library.</h3> <p>Most public libraries have a wide selection of exercise videos, books and e-books that focus on low-impact movement. While some libraries are closed due to the COVID-19 pandemic, some provide curbside pickup options.</p> <h3>Attend a virtual fitness class.</h3> <p>Today's seniors are more connected than ever. Use of technology has grown during the COVID-19 pandemic, with more use of virtual technology to connect with friends and family.</p> <p>Why not use the same technology to participate in an exercise class? Local fitness clubs, and county aging and disability resource centers offer low-impact virtual classes or one-on-one training services using Zoom or other virtual technology.</p> <p>Check with your health insurance company about virtual fitness class coverage, as some plans pay for some or all of class expenses.</p> <h3>Follow an online video.</h3> <p>There are thousands of exercise videos online, but don't just scan through social media sites and try to complete the first workout you find. Search for exercise programs specifically created for seniors, and incorporate stretching, strengthening and low-impact cardio. This may include chair yoga, seated strengthening exercises or chair stretching.</p> <h3>Schedule movement into your day.</h3> <p>A body at rest tends to stay at rest. This is especially true when the weather outdoors is bad.</p> <p>Plan a specific time each day to move. Many people find it best to complete a workout in the morning when they feel the freshest and the day hasn't gotten away from them.</p> <p>You can incorporate additional movement throughout your day, such as completing 10 squats while preparing lunch or coffee, putting away laundry one item at a time to walk extra steps, march in place during commercial breaks of your favorite TV show or getting up out of your chair every hour to walk a short distance in your home. Try these <a href="/hometown-health/speaking-of-health/15-minute-workouts-you-can-do-at-home" target="_self" title="Opens in same window.">15-minute workouts you can do at home</a>.</p> <h3>Use what you have.</h3> <p>You don't need expensive fitness equipment at home to get a total body workout.</p> <h4>Consider these examples:</h4> <ul> <li>Use cans of soup or water bottles as hand weights.</li> <li>Go from a sitting to a standing position out of a dining room chair two to three times in a row instead of just once.</li> <li>Walk up and down a hallway or large open space.</li> <li>Go up and down your stairs multiple times.</li> <li>Turn up the music and dance in your kitchen.</li> </ul> <h3>Get outdoors.</h3> <p>Winters can be cold and dark, but with the proper preparation and equipment, seniors can safely enjoy exercising outdoors. On days when it is icy or there is inclement weather and you do not need to go anywhere, stay inside to <a href="/hometown-health/speaking-of-health/winter-weather-are-falls-and-slips-avoidable" target="_self" title="Opens in same window.">prevent falls or slips</a>.</p> <h4>When venturing out, remember these tips:</h4> <ul> <li>Wear proper footwear.</li> <li>Wear a pair of lightweight tennis shoes or boots with good support. You also can purchase snow grips for the bottoms of your shoes or boots.</li> <li>Take your time.</li> <li>Walks in winter are not a race, and there is no need to hurry. Take small steps, and watch for, and avoid, icy spots.</li> <li>Walk with a friend.</li> </ul> <p>Catch up with a friend while exercising, but don't forget to wear a mask.</p> <h3>Incorporate variety.</h3> <p>People tend to focus on only one type of exercise, such as walking. Variety in your routines, incorporating <a href="/hometown-health/speaking-of-health/the-5-elements-of-fitness" target="_self" title="Opens in same window.">five elements of fitness</a>, reduces boredom and lowers the risk of injury.</p> <h3>Try to incorporate these types of exercise into your routines:</h3> <ul> <li><strong>Endurance</strong><br /> These activities increase your breathing and heart rates. Examples include dancing, climbing stairs and brisk walking.</li> <li><strong>Strength</strong><br /> Strong muscles help seniors remain independent and make everyday activities easier. Examples include lifting weights and using resistance bands.</li> <li><strong>Balance</strong><br /> These activities reduce the risk of falls. Examples include standing with your feet next to each other, standing on one foot and then the other, and tai chi.</li> <li><strong>Flexibility</strong><br /> Flexibility improves your joints' range of motion and makes daily tasks easier. Chair yoga and stretching can improve flexibility.</li> </ul> <p>If you have heart disease, diabetes, a history of falls, vertigo or other chronic health conditions, talk with your healthcare provider about the types and amount of physical activity that is right for you.</p> <p>Don't view winter as an excuse to stop exercising. There still are many things that you can do to safely incorporate exercise and movement into your routine. Learn more from the <a rel="noopener" href="https://www.nia.nih.gov/health/exercise-physical-activity" target="_blank" title="Opens in a new window.">National Institute on Aging</a>.</p> <p><em><a href="/providers/kelly-carlson-mspt" target="_self" title="Opens in same window.">Kelly Carlson</a> is a <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapist</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a>, Minnesota.</em></p><ul> <li>Orthopedics</li> <li>Sports medicine</li> </ul>P.T.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Exercise Science, University of Wisconsin, LaCrosse</li> <li>Master's degree, Physical Therapy, Des Moines University, Iowa</li> </ul> <p> </p>Carlson<img src="/-/media/shared-files/images/medical-professionals/full/fairmont/kelly-carlson-mspt.jpg?h=200&iar=0&w=200&sc_lang=en&hash=EF89D19097E1686A47E9713A15E08154" alt="Kelly Carlson PT" width="200" height="200" DisableNVelocity="true" />{C48D3060-B893-44CF-9013-ECD21C0DE9DE}Kelly <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14929198Kelly Carlson, P.T.1<img src="/-/media/national-files/images/hometown-health/2021/senior-woman-working-out-at-home.jpg?h=370&iar=0&w=660&sc_lang=en&hash=58DA2DABB5F6CF7001CC199EDD304078" alt="Senior woman working out at home" width="660" height="370" DisableNVelocity="true" />Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),AgingLife expectancy is 75 for males and 80 for females according to the National Center for Health Statistics. We'll help you keep you informed about potential issues with aging, and steps you can take to maintain your health and keep active.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Dawn Haller9/20/2025Knowing how to eat healthier can help you take control of how much you eat each day. Start with these tips to remind you of easy ways to judge food portions.Strategies to control portions<p>Losing weight and eating healthy may seem difficult. You may be unsure of how much you should eat to lose weight. It can be difficult to estimate portion sizes. Using the visual cues listed here will help you get close to actual recommended serving sizes.</p> <h2>Here are some ways to help judge a healthy portion.</h2> <h3>Fruit — One serving is equivalent to a tennis ball:</h3> <ul> <li>1 medium whole fruit</li> <li>1/2 cup of chopped, cooked or canned fruit</li> </ul> <h3>Vegetables — One serving is equivalent to one or two baseballs:</h3> <ul> <li>2 cups of raw, leafy vegetables (two baseballs)</li> <li>1 cup of chopped, cooked or canned raw veggies (1 baseball)</li> </ul> <h3>Grains — One serving is equivalent to a hockey puck:</h3> <ul> <li>1 slice whole-wheat bread</li> <li>1/2 cup of cooked pasta, potatoes or rice</li> </ul> <h3>Protein foods — One serving is equivalent to a hockey puck:</h3> <ul> <li>3 ounces of cooked meat</li> </ul> <h3>Fat — One serving is equivalent to one die:</h3> <ul> <li>1 teaspoon butter, margarine or oil</li> </ul> <p> Get additional <a href="/healthy-weight" target="_self" title="Opens in same window.">healthy weight resources</a>, and learn more about <a href="/topics/weight-loss-and-bariatric-surgery" target="_self" title="Opens in same window.">losing weight</a>.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2021/forking-vegetable-salsa-on-plate.jpg?h=370&iar=0&w=660&sc_lang=en&hash=920E14DF048E7742D7924894E216FD56" alt="Forking vegetable salsa on plate" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller1/20/2021While acne is common among teens, it can be embarrassing and sometimes difficult to treat. You and your teen can help manage or eliminate acne by following these 13 expert tips.13 tips for managing teen acne<p>Acne is a common condition faced by many teenagers. Although most teens will have acne at some point, your teen still may be embarrassed by it. As a parent or guardian, it is important to take your teen's feelings about acne seriously. Acne can cause low self-esteem and lead to distress in teens. Helping your teen with acne management can make this time less stressful and decrease the long-term effects of acne.</p> <h2>You and your teen can follow these 13 tips to help manage or eliminate acne:</h2> <h3>1. Have your teen use over-the-counter acne products, and wash problem areas with a gentle cleanser twice daily.</h3> <p>Look for products that contain topical benzoyl peroxide as the main active ingredient. Apply cleanser with fingertips, and rinse skin with lukewarm water.</p> <h3>2. After washing the skin, treat with a topical product containing adapelene.</h3> <p>Adapelene is helpful in unclogging pores and preventing new breakouts. A pea-sized amount should be applied to the entire face, avoiding easily irritated areas, such as the eyes and mouth. It also can be applied to the chest and back, if needed.</p> <h3>3. Avoid facial scrubs, astringents and facial cleanser masks, as well as excessive scrubbing and washing.</h3> <p>This can irritate the skin and worsen acne.</p> <h3>4. Remind your teen to use acne treatment, but only remind them occasionally.</h3> <p> A small study shows that fewer reminders from parents are more effective than reminding your child each day, which can be viewed as nagging.</p> <h3>5. Do not touch or pick at problem areas.</h3> <p> This can trigger acne, lead to infections and cause scarring.</p> <h3>6. Make sure your teen is wearing a clean face mask every day.</h3> <p>A dirty face mask will counteract other prevention strategies. Be sure to wash masks prior to wearing the first time. Use regular laundry detergent and hot water for washing face coverings.</p> <h3>7. Your teen should use shampoo every day.</h3> <p>This is especially needed if he or she has oily hair or problem areas around the hairline.</p> <h3>8. Shower after activities that cause sweat and oil production.</h3> <p> Exercising and wearing a hat or helmet can increase sweat and oil production.</p> <h3>9. Treat acne early.</h3> <p> It is easier to treat a few pimples than a breakout. Early treatment also can help prevent acne in adult years and reduce scars.</p> <h3>10. Protect skin from the sun.</h3> <p> Sun exposure can make acne worse, and some medications make skin susceptible to the sun's rays. If your teen is planning to be in the sun, have them apply a nonoily moisturizer that includes sunscreen.</p> <h3>11. Avoid excessive amounts of cosmetics.</h3> <p> Cosmetics can cause pores to clog and worsen acne.</p> <h3>12. Protect skin from items that create friction or cause pressure.</h3> <p> Phones, helmets, backpacks, and tight collars and straps are examples.</p> <h3>13. Help your teenager manage and reduce stress.</h3> <p> Stress can cause acne to flare.</p> <p>If your teen has tried over-the-counter acne products for several weeks and has not seen improvements, schedule an appointment with a <a href="/services-and-treatments/dermatology" target="_self" title="Opens in same window.">dermatologist</a> or <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">pediatrician</a> who can prescribe stronger medications and help with treatment options.</p> <p>Get additional <a href="/hometown-health/speaking-of-health/5-tips-to-help-your-teen-survive-acne" target="_self" title="Opens in same window.">tips to help your teen manage acne</a>.</p> <p><em><a href="/providers/manjunatha-md" target="_self" title="Opens in same window.">Dr. Manjunatha</a> is a pediatrician in <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">Pediatric & Adolescent Medicine</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p> <hr /> <p><em>Information adapted from the American Academy of Dermatology</em></p><ul> <li>Adolescent acne</li> <li>Allergy and asthma</li> <li>Anemia in children</li> <li>Anxiety</li> <li><span style="color: #202124; background-color: #ffffff;">Attention-deficit/hyperactivity disorder (</span>ADHD)</li> <li>Bedwetting issues</li> <li>Depression</li> <li>Lyme disease</li> <li>Migraine headache</li> <li>Newborn care</li> <li>Urinary and kidney problems</li> </ul>M.D.<p>I chose to work at Mayo Clinic Health System since it provides the highest quality of medical care in the Midwest.</p> <p>I look forward to helping create individualized care plans for my patients and their wellness goals. I manage the physical, mental and emotional well-being of children in every stage of development. I believe in developing a trusting relationship and always value parents’ input in childcare decision-making.</p> <p>In my spare time, I enjoy playing cricket and tennis, watching movies, listening to music and spending time with my wife and two sons.</p><p><strong>Education</strong></p> <ul> <li>Jawaharlal Nehru Medical College</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Pediatrics, Marshfield Clinic Health System</li> <li>Pediatrics, Royal College of Pediatrics and Child Health</li> <li>Pediatrics, Mysore Medical College and Research Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Pediatrics</li> <li>Neonatal Resuscitation Program</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Pediatrics, Mayo Clinic College of Medicine and Science</li> </ul>Manjunatha<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/fnu-manjunatha-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=DF32FB2C272DE3D15C5BB00CDBA7B053" alt="Fnu Manjunatha, M.D." width="280" height="280" DisableNVelocity="true" />Fnu<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20712260Fnu Manjunatha, M.D.1{61776FD2-05E8-47E9-AB55-EE465BD29A19}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}|{9B57996D-7C65-499B-8DB5-FBB37D1A5DD1}<img src="/-/media/national-files/images/hometown-health/2019/teenage-girl-doing-face-care.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4BAC2AEDCEC45D3EB11A9353434A61B9" alt="Teenage girl doing face care" width="660" height="370" DisableNVelocity="true" />Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Dawn Haller7/16/2025Your care needs are important, which is why we provide a team-based approach. Learn more about care team collaboration and how it can benefit you.FAQ: Your care team<p>Care teams collaborate to deliver the highest-quality care, with the best patient experience and outcomes, in a way that also reduces costs. Your primary care provider guides your care team.</p> <h2>Why do I need a primary care provider?</h2> <p>Having a primary care provider allows you to establish trusting relationships with a care team who gets to know you and your medical history, and provides continuity of care for you and your family. </p> <h3>A primary care provider:</h3> <ul> <li>Can be a physician or advanced practitioner provider</li> <li>Is available to evaluate and treat day-to-day health problems</li> <li>Advises you on preventive screenings at different stages throughout your life</li> <li>Follows up with you to explain test results and judge how well your treatment is working</li> <li>Refers you to qualified specialists when needed</li> <li>Maintains the big picture of your overall health and treatment needs</li> </ul> <p>Establishing care at Mayo Clinic Health System is easy. <a href="/locations" target="_self" title="Opens in same window.">Find your local clinic's contact information</a> for help selecting a primary care provider and transferring health records.</p> <h2>What is team-based care?</h2> <p>Your care needs are important. The team-based approach to care will support you with a variety of caregivers who can focus on your individual needs in the most convenient, supportive ways possible. The members of your primary care team each have a specific role in supporting your care and health goals.</p> <h2>What are the care team members' roles in my care?</h2> <p>Though collaborative teamwork, your care is delegated to the most appropriate team member.</p> <h3>Your extended care team includes:</h3> <ul> <li><strong>You</strong><br /> You are at the center of the care team and everything they do. Care teams are responsible for understanding your needs and supporting your health.</li> <li><strong>Registered nurses</strong><br /> Registered nurses educate, assess your needs and coordinate care if you need customized plans of care. Also, visits with registered nurses are scheduled for other reasons, such as hypertension checks, 6- and 12-month well-child assessments, and adult annual wellness visits.</li> <li><strong>Licensed practical nurses, medical assistants and clinical assistants</strong><br /> These medical staff members prepare you for the visit, coordinate preventive services and care with other providers if you have chronic conditions, and provide vaccination visits.</li> <li><strong>Allied health staff</strong><br /> Scheduling, registration, clinic assistants and secretarial staff are the doorway to your care team and guide you to the right level of care at the right time.</li> <li><strong>Additional primary care members</strong><br /> Behavioral health specialists, dietitians, pharmacists, therapists, social services support and other healthcare specialists join your care team as needed.</li> <li><strong>Specialists</strong><br /> Your care team will coordinate with specialists to ensure your care plan fits your needs, lifestyle and family circumstances.</li> </ul> <h2>What are the benefits of having a care team instead of seeing my own provider every time?</h2> <p>A care team improves your care in several ways. Instead of depending on just one provider, an entire team is supporting you.</p> <p>When you need to see a specialist, your care team will connect you to the right person. Your team will remind you when it's time for a preventive exam or wellness screening.</p> <p>You'll often be able to receive care more quickly than in the past because you now have more people prepared to meet your needs. This will help make your visit as efficient and productive as possible.</p> <h2>I prefer to see my physician, but I was offered a visit with a nurse instead. Why?</h2> <p>Your appointments and the care team professional you see are tailored to your specific needs and complexity. This allows all patients access to the right provider at the right time. For example, some registered nurses are specifically trained to provide care related to recurring hypertension visits and Medicare annual wellness visits. When a registered nurse determines that your condition has become more complicated, you will be referred to a nurse practitioner, physician assistant or physician.</p> <h2>Why does my doctor suggest I see a nurse practitioner or physician assistant for my next clinic visit?</h2> <p>Nurse practitioners and physician assistants work in partnership with physicians to ensure you get the care you need when you need it. Together, they coordinate treatment for patients seen in Primary Care.</p> <h2>How do I access the care I need?</h2> <p>This team-based approach often can deliver your care via telephone or through the patient portal. In addition to your care team, the <a href="/services-and-treatments/nurse-line" target="_self" title="Opens in same window.">Nurse Line</a> is available 24/7 to access advice from expert and caring nurses, and get help determining the best care option.</p> <h2>How do I receive the care I need?</h2> <p>If you need a visit, your care team or the Nurse Line can determine the best route of care for your needs.</p> <h3>The care you receive may be:</h3> <ul> <li>A visit with a member of your care team or a specialist in the clinic</li> <li>In <a href="/services-and-treatments/urgent-care" target="_self" title="Opens in same window.">Urgent Care</a> or <a href="/services-and-treatments/express-care" target="_self" title="Opens in same window.">Express Care</a></li> <li>Online through a <a href="/hometown-health/featured-topic/6-tips-for-making-the-most-of-your-video-appointment" target="_self" title="Opens in same window.">video appointment</a>, <a href="/services-and-treatments/express-care" target="_self" title="Opens in same window.">Express Care Online</a> or <a href="/-/media/national-files/documents/hometown-health/2019/patient-guide-to-econsults.pdf?sc_lang=en&hash=20F604DE40B7C0B8D8203BBA3D3A3727" target="_blank" title="Opens in a new window.">eConsult</a></li> </ul> <p>If you require immediate medical attention for a severe or life-threatening situation, you will be seen in the <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">Emergency Department</a> nearest you.</p> <h2>How do I get started?</h2> <p>Register for an account in the patient portal or download the Mayo Clinic app to get started. Call 1-877-858-0398 for assistance. Read more about the <a href="/topics/patient-portal" target="_self" title="Opens in same window.">patient portal</a>.</p> <p>Get tips for how to <a href="/hometown-health/speaking-of-health/plan-ahead-to-make-the-most-of-your-health-care-visit" target="_self" title="Opens in same window.">plan ahead to make the most of your healthcare visit</a>. </p> <p><em><a href="/providers/jill-lenhart-md" target="_self" title="Opens in same window.">Jill Lenhart, M.D.</a>, is a </em><em><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/chippewa-falls" target="_self" title="Opens in same window.">Chippewa Falls</a>, Wisconsin.</em></p>M.D.<p>I enjoy spending time with my family, walking and being active with my church.</p> <p>I am the Mayo Clinic Health System – Chippewa Valley vice chief medical officer.</p><p><strong>Medical School</strong> <br /> University of North Dakota School of Medicine-Grand Forks</p> <p><strong>Residency</strong> <br /> Eau Claire Family Practice Residency Program/UW-Madison Affiliate, Eau Claire, WI</p> <p><strong>Certification</strong> <br /> Family Practice </p>Lenhart<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/jill-lenhart-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4EA55C165DA6CAD75D3B28C8357628D5" alt="Jill Lenhart, M.D." width="280" height="280" DisableNVelocity="true" />{E09B30D9-AEAC-4BCE-B17E-ADD7423F8DDD}Jill<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>11881658Jill Lenhart MD1{B3F96F77-F93E-41A4-AE4E-603045CDB443}<img src="/-/media/national-files/images/hometown-health/2018/health-care-team-hands.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B6BC545B5E0BAA4B65A368DAE7297FB4" alt="Health care team break with hands" width="660" height="370" DisableNVelocity="true" />Patient PortalStaying engaged in your healthcare is important. The patient portal is a free, secure and convenient online resource that connects you to your healthcare team and helps you manage your health from the comfort of your home or anywhere else.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Dawn Haller1/21/2021If your job has you sitting at desk most of the day, that can be tough on your body. Here's some tips to ease the stiffness and soreness to keep you alert and focused.Don’t just sit there: Exercises for the office<p>Sitting at a desk all day can be harder than it sounds.</p> <p>Too much sitting in one position puts a lot of strain on the body and can leave you feeling stiff and sore. It can also leave you feeling tired. We’re talking to you, 3 p.m. slump.</p> <p>To break the cycle, try getting up to move every half hour or so. Walk to get a drink of water. Take a flight or  two of stairs. Stand up when on a phone call or during a videoconference meeting.</p> <h2>Try a few of the stretches and exercises below, which can be done right from the comfort of your work area:</h2> <ul> <li><strong>Neck stretches</strong><br /> Bring your chin to your chest and hold for 15 to 30 seconds. Then rotate your head left and then right, holding 15 to 30 seconds on each side. Finally, tilt your head to the side, leaning your ear toward your shoulder. Again, hold for 15 to 30 seconds on each side.</li> <li><strong>Standing stretches<br /> </strong>While standing, put a hand on your desk or chair to stabilize yourself. Bend one leg, grab your ankle and pull it toward your buttock. Hold for 15 to 30 seconds, then repeat on the other side. Then, stand with feet hip width apart and arms crossed across your chest. Twist to the left, then the right. Hold for 30 seconds on each side.</li> <li><strong>Pushups and triceps dips</strong><br /> Use your desk to do pushups. Do triceps dips on the arms of your office chair.</li> <li><strong>Forearm stretches</strong><br /> Lift one of your arms and hold it comfortably in front of you, palm facing down. Bend your hand downward, and gently pull it toward you using your other hand. Hold for 15 to 30 seconds and repeat on the other side. Then lift one of your arms and hold it comfortably in front of you, palm facing up. Bend your hand downward, and gently pull it toward you using your other hand. Again, hold for 15 to 30 seconds on each side.</li> <li><strong>Seated stretches</strong><br /> While seated, bring one of your knees toward your chest. Use your hands to grab the back of your thigh, and gently pull it toward you. Keep your back straight, being careful not to lean forward. Hold the stretch for 30 seconds. Relax and return to the starting position, and repeat the stretch with your other leg.</li> </ul> <p>Just a small amount of movement throughout the day can really help you stay alert and focused.</p> <p>Get additional <a href="/topics/exercise-and-fitness" target="_self" title="Opens in same window.">fitness and exercise tips</a>.</p> <p><em><a href="/providers/beau-johnson-pt" target="_self" title="Opens in same window.">Beau Johnson</a> is a <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapist</a> in <a href="/locations/holmen" target="_self" title="Opens in same window.">Holmen</a>, Wisconsin.</em></p><ul> <li>Sports medicine</li> </ul>P.T.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Exercise Science, University of Minnesota-Duluth</li> <li>Master's degree, Physical Therapy, University of Mary</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Certified Spinal Manual Therapist (CSMT)</li> </ul>Johnson<img src="/-/media/shared-files/images/medical-professionals/full/holmen/beau-johnson-pt.jpg?h=280&iar=0&w=280&sc_lang=en&hash=2FEA4FD6BAEEBFE6D31E1284FD8FD26F" alt="Beau Johnson, PT, MPT, CSMT" width="280" height="280" DisableNVelocity="true" />Beau<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15511979Beau Johnson, P.T.1<img src="/-/media/national-files/images/hometown-health/2021/on-laptop-with-cat-by-window.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F2465D7CD7858BF2F3ACBD41FD90BA0E" alt="Young woman using a laptop with cat on windowsill" width="660" height="370" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Dawn Haller5/11/2023If you're a young adult, is preventive health at the top of your to-do list? Learn why having a primary care provider is an investment to help you stay healthy now and into the future.3 reasons young adults need a primary care provider<p>With young adulthood comes many new goals and expanded responsibilities. The to-do list can be long and ever-growing. The early adult years are filled with meaningful choices that set you on the path toward your long-term plans and goals.</p> <p>Just as you would look for assistance regarding investments from a well-experienced financial advisor, you should seek expert guidance regarding your long-term health and well-being.</p> <h2>Your partner in health</h2> <p>Establishing continuity of care with a primary care provider is key to creating a partnership with a trusted health care team.</p> <h3>Here are three reasons why it's important to invest in a relationship with a primary care provider:</h3> <h4>1. A primary care provider wants to understand you and your health goals.</h4> <p>A <a href="/services-and-treatments/primary-care" target="_self" title="Opens in same window.">primary care</a> provider can provide a wide variety of health care services.</p> <h5>By developing a relationship with a primary care provider, you benefit in these areas:</h5> <ul> <li><strong>Your personal medical history</strong><br /> The provider-patient relationship is valuable. A primary care provider who knows you and your medical history well will apply that knowledge to improve your health care experience.</li> <li><strong>Your personal health values and wellness goals</strong><br /> A long-term professional relationship with a primary care provider enables you to <a href="/hometown-health/speaking-of-health/coming-out-as-lgbtq" target="_self" title="Opens in same window.">develop a comfortable trust</a> ;with that person, particularly when sharing health information and receiving medical guidance. Establishing this relationship also can make you feel more comfortable discussing personal concerns and asking questions about your short- and long-term health.</li> <li><strong>Your overall health</strong><br /> After establishing with a primary care provider, future appointments can be more productive. Seeing a primary care provider who already knows your health history allows you to focus on and invest more time discussing the future. This improves the overall quality of your preventive health and can increase your longevity.</li> </ul> <h4>2. A primary care provider helps you manage your short- and long-term health needs.</h4> <p>Primary care providers are masters of preventive medicine, medical counseling and <a href="/hometown-health/speaking-of-health/mens-health-checkups-and-screenings-are-key" target="_self" title="Opens in same window.">health screenings</a>. An annual visit to the clinic for these things is recommended. Consider it a yearly analysis and tune-up for your physical and mental health. Your primary care provider can ensure your health is up to date according to the latest guidelines on evidence-based medicine. Your primary care provider also can ensure you are well-informed about how to reduce health risks based on your personal and <a href="/-/media/national-files/images/hometown-health/2021/know-your-numbers-family-history.jpg" target="_self" title="Opens in same window.">family medical history</a>.</p> <h4>3. A primary care provider manages your transfer of specialty care.</h4> <p>Primary care providers are generalists by training. They evaluate and treat a broad spectrum of medical conditions. However, your health concerns sometimes may require assistance beyond the primary care clinic.</p> <h5>In these cases, your primary care provider will:</h5> <ul> <li>Ensure a smooth referral to the appropriate specialist.</li> <li>Coordinate care between specialty providers.</li> <li>Actively monitor your updated medical history and status.</li> <li>Follow up with test results, provide meaningful explanations for those results and describe the best next steps in your health care.</li> </ul> <p>Lastly, primary care providers are here to educate and be a point of contact for community resources. Having a primary care provider allows you to maintain the healthiest version of yourself while actively investing in your life goals.</p> <p><em><a href="/providers/trevor-rich-md" target="_self" title="Opens in same window.">Trevor Rich, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/mondovi" target="_self" title="Opens in same window.">Mondovi</a>, Wisconsin.</em></p><ul> <li>Academic medicine and community health education</li> <li>Community nutritional health and preventive wellness</li> <li>Critical access rural clinic and hospital care <ul> <li>Vasectomy counseling and referral service</li> <li>Contraceptive counseling and referral service, OCP prescription management</li> <li>Preconception care & planning, prenatal referral service</li> <li>Wound care and wound management</li> </ul> </li> <li>Rural athletic support</li> <li>Skilled nursing facility medical directorship</li> </ul>M.D.<p>I view my delivery of care to be shared. My role, above all else, is to be a source of evidence-based counseling, such that all my patients feel comfortable with their informed decisions about their health. Patients can expect my undivided attention and eagerness to clarify their questions.</p> <p>I’m a humble family man, who finds purpose in serving my community and neighbors.</p><p><strong>Education</strong></p> <ul> <li>Medical College of Wisconsin-Milwaukee</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Mayo Clinic Family Medicine Residency, Eau Claire</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Clozapine REMS Program</li> <li>MAT, Suboxone Waiver</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians </li> <li>Mayo Clinic Alumni Association</li> <li>Society of Teachers of Family Medicine</li> <li>The National Guard Association of the United States</li> <li>Wisconsin Academy of Family Physicians</li> <li>Wisconsin Medical Society</li> <li>Wisconsin National Guard Association, Inc.</li> </ul>Rich<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/trevor-rich-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=C35BEC1720C4B1DC110D068E43EFF155" alt="Trevor Rich, M.D." width="280" height="280" DisableNVelocity="true" />{DEC439E2-74BD-46D1-94B9-DB111539B3A8}Trevor<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20654405Family Medicine - Trevor Rich MD1{986C767E-E5DE-43F5-957F-B4212DB8E384}|{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}<img src="/-/media/national-files/images/hometown-health/2023/young-adult-couple-smiling.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0E08EFDE38368085772D3325946670DE" alt="Young adult couple smiling" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Michele Halterman1/9/2023Exercise, stress relief and restorative time in nature are just some of the benefits of an outdoor adventure. But winter adds extra challenges, so prepare before you head out.Top 10 essentials for your winter adventure<p>Venturing outdoors for winter recreation can be an exhilarating, and chilly, experience. Outdoor activities include downhill and cross-country skiing, snowshoeing, sledding, snowmobiling, ice fishing and fat-tire biking. In addition to exercise, these activities can relieve stress and improve our overall well-being by being in nature.</p> <h2>However, the winter environment adds extra challenges and dangers to be aware of and prepared for, including:</h2> <ul> <li>Colder temperatures pose an obvious threat, and when combined with wind (wind chill), increase the loss of body heat. Ice and snow make travel to and from recreation spots more dangerous, and slippery conditions make orthopedic injuries more likely.</li> <li>If you're heading to mountains in the West, an avalanche is a major risk. Each year, people lose their lives due to poor preparation and choices.</li> <li>The sun in winter is dangerous in different ways than in summer. You still can get a sunburn in winter. Your eyes also can get sunburned. It's called snowblindness, or ultraviolet keratitis, and is caused by reflection off the snow.</li> </ul> <h2>Consider these safety tips before you head out:</h2> <ul> <li>Study your map and familiarize yourself with the area you're exploring. Don't rely on GPS, which some people say stands for "gets people stuck."</li> <li>Tell someone where you're going and when you plan to return. Also, tell them if your plans change.</li> <li>Check the weather forecast and dress accordingly. Winter is no time to take chances.</li> </ul> <h2>Bring these 10 essential items when out on the trail or ice:</h2> <ol> <li>Compass or navigation equipment</li> <li>Fire-starting equipment</li> <li>Signaling devices, such as flares or a whistle</li> <li>Small snack</li> <li>Knife or multitool</li> <li>Headlamp</li> <li>Sun protection, including sunscreen and sunglasses</li> <li>Insulation, including extra gloves or layers</li> <li>Adequate water or purification equipment</li> <li>Emergency shelter, such as a bivy sack or jumbo trash bag</li> </ol> <p>Also, bring a small first-aid kit. If you or another person is injured, a well-equipped kit can treat wounds and minor injuries until you can seek next-level care.</p> <p>These winter essentials are essential during all seasons, but especially during the cold months. The farther from civilization you plan to go and the colder it is, the more prepared you need to be.</p> <p>Even if you're not on an adventure, take winter seriously. Getting stuck just outside of town can be just as cold and difficult as getting stuck on a remote ski trail. With a little preparation, you can safely enjoy the outdoors in the winter — and any time of year.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2021/snowshoeing-on-sunny-day.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3B7B8F79509C6F0FC99915BF3F840AA0" alt="Snowshoeing on sunny day" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller1/4/2021Cold weather and more time spent indoors can wreak havoc on your skin. Prevent itchy or painful skin with these preventive self-care tips.Winters don’t have to bring dry skin<p>Winter is here, and everyone has begun to prepare for the cold, snow and ice. One thing that isn't always associated with winter weather is dry skin.</p> <p>With a drop off in the level of moisture in the air, as well as humidity, winter months are prime time for skin to become drier and lead to further skin issues. Washing hands and wearing masks are key steps to preventing COVID-19, but they can dry out your skin.</p> <h4>To combat dry skin and save yourself from itchy or painful skin that is prone to infection, try these preventive self-care tips:</h4> <ul> <li><strong>Cover up.</strong><br /> This tip speaks for itself. In winter, it's important to bundle up when going outdoors ― not just for warmth, but also to protect your skin. Hats, mittens, scarves and insulated coats are your best friends, even if you don't have far to go.</li> <li><strong>Moisturize every day.</strong><br /> It's vital to keep your skin healthy and moisturized during the winter. Make it a part of your daily routine. Use a hypoallergenic lotion as opposed to lotions that are heavy with scents. Also, use a brand that doesn't irritate your skin.</li> <li><strong>When outdoors, wear sunscreen.</strong><br /> This may seem like an odd tip, but you still can get a sunburn when outside during the winter. If you're going to be outside for a prolonged period, such as snowshoeing, skiing or snowboarding, lather on the sunscreen before heading outside.</li> <li><strong>Use a humidifier.</strong><br /> During the winter, run a humidifier in your home. Using a humidifier will add moisture to the air that decreases in the cold weather. This moisture will help combat dry skin problems.</li> </ul> <p>Some other skin problems that may arise during the winter include dandruff and dermatitis. For those with dandruff, over-the-counter shampoos can be beneficial. Make sure to choose a dandruff shampoo with selenium sulfide or zinc pyrithione. You may need to switch between these two if either one stops working. You can manage dermatitis by taking shorter baths and showers using warm, rather than hot, water. Use a gentle, nonsoap cleanser and dry yourself gently with a soft towel. While your skin is still damp, seal in moisture with an oil, cream or lotion.</p> <p>See your health care provider if you have chronic or severe dry skin problems that don't improve with over-the-counter treatments.</p> <p><em><a href="/providers/peter-reisner-md" target="_self" title="Opens in same window.">Peter Reisner, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/chetek" target="_self" title="Opens in same window.">Chetek</a>, Wisconsin.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>University of Texas Medical Branch</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Practice</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Reisner<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/peter-reisner-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=E4299ECA7A6FB83591D4D4F91D0769D6" alt="Peter Reisner, M.D." width="280" height="280" DisableNVelocity="true" />Peter<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13818422Peter Reisner, M.D.1<img src="/-/media/national-files/images/hometown-health/2021/bundled-up-winter-clothes.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4121A2A4FF1C66A1E82235C66CD9A3F2" alt="Woman bundled up in winter clothes standing outdoors" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller2/5/2021If you're pregnant, you may have heard about Braxton Hicks contractions and want to know more about them. Here are answers to 5 common questions about these "false labor" pains.5 common questions about Braxton Hicks contractions<p>Some of the bodily changes during pregnancy can be confusing. For some women, Braxton Hicks contractions can be particularly puzzling. They are uncomfortable, but painless, contractions during pregnancy and are sometimes referred to as "false labor" pains.</p> <h2>Here are answers to five common questions about Braxton Hicks contractions:</h2> <h3>1. What do Braxton Hicks contractions feel like?</h3> <p>Braxton Hicks contractions are mild, irregular contractions during pregnancy. They feel like tightness in your abdomen. Some women feel a lot of Braxton Hicks contractions, while some women don't feel them at all. They typically last less than 30 seconds, and they are uncomfortable but rarely painful.</p> <p>These contractions also tend to occur more often and become stronger as you approach your due date. Finally, they're more likely to occur in the afternoon or evening, after physical activity, or after sex.</p> <h3>2. What is the purpose of Braxton Hicks contractions?</h3> <p>Braxton Hicks contractions help tone your uterus' muscles and prepare your cervix for birth.</p> <h3>3. How can you tell the difference between Braxton Hicks contractions and labor contractions?</h3> <h4>There are three primary differences between Braxton Hicks contractions and true contractions:</h4> <ul> <li><strong>Pattern</strong><br /> Time your contractions from the beginning of one to the beginning of the next. Look for a regular pattern of contractions that get progressively stronger and closer together. Braxton Hicks contractions will remain irregular.</li> <li><strong>Duration</strong><br /> Time how long each contraction lasts. True contractions last about 30 to 70 seconds.</li> <li><strong>Change</strong><br /> True contractions continue regardless of your activity level or position. With false labor, the contractions might stop when you walk, rest or change position.</li> </ul> <p>Contact your healthcare provider if contractions become regular and steadily increase in strength.</p> <h3>4. How can you ease the discomfort of Braxton Hicks contractions?</h3> <p>For some women, Braxton Hicks contractions can be uncomfortable, and they tend to become stronger as their due dates approach.</p> <h4>Here are a few things to try to relieve any unpleasant feelings:</h4> <ul> <li>Change your position, such as lying down or going for a walk.</li> <li>Take a warm bath.</li> <li>Get a massage from your partner.</li> <li>Practice your breathing exercises.</li> </ul> <h3>5. What happens if you go to the hospital and you're not actually in labor?</h3> <p>During pregnancy, expect false alarms. No one knows for sure what triggers labor, and every woman's experience is different. Sometimes it's hard to tell when labor begins.</p> <p>Don't hesitate to call your healthcare provider if you're confused about whether you're in labor or if you are experiencing Braxton Hicks contractions. Preterm labor can be especially sneaky. If you have any signs of labor before 37 weeks, especially if you also experience vaginal spotting, consult your healthcare provider.</p> <p>If you arrive at the hospital in false labor, don't feel embarrassed or frustrated. Think of it as a practice run. The real thing is likely on its way.</p> <p><em><a href="/providers/amy-brien-md" target="_self" title="Opens in same window.">Amy Brien, M.D.</a>, is an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Fertility</li> <li>Office hysteroscopy </li> <li>Quality improvement and patient safety initiatives</li> <li>Vulvar disorders</li> <li>Women's health</li> </ul>M.D.<p>My patients — both gynecologic and obstetric — appreciate that I am straightforward and provide them multiple options to choose from. I strive to be efficient and timely.</p> <p><span style="font-family: 'Open Sans', Arial, sans-serif; color: #131313;">I love to travel and spend time with my nephews and nieces. I spend most evenings playing with my Australian shepherd, Bindi.</span></p><p><strong>Education</strong></p> <ul> <li>University at Buffalo School of Medicine and Biomedical Sciences</li> <li>Master's degree, Healthcare Administration, University of Massachusetts Amherst</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Obstetrics and Gynecology, University of Texas Health Science Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Obstetrics and Gynecology, American Board of Obstetrics and Gynecology</li> <li>Fellow, the American Congress of Obstetricians and Gynecologists</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Obstetrics and Gynecology, Mayo Clinic College of Medicine and Science</li> </ul>Brien<img src="/-/media/shared-files/images/medical-professionals/full/mankato/amy-brien-md.jpg?h=280&iar=0&w=280&hash=66A939FCE44D2191BC87BBF12A0DF4AF" alt="Amy Brien MD" width="280" height="280" DisableNVelocity="true" />{2E149FE5-E8DD-474B-84B2-31B20FDE688D}Amy <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15129811Amy Brien MD1{54693F31-87AF-4B21-91DB-1DEC1E21F878}|{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}<img src="/-/media/national-files/images/hometown-health/2021/seated-pregnant-woman-hands-cupping-belly.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4A91CDC9102B236DC8D938341486B8A9" alt="Seated pregnant woman with hands cupping belly" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller4/17/2023Screened devices are part of everyday activities from store checkout to reading on a tablet. There are health benefits to reducing screen time. Here are six tips to help your family trim screen time.6 tips to reduce children's screen time<p>Screened devices are a common part of everyday activities. From using the self-checkout station at the grocery store to reading your favorite author's new book on a tablet, time spent using screened devices is more than just the TV or smartphone.</p> <p>While screens are a part of today's culture, there are health benefits related to reducing screen time, including improved physical health, decreased obesity and more time to play and explore.</p> <h2>Evaluating children's screen time</h2> <p>This is especially true for children spending considerable time learning on computers and tablets. It's important to use break times to get in some physical activity. When the school day wraps up, have a plan to put away devices somewhere out of sight and engage kids in other ways.</p> <p>While the average time spent on screens is seven to 10 hours.</p> <h2>The American Academy of Pediatrics recommends these acceptable amount of screen time limits:</h2> <ul> <li>No screen time for children under 2</li> <li>One hour per day for children 2 to 12</li> <li>Two hours per day for teens and adults</li> </ul> <p>Limiting screen time also helps parents keep a closer eye on what their children are experiencing on social media and the internet.</p> <p>While more research is needed to fully understand the effects screen time levels have on kids, parents are not off the hook. Screen time affects adults the same as children. Too much screen time puts everyone at risk of obesity, and it's linked with sleep disturbances and can affect relationships.</p> <p>For kids, especially teens, there are studies concerning the negative effects of screen time and its relationship to anxiety, depression and attention span.</p> <h2>Tips for reducing screen time</h2> <h3>These six tips can help you trim your children's screen time when not in school:</h3> <h4>1. Be accountable.</h4> <p>Set expectations with your kids, and create goals to be intentional about reducing screen time. Many devices have features to set time limits for use.</p> <h4>2. Be realistic.</h4> <p>If your kids spend a lot of leisure time on screens, including watching TV, start by setting smaller, more attainable goals. Instead of jumping right to the recommended one to two hours or less per day, start by cutting their current screen time in half.</p> <h4>3. Be engaged.</h4> <p>After school or work, spend time each day talking face to face with kids and give them your full attention.</p> <h4>4. Put hand-held devices away.</h4> <p>During screen-free hours, put devices away or at a charging station in a common area so they're not attracting your kids' attention.</p> <h4>5. Create phone-free zones in the home.</h4> <p>Making family meal areas a phone-free zone is an easy way to start.</p> <h4>6. Go outside.</h4> <p>Putting down the phone and taking a walk or playing outdoors increases your endorphins and provides that feeling of happiness in your brain, boosting your mood and improving your physical health.</p> <p><a href="/wellness/slim-your-screen-time" target="_self" title="Opens in same window."><strong>Register for Slim Your Screen Time</strong></a><strong> — a free, at-home, self-guided program designed to help you improve your health by reducing screen time. Join at any time.</strong></p> <p><em> <a href="/providers/sarah-scherger-md" target="_self" title="Opens in same window.">Sarah Scherger, M.D.</a>, is a <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">pediatrician</a> in <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>Johns Hopkins Bloomberg School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Department of Pediatric and Adolescent Medicine, Mayo Clinic</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Pediatrics, Mayo Clinic College of Medicine and Science</li> </ul>Scherger<img src="/-/media/shared-files/images/medical-professionals/full/austin/sarah-scherger-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=6AC1E8D2F4C9C1DBE14B11A7201385A8" alt="Sarah Scherger MD" width="280" height="280" DisableNVelocity="true" />Sarah<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15261310Sarah Scherger, M.D.1<img src="/-/media/national-files/images/hometown-health/2023/overhead-view-of-game-board.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6F99DF9B75DE113877B1485B23CBBFF8" alt="Overhead view of game board" width="660" height="370" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Child DevelopmentWe all want our children to grow up happy and healthy. The reality is most all of them do — but at vastly different rates. Experts across Mayo Clinic Health System see thousands of children each year, and have the experience and resources to know what is normal and what may be cause for closer observation. This includes not only physical and motor skills development, but psychological and social skill advancement.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Get Tools to Live Your HealthiestIt’s never too early — or too late — to plan ahead for health. By making preventive care for you and your family a healthy habit, you’ll help improve your well-being. Be sure to connect with your healthcare provider to discuss any further questions that you may have about your health.Dawn Haller2/9/2021The transition to home for work and school has led more people to skip wearing shoes. While it may feel good in the short term, the lack of arch and foot support can cause some problems. Here's what you need to know.Changes due to COVID-19 pandemic can affect feet<p>The COVID-19 pandemic has caused wide-reaching changes, including the temporary closure of some schools, as well as gyms, salons, bars, restaurants and other businesses. In addition, many people have transitioned to working from home. These changes affect many elements of your health, including how you use your feet. And this can lead to some medical issues.</p> <h2>Transition to bare feet</h2> <p>The transition to work or school from home has led to more people not wearing shoes every day as they previously had when leaving the house. Now they spend most of their time barefoot or stocking-footed.</p> <h3>While going without shoes may feel good in the short term, a lack of arch and foot support can increase the risk of foot conditions, including:</h3> <h4>Plantar fasciitis</h4> <p><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/symptoms-causes/syc-20354846" target="_blank" title="Opens in a new window.">Plantar fasciitis</a>, which is one of the most common causes of heel pain, is the inflammation of a thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes. Plantar fasciitis commonly causes stabbing pain that usually occurs with your first steps in the morning.</p> <h4>Metatarsalgia</h4> <p><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/metatarsalgia/symptoms-causes/syc-20354790" target="_blank" title="Opens in a new window.">Metatarsalgia</a> occurs when the ball of your foot becomes painful and inflamed. Symptoms include a sharp, aching or burning pain in the ball of your foot, and pain that worsens as you stand, run, walk or flex your feet.</p> <h4>Achilles tendinitis</h4> <p><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/achilles-tendinitis/symptoms-causes/syc-20369020" target="_blank" title="Opens in a new window.">Achilles tendinitis</a> is an overuse injury of the band of tissue that connects your calf muscles at the back of the lower leg to your heel bone. The pain associated with Achilles tendonitis typically begins as a mild ache in the back of the leg or above the heel after running or other sports activity.</p> <h4>Tendonitis</h4> <p><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/tendinitis/symptoms-causes/syc-20378243" target="_blank" title="Opens in a new window.">Tendinitis</a>, or inflammation or irritation of a tendon, can occur in your foot. It may be caused by overcompensating or correcting for other conditions. It is described as a dull ache with tenderness and mild swelling.</p> <p>The best way to prevent these conditions and avoid pain or injury is to dedicate a pair of supportive athletic shoes or slippers to wear while in your home.</p> <p>Shoes do more than support your arch and foot. They also protect your foot from injuries, such as stepping on a sharp object or stubbing your toes. If a sharp object penetrates your skin, it could cause an infection or become lodged deeper in the tissue. Stubbing a toe is painful and the primary cause of toe fractures. To avoid painful stubs, remove any clutter along the floor that could catch a toe.</p> <h2>Exercise at home</h2> <p>The pandemic has led to the temporary closure or reduced capacity limits at gyms. That means more people are exercising at home.</p> <p>The importance of wearing supportive athletic shoes while exercising at home should not be minimized. A shoe should provide cushion and support your arch. Multiple studies have shown that there is no one best shoe or a particular foot type, and comfort and proper fit should be the main criteria you use when selecting new athletic shoes.</p> <p>In addition, participate in a variety of exercise regimens, and increase time and intensity gradually. Proper stretching prior to exercise and throughout your workday or school day also is highly recommended to avoid injury and stiffness.</p> <h2>Ingrown toenails</h2> <p>With many salons closed, a painful <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/ingrown-toenails/symptoms-causes/syc-20355903" target="_blank" title="Opens in a new window.">ingrown toenail</a> can develop for people who have relied upon these services to help ward off this condition.</p> <h3>To prevent an ingrown toenail:</h3> <ul> <li>Trim your toenails straight across.</li> <li>Keep toenails at a moderate length.</li> <li>Wear shoes that fit properly and don't place pressure on or pinch your toes.</li> <li>Wear protective footwear to prevent injuries.</li> </ul> <p>You can treat most ingrown toenails at home by soaking your feet in warm water, placing cotton under your toenail and applying antibiotic cream. If home remedies haven't helped your ingrown toenail,<span style="background: white;"> a permanent procedure can be completed to remove the ingrown toenail so it doesn't recur. This procedure is completed in the clinic under local anesthesia but is relatively painless.</span></p> <p>If you have diabetes, seek medical advice and treatment if you have sustained an injury or are having symptoms of pain, redness, swelling or any open wound with drainage. A delay can lead to much more serious conditions from hospitalization to amputation. The sooner issues are addressed, the more likely you will have a positive outcome.<span style="color: #131313; font-family: 'Open Sans', Arial, sans-serif;"> </span></p> <p><em><a href="/providers/sara-vande-kieft-dpm" target="_self" title="Opens in same window.">Sara Vande Kieft, D.P.M.</a>, is a <a href="/services-and-treatments/podiatry" target="_self" title="Opens in same window.">podiatrist</a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a>, <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a> and <a href="/locations/cannon-falls" target="_self" title="Opens in same window.">Cannon Falls</a>, Minnesota.</em></p>D.P.M.<p><strong>Education</strong></p> <ul> <li>University of Osteopathic Medicine and Health Sciences College of Podiatric Medicine and Surgery</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Park Lane Medical Center</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Podiatric Medicine </li> </ul>Vande Kieft<img src="/-/media/shared-files/images/medical-professionals/full/austin/sara-vande-kieft-dpm.jpg?h=280&iar=0&w=280&hash=6C494822F69CD4761B7D1C2215E3FE93" alt="Sara Vande Kieft DPM" width="280" height="280" DisableNVelocity="true" />{FF258BC1-75FA-4B73-818F-0CAD6CB25DDC}Sara<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13194321Sara Vande Kieft, D.P.M.1<img src="/-/media/national-files/images/hometown-health/2021/four-pair-of-athletic-shoes.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B25BAF7A59D2C39E01367C4D718265B0" alt="Four pair of athletic shoes" width="660" height="370" DisableNVelocity="true" />Foot HealthPodiatry is a branch of medicine devoted to the study of diagnosis, medical and surgical treatment of disorders of the foot, ankle and lower extremity.COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Dawn Haller1/26/2022Nasal congestion with a cold or allergy is common. But a long-lasting stuffy nose may be caused by chronic sinusitis. Read a Q&A about this condition and finding relief.Chronic sinusitis: More than a stuffy nose<p>The uncomfortable, plugged feeling of a stuffy nose is common with colds and allergies. For most people, this type of nasal congestion is just an annoyance and inconvenience. It decreases their sense of smell, changes the way that foods taste and causes facial pain, and it can be accompanied by a running or dripping nose. However, it improves after the cold or allergies are gone.</p> <p>Some people's stuffy noses don't resolve after other symptoms are gone. This long-lasting stuffy nose is called chronic rhinosinusitis. This happens when your sinuses are swollen and inflamed for three months or longer, despite treatment.</p> <p><span style="font-weight: bold; font-size: 16px;">Here are some answers to common questions about sinusitis:</span></p> <h4>What is sinusitis?</h4> <p>Sinusitis occurs when the hollow spaces inside your nose and head ― your sinuses ― are swollen and inflamed. Typically, sinuses have a thin lining that produces small amounts of mucus. Healthy sinuses are filled with air. In sinusitis, the lining gets inflamed and makes more mucus. The swelling of the lining also interferes with the way mucus normally drains, making your nose stuffy. Sinusitis can be brought on by an infection; growths in the sinuses, such as nasal polyps; or swelling of the lining of your sinuses due to conditions such as allergies.</p> <h5>Common signs and symptoms of sinusitis include:</h5> <ul> <li>Thick, discolored discharge, or mucus, from the nose</li> <li>Drainage down the back of the throat, which also is known as postnasal drainage</li> <li>Nasal obstruction or congestion, causing difficulty breathing through your nose</li> <li>Pain, pressure, fullness or tenderness, and swelling around your eyes, cheeks, nose or forehead</li> <li>Reduced sense of smell and taste</li> </ul> <h5>Other less common symptoms can include:</h5> <ul> <li>Cough or frequent throat clearing</li> <li>Fatigue</li> <li>Ear pain or pressure</li> <li>Dental pain</li> <li>Nasal or throat irritation</li> <li>Bad breath</li> <li>Headache</li> <li>Voice hoarseness</li> </ul> <h4>What is chronic sinusitis?</h4> <p>Chronic sinusitis is a long-lasting form of sinusitis, and it is diagnosed when symptoms persist for longer than three months. Acute sinusitis is the most common type of sinusitis. It is a temporary condition, typically occurring when you have a cold. It usually gets better within a month or less.</p> <p>Acute sinusitis can turn into a chronic condition if you have had sinusitis multiple times, have infections that don't respond to treatment or you have sinusitis symptoms that last more than three months.</p> <p>Common causes of chronic sinusitis include nasal polyps; deviated nasal septum; complications of conditions, such as cystic fibrosis, HIV and other diseases related to the immune system; recurrent respiratory infections; or allergies.</p> <h4>When should you see an ear, nose and throat specialist?</h4> <p>If you suspect you're having chronic sinus problems, then your primary care provider is a good place to start. He or she may recommend nasal steroid sprays, saline nasal irrigations, oral steroids, allergy medications or antibiotics.</p> <p>If your symptoms don't respond to these more conservative treatments, then it may be time to see an ear, nose and throat specialist, also known as an otorhinolaryngologist. These specialists provide consultation, diagnose and treat disorders of the ear, nose, head and neck, including the sinuses, hearing, adenoids, tonsils and thyroid conditions.</p> <h4>What can you expect during your ear, nose and throat visit?</h4> <p>During a first visit, the specialist likely will spend a good portion of time getting to know you. That includes learning more about your day-to-day life and how sinus symptoms are affecting it. Then the specialist will complete a head and neck exam, paying particular attention to the nose. Typically, a small thin tube with a light and camera at the end called a nasal endoscope is used. This endoscope goes in the nose to get a better look at the nasal passages and sinus openings.</p> <h4>What treatments are available for sinusitis?</h4> <p>Treatment typically starts as conservative as possible. If medical treatments have been tried and your condition hasn't responded, a CT scan of your sinuses may be ordered to get a better look at the sinus anatomy. If allergies are contributing to your symptoms, then allergy shots, or immunotherapy, may improve your condition. If you have nasal polyps, which are growths in your nose and sinuses, then you may be a candidate for new medications called biologic agents that are given as a regular injection and can help shrink nasal polyps and improve your nasal congestion.</p> <p>If you have allergic reactions to aspirin, aspirin desensitization treatment can help your sinusitis and nasal polyposis. If your symptoms persist despite several of the above measures and your condition resists medical treatment, then surgery might be a good option for you.</p> <h4>What does sinus surgery involve?</h4> <p>Sinus surgery is typically performed under general anesthesia in the operating room. Most ENT specialists use a minimally invasive endoscopic approach, which uses a small camera inside the nose. No external incisions are made.</p> <p>Your surgeon will use various instruments to open the natural sinus passages to allow better mucous drainage, and better penetration of nasal sprays and irrigations. Your surgeon will clear the source of the blockage within your sinuses by removing inflamed tissue and shaving away nasal polyps.</p> <p>Your surgeon also may use image guidance during surgery. This allows the surgeon to see the surrounding anatomy and location of instruments as the procedure is performed to avoid damaging critical structures, such as the eye; skull base; and major blood vessels, including the carotid artery. It uses the patient's preoperative CT scan so the surgeon can tell in real time exactly where the instrument tip is.</p> <p>Sinus surgery is typically an outpatient, same-day surgery. Most patients don't experience significant pain afterward and find relief from their chronic sinusitis symptoms.</p> <p><em><a href="/providers/fareeda-hussain-md" target="_self" title="Opens in same window.">Fareeda Hussain, M.D.</a>, is an <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">otolaryngologist</a>, and head and neck surgeon, in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a> and <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</em></p><ul> <li>Ear and hearing-related conditions, including chronic ear disease and cochlear implantation</li> <li>Head and neck endocrine surgeries, including thyroid and parathyroid issues</li> <li>Nonsurgical ear molding</li> <li>Outer ear deformities</li> <li>Pediatric ENT conditions</li> <li>Salivary gland disorders, including parotid masses</li> <li>Sinus and nasal disorders</li> </ul>M.D.<p>I enjoy practicing collaborative, individualized medicine, and including my patients in shared decision-making. I greatly value team care — when the patient, nurses and schedulers all are intimately involved in ensuring we work as a well-functioning team to deliver high-quality care.</p> <p>I grew up in Sri Lanka and moved to Minnesota for college. I did my undergraduate training at Winona State University, then several years of research at Mayo Clinic prior to completing medical school.</p> <p>In my free time, I enjoy being with my family, traveling and staying active.</p><p><strong>Education</strong></p> <ul> <li>Mayo Clinic Alix School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Otolaryngology and Head and Neck Surgery, University of Minnesota</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Head and Neck Surgery, American Academy of Otolaryngology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Otolaryngology-Head and Neck Surgery</li> <li>American Academy of Otolaryngology-Head and Neck Surgery, Women in Otolaryngology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Otolaryngology, Mayo Clinic College of Medicine and Science</li> </ul>Hussain<img src="/-/media/shared-files/images/medical-professionals/full/mankato/fareeda-hussain-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7E1879B82EFF6247427737390FB8C652" alt="Fareeda Hussain MD" width="280" height="280" DisableNVelocity="true" /><ul> <li><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Detection+of+colorectal+serrated+polyps+by+stool+DNA+testing%3A+comparison+with+fecal+immunochemicaltesting+for+occult+blood+(FIT)" target="_blank" title="Opens in new window.">Detection of colorectal serrated polyps by stool DNA testing: comparison with fecal immunochemical testing for occult blood (FIT)</a>, January 2014</li> <li><a href="https://www.ncbi.nlm.nih.gov/pubmed/23347191" target="_blank" title="Opens in new window.">Stool DNA testing for the detection of colorectal neoplasia in patients with inflammatory bowel disease</a>, March 2013</li> <li><a href="https://www.ncbi.nlm.nih.gov/pubmed/23804918" target="_blank" title="Opens in new window.">Surgical Repair of Tetralogy of Fallot at Age 83</a>, October 2012</li> <li><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Sole+abnormalities+of+chromosome+7+in+myeloid+malignancies%3A+Spectrum%2C+histopathologic+correlates%2C+and+prognostic+implications" target="_blank" title="Opens in new window.">Sole abnormalities of chromosome 7 in myeloid malignancies: Spectrum, histopathologic correlates, and prognostic implications</a>, July 2012</li> </ul>{1026DEB5-A821-4F7A-8AA8-A61170A07A2C}Fareeda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14791757Fareeda Hussain, M.D.1{E9B8BDBE-375B-4E7D-A1D2-2B64B5513AF7}|{18E5E65E-45C8-4C48-BD32-A914794E2AA4}<img src="/-/media/national-files/images/hometown-health/2021/blowing-nose-into-tissue.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CBE967CCA382A380268C85B2FC8FE541" alt="Blowing nose into tissue" width="660" height="370" DisableNVelocity="true" />Ear, Nose and Throat (ENT)Get information about symptoms, disorders and diseases affecting the ear, nose and throat, and related head and neck structures.Dawn Haller2/2/2021Knowing and understanding key heart numbers can help you and your health care team determine your risk for developing heart disease. Here's what you need to know about blood pressure.Know your numbers: Blood pressure<p><em>By Mayo Clinic staff</em></p> <p>Knowing and understanding key heart numbers — blood pressure, cholesterol and heart rate, along with your family history — allow you and your health care team to determine your risk for developing heart and cardiovascular disease. Knowing your risk is critical to preventing heart disease and for taking steps to improve your overall heart health.</p> <h3>Here is information about one of the most dangerous and sneakiest health conditions: blood pressure.</h3> <h4>What is blood pressure?</h4> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/multimedia/what-is-blood-pressure/vid-20084747" target="_blank" title="Opens in a new window.">Blood pressure</a> is a measure of how hard your blood pushes against your arteries as it moves through your body. High blood pressure occurs when your blood pressure, the force of your blood against the walls of your blood vessels, is consistently too high. High blood pressure is harmful because it makes the heart work harder and less efficiently.</p> <h4>Why blood pressure matters</h4> <p>High blood pressure can cause significant damage to your eyes, kidneys, brain and blood vessels. Left untreated, it can lead to kidney failure or vision loss. High blood pressure also can affect your ability to think, remember and learn. There's even a type of dementia — <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/vascular-dementia/symptoms-causes/syc-20378793" target="_blank" title="Opens in a new window.">vascular dementia</a> — caused by high blood pressure.</p> <p>High blood pressure is one of the most dangerous health conditions because of how sneaky it can be. You can have high blood pressure for years without experiencing any symptoms. Even without symptoms, damage to your heart can still occur. Fortunately, high blood pressure can be easily detected. And once you know you have high blood pressure, you can work with your health care provider to control it.</p> <h4>How is blood pressure measured?</h4> <p>Blood pressure is traditionally measured using an inflatable cuff around your arm. The cuff is inflated, and the cuff gently tightens on your arm. The air in the cuff is slowly released and a small gauge measures your blood pressure.</p> <h5>Your blood pressure is recorded as two numbers:</h5> <ul> <li><strong>Systolic blood pressure (the first number)</strong> — This number indicates how much pressure your blood is pushing against your artery walls when the heart beats.</li> <li><strong>Diastolic blood pressure (the second number)</strong> — This number indicates how much pressure your blood is pushing against your artery walls while the heart is resting between beats.</li> </ul> <p>Blood pressure is measured using millimeters of mercury, or mm Hg. Mercury was used in the first accurate pressure gauges, and it is still used today as the standard unit for measuring pressure.</p> <h4>What is considered normal?</h4> <h5>Your blood pressure reading will fall into one of these four categories:</h5> <ul> <li><strong>Normal</strong> — Blood pressure readings of less than 120/80 mm Hg are considered in the normal range.</li> <li><strong>Elevated</strong> — Readings consistently ranging from 120–129 systolic and less than 80 mm Hg diastolic are considered elevated.</li> <li><strong>Hypertension stage 1</strong> — This stage is characterized by readings ranging from 130–139 systolic or 80–89 mm Hg diastolic.</li> <li><strong>Hypertension stage 2</strong> — This stage is characterized by readings consistently ranging at 140/90 mm Hg or higher.</li> </ul> <h4>What you can do</h4> <ul> <li><strong>Quit smoking.</strong> Tobacco temporarily raises blood pressure and can damage artery walls over time. Quitting smoking is one of the best things you can do for your health.</li> <li><strong>Follow the DASH diet.</strong> The Dietary Approaches to Stop Hypertension, or DASH, diet includes whole grains, fruits, vegetables and low-fat dairy products. The diet encourages limiting saturated fat and foods containing high cholesterol. Following the DASH diet can lower your blood pressure by up to 11 mm Hg if you have high blood pressure.</li> <li><strong>Get active.</strong> Regular <a href="/topics/exercise-and-fitness" target="_self" title="Opens in same window.">physical fitness</a> ― about 30 minutes per day or 150 minutes per week ― can lower your blood pressure by about 5 to 8 mm Hg.</li> <li><strong>Limit alcohol.</strong> By drinking alcohol in moderation ― generally one drink a day for women or two a day for men ― you can potentially lower your blood pressure by about 4 mm Hg. One drink equals 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80 proof liquor.</li> <li><strong>Skimp on the salt.</strong> In general, limit sodium to 2,300 milligrams per day or less. However, a lower sodium intake ― 1,500 mg a day or less ― is ideal for most adults. <a href="/-/media/national-files/documents/hometown-health/2019/salty-news-for-your-diet.pdf?sc_lang=en&hash=2B265A0F8C2F9CE4DCBA4CE95DD30E53" target="_blank" title="Opens in a new window.">Download an infographic about salt</a>.</li> </ul> <h4>Know your numbers</h4> <p>It's time to know your blood pressure numbers. Adults 40 and older or anyone with risk factors should have their blood pressure checked by a health care provider once a year. Younger people without risk factors should be checked at least every two years. <span style="color: #333333;"></span><a href="/-/media/national-files/documents/hometown-health/2019/get-the-facts-high-blood-pressure.pdf?sc_lang=en&hash=938229F6EA80675E1B647E093FB1D162" target="_blank" title="Opens in a new window.">Download an infographic about high blood pressure</a><span style="color: #333333;">.</span></p> <p>Visit <a href="/classes-and-events" target="_self" title="Opens in same window.">Classes & Events</a> to find a blood pressure screening near you.</p><img src="/-/media/national-files/images/hometown-health/2021/know-your-numbers-blood-pressure.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A47456F532D8CAC5D0DEA25F20B89AD7" alt="Know your numbers blood pressure" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller4/24/2025You can lower your risk of heart disease, stroke and peripheral artery disease by keeping your cholesterol at normal levels. Here's what you need to know.Know your numbers: Cholesterol<p>You can lower your risk of heart disease, stroke and peripheral artery disease by keeping your cholesterol at normal levels. Here's what you need to know.</p> <h2>What is cholesterol?</h2> <p>Cholesterol is a waxy substance that is found in all of your cells. This substance has several useful functions including helping build your body's cells. Cholesterol comes from two sources: your liver and the foods you consume. Cholesterol travels throughout your body in your blood.</p> <h2>Why cholesterol matters</h2> <p>Cholesterol can join with other substances to form a thick, hard deposit on the inside of your arteries, making arteries less flexible. Eventually, these deposits grow, making it difficult for enough blood to flow through your arteries. Sometimes these deposits can break suddenly and form a blockage that causes a heart attack or stroke.</p> <h3>However, not all cholesterol is bad. There are two types of cholesterol:</h3> <ul> <li><strong>High-density lipoprotein cholesterol, or HDL</strong><br /> HDL cholesterol is often referred to as "good" cholesterol. HDL picks up excess cholesterol in your blood and takes it back to your liver, where it is broken down and removed from your body.</li> <li><strong>Low-density lipoprotein cholesterol, or LDL</strong><br /> LDL is the type of cholesterol that can eventually build up within the walls of your arteries, leading to a heart attack or stroke. This is why LDL is often referred to as "bad" cholesterol.</li> </ul> <p>When you have high cholesterol, you have too much LDL and not enough HDL in your blood, increasing your risk for a blockage causing a heart attack or stroke. There are no symptoms for high cholesterol.</p> <h2>What cholesterol level is considered normal?</h2> <h3>Normal or healthy levels of cholesterol are different, depending on your age and sex:</h3> <ul> <li><strong>People 19 and younger</strong><br /> LDL cholesterol is less than 110 milligrams and HDL is more than 45 milligrams.</li> <li><strong>Men 20 and older</strong><br /> LDL cholesterol is less than 100 milligrams and HDL is more than 40 milligrams.</li> <li><strong>Women 20 and older</strong><br /> LDL cholesterol is less than 100 milligrams and HDL is more than 50 milligrams.</li> </ul> <h2>What you can do</h2> <p>The good news is high cholesterol can be lowered, reducing risk of heart disease and stroke.</p> <h3>Often changing your lifestyle or behavior can bring your numbers into line, including these steps:</h3> <ul> <li><strong>Eat a <a href="/hometown-health/speaking-of-health/4-key-elements-of-a-heart-healthy-diet" target="_self" title="Opens in same window.">heart-healthy diet</a>.</strong><br /> The best way to lower your cholesterol is to reduce your intake of saturated and trans fats. Reducing these fats means limiting your intake of red meat and dairy products made with whole milk. Choose skim milk, low-fat or fat-free dairy products instead. A heart-healthy diet also includes recipes incorporating fruits, vegetables, whole grains, poultry, fish and nuts into your diet, and limiting sodium, sugar and fried foods.</li> <li><strong>Become more <a href="/hometown-health/featured-topic/the-importance-of-movement" target="_self" title="Opens in same window.">physically active</a>.</strong><br /> A sedentary lifestyle lowers your good HDL cholesterol. Aim for at least 150 minutes of physical activity per week.</li> <li><strong>Quit smoking.</strong><br /> Smoking and vaping lowers good HDL cholesterol</li> <li><strong>Lose weight.</strong><br /> Being overweight or obese can raise bad cholesterol and lower good cholesterol. Losing as little as 5% to 10% of your body weight can improve cholesterol numbers.</li> </ul> <h2>Know your numbers</h2> <p>To measure your cholesterol, you will need to get a cholesterol test, also called a lipid panel or lipid profile. The test measures the types of fat and cholesterol in your blood. A cholesterol test is a blood test, usually completed in the morning, since fasting is required for the most accurate results. A small amount of blood is collected into a vial or syringe for testing.</p> <p>Adults at average risk of developing coronary artery disease should have their cholesterol checked every five years, beginning at 18. For most children, the National Heart, Lung and Blood Institute recommends one cholesterol screening test between ages 9 and 11 and another between ages 17 and 21.</p> <p>Your health care provider may recommend more frequent testing if initial results were abnormal, if you have a family history of early-onset heart disease, or if you have a personal history of obesity or diabetes.</p><img src="/-/media/national-files/images/hometown-health/2021/know-your-numbers-cholesterol.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2A0738117CCC2145298DC98EA9C5AE05" alt="Know Your Numbers Cholesterol" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller2/23/2021Genes play a role in your health. Understanding your family's heart and health history is key to understanding your risk of heart disease. Find out which relatives you should talk to about family health history.Know your numbers: Family health history<p>Understanding your family's heart and overall health history is key to understanding your overall risk of heart disease.</p> <h2>What is family history?</h2> <p>Your genes play a role in nearly all areas of your health. A gene is like an instruction manual for your body that tells your body how to function, develop and stay healthy. You have around 20,000 genes in your body. Many health conditions have a genetic link, including heart disease and stroke.</p> <p>Outlining your family health history can help you and your healthcare providers understand if you have an increased risk for developing certain conditions that are present in your family. If you are at risk, you may be able to take preventive measures to decrease your risk or undergo genetic testing to clarify your risk.</p> <h2>Why family history matters</h2> <p>Some health conditions are almost completely determined by your genes, meaning they are correlated with a specific harmful genetic change. This is called a mutation or pathogenic variant, like a spelling error within the instruction manual. These genetic changes will cause you to develop a genetic condition ― something you would not have caught or developed purely because of your environment.</p> <h2>What you can do</h2> <p>Your genes usually don't determine anything with complete certainty. Your family health history and genes do not determine your fate, and your environment still plays a role.</p> <p>Your environment can include factors you can't change, such as your biological sex and age, as well as factors you can control, such as diet, physical activity level, and exposures to cigarette smoke and other chemicals. "Multifactorial inheritance" is when your genetic makeup and environment play a role in determining your risk for particular conditions. Many common conditions, such as autoimmune diseases, cancer, and mental health conditions, like anxiety and depression, are considered multifactorial.</p> <p>While you can't change your genes, you can control some aspects of your environment, such as diet, physical activity level and tobacco use. You have some control over how much goes into your various health cups over time. That's why it's still so important to live a healthy life, regardless of your personal and family health history.</p> <h2>Who to talk with to obtain family history</h2> <h3>Generally, you should try to get family history information about:</h3> <ul> <li><strong>First-degree relatives</strong><br /> They are your parents, full siblings and children.</li> <li><strong>Second-degree relatives</strong><br /> They are half-siblings, grandparents, aunts and uncles, nieces and nephews, and grandchildren.</li> <li><strong>Third-degree relatives</strong><br /> They are first cousins, great-aunts and great-uncles, great-grandparents, great-grandchildren, half-aunts and half-uncles</li> </ul> <p>It still may help to gather information from as many relatives as you can, but the more distantly related relatives are, the less their history could affect you.</p> <p>Both your mother's and father's side of your family are relevant, regardless of your biological sex or whether you more closely resemble one side of the family more than the other.</p> <p>Many people find it challenging to capture a complete health history due to adoption, estrangement, or simply a lack of details known or willing to be shared in the family. It's OK to simply record the information that you can gather and know that it can be updated if more information becomes available in the future.</p> <h2>Know your family's numbers</h2> <p>In general, you should try to gather information about whether relatives are living, their current age or age at which they passed away and their medical history. Relevant details about health history include any medical conditions they have had and at what age they were diagnosed. For example, you can ask if they have had major health concerns, have ongoing or chronic health concerns, see a specialist for any medical conditions or are taking medication for health conditions.</p> <p>Learn more about <a href="/hometown-health/featured-topic/knowing-and-recording-your-family-health-history" target="_self" title="Opens in same window.">knowing and recording your family health history</a>.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2021/know-your-numbers-family-history.jpg?h=370&iar=0&w=660&sc_lang=en&hash=307280A73077EA33167B36EC614514CE" alt="Know Your Numbers: Family History" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Genetic TestingGenetic testing examines your DNA — the chemical database that carries instructions for your body's functions — to reveal changes or alterations in your genes that may cause illness or disease. <br/><br/>Karen Sperl2/7/2024The better you understand your heart rate, the more you can maximize your movement to give your heart a good workout. Learn why your heart rate matters and how to find your target heart rate.Know your numbers: What is your heart rate?<h2>Know your numbers: What is your heart rate? </h2> <p>Your heart rate, or pulse, is the number of times your heart beats per minute. Your resting heart rate is when the heart is pumping the lowest amount of blood you need because you're not exercising. If you're sitting or lying down ― and you're calm, relaxed and aren't sick ― your heart rate is typically between 60 and 100 beats per minute. </p> <h3>Other factors that can affect your heart rate include: </h3> <ul> <li><strong>Air temperature.</strong> When <a href="/hometown-health/speaking-of-health/effects-of-high-temperatures-on-blood-pressure-heart">temperatures or humidity increases</a>, the heart pumps more blood, so your pulse or heart rate may increase. </li> <li><strong>Body position.</strong> Sometimes, when going from sitting to standing, your pulse may go up a little. After a few minutes, it should return to a typical rate. </li> <li><strong>Emotions.</strong> If you're stressed, anxious or incredibly happy, your emotions can raise your heart rate. </li> <li><strong>Body size.</strong> Body size usually does not increase your heart rate. However, if you're obese, you may have a higher resting heart rate. </li> <li><strong>Medication use.</strong> Medications that block adrenaline tend to slow your heart rate. Thyroid medication may raise it. </li> </ul> <h3>Why your heart rate matters </h3> <p>Cardiovascular exercise, also called cardio or aerobic exercise, keeps you and your heart healthy. This specific type of exercise gets your heart rate up and your heart beating faster for several minutes. Cardiovascular exercise helps strengthen your heart, allowing it to pump blood more efficiently and improving blood flow to all parts of your body. It also boosts your high-density lipoprotein (or HDL), or "good" <a href="/hometown-health/speaking-of-health/know-your-numbers-cholesterol">cholesterol</a>, and lowers your low-density lipoprotein (or LDL), or "bad" cholesterol. This may result in less buildup of plaque in your arteries. </p> <h2>What's your target heart rate? </h2> <p>Your target heart rate is the minimum heart rate you need to maintain in a given amount of time to reach the energy level necessary to give your heart a good workout. To find your target heart rate to maximize your cardiovascular exercise, the first step is determining your maximum heart rate. </p> <p>Your maximum heart rate is 220 minus your age. Your target heart rate for moderate to vigorous exercise is about 50%–85% of your maximum heart rate. </p> <h3>Averages by age as a general guide are: </h3> <ul> <li>20: 100–170 beats per minute </li> <li>30: 95–162 beats per minute </li> <li>35: 93–157 beats per minute</li> <li>40: 90–153 beats per minute </li> <li>45: 88–149 beats per minute</li> <li>50: 85–145 beats per minute</li> <li>55: 83–140 beats per minute</li> <li>60: 80–136 beats per minute</li> <li>65: 78–132 beats per minute</li> <li>70: 75–128 beats per minute </li> </ul> <h3>What you can do </h3> <ul> <li><strong>Start slow.</strong> If you are beginning an exercise program, aim for the lower end of your target heart rate zone and then gradually build up intensity.</li> <li><strong>Try interval training.</strong> <a href="/hometown-health/speaking-of-health/interval-training-for-heart-health">Interval training</a>, which includes short bursts ― 15–60 seconds ― of higher-intensity exercise, alternated with longer, less strenuous exercise, effectively increases cardiovascular fitness. Talk with your healthcare team before trying interval training, but it is typically safe for those with existing heart disease and Type 2 diabetes. </li> <li><strong>Take the "talk test."</strong> If you can carry on a conversation in brief sentences while exercising, you're probably in the moderate intensity range. You'll be breathing faster, developing a light sweat and feeling some muscle strain. If you're working at a vigorous intensity, you won't be able to say more than a few words without catching your breath. If you can sing while working out, you're probably in the low-intensity range, so step it up. </li> </ul> <h2>Know your numbers </h2> <p>Many wearable activity trackers can <a rel="noopener noreferrer" href="https://www.mayoclinic.org/how-to-take-pulse/art-20482581" target="_blank" title="Opens in a new window.">monitor your heart rate</a> when you exercise and periodically throughout the day. If you don't have an activity tracker, you can use the radial artery in your wrist or the carotid artery in your neck. If you have heart disease or long-standing diabetes, it's best to use the artery on your wrist. </p> <h3>To find your heart rate manually:</h3> <ul> <li>Locate the artery you will use to find your heart rate. </li> <li>Using the tips of your first two fingers, press lightly over the artery. </li> <li>Count your heartbeats for 30 seconds and multiply by two to find your total beats per minute. </li> </ul> <p>If your heart rate is too high, take it easier. If it's too low, add some intensity and push yourself to get your heart rate closer to your target. </p> <h3>Abnormal heart rate </h3> <p>If you experience irregular heartbeats, including a racing heartbeat, slow heartbeat or a feeling of fluttering in your chest, you may be experiencing a <a href="/hometown-health/speaking-of-health/racing-heart-beat-heart-arrhythmia-101">heart arrhythmia</a>. Heart rhythm or heartbeat problems can occur when the electrical impulses that coordinate your heartbeats don't work properly, causing your heart to beat too fast, slow or irregularly. Talk with your healthcare team if you have heart rhythm concerns. </p> <h2>Next steps</h2> <ul> <li>Watch Dr. Liu explain the <a rel="noopener noreferrer" href="https://youtu.be/1OnQHdN4m_Q?si=1URr89jYgsS7EleH" target="_blank" title="Opens in new window. ">best exercise and wearable fitness trackers</a>. </li> <li>Learn when <a href="/hometown-health/speaking-of-health/young-athletes-and-heart-health">athletes need evaluation for heart health</a>. </li> <li>Hear the <a rel="noopener noreferrer" href="https://www.youtube.com/watch?v=fyqFfeC2FE4" target="_blank" title="Opens in a new window.">difference between heart rate and heart rhythm</a>. </li> <li>Find a <a href="/services-and-treatments/cardiology">heart care expert</a> near you. </li> </ul> <p><em><a href="/providers/xiaoke-ken-liu-md-phd">Xiaoke (Ken) Liu, M.D.</a>, is a <a href="/services-and-treatments/cardiology">cardiologist</a> in <a href="/locations/la-crosse">La Crosse</a>, Wisconsin.</em></p><ul> <li>Atrial fibrillation</li> <li>Atrial flutter</li> <li>Cardiac devices</li> <li>Cardiac resynchronization devices</li> <li>Clinical cardiac arrhythmias</li> <li>Supraventricular tachycardia (SVT)</li> </ul>M.D., Ph.D.<p>I believe being able to practice clinical medicine is a privilege granted by our patients, and they have the rights to be treated the same way as our family members and friends would be. It brings me tremendous happiness and joy to see my patients feel better or completely recover from frequently debilitating heart rhythm conditions through treatment. I strive to achieve that for every patient I see, often through a multidisciplinary, team approach offered at the Mayo Clinic Health System and often involving a shared decision-making process.</p> <p>My years of training and experience have also taught me the need to stay up to speed with the latest development in the field, to be humble and stay open-minded in evaluating different ideas and options as the disease may be the same, but the individual patient is not and may benefit from tailored treatment.</p> <p>In my free time, I love to spend time with my family, hike, sightsee and attend sports events. I also enjoy ping-pong, pickleball and swimming. If time allows, I would really like to learn more about fishing and boating in the future.</p><p><strong>Education</strong></p> <ul> <li>Hunan Medical University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Internal Medicine, Mayo Clinic</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>Cardiovascular, Mayo Clinic School of Graduate Medical Education</li> <li>Internal Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Cardiology and Electrophysiology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Cardiovascular Disease, American Board of Internal Medicine</li> <li>Clinical Cardiac Electrophysiology, American Board of Internal Medicine</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American College of Cardiology</li> <li>Heart Rhythm Society</li> </ul>Liu<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/xiaoke-ken-liu-md-phd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=E9FC7400B73A9B49BDB8842EA2B6196E" alt="Xiaoke Ken Liu, M.D., Ph.D." width="280" height="280" DisableNVelocity="true" /><p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/35870261/" target="_blank" title="Opens in new window">Aging-associated susceptibility to stress-induced ventricular arrhythmogenesis is attenuated by tetrodotoxin</a>; October 2022</p> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/36055436/" target="_blank" title="Opens in new window">Role of adjunctive cryoballoon left atrial posterior wall isolation in non-paroxysmal atrial fibrillation: A meta-analysis</a>; August 2022 </p> <p><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/34026498/" target="_blank" title="Opens in new window">Successful fluoroless deviation of the esophagus during atrial fibrillation ablation</a>; April 2021</p> <p><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/30194724/" target="_blank" title="Opens in new window">Outcomes of 200 consecutive, fluoroless atrial fibrillation ablations using a new technique</a>; November 2018</p> <p><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/28748143/" target="_blank" title="Opens in new window">Successful fluoroless ablation of an incessant atypical atrial flutter attributed to AtriClip usage during mini-MAZE surgery for persistent atrial fibrillation</a>; July 2017</p>{E157CC36-5C02-406C-AE55-B6A48D97C400}Xiaoke (Ken)<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13433016Xiaoke (Ken) Liu, M.D., Ph.D.1<img src="/-/media/national-files/images/hometown-health/2024/adult-checking-heart-rate-on-wrist-watch.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F3937BB87F6098187218503C2CEBBBBA" alt="Adult wearing gold checking heart rate on wrist watch" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller6/20/2023When feeling stressed or bored, people often turn to food to cope. It's easy to reach for a snack if you don't have a plan for what and when to eat. Learn easy ways to be mindful about snacking.Tips for mindful snacking<p>As a dietitian, my role is to help patients maintain a healthy lifestyle every day by focusing on these three things: exercise, eating a balanced diet and maintaining a healthy weight.</p> <h2>If your snacking habits are not as healthy as they once were, here are some things to remember when snacking:</h2> <h3>Plan your approach and stock your pantry.</h3> <p>Determining your game plan for what and when to eat is important. The first step is to examine your thoughts. Think and plan — don't react. A game plan will help you stick with healthy habits — or return to them if you have gotten off course.</p> <p> First, plan on enjoying snacks only during specific times or portion out healthy snacks so you stay energized and don't overindulge. Second, fill your home with healthy food choices, such as fruits, vegetables, low-sodium soups, whole grains and lean proteins. Make the healthy snack options easy so you don't reach for unhealthier options. Also, remove unhealthy foods that you know will tempt you.</p> <h3>Track your progress.</h3> <p>If you're concerned about gaining weight, let's deal with the facts. Your weight is based on caloric intake. Women need 10 calories per pound per day to maintain their weight, and men need 11 calories per pound per day. Keep track of what and how much you eat, and use exercise to control weight gain.</p> <p>Many apps are available to track what you eat and how much you exercise. If your schedule changes, problem-solve to find a different approach to accomplish the same level of activity. Be kind to yourself and focus on the larger goal. Research has shown that it can take up to 66 days of consistently repeating a behavior until it forms a habit, so work toward progress, not perfection.</p> <h3>Snack for hunger, not stress.</h3> <p>When feeling stressed or bored, people often turn to food to cope. Treat yourself with love and respect. Don't abuse your body by overeating, which can increase stress levels with the weight gain that often results.</p> <p>If you start craving sweets, which is a normal response to stress, grab lean protein foods to reduce the cravings. Such foods include hard-boiled eggs, pouches of seasoned tuna, cheese sticks, cottage cheese, yogurt with no added sugar or soups made with lots of vegetables and legumes.</p> <p> When you start to feel hungry, ask yourself, "Am I physically hungry or just stressed?" If you realize you are reaching for a snack due to stress or boredom, distract yourself by going for a walk, doing something creative, talking with a friend on the phone, playing a game or meditating on all the blessings you have instead.</p> <h2>Learn more about mindful eating:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/clean-eating-what-does-that-mean" target="_self" title="Opens in same window.">Clean eating: What does that mean?</a></li> <li>Discover why you should <a href="/hometown-health/speaking-of-health/keep-track-of-bite-lick-and-taste-calories" target="_self" title="Opens in same window.">keep track of bite, lick and taste calories</a>.</li> <li>Take <a href="/hometown-health/speaking-of-health/3-steps-to-control-your-environment-and-weight" target="_self" title="Opens in same window.">three steps to control your environment and weight</a>.</li> <li>Find easy meal ideas for <a href="/hometown-health/speaking-of-health/tips-for-healthy-eating-in-a-hurry" target="_self" title="Opens in same window.">healthy eating in a hurry</a>.</li> </ul> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2023/fingers-peeling-clementine.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BD7B4B134A3F9146F7DD0FB9AE2C126C" alt="Fingers peeling clementine" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller2/19/2021As you age, some surprising body changes can occur, like losing height or leaking when laughing. Learn what's natural, what's not and steps to delay or lessen the changes.Q&A: Surprising, but normal, changes in aging bodies<p>Some surprising changes can occur as your body gets older. Learn what's natural to expect, what's not and simple steps to delay or lessen the changes.</p> <h2>I used to be 6 feet tall. Now I'm 5 feet, 11 inches tall. What's up with that?</h2> <p>A. As you age, several changes occur within your body that causes you to lose some height. Some are normal and some are not. You have 24 bones, or vertebrae, in your spine. Discs between each vertebra begin to lose strength and become thinner as you age. When these vertebrae begin to thin out, you will start to shrink little by little. After age 35, the natural bone remodeling process becomes a bit disordered, and you break down our bones faster than you rebuild them, so the bones become thinner. You can help prevent this bone breakdown to a significant degree through weight-bearing exercise, such as walking, jogging, aerobics, weightlifting, resistance training, and a healthy diet rich in calcium and vitamin D. You also should talk to your healthcare provider about whether you are a candidate for osteoporosis screening through <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/bone-density-test/about/pac-20385273" target="_blank" title="Opens in a new window.">bone density testing</a>.</p> <h2>Ugh, I didn't drink that much. Why do I feel so terrible today?</h2> <p>A. Maybe you had a little too much fun celebrating a favorite team's victory last night, but didn't drink as many as you used to. So why do you feel so bad today? As you age, your metabolism slows, and the number and efficiency of liver cells declines in such a way that you can't clear the alcohol from your system like you used to. As a result, alcohol builds to higher levels longer than normal. Therefore, you have a higher likelihood of a hangover as you age. You can't do much to make your liver work better, but you can do a couple of things to help with this process. Drink more water and less alcohol. Drinking water before, during and after will help you feel much better the next day. If you or others feel like alcohol use is becoming a problem for you, speak to your healthcare provider about getting the help that you need to reduce or eliminate alcohol from your life.</p> <h2>I leak when I laugh and at other times, too. What am I to do?</h2> <p>A. Urinary leakage, known as urinary incontinence, is a common problem for women. This problem results from several causes, including pregnancy, childbirth, menopause, overactive bladder muscles, weakened pelvic muscles and nerve damage. There are many types of <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/urinary-incontinence/symptoms-causes/syc-20352808" target="_blank" title="Opens in a new window.">incontinence</a>, and the right treatment requires the proper diagnosis. Making the right diagnosis likely will include a complete history of the symptoms; a physical exam; some urine testing; and perhaps some more advanced studies, such as <a rel="noopener" href="https://www.niddk.nih.gov/health-information/diagnostic-tests/urodynamic-testing#urodynamic" target="_blank" title="Opens in a new window.">urodynamic testing</a> or ultrasound and X-ray imaging. Treatments are helpful and range from behavioral modifications, dietary changes, pelvic muscle strengthening, medications and surgery. Talk to your healthcare provider as soon as you are ready, and solutions will follow.</p> <h2>Why am I in the bathroom again?</h2> <p>A. Getting up in the middle of the night to go to the bathroom, or <a rel="noopener" href="https://www.mayoclinic.org/symptoms/frequent-urination/basics/definition/sym-20050712" target="_blank" title="Opens in a new window.">nocturia</a>, is a problem for many people. Up to one-third of men over 30 make at least two trips to the bathroom after they've gone to bed. This is most commonly caused by <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/benign-prostatic-hyperplasia/symptoms-causes/syc-20370087" target="_blank" title="Opens in a new window.">benign prostatic hyperplasia</a>, or BPH, which is an enlarged prostate. There are, however, other causes, including medications, alcohol, caffeine, nighttime drinking and dietary habits, diabetes, heart conditions and sleep disorders, such as sleep apnea. The treatment of nocturia requires a proper diagnosis. This happens through a visit to your healthcare provider. This visit will include a history, exam and simple laboratory testing to start. Treatments may include behavioral modifications, dietary changes, medications or surgical intervention. Contact your healthcare provider if this is a problem that you want remedied.</p> <p><a href="/topics/aging" target="_self" title="Opens in same window.">Learn more about aging</a> to help you live your healthiest life.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2021/group-of-mature-women-laughing.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E04A970ED129C2D7652ADC185535C877" alt="Group of mature women laughing" width="660" height="370" DisableNVelocity="true" />AgingLife expectancy is 75 for males and 80 for females according to the National Center for Health Statistics. We'll help you keep you informed about potential issues with aging, and steps you can take to maintain your health and keep active.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller2/17/2021Mayo Clinic's Remote Patient Monitoring Program provides patients diagnosed with COVID-19 comprehensive care at home. Learn how it can help quickly escalate care.Remote patient monitoring: Comprehensive care at home<p>When patients are diagnosed with <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/coronavirus/symptoms-causes/syc-20479963" target="_blank" title="Opens in a new window.">COVID-19</a>, they are required to self-isolate until the infection is cleared, often for at least two weeks. Some of these patients will be at risk for complications, and these patients need support at home in a comprehensive way.</p> <p>Providing that support is the goal of Mayo Clinic's Remote Patient Monitoring Program. This program, led by Mayo Clinic's Center for Connected Care, uses medical technology and devices that are sent to patients' homes so vital signs and symptom assessments can be screened every day. A team of Remote Patient Monitoring nurses regularly monitors the data and contacts patients to assess health and progress toward health goals. The program was developed to support patients with complex chronic conditions.</p> <p>In response to the COVID-19 pandemic, the Remote Patient Monitoring Team quickly developed care plans specific to patients with COVID-19. The program is offered across Mayo Clinic.</p> <h2>How the Remote Patient Monitoring Program works</h2> <p>As part of the Remote Patient Monitoring Program, two tracks were developed for patients with COVID-19: one for patients with comorbidities at moderate to high risk for complications and one for lower-risk patients.</p> <p>Patients who are enrolled in the high risk program receive a remote patient monitoring kit that includes a blood pressure cuff, thermometer, pulse oximeter and a weight scale. They use these devices two to four times a day to measure their vital signs. These measurements are sent automatically to Mayo Clinic through a cellular-enabled tablet that patients receive with their kits. Remote Patient Monitoring nurses will also call patients to determine if they are experiencing symptoms such as nausea and shortness of breath.  Patients who are at lower risk for complications record vital signs using the Mayo Clinic app. Each day, these patients receive a notification on their mobile device letting them know that they need to provide information to their care team through the Mayo Clinic app.</p> <h3>Monitoring data</h3> <p>Since COVID-19 patients are asked to self-isolate as they recover, <a rel="noopener" href="https://www.mayoclinic.org/biographies/haddad-tufia-c-m-d/bio-20055534" target="_blank" title="Opens in a new window.">Tufia Haddad, M.D</a>., medical director for the Center for Connected Care's Remote Patient Monitoring Team, says it's important that patients, with what can be an unsettling diagnosis, stay connected to their care team.</p> <p>Patients are monitored 24/7 to assess any changes in their biometric data. One of the monitoring goals is to detect any significant changes in the patients' vitals as early as possible.</p> <p>"Anytime that a patient is reporting new or worsening symptoms, or if any of their vital sign parameters are out of range or trending adversely, that will prompt an automated alert to our Remote Patient Monitoring nurses," says Dr. Haddad. "And then those nurses will check in with the patient. In some cases, they can even connect via video with the patient and get that visual assessment to determine if further escalation is needed to our COVID-19 care team physicians."</p> <p>One biometric value that is monitored closely is oxygenation. "We've observed that there is often a drop in oxygen saturation levels, as measured by the pulse oximeter, before symptoms like shortness of breath develop. Early detection can limit the severity of decompensation potentially reducing need for admission or shortening a hospital stay," explains Dr. Haddad.</p> <h2>Patient responses to the Remote Patient Monitoring Program</h2> <p>Patients are responding well to the technology that is sent to them and find it easy to use.</p> <p>Dr. Haddad also points out that it's important to stay connected while in self-isolation, "Patients have a direct link to their care teams through remote monitoring. Nurses will call and discuss symptoms, and offer other educational information. These interactions are reassuring for patients and provide affirmation that they are being monitored and cared for."</p> <p><a rel="noopener" href="https://www.mayoclinic.org/biographies/goyal-deepi-g-m-d/bio-20054026" target="_blank" title="Opens in a new window.">Deepi Goyal, M.D.</a>, an Emergency Medicine physician and regional chair of practice for Mayo Clinic Health System in Southeast Minnesota, can draw on his personal experience of COVID-19 and Remote Patient Monitoring. He was enrolled in the Remote Patient Monitoring Program during his COVID-19 diagnosis and recovery in 2020.</p> <p>"While I was familiar with the Remote Patient Monitoring Program, I had never seen it in action," says Dr. Goyal. "When my daughter and then I were diagnosed with COVID and then quarantined, I was actually very surprised when I received the kit from the Remote Patient Monitoring group."</p> <p>"I reported my symptoms twice a day to the Remote Patient Monitoring team. I can't even tell you what a sense of comfort having that program wrapped around me (was) when I was quarantined by myself in a room for two weeks," says Dr. Goyal. "It gave us a tremendous sense of comfort to know that there was someone watching our symptoms, vital signs and knowing when to escalate care."</p> <h2>Learn more</h2> <h3>This video explains how remote patient monitoring helps patients go home but still be closely monitored by Mayo Clinic as they continue to reach their healthcare goals:</h3> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/D-Eeygrp6rU" title="Patients and Remote Patient Monitoring" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p> </p> <h3>Jan Lorimar, along with her doctor and nurse, shares her experience as a Remote Patient Monitoring Program patient when she was diagnosed with and recovering from COVID-19:</h3> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/0xJhI1R1Vio" title="Remote Patient Monitoring and COVID 19" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p><img src="/-/media/national-files/images/hometown-health/2020/remote-patient-monitoring-screen.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4D3239E11A5FE1873DAA36EDD8C2AAA8" alt="Remote patient monitoring screen" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller2/12/2021Getting older? Noticing some wrinkles and muscle loss or forgetting names? In this Q&A, learn simple steps to delay or lessen those changes.Weird, but normal, body reactions of aging<p>Throughout life, your body is constantly changing. You can enjoy growing older by knowing what's natural as you age and what's not — and by learning simple steps to delay or lessen the changes.</p> <h2>What's going on with these wrinkles?</h2> <p>Wrinkles are a natural part of aging brought on by several factors. You can thank your parents as genetics play a role. You can thank your kids and bosses as stress also plays a role. However, there are several preventable causes of wrinkles, including ultraviolet light from tanning beds and sun exposure that breaks down the elastin fibers and collagen in skin. Air pollutants and tobacco smoke exposure also play a significant role. Skin becomes less elastic as you age, and the natural oil production in skin causes it to dry out. You lose the fat in the deeper layers of your skin, and the crevices and lines become more prominent. You can slow down Father Time's effects on skin by using sunscreen, protective clothing, hats, moisturizers, stopping smoking, and having a diet full of natural antioxidants that are found in fruits and vegetables. Talk to your health care provider if you're interested in treatment beyond these tips.</p> <h2>I used to be muscular. What happened to my "gun show?"</h2> <p>After the age of 30, you start to lose muscle mass and function. This is called sarcopenia, and those who are physically inactive can lose up to 5% of muscle mass per decade of life. These changes are caused by your diet; inactivity; changes in hormones, such as testosterone, human growth hormone and insulin-like growth factor; and the decreased ability of your cells to use the protein for energy. Even physically active people will notice some muscle loss, but you can continue to build muscle well into your 80s if you exercise using resistance training, eat a healthy diet, reduce alcohol consumption, and treat the associated problems of aging, such as <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/obesity/symptoms-causes/syc-20375742" target="_blank" title="Opens in a new window.">obesity</a>, <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444" target="_blank" title="Opens in a new window.">diabetes</a> and <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410" target="_blank" title="Opens in a new window.">hypertension</a>. Talk to your health care provider about your readiness for exercise, what types of training you're ready to begin and how your diet can help you get back on track.</p> <h2>What's his name again?</h2> <p>Just like our muscles, joints and skin, your brain ages too. You may notice that you forget names or information from time to time, it may take longer to learn new things, your glasses seem to be misplacing themselves or you might forget it was a loved one's birthday. These usually are signs of normal aging. However, there can be lots of causes for memory loss, including medications, vitamin deficiencies, or metabolic conditions, such as a thyroid disorder, depression, anxiety, prior brain trauma or concussion, or ongoing infections. If you or others have noticed that memory is a problem for you, talk to your health care provider. Simple testing can be performed to determine whether your memory loss is normal or a sign of something more significant.</p> <p>Learn more about <a href="/topics/aging" target="_self" title="Opens in same window.">aging</a> to help you live your healthiest life.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2021/arm-with-loose-skin-from-aging.jpg?h=370&iar=0&w=660&sc_lang=en&hash=368BC88437DE94741D7F464D28ED86A9" alt="Arm with loose skin from aging" width="660" height="370" DisableNVelocity="true" />AgingLife expectancy is 75 for males and 80 for females according to the National Center for Health Statistics. We'll help you keep you informed about potential issues with aging, and steps you can take to maintain your health and keep active.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller2/17/2023Having an overactive bladder may cause embarrassment or keep you from social activities. Learn about treatments to relieve symptoms and help you resume life without the worry of leaks.What can you do for an overactive bladder?<p>Overactive bladder, or OAB, is a condition that causes a sudden urge to urinate. It affects both men and women. The urge may be difficult to stop, and overactive bladder may lead to the involuntary loss of urine, known as urge incontinence.</p> <p>If you have overactive bladder, you may feel embarrassed, isolate yourself or limit your work and social life. The good news is that a brief evaluation can determine whether there's a specific cause for your overactive bladder symptoms.</p> <h2>Is an overactive bladder common?</h2> <p>Overactive bladder affects over 34 million U.S. adults. Urge incontinence is the most prominent form of incontinence among women in the U.S., where 1 in 4 women over 18 experience episodes of leaking urine involuntarily.</p> <h2>What causes an overactive bladder?</h2> <p>Pregnancy, childbirth and menopause all are major reasons for the increased prevalence of incontinence in women compared to men. When your bladder is full of urine, the brain usually signals the bladder to empty. Your bladder muscles contract and force urine out of the bladder. When the bladder is not full, your bladder is relaxed.</p> <p>With a healthy bladder, the brain signals that the bladder is getting full, but there is time to wait to go to the bathroom. With an overactive bladder, there is no waiting. People often feel a sudden urge to urinate. This also can happen if the bladder is not full.</p> <p> If the nerve signals between the bladder and brain do not work properly, an overactive bladder can result. Overactive bladder also can occur when your bladder muscles are too active, causing the bladder muscles to contract and pass urine before the bladder is full. This sudden, strong urge to urinate is called urinary urgency.</p> <h2>When is it important to talk to a health care provider?</h2> <p>An overactive bladder can get in the way of your work, social life, exercise and sleep routines. It's important to discuss a variety of treatments with your health care provider, as overactive bladder symptoms can make daily life difficult.</p> <h2>What can you do to reduce your risk of overactive bladder?</h2> <h3>These healthy lifestyle choices may reduce your risk of overactive bladder:</h3> <ul> <li>Maintain a healthy weight.</li> <li>Drink enough water.</li> <li>Get regular, daily physical activity and exercise.</li> <li>Limit consumption of caffeine and alcohol.</li> <li>Quit smoking.</li> <li>Manage chronic conditions, such as diabetes, that might contribute to overactive bladder symptoms.</li> </ul> <h2>How do urology providers help you manage your OAB symptoms?</h2> <p>A combination of treatment strategies may be the best approach to relieve overactive bladder symptoms. There are a variety of treatments for managing overactive bladder, and a combination of treatment strategies may be the best approach. Depending on your situation, options may include simple behavioral modifications, physical therapy, oral medications or outpatient procedures.</p> <p>Scheduling an appointment with your health care team is the first step. Discuss your medical history and current symptoms so they can develop an individualized treatment plan for you. </p> <p><em><a href="/providers/robyn-bernett-pac" target="_self" title="Opens in same window.">Robyn Bernett</a> is a physician assistant in <a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, <a href="/locations/sparta" target="_self" title="Opens in same window.">Sparta</a> and <a href="/locations/tomah" target="_self" title="Opens in same window.">Tomah</a>, Wisconsin.</em></p><ul> <li>Benign prostatic hyperplasia</li> <li>Erectile dysfunction</li> <li>Prostate cancer</li> </ul>P.A.-C.<p><strong>Education</strong></p> <ul> <li>Master's degree, Physician Assistant Studies, Midwestern University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>National Commission on the Certification of Physician Assistants</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Academy of Physician Assistants</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Urology, Mayo Clinic College of Medicine and Science</li> </ul>Bernett<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/robyn-bernett-pac.jpg?h=280&iar=0&w=280&sc_lang=en&hash=6E4BCEFA89C43B6DD51FBC6FC0AAEFCE" alt="Robyn Bernett PAC" width="280" height="280" DisableNVelocity="true" />Robyn<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15402771Robyn Bernett, P.A.-C.1<img src="/-/media/national-files/images/hometown-health/2023/couple-laughing-watching-performance.jpg?h=370&iar=0&w=660&sc_lang=en&hash=604C5096DBCA2CFF07BEBE59ECF0DFE2" alt="Couple laughing watching performance" width="660" height="370" DisableNVelocity="true" />Urinary IncontinenceThe loss of bladder control is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that's so sudden and strong you don't get to a toilet in time. For most people, simple lifestyle changes or medical treatment can ease discomfort or stop urinary incontinence.Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Dawn Haller2/18/2021Staying active is important not only for your body, but for your mind. Here are three 15-minute workouts you can do at home.15-minute workouts you can do at home<p>Staying active is essential, as physical activity has plenty of health benefits and can reduce stress. Luckily, you do not need a gym to get a workout. You can get a great workout in just 15 minutes in the comforts of your own home.</p> <p>Regular exercise controls weight, improves your heart health, enhances mood, promotes better sleep and boosts energy. You still can gain these benefits with a shorter workout and without needing heavy-duty machines or complex equipment. Try one or all three of these 15-minute home workouts. You can find low-cost equipment for each routine at most sporting goods stores or online. You may already have these items in your home.</p> <h2>Core</h2> <p>Your core — the muscles around your trunk and pelvis — support you in almost all physical activities you perform during the day, from folding laundry to running. A strong core prevents back pain and improves posture. This routine requires a stability ball to fully engage your core and prevent back pain. You also can choose to use a yoga mat for floor exercises.</p> <p>Try this <a href="/hometown-health/speaking-of-health/15-minute-workout-core" target="_self" title="Opens in same window.">15-minute core routine</a>.</p> <h2>Combination</h2> <p>Combination exercises work multiple muscle groups at once. These exercises ensure you get the most out of your workout. This routine targets your biceps, triceps, shoulders, back, quads, hamstrings and glutes. You will need a stability ball, resistance band and dumbbells.</p> <p>Try this <a href="/hometown-health/speaking-of-health/15-minute-workout-combo-exercises" target="_self" title="Opens in same window.">15-minute combination routine</a>.</p> <h2>Resistance bands</h2> <p>Using a resistance band and working in a circuit will help increase your heart rate, increase fat burn and build muscle. This routine works your glutes, hamstrings, quads, biceps, triceps, shoulders and back muscles. It requires a resistance band, sturdy pole or object to wrap the band around, stability ball and dumbbells.</p> <p>Try this <a href="/hometown-health/speaking-of-health/15-minute-workout-resistance-bands" target="_self" title="Opens in same window.">15-minute resistance band routine</a>.</p> <p>These short 15-minute workouts can be done three to four days per week. It's also a great idea to get outside and go for walks, bike rides or hikes, as being immersed in nature also offers a variety of health benefits and can reduce stress.</p> <p><em><a href="/providers/andrew-jagim-phd" target="_self" title="Opens in same window.">Andrew Jagim, Ph.D.</a>, is a <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">Sports Medicine</a> physician in <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Examining how different nutrition and exercise interventions influence health and performance — this interest applies to both the general population in regards to improve a person’s quality of life and prevent chronic disease in addition to improving the performance ability of elite athletes</li> </ul>Ph.D.<p><strong>Education</strong></p> <ul> <li>Master's degree, Human Performance, University of Wisconsin – La Crosse</li> <li>Ph.D., Kinesiology – Exercise Physiology Texas A&M University, College Station</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>International Society of Sports Nutrition</li> <li>National Strength and Conditioning Association</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Sports Medicine</li> <li>International Society of Sports Nutrition</li> <li>National Strength and Conditioning Association</li> </ul>Jagim<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/andrew-jagim-phd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=AA07F8D241D507CF3C0C9F28FC00E465" alt="Andrew Jagim PhD" width="280" height="280" DisableNVelocity="true" /><p>Dr. Jagim has authored or collaborated on numerous scholarly publications related to sports medicine. His topics have included:</p> <ul> <li>diets and nutrition</li> <li>workouts and training regimens</li> <li>sports injuries and treatment programs</li> <li>use and affects of drugs and supplements in sports</li> </ul> <p>His research has been published in numerous journals including International Journal of Exercise Science, Journal of Sports Science, Journal of Strength and Conditioning Research, Frontiers in Nutrition, International Society of Sports Nutrition, Journal of Neurosurgery and the Clinical Journal of Sports Medicine.</p>Andrew<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20772289Andrew Jagim, Ph.D.1{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2018/women-working-out-barefoot.jpg?h=370&iar=0&w=660&sc_lang=en&hash=83030591CDD31B4695B27135E4902C30" alt="Women working out barefoot" width="660" height="370" DisableNVelocity="true" />Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller2/11/2021Let's face it. Starting an exercise can be hard. But, it can also be incredibly rewarding. Learn how to get started and stick to it.Taking the first step: Starting or restarting an exercise program <p>When you're starting a fitness program, one thing is true: The first step often is the hardest.</p> <p>Exercise is one of the easiest things to postpone when your schedule is tight. But making time in your day to work out can have a big impact on your health and mood.</p> <h2>It's all abut the base(line)</h2> <h3>Before you start, take note of some baseline measurements of your aerobic fitness, strength and flexibility:</h3> <ul> <li>How long does it takes you to walk 1 mile?</li> <li>How many half sit-ups, standard pushups or modified pushups can you do at a time?</li> <li>How far can you reach forward while seated on the floor with your legs in front of you?</li> </ul> <p>Repeat the process after six weeks and then every few months. Record the numbers in your phone, calendar or notebook. If you find that your numbers plateau after a few months, you may want to increase your workouts to keep seeing gains. It can be incredibly rewarding to see hard evidence that your fitness is improving.</p> <h2>Know your "why"</h2> <p>Do you want to lose weight, stress less, or keep up with your children or grandchildren? It can be helpful to view exercise as a tool to help you reach goals in a lot of areas in life. Exercise can give you more energy, help you sleep better, and reduce depression and anxiety. All of that can make it easier to manage work and family demands.</p> <h2>Know your "what," too</h2> <p>Before you start, think about the type of activities you enjoy. For example, if you like dancing and get energy from being around people, aerobics classes at a gym might be a good fit, being sure to adhere to COVID-19 regulations. If gyms are not open in your state, a virtual class may be a good option. If you're drawn to running as a time to clear your mind, then try a solo run outside.</p> <p>You're much more likely to maintain healthy exercise habits if you enjoy what you do. It may take some trial and error to find the right workout, but it's worth taking time to find an activity that you truly look forward to. For instance, you may not have been a swimmer or biker growing up, but through trial and error, you may discover that you enjoy both of these activities. They are a great way to enjoy nature and step away from the business of life.</p> <h2>How much is enough?</h2> <p>Aim for at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity a week, plus two strength training sessions.</p> <p>Strength training is especially important for people as they age. You lose muscle mass as you get older, and weight training can help preserve it. Strength training also helps build stronger bones, which can help reduce the chance of fractures.</p> <h3>Watch this video on exercising with dumbbell weights:</h3> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/aqRIRqsGdks" title="Exercise with dumbbell weights" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <h2>Schedule your workouts</h2> <p>If you want to make sure that you have time to get those minutes in, put your workout on your calendar. Treat your workouts like an important appointment. Block time to exercise and be serious about honoring that time.</p> <h2>Try foam rolling</h2> <p>If you are sore after a workout, you may want to try foam rolling. Foam rolling is a great way to loosen up before a workout and reduce muscle soreness afterward.</p> <p>The official name for it is more of a mouthful: self-myofascial release. The term refers to the myofascial tissues that cover the muscles, and can become tight or knotted. Rolling over those spots can release or loosen them. Download a basic <a href="/-/media/national-files/documents/hometown-health/2019/foam-rolling-basics-handout.pdf?sc_lang=en&hash=9B9E87D018FFEFC8EAD61BFB6D28BDF1" target="_blank" title="Opens in a new window.">foam rolling routine</a> to help get you started.</p> <h2>Considering a 5K?</h2> <p>Is there a cause that you care about? While there's probably not an in-person 5K race due to the COVID-19 pandemic, you may find a 5K virtual race to support it.</p> <p>Registering for a race can be a fun way to show you care — and give yourself an extra dose of motivation. Download <a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/5k-run/art-20050962" target="_blank" title="Opens in a new window.">Mayo Clinic's 5K training schedule for beginners</a>.</p> <p><em><a href="/providers/mikal-mikkelson-pac" target="_self" title="Opens in same window.">Mikal Mikkelson</a> is a physician assistant in <a href="/services-and-treatments/internal-medicine" target="_self" title="Opens in same window.">Internal Medicine</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Chronic disease management</li> <li>Geriatric medicine </li> <li>Rural medicine </li> <li>Sports medicine </li> </ul>P.A.-C.<p><strong>Education</strong></p> <ul> <li>Master's degree, Physician Assistant Studies, Rosalind Franklin University of Medicine and Science</li> <li>Master's degree, Exercise and Sports Science, University of Wisconsin–La Crosse</li> </ul> <p><strong>Certification</strong></p> <ul> <li>National Commission on Certification of Physician Assistants (NCCPA)</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Physician Assistants (AAPA)</li> <li>Minnesota Academy of Physician Assistants (MAPA)</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul> <p> </p>Mikkelson<img src="/-/media/shared-files/images/medical-professionals/full/mankato/mikal-mikkelson-pac.jpg?h=280&iar=0&w=280&sc_lang=en&hash=068B66BA44682DF6929F8C0307ECBF9D" alt="Mikal Mikkelson PAC" width="280" height="280" DisableNVelocity="true" />Mikal<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15510069Mikal Mikkelson, P.A.-C.1<img src="/-/media/national-files/images/hometown-health/2021/tying-workout-shoes.jpg?h=370&iar=0&w=660&sc_lang=en&hash=85A58B27928F96E19F54A24D8862486E" alt="Tying workout shoes" width="660" height="370" DisableNVelocity="true" />Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Michele Halterman7/13/2023Feeling anxious now and then is common, but you can manage those feelings. Take control the next time your mind is stuck on the worry setting with these steps.5, 4, 3, 2, 1: Countdown to take control of anxiety<p>Anxiety often is described as sustained, excessive worry that a person cannot control related to the anticipation of a future threat, such as a traumatic event. At times, anxiety can have a significant,  adverse effect on daily life, work, relationships and overall happiness. Anxiety also can manifest as an irritable, worried, restless and debilitating stress response lasting minutes to days. Almost everyone has had anxiety surrounding a stressful situation.</p> <h2>Anxiety becomes an obstacle to a happy, healthy life when it affects your day-to-day life in these ways:</h2> <h3>Emotionally, anxiety can appear as:</h3> <ul> <li>Excessive worry</li> <li>Fatigue</li> <li>Irritability</li> <li>Panic attacks</li> <li>Paranoia </li> <li>Poor concentration</li> <li>Restlessness</li> <li>Sleep disturbances</li> </ul> <h3>Physically, anxiety can appear as:</h3> <ul> <li>Chest pain</li> <li>Diarrhea, stool pattern changes or upset stomach</li> <li>Headache</li> <li>Increased heart rate</li> <li>Muscle aches</li> <li>Shaking</li> <li>Shortness of breath</li> <li>Sweating</li> </ul> <h2>The negative effects of anxiety</h2> <h3>Left unchecked, anxiety can negatively affect your life in these ways:</h3> <ul> <li><strong>Interrupting daily life</strong><br /> Causing issues at home, school, work and socially.</li> <li><strong>Isolating</strong><br /> Not wanting to participate in normal daily activities or take new steps in life due to fear.</li> <li><strong>Emotionally</strong><br /> Increasing risk for depression, suicide and failure to progress in life.</li> <li><strong>Physically</strong><br /> Increasing risk for physical distress, nausea, vomiting, diarrhea, constipation, chest pain and tremors.</li> <li><strong>Mentally</strong><br /> Increasing risk for poor decision-making and communication.</li> </ul> <h2>Tips to combat anxiety</h2> <h3>There are several things you can try to help combat anxiety, including:</h3> <ul> <li><a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Behavioral therapy</a></li> <li>Deep breathing</li> <li><a href="/topics/exercise-and-fitness" target="_self" title="Opens in same window.">Exercise</a></li> <li>Journaling</li> <li><a href="#meditation">Meditation</a></li> <li>Reading</li> <li>Socializing</li> <li>Speaking with your health care professional</li> <li><a href="/hometown-health/featured-topic/spiritual-healing-post-pandemic-stress" target="_self" title="Opens in same window.">Spirituality</a></li> <li>Thought reframing</li> </ul> <p id="meditation">Mindfulness is a meditation in which you focus on being intensely aware of what you see and feel in the moment, without interpretation or judgment. <a href="/hometown-health/speaking-of-health/use-mindfulness-to-improve-well-being" target="_self" title="Opens in same window.">Practicing mindfulness</a> involves breathing methods, guided imagery, and other practices to relax the body and mind to help reduce stress. Recent research shows <a href="/hometown-health/speaking-of-health/mindfulness-meditation-improve-your-quality-of-life" target="_self" title="Opens in same window.">mindfulness meditation</a> may be as effective at reducing anxiety as medication for some people.</p> <h4>Try this exercise the next time your mind is stuck on the worry setting.</h4> <h5>Sit quietly. Look around you and notice:</h5> <ul> <li><strong>5</strong> things you can see<br /> Your hands, the sky, a plant on your colleague's desk</li> <li><strong>4</strong> things you can physically feel<br /> Your feet on the ground, a ball, your friend's hand</li> <li><strong>3</strong> things you can hear<br /> The wind blowing, children's laughter, your breath</li> <li><strong>2</strong> things you can smell<br /> Fresh-cut grass, coffee, soap</li> <li><strong>1</strong> thing you can taste<br /> A mint, gum, the fresh air</li> </ul> <p>This exercise helps you shift your focus to your surroundings in the present moment and away from what is causing you to feel anxious. It can help interrupt unhealthy thought patterns.</p> <h2>When to seek advice or treatment from a medical professional</h2> <h3>It's recommended you speak to a health care provider about your anxiety should any of these situations occur:</h3> <ul> <li>Your anxiety becomes an obstacle in any aspect of everyday living, often causing difficulties for six or more months.</li> <li>Your anxiety becomes a negative influence in relationships creating barriers in life.</li> <li>Your anxiety leads to isolation producing thoughts of hopelessness or helplessness.</li> <li>Your anxiety controls your life with emotional or physical response to excessive worry.</li> </ul> <p>Seek support from a therapist, medical professional, family member, friend, community support person, crisis line resource or a crisis center. Depending on the severity of your anxiety, a behavioral therapy plan, anti-anxiety medication and coping mechanisms may be recommended for your situation.</p> <p>Recognition of anxiety is a key factor in dealing with excessive worry and moving forward in life. If you experience symptoms or difficulty controlling worry, ask yourself if it could be anxiety you're experiencing. It's important to share any concerns about excessive worry with your health care provider so we can help you identify ways to address your anxiety and move past the adverse effects of excessive worry.</p> <p><em><a href="/providers/jill-christensen-cnp" target="_self" title="Opens in same window.">Jill Christensen</a></em><em> is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> nurse practitioner in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><ul> <li>Adoption</li> <li>Behavioral and developmental pediatrics</li> <li>Chronic disease management </li> <li> Department of transportation (DOT) exams</li> <li>Diabetes mellitus</li> <li>Mental health – attention-deficit/hyperactivity disorder (ADHD)</li> <li>Newborn and infant care</li> <li>Preventive care and motivational interviewing</li> <li>Sports</li> <li>Telemedicine, care everywhere</li> </ul>APRN, C.N.P.<p>As a Mayo Clinic Health System family medicine provider, I have an established and coveted relationship with the rural and farming community, and I think of families as a bionet of person’s that take care of each other. I enjoy community health education and have done multiple presentations for different communities on sun protection, skin cancer, pediatric health and wellness, and diet education. </p> <p>I enjoy blogging about mental health, diabetes care and how people can navigate through tough times in life, such as the COVID-19 pandemic. I am largely reachable and communicate by phone, email, telemedicine and in-office visits. I enjoy meeting new faces, and connecting with families. </p> <p>My special interests lie in meeting the patient where they are in their health needs, working with their health priorities and guiding them through their care. I want my patients to understand to the best of their ability, their own personal health goals and diagnoses, and who they may seek for questions, care, referrals and follow-up. </p> <p>My personal interests include hobby farming, taking care of my loved ones, gardening, hunting, fishing and meeting new people.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Nursing, Family Nurse Practitioner Program, Minnesota State University-Mankato</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>Nurse Practitioner Residency Program, Mayo Clinic School of Graduate Medical Education</li> <li>Women's Health Rotation, Mayo Clinic Health System-Mankato</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Family Nurse Practitioner, American Academy of Nurse Practitioners</li> <li>Certified medical examiner, Department of Transportation (DOT) </li> <li>Nexplanon implant trained, Merck</li> <li>Preceptor for Nurse Practitioner students, Minnesota State University, Mankato</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Nurse Practitioners</li> <li>Golden Key Honor Society</li> <li>Minnesota Board of Nursing</li> <li>Mortar Board Honor Society</li> <li>Sigma Theta Tau, Nursing Affiliate Honor Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Christensen<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/jill-christensen-np.jpg?h=280&iar=0&w=280&sc_lang=en&hash=E486ED336C7F30C86357408497A2575E" alt="Jill Christensen NP" width="280" height="280" DisableNVelocity="true" />{F972C1E4-A740-4E1A-9126-21A8DA2A563E}Jill<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15458067Jill Christensen, C.N.P.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}<img src="/-/media/national-files/images/hometown-health/2023/outdoors-eyes-closed-earbud.jpg?h=370&iar=0&w=660&sc_lang=en&hash=10C64C5B145259EF276CA6D64A4CC906" alt="Person outdoors with eyes closed, using earbud" width="660" height="370" DisableNVelocity="true" />AnxietyFeelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. Symptoms may start during childhood or the teen years and continue into adulthood. We have the experts who can help diagnose and treat anxiety concerns.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Michele Halterman2/4/2021Raising a family isn't always easy. It can be hard to make healthy choices when life is hectic. These tips can help you create healthy habits and make smart choices for your family early on.Healthy habits for families<p>A healthy, active lifestyle can help you maintain weight and prevent health issues such as diabetes, heart disease, asthma and high blood pressure. If you have a family, it's important to keep them healthy and happy, too. But raising your family isn't always easy. You are busy and so are your children.</p> <p>There are some simple ways to create healthy habits and smart choices for your family early on.</p> <h3>Here are a 12 tips to help you and your family be healthy and happy:</h3> <h4>1. Exercise.</h4> <p>During commercial breaks or between Netflix episodes, have a friendly competition to see who can do the most pushups, hold a plank the longest or do the most jumping jacks. <a href="/hometown-health/speaking-of-health/play-its-good-for-your-familys-health" target="_self" title="Opens in same window.">Play is good for your family's health</a>.</p> <h4>2. Forgive.</h4> <p>Admit mistakes to your children and ask for forgiveness. By modeling this behavior, it can help improve your own health and well-being while teaching kids to <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/forgiveness/art-20047692" target="_blank" title="Opens in new window.">let go of grudges and bitterness</a>.</p> <h4>3. Manage portions.</h4> <p>Offer a fruits and vegetables at every meal. Don't force kids to eat the fruit and veggies, but have them available. Be sure to model healthy eating. Your kids are watching.</p> <h4>4. Be proactive with health care.</h4> <p>Stay on top of well-child visits. These appointments track your child's growth, behavior, sleep, eating and social development.</p> <h4>5. Get quality sleep.</h4> <p><a href="/hometown-health/speaking-of-health/sleep-an-essential-element-of-success-for-children" target="_self" title="Opens in same window.">Sleep is an essential element of success for children</a>. Aim for an early bedtime and a consistent routine of winding down — with no screen time. Remember, sleep-deprived children usually don't slow down, they wind up.</p> <h4>6. Explore new things.</h4> <p>Make a list of activities you'd like to try together and hang it somewhere the whole family can see.</p> <h4>7. Build strength.</h4> <p>Incorporate strength and flexibility into your family's <a href="/topics/exercise-and-fitness" target="_self" title="Opens in same window.">physical activity</a> plan. This can be as simple as stretching during commercials or doing calf raises while brushing teeth.</p> <h4>8. Find joy.</h4> <p>Find something to laugh about with your family every day. Laughter reduces stress and anxiety.</p> <h4>9. Spend time with loved ones.</h4> <p>Instill the importance of forming strong relationships by being kind to your loved ones. Kids will learn that giving — not receiving — can create real happiness. Schedule regular virtual time with loved ones who are not in your household.</p> <h4>10. Kick addictions.</h4> <p>Make screen time a privilege that is allowed only after chores and homework are completed. <a href="/hometown-health/speaking-of-health/6-tips-to-reduce-childrens-screen-time" target="_self" title="Opens in same window.">Limit screen time</a> to less than two hours a day, and keep screens out of your child's bedroom.</p> <h4>11. Reduce stress.</h4> <p>Search online for free videos about yoga for children and families, or try incorporating deep breathing into your children's bedtime routine. Children experience stress and anxiety just like adults do.</p> <h4>12. Show gratitude.</h4> <p>Create a gratitude jar and encourage everyone to put a note in the jar each day with something they are grateful for. While you are all at the dinner table, take time to read them. Open your heart to gratitude and acknowledge suffering during challenging times.</p> <p>If you find yourself struggling to get your family on board, remember that modeling healthy behaviors is a good place to start. You may not be able to make your family change, but you can start on your own wellness journey. Once they see the changes you are making, chances are they will want to jump on board too.</p> <p><em><a href="/-/media/shared-files/images/medical-professionals/full/faribault/maegen-storm-cnp.jpg" target="_self" title="Opens in same window.">Maegen Storm</a> is a nurse practitioner in <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">Pediatric & Adolescent Medicine</a> in <a href="/locations/faribault" target="_self" title="Opens in same window.">Faribault</a>, Minnesota.</em></p><ul> <li>Breastfeeding</li> <li>Health promotion of children</li> <li>Pediatric chronic diseases, i.e. asthma, ADHD, depression, anxiety</li> </ul>C.N.P.<p><strong>Education</strong></p> <ul> <li>Master of Nursing degree at Saint Catherine University, St. Paul, Minnesota</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Certified pediatric nurse practitioner</li> <li>Certified lactation consultant</li> </ul>Storm<img src="/-/media/shared-files/images/medical-professionals/full/faribault/maegen-storm-cnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=D28412CDBBE6AF6BDD77256E83CFB7E2" alt="Maegen Storm CNP" width="280" height="280" DisableNVelocity="true" />{68BA5C85-D987-4133-8B70-C32E52B1235A}Maegen<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15977226Maegen Storm CNP1<img src="/-/media/national-files/images/hometown-health/2021/mom-and-kids-working-out.jpg?h=370&iar=0&w=660&sc_lang=en&hash=90AC14124B23C775334411FA50B0E8A4" alt="Mom and kids working out" width="660" height="370" DisableNVelocity="true" />ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller2/11/2021Experts agree the sooner in life that you build good, healthy habits, the easier it is to keep them and stay as healthy as possible. Get tips to help children create good habits for healthy weight.Healthy weight in children starts with healthy habits<p>Experts agree: <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/childhood-obesity/symptoms-causes/syc-20354827" target="_blank" title="Opens in a new window.">Childhood obesity</a> is a major problem. About one-third of pediatric patients at Mayo Clinic Health System are not at a healthy weight.</p> <p>The issue is not just aesthetic.</p> <h2>Being at an unhealthy weight can lead to a host of physical and mental health problems, including:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/can-children-develop-type-2-diabetes" target="_self" title="Opens in same window.">Type 2 diabetes</a></li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/high-blood-pressure-in-children/symptoms-causes/syc-20373440" target="_blank" title="Opens in a new window.">Increased blood pressure</a> and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/symptoms-causes/syc-20350800" target="_blank" title="Opens in a new window.">cholesterol</a></li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/sleep-disorders/symptoms-causes/syc-20354018" target="_blank" title="Opens in a new window.">Sleep disorders</a></li> <li>Low self-esteem</li> <li><a href="/hometown-health/speaking-of-health/some-answers-to-your-questions-about-bullying" target="_self" title="Opens in same window.">Bullying</a></li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007" target="_blank" title="Opens in a new window.">Depression</a></li> </ul> <p>The number of children struggling to maintain a healthy weight has increased over the past 10 years. The problem is due in part to widespread lifestyle changes.</p> <p>Technology use has increased, activity levels have gone down and the way people eat has changed. Families are eating out or getting takeout a lot more, and children are eating and drinking a lot more things that are not nutritious, such as chips, crackers, juice and pop.</p> <p>To battle these trends and the problems that often come with them, experts recommend adopting healthier habits.</p> <p>The key to a healthy weight is making lifestyle changes that will stick. It's not about putting a kid on a diet. It's about the whole family making changes so everyone is healthier.</p> <h2>Healthy changes include:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/teens-and-exercise" target="_self" title="Opens in same window.">Getting more exercise.</a></li> <li>Avoiding foods that are not nutritious.</li> <li><a href="/hometown-health/speaking-of-health/123-approach-to-eating-fruits-and-vegetables" target="_self" title="Opens in same window.">Eating more fruits and vegetables.</a></li> <li>Drinking low-fat milk or water instead of juice or pop.</li> <li><a href="/hometown-health/speaking-of-health/6-tips-to-reduce-childrens-screen-time" target="_self" title="Opens in same window.">Limiting screen time</a> to two hours or less per day. Screen time is not recommended for children under 2.</li> </ul> <p>These are habits all families should adopt, regardless of whether family members have weight to lose. It's much easier to prevent obesity than to go backward if your child gains weight.</p> <p>Review additional <a href="/hometown-health/speaking-of-health/12-healthy-habits-for-families" target="_self" title="Opens in same window.">healthy habits for families</a>, and choose a few that stand out to give them a try.</p> <p><em><a href="/providers/jennifer-brumm-md" target="_self" title="Opens in same window.">Jennifer Brumm, M.D.</a>, is a pediatrician in <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">Pediatric & Adolescent Medicine</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Developmental Issues</li> <li>Child Abuse Evaluation & Prevention</li> <li>Down Syndrome</li> </ul>M.D.<p><strong>Medical School</strong> <br />University of Wisconsin-Madison Medical School, Madison, WI</p> <p style="margin-bottom: 10px;"><strong>Residency</strong><br /> Mott Children's Hospital, University of Michigan, Ann Arbor, MI</p> <p><strong>Memberships</strong> <br />American Academy of Pediatrics<br /> State Medical Society of Wisconsin<br /> Child Advocacy Center Task Force</p> <p><strong>Certifications</strong> <br />American Board of Pediatrics<br /> American Heart Association Regional Faculty<br /> PALS Instructor</p>Brumm<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/jennifer-brumm-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=61014622147EB63C29D255755C176FC0" alt="Jennifer Brumm MD" width="280" height="280" DisableNVelocity="true" />Jennifer<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12729175Jennifer Brumm MD1<img src="/-/media/national-files/images/hometown-health/2021/5210-child-obesity-illustration.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EDC57303B132B43FDA7A67AE7980D221" alt="5210 child obesity illustration" width="660" height="370" DisableNVelocity="true" />Childhood ObesityUnderstanding what causes obesity and providing healthy alternatives can help lead your child down a lifelong path of wellness.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller3/12/2021Your shoulder can develop a buildup of calcium deposits as you age, causing pain, stiffness and limited mobility. Learn about 6 benefits of a new nonsurgical procedure to remove those deposits.6 benefits of ultrasonic energy shoulder procedure<p>Your shoulder is the most mobile joint in your body. It's a complex group of muscles and tendons that allows you to flex, extend and rotate your arms nearly 360 degrees.</p> <p>While it is a remarkable joint, you could begin to experience pain as you age. One of the more common causes of shoulder pain is called calcific tendonitis, and it occurs when calcium deposits build up in the tendons of your shoulder.</p> <p>Calcific tendonitis is most common in adults ages 40 to 60, and women have a higher risk for the condition. Symptoms include shoulder pain, stiffness and difficulty lifting your arm. For some people, this pain can interfere with their sleep.</p> <p>The goals of treating calcific tendonitis are to control your pain and reduce the inflammation. The first step often is rest and anti-inflammatory medications. If that doesn't resolve your symptoms, your healthcare provider may recommend conservative treatments, such as physical therapy or a cortisone injection.</p> <p>For many years, the final treatment option for refractory cases was surgery to remove the calcium deposits. Now there's a minimally invasive, nonsurgical option to help patients with calcific tendonitis. It involves using a needlelike device attached to ultrasound energy and saline irrigation, which gradually breaks up and aspirates the calcium deposit. This procedure is referred to as ultrasonic tenotomy and calcium deposit removal.</p> <p>The procedure uses ultrasound guidance to insert the device through a 3-millimeter incision in the skin down to the tendon. The device acts like a small jackhammer to precisely target and remove the calcium deposits. A doctor can perform an ultrasonic tenotomy in the clinic under local anesthesia, and no stitches are required.</p> <h2>If you're weighing your options to treat calcific tendonitis, here are six benefits of ultrasonic tenotomy to know:</h2> <h3>1. Avoidance of surgery</h3> <p>Generally, surgery and anesthesia are safe, but they involve the potential of risks or complications. Since ultrasonic tenotomy is completed in the clinic with local anesthesia, you avoid these potential complications and risks.</p> <h3>2. Small incision</h3> <p>Ultrasonic tenotomy uses a small incision that requires no stitches and will not develop a cosmetic scar. When you are done, you will leave with only a small bandage on your shoulder.</p> <h3>3. Quick time to treatment</h3> <p>Conventional surgery requires a presurgical medical exam with your primary care provider, and scheduling an operating room and team. This can add days or even weeks to your treatment time. With an ultrasonic tenotomy, a presurgical exam is not necessary, and it requires fewer staff, so scheduling typically is a quicker process.</p> <h3>4. Short recovery time</h3> <p>Most patients recover from an ultrasonic tenotomy two or three times quicker than conventional shoulder surgery. Most patients can resume daily activities with few restrictions in a matter of weeks. Pain and symptoms gradually improve over a few weeks, and most patients are symptom-free in two to three months.</p> <h3>5. No sling or brace required</h3> <p>It is not necessary to keep the shoulder joint immobilized after an ultrasonic tenotomy so patients are not required to wear any bracing while they heal.</p> <h3>6. Available to a wide range of patients</h3> <p>An ultrasonic tenotomy presents fewer risks than conventional surgery, so it is available for patients who would otherwise not be medically suited for surgery. It puts less strain on the body, so it may be appropriate for patients who have heart disease, diabetes or other chronic health conditions.</p> <p>In addition to treating calcific tendonitis in the shoulder, ultrasonic tenotomy has proven effective in treating Achilles tendonitis; knee, elbow, hip and rotator cuff tendonitis; and plantar fasciitis.</p> <p><em><a href="/providers/jacob-erickson-do" target="_self" title="Opens in same window.">Jacob Erickson, D.O.</a>, is a <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">Sports Medicine</a> physician in <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Minor trauma</li> <li>Musculoskeletal/sports ultrasound</li> <li>Office procedures</li> <li>Preventive medicine</li> <li>Sports/musculoskeletal medicine</li> </ul>D.O.<p><strong>Medical Degree</strong></p> <ul> <li>Kirksville College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo College of Medicine and Science</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Sports Medicine, University of Iowa</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Medical Association</li> <li>American Osteopathic Association</li> <li>American Society of Sports Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor, Family Medicine, Mayo Clinic Alix School of Medicine</li> </ul>Erickson<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/jacob-erickson-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=E94E476103713CA50775C5FD045B05EB" alt="Jacob Erickson DO" width="280" height="280" DisableNVelocity="true" />{C6B5FA43-E21E-423A-A349-342C8DCCBC31}Jacob<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15534570Sports Medicine - Jacob Erickson DO1{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2021/carrying-log-on-shoulder.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F40694A05F0FC154FED21C38AFB062D5" alt="Carrying log on shoulder" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller3/18/2021Though few people look forward to having a colonoscopy, every year millions have one — many completed without sedation. Learn why this may be a good option for you.Benefits of sedation-free colonoscopy<p>Few people look forward to having a screening colonoscopy. Some people even put off having the procedure done because they hear horror stories that are unfounded. Millions of people each year have a colonoscopy and do well, even without sedation.</p> <p>A colonoscopy is the gold standard for <a href="/hometown-health/speaking-of-health/understanding-your-colon-cancer-screening-options" target="_self" title="Opens in same window.">colon cancer screening</a>. During the procedure, a doctor can view your entire colon and rectum, and remove potentially premalignant growths called polyps. Major medical societies recommend screening for colorectal cancer beginning between the ages of 45 to 50.</p> <p>For most patients, a sedative is given in intravenous form to help relax and minimize any discomfort during the procedure. But did you know that using a sedative is optional? In many countries, sedation-free colonoscopies are the norm. Patients are alert and engaged during the procedure.</p> <h3>Here are the most common questions that I answer when discussing a sedation-free option with patients:</h3> <h4>What are the benefits of a sedation-free colonoscopy?</h4> <p>Saving time is the greatest benefit of a sedation-free colonoscopy. If you are sedated for your colonoscopy, you will have restrictions after the procedure until the next day, such as not being able to drive or return to work. You will require a ride home after your procedure, which also may cause your driver to take time off from work. After a sedation-free colonoscopy, you can resume normal activities right away — you can drive, run errands and generally get on with your day.</p> <p>The second benefit is increased safety. Overall, the sedatives used for colonoscopies are very safe, but there is a small risk of side effects, such as drops in blood pressure, breathing problems, vomiting and prolonged sedation. These are avoided by having a sedation-free colonoscopy.</p> <p>The third benefit is lower cost. Sedation adds to the procedure's expense. This may be helpful for patients paying out of pocket due to a high-deductible health plan or lack of health insurance.</p> <h4>Is a sedation-free colonoscopy painful or uncomfortable?</h4> <p>Most patients report little or no discomfort during the procedure. You can request sedation during the procedure if you change your mind and feel you need it, although it has been my experience that this seldom occurs.</p> <p>Selecting a physician who is experienced and comfortable with sedation-free colonoscopies also is important for minimizing any discomfort. When performing a colonoscopy without sedation, I often employ a technique where I infuse water into the colon as the colonoscope is advanced to make the procedure more tolerable for patients.</p> <h4>Who can pick a sedation-free colonoscopy?</h4> <p>Men may do better than women with sedation-free colonoscopies, due to anatomical differences, but, in general, both usually do well without sedation. A previous hysterectomy and a history of other pelvic or abdominal surgeries may result in scar tissue that can make a sedation-free colonoscopy more difficult for some women. Sedation-free colonoscopies also are easier, in general, in people who are a little overweight compared to those who are very thin. Finally, a sedation-free colonoscopy may not be appropriate if you have a history of anxiety, have had a bad experience with a previous colonoscopy or have a low tolerance for discomfort.</p> <h4>Can polyps be removed during a sedation-free colonoscopy?</h4> <p>Yes. In the vast majority of cases, a physician can remove polyps during a sedation-free colonoscopy. The removal of a polyp is not perceived by the patient because the colon lining does not have nerve endings such as those found on the skin.</p> <h4>What do other patients say about the procedure?</h4> <p>Almost universally, my patients have been very satisfied with the experience and choose it again next time they are due for a colonoscopy. They tell me they will recommend it to others as well.</p> <p>Some people decline having a colonoscopy because they are afraid of the procedure. Yet, we have many patients who have it completed with no sedatives and are satisfied with the experience. There is no reason to be afraid of a colonoscopy.</p> <p>Learn more about <a href="/hometown-health/speaking-of-health/what-to-expect-before-and-during-a-colonoscopy" target="_self" title="Opens in same window.">what to expect before and during a colonoscopy</a> and <a href="/hometown-health/speaking-of-health/5-things-you-can-do-to-keep-your-colon-healthy" target="_self" title="Opens in same window.">five things you can do to keep your colon healthy</a>.</p> <p><em>Jaime Zighelboim, M.D., is a <a href="/services-and-treatments/gastroenterology-and-hepatology" target="_self" title="Opens in same window.">gastroenterologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2021/dog-and-woman-sitting-together.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2DCCE244E14543B6CA77DA9334143F84" alt="Dog and woman sitting together" width="660" height="370" DisableNVelocity="true" />Colorectal HealthGet screening and treatment for colorectal cancer symptoms, and learn about risk factors and prevention strategies.Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Dawn Haller3/3/2021Your first instinct may be to go to the gym when you want to lose weight. Learn why this may not produce the results you want and what's more effective.Does exercise help you lose weight?<p>As people continue to pursue New Year's resolutions, often there are efforts to improve on lifestyle habits with a common goal of weight loss. For many people, the first instinct is to go to the gym three or four days per week, hopping on a treadmill for an hour or even just talking the family dog out for a few more walks each week. However many people realize, sometimes quickly, that their valiant and sweaty efforts haven't led to as much weight loss as they had hoped.</p> <p>So is exercise not effective for weight loss? Is it a waste of time and effort?</p> <p>First, exercise provides many health-related benefits and is one of the most important countermeasures you can rely on to prevent chronic disease and reduce overall risk of mortality. However, sometimes the effectiveness of exercise for weight loss is oversold, and people may overestimate how effective it will be toward their goal of losing weight. Therefore, it's important for people to understand how to incorporate exercise into their weight management plan in a way that doesn't lead to one step forward and two steps back.</p> <h4>Overestimated caloric deficits</h4> <p>Being regularly active and taking part in structured exercise activities are ways to expend more energy throughout the day — often referred to as burning more calories. A negative energy balance — more commonly referred to as a caloric deficit — is required for sustained weight loss over time. However, exercise may not lead to as big of a deficit as you may think.</p> <p>Activity trackers and fitness watches often overestimate the amount of calories burned during exercise. Instead of 1,200 calories burned during your 45-minute elliptical session tracked on your fitness watch, it may be closer to 400 to 700 calories, depending on your intensity levels. This may lead you to miscalculate your target calories for the day and ultimately mislead you in how many calories you can consume throughout the rest of the day.</p> <h4>Daily habits</h4> <p>One of the reasons exercise may not meaningfully reduce body weight is because people often take part in other behaviors that offset this action when they're not exercising, thus sabotaging their goal of weight loss.</p> <p>Some people tend to eat more after exercise, either driven by increased hunger or as part of a behavioral reward construct. For example, a person may add in a snack or splurge on a dessert, likely preceded by the inner monologue of "I've earned this." This type of action essentially negates any additional calories the person expended during their hard-earned trip to the gym.</p> <p>Research also has found that people often are less active throughout the day after a bout of activity. Again, this type of behavior may reduce the potential for a daily caloric deficit, as a person may expend less energy throughout the remaining hours of the day. They actually burn fewer overall calories than if they hadn't exercised at all.</p> <h4>Dietary changes</h4> <p>Researchers have found that dietary change is a more effective and time-efficient strategy for promoting substantial weight loss and maintenance over time. Let's face it, making time to work out throughout the week is hard. It takes time and discipline to change your clothes, go to the gym, exercise for an hour, shower and head back to work or home for the day. Not only is it hard to do once, but to follow this routine five to seven days a week over several weeks to months is even harder.</p> <p>This is a lot of effort to burn an extra 400 to 600 calories during exercise, especially if you negate these hard-earned and burned calories by indulging at your next meal. What took you over a few hours of time with travel, preparation and exercise can be offset in minutes by making the wrong choice in the kitchen.</p> <h4>Strength training</h4> <p>The type of exercise you do is important, as well. Strength training is an effective form of exercise for building lean body mass, which can improve weight loss and overall appearance. This improved body composition often is a common goal of many people who set out to lose weight.</p> <p>Yes, losing weight can be important, particularly if you are overweight or obese, but it is just as important to focus on the type of weight you lose. You should emphasize maintaining lean body mass with strength training, rather than only focusing on losing weight. Strength training also helps conserve functionality as you age by preserving muscle tissue, strengthening bones, improving balance and preventing injuries ― if done properly.</p> <p>So is exercise for weight loss pointless? No, absolutely not.</p> <p>Exercise can be an effective lifestyle modification for weight loss, especially when used in conjunction with dietary modifications to ensure a consistent caloric deficit over time. It is worth repeating that exercise also has mental and physical benefits that can profoundly affect health and overall quality of life in addition to serving an important strategic role in losing weight.</p> <p><em><a href="/providers/andrew-jagim-phd" target="_self" title="Opens in same window.">Andrew Jagim, Ph.D.</a>, is an exercise physiologist and sports nutritionist in <a href="/services-and-treatments/sports-medicine">Sports Medicine</a> in <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Examining how different nutrition and exercise interventions influence health and performance — this interest applies to both the general population in regards to improve a person’s quality of life and prevent chronic disease in addition to improving the performance ability of elite athletes</li> </ul>Ph.D.<p><strong>Education</strong></p> <ul> <li>Master's degree, Human Performance, University of Wisconsin – La Crosse</li> <li>Ph.D., Kinesiology – Exercise Physiology Texas A&M University, College Station</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>International Society of Sports Nutrition</li> <li>National Strength and Conditioning Association</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Sports Medicine</li> <li>International Society of Sports Nutrition</li> <li>National Strength and Conditioning Association</li> </ul>Jagim<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/andrew-jagim-phd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=AA07F8D241D507CF3C0C9F28FC00E465" alt="Andrew Jagim PhD" width="280" height="280" DisableNVelocity="true" /><p>Dr. Jagim has authored or collaborated on numerous scholarly publications related to sports medicine. His topics have included:</p> <ul> <li>diets and nutrition</li> <li>workouts and training regimens</li> <li>sports injuries and treatment programs</li> <li>use and affects of drugs and supplements in sports</li> </ul> <p>His research has been published in numerous journals including International Journal of Exercise Science, Journal of Sports Science, Journal of Strength and Conditioning Research, Frontiers in Nutrition, International Society of Sports Nutrition, Journal of Neurosurgery and the Clinical Journal of Sports Medicine.</p>Andrew<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20772289Andrew Jagim, Ph.D.1{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2021/exercising-on-elliptical.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2DE6DA7A3BDA0F1FCCE35719A328B354" alt="Exercising on elliptical" width="660" height="370" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller12/14/2023"I'm all ears" typically means you're listening, but it has a different meaning if you feel self-conscious about prominent ears. Learn about a procedure that can change the ear shape and position.Feeling like you're all ears?<p>The expression "I'm all ears" typically means you're ready to listen to what someone has to tell you. This expression, however, takes on a different meaning if you have prominent or forward-facing ears. You also may feel like you're "all ears."</p> <p>Having ears that are oversized in proportion to the size of your head or that stick out far from your head can cause embarrassment and distress, which can lead to low self-esteem and lack of self-confidence.</p> <p>Fortunately, a cosmetic procedure called otoplasty can change ear shape and position. Otoplasty can help restore self-confidence and make you comfortable in your own skin.</p> <p>People usually have otoplasty performed on both ears to ensure symmetry. A surgeon can do the procedure once ears have reached full size, usually after age 5. The procedure does not change the location of your ears, and it does not affect your ability to hear.</p> <p>People also may consider otoplasty if their ears are misshapen since birth or due to an injury. For babies born with ear-shape problems or prominent ears, splinting or molding may correct these issues. These techniques should be started by 2 weeks of age and last for an average of four to six weeks.</p> <h2>Preparing for otoplasty</h2> <p>Your care team will review your medical history, including current and past medical conditions and any history of ear infections. Your surgeon will examine the ear's placement, size, shape and symmetry to determine your treatment options. Discuss your expectations for what you'd like your ears to look like after the procedure with your care team. Review the risks of otoplasty, including infection, scarring, asymmetry and overcorrection.</p> <h2>During otoplasty</h2> <p>Depending on the technique used during otoplasty, the surgeon may make incisions on the backs of the ears or within the ear's inner creases. Once the incisions are made, the surgeon can remove excess cartilage and skin, and fold the remaining cartilage into the designated position and secure it with internal stitches. The surgeon will use additional stitches to close the incisions, and the ears will be covered in bandages for protection and support.</p> <p>The procedure usually takes about two to three hours.</p> <img alt="Otoplasty illustration" style="width: 300px; height: 382px;" src="/-/media/national-files/images/hometown-health/2023/otoplasty-illustration.jpg?h=382&w=300&sc_lang=en&hash=E176A6730A63BF2B029FF3975A4AB6FA" /> <h2>After otoplasty</h2> <p>After otoplasty, your ears will be covered with bandages, and you likely will feel some soreness and itching. You may be advised to take pain medication if there is a need to reduce discomfort. Your healthcare team will remove the bandages a few days after the procedure. Your ears may be swollen or red for a short period, but you will notice the change in the appearance of your ears immediately. The surgeon may use stitches that dissolve or those a healthcare professional can remove in the clinic.</p> <p>Your surgeon also will advise you when it's OK to resume daily activities, such as bathing and physical activity.</p> <p><em><a href="/providers/patrick-shinners-md" target="_self" title="Opens in same window.">Patrick Shinners, M.D.</a>, is an <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">ear, nose and throat specialist</a> with expertise in head and neck surgery in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li><a href="/locations/eau-claire/services-and-treatments/pulmonology/alternative-cpap-therapy" target="_self" title="Opens in same window.">Alternative CPAP therapy</a></li> <li>Blepharoplasty (surgery to repair droopy eyelids)</li> <li>Facial reconstruction after skin cancer excisions</li> <li>Facial trauma surgical repair</li> <li>Otoplasty (cosmetic ear surgery)</li> <li>Rhinoplasty (surgery to change the shape of the nose)</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Wisconsin-Madison</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Mayo Clinic College of Medicine</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Otolaryngology, American Board of Otolaryngology</li> </ul> <p><strong>Membership</strong></p> <ul> <li>Wisconsin Medical Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Otolaryngology, Mayo Clinic College of Medicine and Science</li> </ul>Shinners<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/patrick-shinners-md.jpg?h=200&iar=0&w=200&sc_lang=en&hash=9D31AE144AE1051F01B0A3DEA8BC5AD9" alt="Patrick Shinners, M.D." width="200" height="200" DisableNVelocity="true" />{AE0EACBF-9D45-4187-9674-5EFEE0335705}Patrick <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12102741Patrick Shinners, M.D.{E9B8BDBE-375B-4E7D-A1D2-2B64B5513AF7}<img src="/-/media/national-files/images/hometown-health/2023/wearing-red-scarf-and-knit-hat.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F7DBFC9A5D3B85571DBEC889C3E93699" alt="Wearing red scarf and knit hat" width="660" height="370" DisableNVelocity="true" />Ear, Nose and Throat (ENT)Get information about symptoms, disorders and diseases affecting the ear, nose and throat, and related head and neck structures.Ear HealthAn audiologist specializes in evaluating and treating people of all ages with hearing loss, dizziness and balance disorders. Specialty audiology consultation is available for assessment and treatment of hearing loss, tinnitus, dizziness and balance disorders.Plastic and Reconstructive SurgeryPlastic and reconstructive surgery provides services that not only include cosmetic or aesthetic surgery, but also surgical repair of congenital deformities, laser surgery, postsurgical reconstruction, such as breast, head and neck defects, and microsurgery.Dawn Haller3/5/2021It’s time to spring forward as daylight saving time begins this weekend. Here are a few tips for managing the transition so you aren’t so groggy. The best part is an afternoon nap is on the list!How to manage daylight saving time<p><em>Updated Feb. 22, 2024</em></p> <p>Fall back. Spring forward. Many people have heard this saying and it helps us remember which way to set our clocks for the start and end of daylight saving time. Although it would be nice to gain an hour of sleep twice a year, that's not the case. </p> <p>On March 10, we will lose an hour. Altering your sleep schedule can have a greater effect on your health than you may think, with adverse effects greatest in teenagers and those who have poor sleep habits to begin with. Learn why <a href="/hometown-health/speaking-of-health/sleep-an-essential-element-of-success-for-children" target="_self" title="Opens in same window.">sleep is an element of success for children</a>.</p> <p>With daylight saving time, we lose an hour of sleep in the spring. This loss causes sleep deprivation and sleepiness in most people, and can linger for days to weeks. To minimize the effects, you can make gradual adjustments. </p> <h2>I recommend these tips to manage the transition to daylight saving time: </h2> <ul> <li>Go to bed 15 minutes early, starting several days before the change, and increase by 15 minutes every couple of nights. Make an extra effort to be well-rested the week before the time change.</li> <li>If you feel sleepy the Sunday after the change to daylight saving time, take a short 15- to 20- minute nap in the early afternoon — not too close to bedtime.</li> <li>Assess how a nap affects your sleep quality. For some, napping can make nighttime sleeping more difficult. For others, however, a short nap can be revitalizing without affecting nighttime sleep. Learn <a href="/hometown-health/speaking-of-health/how-to-get-the-most-out-of-napping" target="_self" title="Opens in same window.">how to get the most out of napping</a>.</li> <li>Avoid sleeping in an hour longer in the morning.</li> </ul> <p>In general, you should try to go to bed and wake up at the same time each day. This helps your body regulate its sleep. If possible, wake up at the same time on the weekends, which can make Monday mornings easier to bear. Read more about <a href="/hometown-health/speaking-of-health/5-ways-to-get-better-sleep" target="_self" title="Opens in same window.">ways to get better sleep</a>.</p> <p>Regardless of the time of year, proper sleep is an essential part of life.</p> <h2>Benefits to practicing good sleep health, as well as risks for cutting sleep too short, include:</h2> <ul> <li><strong>Learning and memory</strong><br> Sleep allows the brain to better process new experiences and knowledge, and improves comprehension and memory.</li> <li><strong>Metabolism and weight</strong><br> Sleep helps regulate the hormones that affect and control appetite. Studies have shown that during sleep deprivation, the normal hormonal balance is affected and appetite increases.</li> <li><strong>Cardiovascular health</strong><br> Serious sleep disorders, such as sleep apnea, have been linked to hypertension, increased stress hormone levels and irregular heartbeat. Learn more about <a href="/hometown-health/speaking-of-health/do-i-have-sleep-apnea" target="_self" title="Opens in same window.">sleep apnea signs and symptoms</a>.</li> <li><strong>Mood</strong><br> Insufficient sleep can make people more agitated or moody the following day. Chronic sleep deprivation can contribute to long-term mood disorders, such as depression or anxiety.</li> <li><strong>Immunity</strong><br> During sleep, the immune system releases proteins called cytokines. These proteins deal with stress, fight infections and decrease inflammation in the body. Without enough sleep, these protective proteins and other important infection-fighting cells are reduced. Our body needs adequate sleep to fight infections and inflammation.</li> <li><strong>Alertness</strong><br> Lack of sleep can take a toll on perception and judgment. In the workplace, its effects can be seen in reduced efficiency and productivity, errors and accidents. It also can be deadly, such as drowsy driving fatalities.</li> </ul> <p>Make sleep health a priority, and you'll start seeing the positive effects.</p> <p><em>Rachel Ziegler, M.D.</em><em>, is a physician in <a href="/services-and-treatments/neurodiagnostics" target="_self" title="Opens in same window.">Sleep Medicine</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2020/clock-face-for-daylight-saving-time.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A9ACFED46E486A94CB98F89B79D62F44" alt="Clock face for daylight saving time" width="660" height="370" DisableNVelocity="true" />SleepSleep is essential to good health. It's one of the body's basic needs. But, what do you do when you have troubles sleeping, or getting enough hours of sleep? Dawn Haller3/11/2021The excruciating pain caused by a kidney stone can occur suddenly. Learn about how they form, personal risk factors and treatment options.Kidney stones: Tiny and painful, but treatable<p>The pain may start in your back, then radiate into your groin. You may think you've twisted something, but the pain continues to worsen, often coming in waves. That's when you may head to the Emergency Department — only to find that the cause of your excruciating pain is caused by a little rock of calcium, minerals and salts: a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/kidney-stones/symptoms-causes/syc-20355755" target="_blank" title="Opens in a new window.">kidney stone</a>.</p> <p>Kidney stones also may be the cause of blood in your urine, which is the result of stones bouncing around inside your kidneys. They usually don't cause pain until they pass into your ureters, which are the tubes connecting the kidneys and bladder. If a stone becomes stuck, it may block the flow of urine, cause your kidneys to swell and the ureter to spasm ― and for you to be awash in pain.</p> <h4>How kidney stones form</h4> <p>Kidney stones form when your urine contains more crystal-forming substances, such as calcium and uric acid, than can be diluted by the fluid in your urine. Most kidney stones are 6 millimeters or smaller — about the size of a pencil eraser. There are four main types of stones: calcium, struvite, uric acid and cystine. Knowing what kind you have can give you clues for reducing your risk of getting more.</p> <h4>Risk factors</h4> <h5>Your risk of getting kidney stones can increase because of:</h5> <ul> <li><strong>Family or personal history</strong><br /> If someone in your family has had a kidney stone, you may be prone to develop one. If you've had a kidney stone, you're 50% more likely to get another.</li> <li><strong>Dehydration</strong><br /> Be sure to drink enough water every day, especially if you've been sweating.</li> <li><strong>Certain diets</strong><br /> A diet high in protein, salt and sugar increases your risk. Certain fruits and vegetables (rhubarb, beets, okra, spinach and sweet potatoes) and foods and beverages (nuts, black pepper, soy products, chocolate and tea) also can contribute to kidney stone formation.</li> <li><strong>Obesity</strong><br /> A high body mass index, large waist size and weight gain can be contributing factors.</li> <li><strong>Digestive diseases and surgery</strong><br /> Gastric bypass surgery, inflammatory bowel disease or chronic diarrhea can affect how you absorb calcium and water.</li> <li><strong>Medical conditions</strong><br /> These include renal tubular acidosis, cystinuria and recurring urinary tract infections.</li> <li><strong>Certain supplements, medications</strong><br /> These range from vitamin C to dietary supplements to calcium-based antacids to medications for migraines or depression.</li> </ul> <h4>Treating kidney stones</h4> <p>Some patients choose to tough it out by taking over-the-counter pain medication, drinking plenty of water, being active ― for example, walking up and down steps seems to help ― and hoping the stone passes soon on its own. For others, surgery may be required to remove the stone.</p> <p>If a kidney stone is suspected, an X-ray, CT scan or ultrasound will help your provider evaluate the size, where it's at and if it's blocking urine flow. Evaluation typically takes place in the clinic, but treatment is usually performed in the operating room.</p> <h5>Treatments include:</h5> <ul> <li><strong>Shock wave therapy</strong><br /> This treatment uses sound waves from outside your body to break up the stone so it can pass.</li> <li><strong>Ureteroscopy</strong><br /> You'll need to undergo anesthesia for this procedure. A scope is fed into the ureter, followed by a laser fiber, which breaks the stone into pieces. The pieces are then pulled out. This process may take 20 minutes or several hours, depending on how many stones are found. A stent is inserted for three to 10 days to keep the ureter open so any remnants can pass easily.</li> <li><strong>Percutaneous surgery</strong><br /> If a stone is larger than 1.5 centimeters — the size of the end of your thumb — or it's really hard, your provider will schedule a second surgery. A small incision is made in the back and a tube is placed to reach the kidney. The stones are then broken up and removed through the tube. A stent is left afterward.</li> </ul> <p>These procedures are followed by an X-ray or ultrasound in 30 days to confirm the stones are gone.</p> <p>There are no medications or supplements known to prevent kidney stones. If you're prone to kidney stones, your best approach is to work with your provider to adjust your diet or medications to prevent them.</p> <p><em><a href="/providers/dana-rademacher-md" target="_self" title="Opens in same window.">Dana Rademacher, M.D.</a>, is a <a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">urologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Benign prostatic hyperplasia (BPH) treatment with laser prostatectomy</li> <li>Female urology and incontinence</li> <li>Minimally invasive kidney stone surgery</li> <li>No-scalpel vasectomy</li> <li>Urologic cancer, including nerve sparing radical prostatectomy</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Colorado Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Surgery, University of California-Davis</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Urology, University of California-Davis</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Urological Association</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Urology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Radiology, Mayo Clinic College of Medicine and Science</li> </ul>Rademacher<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/dana-rademacher-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=25345D455989E8D959437667EF97F74C" alt="Dana Rademacher MD" width="280" height="280" DisableNVelocity="true" />{92A3F1B8-11FB-48BF-8026-DDCF4C824F87}Dana<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>11366974Dana Rademacher, M.D.1{BFAFB863-D571-4781-ADD9-1398B77B549E}|{83EB2AA2-1436-4DDC-B7BB-51F8E6A87FC9}<img src="/-/media/national-files/images/hometown-health/2021/hands-on-back-over-kidneys.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C3A24E985656272ABDAC2D9F3268A43A" alt="Hands on back over kidneys" width="660" height="370" DisableNVelocity="true" />Kidney HealthYour kidneys are responsible for filtering waste and excess fluids from your body. So when kidney functionality decreases, harmful amounts of fluid and waste can build up in your body. In most cases, you can prevent or manage kidney issues by making healthy, kidney-conscious decisions.Dawn Haller10/21/2024 Adding cruciferous vegetables is an easy way to increase fiber, support a healthy diet and reduce obesity. They are versatile and can be eaten raw or cooked as a main or side dish. Try these recipes. Superfoods: Why you should eat cruciferous vegetables<p>Since childhood, people may have told you to "Eat your vegetables because they're good for you." Although you might prefer to skip them, substantial evidence supports the reason behind consuming <a href="/hometown-health/speaking-of-health/eat-the-rainbow-for-good-health" target="_self" title="Opens in same window">a variety of veggies</a>.</p> <p>One group of vegetables, known as cruciferous vegetables, is a powerhouse of vitamins, minerals, <a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/add-antioxidants-to-your-diet/art-20546814" target="_blank" title="Opens in a new window.">antioxidants</a> and other phytochemicals. Research has found that these components can reduce the risk of many of the diseases prevalent today. </p> <p>Cruciferous vegetables contain a potent phytochemical called sulforaphane. Studies show this phytochemical to be a powerful antioxidant and <a href="/hometown-health/speaking-of-health/want-to-ease-chronic-inflammation" target="_self" title="Opens in same window">anti-inflammatory</a>, which aids in <a href="/hometown-health/speaking-of-health/diet-factors-for-cancer-prevention" target="_self" title="Opens in same window">preventing several types of cancer.</a> </p> <p>Some studies also indicate a correlation between eating vegetables high in sulforaphane and a reduction in depression and obesity, as well as an improvement in pain management and symptoms related to <a href="/hometown-health/speaking-of-health/4-key-elements-of-a-heart-healthy-diet" target="_self" title="Opens in same window">cardiovascular disease</a>. </p> <h3>Superfoods in this group include:</h3> <ul> <li>Arugula</li> <li>Broccoli</li> <li>Brussels sprouts</li> <li>Cabbage</li> <li>Cauliflower</li> <li><a href="/hometown-health/speaking-of-health/the-many-types-and-health-benefits-of-kale" target="_self" title="Opens in same window">Kale</a></li> <li><a href="/hometown-health/speaking-of-health/radishes-big-flavor-in-a-small-package" target="_self" title="Opens in same window">Radishes</a></li> <li>Turnips</li> </ul> <p>These nutrition-packed vegetables range from 5 to 14 calories per ounce. Consuming cruciferous vegetables, which are high in fiber, supports a <a href="/hometown-health/speaking-of-health/whats-the-big-deal-about-the-mediterranean-diet" target="_self" title="Opens in same window">healthy diet</a> and helps reduce obesity.</p> <p>Cruciferous vegetables are versatile. Eat them raw or cooked, as a main or side dish and in salads. These superfoods can be mashed or pureed to thicken soups or used as the main ingredient in a pizza crust.</p> <h3>Here are easy recipes packed with cruciferous vegetables:</h3> <h4>Roasted broccoli and cauliflower</h4> <p>By Mayo Clinic<br /> Serves 4</p> <p>4 cups broccoli, cut into quarter-size florets<br /> 4 cups cauliflower, cut into quarter-size florets<br /> 1 to 2 tablespoons olive oil<br /> 1 clove garlic, minced<br /> 1/2 cup shredded Parmesan cheese<br /> Pinch of ground black pepper<br /> Pinch of salt</p> <p>Preheat oven to 400 F. Place broccoli and cauliflower in a bowl and drizzle with garlic and olive oil. Season with salt and pepper. Sprinkle half of the Parmesan cheese over the vegetables. Spread the mixture on a sheet pan. Bake for 20–30 minutes, stirring after 15 minutes.</p> <p>Remove the pan from the oven when the florets are crispy and brown. Sprinkle the other half of the Parmesan cheese over the mixture and serve. </p> <p>Nutritional per cup serving: 100 calories, 4 grams fat, 7 grams carbohydrates, 6 milligrams cholesterol, 3 grams dietary fiber, 163 milligrams sodium.</p> <h4>Brussels sprouts with shallots and lemon</h4> <p>By Mayo Clinic<br /> Serves 4</p> <p>3 teaspoons extra-virgin olive oil, divided<br /> 3 shallots, thinly sliced (about 3 tablespoons)<br /> 1/4 teaspoon salt, divided<br /> 1 pound Brussels sprouts, trimmed and cut into quarters<br /> 1/2 cup no-salt-added vegetable stock or broth<br /> 1/4 teaspoon finely grated lemon zest<br /> 1 tablespoon fresh lemon juice<br /> 1/4 teaspoon freshly ground black pepper</p> <p>In a large, nonstick frying pan, heat 2 teaspoons of the olive oil over medium heat. Add the shallots and saute until soft and lightly golden, about 6 minutes. Stir in 1/8 teaspoon salt. Transfer to a bowl and set aside. </p> <p>Heat the remaining 1 teaspoon of olive oil over medium heat in the same frying pan. Add the Brussels sprouts and saute for about 3 to 4 minutes until they brown. Add the vegetable stock and bring to a simmer. Cook, uncovered, for 5 to 6 minutes until the Brussels sprouts are tender. Return the shallots to the pan. Stir in the lemon zest and juice, 1/8 teaspoon salt, and pepper. Serve immediately.</p> <p>Nutritional per 1 1/4 cup serving: 104 calories, 4 grams fat, 12 grams carbohydrates, 0 milligrams cholesterol, 5 grams dietary fiber, 5 grams protein, 191 milligrams sodium. </p> <p><em>By Mayo Clinic Health System staff. </em></p><img src="/-/media/national-files/images/hometown-health/2021/superfoods-cruciferous-vegetables.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E21CB879E8BE8FA60BAE937564487AF8" alt="Superfoods: Cruciferous vegetables" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller3/17/2021A traumatic brain injury can have wide-ranging, long-lasting physical and psychological effects. That's why a team approach is needed to improve and restore function as much as possible.Team approach to treating traumatic brain injuries<p>The brain is a precious thing. It controls your muscles, thoughts, reasoning, breathing and a host of other vital bodily functions. Unfortunately, the brain is not exempt from damage.</p> <p>A <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/symptoms-causes/syc-20378557" target="_blank" title="Opens in a new window.">traumatic brain injury</a> is caused by a violent bump, blow, jolt or penetrating injury to the head that alters normal brain function. An injury to the brain is serious and requires prompt medical attention.</p> <p>Traumatic brain injuries are a major cause of death and disability in the U.S., with about 2.8 million such injuries resulting in Emergency Department visits, hospital stays and deaths each year, according to the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.cdc.gov/traumaticbraininjury/index.html" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention</a>. About 30% of all injury-related deaths are due to traumatic brain injuries.</p> <p>"A traumatic brain injury can have wide-ranging physical and psychological effects, lasting for a few days to the rest of the person's life," says <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayo.edu/research/faculty/sandroni-paola-m-d-ph-d/bio-00078221?_ga=2.267749390.1266878767.1614200304-1510257457.1614200304" target="_blank" title="Opens in a new window.">Paola Sandroni, M.D., Ph.D.</a>, a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/" target="_blank" title="Opens in a new window.">Mayo Clinic</a> neurologist who cares for patients in Rochester and Mankato, Minnesota. "Because of the wide-ranging effects of the injury, a team of physicians and other medical providers are needed to effectively treat traumatic brain injuries."</p> <h4>Mild injuries</h4> <p>The terms "mild," "moderate" and "severe" are used to describe the effect of the injury on brain function. A mild injury to the brain is still a serious injury that requires prompt attention and an accurate diagnosis.</p> <p>"A person does not need to lose consciousness to have a mild brain injury," says Dr. Sandroni. "The most common type is a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/concussion/symptoms-causes/syc-20355594" target="_blank" title="Opens in a new window.">concussion</a>, which is often associated with contact sports. The term 'mild' can be a bit misleading, as the long-term consequences of the injury, especially multiple injuries, can be significant."</p> <p>Symptoms of a mild traumatic brain injury can include headache, blurred vision, nausea, dizziness, drowsiness, ringing in ears, or sensitivity to light or sound. Most mild traumatic brain injuries usually require no treatment other than rest and over-the-counter pain relievers.</p> <p>"However, it is important that a person with a mild traumatic brain injury is monitored closely at home for persistent, worsening or new symptoms," says Dr. Sandroni. "In addition, the person may require a follow-up appointment with a neurologist for a physical and cognitive test before returning to work or school."</p> <p>Symptoms usually resolve within three weeks, though they may persist or complications can occur.</p> <h4>Emergency treatments for moderate to severe injuries</h4> <p>Moderate to severe brain injuries require immediate emergency medical treatment. In addition to assessing the brain injury, the medical team will focus on minimizing secondary damage due to inflammation, bleeding or reduced oxygen supply to the brain.</p> <p>"Often, a CT or MRI scan is performed to create a detailed view of the brain, skull, blood vessels and other soft tissue," says Anthony Burrows, M.D., a <a href="/services-and-treatments/neurosurgery" target="_self" title="Opens in same window.">neurosurgeon</a> who sees patients at Mayo Clinic Health System in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a>, <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a> and <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota. "This helps the medical team to visualize any fractures, blood clots, bleeding on the brain, tissue swelling or bruised brain tissue. From that information, the team can diagnose the brain injury and plan medical or surgical interventions."</p> <p>Moderate to severe traumatic brain injuries can include any of the signs and symptoms of mild injury, as well as seizures, clear fluids draining from nose or eyes, profound confusion, extremity weakness, repeated vomiting, agitation, slurred speech, loss of coordination, loss of consciousness from several minutes to hours, inability to be awakened from sleep and dilation of one or both pupils of the eyes.</p> <h4>Surgical treatments for moderate to severe injuries</h4> <p>If tissue swelling or increased pressure on inside of the skull is discovered, a neurosurgeon may insert a probe through the skull to monitor the pressure.</p> <p>"Cerebrospinal fluid may build up in the spaces in the brain of some people who have had traumatic brain injuries, causing increased pressure and swelling in the brain," says Dr. Burrows. "This increased pressure in the skull can cause additional damage to the brain."</p> <p>In addition to a pressure monitor, a surgeon can relieve pressure inside the skull by draining accumulated cerebrospinal fluid with a catheter or by removing a portion of the skull to provide more room for swollen tissues.</p> <p>"An emergency craniectomy is a procedure to temporarily remove a portion of the skull to allow more room for the injured brain to swell and minimize additional damage," says Dr. Burrows. "After the brain has a chance to heal and the swelling has gone down, the bone flap can be returned in a second surgery. It is an effective surgical treatment for the most serious, life-threatening traumatic brain injuries."</p> <h5>Other emergency surgical procedures may be needed to minimize additional damage to brain tissues, such as:</h5> <ul> <li><strong>Removing clotted blood</strong><br /> Bleeding outside or within the brain can result in a collection of clotted blood (hematoma) that puts pressure on the brain and damages brain tissue.</li> <li><strong>Repairing skull fractures</strong><br /> Surgery may be needed to repair severe skull fractures or remove pieces of skull in the brain.</li> <li><strong>Bleeding in the brain</strong><br /> Head injuries that cause bleeding in the brain may need surgery to stop the bleeding.</li> </ul> <p>Patients often receive care from a multidisciplinary team in the ICU after they are stabilized with surgery for a severe traumatic brain injury.</p> <h4>Rehabilitation</h4> <p>Recovery from traumatic brain injury can require a significant amount of time, as some people need to relearn basic skills, such as walking or talking.</p> <p>"Therapy usually begins in the hospital, and continues at an inpatient rehabilitation unit, a residential treatment facility or through outpatient services," says John Jakovich, D.O., a <a href="/services-and-treatments/physical-medicine-and-rehabilitation" target="_self" title="Opens in same window.">Physical Medicine and Rehabilitation</a> physician at Mayo Clinic Health System in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>. "The goal is to improve function and improve the ability to perform daily activities of patients with a traumatic brain injury."</p> <p>Physical medicine and rehabilitation physicians have specialized training in brain injury rehabilitation, and work with occupational, physical, and speech and language physical therapists.</p> <p>"Each patient has different therapy needs that depend on the severity of the brain injury and the part of the brain that was injured," says Dr. Jakovich. "We conduct a thorough physical exam to evaluate the patient's strength, balance, memory and cognition, and discuss the patient's goals. From this information, we develop an individualized program for care and recovery."</p> <p>Dr. Jakovich stresses that patients who are recovering from a traumatic brain injury have a long journey, ranging from months to years. Most of the recovery will happen in the first year after injury. This makes the rehabilitation process in this time frame the most critical.</p> <p>"The therapies have a significant impact and patients make the greatest gains in the first six months after injury. This is because the brain has a heightened state of plasticity during this phase. This is the ability of the brain's neural networks to grow and reorganize in response to the injury," says Dr. Jakovich. "After that, progress slows or even appears to stall. While it can be discouraging, plateaus are often temporary and part of the rehabilitation process. Incremental progress can continue over time. The main rehabilitation goal is to improve and restore function as much as possible.”</p> <h4>Read a patient story about traumatic brain injury:</h4> <ul> <li><a href="/hometown-health" target="_self" title="Opens in same window.">Mick Caron's miraculous recovery from a traumatic brain injury got him to graduation on time.</a></li> </ul><img src="/-/media/national-files/images/hometown-health/2021/looking-to-the-side.jpg?h=370&iar=0&w=660&sc_lang=en&hash=27F35F273B19D9100B30F006C834FA90" alt="Looking to the side" width="660" height="370" DisableNVelocity="true" />NeurosurgeryNeurosurgery treats disorders that impact any part of the nervous system, which may include the brain, spine or peripheral nerves. Conditions treated range from life-threatening brain tumors, to disorders impacting quality of life, such as back pain and carpel tunnel syndrome.Dawn Haller3/8/2021There never seems to be enough hours in a day. With stress weighing you down, your daily tasks get harder and harder to handle. These 4 steps can help you reduce stress and cope with the inevitable stressors of everyday life.The 4 A's of stress relief<p>There never seems to be enough hours in a day. And in those few hours, you're loaded with deadlines, responsibilities, errands and expectations. With stress weighing you down, daily tasks get harder and harder to handle — like a heavy backpack getting heavier as the day goes on.</p> <h3>Fortunately, there are 4 steps to help reduce stress and cope with the inevitable stressors of everyday life:</h3> <h4>1. Avoid.</h4> <h5>Believe it or not, it is possible to escape some of the minor stressors that tend to trouble people:</h5> <ul> <li>Take control of the stress that fills your day by finding ways to ways to make the situation better. For example, if your commute is stressful, try buying a new CD to make it more enjoyable.</li> <li>Create distance between you and something that causes stress. If a co-worker continually irritates you, create physical distance between the two of you.</li> <li>Say no when necessary.</li> </ul> <h4>2. Alter.</h4> <h5>Communicate clearly and let people know your expectations. It can make a world of difference:</h5> <ul> <li>Respectfully ask someone to alter how they are treating you. Remember to use "I" statements when addressing someone about how you feel.</li> <li>State your limitations in advance. For example, you can say, "I only have five minutes to talk."</li> </ul> <h4>3. Accept.</h4> <h5>Accepting the situation can ease much of the stress when avoiding and altering doesn't work:</h5> <ul> <li>Talk with someone about how you are feeling. Call a friend, get coffee with a relative or schedule an appointment with a therapist.</li> <li>Forgive yourself or others. It is an important element of accepting stressful situations, and moving on is easier than sitting around stressing about uncontrollable situations.</li> </ul> <h4>4. Adapt.</h4> <h5>Changing your standards and expectations of stressful situations can help you cope with stress:</h5> <ul> <li>Don't strive for perfection. Instead make reasonable substitutes throughout your daily life.</li> <li>Choose dinners that are easier to prepare and still make your family happy.</li> <li>Don't replay stressful situations over and over in your head.</li> <li>Choose to focus on the positive aspects in your life.</li> <li> Change your perspective by asking yourself if the stressor will matter in five years.</li> </ul> <p>Stress is a part of everyday life. Practicing these four steps can help to provide balance for a healthier, happier lifestyle.</p> <h4>Learn more about stress:</h4> <ul> <li><a href="/hometown-health/speaking-of-health/5-tips-to-manage-stress" target="_self" title="Opens in same window.">Get 5 tips to manage stress.</a></li> <li><a href="/hometown-health/speaking-of-health/mental-health-assessment" target="_self" title="Opens in same window.">Take a mental and emotional health assessment.</a></li> <li><a href="/hometown-health/speaking-of-health/overwhelmed-by-anxiety" target="_self" title="Opens in same window.">Find out how to cope if you're overwhelmed by anxiety.</a></li> <li><a href="/hometown-health/speaking-of-health/tips-to-keep-stress-from-hurting-your-heart" target="_self" title="Opens in same window.">Get tips to keep stress from hurting your heart.</a></li> </ul> <p><a href="/providers/alan-conway" target="_self" title="Opens in same window."><em>Alan Conway, M.D.</em></a><em>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Dermatology</li> <li>Orthopedics</li> <li>Weight loss</li> </ul>M.D. <p>I want to help you live your best life, with a focus on disease prevention and treatment as well as symptom management.</p> <p>I enjoy spending time with my family and playing golf and pickleball.</p> <p><strong>Education</strong></p> <ul> <li>University of Illinois College of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Martin Army Community Hospital</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Family Medicine</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Academy of Family Practice</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul> Conway<img src="/-/media/shared-files/images/medical-professionals/full/tomah/alan-conway-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=9AA9749A8064F3DB5F3BFF37D223FF95" alt="Alan Conway MD" width="280" height="280" DisableNVelocity="true" /> Alan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15949125Alan Conway, M.D. 1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{94B2E140-AEF8-44BA-B6A9-4538B77501BC}|{EAC4F099-8A2B-4C7A-8911-5AF0769EADA7}|{DEF55970-853F-4E96-9A4D-3413874FF059}<img src="/-/media/national-files/images/hometown-health/2021/eyes-closed-glasses-smile.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7A6958E9B8765E944722180867BFD358" alt="Woman wearing glasses, eyes closed and smiling" width="660" height="370" DisableNVelocity="true" />Stress ManagementGuidance to help you reduce and manage daily stress.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller3/24/2021Migraines affect 39 million people in the U.S. Understanding the four stages of a migraine can lead to improving migraine prevention and treatment.What are the stages of a migraine?<p>Migraines are a common condition with about 15% of U.S. adults reporting a migraine or severe headache in the previous three months, according to the Centers for Disease Control and Prevention. <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/syc-20360201" target="_blank" title="Opens in a new window.">Migraines</a>, which often begin in childhood, adolescence or early adulthood, can progress through four stages: <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/migraine-with-aura/multimedia/migraine-aura/vid-20084707" target="_blank" title="Opens in a new window.">prodrome</a>, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/migraine-with-aura/symptoms-causes/syc-20352072" target="_blank" title="Opens in a new window.">aura</a>, attack and post-drome. Not everyone who has migraines goes through all stages.</p> <h3>Learn more about each stage of a migraine:</h3> <h4>1. Prodrome</h4> <p>One or two days before a migraine, you might notice subtle changes that warn of an upcoming migraine, including constipation, mood changes from depression to euphoria, food cravings, neck stiffness, increased thirst and urination or frequent yawning.</p> <h4>2. Aura</h4> <p>For some people, aura might occur before or during migraines. Auras are reversible symptoms of the nervous system. They're usually visual, but they also can include other disturbances. Each symptom usually begins gradually, builds up over several minutes and lasts 20 minutes to one hour.</p> <h5>Examples of auras include:</h5> <ul> <li>Visual phenomena, such as seeing various shapes, bright spots or flashes of light</li> <li>Vision loss</li> <li>"Pins-and-needles" sensations in an arm or leg</li> <li>Weakness or numbness in the face, or one side of the body</li> <li>Difficulty speaking</li> <li>Hearing noises or music</li> <li>Uncontrollable jerking or other movements</li> </ul> <h4>3. Attack</h4> <p>A migraine usually lasts from four to 72 hours if untreated, and the frequency varies by the person. Migraines might occur rarely or strike several times a month.</p> <h5>During a migraine, you might have:</h5> <ul> <li>Pain, usually on one side of your head, but often on both sides</li> <li>Pain that throbs or pulses</li> <li>Sensitivity to light, sound, and sometimes smell and touch</li> <li>Nausea and vomiting</li> </ul> <h4>4. Post-drome</h4> <p>After a migraine attack, you might feel drained, confused and washed out for up to a day. Some people report feeling elated. Sudden head movement might bring on pain again briefly.</p> <p>Migraines are often undiagnosed and untreated. If you regularly have signs and symptoms of migraines, keep a record of your attacks and how you treated them. Then make an appointment with your health care provider to discuss your headaches.</p> <h4>Learn more about headaches:</h4> <ul> <li>Get <a href="/hometown-health/speaking-of-health/6-tips-for-headache-relief" target="_self" title="Opens in same window.">6 tips for headache relief</a>.</li> <li>Get the <a href="/hometown-health/speaking-of-health/headache-medication-get-the-facts" target="_self" title="Opens in same window.">facts about headache medication</a>.</li> <li>Learn about <a href="/hometown-health/speaking-of-health/botox-as-a-treatment-for-chronic-migraines" target="_self" title="Opens in same window.">Botox as a chronic migraine treatment</a>.</li> <li>Read <a href="/hometown-health/speaking-of-health/common-questions-about-headaches" target="_self" title="Opens in same window.">common questions about headaches</a> and get answers.</li> </ul> <p><em><a href="/providers/nancy-erickson-md" target="_self" title="Opens in same window.">Nancy Erickson, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p>M.D.<p><strong>Medical School</strong></p> <ul> <li>University of Wisconsin-Madison Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Mayo Clinic Family Medicine Residency Program, Mayo Clinic Health System in La Crosse</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Family Practice </li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Medical Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Erickson<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/nancy-erickson-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=9996225D517CD759B325403005262556" alt="Nancy Erickson MD" width="280" height="280" DisableNVelocity="true" />Nancy <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13043188Nancy Erickson, M.D.1<img src="/-/media/national-files/images/hometown-health/2021/eyes-closed-standing-on-city-sidewalk.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5F011CE01B5653F723324E75530A94B6" alt="Eyes closed standing on city sidewalk" width="660" height="370" DisableNVelocity="true" />HeadacheHeadache is pain in any region of the head that feels like a sharp pain, throbbing sensation or dull ache. It may develop gradually or suddenly, and last for minutes or days.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Michele Halterman3/22/2021When medicines are no longer are needed, it is important to dispose of them properly to reduce risk from accidental exposure or intentional misuse. Consider your options.Medication disposal: Why, how to safely clean out your medicine cabinet<p>Medicines play an important role in treating many conditions and diseases. But when those medicines are no longer are needed, it's important to dispose of them properly to reduce risk from accidental exposure or intentional misuse.</p> <p>Accidental exposure to medicine in the home is a major source of unintentional poisonings. There were 294,317 cases of improper medicine use in 2019, according to the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.poison.org/" target="_blank" title="Opens in a new window.">American Association of Poison Control Centers</a>. Approximately 9% of those cases — about 26,317 — involved accidental exposure to another person's medicine. Approximately 3,846 of these accidental exposure cases involved children 5 and younger.</p> <p>The American Association of Poison Control Centers managed 2.6 million cases by telephone in 2019 — about 2.1 million of which were about people coming into contact with potentially dangerous substances. Of human exposure cases managed by poison control centers, 49% involved pharmaceuticals.</p> <h4>What ages are affected by unintentional medication poisoning?</h4> <p>Keeping medicines after they are no longer needed creates an unnecessary health risk in the home, especially if children are present. Even child-resistant containers cannot completely prevent a child from ingesting medicines that belong to someone else.</p> <p>Children younger than 6 make up a disproportionate percentage of the cases, but poisoning affects all age groups, according to a 2019 study conducted by the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.poison.org/poison-statistics-national" target="_blank" title="Opens in a new window.">American Association of Poison Control Centers</a>. Peak poisoning frequency occurs in children ages 1–2, but poisonings in teens and adults are more serious. A larger percentage of children under 13 involved in a poison exposure are male and the trend switches to more females as children become teens and adults.</p> <p>A small number of medicines may be especially harmful, and in some cases fatal, with just one dose if used by someone other than the person for whom the medicine was prescribed.</p> <p>To prevent accidental exposure or ingestion of these potentially dangerous medicines by children and others, the Food and Drug Administration (FDA) recommends that people lock up medications and quickly dispose of extra doses.</p> <h4>Types of disposal</h4> <p>When there is a high risk of accidental poisoning, overdose or diversion, it is better to dispose of unused medications than to keep them.</p> <h5>Consider these options and special instructions when disposing of expired, unwanted or unused medicines:</h5> <h5>Local medication take-back program</h5> <p>The best disposal option is using a local medication take-back program operated by local law enforcement agencies. Many county agencies and police departments offer take-back events or have permanent drug drop boxes that are available during normal business hours. You also can contact your local waste management authority to learn about medication disposal options and guidelines for your area.</p> <p>The <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.fda.gov/media/111887/download" target="_blank" title="Opens in a new window.">FDA recommends</a> trash disposal or flushing down toilet in certain situations if a take-back program is not an option for you.</p> <h5>Disposal in household trash</h5> <h5>There are a few simple steps to follow if you dispose of medicines in the household trash:</h5> <ol> <li>Mix medicines with an unpalatable substance, such as dirt, kitty litter or used coffee grounds.</li> <li>Place the mixture in a container, such as a sealed plastic bag.</li> <li>Throw the container in your household trash.</li> <li>Scratch out all personal information on the prescription label of the empty pill bottle or medicine packaging to make it unreadable and dispose of the container.</li> </ol> <h5>Flush down toilet</h5> <p>The FDA maintains a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.fda.gov/drugs/disposal-unused-medicines-what-you-should-know/drug-disposal-fdas-flush-list-certain-medicines" target="_blank" title="Opens in a new window.">list of medications that can be flushed if a take-back center is not available</a>.</p> <p><em>Troy Taylor is a <a href="/services-and-treatments/pharmacy" target="_self" title="Opens in same window.">pharmacist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2018/prescription-medications-and-bottles.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D9ADFA0DCCBED9249E9D6715C174BDAB" alt="Prescription medications and bottles" width="660" height="370" DisableNVelocity="true" />Medication ManagementNearly 70% of Americans take at least one prescription drug, and more than half take two.Michele Halterman3/3/2021As many as 30% of children have issues with bowel movements due to constipation. Learn what's normal, what's not, what to try and when to seek help.Q&A: Constipation in children<p><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/constipation-in-children/symptoms-causes/syc-20354242" target="_blank" title="Opens in a new window.">Constipation</a> can cause issues with bowel movements in as many as 30% of children. It's a common concern for many parents.</p> <p>Most often, constipation affects children of preschool-age, but it also can occur in older children. No common cause or medical condition consistently contributes to symptoms that lead to less frequent, hard, large or uncomfortable bowel movements. However, understanding what's normal, depending on your child's age, may help you to decide if it's time to seek help.</p> <h2>Here's how normal bowel habits break down by age:</h2> <ul> <li><strong>Newborns</strong> — Expect four soft bowel movements daily</li> <li><strong>First 3 months for children who are breastfed</strong> — Expect three soft bowel movements daily.</li> <li><strong>First 3 months for children who are formula-fed</strong> — Expect two to three soft bowel movements daily.</li> <li><strong>6 months–1 year</strong> — Expect two bowel movements daily.</li> <li><strong>1–3 years</strong> — Expect one to two bowel movements daily.</li> <li><strong>4 years and older</strong> — Expect one bowel movement daily.</li> </ul> <p>It can be common for a breastfed infant to have as many as one bowel movement after each feeding to as little as one bowel movement every five to seven days.</p> <h3>Constipation is common and can be caused by a change in diet. In this video, Glenn Kauppila, D.O., explains the symptoms of constipation and steps to take for prevention:</h3> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/tO4oCKmL-CQ" title="Ask Mayo Clinic Health System: Constipation - Symptoms and Prevention" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <h2>What should the bowel movement look like?</h2> <p>A breastfed infant will have stool that can look more yellow and seedy. A formula-fed infant will have a peanut butter-consistency stool. As a child ages and solids are introduced, the stool can vary dependent on diet. As a child ages and becomes potty trained, a soft, formed banana-shaped stool each day is common.</p> <h2>When does a bowel movement become abnormal?</h2> <p>Bowel movements are abnormal when they become hard or pellet-like, or they cause straining and discomfort. Other signs of an abnormal bowel movement include blood in the stool or on the toilet paper due to straining or size of the bowel movements, leakage of stool in underwear, and urinary accidents in correlation with infrequent bowel habits that previously were not occurring</p> <h2>When does constipation commonly occur in children?</h2> <p>Constipation in children commonly occurs during the transition to a solid diet, such as moving from breast milk or formula to solid foods. It also can occur during toilet training, where withholding can occur when a child isn't ready or painful bowel movements are an issue, and when school starts, where an unfamiliar setting, privacy issues or concerns of time can result in withholding.</p> <h2>What are common symptoms of constipation?</h2> <h3>Signs of constipation include:</h3> <ul> <li>Abdominal bloating</li> <li>Blood in the stool or diaper</li> <li>Changes in appetite</li> <li>Frequent complaints of stomach ache or abdominal discomfort</li> <li>Hard, formed and painful bowel movements</li> <li>Infrequent bowel movements</li> <li>Leakage of stool in the underwear</li> <li>Urinary leakage or incontinence</li> <li>Weight loss or poor weight gain</li> </ul> <h3>Tips to avoid constipation</h3> <h4>You can try several things to help your child develop better bathroom habits early on to avoid potential issues, including:</h4> <ul> <li>Toilet train when your child is showing interest.</li> <li>Provide positive reinforcement.</li> <li>Incorporate a foot support, such as a stool, for proper positioning and comfort.</li> <li>Encourage routine, especially after a meal, as eating stimulates the bowels.</li> <li>Allow for enough time - at least five to 10 minutes - to have a bowel movement.</li> <li>Encourage and offer plenty of water to drink throughout the day, typically three to five cups daily.</li> <li>Choose a balanced diet that includes whole grains, fruits and vegetables. High-fiber foods include apricots, sweet potatoes, pears, prunes, peaches, plums, beans, peas, broccoli, berries or spinach. You also can utilize 2-4 ounces of 100% fruit juice - apple, prune or pear - diluted with water, as needed, for a child with a history or concerns of constipation.</li> <li>Taking a fiber supplement is an option to discuss with your child's primary care provider.</li> </ul> <h2>When to see your child's primary care provider</h2> <h3>You should see your child's primary care provider when your child:</h3> <ul> <li>Is having hard, formed, painful stools</li> <li>Doesn't want to eat and is losing weight</li> <li>Has blood in his or her stool or diaper.</li> <li>Is having repeated episodes of constipation.</li> </ul> <p>You also should see your child's primary care provider when you have questions or concerns about your child's bowel habits.</p> <p>Constipation is a common occurrence is children. Thankfully, there are many options available to help. Your child's health care provider is the best source of information for questions or concerns related to your child's constipation.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2021/child-holding-toilet-paper-roll.jpg?h=370&iar=0&w=660&sc_lang=en&hash=15C7D310BE484BD99A8586D37BFE7C64" alt="Child holding toilet paper roll" width="660" height="370" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Michele Halterman3/31/2021Colorectal cancer is the second leading cause of cancer death among men and women. Early detection is key. Read FAQ about a screening test you can do in the privacy of your own home.5 questions about stool DNA tests for colon cancer<p>Colorectal cancer is the second most common cause of cancer death in men and women. More than 149,000 new cases of colon or rectal cancer will be diagnosed and nearly 53,000 deaths will occur in 2021, according to American Cancer Society estimates. Fortunately, when detected early, the five-year survival rate can be greater than 90%. The earlier colorectal cancer is found easier is to treat.</p> <p>Screening has been shown to reduce your risk of dying of colon cancer. For people with average risk, screening begins around 45. However, people with an increased risk should be screened sooner.</p> <p>A colonoscopy is the most common screening tool for colon cancer, but there is another option, as well: a stool DNA test.</p> <h3>Here are answers to common questions about the stool DNA test:</h3> <h4>What is a stool DNA test, and why is this test performed?</h4> <p>The stool DNA test is a noninvasive test to screen for colon cancer. Stool DNA testing is intended to screen for colon cancer or precancerous polyps in people with no symptoms.</p> <p>This test identifies DNA changes in the cells of a stool sample and looks for abnormal DNA associated with colon cancer or polyps. The test also detects small amounts of blood shed into the stool from colon cancer or polyps. When present in your colon, cancer or polyps continuously shed cells with abnormal DNA changes into the stool. The DNA changes are found in tiny amounts, so sensitive laboratory methods are required to detect them.</p> <p>Research shows the stool DNA test effectively detects colon cancer and precancerous polyps.</p> <h4>Who is a stool DNA test appropriate for?</h4> <p>A stool DNA test is not for everyone, and it does not replace a screening colonoscopy. It is appropriate for people 45 and over with an average risk of colon cancer.</p> <p>It is not the right option if you have had an abnormal colonoscopy in the past; a personal or family history of colon cancer; or a condition that puts you at higher risk for colon cancer, such as inflammatory bowel disease, Crohn's disease or chronic ulcerative colitis.</p> <h4>What preparation is required for a stool DNA test?</h4> <p>The test requires no preparation or anesthesia. Before the test, you can eat and drink normally, and take your current medications. There's no need to undergo bowel preparation to clean out or empty your colon prior to taking the test. Finally, the test is completed in the privacy of your own home.</p> <h4>What can you expect during a stool DNA test?</h4> <p>Your health care provider will give you a stool DNA test kit to collect and submit a stool sample. The kit includes a container that attaches to the toilet and a preservative solution that you add to the stool sample before sealing the container. The test requires only one stool sample.</p> <p>After the stool sample is collected, you will return it to the screening lab in a prepaid shipping container. The test is noninvasive, meaning nothing enters your body during the test. There are also no side effects from collecting a stool sample.</p> <h4>When will you receive the results from a stool DNA test, and what do these results mean?</h4> <p>You can expect to receive your results from your health care provider in approximately one week through Patient Online Services or in the mail.</p> <h5>Your test result will be negative or positive:</h5> <ul> <li><strong>Negative result</strong><br /> Your test is considered negative if there are no abnormal DNA changes common to colon cancer, or precancerous polyps and signs of blood, found in your stool. Your health care provider may recommend that you repeat the test in three years.</li> <li><strong>Positive result</strong><br /> Your test is considered positive if abnormal DNA changes common to colon cancer, or precancerous polyps or signs of blood, are found in your stool sample. In most cases, you will need to have a screening colonoscopy to examine the inside of the colon to determine if cancer or polyps are present.</li> </ul> <p>It's important to understand that a stool DNA test is less sensitive than colonoscopy at finding precancerous polyps. Approximately 5% to 10% of people who undergo stool DNA testing will have a positive result, but no cancer or polyps will be found during a follow-up colonoscopy. Your health care provider will discuss follow-up steps in this circumstance.</p> <p>Finding colon cancer at its earliest stage provides the greatest chance for a cure. That's why health care providers recommend colon cancer screenings beginning at 45. A stool DNA test is an easy-to-complete screening option that can motivate more people to be screened and take the critical step in beating this common and preventable cancer.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2021/smiling-woman-looking-off-to-side.jpg?h=370&iar=0&w=660&sc_lang=en&hash=96CB0D0EB8A6C9DCB682A61E52970E48" alt="Smiling woman looking off to side" width="660" height="370" DisableNVelocity="true" />Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Michele Halterman3/25/2021Spring is in the air, which can mean misery for allergy sufferers. Fortunately, you can treat yourself right with these tips and leave the tissues at home.Say goodbye to springtime allergies<p>Spring is in the air. Warmer temperatures mean that trees bud, flowers bloom, grass grows and animals get more active. People do, too. But for some, spring means handfuls of tissues and a heavy dose of misery in the form of sneezing, watery eyes and stuffy noses.</p> <h2>Here are a few tips to help allergy sufferers enjoy the beautiful spring weather:</h2> <h3>Oral allergy medications</h3> <p>Oral medications are especially useful for mild allergy symptoms, and many are available over the counter.</p> <h4>Nonsedating antihistamines can relieve itching, sneezing, runny nose and watery eyes. Options include:</h4> <ul> <li>Loratadine (Claritin), cetirizine (Zyrtec), levocetirizine (Xyzal) and fexofenadine (Allegra) all are available without prescription.</li> <li>Oral decongestants, like pseudoephedrine (Sudafed) and phenylephrine (Sudafed PE) can ease stuffiness, and pseudoephedrine is often combined with an antihistamine. These medications are generally well-tolerated, with minimal side effects.</li> </ul> <h4>Common side effects</h4> <p>Oral decongestants cause insomnia and elevated blood pressure for some people, and antihistamines can cause drowsiness. If you find that one brand of antihistamine makes you sleepy, try a different one to see if you tolerate that better.</p> <p>Older antihistamines, like diphenhydramine (Benadryl), are more likely to cause drowsiness compared to the newer antihistamines. Be careful about driving or working around heavy machinery if you take diphenhydramine.</p> <h3>Nasal steroid sprays</h3> <p>For more persistent allergy symptoms, nasal steroid sprays often are the best treatment option. Nasal steroid sprays block inflammation and swelling caused by airborne irritants and allergens, and prevent allergy symptoms.</p> <h4>Over-the-counter steroid nasal sprays include:</h4> <ul> <li>Triamcinolone (Nasacort)</li> <li>Fluticasone (Flonase or Flonase Sensimist)</li> <li>Budesonide (Rhinocort)</li> </ul> <p>These medications usually start working after a few days. They can take a few weeks to reach peak effect, so they work best when used consistently, at least during your allergy season. It is fine to combine nasal steroid sprays with oral antihistamines, but the nasal steroid spray can prevent excess histamine production when it works well.</p> <p>Be careful not to confuse nasal steroid sprays with decongestant nasal sprays, such as oxymetazoline (Afrin). Afrin-type sprays work well for rapid relief of severe nasal congestion, but they are addictive and can actually worsen nasal congestion when used too long. This type of nasal spray should not be used for more than three days in a row, and even then only occasionally.</p> <h3>Eye drops</h3> <p>Over-the-counter antihistamine eye drops, such as ketotifen (Zaditor) or olopatadine (Pataday), can rapidly relieve itchy eyes. Eyedrops often are more soothing when refrigerated. Oral antihistamines and nasal steroid sprays can help itchy eyes eventually, but antihistamine eye drops often provide the most rapid relief.</p> <h3>Inhalers</h3> <p>If you have asthma along with your allergies, inhaled medications likely will be an important part of your treatment plan. Some inhalers suppress the lung inflammation that causes asthma. Other inhalers, such as albuterol, dilate your airways for temporary relief of asthma symptoms.</p> <h3>Allergy shots</h3> <p>If you find that first-line treatments like nasal sprays and oral medications are ineffective or poorly tolerated, a series of shots to combat allergic symptoms is available.</p> <h4>However, you may first want to know more details about allergy shots before considering:</h4> <ul> <li>Allergy shots take months to start working and require a large time commitment, but their effectiveness is well documented.</li> <li>Allergy shots contain miniscule amounts of the proteins that cause your allergic symptoms.</li> <li>The shots are administered in gradually increasing doses once or twice per week for the first few months, then once per month for three to five years.</li> </ul> <p>Visit with your health care provider about these and other ways to combat seasonal allergies, and you'll be able to enjoy all the pleasures this season has to offer. Go for a bike ride, take a hike or picnic with your family. Treat yourself right, and you can leave the tissues at home.</p> <p><em>Richard Crockett, M.D., is an <a href="/services-and-treatments/immunology" target="_self" title="Opens in same window.">allergist</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2021/smiling-open-arms-in-outdoors.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F1EFC25B0C5955FDE5E1AABC876395C0" alt="Smiling open arms in outdoors" width="660" height="370" DisableNVelocity="true" />Allergy and AsthmaOur allergists provide care for your allergies, asthma and conditions that affect the immune system's ability to defend the body against foreign or abnormal cells. The main treatment goal is your satisfaction when your condition is under control and quality of life is improved.Dawn Haller3/23/2021Trying to get some spring cleaning done? Don't forget your refrigerator. Get tips on what to select for food and how to keep it healthy in the refrigerator.Spring into better health: Refrigerator edition<p>Food items can quickly expire in the refrigerator or get stuck in the far back corner, resulting in forgotten, potentially expired items. And sometimes food spills make a refrigerator look more like a science project than a storage place for food.</p> <h2>Here are some tips to keep your food healthy in the refrigerator:</h2> <ul> <li><strong>Throw away any food that may be questionable.</strong><br> Most canned items have an expiration date, but if there's no expiration date, use your best judgment. When in doubt, throw it out.</li> <li>Cleaning your refrigerator also is a good time to throw away any enticing, unhealthy food.<br> Get rid of whatever your downfall to losing weight might be, such as whipped cream, chocolate syrup, frosting, salted caramel ice cream topping, full-fat mayonnaise or cheese sauce.</li> <li><strong>Remove all foods and items from your refrigerator, and wipe the bottoms.</strong><br> Clean your refrigerator with warm dish soap and water, and then wipe it dry with a towel. This will prevent bacteria from growing in your refrigerator.</li> <li><strong>At this point, it's also a good time to check the temperature.</strong><br> Make sure your refrigerator is at 40 degrees Fahrenheit or colder.</li> <li><strong>Use the fruit and vegetable bins for their intended food occupants.</strong><br> Stock up on these items, and make them easy to grab and eat by washing and cutting them into snack-size portions. Make snacking healthy by taking the effort out of the equation when cravings hit.</li> <li><strong>Consider the colors of your fruits and vegetables.</strong><br> Color matters. More intense color means more nutrients. Learn what eating the rainbow of colors can do for you.</li> <li><strong>Choose low-fat mayonnaise, yogurt, cheese and milk.</strong><br> Reduced-fat cheese or milk are good second choices.</li> <li><strong>Leave room on the bottom shelf to properly thaw frozen meats.</strong><br> Use a plate under the meat to catch any possible liquids and avoid contaminating other foods. Thawing meat in the refrigerator can take time, so plan ahead. Remember to thaw meat in the refrigerator rather than on the counter to avoid bacteria growth and foodborne illness.</li> <li><strong>Give yourself time to thaw out other frozen foods in the refrigerator, depending on their size.</strong></li> </ul> <p>Read about spring cleaning in your <a href="/hometown-health/speaking-of-health/spring-into-better-health-pantry-edition" target="_self" title="Opens in same window.">pantry</a> and <a href="/hometown-health/speaking-of-health/spring-into-better-health-freezer-edition" target="_self" title="Opens in same window.">freezer</a>.</p> <p><em><a href="/providers/amanda-halls-rd-ld" target="_self" title="Opens in same window."></a><a href="/providers/amanda-halls-rd-ld" target="_self" title="Opens in same window.">Amanda Halls</a> is a <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">dietitian</a> in <a href="/locations/lake-city" target="_self" title="Opens in same window.">Lake City</a>, Minnesota.</em></p><ul> <li>Diabetes</li> <li>Overall nutritional changes are lifelong changes for patients and their families</li> <li>Weight Management</li> </ul>RDN, LD<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Dietetics, College of Saint Benedict</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Registered Dietitian</li> <li>Licensed Dietitian</li> </ul>Halls<img src="/-/media/shared-files/images/medical-professionals/full/lake-city/amanda-halls-rdn-ld.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B0FA1017FC839B7CCA36917E15C4BB68" alt="Amanda Halls, R.D.N., L.D." width="280" height="280" DisableNVelocity="true" />Amanda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16305141Amanda Halls, R.D., L.D.1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2021/looking-inside-refrigerator-fruits.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F06B86581B7AF22D42AFECB179B40E9E" alt="Looking inside refrigerator with fruits and lettuce" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller3/30/2021 If you're trying to eat healthier, a good place to start is right in your own pantry. Learn how a little spring cleaning of the pantry can lead to better choices.Spring into better health: The pantry edition<p>With spring often comes spring cleaning. You may have a chance to clean your house inside and out. However, what about your pantry? How often do you clean your pantry? </p> <p>There are many reasons to consider cleaning out your pantry. You might have set a New Year’s resolution to start eating healthier, but still have old temptations waiting for you on the shelf. Removing those temptations from your grasp will help you stay on track with your goals.</p> <h3>If you're trying to lose weight or adopt a healthier lifestyle, consider these tips for creating a healthier pantry:</h3> <h4>Throw away old, unhealthy enticements and replace with new, healthy options, including:</h4> <ul style="list-style-type: disc;"> <li>Low-sodium pretzels</li> <li>Hummus</li> <li>Light popcorn</li> <li>Baked chips</li> <li>Low-sodium nuts, such as almonds, peanuts or walnuts</li> <li>Canned salmon tuna</li> <li>Canned smoked herring </li> <li>Whole-wheat or whole-grain bread, crackers, past and rice (make sure the first ingredient listed is whole grain)</li> <li>Extra-virgin olive oil</li> <li>Couscous, farro, oatmeal, quinoa, rolled oats and wild rice</li> <li>Low-sodium beans and lentils</li> <li>Low-sodium beef or chicken broth</li> <li>Canned vegetables and fruits in their own juices or in light syrup</li> </ul> <h4>Note that herbs and spices can expire.</h4> <p>Keep in mind that herbs and spices can expire and lose their potency. This causes your favorite recipes to have different tastes. Spices and herbs also can also be expensive, but you can grow them yourself, even if you do not have a large space to do it.</p> <p>You can plant herbs and spices in small boxes indoors near windows or outside on a patio. You can create a small box or leftover pots with soil, and use that to plant the herbs without worrying about weeds taking over. Any vessel will work, so green thumbs can get creative and use what works best.</p> <p>You can use fresh herbs and spices to make any dish more delightful. You can also dehydrate the herbs and spices for use over the winter. The aroma of fresh basil, oregano or chives growing near where you’re cooking will help inspire creative new recipes, as well.</p> <p><strong>Like this article? Read about spring cleaning in your <a href="/hometown-health/speaking-of-health/spring-into-better-health-freezer-edition" target="_self" title="Opens in same window.">freezer</a> and <a href="/hometown-health/speaking-of-health/spring-into-better-health-refrigerator-edition" target="_self" title="Opens in same window.">refrigerator</a>.</strong></p> <p><em><a href="/providers/amanda-halls-rd-ld" target="_self" title="Opens in same window.">Amanda Halls</a> is a <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">dietitian</a> in <a href="/locations/lake-city" target="_self" title="Opens in same window.">Lake City</a>, Minnesota.</em></p><ul> <li>Diabetes</li> <li>Overall nutritional changes are lifelong changes for patients and their families</li> <li>Weight Management</li> </ul>RDN, LD<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Dietetics, College of Saint Benedict</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Registered Dietitian</li> <li>Licensed Dietitian</li> </ul>Halls<img src="/-/media/shared-files/images/medical-professionals/full/lake-city/amanda-halls-rdn-ld.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B0FA1017FC839B7CCA36917E15C4BB68" alt="Amanda Halls, R.D.N., L.D." width="280" height="280" DisableNVelocity="true" />Amanda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16305141Amanda Halls, R.D., L.D.1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2021/jars-on-shelves-in-pantry.jpg?h=370&iar=0&w=660&sc_lang=en&hash=67A2C46053413C895D81774F22AD882B" alt="Jars on shelves in pantry" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller3/10/2021Colorectal cancer is the third most commonly diagnosed cancer in the U.S., but prevention is possible. Learn more in this Q&A.Colorectal cancer Q&A<p>Colorectal cancer ― the third most commonly diagnosed cancer in the U.S. ― will account for nearly 53,000 deaths in 2021, according to the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.cancer.org/cancer/colon-rectal-cancer/about/key-statistics.html" target="_blank" title="Opens in a new window.">American Cancer Society</a>. Yet prevention is possible when combining proper screenings, healthy lifestyle changes and increased awareness.</p> <h2>Learn more in this Q&A:</h2> <h3>What is colorectal cancer?</h3> <p>Colorectal cancer is an umbrella term used for cancer of the large intestine (colon), which is the lower part of your digestive system, and rectal cancer, which occurs in the last several inches of your colon. Cancer of the large intestine and cancer in the lower colon, or rectum, will be found in approximately 150,000 Americans and 45,000 Americans, respectively, in 2021. More than 1.5 million Americans are alive after a diagnosis of colorectal cancer.</p> <h3>How does colorectal cancer begin?</h3> <p>Most often, colorectal cancer starts with precancerous polyps in the lining of the colon. These precancerous cells can form in the shape of a mushroom, lie flat or be embedded in the colon walls. Finding and removing the polyps helps prevent colorectal cancer.</p> <h3>Does genetics play a role in colorectal cancer?</h3> <p>Most colorectal cancer is found in people without a family history of colon cancer. People with a family history have an increased risk of developing the disease, but it is not the only risk factor that should be considered when assessing individual risk.</p> <h4>A few factors put you at an increased risk for colorectal cancer:</h4> <ul> <li><strong>Age</strong><br /> Most people diagnosed with colorectal cancer are over 50. However, colorectal cancer affects young people, as well, albeit less frequently. A recent study suggests a small increase of colon cancer in U.S. adults under 40. This increase amounts to about 2% of the annual rates over the past decades. Given this increase, the recommended age for a person's first colon cancer screening has been lowered from 50 to 45.</li> <li><strong>Race</strong><br /> African Americans are more susceptible to colorectal cancer than other races. Both African Americans, and Native Americans and Alaska Natives over 45 are at a higher risk, as well.</li> <li><strong>Personal and family history</strong><br /> Previously having colorectal cancer, polyps or family history of the disease heightens colorectal cancer risk.</li> <li><strong>Intestinal conditions</strong><br /> Preexisting inflammatory bowel diseases like ulcerative colitis and Crohn's disease increase the chance you'll develop colorectal cancer.</li> <li><strong>Health problems and unhealthy lifestyle</strong><br /> Health conditions, such as diabetes and obesity, and unhealthy lifestyle decisions, such as lack of exercise, a diet high in fat, as well as smoking and heavy alcohol consumption, contribute to colorectal cancer. The rise of colorectal cancer in younger American adults has been linked to these modifiable risk factors, such as changes in diet and activity.</li> </ul> <h3>Can you prevent colorectal cancer?</h3> <p>The overall lifetime risk of colorectal cancer is 1 in 23 for men and 1 in 25 for women. While you can't completely eliminate all risk factors, like age, you can take steps to reduce your personal risk by making changes in your everyday life.</p> <h4>These steps will reduce your risk of developing colorectal cancer:</h4> <ul> <li><strong>Eat a variety of fruits, vegetables and whole grains.</strong><br /> Fruits, vegetables and whole grains contain vitamins, minerals, fiber and antioxidants that may play a role in cancer prevention. Choose a variety of fruits and vegetables so that you get an array of vitamins and nutrients.</li> <li><strong>Drink alcohol in moderation, if at all.</strong><br /> If you choose to drink alcohol, limit the amount of alcohol you drink to no more than one drink a day for women and two for men.</li> <li><strong>Stop smoking.</strong><br /> Talk to your health care provider about ways to quit that may work for you.</li> <li><strong>Exercise most days of the week.</strong><br /> Try to get at least 30 minutes of exercise on most days. If you've been inactive, start slowly and build up gradually to 30 minutes. Also, talk to your health care provider before starting any exercise program.</li> <li><strong>Maintain a healthy weight.</strong><br /> If you are at a healthy weight, work to maintain your weight by combining a healthy diet with daily exercise. If you need to lose weight, ask your health care provider about healthy ways to achieve your goal. Aim to lose weight slowly by increasing the amount of exercise you get and reducing the number of calories you eat.</li> </ul> <p>If you have been diagnosed with an advanced colon polyp, talk with your health care provider about taking preventive aspirin. The U.S. Preventive Services Task Force concluded that aspirin reduces the risk of colorectal cancer by 40% in patients with advanced colorectal polyps. It is not recommended for everyone, so be sure to follow your health care provider's recommendations.</p> <h3>How is colorectal cancer diagnosed?</h3> <p>Colon cancer screening is of paramount importance for preventing and catching colorectal cancer early. Although a colonoscopy isn't perceived as the most glamorous screening, the benefits far outweigh the downfalls. Experts recommend that patients should begin colon screening at 45 or 10 years prior to when an immediate family member was diagnosed with colon cancer. For example, if your mother was diagnosed with colon cancer at 48, have your first screening at 38.</p> <p>An alternative to a traditional colonoscopy is a new at-home test that Mayo Clinic helped develop. This test uses a stool sample to detect cancerous DNA. Talk to your health care provider to see if this may be an option for you.</p> <p>This test requires no bowel preparation and no time off work, and it is covered by most health insurance plans as a colon cancer screening. It detects polyps and cancer. If abnormal, a follow-up colonoscopy is recommended to determine the source of cancerous DNA detected in the stool. Most tests will be negative, which will reduce the need for routine screening colonoscopies.</p> <h3>What are the symptoms?</h3> <p>Symptoms are usually subtle, if at all noticeable, during the early stages of colorectal cancer, which is why regular screening is vital.</p> <h4>If signs appear, they're usually in the form of:</h4> <ul> <li>Blood in your stool or rectal bleeding.</li> <li>Unexplained weight loss.</li> <li>Persistent abdominal issues, including cramps, gas and pain.</li> <li>Persistent changes in bowel movements, including diarrhea, constipation or stool consistency.</li> <li>Fatigue or weakness.</li> <li>A feeling that your bowel doesn't empty completely.</li> </ul> <h3>Can colorectal cancer spread to other areas of the body?</h3> <p>Yes, colorectal cancer can spread to other areas of your body, most commonly to the liver. It can spread to your lungs, brain or lymph nodes, as well. It is more difficult to treat after it spreads. That's why it is so important to detect and diagnose it as soon as possible.</p> <h3>How is colorectal cancer treated?</h3> <p>Colorectal cancer treatments are more effective if the cancer is discovered early. Which treatments are most likely to help you depends on your particular situation, including the location of your cancer, its stage and your other health concerns. Treatment for colon cancer usually involves surgery to remove the cancer. Other treatments, such as radiation therapy and chemotherapy, also may be recommended.</p> <h3>What is the survival rate of colorectal cancer?</h3> <p>The bad news is that colorectal cancer is the third leading cause of cancer-related deaths in men and women. It is expected to cause about 53,000 deaths in 2021. The good news is that the death rate has been dropping for decades due to increased screenings, removal of polyps earlier and improvements in treatments.</p> <p>The relative survival rate of any cancer compares people with the same type and stage of cancer to people in the overall population. The relative survival rate for colorectal cancer varies based on the stage of the cancer. According to the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/survival-rates.html" target="_blank" title="Opens in a new window.">American Cancer Society</a>, colorectal cancer that has not spread outside the colon or rectum has a five-year relative survival rate of nearly 90%; whereas, cancer that has spread to other areas of the body is 14%–16%.</p> <p>Colorectal cancer can be prevented with proper screening in concert with healthy lifestyle changes and increased awareness. Talk to your health care team if you have questions or concerns regarding colorectal health. And be sure to encourage your friends and loved ones to follow screening guidelines.</p> <p><em><a href="/providers/stephan-thome-md" target="_self" title="Opens in same window.">Stephan Thome, M.D.</a>, is a <a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">medical oncologist</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li> University of Ulm School of Medicine West Germany</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Hematology and Oncology,Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Hematology, American Board of Internal Medicine</li> <li>Internal Medicine, American Board of Internal Medicine</li> <li>Medical Oncology, American Board of Internal Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Oncology, Mayo Clinic College of Medicine and Science</li> </ul>Thomé<img src="/-/media/shared-files/images/medical-professionals/full/mankato/stephan-thome-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=3B79B852796153607E376F4CB860D95E" alt="Stephan Thome MD" width="280" height="280" DisableNVelocity="true" />Stephan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>10322663Stephan Thomé, M.D.1{BCFC3BDC-CF55-458E-A41C-9360527B6CCC}|{0DD9D3C9-86C5-47FC-A2CF-8AEEA4717B70}<img src="/-/media/national-files/images/hometown-health/2021/couple-sitting-and-smiling.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B04C41CB8FBD8D275B37239389F7CF53" alt="Couple sitting and smiling" width="660" height="370" DisableNVelocity="true" />Colorectal HealthGet screening and treatment for colorectal cancer symptoms, and learn about risk factors and prevention strategies.CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Dawn Haller3/10/2021Thinking about having a baby? Planning ahead can increase your chances for a healthy pregnancy and baby. Here are some important questions to ask yourself and your provider before trying to conceive.Are you ready to have a baby?<p>When you are thinking about becoming pregnant, whether it's the first time or not, it's important to discuss your plans with your health care provider before you become pregnant. Traditional prenatal care once you are pregnant is not usually started until after 13 weeks. Therefore, ensuring you're healthy before trying to conceive is essential.</p> <h3>Here are some questions to ask yourself and your provider about having a baby:</h3> <h4>Am I healthy enough to have a baby?</h4> <p>Some medical diagnoses put mom and baby at higher risk and will require closer monitoring. Examples include seizures, diabetes, high blood pressure, depression and thyroid disease. Your provider will help you make sure these conditions are well managed before you become pregnant. Being 35 and older also increases your risk.</p> <p>If you or your partner have a family history of genetic disease, you may be sent to a genetic specialist to discuss possible screening tests for the disease.</p> <p>A recent pregnancy or complications with previous pregnancies may mean your provider will follow you more closely or advise waiting to become pregnant until you have had a more thorough evaluation.</p> <p>It also is important to be screened for infections you may not know you have. And you should confirm that you have been given all recommended vaccines. For example, some women who were vaccinated against rubella find that they no longer are immune. Babies born to a mom who was sick with rubella, especially in early pregnancy, are at greater risk for birth defects.</p> <h4>Are the medications and supplements I'm taking safe in pregnancy?</h4> <p>Prescribed and over-the-counter medications can be harmful to an unborn baby. There are only about 30 medications with proof that they are safe in pregnancy. Some medications also can affect your ability to become pregnant. Your provider can assist with stopping necessary medications, changing to an alternative medication and starting recommended medications, such as folic acid. The best time to do this is several months before becoming pregnant.</p> <h4>Will my current lifestyle provide a safe, comfortable environment for a newborn?</h4> <p>If you are employed, check to see if your place of work provides paid family medical leave after delivery. Learn about policies for time off as your child grows.</p> <p>Make a list of people available to help you if you or your baby need it. Consider the potential need for help during pregnancy, such as when you are tired or nauseous, or if bedrest is recommended.</p> <p>Consider the cost of having and raising a child. Babies can be expensive. From buying a package of diapers to covering day care, the costs add up quickly. Look into the prices of the essentials to know what to expect and start a budget.</p> <p>Pregnancy rarely is perfect, but planning ahead can increase your chances for a healthy pregnancy and baby. Schedule a preconception appointment with your health care provider as soon as you begin thinking about becoming pregnant.</p> <p><em><a href="/providers/breanna-weisbrod-cnp" target="_self" title="Opens in same window.">Breanna Weisbrod</a> is a nurse practitioner in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><ul> <li>Cancer prevention</li> <li>Child development and wellness </li> <li>Health literacy</li> <li>LGBTQ+ health care</li> </ul>APRN, C.N.P.<p>I view myself as a partner to my patients in managing their health and place a strong emphasis on establishing a comfortable and trusting relationship with them. I am passionate about my job and learning about updated health guidelines and evidence-based medicine.</p> <p> Outside of work, I enjoy spending time outdoors with my family, reading and sleeping.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Clinical Nurse Specialist Program, Winona State University, Rochester, Minnesota</li> <li>Post-Master's Certificate, Family Nurse Practitioner Program, Graceland University, Independence, Missouri</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Family Nurse Practitioner, American Nurses Credentialing Center</li> <li>Adult-Geriatric Clinical Nurse Specialist, American Nurses Credentialing Center</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Association of Nurse Practitioners</li> </ul>Weisbrod<img src="/-/media/shared-files/images/medical-professionals/full/mankato/breanna-weisbrod-cnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=8DE0D736EE04A78B890235625AAD2B3E" alt="Breanna Weisbrod CNP" width="280" height="280" DisableNVelocity="true" />{E65B9B2C-380D-478F-B43B-6F20F994708A}Breanna<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14070022Breanna Weisbrod, C.N.P.1{986C767E-E5DE-43F5-957F-B4212DB8E384}|{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}<img src="/-/media/national-files/images/hometown-health/2021/couple-happy-about-pregnancy-test-results.jpg?h=370&iar=0&w=660&sc_lang=en&hash=32DEC67F9AFBA64365D92632D4EC456B" alt="Couple happy about pregnancy test results" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller12/8/2023Caring adults in children's lives have the power of influence. Get tips to help you talk with your children about the dangers of alcohol. It could save a life.Have you talked to your children about alcohol use?<p>Children are constantly challenged to decipher the messages they see and hear about alcohol, not only from the ads they see on TV but also from social media, friends, billboards, clothing and more. </p> <p>But are the messages children receive facts or myths? Are the messages the ones you want adolescents and young adults to have as they're faced with making a big choice — deciding whether or not they want to consume an alcoholic drink?</p> <p>As a parent, there are benefits to having crucial conversations about alcohol use with your children, according to statistics from the <a rel="noopener" href="https://www.niaaa.nih.gov/" target="_blank" title="Opens in a new window.">National Institute on Alcohol Abuse and Alcoholism (NIAAA)</a>. Around 80% of teens feel that parents should have a say in whether or not they drink alcohol. Talking with children helps ensure they're receiving the facts and developing healthy refusal skills in situations involving alcohol.</p> <h2>Facts to know about alcohol use:</h2> <ul> <li>More than 29 million people ages 12 and older have <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/symptoms-causes/syc-20369243" target="_blank" title="Opens in a new window.">alcohol use disorder</a>. The disorder is identified by patterns of alcohol use that involve a problem controlling drinking, being preoccupied with alcohol and continuing to use alcohol even after it causes problems. </li> <li>An estimated 894,000 adolescents ages 12 to 17 have alcohol use disorder.</li> <li>An estimated 140,000 people ― approximately 97,000 men and 43,000 women ― die from alcohol-related causes annually, according to the NIAAA</li> <li>Research has shown that <a href="/hometown-health/speaking-of-health/recognizing-and-addressing-a-loved-ones-alcohol-abuse" target="_self" title="Opens in same window.">people who drink excessively</a> have a greater risk of liver disease, heart disease, depression, stroke and stomach bleeding, as well as cancers of the oral cavity, esophagus, larynx, pharynx, liver, colon and rectum.</li> <li>Studies indicates that alcohol use during the teenage years can interfere with normal <a href="/hometown-health/speaking-of-health/how-teen-marijuana-use-impacts-brain-development" target="_self" title="Opens in same window.">adolescent brain development</a> and increase the risk of developing alcohol use disorder. In addition, underage drinking contributes to a range of acute consequences, such as injuries, <a href="/hometown-health/speaking-of-health/speak-out-about-abuse-or-assault" target="_self" title="Opens in same window.">sexual assaults</a> and alcohol overdoses, as well as deaths, including those from motor vehicle crashes.</li> <li>Alcohol-related problems cost America $249 billion in lost productivity, absenteeism, healthcare costs, crime and family problems.</li> </ul> <h2>Identifying, preventing alcohol-related issues</h2> <p>Early intervention can prevent alcohol-related problems.</p> <h3>Be alert to signs and symptoms that may indicate your children may have a problem with alcohol, including:</h3> <ul> <li>Declining grades and problems in school</li> <li>Difficulties or changes in relationships, such as joining a new group of friends</li> <li>Frequent mood changes and defensive behavior</li> <li>Loss of interest in activities, hobbies and personal appearance</li> <li>Red eyes, slurred speech, problems with coordination and memory lapses</li> </ul> <h3>You also can help your children avoid alcohol problems by:</h3> <ul> <li>Connecting with other parents about sending clear messages stressing the importance of youth not drinking alcohol.</li> <li>Encouraging your children to participate in healthy, fun activities that don't involve alcohol.</li> <li>Getting to know your children's friends.</li> <li>Letting your children know what behavior you expect and the consequences for not following the rules.</li> <li>Not making alcohol available.</li> <li>Serving as a positive role model.</li> <li>Setting a good example with <a href="/hometown-health/speaking-of-health/balancing-the-risks-benefits-of-alcohol" target="_self" title="Opens in same window.">your alcohol use</a>.</li> <li><a href="/hometown-health/speaking-of-health/teens-and-substance-free-celebrations" target="_self" title="Opens in same window.">Supervising all parties</a> to ensure there's no alcohol.</li> <li>Talking openly with your children and having regular conversations about their lives.</li> </ul> <p>Caring adults in children's lives have the power of influence. Talk with your children about the dangers of alcohol. It could save their lives.</p> <p>Learn more about <a href="/topics/substance-abuse" target="_self" title="Opens in same window.">alcohol and other substance abuse</a>.</p> <p><em>Tyler Oesterle, M.D., is a <a href="/services-and-treatments/addiction-treatment" target="_self" title="Opens in same window.">addiction treatment</a> physician in Rochester, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2021/dad-and-child-sitting-on-sofa-talking.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EF9E220CDB87DAE9325D982A4F9F2F6B" alt="Dad and child sitting on sofa talking" width="660" height="370" DisableNVelocity="true" />Substance AbuseInformation for helping those with alcohol and other drug abuse concerns.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller6/20/2024A tattoo often marks a milestone or celebrates a moment, including after having breast cancer. Learn how a 3D tattoo can help restore the appearance of the breast after reconstructive surgery.3D tattooing after breast reconstruction<p><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/breast-cancer/symptoms-causes/syc-20352470" target="_blank" title="Opens in a new window.">Breast cancer</a> is the most diagnosed cancer in U.S. women with about 1 in 8 women diagnosed over the course of their lifetime. In about 35% of cases, a <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/mastectomy/about/pac-20394670" target="_blank" title="Opens in a new window.">mastectomy</a> is part of a woman's treatment plan and involves removing all tissue in one or both breasts, sometimes including the nipples and areolas. While it is considered a lifesaving procedure for women with breast cancer, it can take an emotional toll that can lead to a distorted self-image.</p> <p><a href="/hometown-health/speaking-of-health/breast-cancer-reconstruction-options" target="_self" title="Opens in same window.">Breast reconstruction</a> is a series of optional procedures that uses a woman's tissue or implants to restore the appearance of natural breasts and help improve confidence and self-image after cancer.</p> <p>A few months after reconstruction surgery is complete, women can decide to restore the appearance of their missing nipples and areolas with a nipple reconstruction procedure or 3D tattoos. During a nipple reconstruction procedure, a surgeon uses skin from the breast to rebuild the nipple, whereas a 3D tattoo adds color to the nipple and areola areas. A woman can select one, both or neither of these elective procedures.</p> <h2>Find out what you need to know about 3D tattoos in this Q&A.</h2> <h3>What is a 3D tattoo?</h3> <p>A 3D tattoo uses pigments to replicate the areola on a woman's reconstructed breast. It uses light and dark pigments to create a 3D illusion and make it appear that the woman has an areola and nipple after they have been removed during surgery. The pigments are color-matched to each patient, and the goal is to restore the breast's natural appearance.</p> <h3>Are 3D tattoos painful?</h3> <p>No, unlike a traditional tattoo, 3D tattooing is a comfortable, nearly pain-free procedure because the breasts lose sensation after a mastectomy. Aftercare and recovery are similar to a conventional tattoo, including light coverage with gauze for a few days, cleansing with antibacterial soap and applying fragrance-free, gentle lotion until the site heals.</p> <h3>How many sessions are required?</h3> <p>Most women complete the procedure in the clinic over two visits. The initial visit takes two hours. During that' time, the woman works with the healthcare professional to select pigments and determine the position of the areolas. Then the tattooing is performed. The second visit is six to eight weeks later for pigment touch-up and evaluation.</p> <h3>What are the benefits of 3D tattoos?</h3> <p>Some women have said that their breasts appear incomplete without nipples or areolas, similar to a face without a nose. Tattooed areolas and nipples can help women focus less on what is missing and eliminate the constant visual reminder of their cancer journeys.</p> <p>Many women also have reported that it improves intimacy with their partners because it helps partners feel more comfortable with their new breasts. Also, it distracts from any scarring and leads the eye to a new focal point rather than just the scars across the breasts.</p> <h3>How soon after reconstruction can I get a 3D tattoo?</h3> <p>A woman must have completed all her reconstruction surgeries and cancer treatments before getting a 3D tattoo. Typically, three months after reconstruction is enough time to ensure that all incisions have healed correctly and for the new breast tissue or implants to settle into their natural positions.</p> <p>3D tattoos are not only for women with a recent cancer journey. The procedure also is available for women who have had mastectomy surgeries years ― or even decades ― ago when 3D tattooing wasn't available.</p> <h3>Does insurance cover the cost of 3D tattoos?</h3> <p>Typically, 3D tattoos are covered by private insurance, but women are encouraged to check with their healthcare insurance providers regarding coverage. A private pay option also is available.</p> <p>Some people get a traditional tattoo to mark a milestone or celebrate a moment. A 3D nipple and areola tattooing are no different. For many women, a 3D tattoo is the milestone step in their cancer journeys.</p> <h2>Next steps:</h2> <ul> <li>Read <a href="/hometown-health/speaking-of-health/the-emotional-side-of-cancer-7-tips" target="_self" title="Opens in same window.">seven tips for dealing with the emotional side of cancer: 7 tips</a>.</li> <li>Learn about <a href="/hometown-health/speaking-of-health/surgical-options-to-remove-breast-cancer" target="_self" title="Opens in same window.">surgical options to remove breast cancer</a>.</li> <li>Read Kathleen's story about finding the perfect balance with Goldilocks surgery.</li> <li>Find a <a href="https://www.mayoclinichealthsystem.org/providers?service=Plastic%20and%20Reconstructive%20Surgery&populateTracking=True" target="_self" title="Opens in same window.">plastic and reconstructive surgery expert near you</a>.</li> </ul> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2021/smiling-looking-in-mirror.jpg?h=370&iar=0&w=660&sc_lang=en&hash=17CD561E4EE56BC35441D02AB5B355B3" alt="Smiling looking in mirror" width="660" height="370" DisableNVelocity="true" />Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.Plastic and Reconstructive SurgeryPlastic and reconstructive surgery provides services that not only include cosmetic or aesthetic surgery, but also surgical repair of congenital deformities, laser surgery, postsurgical reconstruction, such as breast, head and neck defects, and microsurgery.Dawn Haller5/2/2023Nearly 100 million Americans experience chronic pain ranging from back pain to headaches. Read about the most common types evaluated and treated by neurosurgeons.5 most common types of chronic pain treated by neurosurgeons<p>Nearly 100 million Americans suffer from chronic pain, which is pain that persists for three months or longer. It can occur after an injury, or without apparent damage or previous injury.</p> <p>Living with chronic pain can significantly affect your relationships, quality of life, and physical and mental health. It also can affect your mobility, independence and ability to work.</p> <h2>Many types of chronic pain are assessed and treated by a neurosurgery care team. Here are the five most common types:</h2> <h3>Back and neck pain</h3> <p>Pain in the back or neck is the most common health reason that people miss work or schedule an appointment with a health care professional. About 80% of people will have back pain at least once in their lives. For most people, back pain is a short-term annoyance, but for others, it can be a disabling, long-term condition.</p> <h4>Conditions commonly linked to chronic back pain include:</h4> <ul> <li><strong>Osteoporosis</strong><br /> Osteoporosis occurs when the creation of new bone tissue can't keep up with the loss of old bone. This causes bones, including those in your spine, to become weak and brittle. Over time, vertebrae can develop compression fractures and cause pain. These fractures can happen with or without accident or trauma.</li> <li><strong>Skeletal irregularities</strong><br /> Back pain also can occur if your spine has abnormal alignment and instability. Spondylolisthesis is a common condition caused when a vertebra slips out of alignment. For some people, this does not cause pain. For others, it can cause abnormal motion or spinal instability, leading to pain in the back and or down the legs. This can include scoliosis, a condition in which the spine curves to the side. You may experience back pain if you have progressive and severe adult degenerative scoliosis. Many adults have some degree of degenerative scoliosis, but generally, curves of less than 30 degrees do not cause significant back pain and treatment is unnecessary.</li> <li><strong>Spondylosis</strong><br /> The vertebra and disks in your spine degenerate as a natural part of aging. Common terms to describe this condition include osteoarthritis of the spine, degenerative disk disease and lumbar spondylosis. These conditions can result in overgrowth of the joints and lead to narrowing of the space between the vertebrae. These changes may cause pain.</li> </ul> <p>Back and neck pain can have many causes. Surgery can help alleviate pain for some causes but not all. In those situations, nonsurgical options like steroid injections and physical therapy may be better options. Talk with your health care team about the right surgical or nonsurgical treatment options for you.</p> <h3>Pain after back surgery</h3> <p>Some people who previously had back surgery continue to experience pain. The Neurosurgery team specializes in revision surgery, which is performed to correct earlier spine surgery problems. These could include spinal instability, adjacent segment degeneration, instrumentation issues or failures, recurring herniated disks, pseudoarthrosis (nonfusion) or flat back syndrome. Pain also could be the result of an improper previous diagnosis or procedure.</p> <h3>Facial pain</h3> <p>Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain. If you have trigeminal neuralgia, even mild stimulation of your face, such as brushing your teeth or putting on makeup, can trigger a jolt of excruciating pain.</p> <p>Trigeminal neuralgia may initially start as short, mild attacks but progress to longer, more frequent bouts of searing pain. Usually, neurosurgeons can effectively manage trigeminal neuralgia with medications, injections or surgery.</p> <h3>Radiating leg pain</h3> <p>Pain that radiates down your leg could be caused by lumbar radiculopathy. This is due to lumbar, or low back, nerve root compression. The most common type, called sciatica, causes pain that radiates down the leg in a similar path to the sciatic nerve, from the low back down the back to the outside of the leg. Sciatica is not caused by compression of the sciatic nerve but rather by compression of the L5 or S1 nerve root in the spine.</p> <p>Often, sciatica occurs when a person has a herniated disk or narrowing of the spine, known as spinal stenosis, that compresses the L5 or S1 nerve root. This compression causes inflammation, leading to symptoms of pain, weakness along the distribution of the nerve or numbness along the distribution of the nerve. Some people experience all three of these symptoms.</p> <p>Although the pain associated with sciatica can be severe, nonsurgical treatments can resolve most cases within a few months. If the pain persists and nonsurgical treatments are not successful, then surgery may be an option to alleviate this pain.</p> <h3>Radiating shoulder or arm pain</h3> <p>Similar to lumbar radiculopathy, pain that radiates along your shoulder or arm could be due to cervical radiculopathy. This is compression along a cervical nerve root in your neck. In some cases, the pain also can be felt in the hand.</p> <p>Typically, cervical radiculopathy is caused by a herniated disk, bone spur or narrowing of the spinal canal. It can cause pain and weakness, or numbness, along the nerve.</p> <p>Most cases of cervical radiculopathy improve in a few months with nonsurgical treatments. Surgery may be necessary for severe cases.</p> <p>It's important to note that compressed nerve roots are not the only cause of leg or arm pain. Bone or joint issues could be the cause of pain and require care by an orthopedic provider. Talk with your health care team about your symptoms and treatment options based on your specific needs.</p> <p><a href="/providers/tk-schiefer-md" target="_self" title="Opens in same window."><em>T.K. Schiefer, M.D.</em></a><em>, is a <a href="/services-and-treatments/neurosurgery" target="_self" title="Opens in same window.">neurosurgeon</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/menomonie" target="_self" title="Opens in same window.">Menomonie</a>, Wisconsin.</em></p><ul> <li>Herniated discs</li> <li>Spinal deformity</li> <li>Spinal stenosis, also known as narrowing of the spinal canal</li> <li>Spondylolisthesis, also known as slipped vertebrae</li> <li>Traumatic brain injuries</li> <li>Traumatic spine injuries, such as fractures and spinal cord injury</li> <li>Tumors, spinal and brain</li> </ul>M.D. <p>I view the doctor-patient relationship as a partnership. We will work together to find solutions to treat your condition and improve your quality of life. </p> <p>Since we are working together, it is very important we are on the same page and develop a plan as a team. To help facilitate this, first, I will ask you questions to get details about what is going on. Second, I usually perform a neurological examination pertinent to your problem. Third, we typically review your imaging studies together to better understand the problem. Finally, we have an open and honest discussion about possible solutions and treatments, both surgical and non-surgical. </p> <p>Sometimes non-surgical treatments may be the best option. I only offer and recommend a surgery if I feel it is in your best interest and something I would recommend to one of my own family members. I also try to avoid “doctor jargon” and explain things so they are straight forward and easy to understand. I look forward to partnering together in your neurosurgical care. </p> <p>I am a husband and father of four children. I am very active in my church community and enjoy serving others. I am an Eagle Scout and worked as scoutmaster for my sons' troop for many years. I enjoy traveling, backpacking, being outdoors, staying physically fit and personal finance/investing.</p> <p><strong>Education</strong></p> <ul> <li>Mayo Clinic Alix School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Preliminary Surgery, Mayo Clinic College of Medicine and Science</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Neurologic Surgery, Mayo Clinic College of Medicine and Science</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Neurological Surgery</li> <li>Certificate in Clinical and Translational Science, Mayo Graduate School</li> <li>Silver Level Certification, Mayo Clinic Quality Academy</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Neurological Surgeons</li> <li>Congress of Neurological Surgeons</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Neurosurgery, Mayo Clinic College of Medicine and Science</li> </ul> Schiefer<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/tk-schiefer-md.jpg?h=200&iar=0&w=200&sc_lang=en&hash=5328718020A2786933F34ECF5D6846CB" alt="T.K. Schiefer, M.D." width="200" height="200" DisableNVelocity="true" /> <ul> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/25545552/" target="_blank" title="Opens in new window">In-hospital neurologic deterioration following fractures of the ankylosed spine: a single-institution experience</a>, May 2015.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/24476904/" target="_blank" title="Opens in new window">Significance of cochlear dose in the radiosurgical treatment of vestibular schwannoma: controversies and unanswered questions</a>, May 2014.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/22084629/" target="_blank" title="Opens in new window">Moving forward: advances in the treatment of movement disorders with deep brain stimulation</a>, November 2011.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/19929340/" target="_blank" title="Opens in new window">Importance of the vasculature in cyst formation after spinal cord injury</a>, October 2009.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/18423548/" target="_blank" title="Opens in new window">Epidermoids of the cerebellopontine angle: a 20-year experience</a>, December 2008.</li> </ul> {000BB0CC-A7F9-4570-B165-7B3E176167E9}T.K.<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14270005T.K. Schiefer, M.D. 1{4EA2A40E-3721-48EC-AFC9-E6D0E13BCDEC}|{993AF103-0FE1-4CF2-9F2A-3D064CDA9F32}<img src="/-/media/national-files/images/hometown-health/2021/looking-out-a-window.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C4F8A7878212931E75AEB6D2A6749361" alt="Looking out a window" width="660" height="370" DisableNVelocity="true" />NeurosurgeryNeurosurgery treats disorders that impact any part of the nervous system, which may include the brain, spine or peripheral nerves. Conditions treated range from life-threatening brain tumors, to disorders impacting quality of life, such as back pain and carpel tunnel syndrome.Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.HeadacheHeadache is pain in any region of the head that feels like a sharp pain, throbbing sensation or dull ache. It may develop gradually or suddenly, and last for minutes or days.ArthritisArthritis is inflammation of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis.Pain ReliefApproximately 50 million people in the U.S. live with chronic pain. If you experience chronic pain, you're not alone. Learn about the ways to deal with painful disorders, from at-home solutions to drug treatments, injectable or implantable therapies to surgery.Dawn Haller11/15/2023Nicotine is addictive regardless of the delivery method, including cigarettes or electronic cigarettes. Get the ugly truth, learn the warning signs and talk to your kids about the dangers of vaping.A doctor's warning about the dangers of vaping<p>Vaping is the term often used to describe the use of an electronic nicotine delivery system, or ENDS, including electronic cigarettes, or e-cigarettes, vape pens or vaporizers. These battery-operated devices heat a liquid solution — usually, but not always, containing nicotine — to turn it into a vapor that can be inhaled. If the base nicotine mixture isn't palatable, flavors like mint, apple and cotton candy, can be added that make vaping attractive, especially to adolescents. E-cigarettes can resemble a pen or USB flash drive, and may be disposable after one use or have rechargeable systems.</p> <p>Unfortunately, today's teens, and even tweens, know more about vaping than their parents. First publicized as a safer alternative to smoking tobacco, vaping caught on because it didn't contain the carcinogens or tars found in most smoking tobacco products. Also, vaping was supposed to eliminate the dangers of secondhand smoke to those nearby.</p> <p>It all sounded pretty harmless in theory. However, those theories were wrong.</p> <h2>Here are the dangers associated with vaping:</h2> <h3>No matter the delivery method, nicotine is addictive.</h3> <p>Studies have shown that it may be harder to quit a nicotine addiction than a heroin addiction. Most discussions about helping teens stop vaping fail to address that they already may be addicted. In many cases, teens at this phase may a need replacement option or medications, such as bupropion, to help curb the nicotine cravings that can be overwhelming.</p> <p>If you've ever tried to quit smoking or had friends or family members try to quit, you know how difficult it can be. That's why, in certain situations, e-cigarettes still are considered an option to help someone who has smoked tobacco for years to <a href="/hometown-health/speaking-of-health/a-smokers-guide-to-quitting" target="_self" title="Opens in same window.">become a nonsmoker</a>.</p> <h3>The flavors and stabilizers in e-cigarettes can cause unknown inflammation to delicate lung tissue.</h3> <p>All one has to do is turn on the national news to hear about more and more teens who suffered severe — sometimes irreversible — damage to the lungs, and in extreme cases have died as a result of vaping. Adolescents often believe that bad things happen to everyone else, but the risks associated with vaping are real.</p> <p>Many teens are taking vaping a step further, adding cannabis, CBD oils and other <a href="/hometown-health/speaking-of-health/marijuana-and-lung-cancer-risk" target="_self" title="Opens in same window.">dangerous additives</a>. When patients go to the emergency department in respiratory distress from vaping, it's challenging for healthcare professionals to treat them due to the difficulty in correctly identifying what they inhaled, especially when they are intubated or unconscious.</p> <h3>The length of time spent vaping can be much longer than smoking a standard cigarette.</h3> <p>Did you know that it takes two to five minutes to smoke most cigarettes? On the other hand, e-cigarettes can last up to 20 minutes, delivering more nicotine and damaging chemicals to the lungs. In addition, some vaping mixtures can contain 20 times the nicotine in a single cigarette.</p> <h3>Brain development can be affected.</h3> <p>Nicotine can affect concentration, learning, memory and brain development, according to information and data from a new report from the surgeon general. Also, nicotine use in young adults can still lead to other illicit substance use.</p> <p>People under 21 can't buy tobacco products, including vape products, under federal law.</p> <h2>Talk about the dangers of vaping</h2> <h3>Talk with your kids about the dangers of vaping, but also look for warning signs including:</h3> <ul> <li>Changes in emotions or new behaviors like secrecy</li> <li>Dry cough or wheezing</li> <li>Scents of fruity odors on skin, breath and clothes</li> <li>Strange cylinders, chargers or batteries lying around</li> <li>Trouble sleeping</li> </ul> <p>Remember, it's essential to have conversations rather than suspicions and accusations. Encourage your teen to look into the warnings and media stories related to vaping or contact their healthcare team with questions.</p> <p>Many healthcare professionals ask their patients about alcohol, drug use and smoking, yet forget to ask about vaping. <a rel="noopener noreferrer" href="https://www.projectforteens.org/" target="_blank" title="Opens in a new window.">Project for Teens</a> is an example of a local outreach program that provides support and education on the dangers of vaping. Similar programs may be available in your area. Find resources to help teens quit through the <a rel="noopener noreferrer" href="https://www.lung.org/quit-smoking/helping-teens-quit" target="_blank" title="Opens in a new window.">American Lung Association</a> and <a rel="noopener noreferrer" href="https://teen.smokefree.gov/" target="_blank" title="Opens in a new window.">teen.smokefree.gov</a>.</p> <p>It's up to everyone to work together as a community to stop the young population from starting or continuing to use vaping products.</p> <h3>In this video, pulmonologist Adel Zurob, M.D., explains the risks of vaping, smoking and using chewing tobacco, and how the products harm your health:</h3> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/9pU3Ls2h2M8" title="Smoking, Vaping and Chewing Tobacco Risks: Ask Mayo Clinic Health System" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <p><em><a href="/providers/graham-king-md" target="_self" title="Opens in same window.">Graham King, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Community fitness outreach programs</li> </ul>M.D.<p>I enjoy caring for the health needs of families from prenatal care and pediatrics to adult medicine, and specialize in women's health and reproductive health. I focus on listening and hearing my patients, and forming partnerships with them in delivering their care.</p> <p>I am married to an elementary school teacher with four energetic boys who are active in community, school and sports. I enjoy playing guitar and piano, writing educational blogs and practicing healthful living. </p> <p>I am an 80s rock superfan and love going to concerts with my family and friends. I also enjoy Vikings, Twins, Wild and Maverick sports.</p><p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Mercy Hospital</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Sutter Health Family Medicine Residency Program</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Family Medicine</li> <li>Mayo Clinic Quality Fellow, Bronze Level</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Medical Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>King<img src="/-/media/shared-files/images/medical-professionals/full/mankato/graham-king-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=78048D61A3A60EF1DF00C06F2F6CCBEE" alt="Graham King MD" width="280" height="280" DisableNVelocity="true" />{46521252-3F34-48F2-80D2-338AA6DD4C22}Graham<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14899019Graham King, M.D.1<img src="/-/media/national-files/images/hometown-health/2023/two-people-sitting-on-dock.jpg?h=370&iar=0&w=660&sc_lang=en&hash=318C9C2E98B8D2CA34D1EF8366DE1A58" alt="Two people sitting on dock" width="660" height="370" DisableNVelocity="true" />Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Lung CancerLung cancer is a type of cancer that begins in the lungs. It is the leading cause of cancer deaths in the U.S., among both men and women. Lung cancer claims more lives each year than do colon, prostate, ovarian and breast cancers combined. <br/><br/>Dawn Haller4/19/2021Breastfeeding is a learning experience for mother and baby. It's a natural activity, but it takes practice. Get answers to some of your most-asked questions. Breastfeeding 101: Tips for new moms<p>As a lactation specialist, I see many new moms who are anxious about breastfeeding, but want to give their baby the best start. And breastfeeding is one of the best things mothers can do to give their infant a strong start in life.</p> <p>Human milk is the perfect food for babies. It decreases their risk for asthma, ear infections, obesity, Type 1 diabetes, stomach infections and sudden infant death syndrome. It's good for moms, too, reducing their risk of breast and ovarian cancer, Type 2 diabetes and high blood pressure.</p> <p>Breastfeeding is a learning experience for mother and baby. It's a natural activity, but it takes practice, which requires time and patience.</p> <p>Feeding sessions can take 30 minutes or longer, especially in the beginning. New moms need to remember that the process will get easier and babies will get more efficient at nursing.</p> <p>During pregnancy, a woman's health care provider will talk about breastfeeding, but at about 28 weeks, that conversation becomes more detailed, giving the mother-to-be an opportunity to ask questions and consider what she'd like to do. Prenatal breastfeeding classes also are available, which provide excellent resources for the expectant mother and her support person.</p> <p>Pregnant women who opt for breastfeeding are now being given instruction and shown how to hand-express the first milk (colostrum) once a day, starting at 37 weeks, to jump-start flow and supply. Any colostrum that's collected can be frozen and brought to the hospital at delivery so the baby can start on their mother's milk right away, rather than formula, until the mom's milk comes in and supplementation is necessary. This has been exciting for new moms and seems to have really helped support their breastfeeding journey.</p> <h3>During consultations and classes, here are the questions new mothers most often ask and the answers:</h3> <h4>When will I start producing milk?</h4> <p>A mother's milk doesn't come in immediately after delivery. It can take three to five days postpartum for this to happen. Those first few days, mothers produce colostrum, which provides protective antibodies and helps the baby's digestive system develop. By starting with this small amount of colostrum, the baby gets time to coordinate sucking, swallowing and breathing at the same time.</p> <h4>How do I know if I'm producing enough milk?</h4> <p>Most moms will make enough breast milk with no problems. To make sure, they should monitor baby's wet and soiled diapers. Babies who get enough to eat will go through five to six diapers a day once their mother's milk fully comes in. Also, their pediatrician will check the baby's weight regularly.</p> <h4>How do I know I'm doing it right?</h4> <p>I've found that moms just need reassurance. They can ask their health care provider or consult with a breastfeeding specialist or public health nurse. These specialists can check that mom and baby are positioned comfortably and assess the latch on the breast. They also can answer any questions. Learning to breastfeed can feel overwhelming in the beginning, but we're fortunate to have so many resources who are here to help you set and reach the goals best for you and your baby.</p> <h4>How will I know when my baby is hungry?</h4> <p>Newborns need to eat at least eight to 12 times during a 24-hour period. Watch your baby, not the clock. Babies give cues when they're hungry. These include rooting from side to side, putting their hands up to their mouth, and searching for a breast or nipple. You'll quickly learn to recognize these cues. Crying is the last sign of hunger, so it's important to try to feed before crying starts. It can be difficult to calm a crying baby and get them latched.</p> <h4>What if I need to go back to work?</h4> <p>Work is a reality for most women, but that doesn't mean once you go back that you have to stop breastfeeding. Workplaces are supportive of breastfeeding, and laws allow you to pump at work in an appropriate space ― not a bathroom. There are wonderful breast pumps available and most insurance covers them. We can help make sure you have a prescription for a breast pump when you leave the hospital. There are so many tools and support systems for moms to reach their breastfeeding goals.</p> <p>Breastfeeding doesn't have to be all or nothing. You can determine what works best for you and your baby. You can choose to do a combination — just breastfeeding when you're at home and giving baby formula when you're not. It's also up to you how long you breastfeed, whether it's a few months or more than a year.</p> <p>The most important goal is for baby to be fed. We want new moms to feel they have the tools and resources they need to feed their baby and enjoy the process. We're here to help make that happen.</p> <p><em><a href="/providers/amy-newman-np" target="_self" title="Opens in same window.">Amy Newman</a> is a nurse practitioner and lactation consultant in <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a> and <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</em></p><ul> <li>Infertility evaluation and treatment</li> <li>Obstetrics and gynecology</li> <li>Women's health</li> </ul>C.N.P.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Nursing, Mankato State University</li> <li>Master's degree, Nursing, Drexel University</li> </ul> <p><strong>Certification</strong></p> <ul> <li><strong></strong>Women's Health Care Nurse Practitioner</li> </ul>Newman<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/amy-newman-np.jpg?h=280&iar=0&w=280&hash=8C0CE715CA21AD70241D252B63EF15F0" alt="Amy Newman NP" width="280" height="280" DisableNVelocity="true" />{A33DD384-8A00-4D3E-8649-4F9A81B8BC3B}Amy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13010603Amy Newman CNP1{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}|{54693F31-87AF-4B21-91DB-1DEC1E21F878}|{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}<img src="/-/media/national-files/images/hometown-health/2021/mom-holding-baby-as-dad-cooks.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0C9DCF0B0E82F12EDB13E1FE8E0DC2D8" alt="Mom holding baby as dad cooks" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller12/6/2022Studies show that feeling grateful improves health, but the brain is designed to problem-solve rather than appreciate. Learn how to reap the benefits of gratitude with a daily activity.Can expressing gratitude improve your mental, physical health?<p>Expressing gratitude is associated with a host of mental and physical benefits. Studies have shown that feeling thankful can improve sleep, mood and immunity. Gratitude can decrease <a href="/topics/depression" target="_self" title="Opens in same window.">depression</a>, anxiety, difficulties with chronic pain and risk of disease.</p> <p>If a pill that could do this, everyone would be taking it. Your brain is designed to problem-solve rather than appreciate. You often must override this design to reap the benefits of gratitude.</p> <h2>What's the right amount of gratitude?</h2> <p>Simply stated, gratitude should be practiced daily — just as you'd take that magic pill if it existed. Try starting your day by thinking of someone you're grateful for as soon as you wake up. It could be appreciating a friend who sends you funny texts, a teacher who recognizes your child's gifts, or the barista who hands you your coffee and shares friendly conversation. Later, thank that person with a text, note or kind word when you see the person.</p> <h2>Behavior changes biology</h2> <p>Remember that behavior changes biology. Positive gestures benefit you by releasing oxytocin, a hormone that helps connect people. Some people call it the love hormone.</p> <p>You'll also benefit the person on the other end of the gesture. After all, who doesn't like to be thanked for their efforts or just for being who they are? Sharing kindness can make you healthier and happier.</p> <h2>Track your gratitude</h2> <p>Another idea is to keep a gratitude journal. Set aside some time during your day, perhaps while attempting to relax your mind before sleep. Think back on your day and write down the things that went right. Maybe your spouse took care of a household repair, you heard your favorite song on the radio or you saw a double rainbow. Try writing about the many blessings you may have taken for granted, such as having clean water or having certain abilities.</p> <p>Our lives are full of reasons to feel thankful. Sometimes we need to remember to notice them.</p> <p>Consider joining Mayo Clinic Health System's <a href="/wellness/gratitude" target="_self" title="Opens in same window.">Discover Gratitude program</a>. The virtual month-long program consists of daily journaling about thankfulness, mindfulness and kindness on journal sheets. Acknowledging gratitude and being mindful support a positive shift to improve your mental well-being and health.</p> <h3>Read more about gratitude and kindness:</h3> <ul> <li><a href="/hometown-health/speaking-of-health/the-art-of-kindness" target="_self" title="Opens in same window.">The art of kindness</a></li> <li><a href="/hometown-health/speaking-of-health/recharge-with-planned-mental-health-day" target="_self" title="Opens in same window.">Recharge with a planned mental health day</a></li> <li><a href="/hometown-health/speaking-of-health/kindness-in-action-brings-healthy-rewards" target="_self" title="Opens in same window.">Kindness in action brings healthy rewards</a></li> <li><a href="/hometown-health/speaking-of-health/how-to-create-happiness" target="_self" title="Opens in same window.">How to create happiness</a></li> </ul> <p><a href="/providers/amanda-logan-cnp" target="_self" title="Opens in same window."><em>Amanda Logan</em></a><em> is a nurse practitioner in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><ul> <li>Effective hydration for maturing, dehydrated skin, and collagen building and maintenance</li> <li>Pharmacogenomics</li> <li>Skin care for all ages</li> <li>Using food as medicine for healthy gut, weight loss, and improving fatigue and inflammation</li> </ul>APRN, C.N.P.<p> I like to work with you and want your input. I want to know how we can work together to help you live your best life. Everyone is different and it is in the uniqueness that we can find solutions that are tailored to you. You are the captain of your ship, and I am your navigator. I will help guide and show you your options, but it is you who will ultimately decide your path.</p> <p>I will be open and honest when I see something that may be problematic, need further investigation or could use improvement. I am not opposed to alternative therapies; however, just as with anything you put in the body, even natural therapies have side effects and consequences that should be monitored. I am a big fan of mindfulness, meditating, gratitude, exercise and healthy eating as a basic foundation to good health. </p> <p>I am an avid reader. I read something related to the medical field at least daily, as well as something to stretch the imagination and keep my sense of childlike wonder. I am a huge Harry Potter fan and not ashamed to admit it. Some of my other favorite authors are Jeff Wheeler, Katherine Arden, Kate Quinn and countless others. I'm a huge Simpsons fan, and if I could guess what I was in a past life, it would have to be a dog. I love animals in general, but the best would have to be the dog. How better the world would be if we were all a little more like a dog.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Nursing, Bradley University</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul> <p class="telerik_paste_container" style="border-width: 0px; position: absolute; overflow: hidden; margin: 0px; padding: 0px; left: 3px; top: 66px; width: 1px; height: 1px;"> </p>Logan<img src="/-/media/shared-files/images/medical-professionals/full/mankato/amanda-logan-cnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=855113749ECDCE27DD0FF87769EE15A9" alt="Amanda Logan, C.N.P." width="280" height="280" DisableNVelocity="true" />{3D39AC94-41D4-46AA-9E8E-885783F8246E}Amanda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12858811Amanda Logan, C.N.P.1<img src="/-/media/national-files/images/hometown-health/2022/hugging-couple-holding-flowers.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BB405BE3954D345F0100298E9FA185A2" alt="Hugging couple holding flowers" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller4/19/2021Some seasonal allergy symptoms are similar those associated with COVID-19. Know the difference and when to seek medical care.Combating allergies, asthma during COVID-19<p>In many parts of the U.S., spring is in full bloom. And with the arrival of spring comes an increase in <a href="/hometown-health/speaking-of-health/say-goodbye-to-springtime-allergies" target="_self" title="Opens in same window.">seasonal allergies</a>, often due to pollen produced by trees. Given the COVID-19 pandemic, many people have questions regarding how to differentiate between symptoms caused by environmental allergens versus the COVID-19 infection.</p> <p>COVID-19 is a viral illness that can present with fever; headache; nasal congestion; loss of sense of smell and taste; coughing; wheezing; shortness of breath; or cardiac, gastrointestinal or neurologic manifestations. Symptoms can range widely, from mild to severe.</p> <p>Most people may have heard the term allergic rhinitis, which can affect millions of people. This condition occurs when a person's immune system reacts to a foreign substance, such as pollen or pet dander. Typical seasonal allergy symptoms include itchy, watery eyes; itchy, runny nose; sneezing; nasal congestion; or postnasal drip.</p> <p>Though certain symptoms can overlap, allergies differ from COVID-19 with respect to the sudden onset of illness and symptoms. COVID-19 symptoms tend to come on quickly and worsen. Though you might experience some of the same symptoms with a cold or other virus, COVID-19 symptoms include fever, shortness of breath, difficulty breathing and potentially some gastrointestinal upset. With allergic rhinitis, patients would not have a fever, which is a COVID-19 symptom.</p> <p>For patients with allergies, medications and a change of scenery can improve symptoms. Having seasonal allergies does not put you at greater risk of catching COVID-19.</p> <p>If you have known allergies, it is important to know your triggers and make accommodations, especially given the ongoing pandemic. For example, if you are allergic to oak tree pollen, but you have taken to running outdoors versus in a gym, you may want to reduce your mileage and plan to shower immediately after you complete your exercise. If you know dust is a trigger for your allergies, be mindful to adjust your chore schedule to vacuum or mop more often.</p> <p>Also, continue to use your medications as prescribed. For effectiveness, make sure you're <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-minute-combat-allergies-like-a-pro-by-learning-how-to-use-your-nasal-spray-properly/" target="_blank" title="Opens in a new window.">using your nasal sprays properly</a>. Avoid spraying your septum or nasal bone, which can thin the skin and cause bleeding. Rather, tilt the head down, shake the bottle and then aim toward the ear. Spray and sniff in slowly. Then shake the bottle and repeat in the other nostril.</p> <p>Also remember to wipe the nozzle down after each use and not share bottles with anyone else.</p> <p>If you find your current over-the-counter allergy medication is not working as effectively as you'd like, consider switching brands for a short time. Oftentimes, your body can build up a tolerance and the medication may become less effective at controlling your symptoms. Switching to another brand for a few weeks may help.</p> <p>If your symptoms worsen and you have concerns that you may have contracted COVID-19, you should contact your health care provider.</p> <p><em><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/bhasin-arveen-k-m-d/bio-20055626" target="_blank" title="Opens in a new window.">Arveen <span class="RadEWrongWord" id="RadESpellError_1">Bhasin</span>, M.D.</a>, is an <a href="/services-and-treatments/immunology" target="_self" title="Opens in same window.">Allergy and Immunology</a> physician at Mayo Clinic in Jacksonville, Florida.</em></p> <p><em>Information in this post was accurate at the time of its posting. Due to the fluid nature of the COVID-19 pandemic, scientific understanding, along with guidelines and recommendations, may have changed since the original publication date.</em></p><img src="/-/media/national-files/images/hometown-health/2021/blowing-nose-or-sneezing-into-tissue.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D2102D8AFD2430BC4AB54F7E7623D515" alt="Blowing nose or sneezing into tissue" width="660" height="370" DisableNVelocity="true" />Allergy and AsthmaOur allergists provide care for your allergies, asthma and conditions that affect the immune system's ability to defend the body against foreign or abnormal cells. The main treatment goal is your satisfaction when your condition is under control and quality of life is improved.COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller5/1/2023Increasing awareness of autism spectrum disorder aims to bring an understanding of autism and inspire a kinder, more inclusive world. Learn about the signs of autism and when to seek care.Could my child have autism spectrum disorder?<p>Autism spectrum disorder is a developmental condition that alters a person's ability to communicate and interact. Diagnosing <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/symptoms-causes/syc-20352928" target="_blank" title="Opens in a new window.">autism spectrum disorder</a> early can improve quality of life and better access to <a href="/hometown-health/speaking-of-health/autism-treatments-and-therapies" target="_self" title="Opens in same window.">early intervention</a> services. By recognizing the early signs and symptoms, you can get your child the help they need to learn, grow and thrive.</p> <h2>Autism spectrum disorder symptoms</h2> <p>Some children show signs of autism spectrum disorder in early infancy, such as reduced eye contact, lack of response to their name or indifference to caregivers. Others develop normally for the first few months or years of life, but then there are signs of decreased emotional responses, aggression or loss of skills previously acquired with motor movement or language. These signs usually appear by age 2.</p> <p>Each child with autism spectrum disorder has a unique pattern of behavior and severity level — from low-functioning to high-functioning. The child may or may not have a language delay or intellectual disability.</p> <p>Some children with the disorder have difficulty with learning and language, and others may have signs of lower-than-normal intelligence. Other children have normal-to-high intelligence. They learn quickly, yet have trouble communicating and applying what they know in everyday life, particularly in social situations. Although the symptoms identified may vary, clinical diagnosis is based on autism spectrum disorder diagnostic criteria to differentiate and determine symptom severity.</p> <h2>Social communication, interaction with autism</h2> <p>A child with autism spectrum disorder may have problems with <a href="/hometown-health/speaking-of-health/helping-your-childs-education-through-an-iep-or-504-plan" target="_self" title="Opens in same window.">communication skills</a> and social interaction.</p> <h3>These signs may include:</h3> <ul> <li>Appearing to not understand simple questions or directions.</li> <li>Failing to respond to their name or appearing not to hear you at times.</li> <li>Having difficulty recognizing nonverbal cues, such as interpreting other people's facial expressions, body postures or tone of voice.</li> <li>Having poor eye contact and lacking facial expression.</li> <li>Inappropriately approaching a social interaction by being passive, aggressive or disruptive.</li> <li>Not being able to start a conversation or keep one going.</li> <li>Not expressing emotions or feelings and appearing unaware of others' feelings.</li> <li>Not pointing at or bringing objects to share an interest and struggling to ask for help with tasks.</li> <li>Not speaking, having delayed speech or losing previous ability to say words or sentences.</li> <li>Repeating words or phrases verbatim that are out of context or don't make sense to the conversation.</li> <li>Speaking with an abnormal tone or rhythm, and using a sing-song voice or robot-like speech.</li> <li>Struggling to understand jokes and sarcasm.</li> <li>Resists cuddling and holding, and seems to prefer playing alone.</li> </ul> <h2>Patterns of behavior</h2> <p>A child with autism spectrum disorder may have limited, repetitive behavior patterns, interests or activities.<strong> </strong></p> <h3>These signs may include:</h3> <ul> <li>Being fascinated by details of an object, such as the spinning wheels of a toy car, but not understanding the overall purpose or function of the object.</li> <li>Being unusually sensitive to light, sound or touch, yet being indifferent to pain or temperature.</li> <li>Developing specific routines or rituals, and becoming upset at the slightest change.</li> <li>Fixating on an object or activity with abnormal intensity or focus.</li> <li>Having problems with coordination or has odd movement patterns, with odd, stiff or exaggerated body language.</li> <li>Not engaging in imitative or make-believe play or cooperative play with other children.</li> <li>Performing repetitive movements, such as hand-flapping, rocking or spinning.</li> <li>Performing activities that could cause self-harm, such as biting or head-banging.</li> <li>Wanting only to eat few, specific foods, or refusing foods with a certain texture.</li> </ul> <p>Some children with the disorder become more engaged with others and show fewer disturbances in behavior as they mature. Even with a diagnosis of autism, higher-functioning individuals may lead normal or near-normal lives. However, people with more significant impairment continue to have difficulty with language or social skills, and the transition to the teen years can bring worse behavioral and emotional problems.</p> <h2>When to seek help</h2> <p>If you're concerned about your child's development or you suspect that your child may have autism spectrum disorder, discuss this with your health care team. The symptoms associated with the disorder also can be linked with other developmental disorders that can be evaluated by a health care professional.</p> <h3>Your health care team may recommend developmental tests if your child doesn't:</h3> <ul> <li>Babble or coo by 12 months.</li> <li>Gesture, such as point or wave, by 14 months.</li> <li>Loses language skills or social skills at any age.</li> <li>Mimic sounds or facial expressions by 9 months.</li> <li>Play make-believe or pretend by 18 months.</li> <li>Respond with a smile or happy expression by 6 months.</li> <li>Say single words by 16 months.</li> <li>Speak two-word phrases by 24 months.</li> </ul> <p><a href="/providers/ashley-holland-do" target="_self" title="Opens in same window."><em>Ashley Holland, D.O.</em></a><em>, sees patients in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Cognitive neurology/neuropsychiatry for children and adults with a focus on diagnosis, management and treatment of neurologic issues with psychiatric comorbidities which can include dementia syndromes, intellectual disability, and genetic syndromes, and autism spectrum disorder.</li> </ul>D.O.<p>I provide high-quality specialty psychiatric services with the support of such a fabulous organization. Northwest Wisconsin is such a beautiful area with wonderful people, and I enjoy serving the community in every capacity I can.</p> <p>In my free time, I enjoy all types of outdoor activities and spending time with my family, which includes my young children and two dogs.</p><p><strong>Education</strong></p> <ul> <li>Des Moines University College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Psychiatry, Maine Medical Center</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Child and Adolescent Psychiatry, University of Massachusetts</li> <li>Neuropsychiatry/Cognitive Neurology, University of Massachusetts</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Psychiatry, American Board of Psychiatry and Neurology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Child and Adolescent Psychiatry</li> <li>American Medical Association</li> <li>American Neuropsychiatric Association</li> <li>American Psychiatric Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Psychiatry, Mayo Clinic College of Medicine and Science</li> </ul>Holland<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/ashley-holland-do.JPG?h=280&iar=0&w=280&sc_lang=en&hash=7E7B63A5C3437B6B7140CA75A45E94CE" alt="Ashley Holland, D.O." width="280" height="280" DisableNVelocity="true" />{B057D720-A165-4F91-A49D-EC778E53CF6A}Ashley<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21357072Ashley Holland, D.O.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}|{84749020-F092-4F95-A217-669CCCD77721}|{F43164BF-0164-44CF-83E6-DA8DAB5D2B18}<img src="/-/media/national-files/images/hometown-health/2021/playing-with-toy-cars-and-trucks.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A93989F2B6B274C43CBB2B887809126B" alt="Playing with toy cars and trucks" width="660" height="370" DisableNVelocity="true" />AutismAutism is one of a group of serious developmental problems called autism spectrum disorders that appear in early childhood — usually before age 3. Though symptoms and severity vary, all autism spectrum disorders affect a child's ability to communicate and interact with others.<br /><br /><br/><br/>While there is no cure for autism, intensive, early treatment can make a big difference in the lives of many children with the disorder.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller4/28/2021Many people associate Parkinson's disease with tremors or shaking hands. While these are common symptoms, find out about other early symptoms.Early symptoms of Parkinson's disease<p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptoms-causes/syc-20376055" target="_blank" title="Opens in a new window.">Parkinson's disease</a> is a progressive disease of the nervous system that affects movement. Approximately 1 million people in the U.S. are living with the disease. This year, about 60,000 more will be diagnosed with Parkinson's disease.</p> <p>Many people associate Parkinson's disease with tremors or shaking of their hands. While this is a common symptom, other important symptoms include stiffness of muscles and slowing of movement.</p> <p>Symptoms of Parkinson's disease usually start on one side of the body. They usually remain worse on that side even after symptoms begin to affect both sides.</p> <p>The early signs and symptoms are different for each person. The symptoms may be mild enough to go unnoticed for months or years.</p> <h4>Here are early symptoms that can raise concern for Parkinson's disease:</h4> <ul> <li><strong>Smaller handwriting</strong><br /> The act of writing becomes slower, letters become smaller and the words crowd together.</li> <li><strong>Tremors</strong><br /> This usually begins in one limb, often the hands or fingers. Tremor appears when the hand is resting. It stops when the hand is active.</li> <li><strong>Muscle stiffness</strong><br /> This may occur in the arms or legs, usually on the same side as the tremor.</li> <li><strong>Slowing of movement</strong><br /> This is perhaps the most important early symptom of Parkinson's disease. Patients often complain of being weak when in fact they are slow. Slowed movements can make simple tasks difficult and time-consuming. Steps become shorter. It may be difficult to get out of bed or off a chair. Simply buttoning buttons or putting on a coat becomes a task.</li> <li><strong>Stooped posture</strong><br /> Friends and love ones may notice that a hunched or stooped posture when standing.</li> <li><strong>Lack of facial expression</strong><br /> The face may show little or no expression, even when feeling happy or sad.</li> <li><strong>Decreased arm swing</strong><br /> Family members may observe that one arm swings less on one side when walking.</li> <li><strong>Soft or low voice</strong><br /> Again, it is family members or friends who may ask one to speak louder. The speech may be more of a monotone without the usual inflections.</li> </ul> <p>It is the combination of several symptoms that would raise suspicion for Parkinson's disease. A single symptom is not enough to make a diagnosis of Parkinson's disease.</p> <p>It is important to talk with your health care provider if you have any of the symptoms associated with Parkinson's disease. This is to properly diagnose the condition and rule out other conditions with similar symptoms.</p> <p><em><a href="/providers/leonardo-fugoso-md" target="_self" title="Opens in same window.">Leonardo Fugoso, M.D.</a>, is a <a href="/services-and-treatments/neurology" target="_self" title="Opens in same window.">neurologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em> </p><ul> <li>Movement disorders, such as Parkinson’s disease</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Far Eastern University, Institute of Medicine in Manila, Philippines</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Neurology, State University of New York, Health Science Center</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Movement disorders and clinical motor physiology, Neurological Institute of New York, NY – Presbyterian Medical Center</li> </ul> <p><strong>Membership</strong></p> <ul> <li>Diplomate, American Board of Psychiatry and Neurology</li> </ul>Fugoso<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/leonardo-fugoso-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=E4BD9864F4EA47733419860F98D53ECE" alt="Leonardo Fugoso, M.D." width="280" height="280" DisableNVelocity="true" />{B0AF9EF9-07BD-46CF-918A-763C5D08B306}Leonardo<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15963659Leonardo Fugoso, M.D.1<img src="/-/media/national-files/images/hometown-health/2021/writing-in-notebook.jpg?h=370&iar=0&w=660&sc_lang=en&hash=86247C2DC10DF78DAD6E9FADA1C86200" alt="Writing in notebook" width="660" height="370" DisableNVelocity="true" />Dawn Haller4/9/2021Spring is a wonderful time to get outside and be active. Here's some tips to ensure your family is safe while enjoying the outdoors.Get healthy, stay safe outside in spring<p>With longer daylight and birds returning from winter retreats, we welcome spring and say goodbye to winter. Playing outside is an important part of childhood. It encourages curiosity and physical activity, promotes children's development and social skills, and gives your kids a greater appreciation of nature. However, an accident outside can ruin a beautiful spring day and potentially lead to injuries.</p> <h3>Follow these safety tips to maximize fun family activities when outside this spring season:</h3> <h4>Dealing with stinging and other insects</h4> <p>Warmer temperatures bring out all types of flying and crawling insects for your kids to discover. While some are cool to explore, others can be dangerous. So proceed with caution when exploring this season. Make sure you are using the appropriate insect repellant and wearing proper outdoor clothing. The insects responsible for most stings include yellow jackets, paper wasps, hornets, honeybees and fire ants. Learn to recognize and avoid these insects.</p> <p>These insects generally do not attack when there is no perceived danger. However they are territorial, and will become aggressive when their territory is invaded. Yellow jackets may sting multiples times. Hornets release a large amount of venom with each sting. Regardless of where it is coming from, a sting can be painful and life-threatening.</p> <p>If you are stung, make sure to leave the area immediately to prevent further attack. Remove the stinger with a quick scrape of a fingernail or credit card edge. Stinging may cause redness, swelling, itching or discomfort. Wash the sting site with soap and water. Then apply cold compresses. You also may use antihistamines or calamine lotion to treat site reaction.</p> <p>Seek immediate medical help if your child has tightness in the chest, difficulty breathing, swelling of the tongue, hoarse voice, dizziness, nausea or a loss of consciousness. Use an injectable dose of epinephrine (EpiPen) if available. If your child has a previous known allergic reaction, make sure to carry an EpiPen with you at all times.</p> <h4>Watch for concussion symptoms</h4> <p>Springtime means new and fun sport activities for your kids. It's important that you learn about concussion symptoms before they start sports this spring. Make sure that your kids are using appropriate sport gear for safety and to prevent injuries.</p> <p>A concussion is a mild traumatic brain injury that is caused by a blow to the head that alters the way your child's brain functions.</p> <h5>These are a few of the common symptoms of a concussion:</h5> <ul> <li>Temporary loss of consciousness</li> <li>Headache or a feeling of pressure in the head</li> <li>Confusion or feeling as if in a fog</li> <li>Amnesia surrounding the traumatic event</li> <li>Dizziness or "seeing stars"</li> </ul> <p>Some symptoms of concussions may be immediate and others may be delayed in onset by hours to days after injury. It also is important to be alert for symptoms that worsen over time. Concussion is a serious condition that can be life-threatening. However, with proper treatment, most kids recover with no long-term effects. Seek immediate care when your child develops these symptoms, or his or her behavior changes after an injury.</p> <h4>Make bicycle safety routine</h4> <p>Bicycles are a fun way for everyone to exercise in warmer weather. Check that every rider has a bicycle helmet that properly fits before you get the bikes out of winter storage. Each helmet should have a durable outer shell and polystyrene liner. It should sit low and level on your forehead. Take the time to adjust all straps so it fits securely. To ensure helmets are well-fitted, you should only be able to place one finger between your chin and the helmet straps. A helmet that moves with head movements should be readjusted.</p> <p>Parents should model good behaviors and wear a helmet when they ride. Do not use helmets that have been in an accident, even if they appear to be undamaged. Avoid nighttime biking.</p> <p>Remind your kids that riding with the flow of traffic not only is recommended — it's the law. Also, they should stop at all stop signs and check for traffic before turning. Ensure that your bicycle is functioning properly before setting out to ride.</p> <h4>Don't forget the sunscreen</h4> <p>Spring's sun rays can be surprisingly intense, especially if you have been indoors for most of the winter. Don't forget to wear sunscreen, a hat and sunglasses when outside. Sunscreen should have a sun protection factor, or SPF, of 30 or higher. Apply sunscreen on all exposed body areas. Use sunscreen on cloudy days, in the shade and especially when in or near water. Remember that the sun's rays are strongest during the midday, so keep children out of the sun during this time. Wear lightweight, light-colored clothing.</p> <p>With the warmer weather, sun and outdoor activities also comes the risk for dehydration leading to heat exhaustion or heatstroke. So make sure you and your kids drink plenty of water, even if they are not thirsty, and find shade on those sweltering days. When your child develops signs of dehydration or heat exhaustion, stop whatever activity he or she is doing, cool the child down and encourage fluids. If your child does not improve or show signs of heatstroke, seek help.</p> <h5>Some signs and symptoms of heatstroke to watch for include:</h5> <ul> <li>Clammy, pale or flushed skin</li> <li>Confusion, agitation or irritability</li> <li>Dizziness</li> <li>Dry mouth</li> <li>Fatigue</li> <li>Headache</li> <li>Lack of tears with cries</li> <li>Muscle cramps</li> <li>Nausea or vomiting</li> <li>Rapid breathing</li> <li>Rapid heart rate</li> </ul> <h4>Take a walk on the wild side</h4> <p>Hiking is a great way to get exercise, as well as explore the best sights and sounds within and around your community. A quick trip to a local park or trail is great for weekdays, but try venturing out further on weekends by visiting a new community. See a list of regional hiking trails to try with your family this spring. Make sure to wear proper footwear and clothing. Finally, don't forget to pack water and a small first-aid kit, and stay on marked trails.</p> <p><em><a href="/providers/aicha-katty-np" target="_self" title="Opens in same window.">Aicha Katty</a> is a nurse practitioner in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em> </p><ul> <li>Community/public health</li> <li>Mental health and wellness</li> <li>Women’s health</li> </ul>D.N.P.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Nursing, The College of St. Scholastica</li> <li>Doctor of Nursing Practice, Winona State University</li> </ul> <p><strong>Internships</strong></p> <ul> <li>Allina Health, Cambridge, Minnesota</li> <li>Fairview Health Services, Woodbury, Minnesota</li> <li>Allina Health, Richfield, Minnesota</li> <li>Apple Valley Medical Center, Apple Valley, Minnesota</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Family Nurse Practitioner, American Academy of Nurse Practitioners</li> <li>Public Health Nurse</li> <li>Psychiatric Mental Health Nurse Practitioner, American Psychiatric Nurses Association</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Nurse Practitioners</li> <li>American Psychiatric Nurses Association</li> <li>Minnesota APRN Coalition</li> <li>Minnesota Board of Nursing</li> <li>Sigma Theta Tau International Honor Society of Nursing</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Katty<img src="/-/media/shared-files/images/medical-professionals/full/owatonna/aicha-katty-np.JPG?h=280&iar=0&w=280&sc_lang=en&hash=F6C5BE407BB09E4A03DFAA2EEC73C1B7" alt="Aicha Katty NP" width="280" height="280" DisableNVelocity="true" />Aicha<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21597332Aicha Katty DNP1<img src="/-/media/national-files/images/hometown-health/2021/kids-kicking-soccer-ball.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F7B82B06A4D18F93ABBE09B6DE1CA07D" alt="Kids kicking soccer ball" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Dawn Haller4/9/2021Grocery stores are stocked with many foods and beverages — some healthy, others not so much. Learn how nutrient-dense foods can help you make every bite count.Make every calorie count with nutrient-dense foods<p>With grocery stores stocked with so many foods and beverages, consumers have an almost bewildering array of options to choose from. Some are healthy, others not so much. When making choices, look for foods and beverages that provide the best nutrient bang for your buck. These items provide the most amount of nutrients in relation to their calorie content. In other words, they are nutrient dense. The federal government's new <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://dietaryguidelines.gov/" target="_blank" title="Opens in a new window.">Dietary Guidelines</a> emphasize how nutrient-dense foods can help you make every bite count.</p> <p>What are nutrients? They include carbohydrates, proteins or fats, as well as other essential substances that promote growth, provide energy and maintain health. Nutrients are used by many systems of our body to keep them functioning at optimum levels.</p> <p>Nutrient-dense foods often are lower in calories compared to other foods with fewer nutrients. For example, fruits, vegetables, whole grains, lean meats, nuts, beans, seeds and certain oils are all considered nutrient dense.</p> <p><strong>They include one or more of nutrients including:</strong></p> <ul> <li>Vitamins A, B, C, D, E and K</li> <li>Calcium</li> <li>Iron</li> <li>Fiber</li> <li>Magnesium</li> <li>Potassium</li> <li>Other minerals</li> </ul> <p>The calories in foods with few healthful nutrients often are referred to as empty calories. Some empty-calorie or low-nutrient foods are potato chips, white bread and fruit snacks, while a baked potato, whole-grain bread and fresh fruits are nutrient dense.</p> <h2>Tips for making nutrient-dense choices</h2> <p>Aside from fresh fruits and vegetables, packaged and frozen items also can be nutrient dense. To find out, check the Nutrient Facts label on the side of the container. The label identifies nutrients in the product and how much of each that a serving contains, along with calories per serving. Even though some foods, such as nuts, seeds and oils, are nutrient dense, they may contain high amounts of healthy fats, which add extra calories to your diet. That's where the Nutrition Facts label can help, too, by describing the size of a serving.</p> <p>Other resources for consumers are healthy foods symbols, such as the red heart indicating whole grain, which quickly help you identify foods that are heart healthy. You also can learn more about nutrient-dense foods online, such as <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.fda.gov/food/food-labeling-nutrition/raw-fruits-poster-text-version-accessible-version" target="_blank" title="Opens in a new window.">fruits</a>, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.fda.gov/food/food-labeling-nutrition/nutrition-information-raw-vegetables" target="_blank" title="Opens in a new window.">vegetables</a> and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.fda.gov/food/food-labeling-nutrition/nutrition-information-cooked-seafood-purchased-raw" target="_blank" title="Opens in a new window.">seafood/fish</a>.</p> <h3>Making nutrient-dense foods part of everyday meals</h3> <p>It's one thing to know what a nutrient-dense food is, it's another to know how to work it into your everyday meals and snacks. One way to start is with your favorite meal of the day and add one nutrient-dense food.</p> <h4>Here are some easy meal ideas: </h4> <ul> <li><strong>Breakfast</strong> <ul> <li>Whirl up a smoothie of nonfat milk and frozen fruit in the blender.</li> <li>Smear a whole-wheat bagel with low-fat cream cheese.</li> <li>Make your own breakfast sandwich by slipping a fried egg onto a toasted, whole-grain English muffin, sprinkle with cheese and zap for a few seconds in the microwave.</li> <li>Add chopped nuts or fresh blueberries to homemade pancakes.</li> </ul> </li> <li><strong>Lunch</strong> <ul> <li>Enjoy your favorite sandwich, but add an apple or orange instead of chips.</li> <li>Toss a salad of greens, grilled chicken, sliced tomatoes and hard-boiled egg, then drizzle with a nonfat dressing.</li> </ul> </li> <li><strong>Snack</strong> <ul> <li>Keep hunger at bay with sliced veggies and dip or hummus.</li> <li>Curb your appetite with a string cheese stick.</li> </ul> </li> <li><strong>Dinner</strong> <ul> <li>Thread marinated chicken breast pieces, green peppers, tomatoes and mushrooms on a skewer and grill.</li> <li>Heat up chili.</li> <li>Make breakfast for dinner with ham and cheese omelets and whole-wheat toast.</li> </ul> </li> </ul> <p>Looking for more help? Consult with a registered dietitian. We'll work with you to develop and use a healthy meal plan customized to your preferences, cultural traditions and budget.</p> <p><em>Anne Harguth is a registered dietitian providing <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">nutrition education and counseling</a> in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2021/dad-and-child-sharing-nutritious-food.jpg?h=370&iar=0&w=660&sc_lang=en&hash=AE7420EA82FF3E5AC898B823BFAB83C5" alt="Dad and child sharing nutritious food" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller3/4/2025Some women wean their baby from breastfeeding early because of breast pain caused by plugged ducts or mastitis. Learn how to prevent these conditions and get tips to manage pain during breastfeeding.Managing plugged ducts, mastitis when breastfeeding<p>The American Academy of Pediatrics recommends infants be exclusively <a href="/hometown-health/speaking-of-health/breastfeeding-101-tips-for-new-moms" target="_self" title="Opens in same window.">breastfed or given only breast milk</a> only for the first six months of life. The group also recommends that continuing breastfeeding as solid foods are introduced, up to and beyond the child's first year or as long as the mother and child desire. Many people desire to exclusively breastfeed their child for six months and plan to continue to breastfeed for one year or more. </p> <p>Breast pain is the most frequently stated reason for early weaning. The longer a person experiences breast pain, the more likely they will wean the baby before they intend to. Immediate intervention and treatment of breast pain is crucial to preserving the breastfeeding relationship, and helping the person and their child continue breastfeeding.</p> <p>Plugged ducts and <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/mastitis/symptoms-causes/syc-20374829" target="_blank" title="Opens in a new window.">mastitis</a> are common conditions that can affect up to 1 in 5 people who begin breastfeeding. Both conditions cause pain and discomfort in the breast, which can affect long-term breast milk feeding goals. A plugged duct obstructs milk flow in a portion of the breast, either at the nipple or further back in the ductal system. Mastitis is inflammation and infection of the breast. These conditions happen most often in the first six to eight weeks postpartum, but they can occur at any time during breastfeeding.</p> <h2>Risk factors for plugged ducts, mastitis</h2> <p><a href="/hometown-health/speaking-of-health/too-embarrassed-to-ask-i-just-had-a-baby-whats-wrong-with-my-moods" target="_self" title="Opens in same window.">Stress</a>, fatigue, anemia and a weakened immune system are risk factors for plugged ducts and mastitis.</p> <h3>Additional risk factors for plugged ducts include:</h3> <ul> <li><strong>Inadequate breast emptying</strong><br /> This could be caused by a poor latch or nipple pain, or a baby who is sleepy, tongue-tied or uncoordinated with suck and swallow.</li> <li><strong>Limited time during feedings</strong><br /> This could occur if feedings are rushed or if the person is breastfeeding multiple babies.</li> <li><strong>Missed feedings</strong><br /> Plugged ducts are possible when there is a longer interval between breast emptying when the baby starts sleeping for longer periods, an abrupt weaning or overuse of a pacifier.</li> <li><strong>Pressure on the breast</strong><br /> This could include pressure from fingers during feedings, tight clothing around or on the breast, underwire bras, or pressure from carrying purse or diaper bag, car seat or baby carrier.</li> </ul> <p>Mastitis can be caused by any of these risk factors, in addition to having sore cracked or bleeding nipples, which can serve as an entry point for an infection and possibly lead to a prolonged hospital stay. People with a history of plugged ducts or mastitis also are at an increased risk for a future infection.</p> <h2>Symptoms of plugged ducts, mastitis</h2> <p>Plugged ducts and mastitis can be uncomfortable for people who are breastfeeding. Plugged duct symptoms progress gradually, and can include pain, a hard lump, a warm and painful localized spot or a wedge-shaped area of engorgement on the breast. Mastitis symptoms appear rapidly and include flu-like symptoms such as fever, chills, fatigue and body aches. The pain typically is more intense than a plugged duct, and the person also may notice red streaking on the breasts.</p> <h2>Prevention of plugged ducts, mastitis</h2> <p>You may have heard the saying "An ounce of prevention is worth a pound of cure." That is true for breast pain caused by plugged ducts or mastitis.</p> <h3>To get your breastfeeding relationship with your infant off to its best start — and avoid complications such as mastitis — keep these tips in mind:</h3> <ul> <li>Breastfeed in different positions to allow for more thorough emptying of the breast.</li> <li>Create a frequent feeding schedule and empty each breast completely. With a newborn, this could be eight to 12 feedings in 24 hours.</li> <li>Establish a good latch at every feeding to empty the breast better and prevent damaging the nipple.</li> <li>Use high-quality pure lanolin or lanolin ointment for sore, cracked or bleeding nipples.</li> <li>Wear a well-fitting nursing bra, and avoid underwire bras or tight straps from clothing, bags, purses or infant carriers.</li> </ul> <p>It also may be helpful to <a href="/services-and-treatments/breast-care" target="_self" title="Opens in same window.">meet with a lactation consultant</a> who can provide additional tips and advice on proper breastfeeding techniques.</p> <p>People with frequent plugged ducts may see improvement by taking a supplement called lecithin, which can reduce the "stickiness" of the milk and prevent plugged ducts from occurring. In addition, new research has found that taking probiotics can prevent and decrease the incidence of mastitis and is safe during breastfeeding. Look for a probiotic that contains Lactobacillus fermentum and Lactobacillus salivarius.</p> <h2>Treatment for plugged ducts, mastitis</h2> <p>Most people can unclog a milk duct at home within two days. Continue to breastfeed or pump as much as your baby needs. Don’t feed or pump more than usual because this can put more stress on the ducts and cause even more inflammation.</p> <p>Some of the best ways to clear a clogged milk duct are easily remembered by the acronym B.A.I.T:</p> <ul> <li><strong>Breast rest</strong>: Don’t over massage or overfeed. Decrease production if you have an oversupply</li> <li><strong>Advil</strong>: 800 milligrams (mg) every eight hours for 48 hours</li> <li><strong>Ice</strong>: Apply for 10 minutes at a time while laying on your back. Repeat every 30 minutes</li> <li><strong>Tylenol</strong>: 1,000 mg every 8 eight hours for 48 hours</li> </ul> <p>You can also:</p> <ul> <li>Lightly stroke your breasts using the same motion as if you are petting a cat. Stroke toward the lymph nodes above your collarbone (clavicle) and in your armpits to help drain swelling into your lymphatic system</li> <li>Eat a well-balanced, healthy diet</li> <li>Rest</li> <li>Practice therapeutic breast massage taught by a certified lactation consultant</li> </ul> <p>Treating a plugged duct promptly is essential to prevent further progression, reduce pain and eliminate frustration.</p> <p>A healthcare professional may prescribe antibiotics if a person has mastitis, is acutely ill and the symptoms persist or worsen. Breastfeeding and expressed breast milk feeding are safe and recommended, even with antibiotic therapy.</p> <p><a href="/providers/abbey-rose-cnm-apnp" target="_self" title="Opens in same window."><em>Abbey Rose</em></a><em> is a <a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">certified nurse midwife</a> in <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/tomah" target="_self" title="Opens in same window.">Tomah</a>, Wisconsin.</em></p><ul> <li>Lactation support</li> <li>Postpartum depression management and support</li> </ul>CNM, A.P.N.P.<p>I pursued by master's in midwifery to give women a different option of care. I strive to educate and empower women to take ownership of their health care experience. It is important for me to ask each woman I care for to share with me her story. I want women to be heard in their own voice.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Nursing, Viterbo University</li> <li>Master's degree, Nursing, Frontier Nursing University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Internation Board Certified Lactation Consultants</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Nurse Midwives (ACNM)</li> <li>American Collete of Obstetricians and Gynecologists (ACOG)</li> <li>Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN)</li> </ul>Rose<img src="/-/media/shared-files/images/medical-professionals/full/tomah/abbey-rose-cnm-apnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A10B8590322E2098992335DE530EC543" alt="Abbey Rose, CNM, A.P.N.P." width="280" height="280" DisableNVelocity="true" />Abbey<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21231567Abbey Rose, CNM, A.P.N.P.1{54693F31-87AF-4B21-91DB-1DEC1E21F878}<img src="/-/media/national-files/images/hometown-health/2021/baby-resting-on-moms-chest.jpg?h=370&iar=0&w=660&sc_lang=en&hash=00A0E6671F58D77FEA1489AC16F94BC6" alt="Baby resting on mom's chest" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller4/21/2021Most men will experience benign prostatic hyperplasia, or BPH, as they age. Get the basics about this noncancerous condition.Men's health: What's benign prostatic hyperplasia?<p>Most men will experience benign prostatic hyperplasia (BPH), to some degree, as they age. By age 60, about 70% of men show symptoms of BPH. By age 70, that number grows to 80%. Let's start with the basics about this noncancerous condition.</p> <h2>What is the prostate?</h2> <p>The prostate is a walnut-sized gland that lies between the bladder and the penis. Urine flows from the bladder through the prostate to the penis. Inside the prostate, tissue continues to grow throughout a man's life, often blocking the flow of urine from the bladder. This tissue growth is BPH.</p> <h2>What causes BPH?</h2> <p>Prostate growth is normal, and the amount of growth is related to the balance in a man's sex hormones. Because it's part of the normal aging process, not much can be done to prevent BPH. Dietary changes or supplements appear to have minimal effect on this condition.</p> <h2>What are the symptoms?</h2> <p>As the tissue enlarges, a man may experience that his urine stream isn't as strong as it once was. In severe cases, he may not be able to urinate at all.</p> <h3>Symptoms fall into two categories:</h3> <ul> <li><strong>Obstructive</strong><br /> The man's urine stream is weak, and he feels as though he can't empty his bladder. A man may have trouble starting his stream, his stream may start and stop, and he may experience dribbling at the end of urination.</li> <li><strong>Irritative</strong><br /> The bladder gets irritated by the blocked urine, causing more frequent urination and increased urge to urinate ― the "I have to go now" feeling. The need to urinate may wake a man up frequently during the night versus once or twice, which is more normal.</li> </ul> <h2>When should you see a provider?</h2> <p>If symptoms are getting worse or they're bothering you more, then it's time to make an appointment with your primary care provider, who can refer you to a urologist, if necessary. Even minor changes in symptoms could prompt an evaluation.</p> <p>Late symptoms of BPH include urinary tract infections, difficulty or inability urinating, development of bladder stones, kidney damage and even permanent bladder damage. It's important for you to be evaluated if you have any of these conditions.</p> <p>The first line of treatment is making changes to behavior, including avoiding bladder irritants such as caffeine and soda, preventing the bladder from getting too full by urinating every three to four hours during the day, and limiting fluid intake before bedtime. Weight loss and exercise also have been shown to be beneficial.</p> <p><em><a href="/providers/adam-miller-md">Adam Miller, M.D.</a>, is a <a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">urologist</a> practicing in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a>, <a href="/locations/austin">Austin</a>, and <a href="/locations/rochester" target="_self" title="Opens in same window.">Rochester</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2021/feet-in-slippers.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7855F3C45B3A3988E682AD9F1683C63C" alt="Feet in slippers" width="660" height="370" DisableNVelocity="true" />Prostate HealthProstate cancer is the most common cancer diagnosed in men. You may have friends or family members who have been diagnosed with prostate cancer, and this may make you wonder about what you can do for prostate cancer prevention.Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Dawn Haller4/15/2021A fast heart rate is common when you're exercising, or feeling excited or nervous. But what's happening when your heart rhythm changes unexpectedly?Racing heart beat? Heart arrhythmia 101<p>A fast heart rate is common when people exercise or are feeling excited or nervous. But what is happening when your heart rhythm changes when you aren't expecting it? That condition is known as heart arrhythmia. Heart arrhythmias, also called heart rhythm problems, occur when the electrical impulses that coordinate your heartbeats don't work properly. This causes your heart to beat too fast, too slow or irregularly.</p> <p>Palpitations can be felt as a sensation of fast heartbeats or skipped beats. Additional symptoms, such as loss of consciousness, lightheadedness to the point of almost losing consciousness, chest pain and increasing shortness of breath, should always be taken seriously and may require evaluation in an emergency department. It is important to talk with your health care provider if you have changes in heart rate without other symptoms, as well.</p> <h4>Atrial fibrillation</h4> <p>Atrial fibrillation is the most common type of arrhythmia. It is a rapid heart rate caused by chaotic electrical impulses in the upper chambers of your heart. These signals result in rapid, uncoordinated, weak contractions.</p> <p>It is more common with age and for people who are obese or have been diagnosed with heart disease, diabetes or sleep apnea.</p> <p>Atrial fibrillation is different than other forms of arrhythmia in several ways. It may increase your risk of stroke, so treatment plans often include a blood thinner to lower the risk of stroke. It also can be caused by lifestyle choices, so changes to your habits may reduce the frequency of atrial fibrillation or improve the outcomes of treatment.</p> <h4>Treatment options</h4> <p>Often, the first treatment option for arrhythmia is commonly used cardiac medications, including beta blockers and calcium channel blockers.</p> <h5>Depending on the type of arrhythmia, minimally invasive options, such as cardiac ablation or other treatments, could be part of your treatment plan:</h5> <h5>Cardiac ablation</h5> <p>Cardiac ablation is a minimally invasive procedure in which a thin, movable catheter is introduced into the cardiac chambers, and the areas of the heart responsible for arrhythmia are destroyed. The abnormal tissue can be impaired or destroyed with heat (radiofrequency ablation) or extreme cold (cryoablation).</p> <p>In general, this treatment option is best for patients who have an abnormally fast heartbeat, called supraventricular tachycardia, or patients with a history of going in and out of atrial fibrillation. However, ablation using advanced techniques is increasingly performed for patients with constant atrial fibrillation, as well.</p> <h5>Pacemakers</h5> <p>Pacemakers are devices used to treat slow heart rhythms, also called bradyarrhythmias. A pacemaker can improve quality of life by preventing loss of consciousness and improving shortness of breath and fatigue. It can be a lifesaving treatment option for people who experience long pauses in the rhythm of their heart due to a condition called complete heart block.</p> <p>Pacemaker battery packs are placed underneath the skin on the chest wall. One or two wires pass from the battery to the top and bottom chambers of the heart. If your heart rate is too slow or if it stops, the pacemaker sends out electrical impulses that stimulate your heart to beat at a steady rate.</p> <p>There is a new form of pacemaker therapy which involves a miniaturized pacemaker placed entirely inside the chamber of the heart, called a leadless pacemaker. Another type is called a cardiac resynchronization therapy device, which is used specifically for people diagnosed with heart failure. This device has wires that pass to the right and left ventricles of the heart, and aims to restore a synchronous rhythm between these two chambers.</p> <h5>Implantable cardioverter-defibrillator (ICD)</h5> <p>An ICD is a device that constantly monitors your heart rhythm. If a cardiac arrest occurs, it can deliver a lifesaving shock to reset your heart to a normal rhythm. An ICD doesn't prevent an abnormal heart rhythm from occurring, but it treats it if it happens. ICDs are placed similar to a pacemaker, but the batteries are larger.</p> <p>Most patients who have survived a cardiac arrest due to a fast arrhythmia (tachyarrhythmia) are good candidates for this treatment. ICDs also may be implanted in patients who have not yet experienced a cardiac arrest but are considered at increased risk of cardiac arrest in the future. This includes people who have a condition called heart failure (weak heart-pumping function) due to a previous heart attack or other reasons; specific congenital diseases of the heart muscle; or those with genetic electrical problems of the heart.</p> <p>Talk with your health care provider if you have concerns about your heart rhythm or heart health. Always call 911 if you are experiencing signs of a heart attack, including chest pain; pain spreading to the shoulders, neck or arms; lightheadedness; fainting; sweating; nausea; or shortness of breath.</p> <p><em><a href="/providers/vaibhav-vaidya-mbbs" target="_self" title="Opens in same window.">Vaibhav Vaidya, M.B.B.S.</a>, is a <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiac electrophysiologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Cardiac resynchronization therapy </li> <li>Catheter ablation for atrial fibrillation</li> <li>Catheter ablation for ventricular tachycardia </li> <li>Clinical research in arrhythmia in pregnancy, arrhythmia in mitral valve prolapse, arrhythmia in noncompaction cardiomyopathy </li> <li>Device extraction</li> <li>Novel device development in electrophysiology</li> <li><a href="/locations/eau-claire/services-and-treatments/cardiology/diseases/arrhythmia" target="_self" title="Opens in same window">Pulsed field ablation</a></li> </ul>M.B.B.S. <p>I am a cardiac electrophysiologist and treat disorders of heart rhythm by various techniques including lifestyle modification, medical therapy and minimally invasive procedures. The principle that the best interest of the patient is the only interest to be considered has held true for more than a hundred years. I believe it is critical to understand each patient’s unique situation and deliver care in a compassionate manner, incorporating shared decision making in management choices. </p> <p><span style="color: #333333;">I'm from Mumbai, India, where I completed medical school. When I'm not working, I enjoy spending time with my family, traveling, hiking, reading, listening to music and sports.</span></p> <p><strong>Education</strong></p> <ul> <li>Seth Gordhandas Sunderdas Medical College</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Cardiovascular Disease, Mayo Clinic School of Graduate Medical Education</li> <li>Clinical Cardiac Electrophysiology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Cardiovascular Diseases, American Board of Internal Medicine</li> <li>Examination of Special Competence in Adult Echocardiography, National Board of Echocardiography</li> <li>Internal Medicine, American Board of Internal Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Vaidya<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/vaibhav-vaidya-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=3EC2579B1361276651F3F25454CAB416" alt="Vaibhav Vaidya MD" width="280" height="280" DisableNVelocity="true" /> Vaibhav<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15677753Vaibhav Vaidya, M.B.B.S. 1{676428F6-179A-4C9B-9B23-5F1E40032A38}<img src="/-/media/national-files/images/hometown-health/2021/walking-bicycle-fall-sidewalk.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8647E2A8AC8D81E1B8963D007D860245" alt="Walking bicycle on the sidewalk in fall" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller4/1/2021It's now possible to return home the same day after knee or hip replacement surgery. Learn about this safe option and the "prehab" you'll get the day before.Same-day joint replacement surgery possible<p>Years ago, an extended hospital stay was required after a knee or hip replacement surgery. This has changed with the wider adoption of same-day joint replacement surgeries. Same-day surgeries, also called outpatient surgery, are when a patient safely leaves the hospital to recover at home the same day as the surgery.</p> <p>About one-third to one-half of my patients with a knee or hip replacement surgeries can go home the same day as their procedures. To accomplish this, additional safety measures have been put in place in the surgical and recovery process that make it safe for patients to recover at home. The care team is caring for outpatients and inpatients at the same time, and they are prepared to care for patients no matter their preferences.</p> <h2>The right fit</h2> <p>Outpatient joint replacement surgery is a good option for many patients. There are minimal medical risks for patients who are younger, active and otherwise healthy. Joint replacements are safe operations for patients to go home the same day, and outcomes are no different than patients who stay in the hospital, based on numerous research studies.</p> <p>When determining whether a patient is appropriate for going home the same day as surgery, one of the most important factors considered is a patient's social support at home. It's critical that patients have good social networks to provide the care that they need when they go home. They need to have friends or family members lined up who can assist with exercises, household chores and meals while the patient recovers.</p> <p>In addition, it is safer to keep patients overnight in the hospital who have a complicated medical history or a chronic condition, such as a long cardiac history, respiratory concerns or a previous transplant.</p> <h2>Possible anesthesia differences</h2> <p>Overall, the surgical process is the same whether a patient recovers in the hospital or at home, but different types of anesthesia could be used during surgery. We try to use spinal anesthesia for most same-day surgeries. This type of anesthetic is administered through a needle temporarily placed in the lower back. We find that this type of anesthesia is easier for patients to tolerate and recover from compared to general anesthesia, and it has lower risks of some possible complications.</p> <p>Regardless of the type of anesthesia used, patients are closely monitored and attended to by an anesthesiologist or nurse anesthetist throughout and immediately following surgery.</p> <h2>Education and rehabilitation</h2> <p>It's critical to the success of the joint replacement surgery that the patient is thoroughly educated about the rehabilitation process. Previously, patients would receive education, learn how to perform the necessary exercises and how to use a walker, and get proper home preparation instruction after the operation.</p> <p>With the change to more outpatient surgeries, that process has transitioned to before the day of surgery. It is called "prehab." Patients receive a refresher on the information they learned during prehab on the day of surgery. This process makes it easier for patients and their families to feel comfortable and confident with recovering at home following an outpatient surgery.</p> <p>After the surgery, patients may feel a bit groggy, but they don't need to worry about learning new information. It's a much more restful situation for them, as they only need to get home and rest.</p> <p>This prehab process has benefited patients who recover in the hospital, as well. Patients who completed prehab and recovered in the hospital performed better and rehabilitated faster. This change decreased the number of days the patients needed to be in the hospital and improved their surgery results.</p> <h2>Patient benefits</h2> <p>The biggest benefit is that patients are more rested and feel more secure in their own beds surrounded by family and pets. They are not awoken multiple times overnight by care team members or beeping monitors.</p> <p>Overall, my patients have been happy with the outpatient total joint process. I also have found that patients talk about their same-day surgery with others, and some patients come to me asking about it.</p> <h2>Next steps:</h2> <ul> <li><a href="https://www.mayoclinichealthsystem.org/providers?service=Orthopedic%20Surgery" target="_self" title="Opens in same window.">Find an orthopedic surgeon near you.</a></li> <li>Get the <a href="/hometown-health/speaking-of-health/get-the-facts-about-knee-pain" target="_self" title="Opens in same window.">facts about knee pain.</a></li> <li>Discover how a joint effort made Laurie Bakkum's knee surgery possible.</li> </ul> <p><a href="/providers/jonathan-webb-md" target="_self" title="Opens in same window."><em>Jonathan Webb, M.D.</em></a><em>, is an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgeon</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Adult reconstruction, including total hip and knee replacements</li> <li>Orthopedic trauma</li> <li>Osteoarthritis</li> <li>Revision total hip and knee replacements</li> </ul>M.D.<p>In my free time, I enjoy spending time with my family and dogs, traveling and outdoor activities, including golfing.</p><p><strong>Education</strong></p> <ul> <li>University of California-San Diego School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, Mayo School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Adult Reconstruction/Total Joint, Brigham and Women’s Hospital</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Orthopaedic Surgery</li> <li>Mayo Clinic Quality Fellow, Bronze Level</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Orthopaedic Surgeons</li> <li>American Association of Hip and Knee Surgeons</li> <li>Mid-America Orthopedic Association</li> <li>Wisconsin Medical Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Orthopedics, Mayo Clinic College of Medicine and Science</li> </ul>Webb<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/jonathan-webb-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=2F7619F3E475ED155E19560B59D95B97" alt="Jonathan Webb, M.D." width="280" height="280" title="Jonathan Webb, M.D." DisableNVelocity="true" />{4CC5C115-4676-4DBD-872E-A81D75CB0136}Jonathan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15384616Jonathan Webb, M.D.1{DEF55970-853F-4E96-9A4D-3413874FF059}<img src="/-/media/national-files/images/hometown-health/2021/senior-couple-sitting-together.jpg?h=370&iar=0&w=660&sc_lang=en&hash=058BBCB8A66E33569839D9122140EE4B" alt="Senior couple sitting together" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Karen Sperl11/20/2023<p>If you or a loved one is experiencing memory loss, dementia or Alzheimer’s disease could be the cause. Learn more about these conditions, their symptoms, diagnosis and treatment.</p>An introductory guide to understanding dementia, Alzheimer’s disease<p>While the terms <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/dementia/symptoms-causes/syc-20352013" target="_blank" title="Opens in new window.">dementia</a> and <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/symptoms-causes/syc-20350447" target="_blank" title="Opens in a new window.">Alzheimer's disease</a> often are used interchangeably, they have two different meanings regarding diagnoses. Dementia refers to a wide range of symptoms that affect a person's ability to perform everyday activities independently. Alzheimer's disease is the most well-known and common form of dementia. It's a progressive condition that gets worse over time.</p> <h2> Signs and symptoms of dementia </h2> <p>Depending on the cause of dementia ― and there are many ― some of its symptoms are reversible. While dementia generally involves memory loss, this symptom alone doesn't mean that a person has dementia. Some treatable medical conditions can cause dementia-like symptoms. </p> <p>Symptoms of dementia include: </p> <ul> <li>Changes in thinking skills </li> <li>Changes in behavior and language</li> <li>Decline in memory</li> <li>Decreased focus and attention</li> <li>Poor judgment and reasoning skills </li> </ul> <h2>Signs and symptoms of Alzheimer's disease</h2> <p> While dementia is a general term, Alzheimer's disease is a specific brain disease. It's marked by symptoms of dementia that gradually get worse over time. Alzheimer's disease first affects the part of the brain associated with learning, so early symptoms often include changes in memory, thinking and reasoning skills. As the disease progresses, symptoms become more severe, including confusion, behavior changes and other challenges. </p> <p>Early signs of Alzheimer's disease include: </p> <ul> <li>Changes in mood, such as depression or other behavior and personality changes </li> <li>Confusion with location or passage of time </li> <li>Difficulty concentrating, planning or problem-solving </li> <li>Having visual or space difficulties, such as not understanding distance in driving, getting lost or misplacing items </li> <li>Language problems, such as word-finding problems or reduced vocabulary in speech or writing </li> <li>Memory impairment, such as difficulty remembering events </li> <li>Problems finishing daily tasks at home or at work, such as writing or using eating utensils </li> <li>Using poor judgment in decisions</li> <li> Withdrawing from work events or social engagements </li> </ul> <h2>Diagnosing dementia and Alzheimer's disease </h2> <p>Diagnosing dementia and identifying the type of dementia can be challenging. Your healthcare team will evaluate the pattern of the loss of skills and function, and determine what abilities the person has.</p> <p> Diagnosing Alzheimer's disease involves the self-reporting of symptoms, as well as administering tests to assess memory and thinking skills. While this can be difficult, there are multiple diagnostic tools that can help detect dementia and determine with relatively high accuracy whether Alzheimer's disease or another condition is the cause. </p> <h2>Treating dementia and Alzheimer's disease </h2> <p>Although there’s no cure for most types of dementia or Alzheimer's disease, managing symptoms is possible. Medications can help with memory symptoms and other cognitive changes.</p> <p> Dementia and Alzheimer's disease can be unpredictable and move progressively, so those with the diagnosis should be prepared as the condition changes over time. </p> <p>Some ways to enhance the well-being of someone with dementia or Alzheimer's disease include: </p> <ul> <li>Making sure they are eating well</li> <li>Encouraging regular exercise </li> <li>Having the person's hearing checked </li> <li>Keeping them involved with social activities </li> </ul> <p>Many communities have in-person or online support groups for caregivers and people with mild to mid-stage memory disorders. For more information, contact your healthcare team or county human services department. </p> <p>Check out these resources for more information on brain health and caregiving: </p> <ul> <li><a href="/hometown-health/speaking-of-health/maximize-memory-function-with-a-nutrient-rich-diet">Eating to maximize memory function</a> </li> <li><a href="/hometown-health/speaking-of-health/memory-lapses-normal-aging-or-something-more">Memory lapses: Normal or something more?</a> </li> <li><a href="/hometown-health/speaking-of-health/5-tips-to-keep-your-brain-healthy">Tips to keep your brain healthy</a> </li> <li><a href="/hometown-health/speaking-of-health/dementia-related-pain-and-caregivers">What caregivers need to know about dementia-related pain</a></li> <li><a href="/hometown-health/speaking-of-health/when-to-seek-help-for-memory-loss">When to seek help for memory loss</a> </li> </ul> <p><em>Natalie Makepeace is a clinical social worker in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2023/two-people-embracing-and-smiling.jpg?h=370&iar=0&w=660&sc_lang=en&hash=78364072168A6F0B3EA4BD388A48FD39" alt="Two people embracing and smiling." width="660" height="370" DisableNVelocity="true" />Dementia/Alzheimer's DiseaseDementia isn't a specific disease. Instead, dementia describes a group of symptoms affecting thinking and social abilities severely enough to interfere with daily functioning. Many causes of dementia symptoms exist. Alzheimer's disease is the most common cause of a progressive dementia. Dawn Haller4/16/2021Have an upcoming health care appointment with your provider? Here's some tips and things to keep in mind so you get the most from your visit.Plan ahead to make the most of your health care visit<p>A visit with your health care provider can be overwhelming. There are a few things to consider before, during and after your visit so you make the most of the time you have with your health care provider.</p> <h4>Prepare a discussion checklist.</h4> <p>Your health care provider will ask you several questions. The amount of questions depends on the reason for your visit and whether this provider has seen you before. Your answers help your provider understand your health and your health concerns.</p> <h5>Be prepared to discuss:</h5> <ul> <li>The main reason for your visit</li> <li>New concerns</li> <li>Past and present medical conditions</li> <li>Any past surgeries</li> <li>Prescription and nonprescription medications, vitamins and herbal remedies</li> <li>All allergies</li> <li>Immunization records</li> <li>Family medical history</li> </ul> <h4>Write down your main concerns.</h4> <p>Prepare a list of main concerns. Rank them in order of importance.</p> <h5>You may want to ask:</h5> <ul> <li>How can I improve my health?</li> <li>Are there conditions or diseases I am at risk for?</li> <li>What are possible side effects of medications I am taking?</li> <li>Are there any available resources that will help me understand my medical conditions?</li> </ul> <p>It also is important to tell your health care provider about anything in your personal life, such as an illness in the family, financial worries or job difficulties, that may affect your health.</p> <h4>Describe new symptoms or recent changes in symptoms.</h4> <h5>Your health care provider may ask you detailed questions, such as:</h5> <ul> <li>How long have you had the problem?</li> <li>What does it feel like?</li> <li>How often do the symptoms occur?</li> <li>What brings on the symptoms?</li> <li>What reduces the symptoms?</li> <li>Is the problem getting worse?</li> <li>Have other family members had similar problems?</li> </ul> <p>Having a family member or friend with you can be helpful. Having two people hear the discussion can help later when you want to remember what was talked about. In addition, you can read the provider's notes from your visit through the patient portal.</p> <p>Expect to ask all of your questions and have them answered. Talk with your health care provider about resources that may help answer your questions. This may take more time than this visit allows. If you need more time for questions, you may need to schedule a follow-up visit or a phone call.</p> <h4>Recap what you heard after the visit.</h4> <p>It may be helpful to write down what you learned from your visit. Include information about how your health care provider is planning to help you and what actions you can take to improve your health. Request an after-visit summary that includes visit diagnoses, treatment plans, medication list and patient education, if one was not provided to you.</p> <p>Contact your health care provider by phone or the patient portal if you have additional questions about your visit. Read more about <a rel="noopener noreferrer" href="https://mayoclinichealthsystem.org/hometown-health?topic=Patient%20Online%20Services" target="_blank" title="Opens in a new window.">how you can use the patient portal for your health care</a>.</p> <p><em><a href="/providers/lindsey-ruppel-do" target="_self" title="Opens in same window.">Lindsey Ruppel, D.O.</a>, sees patients in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/barron" target="_self" title="Opens in same window.">Barron</a> and <a href="/locations/rice-lake" target="_self" title="Opens in same window.">Rice Lake</a>, Wisconsin.</em></p><ul> <li>Pediatrics</li> <li>Women's health</li> </ul>D.O.<p>I find it rewarding working with families and developing a collaborative relationship with patients. I’m passionate about serving all ages of patients while making a positive difference in their lives.</p> <p>I love spending time with my husband and three children. I also enjoy hiking, biking, skiing, cooking, baking and playing the piano.</p><p><strong>Education</strong></p> <ul> <li>Pacific Northwest University of Health Sciences</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Spokane Family Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Spokane Family Medicine</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Medicine, American Board of Family Medicine</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>Idaho Academy of Family Physicians</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Ruppel<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/lindsey-ruppel-do.JPG?h=280&iar=0&w=280&sc_lang=en&hash=9C71BCAA6884A320158826DC447AF401" alt="Lindsey Ruppel, D.O." width="280" height="280" DisableNVelocity="true" />Lindsey<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30039662Lindsey Ruppel, D.O.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}|{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}<img src="/-/media/national-files/images/hometown-health/2018/medical-checklist-on-clipboard.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5CA1C53530CAF29B2FE877F7704D9D88" alt="Medical checklist on clipboard and stethoscope" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Patient PortalStaying engaged in your healthcare is important. The patient portal is a free, secure and convenient online resource that connects you to your healthcare team and helps you manage your health from the comfort of your home or anywhere else.Michele Halterman3/17/2023You can learn to be happy — or at least happier. Make a commitment to yourself to find happiness in each day. Ask yourself five questions to reflect on ways to boost your happiness.How to create happiness<p>It may seem hard to believe, but there's much truth behind the idea that happiness is a choice. Although genetics and life circumstances play a role in your level of happiness, you can take steps to increase your enjoyment of life.</p> <p>It's unrealistic to snap your fingers and decide to be happy. But if you bring consciousness, gratitude and even frivolity to your day, you'll likely feel happier.</p> <p>The bulk of what determines happiness is due to personality, and thoughts and behaviors that can be changed.</p> <h2>Think about what makes you happy</h2> <p>You can learn how to be happy — or at least happier. But how can you do that?</p> <h4>Take time to reflect on these questions to find ways to boost your happiness:</h4> <ul> <li>What might you be able to reconnect with that bring you joy, contentment or delight?</li> <li>How might you stay focused on the tasks at hand when life continues around you?</li> <li>How might you find novelty in everyday life?</li> <li>What would it look like if you <a href="/hometown-health/speaking-of-health/self-care-tips-for-moms" target="_self" title="Opens in same window.">put yourself first</a> instead of making everyone and everything else a priority?</li> <li>When was the last time you spent time immersed in nature?</li> </ul> <p>If you've been looking for happiness, the good news is that your choices, thoughts and actions can influence your level of happiness. It's not as easy as flipping a switch, but you can increase your happiness level.</p> <h2>Small steps to increase happiness</h2> <p>Surround yourself with happy people. Being around people who are content raises your own mood. And by being happy, you give back something to those around you.</p> <p>Make a commitment to <a href="/wellness/gratitude" target="_self" title="Opens in same window.">practice gratitude</a>. Identify at least one thing each day that improves your life. When you find yourself thinking an ungrateful thought, try substituting it for a grateful one. Think about what you're grateful for when you wake up in the morning and before you go to sleep at night.</p> <p>Don't postpone joy waiting for a day when your life is less busy or less stressful. Look for opportunities to appreciate the small pleasures of everyday life. Focus on the positives in the present moment, instead of dwelling on the past or worrying about the future.</p> <p>Spending time with friends or family, creating a grateful attitude and an optimistic outlook, focusing on your purpose, and living in the present can help you <a href="/hometown-health/speaking-of-health/12-healthy-habits-for-families" target="_self" title="Opens in same window.">take steps toward being happier.</a></p> <p>Exercise improves mood and provides an emotional lift in your day. Physical activity releases chemicals in your brain that can lead to feeling happier, more relaxed and less stressed. You may feel better about yourself when you exercise regularly, which can improve self-esteem and boost <a href="/hometown-health/speaking-of-health/practical-ways-to-raise-confident-kids" target="_self" title="Opens in same window.">confidence</a>.</p> <h4>Commit yourself to finding happiness in each day. Use this list to get started:</h4> <ul> <li><strong>Make a list of activities you used to enjoy but have given up in recent years.</strong><br /> Choose one to reconnect with and dedicate at least two weeks to it. See if this activity makes you happier and consider making time for it again.</li> <li><strong>Spend at least 10 minutes a day outside.</strong><br /> Pay attention to the trees, grass, water, breeze or whatever else surrounds you.</li> <li><strong>Consider things that have made you happy and unhappy in the past.</strong><br /> Make a list and let it help guide your path to happiness.</li> </ul> <p><em><a href="/providers/mysoon-ayuob-md" target="_self" title="Opens in same window.">Mysoon Ayuob, M.D.</a>, is a physician in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/faribault" target="_self" title="Opens in same window.">Faribault</a>, Minnesota.</em></p><ul> <li>Chronic disease</li> <li>Community education</li> <li>Community health and wellness</li> <li>Pediatrics</li> <li>Public safety regarding COVID-19</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Khartoum College of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, New York Medical College at St. Joseph's Medical Center</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Family Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Medical Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Ayuob<img src="/-/media/shared-files/images/medical-professionals/full/faribault/mysoon-ayuob-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=CFE58C08C0B03A51DD513CAC27D3A307" alt="Mysoon Ayuob MD" width="280" height="280" DisableNVelocity="true" />Mysoon<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16315847Mysoon Ayuob MD1{B3F96F77-F93E-41A4-AE4E-603045CDB443}<img src="/-/media/national-files/images/hometown-health/2022/sitting-hugging-knees.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C29C01BF490DDFD2D663D42065E6C7B1" alt="Sitting, hugging bent knees close" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Michele Halterman2/6/2023Stress can wreak havoc on your health, impacting your risk of developing serious issues like heart disease. Identifying your stress triggers is the first step in the stress management process.Tips to keep stress from hurting your heart<p>Everyone reacts to stress differently, and how you react can impact the chance of developing serious health issues, including <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.mayoclinic.org/diseases-conditions/heart-disease/basics/definition/con-20034056" target="_blank" title="Opens in a new window.">heart disease</a>.</p> <p>Your body's response to stress may include muscle aches and headaches, back strain, stomach pains, and other physical symptoms. Stress also can make you tired, disturb normal sleep patterns, and leave you irritable, forgetful and out of control. When stress is constant, your body remains in high gear for days or weeks, which can lead to more significant health problems.</p> <p>Periods of excessive and pervasive stress can result in direct effects on health, such as high blood pressure and higher cholesterol levels. Indirect impacts, such as increasing behaviors and habits that worsen physical health and functioning, include smoking, overeating or engaging in less physical activity. </p> <h2>Can managing stress reduce or prevent heart disease?</h2> <p>Managing stress levels always is a good idea when it comes to your overall health. Studies are underway looking more closely into how managing stress reduces risk for heart disease given the direct effects of stress on health. Patients who have experienced a heart attack or <a href="/topics/stroke" target="_self" title="Opens in same window.">stroke</a> and feel depressed, anxious or overwhelmed by stress should contact their health care team for additional help.</p> <h2>Beginning the stress management process</h2> <p>Reducing stress can take many forms. Understanding your triggers and identifying your stress symptoms can start the stress management process. Then you'll be able to recognize and modify triggers of heightened stress levels. The first step in altering your stress response is to identify stressors and ask yourself, "What can I stop doing, and what can I let go of?"</p> <p>After you have removed or modified external stressors, it's time to build specific management skills and techniques. Many things can be done to manage stress and build resources. As a psychologist, I typically ask people to adopt things from each of these categories: physical, emotional, mental and spiritual.</p> <h3>A few ideas to adopt include:</h3> <ul> <li><strong>Harness your strengths.</strong><br /> Reflect: "I feel most energetic, fulfilled and full of life when I am doing …"</li> <li><strong>Take part in social activities.</strong><br /> Chat with a colleague or loved one, or catch up with an old friend virtually.</li> <li><strong>Give to others.</strong><br /> Try volunteering or performing a random act of kindness.</li> <li><strong>Start something.</strong><br /> Be creative, and try it for five minutes to begin with.</li> <li><strong>Begin to journal.</strong><br /> Be mindful of your daily life.</li> </ul> <h2>Additional tips to help combat stress</h2> <h3>There are several things you can do to relieve stress in your life, including:</h3> <ul> <li>Exercise regularly.</li> <li>Challenge negative and catastrophic thoughts.</li> <li>Avoid smoking and caffeine.</li> <li>Eat foods with high nutritional value.</li> <li>Maintain a <a href="/healthy-weight" target="_self" title="Opens in same window.">healthy weight</a>.</li> </ul> <p>In some situations, medicine can help. However, when it comes to stress, medication often is used as a last resort. Instead, look to manage the stress you are experiencing using relaxation or other learned stress reduction techniques. Also, make sure you're not confusing stress for an <a href="/hometown-health/speaking-of-health/tips-to-keep-stress-from-hurting-your-heart" target="_self" title="Opens in same window.">anxiety</a> disorder, which is a separate condition you should discuss with your health care team.</p> <h2>Can stress be good for you?</h2> <p>Yes, stress can be good for you. "Good" stress can come from weddings, a job you love or your children. Many of the things you love also can be some of the most significant challenges at times. </p> <p> Everyone needs a little stress for motivation to meet the daily challenges and ultimately promote optimal functioning in daily life. Stress that's managed can enhance focus and concentration, move you to connect more with others and provide you with a sense of mastery, which promotes better health.</p> <p><em><a href="/providers/lisa-hardesty-phd-lp" target="_self" title="Opens in same window.">Lisa Hardesty, Ph.D.</a>, is a clinical psychologist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Co-morbid medical and behavioral health conditions</li> <li>Integrated behavioral health</li> <li>Optimizing health and well-being</li> <li>Weight management</li> </ul>Ph.D., L.P.<p><strong>Education</strong></p> <ul> <li>Master's degree, Health and Clinical Psychology, Minnesota State University-Mankato</li> <li>Doctor of Philosophy degree, Western Michigan University-Kalamazoo</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Post Doctoral Fellowship, Health Psychology, Henry Ford Hospital</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Clinical Health Psychology, American Board of Professional Psychology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Psychology, Mayo Clinic College of Medicine and Science</li> </ul>Hardesty<img src="/-/media/shared-files/images/medical-professionals/full/mankato/lisa-hardesty-phdlp.jpg?h=280&iar=0&w=280&hash=0F1D1C9CA069ED45487CBB5A40FD588A" alt="Lisa Hardesty, Ph.D., L.P." width="280" height="280" DisableNVelocity="true" />{A9A6221E-C37E-4EAE-B151-BFE624FC511D}Lisa<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>11683651Lisa Hardesty, Ph.D., L.P.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}|{94B2E140-AEF8-44BA-B6A9-4538B77501BC}<img src="/-/media/national-files/images/hometown-health/2023/florist-working-with-plant.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F57BB859F0ED5FCB43B4D8DBE0DF1D2B" alt="Florist working with plant" width="660" height="370" DisableNVelocity="true" />Stress ManagementGuidance to help you reduce and manage daily stress.Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Michele Halterman4/23/2021Everyone has heard the saying "No pain, no gain." If you're training for race, chances are you've felt some pain. Here's how to keep working toward your goal.Managing pain, swelling during marathon training<p>Everyone has heard the saying "No pain, no gain," and, if you're training for a long-distance race, chances are that you've felt some pain.</p> <p>General muscle soreness and mild discomfort is common among runners, and it often is the sign of a successful training program. When training for a long-distance race, it's important to gradually progress your training and not overstress your body. Overtraining can result when you push your training too quickly and the workload exceeds your body's normal ability to adapt to the stress placed on it without appropriate rest or recovery time.</p> <p>When putting your body through the rigorous training required for a marathon, how much pain is too much? When should you power through, and when should you take it easy and get checked out?</p> <p>The most important thing is to listen to your body. Sometimes runners get into a mentality that they must finish a particular run in progress, and they don't listen to or respond appropriately to their aches and pain.</p> <p>A lot of runners experience knee pain, and it doesn't mean that you have to give up on your goal, especially if your pain level is low ― 0 to 3 on a 10-point scale ― consistent, doesn't escalate and you don't have swelling the day after the run.</p> <p>If your knee pain is at a lower level and never changes, you can keep running, but you should get it evaluated by a health care provider. Also, use ice and stretching or lower your running intensity to ease the pain, rather than use medication to mask the pain.</p> <p>However, if your pain level escalates more than two points, or you wake up with swelling in your hip, knee or foot, you need to get checked out or you may increase your risk of worsening the injury.</p> <p>One thing that prevents athletes from getting checked out is the fear they'll be told they must stop training. While there are cases when a health care provider must say a runner shouldn't run, it's likely you can keep working toward your goal in some capacity. Pain that is short-lived, improves with activity or resolves with rest is generally not concerning.</p> <p>Researchers have found that runners can moderate knee pain with changes in pace. An athletic trainer or physical therapist can help you modify your plan and educate you about stretching and interventions so you can finish your training and race. So listen to your body and keep working toward your goal.</p> <p><em><a href="/providers/paul-osterman-lat" target="_self" title="Opens in same window.">Paul Osterman</a> is a licensed athletic trainer in <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">Orthopedics</a> and <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">Sports Medicine</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Acute care</li> <li>Athletic training education and research </li> <li>Concussion identification and management </li> <li>Critical incident stress management</li> <li>Injury care and prevention </li> <li>Mental health </li> <li>Musculoskeletal ultrasound </li> <li>Psychological aspects of injury </li> <li>Rehabilitation</li> <li>Sports medicine</li> </ul>L.A.T., A.T.CI have a wife and two sons. In my free time, I enjoy being outdoors, camping, hiking, fishing, playing a variety of sports and exercising and strength training. <p><strong>Education</strong></p> <ul> <li>Bachelor of Science, Athletic Training, Minnesota State University, Mankato</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Great Lakes Athletic Trainers Association</li> <li>Minnesota Athletic Trainers Association – ATs Care Committee Chair</li> <li>National Athletic Trainers Association</li> <li>National Strength and Conditioning Association</li> </ul>Osterman<img src="/-/media/shared-files/images/medical-professionals/full/mankato/paul-osterman-lat.JPG?h=280&iar=0&w=280&sc_lang=en&hash=B6B042C47E8363AA3002B86D5F84FF5A" alt="Paul Osterman LAT" width="280" height="280" DisableNVelocity="true" />Paul<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21635293Paul Osterman LAT1<img src="/-/media/national-files/images/hometown-health/2021/hands-holding-knee-in-pain.jpg?h=370&iar=0&w=660&sc_lang=en&hash=045797B62C700177070AE6E9FA19D8AC" alt="Hands holding knee in pain" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Dawn Haller4/6/2021Spring cleaning your freezer is not only a way to find out what's on the bottom. It can help you make healthy choices. Here's some suggestions to get you started.Spring into better health: The freezer edition<p>Thinking about what is in the bottom of your freezer and what year it was frozen can be overwhelming. While freezing foods prolongs their shelf life, frozen food can still expire.</p> <h4>Here are a few suggestions for maintaining a healthy freezer:</h4> <ul> <li>It's important to go through your freezer at least once per year and throw away any questionable food or items more than a year old.</li> <li>Freezer burn also can happen. This comprises the taste and integrity of food. If you have frozen foods that are still edible, but they are getting close to their expiration date, move them to the front of the freezer to grab first when meal planning.</li> <li>Freezer cleaning also presents a good time to throw away any frozen foods that may be tempting and result in broken healthy eating habits. Some examples include ice cream; frozen pizza or pizza rolls; cookie dough; breaded and fried meats, such as chicken wings or fish sticks; and frozen candy bars. Once cleaned, filling the freezer with healthy items makes meal prep easy.</li> <li>Frozen vegetables are a great option for vegetables that aren't in season. An added benefit is frozen vegetables often have less sodium than their canned counterparts. They're easy to make and can be frozen until ready to eat.</li> <li>Fruit also can be frozen and made into smoothies, topped on frozen yogurt or simply enjoyed as a cool, refreshing snack.</li> <li>A budget-friendly option is buying unfrozen, nonbreaded meat from the store in larger quantities. Then before freezing, place a serving size in each freezer bag.</li> <li>A healthier option to premade frozen pizza is making pizza dough when you have time and freezing it. Homemade pizza dough tastes better and has no preservatives. You can add healthy toppings, such as low-fat cheese, vegetables and olive oil- or pesto-based sauces. Try pulling out the frozen dough in the morning, letting it thaw in the refrigerator and rolling it out — determining the desired thickness as you do so — when you're ready to eat. Add flavor to the dough by using basil, oregano, onion powder and garlic powder. In addition, sprinkling cornmeal on the crust adds texture.</li> <li>Remember to label and date all freezer items to track how long food has been frozen.</li> </ul> <p><strong>Like this article? Read about spring cleaning in your <a href="/hometown-health/speaking-of-health/spring-into-better-health-pantry-edition" target="_self" title="Opens in same window.">pantry</a> and <a href="/hometown-health/speaking-of-health/spring-into-better-health-refrigerator-edition" target="_self" title="Opens in same window.">refrigerator</a>.</strong></p> <p><em><a href="/providers/amanda-halls-rd-ld" target="_self" title="Opens in same window.">Amanda Leisenheimer</a> is a <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">dietitian</a> in <a href="/locations/lake-city" target="_self" title="Opens in same window.">Lake City</a>, Minnesota.</em></p><ul> <li>Diabetes</li> <li>Overall nutritional changes are lifelong changes for patients and their families</li> <li>Weight Management</li> </ul>RDN, LD<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Dietetics, College of Saint Benedict</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Registered Dietitian</li> <li>Licensed Dietitian</li> </ul>Halls<img src="/-/media/shared-files/images/medical-professionals/full/lake-city/amanda-halls-rdn-ld.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B0FA1017FC839B7CCA36917E15C4BB68" alt="Amanda Halls, R.D.N., L.D." width="280" height="280" DisableNVelocity="true" />Amanda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16305141Amanda Halls, R.D., L.D.1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2021/vegetables-in-containers-in-freezer.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E621F932CF25FCDE4D9B53326E896BFF" alt="Vegetables in containers in freezer" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller12/19/2023Addiction to alcohol affects millions of people every year. Learn the signs that alcohol may be an issue for your loved one, and get tips for providing support for recovery.Recognizing, addressing a loved one's alcohol use<p><a rel="noopener" href="http://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/basics/definition/con-20020866" target="_blank" title="Opens in a new window.">Alcohol</a> abuse affects millions of people every year. Approximately 3 million people worldwide die each year due to alcohol use, according to the World Health Organization. Alcohol is a danger for many people.</p> <p>Addiction to alcohol, also known as a process addiction, changes the brain, impairs thinking and damages relationships. It also causes endless problems.</p> <p>Unfortunately, there continues to be a stigma surrounding addiction. This stigma can prevent people, especially professionals, from seeking necessary help.</p> <p>Alcohol, while legal for consumption by adults 21 and older, can lead to accidents and other risky behavior, such as fighting and leaving family members uncertain of what just happened.</p> <p>So what do you do when your loved ones' glass of wine becomes the whole bottle and concerns arise? You have options.</p> <h2>How to identify signs of alcohol abuse</h2> <h3>First, recognize signs that alcohol is an issue for your loved one. Watch for these indicators:</h3> <ul> <li><strong>Change in daily patterns.</strong><br /> This often includes changes in eating and appearance. Addiction will begin to alter behavior and personal hygiene.</li> <li><strong>Drinking larger quantities of alcohol and drinking more frequently.</strong><br /> Addiction is a disease that cannot be haphazardly turned on and off.</li> <li><strong>Loss of interest in what your loved ones used to care about most.</strong><br /> This can include family, hobbies, work and health. As addiction takes over, nothing else seems as important.</li> <li><strong>Separation from close friends and family.</strong><br /> Isolation will set in — from shame, guilt or embarrassment — as well as anger and resentment toward others they blame for their addictive behavior.</li> </ul> <h2>Helping a loved one with an addiction</h2> <h3>Once you identify that your loved one may be in trouble, you can act. Here are a few tips:</h3> <ul> <li><strong>Identify how the behavior affects you and others.</strong><br /> Think about specific examples of when you have witnessed alcohol use getting out of hand and how that affected you.</li> <li><strong>Talk with other family and friends.</strong><br /> Speak with other family members and friends about your concerns. Ask if they've witnessed the same concerns.</li> <li><strong>Seek professional advice.</strong><br /> Contact a substance abuse professional, mental health professional, physician, member of the clergy or another trained professional to discuss your concerns.</li> <li><strong>Have an open and honest conversation.</strong><br /> When you're ready to talk with your family member or friend about your concerns, be prepared. Set aside some time that works for both of you when your loved one is not drinking. Make sure you let the person know that you care and that is why you are bringing this to his or her attention. Make the conversation a two-way street and be careful not to lecture or badger.</li> <li><strong>Be supportive.</strong><br /> Don't anticipate a drastic change and don't push if they aren't ready to address these concerns. Ask if you can speak again in the future about the topic.</li> </ul> <h2>Encouraging your loved one to get help</h2> <p>Don't expect your loved one to overcome a drinking problem alone. They may need medical supervision to withdraw safely, as well as professional counseling support and guidance to establish new coping skills to quit or cut back on drinking.</p> <h3>You can encourage your loved one to get help by:</h3> <ul> <li>Offering to accompany them to appointments with their healthcare team, group meetings or counseling sessions. Learn more about <a href="/services-and-treatments/addiction-treatment" target="_self" title="Opens in same window.">addiction treatment</a> near you.</li> <li>Sitting with your family member or friend while they call a help line for assistance.</li> <li>Making a detailed plan together, outlining what changes they will make and how. You can help your loved one by recognizing when they need help and intervening appropriately.</li> </ul> <p>Your role doesn't end when your loved one agrees to seek help. Recovery is an ongoing process, requiring time and patience. But with your ongoing support, they can get there.</p> <p><em>Tyler Oesterle, M.D., is a addiction treatment physician in Rochester, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2023/close-up-of-holding-hands.jpg?h=370&iar=0&w=660&sc_lang=en&hash=485C8270A7657C6DFCF00E78EE24A11C" alt="Close up of holding hands" width="660" height="370" DisableNVelocity="true" />Substance AbuseInformation for helping those with alcohol and other drug abuse concerns.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller4/20/2021The mental health of infants is as important as physical health. Early intervention is essential to preventing mental health disorders. Learn about warning signs and when to seek help.Infants have mental health needs, too<p>Discussions surrounding mental health often focus on the experiences of adolescents and adults, leading many to believe that these are the only people in our community affected by emotional concerns. We rarely consider the mental health of infants and young children because after all, what could these little ones with their relatively uncomplicated lives possibly be upset about? Unfortunately, many mental health concerns have roots traceable to challenges occurring in infancy and early childhood, and early interventions for these developing minds are necessary to prevent future mental health disorders.</p> <p>Infant mental health refers to the well-being of infants and children up to age 3, and it includes a child's emotional and social growth and development. Many new caregivers ― moms, dads, grandparents and foster parents ― can experience normal challenges with their infants. When challenges become persistent or apparently unchangeable, caregivers can experience anxiety and frustration themselves. Seeking support with an expert in infant and early childhood development can provide helpful strategies to reduce stress for everyone involved.</p> <h3>Warning signs</h3> <h4>Indicators of infant mental health concerns can include:</h4> <ul> <li>Poor sleep patterns</li> <li>Difficulties with feeding</li> <li>Persistent or unremitting crying</li> <li>Restlessness</li> <li>Gastric disturbance</li> <li>Anxiety and tension</li> <li>Distress and fear</li> <li>Lack of weight gain or failure to thrive</li> <li>Failure to meet expected developmental milestones</li> </ul> <p>Central to an infant's mental health is his or her relationship with primary caregivers. Newborns come into the world with a highly impressionable neurological system. They are vulnerable and unable to regulate their physical and emotional states independently. They learn how through interactions with their caregivers.</p> <p>Infants initially have four identifiable biological states: deep sleep, light sleep, active alert and quiet alert. And they rely on caregivers to help them maintain a sense of well-being. Each state serves an essential function for growth and development. It is through predictable, sensitive and responsive care that infants regulate their biological states and feel safe in their environment. State regulation creates an optimal biophysical environment for brain development. A sense of well-being builds secure attachment — a connection that sets the stage for social and emotional learning.</p> <p>Infants communicate without words. Instead, they use cues such as crying, hiccups and gaze aversion to suggest to their caregiver that they are in distress. When their needs are successfully met by a responsive caregiver, infants learn that they can rely on that person, and the social bond builds. This first relationship serves as the building block for all subsequent relationships and forms the foundation of the infant's mental health and emotional growth.</p> <h4>Healthy social emotional growth</h4> <p>Let's think about the effects of healthy social emotional growth in infants. Social emotional growth is known to be the first learning priority for infants, and it can be defined as an infant's experience, expression and management of emotions, and the ability to establish positive and rewarding relationships with others.</p> <h4>Core features of an infant's successful social emotional growth include:</h4> <ul> <li>Understanding one's own emotional states</li> <li>Reading and understanding emotional states in others</li> <li>Managing strong emotions and expressing these in a constructive manner</li> <li>Regulating one's own behavior</li> <li>Developing empathy for others</li> <li>Establishing and maintaining relationships</li> </ul> <p>These core features are observable in the child's behavior as he or she continues to develop. For instance, babies will smile when caregivers smile. An infant or young child may avoid eye contact when he or she is overstimulated. Young children will cry when another child cries. Toddlers will want to cuddle or give hugs when their caregiver is sad. Kids will even tell the caregiver that "It's OK" when they perceive that a caregiver is distressed.</p> <p>An infant's future ability to pay attention; adapt in flexible ways; learn in school and in life situations; make friends; and manage unpleasant emotions, such as anger or anxiety all depend on early social emotional development and the connection of secure attachment that leads to the ability to trust in others and self. When infants and young children struggle to develop these essential abilities, mental illness can follow.</p> <h3>Barriers</h3> <h4>Identifiable factors that can interfere with a caregiver's ability to provide sensitive responsive care include:</h4> <ul> <li>Mental illnesses in the caregiver, such as depression and anxiety</li> <li>A caregiver's own history of neglect and abuse</li> <li>Single parenthood without social support</li> <li>Temperament mismatches between infant and caregiver</li> <li>Financial stress</li> <li>Relationship conflict between caregivers</li> <li>Alcohol or drug abuse in the caregiver</li> </ul> <p>Despite facing challenges listed above, caretakers of infants and young children can still provide an exceptionally nurturing environment. Raising a child is hard work and the unfortunate, yet common experience of feeling judged by others can make providing a consistent support to a developing child even more difficult. It is important to recognize that help is available.</p> <p>If you identify as a caregiver and would like more information about preventive mental health in infants or young children, first know that there are professionals trained extensively in newborn behavior observation. Newborn behavior examination can be performed in infants 3 months and younger. Meeting with such a professional can give you insight into your interactions with your baby, help you understand his or her cues and also increase your overall bond. Methods such as dyadic therapy, which involve treatment delivered to a parent and child simultaneously, help to support caretakers to improve their response to their infant and promote a lifelong journey of mutual social and emotional growth.</p> <p><a href="/providers/kyja-stygar-md" target="_self" title="Opens in same window.">Kyja Stygar, M.D.</a>, and John Zadroga, D.O., are <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physicians in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</p><ul> <li>Behavioral health</li> <li>Family medicine</li> <li>Gender-affirming care</li> <li>Pediatrics</li> <li>Prenatal care, including deliveries at the hospital</li> <li>Women's health</li> </ul>M.D.<p>I grew up in Eau Claire and returned to the area to be near family. I enjoy the outdoors with gardening, hiking, biking and kayaking.</p><p><strong>Education</strong></p> <ul> <li>Medical College of Wisconsin-Milwaukee</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Practice, UW Health Fox Valley</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>Society of Teachers of Family Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Stygar<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/kyja-stygar-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7E96C8C7EA40638FE2257BF7C24AC8E4" alt="Kyja Stygar, M.D." width="280" height="280" DisableNVelocity="true" />{1D673FAD-1DF2-4856-A86D-ED615A7310F2}Kyja<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12585912Kyja Stygar, M.D.1{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}|{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{61776FD2-05E8-47E9-AB55-EE465BD29A19}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}|{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}<img src="/-/media/national-files/images/hometown-health/2021/baby-laying-on-back-smiling.jpg?h=370&iar=0&w=660&sc_lang=en&hash=765E5BB9CAB956FBAFEBA16053E392FB" alt="Baby laying on back smiling" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Child DevelopmentWe all want our children to grow up happy and healthy. The reality is most all of them do — but at vastly different rates. Experts across Mayo Clinic Health System see thousands of children each year, and have the experience and resources to know what is normal and what may be cause for closer observation. This includes not only physical and motor skills development, but psychological and social skill advancement.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller4/29/2021Pregnancy can be a wonderful time to get active. Learn how exercise can help you cope with the physical changes of pregnancy and labor, plus what to do and and how much.Exercise during pregnancy: Safe, beneficial<p>Some days, being pregnant might feel like its own exercise routine — you might be feeling extreme fatigue, swollen feet or an aching back. While it might feel like just living your day-to-day life while pregnant is enough of a workout, there's evidence that pregnancy can be a fantastic time to get active — even if you haven't exercised in a while.</p> <h4>What's in it for me (and my baby)?</h4> <p>Physical activity improves mood, posture, muscle tone, strength and endurance. It also may help you sleep better. Exercise during pregnancy has been shown to decrease rates of <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339" target="_blank" title="Opens in a new window.">gestational diabetes</a>, C-sections and high blood pressure (preeclampsia). While you're pregnant, exercise helps promote healthy weight gain and can alleviate some of the pains associated with changes in your body, including constipation, bloating, swelling and backaches. Overall, exercising regularly keeps you fit during pregnancy, increases your energy level and can help you cope better with labor. <a rel="noopener" href="http://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/exercise-after-pregnancy/art-20044596" target="_blank" title="Opens in a new window.">Workouts after your baby is born</a> can speed up your recovery and also can help prevent postpartum depression.</p> <h4>What exercise should I do?</h4> <p>Exercise that incorporates cardiovascular fitness is most beneficial. Walking, swimming, cycling, aerobics, yoga, Pilates and running are safe exercises during pregnancy. Be sure to listen to your body and drink plenty of fluids to stay hydrated.</p> <p>If you are interested in other exercises that strengthen your pelvic floor muscles which support the uterus, bladder, small intestine and rectum, you can try <a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/kegel-exercises/art-20045283" target="_blank" title="Opens in a new window.">Kegel exercises</a>.</p> <h4>Is it safe?</h4> <p>Absolutely. There are very few reasons why a woman shouldn't exercise during pregnancy, and your doctor will tell you if you fall into that category. If you were active before your pregnancy, it's OK to keep exercising at a similar intensity level while you're pregnant. If you were not active before your pregnancy, it's not too late. Consider starting with lower-intensity exercises, such as walking, stationary biking or stretching.</p> <p>You can be safe while exercising by staying well-hydrated and avoiding very hot conditions. Avoid contact sports and activities that put you at high risk for falling, such as downhill skiing, hockey, basketball, soccer, wrestling, scuba, gymnastics, water skiing, horseback riding and hot yoga. Also avoid exercises that require you to lie on your back after the first trimester or require balance skills later in pregnancy.</p> <h4>How much is enough?</h4> <p>Health care providers often recommend working up to at least 150 minutes of moderate intensity aerobic exercise per week — think 30 minutes of exercise, five days a week. But if that seems out of reach, don't let it stop you from being active. Any physical activity you can do is helpful to you and your baby.</p> <h5>Depending on your fitness level, consider these guidelines:</h5> <ul> <li><strong>You haven't exercised for a while</strong> — Begin with as little as five minutes of physical activity a day. Build up to 10 minutes, 15 minutes and so on until you reach at least 30 minutes a day.</li> <li><strong>You exercised before pregnancy</strong> — You can probably continue to work out at the same level while you're pregnant if you're feeling comfortable and your health care provider says it's OK.</li> </ul> <h4>What are warning signs that I should stop?</h4> <p>If you are exercising and experience vaginal bleeding, abdominal pain, regular painful contractions or leaking of amniotic fluid, you should stop and contact your health care provider. Also notify your provider if you have dizziness, headaches, chest pain or severe shortness of breath when exercising. Otherwise, keep up the good work of keeping your body healthy for you and your growing baby.</p> <h4>Watch this pregnancy exercise video to learn more:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/vfpkYRyt7mU" title="pregnancy exercise" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p><em><a href="/providers/sarah-hotovy-md" target="_self" title="Opens in same window.">Sarah Hotovy, M.D.</a>, and <a href="/providers/terri-nordin-md" target="_self" title="Opens in same window.">Terri Nordin, M.D.</a>, are <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physicians in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Geriatric medicine</li> <li>Maternity care</li> <li>Office procedures, such as joint injections, dermatologic procedures, gynecologic procedures and vasectomies</li> <li>Pediatric care</li> <li>Women's health</li> </ul>M.D.<p>I believe in a collaborative approach to helping people meet their individualized health goals, knowing that having a trusted primary care provider makes people healthier. I take great joy in caring for people of all ages, from newborn medicine to end-of-life care. I enjoy practicing broad-spectrum family medicine, including prenatal care, delivering babies, joint injections, skin procedures, gynecologic procedures, and vasectomies.</p> <p>I was born and raised in Nebraska and, for as much as I love being a Wisconsinite, am a Cornhusker through and through. In my free time, I love to explore nature (hiking, kayaking, snowshoeing) with my husband and son, make music and try new recipes.</p><p><strong>Education</strong></p> <ul> <li>University of Nebraska Medical Center</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Family Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Family Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Medical Association</li> <li>Pisacano Leadership Foundation</li> </ul>Hotovy<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/sarah-hotovy-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A157CDCC141965A8F63D49F9075F491F" alt="Sarah Hotovy MD" width="280" height="280" DisableNVelocity="true" />Sarah<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30025341Sarah Hotovy, M.D.1{986C767E-E5DE-43F5-957F-B4212DB8E384}|{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}|{B3F96F77-F93E-41A4-AE4E-603045CDB443}<ul> <li>Maternity care, including deliveries at the hospital</li> <li>Medical education</li> <li>Pediatric care</li> <li>Women’s health</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Iowa Roy J. and Lucille A. Carver College of Medicine</li> </ul> <p><strong>Internship/Residency</strong></p> <ul> <li>Family Medicine, Rutgers-Robert Wood Johnson Medical School</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Maternity care, Rutgers-Robert Wood Johnson Medical School</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Family Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>Pisacano Leadership Foundation</li> <li>Society of Teachers of Family Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Nordin<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/terri-nordin-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=746184477F57E3BF501AEDA7D56F4FCC" alt="Terri Nordin, M.D." width="280" height="280" DisableNVelocity="true" />{7225EEB8-0AC2-4825-BCEF-B7E22114E97A}Terri<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16304497Terri Nordin, M.D.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}<img src="/-/media/national-files/images/hometown-health/2021/exercise-during-pregnancy.jpg?h=370&iar=0&w=660&sc_lang=en&hash=345F7DBCC39B1C4C8670C2CFC710BC04" alt="Exercise during pregnancy" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Dawn Haller4/13/2023While there isn't a cure for autism, there's reason for optimism with evidence-based therapies. Learn about autism treatments and therapies to reduce symptoms and help children achieve their goals.Autism: Strategies for treatments and therapies<p>The families who reach out to others after an autism diagnosis are best able to cope. This includes other families managing the condition and health care teams with pediatricians, child psychiatrists, primary care providers and therapists who work with children and families with <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/symptoms-causes/syc-20352928" target="_blank" title="Opens in a new window.">autism</a>.</p> <p>Autism is a spectrum of symptoms, and severity can greatly differ from person to person. While there isn't a cure for autism, there's a reason for optimism in many evidence-based therapies. The ultimate goal of treatment is to increase children's ability to function, reduce symptoms and help them achieve their goals.</p> <p>Treatment options for children diagnosed with autism vary. Individualized treatment plans could include therapies, school and community support programs, and medications, if necessary.</p> <p>Working together at home and school, and with the children's health care team, families may find treatment options include:</p> <h2>Behavior and communication therapies</h2> <p>Multiple specialties typically provide these therapies, including occupational and speech therapy. <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/diagnosis-treatment/drc-20352934" target="_blank" title="Opens in a new window.">Applied behavior analysis</a> is an evidence-based behavioral treatment to reinforce desirable behaviors and decrease undesirable behaviors through assessing children in their home environments. It focuses on decreasing behavioral problems, enhancing communication and teaching new skills. Often, these skills include service provisions in the patient's home, therapy centers and the community to help practice and provide guidance on functioning in different social situations. </p> <h2>Educational therapies</h2> <p>Therapies often are provided in an educational setting, where students and families work with educators to <a href="/hometown-health/speaking-of-health/helping-your-childs-education-through-an-iep-or-504-plan" target="_self" title="Opens in same window.">create structured, specific goals</a> and multifaceted treatment plans. Early detection and treatment of autism show the best response and progress. When diagnosed before preschool age, children can receive more intensive services and be involved with early intervention programs, including applied behavior analysis, and speech and occupational therapy.  </p> <h2>Family therapies</h2> <p>Beyond early <a href="/hometown-health/speaking-of-health/autism-vaccine-link-debunked" target="_self" title="Opens in same window.">diagnosis of autism</a>, a key symptom management tactic is getting the whole family involved. Parents can learn special ways to play with their children with autism. This can help children learn daily living skills and how to communicate with others. It helps reinforce consistency from integral family members to create steady routines and goals. </p> <h2>Medications for autism symptoms</h2> <p>No medication specifically treats the core symptoms of autism, such as social difficulty, repetitive behaviors and restricted interests.</p> <h3>However, medications can sometimes be a helpful option in managing some struggles and disorders that can coincide with autism symptoms, including: </h3> <ul> <li>Anxiety</li> <li>Perseverating, which is getting "stuck," such as counting the same series of numbers repeatedly</li> <li>Unpredictable negative behaviors, such as mood swings and unprovoked aggression</li> </ul> <p>It's important to remember that any therapy must come in the context of loving and accepting your children for who they are while maintaining an optimistic, yet realistic, expectation for their future. Talk to your health care team about treatment options that best suit your children's needs.</p> <p><a href="/providers/ashley-holland-do" target="_self" title="Opens in same window."><em>Ashley Holland, D.O.</em></a><em>, sees patients in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Cognitive neurology/neuropsychiatry for children and adults with a focus on diagnosis, management and treatment of neurologic issues with psychiatric comorbidities which can include dementia syndromes, intellectual disability, and genetic syndromes, and autism spectrum disorder.</li> </ul>D.O.<p>I provide high-quality specialty psychiatric services with the support of such a fabulous organization. Northwest Wisconsin is such a beautiful area with wonderful people, and I enjoy serving the community in every capacity I can.</p> <p>In my free time, I enjoy all types of outdoor activities and spending time with my family, which includes my young children and two dogs.</p><p><strong>Education</strong></p> <ul> <li>Des Moines University College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Psychiatry, Maine Medical Center</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Child and Adolescent Psychiatry, University of Massachusetts</li> <li>Neuropsychiatry/Cognitive Neurology, University of Massachusetts</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Psychiatry, American Board of Psychiatry and Neurology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Child and Adolescent Psychiatry</li> <li>American Medical Association</li> <li>American Neuropsychiatric Association</li> <li>American Psychiatric Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Psychiatry, Mayo Clinic College of Medicine and Science</li> </ul>Holland<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/ashley-holland-do.JPG?h=280&iar=0&w=280&sc_lang=en&hash=7E7B63A5C3437B6B7140CA75A45E94CE" alt="Ashley Holland, D.O." width="280" height="280" DisableNVelocity="true" />{B057D720-A165-4F91-A49D-EC778E53CF6A}Ashley<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21357072Ashley Holland, D.O.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}|{84749020-F092-4F95-A217-669CCCD77721}|{F43164BF-0164-44CF-83E6-DA8DAB5D2B18}<img src="/-/media/national-files/images/hometown-health/2021/mom-and-daughter-reading-book-on-sofa.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4BD4E91301CBAE0CA430EBF6BAABEA96" alt="Mom and daughter reading book on sofa" width="660" height="370" DisableNVelocity="true" />AutismAutism is one of a group of serious developmental problems called autism spectrum disorders that appear in early childhood — usually before age 3. Though symptoms and severity vary, all autism spectrum disorders affect a child's ability to communicate and interact with others.<br /><br /><br/><br/>While there is no cure for autism, intensive, early treatment can make a big difference in the lives of many children with the disorder.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller5/24/2021Stroke recovery can be difficult and takes time. But the good news is that a diversified team of health care specialists is available to help each patient.A team approach to stoke recovery<p>Recovering from any health condition is rarely easy, and stroke is no exception. It is the No. 1 cause of long-term disability in the U.S., with only 10% of people who experience a stroke fully recovering with no adverse long-term effects. Recovery time differs by person, ranging from days or weeks to a lifetime.</p> <p>The effects of stroke depend on the area of the brain involved and the amount of tissue damaged.</p> <h4>Common complications for stroke survivors include:</h4> <ul> <li>Paralysis or loss of muscle strength on both or one side of the body</li> <li>Loss of vision</li> <li>Pain or numbness in specific areas of the body</li> <li>Difficulty swallowing or chewing</li> <li>Difficulty understanding or forming speech</li> <li>Memory loss</li> <li>Changes in behavior, such as controlling or expressing emotions</li> <li>Difficulty with bladder or bowel control</li> </ul> <p>Rehabilitation after stroke focuses on helping each person recover as much function as possible and return to independent living. It often starts while the patient is still in the hospital, sometimes as early as hours after a stroke.</p> <p>Each person's stroke recovery is different, and therapy programs are based on the patient's age, overall health and degree of disability. The good news is many health care specialists are ready to help each patient on the path to recovery.</p> <h4>Depending on a patient's condition, the treatment team can include:</h4> <ul> <li>Primary care physician</li> <li>Neurologist</li> <li>Physiatrist (physical medicine and rehabilitation)</li> <li>Nurse</li> <li>Dietitian</li> <li>Physical therapist</li> <li>Occupational therapist</li> <li>Recreational therapist</li> <li>Speech pathologist</li> <li>Social worker or case manager</li> <li>Psychologist or psychiatrist</li> <li>Chaplain</li> </ul> <p>The recovery process can be strenuous and time-consuming, but support from the medical team, and friends and family goes a long way in helping a patient recover as much as possible. It's important to approach each problem with patience, creativity and tenacity.</p> <h4>Learn more about stroke:</h4> <ul> <li><a href="/hometown-health/speaking-of-health/stroke-what-it-is-and-the-different-types" target="_self" title="Opens in same window.">Stroke: What it is and the different types</a></li> <li><a href="/hometown-health/speaking-of-health/is-it-a-stroke-how-to-know-and-help" target="_self" title="Opens in same window.">Is it a stroke? How to know and help</a></li> <li><a href="/hometown-health/speaking-of-health/who-is-most-at-risk-for-a-stroke" target="_self" title="Opens in same window.">Who is most at risk for a stroke?</a></li> </ul> <p><em><a href="/providers/han-wang-md" target="_self" title="Opens in same window.">Han Wang, M.D.</a>, is a <a href="/services-and-treatments/neurology" target="_self" title="Opens in same window.">neurologist</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Dementia</li> <li>Epilepsy</li> </ul>M.D., M.P.H.<p>I am a good listener and care about my patients and their family’s concerns and needs.</p> <p>My personal interests include cooking, painting and hiking. </p><p><strong>Education</strong></p> <ul> <li>National Yang-Ming University</li> <li>Master's degree, Public Health with a Concentration in Epidemiology and Biostatistics, Johns Hopkins School of Public Health</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Neurology, University Hospitals Cleveland Medical Center</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Epilepsy, University Hospitals Cleveland Medical Center</li> <li>Post-doctoral Research Fellow, Johns Hopkins School of Medicine</li> </ul> <p> <strong>Membership</strong></p> <ul> <li>American Academy of Neurology</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Neurology, American Board of Psychiatry and Neurology (ABPN)</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor, Mayo Clinic College of Medicine & Science</li> </ul>Wang<img src="/-/media/shared-files/images/medical-professionals/full/mankato/han-wang-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4534444836ADE525CC47D2DEC11E4EAA" alt="Han Wang, M.D." width="280" height="280" DisableNVelocity="true" />Han<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21145989Han Wang, M.D., M.P.H.1<img src="/-/media/national-files/images/hometown-health/2021/dog-and-owner-in-the-woods.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D4AD0DA0BAF676FD0F1FBA42E14C136E" alt="Dog and owner in the woods" width="660" height="370" DisableNVelocity="true" />StrokeAs one of the leading causes of death in the U.S., stroke will affect 80% of families during their lifetimes, according to the National Stroke Association. And the faster care you receive for stroke, the better. Learn more about stroke prevention, symptoms and treatments here.Dawn Haller5/21/2024UV rays from the sun can cause skin damage in as little as 15 minutes. The key is to be sun savvy and know how to keep your skin healthy. Explore ways to be smart in the sun to help protect your skin.Be sun savvy, protect yourself from skin cancer<p>Ultraviolet rays from the sun can cause skin damage in as little as 15 minutes. Prolonged exposure and damage can lead to various forms of <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/skin-cancer/basics/definition/con-20031606" target="_blank" title="Opens in a new window.">skin cancer</a>, many of which, thankfully, are preventable.</p> <p>The sun isn't the only skin-damaging predator. Tanning beds and smoking also can have ill effects on the body's outer layer.</p> <h2>What are the common forms of skin cancer?</h2> <h3>Skin cancer can take many forms, but the three most common are:</h3> <ul> <li><strong><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/basal-cell-carcinoma/basics/definition/con-20028996" target="_blank" title="Opens in a new window.">Basal cell carcinoma</a></strong><br /> Basal cell carcinoma is the most common type of skin cancer. It typically develops on skin that receives a lot of sun, such as the scalp, face, nose, neck and hands. It often appears as a dome-shaped growth with visible blood vessels, a shiny, pinkish patch or a sore that heals and then returns.</li> <li><strong><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/squamous-cell-carcinoma/basics/definition/con-20037813" target="_blank" title="Opens in a new window.">Squamous cell carcinoma</a></strong><br /> Squamous cell carcinoma is the second most common type of skin cancer. It also frequently develops on skin exposed to the sun, such as the face, ears, lips, back of the hands, arms and legs. Squamous cell carcinoma often appears as a crusted or rough bump; a red, rough flat patch; a dome-shaped bump that grows and bleeds; or a sore that does not heal or heals and returns.</li> <li><strong><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/melanoma/basics/definition/con-20026009" target="_blank" title="Opens in a new window.">Melanoma</a></strong><br /> Melanoma is the deadliest form of skin cancer. It may develop on the skin or in an existing mole. Moles that change in size, color or shape, or develop symptoms, such as pain, itching or bleeding, can be a sign of melanoma. Melanoma can occur anywhere on the skin, including the hands and feet, under the fingernails or toenails, and in the mouth and genital area.</li> </ul> <h3>Watch this video to raise your skin cancer IQ:</h3> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/OEnfK1Jldwc" title="Raise your skin cancer IQ" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <h2>Preventing skin cancer</h2> <p>The keys to preventing skin cancer are to be sun savvy and know how to keep your skin healthy.</p> <h3>Be smart in the sun and protect your skin with these tips:</h3> <ul> <li><strong>Avoid the sun between 10 a.m. and 4 p.m.</strong><br /> This is when the sun is most intense and produces the greatest chance of sunburn. If you must be outside during these hours, seek shade using an umbrella, tree or other shelter. Use protective clothing and sunscreen even when in the shade. Learn more with this <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/skin-cancer/multimedia/skin-cancer-infographic/ifg-20441507" target="_blank" title="Opens in a new window.">"More Fun, Less Sun" infographic</a>.</li> <li><strong>Be aware of medications that increase your sensitivity to the sun.</strong><br /> Some prescription and over-the-counter medications can make you more sensitive to sunlight. Common drugs include antihistamines such as Benadryl; nonsteroidal anti-inflammatory drugs (NSAIDs), including naproxen or ibuprofen; certain antibiotics, including Bactrim or tetracycline; antidepressants; antipsychotics and oral diabetes medications. Check with your pharmacist regarding the side effects of your medication.</li> <li><strong>Don the right head gear.</strong><br /> A wide-brimmed hat can protect your face, ears and neck. If you wear a baseball cap, remember to apply sunscreen to your neck and ears. Also, wear protective clothing that covers exposed areas.</li> <li><strong>Don't use tanning beds.</strong><br /> Tanning beds produce harmful ultraviolet A (UVA) and ultraviolet B (UVB) rays, increasing your risk for skin cancer. There also is no proven evidence that using tanning beds to obtain a "base tan" will decrease your risk of sunburn. Beyond that, using tanning beds increases the chance of developing cataracts and <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/eye-melanoma/basics/definition/con-20027875" target="_blank" title="Opens in a new window.">ocular melanoma</a>.</li> <li><strong>Make healthy lifestyle choices.</strong><br /> Your behaviors and habits affect the health of your skin. Do not smoke because it damages collagen and elastin in your skin. When caring for your skin, use mild soaps and daily moisturizers while limiting hot showers which can strip essential oils from your skin. Drink plenty of water to remain hydrated, and get regular sleep to <a href="/hometown-health/speaking-of-health/what-to-do-about-dry-skin" target="_self" title="Opens in same window.">keep your skin looking refreshed</a>.</li> <li><strong>Perform regular skin checks.</strong><br /> Look for any changes to <a href="/hometown-health/speaking-of-health/the-abcdes-of-moles" target="_self" title="Opens in same window.">moles</a>, freckles or birthmarks. Additionally, monitor any new skin changes that have occurred. Use a mirror to evaluate hard-to-see areas, and have regular skin evaluations by your healthcare team or dermatologist.</li> <li><strong>Protect children's skin.</strong><br /> Children younger than 6 months should not use sunscreen but should be protected from the sun's rays with protective clothing and shade. Apply sunscreen regularly to children 6 months and older.</li> <li><strong>Use sunscreen when outdoors.</strong><br /> A higher sun protection factor, or SPF, number in sunscreen indicates increased protection. The American Academy of Dermatology recommends using at least SPF 30. Use sunscreen even on cloudy or cool days because damage from the sun's rays can still occur. Reapply every two hours. You also should reapply after swimming or when sweating. Check the sunscreen's expiration date. The shelf life typically is three years or less if it has been stored in high temperatures.</li> <li><strong>Wear sunglasses with UVA and UVB protection.</strong><br /> Proper, protective sunglasses help prevent damage to the sensitive skin around your eyes and block ultraviolet light from the sun that may cause <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/cataracts/basics/definition/con-20015113" target="_blank" title="Opens in a new window.">cataracts</a>.</li> </ul> <p><em><a href="/providers/rebecca-danof-md" target="_self" title="Opens in same window.">Rebecca Danhof, M.D.</a>, is a <a href="/services-and-treatments/dermatology" target="_self" title="Opens in same window.">dermatologist</a> in <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Cosmetic dermatology</li> <li>General and surgical dermatology</li> </ul>M.D., M.P.H.<p>I love spending time getting to know my patients. I hope this helps put them at ease and also allows me to take into account their lifestyle and preferences in my therapeutic approach.</p> <p>I am the chair of the Dermatology Department in Southwest Wisconsin.</p> <p>I grew up on a farm in the upper Midwest. When not at work, I enjoy spending time outdoors with my husband and two daughters.</p><p><strong>Education</strong></p> <ul> <li>University of Wisconsin-Madison School of Medicine and Public Health</li> <li>Master of Public Health, Epidemiology, University of Michigan School of Public Health</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Presbyterian St. Luke's Medical Center</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Dermatology, University of Colorado-Denver</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Dermatology</li> <li>American Society of Dermatologic Surgery</li> <li>Wisconsin Dermatologic Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Dermatology, Mayo Clinic College of Medicine and Science</li> </ul>Danhof<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/rebecca-danhof-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=E9EC4FF3D8A110DB9E95681536D696AA" alt="Rebecca Danhof MD" width="280" height="280" DisableNVelocity="true" />{0BA89695-346C-4055-9F00-8814DB529BFD}Rebecca<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15717976Rebecca Danhof, M.D., M.P.H.1{276FDCB2-F341-4C45-B04B-F71FB963B8CB}|{20D94572-B26A-4FB7-8C9D-7555CE785162}<img src="/-/media/national-files/images/hometown-health/2024/wearing-hats-for-sun-protection.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CB5D07325EA48F1ACA5756864C490E33" alt="Wearing hats for sun protection" width="660" height="370" DisableNVelocity="true" />Skin CancerSkin cancer — the abnormal growth of skin cells — most often develops on skin exposed to the sun. But this common form of cancer can also occur on areas of your skin not ordinarily exposed to sunlight.Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Dawn Haller5/4/2021As you make plans to celebrate Cinco de Mayo, follow these tips for enjoying dishes that are lighter on the calories and sodium.Celebrate Cinco de Mayo with lighter versions of popular dishes<p>Cinco de Mayo, the fifth of May, is a celebration of the Mexican army's victory over the French at the Battle of Puebla in 1862 during the Franco-Mexican War. In the U.S., many people celebrate with Mexican-inspired foods and drinks.</p> <h2>Here are some tips for enjoying dishes that are lighter on the calories and sodium, compared to popular restaurant dishes:</h2> <h3>Turn up the spices.</h3> <p>Enhance the flavor of your dishes with traditional spices, chilis, herbs and citrus juice rather than salt.</p> <h4>Common herbs and spices that you may be familiar with include:</h4> <ul> <li>Chili powder</li> <li>Cumin</li> <li>Fresh or dried cilantro</li> <li>Coriander seeds</li> <li>Cinnamon</li> <li>Cayenne pepper</li> <li>Garlic</li> </ul> <p>Less common spices to consider include ancho chile powder, Mexican oregano, tomatillos and serrano peppers. Many local grocery stores have a Hispanic foods section to explore. Flavorful vegetables, such as onion, jalapenos, chipotle peppers and poblano peppers, enhance flavor and add to your daily vegetable goal. If you feel your dish's flavor is a little flat, try a splash of lime juice to brighten up the flavor before reaching for the salt.</p> <h3>Load up on vegetables.</h3> <p>Many Mexican American dishes revolve around protein, but increasing vegetables in these dishes increases flavor and reduces calories. Make sure your dish includes at least a serving of vegetables, or a half-cup of cooked or one cup of raw vegetables. For example, a half-cup of cooked bell peppers is only about 25 calories. Many traditional Mexican dishes use summer squash or zucchini. These vegetables can be added to many dishes as they take on flavor well.</p> <p>Salsa can count as a vegetable, but many store brands are high in sodium. Summer is a great time to experiment with making your own lower-sodium salsa as fresh produce becomes more abundant.</p> <h3>Add lean proteins.</h3> <p>Choose lean proteins, such as fish; chicken; ground turkey; or lean steak, such as top sirloin. Another option is using pinto, black or fat-free refried beans in place of meat. If using ground beef, try substituting half of the beef for ground turkey, vegetarian soy crumbles or black beans.</p> <h3>Select whole grains.</h3> <p>If you are watching your carbohydrates, choose smaller tortillas or look for a low-carb wrap. Many people assume tortillas are lower in carbohydrates, as they are marketed as being healthier than bread, but one 10-inch tortilla has more grams of carbohydrate than two slices of bread.</p> <p>Work in whole grains by substituting whole-wheat tortillas for white flour tortillas and brown rice for white rice.</p> <h3>Curb added fat.</h3> <p>Limit the added fat by choosing low-fat or fat-free sour cream, reduced-fat cheese and fat-free refried beans. You can use low-fat plain Greek yogurt in place of the sour cream for a protein boost. Limit the amount of oil in cooking by using an oil spray and a nonstick pan or by baking in the oven.</p> <h3>Try some lighter recipes of these popular Cinco de Mayo dishes:</h3> <h4>Chicken fajitas</h4> <p>Serves 12</p> <p>Dietitian's tip: It's easier to slice the chicken when it is still partially frozen rather than waiting until it's completely thawed.</p> <ul> <li>¼ cup lime juice</li> <li>1–2 cloves garlic, minced</li> <li>1 teaspoon chili powder</li> <li>½ teaspoon ground cumin</li> <li>3 pounds boneless, skinless chicken breasts, cut in ¼-inch strips</li> <li>1 large onion, sliced</li> <li>Half a green sweet bell pepper, slivered</li> <li>Half a red sweet bell pepper, slivered</li> <li>12 low-fat, whole-wheat 8-inch tortillas</li> <li>½ cup salsa</li> <li>½ cup fat-free sour cream</li> <li>½ cup low-fat shredded cheddar cheese</li> </ul> <p>Combine the first four ingredients in a large bowl. Add chicken slices and stir until chicken is well-coated. Marinate for 15 minutes. Cook chicken in a pan, or on a grill or stovetop, for 3 minutes or until no longer pink. Stir in onions and peppers. Cook 3 to 5 minutes or until done to your liking. Divide mixture evenly among tortillas. Top each tortilla with 2 teaspoons salsa, 2 teaspoons sour cream and 2 teaspoons shredded cheese. Roll up and serve.</p> <p>Nutritional information per serving (1 filled tortilla): 220 calories, 4 grams fat, 1 gram saturated fat, 84 milligrams cholesterol, 830 milligrams sodium, 16 grams carbohydrates, 10 grams fiber, 30 grams protein</p> <h4>Fish tacos with tomatillo sauce</h4> <p>Serves 4</p> <p>Dietitian's tip: If cilantro isn't to your liking, use parsley instead. You can use a different pepper in place of the Fresno peppers and your favorite salsa in place of the tomatillo salsa. Just watch the sodium content.</p> <ul> <li>12 ounces whitefish, such as cod or tilapia</li> <li>Salt and pepper to taste (optional)</li> <li>¼ head Napa cabbage (1½ cups)</li> <li>1 teaspoon cumin</li> <li>2 teaspoons paprika</li> <li>½ teaspoon chili powder</li> <li>½ small yellow onion, diced (¼ cup)</li> <li>2 tablespoons minced cilantro</li> <li>2 red Fresno peppers, diced</li> <li>Zest and juice of 1 lime (½ teaspoon zest, 1 tablespoon juice)</li> <li>4 tablespoons tomatillo salsa</li> <li>4 wheat tortillas (6-inch diameter), lightly grilled or toasted</li> </ul> <p>Season fish with salt and pepper if you like. Then bake fish at 375 F for about 20 minutes until internal temperature reaches 145 F. Or grill fish if you prefer. Place remaining ingredients, except tortillas, in a mixing bowl and toss to combine. Flake fish and place on tortillas. Top with cabbage and salsa mixture. Serve immediately.</p> <p>Nutritional information per serving (1 filled tortilla): 187 calories, 3 grams fat, 0.5 grams saturated fat, 39 milligrams cholesterol, 190 milligrams sodium, 21 grams carbohydrates, 2.5 grams fiber, 19 grams protein</p> <p><em><a href="/providers/romi-londre-rdn" target="_self" title="Opens in same window.">Romi Londre</a> is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Eating disorders</li> <li>Enteral nutrition or tube feedings</li> <li>Weight management</li> </ul>RDN, CD<p><strong>Education</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Registered Dietitian Nutritionist</li> <li>Certified Nutrition Support Clinician </li> <li>Certificate of Training in Adult Weight Management</li> </ul> <div> </div>Londre<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/romi-londre-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7919B2F8260054ECC4308684471EEEDB" alt="Romi Londre RDN" width="280" height="280" DisableNVelocity="true" />Romi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15183670Romi Londre, RDN, CD1{2BEE5070-65FF-4406-9E59-103E06C5A535}<img src="/-/media/national-files/images/hometown-health/2021/tacos-on-plate.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BA59F81039E94AB073988993E3F34909" alt="Tacos on plate" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller5/26/2021Parents often think to protect their children's skin with sunscreen when going outside. But what about protecting their eyes? Do children need sunglasses?Do children need sunglasses?<p>Children spend a lot of time outside enjoying school recess, sports and playtime. You likely send them outside with sunscreen to protect their skin. But what about protection for their eyes? Do children need to wear sunglasses?</p> <p>Children receive more annual sun exposure than adults. This increased exposure to sunlight increases risk of eye damage from ultraviolet (UV) light — an invisible electromagnetic radiation emitted by the sun. Unlike adult eyes, children's eyes are still maturing and cannot filter out the harmful UV rays as effectively.</p> <p>Children's eyelids and skin around the eye are delicate and more vulnerable than adult skin. Damage from UV rays builds up over time. Long-term eye problems not specific to children could include <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/cataracts/symptoms-causes/syc-20353790" target="_blank" title="Opens in a new window.">cataracts</a> and <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/wet-macular-degeneration/symptoms-causes/syc-20351107" target="_blank" title="Opens in a new window.">age-related macular degeneration</a> that can blur vision, dull colors and lead to the development of a pterygium, which is a noncancerous growth of tissue on the surface of the eye.</p> <p>There also are some short-term physical side effects from too much UV light, including photokeratitis, also known as "snow blindness." This occurs when UV rays reflect off sand, water, ice and snow, or if you stare at the sun. Photokeratitis is like having a sunburned eye.</p> <p>Fortunately, sunglasses will protect the skin around the eye and the eye itself. Consider having your children wear sunglasses every day. UV rays can still damage eyes on cloudy days.</p> <h2>What to look for in sunglasses</h2> <h3>Keep these tips in mind with selecting sunglasses for your children:</h3> <h4>1. Look for UV protection.</h4> <p>Sunglasses should conform to the American National Standards Institute's guideline ANSI Z80.3, which specifies UV protection and impact protection. Choose sunglasses that block 99%–100% of both UVA (long-length) and UVB (short- length) rays. Look for large wraparound-style sunglasses that cover a lot of skin. If your children need to wear corrective lenses, you may want to consider photochromic lenses, also called transition lenses, to eliminate the need for sunglasses. Photochromic lenses automatically change from clear lenses to darkened lenses in the presence of sunlight. These lenses block 100% of the sun's UV rays.</p> <h4>2. Make sure the sunglasses are durable.</h4> <p>Active children need sunglasses made of impact-resistant polycarbonate with scratch-proof lenses. Frames should be bendable but unbreakable. Make sure the fit is snug.</p> <h4>3. Consider activities.</h4> <p>Some sunglasses come with amber or green lenses and can increase contrast, which may be useful for sports.</p> <h4>4. Let kids choose.</h4> <p>Kids are more likely to wear sunglasses if they've been allowed to pick them out. Let them choose among a few pairs of sunglasses.</p> <h4>5. Be the keeper of the sunglasses.</h4> <p>To prevent the sunglasses from being lost, broken or forgotten, parents may want to consider keeping their children's sunglasses in a safe place when they are not being worn.</p> <h4>6. Listen to your children or observe them.</h4> <p>If your children resist wearing glasses or sunglasses, observing their behavior or talking to them further might give you a clue to the barriers, such as poor fit or discomfort while wearing them.</p> <h4>7. Set a good example.</h4> <p>Your eye health is important. Set a good example for your children by wearing your sunglasses consistently, and make wearing them part of your children's routine.</p> <p>As an added protection, have your children wear wide-brimmed hats and sunscreen to further reduce their UV exposure. Sunglasses block UV rays that come through the lenses. UV rays also can reflect off surrounding surfaces and damage skin around the eyes, ears, forehead and cheeks. An appropriate hat and sunscreen can block the sun from above and from the sides.</p> <p><a href="/providers/nitika-arora-mbbs">Nitika Arora, M.B.B.S.</a>, is a glaucoma specialist in <a href="/services-and-treatments/ophthalmology" target="_self" title="Opens in same window.">Ophthalmology</a>, and Angela Schneider is an optician in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</p>M.B.B.S.<p><strong>Education</strong></p> <ul> <li>Kasturba Medical College</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>RML Hospital</li> <li>University of Illinois College of Medicine</li> <li>Ophthalmology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Research, Mayo Clinic School of Graduate Medical Education</li> <li>Glaucoma, Mayo Clinic School of Graduate Medical Education</li> </ul> <div><strong>Memberships</strong></div> <ul> <li>American Academy of Ophthalmology</li> <li>American Glaucoma Society</li> <li>Women in Ophthalmology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Ophthalmology, Mayo Clinic College of Medicine and Science</li> </ul>Arora<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/nitika-arora-mbbs.jpg?h=280&iar=0&w=280&sc_lang=en&hash=9675C67908761C784DE1E007AA073959" alt="Nitika Arora, M.B.B.S." width="280" height="280" DisableNVelocity="true" />{14B42962-0BAD-44FB-8670-D80CDFEE2C79}Nitika<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15500586Nitika Arora, M.B.B.S.1{C5680DDD-C649-4B63-AFCC-B52A244736B7}<img src="/-/media/national-files/images/hometown-health/2021/child-with-sunglasses-bucket-hat.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A0606E5CAA00427F77825B06E52D9761" alt="Child wearing sunglasses and bucket hat" width="660" height="370" DisableNVelocity="true" />Eye HealthYour eyes are responsible for providing you with vision, perhaps the most important of the senses. However, the eye is a delicate and complicated structure that needs protection. The ugly truth is that eye injuries can happen at any time and place.Dawn Haller1/18/2023Running doesn't require much gear, but well-fitting, running-specific shoes are a must. Start by shopping at a specialty shoe store and keep these expert tips in mind to ensure a good fit.Expert tips for running shoe fit<p>Congratulations on setting a goal to run a long-distance race. You've just joined a group of more than 60 million people in the U.S. who participate in organized runs and races. Running doesn't require much gear, but well-fitting, running-specific shoes are a must.</p> <p>Someone training for a long-distance run, such as a marathon, can log 800 or more miles before a race. With your feet enduring this kind of mileage, it's essential to choose the appropriate footwear to maintain the health of your feet and prevent injury.</p> <h2>Shop in the evening</h2> <p>Throughout the day, your feet retain fluid, causing them to swell. For this reason, it's best to go shoe shopping late in the day or evening, when swelling is at its maximum. This increases the likelihood of choosing a fit that's comfortable throughout the day.</p> <h2>Check out specialty shoe stores</h2> <p>Specialty shoe stores offer valuable services, including in-store fittings and measurement, unique styles, extended sizes, shoes with varying levels of cushion and special inserts. Experienced store associates help customers determine appropriate shoe size, style and support to maximize comfort and functionality.</p> <p>Since you're starting a running program, ask about shoes designed especially for road running. These shoes tend to have flatter, smoother soles that create a consistent surface for running on roads, sidewalks, tracks and treadmills.</p> <h3>In this video, physical therapist Beau Johnson explains how movement pattern affects running shoe choice and fit:</h3> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/GyO0sS5zRd8" title="Movement pattern and running shoes" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <h2>Not all brands are equal</h2> <p>Shoe size can slightly vary from brand to brand. Don't be afraid to venture up or down a half or full size if you're trying a new brand or a new style from a familiar brand.</p> <h2>Choose the right size and fit</h2> <p>More than two-thirds of the population has one foot that's larger than the other. This rarely exceeds one-half size. However, this should be considered when buying new shoes.</p> <p>Always choose your size based on the fit of the larger foot, since the fit of the smaller foot can be easily adjusted by adding an insert or arch support. That's why it's important to try on both shoes. If a shoe fits properly, there should be a half-inch of space between your longest toe and the front of the shoe, leaving plenty of room to wiggle your toes.</p> <p>When trying on shoes, bring your running socks and any custom orthotics.</p> <h2>Accommodate deformities</h2> <p>Common foot deformities, including bunions and hammertoes, can pose challenges when it comes to footwear. Luckily, many brands offer shoes that are available with extra width and depth to accommodate these deformities, and prevent painful corns and calluses from developing. Specialty shoe stores also may provide stretching to accommodate a deformity.</p> <h2>Lace shoes correctly</h2> <p>How you lace your shoes can improve the fit. To help lock your heel in place, try the runner's loop. To relieve pressure points on the top of your foot, window or box lacing might work best for you.</p> <h2>Take shoes for a test spin</h2> <p>Take a stroll around the store, paying attention to any rubbing or discomfort as you stand, walk or jog in place. If a shoe is uncomfortable in the store, it likely will be uncomfortable after wearing it for a month or two. Running shoes that feel right in the store shouldn't need to be broken in.</p> <h2>Know when to buy a new pair</h2> <p>Your shoes are going to get a workout as you train. In general, a pair of running shoes lasts 400 to 500 miles or three to four months. Keep an eye on the midsoles and outsoles. If they're compressed or worn, it's time to buy a new pair.</p> <p>If you have questions about foot health, talk with your health care professional or schedule an appointment with a podiatrist. Because podiatrists specialize in foot issues, they can provide the best recommendations based on your specific needs.</p> <p><em><a href="/providers/stephanie-kvas-dpm" target="_self" title="Opens in same window.">Stephanie Kvas, D.P.M.</a>, is a <a href="/services-and-treatments/podiatry" target="_self" title="Opens in same window.">podiatrist</a> in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a> and <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><ul> <li>Ankle arthroscopy</li> <li>Arthritic conditions</li> <li>Bunion surgery</li> <li>Community education and outreach</li> <li>Community health and wellness</li> <li>Diabetic wound care</li> <li>Flatfoot reconstruction</li> <li>Hammertoe surgery</li> <li>Limb salvage</li> <li>Pediatric foot and ankle conditions</li> <li>Reconstructive foot and ankle surgery  </li> <li>Sports injuries</li> <li>Traumatic fracture care</li> </ul>D.P.M. <p>I am committed to developing a meaningful patient-doctor relationship with each of my patients. I encourage patients to take an active role in their medical care and work with them to select a treatment plan that is right for them. </p> <p>As a Minnesota native, I'm exceptionally excited to join Mayo Clinic Health System in New Prague. My extensive training in reconstructive foot and ankle surgery has prepared me for my role as a surgical podiatrist at Mayo Clinic Health System. </p> <p>I look forward to providing foot and ankle care to the region and being an active member of the community. </p><p><strong>Education</strong></p> <ul> <li>Midwestern University Arizona College of Podiatric Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Podiatric Medicine & Surgery, Reconstructive Rearfoot/Ankle, Hennepin County Medical Center</li> </ul> <p><strong>Certification</strong></p> <ul> <li>State of Minnesota Board of Podiatric Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Foot and Ankle Surgeons</li> <li>American Podiatric Medical Association</li> <li>Minnesota Podiatric Medical Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Podiatric Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Kvas<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/stephanie-kvas-dpm.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A7F1FBFFDD180559BD4211C661476E99" alt="Stephanie Kvas DPM" width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Utilization+of+Fluorescence+Microangiography+in+Pediatric+Acute+Compartment+Syndrome%3A+A+Case+Report" target="_blank" title="Opens in new window. ">Utilization of Fluorescence Microangiography in Pediatric Acute Compartment Syndrome: A Case Report</a>, January 2020</li> <li><a rel="noopener noreferrer" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Utilization+of+Fluorescence+Microangiography+in+Pediatric+Acute+Compartment+Syndrome" target="_blank" title="Opens in new window. ">Utilization of Fluorescence Microangiography in Pediatric Acute Compartment Syndrome: A Case Report</a>, February 2019</li> </ul>{ED85D0D4-A69F-4AFC-8DF7-CC90B84DFB35}Stephanie <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21681643Stephanie Kvas, D.P.M.1{D170DE7F-251A-4290-9CC3-0A9B8D67B28A}<img src="/-/media/national-files/images/hometown-health/2023/trying-on-running-shoes.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B34DF51488BA1821F18A775211D84D93" alt="Trying on running shoes" width="660" height="370" DisableNVelocity="true" />Foot HealthPodiatry is a branch of medicine devoted to the study of diagnosis, medical and surgical treatment of disorders of the foot, ankle and lower extremity.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller10/3/2022With a stroke, every minute counts. If you suspect someone is experiencing a stroke, conducting a FAST test can help save their life and prevent long-term disabilities.Is it a stroke? How to know and help<p>Many emergencies give you warning signs before they become life-threatening. For example, heart attacks often come after chest pain and severe allergic reactions, or anaphylaxis — often beginning with hives or swelling.</p> <p>But stroke symptoms can arise suddenly, leaving you a small window of time to react effectively. It's important to act immediately if you suspect someone is having a stroke.</p> <h2>Symptoms that may signal a stroke include:</h2> <ul> <li>Sudden weakness, numbness or paralysis on one side of the body</li> <li>Sudden difficulties with speech or understanding speech</li> <li>Visual impairment affecting one or both eyes</li> <li>Issues with balance, feeling dizzy or having difficulty walking</li> <li>Overwhelming headaches with no clear cause or decreased responsiveness</li> </ul> <h3>A simple way to tell if someone is having a stroke is to complete the FAST test:</h3> <ul> <li><strong><span style="text-decoration: underline;">F</span>ace</strong><br /> Ask the person to smile. Is it abnormal or drooping on one side?</li> <li><strong><span style="text-decoration: underline;">A</span>rm</strong><br /> Ask the person to extend their arms straight out from the body. Can the person hold both arms parallel? Does one arm drop downward?</li> <li><strong><span style="text-decoration: underline;">S</span>peech</strong><br /> Ask the person to repeat a simple sentence, such as "The sky is blue." Were the words missed? Is the speech slurred?</li> <li><strong><span style="text-decoration: underline;">T</span>ime</strong><br /> If you can answer yes to one or more of these questions, it's time to call 911.</li> </ul> <p>If the person stops breathing, begin CPR. If they vomit, turn their head to the side to prevent breathing in any material and choking. That's why it's important to keep anyone who may be having a stroke from eating or drinking.</p> <p>With a stroke, every minute counts, so always seek medical attention immediately if you think someone may be having a stroke. The sooner you act, the greater the chance of survival and preventing long-term disabilities.</p> <h2>Learn more about stroke:</h2> <ul> <li>Print a <a href="/-/media/local-files/eau-claire/documents/medical-services/neurology/what-to-know-about-stroke.pdf?sc_lang=en&hash=2CE70A380EC23B3E31C7D49C44072E36" target="_blank" title="Opens in a new window.">"What to know about stroke"</a> flier.</li> <li>Find out <a href="/hometown-health/speaking-of-health/stroke-what-it-is-and-the-different-types" target="_self" title="Opens in same window.">what a stroke is and the different types</a>.</li> <li>Discover <a href="/hometown-health/speaking-of-health/women-and-stroke-what-you-need-to-know" target="_self" title="Opens in same window.">what you need to know about women and stroke</a>.</li> </ul> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2021/couple-looking-at-tablet-on-table.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8CAEB01BECABEF9ABD6B5CADA3571D84" alt="Couple looking at tablet on table" width="660" height="370" DisableNVelocity="true" />StrokeAs one of the leading causes of death in the U.S., stroke will affect 80% of families during their lifetimes, according to the National Stroke Association. And the faster care you receive for stroke, the better. Learn more about stroke prevention, symptoms and treatments here.Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Dawn Haller5/14/2021The goal of total knee replacement is to get you active again without pain or restrictions. Here's how to know when it’s time for surgery.Is it time for a total knee replacement?<p>Climbing stairs has become an ordeal. Taking the dog for a long walk is out of the question. Squatting to pick up a grandchild just doesn't happen anymore. When you're not able to do the things you want — and love — to do, your body may be telling you it's time for a total knee replacement.</p> <p>A total knee replacement is a major surgery that requires a big commitment on your end to recover from it. For the first three months after surgery, you'll be healing and doing exercises to build strength and improve your range of motion. Full recovery from a total knee replacement takes a up to a year.</p> <h4>Before you and your orthopedic specialist decide it's time, you'll want to give noninvasive therapies a chance, including:</h4> <ul> <li>Modifying your activities.</li> <li>Taking pain relievers, such as acetaminophen.</li> <li>Bracing your damaged knee.</li> <li>Undergoing cortisone injections.</li> <li>Using a cane or walker.</li> <li>Working with a physical therapist.</li> </ul> <p>There's no age range for having a total knee replacement. It's a matter of decreasing function and increasing pain that matches up with what X-rays of your knee are showing. For instance, if you're 50, have bad arthritis and are unhappy with your quality of life, then it's reasonable to undergo a total knee replacement to regain function and mobility at a younger age.</p> <p>When you decide you're ready, and you've "checked all the boxes" for appropriate noninvasive therapies, then it's time to plan for a total knee replacement. Since this is most commonly an elective surgery, you can time it to fit your work and home calendars for when you'll have a three-month stretch to devote to recovery.</p> <h4>You'll also consult with an orthopedic surgeon and begin preparing for surgery by:</h4> <ul> <li>Undergoing a physical check up and any needed tests.</li> <li>Ensuring your diabetes is under control, if applicable.</li> <li>Losing weight or stopping smoking, if recommended.</li> <li>Working with a physical therapist on a series of muscle-strengthening exercise so your leg is as strong as possible going into surgery.</li> <li>Consulting with an occupational therapist to learn what adjustments and aids may make your recovery at home safer and easier.</li> <li>Arranging for someone to care for you when you get home.</li> <li>Undergoing imaging so your surgeon has the latest picture of your knee.</li> </ul> <p>Depending on a number of factors, you may be a good candidate for <a href="/hometown-health/speaking-of-health/same-day-joint-replacement-surgery-possible" target="_self" title="Opens in same window.">same-day surgery</a>. Be sure to discuss this option with your surgeon. Otherwise, expect to spend one or more nights in the hospital.</p> <p>The goal of a total knee replacement is to get back to the activities you've been missing and live the life you want to live without pain or restrictions. You'll know when it's time.</p> <p><em><a href="/providers/marcus-greatens-md" target="_self" title="Opens in same window.">Marcus Greatens, M.D.</a>, is an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgeon</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Complex primary hip and knee replacements</li> <li>Complex revision hip and knee replacements</li> <li>Periprosthetic fractures</li> <li>Primary total hip and knee replacements</li> <li>Prosthetic joint infection management</li> </ul>M.D.<p>I am comfortable with the full spectrum of hip and knee replacement surgery. This ranges from routine primary (first-time) joint replacements to complex revision of failed joint replacements. I strive to understand each patient’s individual situation, symptoms and goals to provide the most accurate, attainable plan for managing joint pain. The overarching goals of all of my surgeries are to relieve pain, improve function and allow patients to return to the activities they most enjoy.</p> <p>Outside of work I enjoy spending time outdoors camping, hiking, fishing and biking. I am a Wisconsin native, and my wife and I love supporting local businesses and experiencing all the amazing things this state has to offer. We also enjoy cooking and spending time with family, friends and our rescue pup.</p><p><strong>Education</strong></p> <ul> <li>University of Wisconsin School of Medicine and Public Health</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Orthopedic Surgery, University of Michigan</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, University of Michigan</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Adult Reconstruction Surgery, University of Colorado</li> </ul> <p><strong>Certification</strong></p> <ul> <li><strong> </strong>American Board of Orthopedic Surgery</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Orthopedics, Mayo Clinic College of Medicine and Science</li> </ul>Greatens<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/marcus-greatens-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=E55A1DBDC6CF7CD84DBAFCEE5EEA0F62" alt="Marcus Greatens, M.D." width="280" height="280" DisableNVelocity="true" />{788B98DB-7493-41F5-88CB-DA59E4287DAE}Marcus<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21343454Marcus Greatens, M.D.1{DEF55970-853F-4E96-9A4D-3413874FF059}<img src="/-/media/national-files/images/hometown-health/2021/hands-holding-knee-replacement.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E92AA99ECDA6CCC7C4851EDC0FAF1EAD" alt="Hands holding knee; total knee replacement" width="660" height="370" title="Hands holding knee; total knee replacement" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller5/20/2021Ankle injuries are common in sports and everyday life. Here's how to know if yours is a sprain or break.Is your injury a sprain or break?<p>Whether you're a competitive athlete, a weekend warrior or just enjoy spending time outdoors, chances are you've rolled your ankle at some point and wondered whether it was broken or sprained.</p> <p>Ankle injuries are common in sports and everyday life, and they come in a variety of patterns, ranging from simple to severe.</p> <p>Sprains are often billed as less severe. But a sprained ankle can be just as painful as a broken one.</p> <p>A sprain is an injury to a ligament. Ligaments are bands of tissue that attach two bones together at a joint. They provide stability to the joint, while allowing it to bend. When a sprain occurs, it can be very painful to bend or put weight on the ankle. A common misconception is that if you can put weight on the ankle, then it's not broken. However, there are situations where the ankle can be broken, and it's still possible to put weight on it.</p> <p>So how can you tell if your ankle is broken or sprained? If there's any deformity of the ankle, that indicates the ankle is broken. If the ankle doesn't look deformed, then the only way to really know is to get X-rays.</p> <p>In the case of a sprain, the vast majority will heal with rest, ice, anti-inflammatory medications and sometimes wearing a walking boot. While return to activity varies based on the severity of the sprain, that's generally achieved within two weeks for minor sprains and up to six weeks for more severe sprains.</p> <p>How to manage a broken ankle depends on the severity of the break. This is mainly determined by whether the bones of the ankle have shifted or changed position. If they didn't move and the ankle joint is stable, then the treatment can look similar to a severe sprain. For more unstable or severe injuries, surgery is often required to restore alignment of the bones. Recovery from this type of injury can often take three months or longer.</p> <p>Unfortunately, there is no easy way to determine whether an ankle injury is a sprain or break. If in doubt, it's always best to see a provider, and undergo an exam and X-rays, to determine the type of injury.</p> <p><em><a href="/providers/timothy-oconnor-md" target="_self" title="Opens in same window.">Timothy O'Connor, M.D.</a>, is an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgeon</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Adult and pediatric fractures</li> <li>Geriatric fractures</li> <li>Hip and knee replacement</li> <li>Nonunion (permanent failure of healing following a broken bone)</li> <li>Orthopedic trauma/fracture surgery</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Georgetown University School of Medicine</li> <li>Master's of Public Health, Epidemiology, University of Minnesota School of Public Health</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, University of Wisconsin Hospital and Clinics</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Orthopedic Trauma, Regions Trauma Center/University of Minnesota</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Orthopedic Surgery, American Board of Orthopedic Surgery</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Orthopaedic Surgeons</li> <li>Orthopaedic Trauma Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Orthopedics, Mayo Clinic College of Medicine and Science</li> </ul>O'Connor<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/tim-oconnor-md.jpg?h=200&iar=0&w=200&sc_lang=en&hash=A51CDB4874C792AB46122646EAD602A8" alt="Tim O'Connor, M.D." width="200" height="200" DisableNVelocity="true" />Timothy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16053567Timothy O'Connor, M.D.1{DEF55970-853F-4E96-9A4D-3413874FF059}<img src="/-/media/national-files/images/hometown-health/2021/holding-ankle-with-pain.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0830B3467C0037899EA5D71062D5CADA" alt="Holding ankle with pain" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller6/1/2022If you've been diagnosed with benign prostatic hyperplasia (BPH), it's time for you and your provider to talk about treatment options.Men's health: How is benign prostatic hyperplasia treated?<p>If you've been diagnosed with benign prostatic hyperplasia (BPH) — noncancerous tissue growth within the prostate — it's time for you and your health care team to talk about treatment options. These options depend on the severity of your symptoms, which can range from having a weak urine stream to not being able to urinate at all. Most treatments are done in the outpatient setting, including your provider's office, while others may require a hospital stay.</p> <h2>Behavior modifications</h2> <h4>If you're experiencing bothersome, but not severe, symptoms, such as having a weak urine stream or frequently getting up at night to urinate, your provider may have you start with behavior modification, including:</h4> <ul> <li><strong>Changes to your diet</strong><br /> Some foods, such as chocolate, citrus, carbonated beverages and caffeine, can irritate your bladder, which can increase your urge to urinate. Cutting back on these foods may ease your symptoms.</li> <li><strong>Fluid intake</strong><br /> Reducing the amount of fluid you drink before bedtime can decrease your need to urinate during the night.</li> <li><strong>Timed urination (voiding)</strong><br /> Holding your urine also can irritate your bladder, so making a point to urinate every hour-and-a-half to two hours can reduce the urge to go "now."</li> </ul> <h2>Medications</h2> <p>If these behavior modifications no longer work as effectively for you, your health care provider may prescribe a medication, which you'll need to take every day.</p> <h4>There are a number to choose from to give you the best outcomes, including:</h4> <ul> <li><strong>Alpha blockers</strong><br /> These drugs relax muscles in the bladder and prostate and open up the urinary channel to reduce blockage. There are multiple types of alpha blockers, but Flomax (tamsulosin) specifically targets the prostate. Side effects include decrease in blood pressure, dizziness and lightheadedness. They also can cause semen to go back into the bladder instead of the penis (retrograde ejaculation). This may be startling, but it's harmless.</li> <li><strong>5-alpha reductase inhibitors</strong><br /> These medications work to shrink the prostate by lowering the production of a specific hormone. They're only prescribed for men with higher prostate-specific antigen (PSA) levels and larger prostates. There are more side effects, and it may take six to nine months to see any results. Men may have a lower sex drive, and some will experience erectile dysfunction.</li> </ul> <h2>Surgical procedures</h2> <p>You and your health care team may decide that in-office therapies or surgery would be the best treatment option for you. They are done to shrink or remove overgrown prostate tissue. This can relieve bladder obstruction caused by an enlarged prostate. </p> <p>Minimally invasive procedures, also known as therapies, are best for people with smaller prostates who can't tolerate anesthesia or are concerned with preserving ejaculation and erections. The least invasive options can be done in your provider's office or in an operating room. These are known as transurethral procedures and don't require an incision.</p> <p> Some treatments work better than others, depending on your symptoms, treatment goals and the size of your prostate. Most of these treatments preserve sexual function and have little or no impact on erectile or ejaculatory function.</p> <h4>Talk with your health care team about which of the following options might be best for you:</h4> <ul> <li><strong>Temporarily implanted nitinol device</strong><br /> This procedure reshapes the tissue of the prostatic urethra and the bladder neck to create a wider channel through which urine can flow. A nickel titanium device is inserted into the prostatic urethra in a narrow, folded configuration. As the device expands, it exerts gentle pressure to reshape the prostatic urethra and opening of the bladder. After five to seven days, the device is removed.</li> <li><strong>Prostatic urethral lift PUL</strong><br /> This procedure reshapes the prostate using a small, permanent implants to compress and lift the side of the enlarged prostate. This increases the opening of the urethra.</li> <li><strong>Steam therapy</strong><br /> This therapy, also known as uses steam to reduce the size of the prostate. During the treatment, a tiny needle is inserted into the urethra and positioned within the prostate gland. In nine seconds, the needle produces a 2-centimeter-wide steam ball that shrinks surrounding prostate tissue.</li> <li><strong>Transurethral resection of the prostate TURP and photo selective vaporization PVP</strong><br /> During a TURP, a lighted scope is inserted into the urethra and the surgeon uses an electric loop to remove all but outer part of the prostate. TURP generally relieves symptoms quickly, and most men have a stronger urine flow soon after the procedure. PVP is laser therapy, also called transurethral electroevaporation of the prostate, and performed in an operating room under anesthesia. A surgeon inserts a thin, tube-like instrument into the urethra. This instrument has a lens, light and tool that sends out an electrical current to destroy prostate tissue. Heat from the electrical current seals small blood vessels, reducing the risk of bleeding. This procedure destroys or removes overgrown prostate tissue and is a good choice if you need to stay on blood thinners.</li> <li><strong>Prostate enucleation BipoLEP or HoLEP</strong><br /> This procedure removes nearly the entirety of the prostate gland without an incision. It is often a good option for patients with especially large prostates, the inability to stop blood thinners or in significant urinary retention. A thin instrument is inserted into the urethra. Then a laser cuts the prostate tissue into small removable pieces. Enucleation of the prostate can be performed with either bipolar plasma energy or light energy. These are known as <a href="/hometown-health/speaking-of-health/treatment-for-enlarged-prostate" target="_self" title="Opens in same window.">BipoLEP</a> and <a href="/hometown-health/speaking-of-health/laser-based-prostate-procedure-treats-bph" target="_self" title="Opens in same window.">HoLEP</a>.</li> <li><strong>Prostatectomy</strong><br /> This minimally invasive surgery removes tissue blocking the flow or urine. It usually requires a one-night stay in the hospital and is done laparoscopically through a small incision in your side, most often using a surgical robot.</li> </ul> <p>Wherever you are on the range of symptoms, there are treatment options that can relieve them. Be sure to discuss treatments thoroughly with your provider, asking any questions that will help you make the best choice.</p> <p><a href="/services-and-treatments/urology" target="_self" title="Opens in same window."><strong>Find a urology specialist near you.</strong></a></p> <p><em><a href="/providers/ross-avant-md" target="_self" title="Opens in same window.">Ross Avant, M.D.</a>, is a <a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">urologist</a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a> and <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota. He also cares for patients at Mayo Clinic in <a href="/locations/rochester" target="_self" title="Opens in same window.">Rochester</a>, Minnesota.</em></p><ul> <li>Benign and malignant scrotal conditions</li> <li>Benign prostatic hyperplasia/enlarged prostate</li> <li>Bladder cancer</li> <li>Erectile dysfunction</li> <li>Gross and microscopic hematuria</li> <li>Management of kidney stones</li> <li>Minimally invasive/robotic surgery for treatment of prostate cancer and kidney cancer</li> <li>Vasectomy</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Louisiana State University Health Sciences Center, School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>General Surgery, Mayo School of Graduate Medical Education, Mayo Clinic College of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Urology, Mayo School of Graduate Medical Education, Mayo Clinic College of Medicine</li> <li>Chief resident, Urology, Mayo School of Graduate Medical Education, Mayo Clinic College of Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Medical Association</li> <li>American Urology Association</li> </ul>Avant<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/ross-avant-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=54DB2876B3B708B3760C7C9DE50B9406" alt="Ross Avant MD" width="280" height="280" DisableNVelocity="true" />Ross<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16235801Ross Avant, M.D.1<img src="/-/media/national-files/images/hometown-health/2021/man-sitting-on-exam-table-talking-to-doctor.jpg?h=370&iar=0&w=660&sc_lang=en&hash=004FE1D1F9FF5DE1946B57AF85E2A896" alt="Man sitting on exam table talking to doctor" width="660" height="370" DisableNVelocity="true" />Prostate HealthProstate cancer is the most common cancer diagnosed in men. You may have friends or family members who have been diagnosed with prostate cancer, and this may make you wonder about what you can do for prostate cancer prevention.Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Dawn Haller5/12/2021While many women talk about breastfeeding, stretch marks and hot flashes, few discuss pelvic organ prolapse and its effects. Get answers to questions about this common condition.Pelvic organ prolapse: What's going on down there?<p>A woman's body changes over time. Some are welcomed and celebrated, while others are surprising or embarrassing. While many women discuss details of breastfeeding, stretch marks, weight gain and hot flashes, few discuss prolapse and how it can affect their lives.</p> <h2>Here are answers to some common questions about this pelvic organ prolapse:</h2> <h3>What is prolapse, and why does it happen?</h3> <p>Prolapse occurs when an organ in your pelvis shifts from its normal position, usually downward or outward. It can affect the organs of the pelvis, including the rectum, bladder, uterus, intestines or vagina.</p> <p>Normally, these organs are held in place by the muscles and connective tissues of the pelvic floor. Prolapse occurs when the pelvic floor becomes weak or if too much pressure is put on the pelvic floor, which then results in shifting of organs in the pelvis.</p> <h3>What are symptoms of prolapse?</h3> <h5>Women can have one or a combination of symptoms, depending on the location and severity of their prolapses:</h5> <ul> <li>A feeling of fullness or pressure in your pelvis and vagina.</li> <li>A bulge of tissue in your vagina that you can see or feel.</li> <li>Leaking urine or difficulty urinating.</li> <li>Urgent need to urinate.</li> <li>Need to cross legs before coughing to prevent urine leaks.</li> <li>Need to physically push a bulge in when urinating to allow urine to pass.</li> <li>Increased pelvic pressure when you strain, cough, bear down or lift.</li> <li>Problems having sexual intercourse.</li> </ul> <h3>Is prolapse common?</h3> <p>Yes. About half of women who have given birth to a child through the vagina have some degree of pelvic organ prolapse. Prolapse can increase with age and is most common after menopause when the body's estrogen levels change. This change in estrogen levels causes pelvic floor ligaments to stretch and organs to shift. While it may be common, it isn't something women need to simply put up with.</p> <h3>Is prolapse just a natural part of aging?</h3> <p>No. It is more common to experience prolapse as you age, but it is not something you just have to live with. Treatment options are available and health care professionals are ready to help.</p> <h3>Can prolapse affect sexual health?</h3> <p>Yes. Prolapse can result in uncomfortable or difficult sex. When considering treatment, it's important to consider how prolapse affects your whole life, including your mental, physical and sexual health. Proper treatment can help correct not only the prolapse, but improve other aspects of your well-being, as well.</p> <h3>Can I prevent a prolapse?</h3> <h5>Maybe. Many factors can increase your risk of prolapse and you can reduce your risk by adopting healthy lifestyle choices:</h5> <ul> <li><strong>Constipation</strong><br /> Continual straining with bowel movements can weaken your pelvic floor muscles and increase your risk of prolapse.</li> <li><strong>Repeated heavy lifting</strong><br /> The connections between your pelvic organs and ligaments can weaken over time because of chronic straining.</li> <li><strong>Pregnancy and childbirth</strong><br /> Women who have had a vaginal or instrument-assisted delivery, multiple pregnancies, or whose infants had a high birth weight have a higher risk of prolapse.</li> <li><strong>Age</strong><br /> Your risk of prolapse increases as you age. This is especially true after menopause, when your body's production of estrogen — which helps keep the pelvic floor strong — decreases.</li> <li><strong>Hysterectomy</strong><br /> Having your uterus removed may contribute to weakness in your pelvic floor, but this is not always the case.</li> <li><strong>Genetics</strong><br /> Some women are born with weaker connective tissues, making them more susceptible to prolapse.</li> <li><strong>Obesity</strong><br /> Women who are overweight or obese are at higher risk of prolapse.</li> </ul> <h3>What treatment options are available?</h3> <p>If you are evaluated for prolapse, your health care team will develop a treatment plan based on the severity of the prolapse and your symptoms. For some women, treatment begins conservatively with pelvic floor physical therapy. In addition, the team may discuss ways to manage constipation, chronic cough or avoiding repetitive lifting and straining.</p> <p>Other treatment plans could include placement of pessary devices that fit into the vagina and support vaginal tissues displaced by prolapse. This is a nonsurgical option to treat prolapse. The health care team can help decide which type of pessary best meets each woman's needs. Finally, surgery can be required, depending on the type and severity of the prolapse, and the health care team will discuss all options available.</p> <h4>Watch this video to learn more about pelvic organ prolapse and treatment options that can make a difference:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/cPHJ_PT1eP4" title="Pelvic organ prolapse" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <h4>Read more about women's health:</h4> <ul> <li><a href="/hometown-health/speaking-of-health/womens-sexual-health-when-being-intimate-hurts" target="_self" title="Opens in same window.">Women's sexual health: When being intimate hurts</a></li> <li><a href="/hometown-health/speaking-of-health/too-dry-for-tampons-now-what" target="_self" title="Opens in same window.">Too dry for tampons: Now what?</a></li> <li><a href="/hometown-health/speaking-of-health/uterovaginal-prolapse-whats-that" target="_self" title="Opens in same window.">Uterovaginal prolapse — What's that?</a></li> </ul> <p><em><a href="/providers/amy-hagen-cnp" target="_self" title="Opens in same window.">Amy Hagen</a>, is an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> nurse practitioner in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em> </p><ul> <li>Family planning</li> <li>Obstetrical care</li> <li>Overactive bladder </li> <li>Preventive healthcare for women</li> <li>Preventive medicine</li> <li>Screening, diagnosis and treatment of sexually transmitted infections</li> <li>Urinary incontinence</li> </ul>APRN, C.N.P.<p>My desire is to help my patients reach the greatest level of health possible. My care includes addressing women’s gynecological and urological needs throughout all stages and years of their life. I focus on how each healthcare concern can affect the individual as a whole — physically and emotionally. I am passionate about patient education, shared decision making, and collaborative care with other colleagues, to ensure my patient's concerns and needs are met.</p> <p>I was born and raised in Minnesota. I am an outdoor enthusiast and enjoy the lakes, camping, hiking, exploring and downhill skiing. I am married with three children, and love trying to keep up with them — they keep me young at heart. My husband and I love to cook and I am always interested in trying new foods!</p><p><strong>Education</strong></p> <ul> <li>Metropolitan State University</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Nurse Practitioner, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Nurse Practitioner, American Academy of Nurse Practitioners</li> </ul> <p><strong>Membership</strong></p> <ul> <li>Minnesota Nurses Association</li> </ul>Hagen<img src="/-/media/shared-files/images/medical-professionals/full/mankato/amy-hagen-cnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B2F81EC99A90EA3ED1654D82D5CCD805" alt="Amy Hagen CNP" width="280" height="280" DisableNVelocity="true" />Amy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14603420Amy Hagen APRN, C.N.P.1{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{54693F31-87AF-4B21-91DB-1DEC1E21F878}<img src="/-/media/national-files/images/hometown-health/2021/mother-bouncing-child-on-legs.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8A63BCBBF1DCAA827AFF9078FEDD2721" alt="Mother bouncing child on legs" width="660" height="370" DisableNVelocity="true" />Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller5/26/2021The next time you're in the grocery store produce section or at the farmer's market, check out the radishes. They pack a lot of flavor and nutrients in a small package.Radishes: Big flavor in a small package<p>The next time you're in your grocery store produce section or at your local farmer's market, check out the radishes. They are available in many colors and shapes. If you want more variety, they are easy to grow in your garden.</p> <p>Radishes are part of the Brassica plant family. These cruciferous vegetables are full of antioxidants that alter the way cancer cells reproduce so they may reduce cancer risk.</p> <p>For their size, radishes are a good source of vitamin C, an antioxidant that may fight cellular damage that can lead to cancer and other diseases. They are full of fiber but low in calories. For big flavor and big nutrition, try adding some radishes to your menu throughout the year.</p> <p>Radishes can be eaten raw, roasted, braised or pickled. Spring radishes may be best when eaten raw, sliced on top of a green salad, grated in a slaw, or dipped in a bit of salt or other dressing. They can be enjoyed year-round when roasted, braised or pickled. If you find radishes to be too spicy, you may find that roasting or braising them mellows their heat.</p> <p>For a simple roasted radish dish, trim the top and stem ends, and rinse with water. After patting dry, toss sliced radishes with salt, pepper and 1 tablespoon of olive oil. Arrange them, cut side down, on a heavy, dark sheet pan or cast-iron skillet, and roast at 450 degrees F for 10 to 12 minutes. The white sides should brown a little but remain firm. A sprinkle of finely chopped garlic or parsley before serving takes the flavor up a notch.</p> <h3>Give these other recipes a try:</h3> <h4>RADISHES WITH DUKKAH</h4> <p>Servings: 12</p> <p>Ingredients</p> <ul> <li>¼ cup pistachios</li> <li>1 tablespoon pine nuts</li> <li>1 tablespoon sesame seeds</li> <li>1 teaspoon coriander seeds</li> <li>1 teaspoon cumin seeds</li> <li>1 teaspoon kosher salt</li> <li>½ teaspoon freshly ground black pepper</li> <li>Radishes (with tops, if possible, for easier dipping)</li> <li>Olive oil (for dipping)</li> </ul> <p>Preheat oven to 350 degrees F. Place pistachios and pine nuts on a rimmed baking sheet and toast for 5 minutes. Add sesame seeds, coriander seeds and cumin seeds, and toast until nuts are golden brown and spices are fragrant, about 5 minutes. Transfer to another pan to cool. Coarsely grind in a blender or food processor with salt and pepper. Serve radishes with olive and dukkah for dipping.</p> <h4>BRAISED RADISHES</h4> <p>Servings: 6</p> <p>Ingredients</p> <ul> <li>1 tablespoon butter</li> <li>2 large shallots, finely sliced</li> <li>1 pound radishes, about 2 bunches, tops trimmed and radishes sliced in half</li> <li>2 tablespoons balsamic vinegar</li> <li>1 tablespoon sugar</li> <li>½ cup vegetable broth</li> <li>½ cup finely chopped Italian parsley</li> <li>¼ teaspoon freshly ground black pepper</li> </ul> <p>Melt the butter over medium-high heat in a wide skillet. Place radishes cut side down in the pan and cook undisturbed for 2–3 minutes or until bottoms begin to brown. Add the shallots and cook, stirring, for another minute. Add the balsamic vinegar and the broth. The liquid should just come up around the sides of the radishes. Cover, lower heat and simmer for 8–10 minutes or until the radishes are tender. Remove the lid and continue to simmer for 3–4 minutes or until the liquid has reduced into a syrupy sauce. Add the parsley and stir to wilt. Season with pepper and serve.</p> <p><em>Susan Leifer is a <a href="/services-and-treatments/nutrition">dietitian</a> in La Crosse, Wisconsin.</em> </p><img src="/-/media/national-files/images/hometown-health/2021/radishes.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C20C214A0B0FDB1B75ED875A139BCCC8" alt="Radishes" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller5/7/2021When Susan Mensch had her first total knee replacement in 2017, she spent three nights in the hospital. This time, she had a new option: same-day surgery.Same-day knee replacement surgery, sister's support equal perfect option<p><em>Susan Mensch (right) recovered from same-day total knee replacement with care from her sister, Karen Senne.</em></p> <p>Two months after her total knee replacement surgery, Susan Mensch went shopping with her sister, Karen Senne. "She didn't have to drop me off at the door, and I didn't have to look for places to sit and rest my knee," Susan says. "It was a such a relief to be able to walk without knee pain."</p> <p>Susan, who is an aide at St. John Vianney Catholic School in Fairmont, Minnesota, knew she was ready for another total knee replacement when walking and standing became more difficult, and going up and down steps brought her to tears.</p> <p>"I wasn't able to monitor the kids at recess like I used to," she says.</p> <p>When Susan had her first total knee replacement in 2017, she spent three nights in the hospital and then went home to an empty apartment. This time, she had a new option: same-day surgery at <a href="/locations/fairmont" target="_self" title="Opens in same window.">Mayo Clinic Health System in Fairmont</a>, where she was the first patient to qualify and take advantage of it.</p> <p>The benefits of same-day surgery include eliminating the chance of picking up an infection or illness during your hospital stay and recovering in your own home.</p> <p>To be a candidate for same-day surgery, you'll need to have someone staying in your home with you for five to seven days after surgery to ensure your safety. Other criteria range from overall general health, the ability to tolerate spinal or local anesthesia, and taking part in "pre-hab" — a consultation that takes place before surgery with physical and occupational therapists who will:</p> <ul> <li>Ensure you know how to use a walker or crutches, and a cane.</li> <li>Teach the exercises you'll need for strengthening your leg and gaining range of motion.</li> <li>Introduce you to aids and equipment that would be useful at home.</li> </ul> <p>On the day of her surgery, Karen drove Susan to the hospital, picked her up when she was out of recovery and brought Susan to her home in Welcome, Minnesota, where she spent just over two weeks.</p> <p>"Having someone to take care of you after surgery is so important," Susan says. "That's a big reason why I was able to qualify for the same-day option. Karen and her husband, Aldo, were so sweet and supportive, and made sure I had everything I needed. Karen even gave me a bell to ring if I needed something." That support included preparing meals, walking with her as she got used to the walker, helping lift her leg into bed, guiding her at-home physical therapy exercises and bathing.</p> <p>Even after she returned to her apartment, Karen drove Susan to her regular outpatient <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapy</a> sessions with therapists <a href="/providers/melissa-sanvig-mspt" target="_self" title="Opens in same window.">Melissa Sanvig</a> and Jay Schmidt. "Pretty quickly, I was able to do a lot on my own. After about six weeks, I was given the OK to drive," says Susan.</p> <p>When Susan had completed her last physical therapy session, she brought cupcakes to her Same-Day Surgery and Physical Therapy teams to celebrate her recovery.</p> <p>"This really was the way to go, especially if you have someone who's willing to give their time to take care of you," Susan says.</p><img src="/-/media/national-files/images/hometown-health/2021/susan-mensch-and-karen-senne.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CFFAA76959FA570FE9977599B5B1320E" alt="Susan Mensch and Karen Senne" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Rehabilitation TherapyRestoring movement and function to people injured or impaired by disease or injury.Dawn Haller5/3/2021You probably know what a heart attack is, but did know you that a stroke is a medical emergency that also could be called a "brain attack?" Here are the details and explanation of the two types of stroke.Stroke: What it is and the different types<p>You probably know what a heart attack is, but did you know there also is a medical emergency that could be called a "brain attack?" It's called a stroke, and it's a serious medical emergency.</p> <p>A heart attack occurs when the blood supply to your heart is blocked. A stroke occurs when the blood supply to your brain is interrupted or cut off. This disrupts the flow of oxygen to your brain and causes brain cells to die in minutes.</p> <h3>The two primary types of stroke are:</h3> <h4>Ischemic stroke</h4> <p>Ischemic strokes are the most common type, occurring in about 87% of strokes. This type occurs when a blood clot blocks blood flow to an area of your brain. Blocked or narrowed blood vessels are caused by fatty deposits that build up in blood vessels, or by blood clots or other debris that travel through your bloodstream and lodge in the blood vessels in your brain.</p> <p>Treatments for ischemic stroke include clot-busting medications and using a guided wire to retrieve blood clots in the blood vessels. These treatments can immediately restore blood flow to brain tissues in some patients.</p> <p>A transient ischemic attack — sometimes known as a ministroke or a TIA — is a temporary period of symptoms similar to those you'd have in a stroke. They're caused by a temporary decrease in blood supply to part of your brain, which may last as little as five minutes.</p> <p>Although transient ischemic attacks don't typically cause lasting brain damage, they should be taken as a serious warning sign that a serious stroke could occur in the future. Approximately 40% of people who experience a transient ischemic attack will go on to have an ischemic stroke.</p> <h4>Hemorrhagic stroke</h4> <p>These strokes occur when a blood vessel leaks or ruptures in the brain. Brain hemorrhages can result from many conditions that affect your blood vessels, including uncontrolled high blood pressure; bulges at weak spots in the blood vessel walls; trauma, such as a car accident; or overtreatment of blood thinners. Hemorrhagic strokes are less common than ischemic strokes, but they are more fatal.</p> <p>Treatment options for hemorrhagic stroke include surgical clipping and coiling of the blood vessel. Patients require close monitoring at the hospital.</p> <p>A stroke is a medical emergency, and prompt treatment is crucial. Early action can reduce brain damage and other complications. Always call 911 at the <a href="/-/media/local-files/eau-claire/documents/medical-services/neurology/what-to-know-about-stroke.pdf?sc_lang=en&hash=2CE70A380EC23B3E31C7D49C44072E36" target="_blank" title="Opens in a new window.">first signs of stroke</a>.</p> <p><a href="/providers/angela-oldenberg-np" target="_self" title="Opens in same window."><em>Angela Oldenberg</em></a><em> is a <a href="/services-and-treatments/neurology" target="_self" title="Opens in same window.">Neurology</a> nurse practitioner in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Memory disorders</li> <li>Sports concussions</li> <li>Stroke</li> </ul>C.N.P.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Nursing, College of St. Scholastica</li> <li>Master's degree, Nursing, University of Wisconsin-Eau Claire</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Adult Nurse Practitioner, American Nurses Credentialing Center</li> <li>Advance Practice Nurse Prescriber</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Neurology, Mayo Clinic College of Medicine and Science</li> </ul>Oldenberg<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/angela-oldenberg-np.JPG?h=280&iar=0&w=280&sc_lang=en&hash=D5AD46D600A370D50EE83A7509D89A54" alt="Angela Oldenberg, N.P." width="280" height="280" DisableNVelocity="true" />{E0BFC8AE-B723-4AB5-93EF-94AD051C52DB}Angela<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14316731Angela Oldenberg, C.N.P.1{2951D78A-CC76-4C49-B556-549282DF4345}|{D68138A4-E93F-4DDA-BA2A-9B9545F14DD3}<img src="/-/media/national-files/images/hometown-health/2021/looking-at-laptop-screen.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2C01492AE9FCAC47B0C2CD9F568E20E1" alt="Looking at laptop screen" width="660" height="370" DisableNVelocity="true" />StrokeAs one of the leading causes of death in the U.S., stroke will affect 80% of families during their lifetimes, according to the National Stroke Association. And the faster care you receive for stroke, the better. Learn more about stroke prevention, symptoms and treatments here.Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Dawn Haller5/28/2021Your hands do an amazing range of motions, but use and age can take a toll. Give your hands a helping hand from your health care provider.When hands need a helping hand<p>Your hands are designed to accomplish a variety of tasks, from writing and fastening buttons to opening a jar or picking up a heavy weight. When they're functioning normally, you can perform your daily activities without a second thought to how much your hands do. When trauma or overuse injuries occur, pain or stiffness can significantly affect your daily routines.</p> <h2>When nerve compression causes decreased function, pain</h2> <p>Carpal tunnel syndrome is one of the most common disorders affecting the hands. The carpal tunnel is a space where a nerve and several tendons pass. When the nerve is compressed, it can cause numbness and tingling in the fingers and even weakness, which can make it difficult to grasp objects. Those with carpal tunnel syndrome can wake up at night to "shake out" the uncomfortable tingling feeling in their hands.</p> <h3>To evaluate for carpal tunnel syndrome, your health care provider may obtain or perform:</h3> <ul> <li>X-rays of your affected hand</li> <li>Electromyography nerve test to determine whether nerves are compressed</li> <li>Two-point discrimination test on your fingertips to identify which fingers have decreased sensation</li> <li>Tinel's test, which involves tapping the nerve in the carpal tunnel at the wrist to see if it causes tingling in your fingers</li> <li>Durkan's test, where your health care provider presses their thumbs over the nerve in the carpal tunnel at the wrist to see if the numbness or tingling gets worse</li> </ul> <p>If these tests confirm carpal tunnel syndrome, your health care provider may recommend wearing a wrist brace at night or having a corticosteroid injection in the wrist, or surgery.</p> <p>Both open and endoscopic surgery relieve compression on the nerve in the carpal tunnel. Endoscopic surgery is less invasive. It's an outpatient surgery performed in an operating room under light sedation. It begins with a small cut on the wrist. A tiny camera is inserted through the incision into the carpal tunnel. The surgeon inspects the tunnel and then uses a blade attached to the camera to cut the transverse carpal ligament ― the roof of the tunnel ― to relieve nerve compression.</p> <h2>Relieving other hand, wrist issues</h2> <p>Another common condition that affects the hands and wrists is osteoarthritis. That occurs when the cushioning cartilage layer between bones wears out.</p> <h5><span style="font-size: 16px; color: #333333;">Several noninvasive treatments can improve arthritis pain, including:</span></h5> <ul> <li>Modifying how you use your hands to reduce pain and improve function. An occupational therapist can help direct these changes.</li> <li>Using oral anti-inflammatory medications or rubbing anti-inflammatory creams onto your skin.</li> <li>Wearing compression gloves, or a wrist or thumb brace.</li> <li>Undergoing corticosteroid injections.</li> </ul> <p>If you continue to have symptoms despite noninvasive treatments, you may want to discuss surgery to fuse or replace bones in your hand or wrist to improve pain and motion.</p> <p>Women in particular can develop arthritis at the base of the thumb. Activities such as opening jars and turning doorknobs become painful and challenging. Noninvasive therapies like those for arthritis in the hand can decrease symptoms. Surgery also can treat this condition, and it involves removing one of the bones that makes up the painful base of the thumb joint.</p> <p>If hand and wrist issues are impairing your quality of life, see your health care provider to discuss which options are best for you.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2021/working-on-crossword-puzzle.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C575317F8C5F3E1D88476AAFF004CA59" alt="Working on crossword puzzle" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller2/27/2023Talking with your primary care provider about as chest discomfort, shortness of breath and fainting can determine if you need a referral to a cardiologist for individualized treatment.When to see a cardiologist<p>Cardiologists specialize in diagnosing and treating diseases or conditions of the heart and blood vessels — the cardiovascular system.</p> <p>If you are concerned about your cardiovascular system, the first step is to discuss your symptoms with your primary care team, who will determine if you need a referral to a cardiologist. You also may be referred to learn about actions you can take to prevent heart disease.</p> <h2>Be aware of heart-related symptoms</h2> <h3>Symptoms that suggest you may need a referral to a cardiologist include:</h3> <ul> <li>Chest discomfort</li> <li>Shortness of breath</li> <li>Swelling in your legs</li> <li>High blood pressure</li> <li>Abnormally fast or slow heart rate</li> <li>Dizziness or fainting</li> <li>Strong family history of premature heart disease or cardiac death</li> <li>Leg pain or ulcers resulting from blood vessel diseases</li> </ul> <p>The cardiologist will evaluate your symptoms, review your medical history and may recommend diagnostic tests to appropriately diagnose the cause of your symptoms and help your cardiology care team evaluate the best form of treatment for you.</p> <h2>Specialized cardiac care plans</h2> <h3>Your individualized treatment plan could include:</h3> <ul> <li><strong>Advice on diet and exercise changes</strong><br /> You can lower your risk of heart disease by eating a low-fat and low-sodium diet, getting at least 30 minutes of moderate exercise most days of the week, quitting smoking, and limiting alcohol intake.</li> <li><strong>Medications</strong><br /> If lifestyle changes alone aren't enough, your cardiologist may prescribe medications to control your condition. The type of medication you receive will depend on the type of heart condition and severity.</li> <li><strong>A cardiac procedure</strong><br /> If medications aren't enough, your cardiology care team may recommend specific procedures or surgery. The type of procedure or surgery will depend on the type of heart condition and the extent of the damage to your heart.</li> </ul> <h2>Types of cardiovascular care</h2> <h3>Cardiology and the treatment of cardiovascular conditions is a complex field, so many cardiologists specialize in different areas, including:</h3> <ul> <li>General cardiology</li> <li>Cardiac imaging ― focused on diagnostic tests to help diagnose cardiovascular conditions</li> <li>Cardiovascular health ― focused on preventing or slowing the progression of cardiovascular conditions</li> <li>Electrophysiology and device therapy ― focused on assessing and treating electrical problems of the heart, including heart arrhythmia</li> <li>Interventional cardiology ― focused on artery and valve blockages</li> <li>Pediatric cardiology ― focused on cardiovascular conditions in patients under 18</li> <li>Vascular medicine ― focused on conditions affecting the arteries and veins</li> </ul> <p>If your cardiologist decides that you need surgery, you may be referred to a cardiovascular surgeon who specializes in operations on the heart, lungs and blood vessels. After you recover from the surgery, you will be sent back to your cardiologist for long-term monitoring and care.</p> <p><em><a href="/providers/robert-houlihan-md" target="_self" title="Opens in same window.">Robert Houlihan, M.D.</a>, is a <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiologist</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a> and <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Cardiac pacing</li> <li>Echocardiography</li> <li>Heart failure</li> </ul>M.D.<p>I strive to treat my patients like they are family and how I would want my family to be treated.</p> <p>I'm an avid outdoorsman and like to go mountain biking, skiing and scuba diving.</p><p><strong>Education</strong></p> <ul> <li>Carver College of Medicine, University of Iowa</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Internal Medicine, University of Iowa Hospitals and Clinics</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, University of Iowa</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Cardiology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Cardiovascular diseases, American Board of Internal Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Cardiology</li> <li>American Medical Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Houlihan<img src="/-/media/shared-files/images/medical-professionals/full/mankato/robert-houlihan-md.jpg?h=200&iar=0&w=200&hash=A68345828CDB01DDEB63FFA76DAE724E" alt="Robert Houlihan MD" width="200" height="200" DisableNVelocity="true" /><ul> <li><a href="https://www.ncbi.nlm.nih.gov/pubmed/12454334" target="_blank" title="Opens in new window. ">Immediate ambulation following diagnostic coronary angiography procedures utilizing a vascular closure device (The Closer)</a>, December 2002</li> <li><a href="https://www.ncbi.nlm.nih.gov/pubmed/12595845" target="_blank" title="Opens in new window. ">Low-risk percutaneous coronary interventions without on-site cardiac surgery: two years' observational experience and follow-up</a>, February 2003</li> </ul>Robert <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>11634278Robert Houlihan, M.D.1{676428F6-179A-4C9B-9B23-5F1E40032A38}<img src="/-/media/national-files/images/hometown-health/2023/using-home-blood-pressure-machine.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D3B3713200FC17CA26DCEA1A683CF1BB" alt="Using home blood pressure machine" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller5/17/2021Although stroke risk increases after age 55, many factors play a role in who has one. Learn about risks and preventive steps you can take to reduce personal risk for stroke.Who is most at risk for a stroke?<p>Strokes don't just affect people over 65. About 34% of all people hospitalized for stroke are younger than 65. While stroke risk increases with age, anyone at any age can have a stroke.</p> <h3>Many potentially treatable factors increase your stroke risk.</h3> <h4>Lifestyle risk factors include:</h4> <ul> <li>Being overweight or obese</li> <li>Physical inactivity</li> <li>Heavy or binge drinking</li> <li>Use of illegal drugs, such as cocaine and methamphetamine</li> </ul> <h4>Medical risk factors include:</h4> <ul> <li>High blood pressure</li> <li>Cigarette smoking or secondhand smoke exposure</li> <li>High cholesterol</li> <li>Diabetes</li> <li>Obstructive sleep apnea</li> <li>Cardiovascular disease, including abnormal rhythm, such as atrial fibrillation</li> <li>Hormone use, such as the use of birth control pills or hormone therapies that include estrogen</li> </ul> <h4>Other factors that you can't control are associated with a higher stroke risk, including:</h4> <ul> <li><strong>Age</strong><br /> People 55 or older have a higher risk of stroke than younger people.</li> <li><strong>Race</strong><br /> African American and Hispanic patients have a higher risk of stroke than people of other races.</li> <li><strong>Sex</strong><br /> Men have a higher risk of stroke than women. Women are usually older when they have strokes, and they're more likely to die of strokes than men. It kills more than twice as many U.S. women as breast cancer each year.</li> </ul> <p>Although strokes are a common cause of death and disability, stroke risk can be reduced significantly through awareness, managing existing medical conditions and living a healthy lifestyle.</p> <p>Taking preventive steps is straightforward. Developing and maintaining healthy habits can make a significant difference in preventing stroke and many other conditions, as well. Exercise at least 30 minutes each day. Eat a diet rich in fruits, vegetables, whole grains and lean sources of protein. Cut down on alcohol consumption, and don't use tobacco products.</p> <p>If you have high blood pressure or high cholesterol, work with your health care team to monitor and lower your values into normal ranges. By making these changes, you won't eliminate your risk completely, but you can considerably reduce your risk of stroke.</p> <p>Learn more about <a href="/hometown-health/speaking-of-health/stroke-what-it-is-and-the-different-types" target="_self" title="Opens in same window.">what stroke is and the different types</a>, and knowing <a href="/hometown-health/speaking-of-health/is-it-a-stroke-how-to-know-and-help" target="_self" title="Opens in same window.">how to know if it's a stroke and help</a>.</p> <p><em><a href="/providers/micah-yost-do" target="_self" title="Opens in same window.">Micah Yost, D.O.</a>, is a <a href="/services-and-treatments/neurology" target="_self" title="Opens in same window.">neurologist</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p> <ul> <li>Vascular and hospital neurology</li> </ul> D.O.<p>When I am not working, I enjoy traveling with family, playing golf and fishing.</p><p><strong>Education</strong></p> <ul> <li>Oklahoma State University Center for Health Sciences</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Internal Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Adult Neurology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Vascular Neurology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Neurology, American Board of Psychiatry and Neurology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Neurology</li> <li>American Heart Association</li> <li>Neurohospitalist Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Neurology,Mayo Clinic College of Medicine and Science</li> </ul>Yost<img src="/-/media/shared-files/images/medical-professionals/full/mankato/micah-yost.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A36D3EA288E3D14D89FF576B6D1070EF" alt="Micah Yost" width="280" height="280" DisableNVelocity="true" /> Micah<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16236858Micah Yost, D.O. 1{954F8C76-231B-4BB6-AB03-24CD0E4834AC}|{D68138A4-E93F-4DDA-BA2A-9B9545F14DD3}<img src="/-/media/national-files/images/hometown-health/2021/couple-on-sofa-holding-hands.jpg?h=370&iar=0&w=660&sc_lang=en&hash=AA99D594B0AF1C1C470CB0E7879A93B3" alt="Couple on sofa holding hands" width="660" height="370" DisableNVelocity="true" />StrokeAs one of the leading causes of death in the U.S., stroke will affect 80% of families during their lifetimes, according to the National Stroke Association. And the faster care you receive for stroke, the better. Learn more about stroke prevention, symptoms and treatments here.Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Dawn Haller5/10/2021Is pain getting in the way of intimacy? If you're experiencing pain during intercourse, learn about the causes, and get treatment options to relieve pain and ease anxiety.Women's sexual health: When being intimate hurts<p>If you experience pain during intercourse, you are not alone. An estimated 40% of women experience painful intercourse at some point in their lives.</p> <p>Dyspareunia is the medical term for pain that occurs immediately before, during or after intercourse but not during other activities. It is important to discuss the pain you are experiencing with your health care provider, even if you don't experience pain every time you have intercourse. There is no minimum amount of time that you should experience discomfort before discussing it.</p> <p>Some women never discuss their concerns, either because they are embarrassed or feel the issue was dismissed or not fully investigated before. A trusted health care provider can help diagnose and treat the underlying issue and prevent symptoms from worsening or progressing into a more complex problem like decreased libido, anxiety or fear of sexual activity.</p> <h4>There are many possible causes of painful intercourse, including:</h4> <ul> <li><strong>Infections</strong><br> Sexually transmitted infections like chlamydia and gonorrhea as well as vaginal infections like yeast and bacterial vaginitis can cause painful intercourse. Your health care provider can provide an accurate diagnosis and appropriate treatment plan to provide relief from your symptoms.</li> <li><strong>Hormonal changes</strong><br> Times of extreme hormonal fluctuation, like pregnancy, breastfeeding and menopause, can contribute to discomfort to the area outside the vagina (vulva) and along the vaginal walls. Your treatment will vary based on the cause of your hormonal changes.</li> <li><strong>Pelvic muscles changes</strong><br> Women's pelvic muscles are at an increased risk of contracting and relaxing at incorrect times due to pregnancy, childbirth, abdominal or pelvic surgeries, sports injuries, trauma or chronic constipation. This can lead to pain during intercourse. Early detection of the issue and beginning a treatment plan is important to prevent a snowball effect of worsening symptoms.</li> <li><strong>Physical changes</strong><br> Uterine fibroids and pelvic organ prolapse are examples of physical changes that can cause discomfort with certain sexual positions. Changes to your skeletal system also could cause dyspareunia, including scoliosis, lumbar spine disease and hip injuries.</li> </ul> <h4>Various treatment options are available, and the treatment right for you will depend on the cause of your dyspareunia:</h4> <ul> <li><strong>Medications</strong><br> Antibiotic or antifungal medications are used if a pelvic or vaginal infection is suspected. For hormonal causes, treatment can include starting or changing contraceptives, or applying creams or other ointments directly to the vulva and vaginal tissue. Some women find relief from medications that target the nerves and muscles of the pelvis, and this can include topical or injectable medications. Do not use over-the-counter preparations without speaking to a health care provider first.</li> <li><strong>Therapy</strong><br> Physical therapy is often helpful for women with dyspareunia due to pelvic muscle or other physical changes. Some therapists specialize in treating the pelvic floor, while others focus on spine or skeletal issues or injuries. Many women with pain experience anxiety related to intercourse, especially if they have a history of trauma or chronic disease. Counseling can help address these concerns, and it is an important part of a treatment plan. But counseling is rarely used alone.</li> <li><strong>Surgery</strong><br> For most women, surgery is not required to resolve dyspareunia, but it is appropriate in some cases. Significant anatomical physical changes or injuries can require surgery to correct the underlying issue. Occasionally, dyspareunia is caused by a combination of conditions and surgery is pursued after all noninvasive treatments have been explored.</li> </ul> <p>If you are bothered by painful intercourse, talk with your primary care or OB-GYN provider about the right treatment plan for you.</p> <h4>Learn more about women's health issues:</h4> <ul> <li><a href="/hometown-health/speaking-of-health/6-contributors-to-bacterial-vaginosis" target="_self" title="Opens in same window.">6 contributors to bacterial vaginosis</a></li> <li><a href="/hometown-health/speaking-of-health/choose-the-birth-control-thats-best-for-you" target="_self" title="Opens in same window.">Choose the birth control that’s best for you</a></li> <li><a href="/hometown-health/speaking-of-health/lets-talk-low-libido" target="_self" title="Opens in same window.">Let's talk low libido</a></li> <li><a href="/hometown-health/speaking-of-health/uterovaginal-prolapse-whats-that" target="_self" title="Opens in same window.">Uterovaginal prolapse — What's that?</a></li> </ul> <p>Becky DeLuca is an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> nurse practitioner in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</p><img src="/-/media/national-files/images/hometown-health/2021/couple-nose-to-nose.jpg?h=370&iar=0&w=660&sc_lang=en&hash=23538943A1FEF9073B4F3F04393CEE2D" alt="Couple nose to nose" width="660" height="370" DisableNVelocity="true" />Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Michele Halterman5/18/2021If you're looking to make the most of your time at home — and prevent obesity — consider unplugging screens and reconnecting with your family. These tips will help you get started.Screen time and body weight — is there a connection?<p>According to an article published by the Academy of Nutrition and Dietetics, kids spend an average of 7.5 hours per day in front of a screen. This equates to 52.5 hours per week with media. For most, that’s more than the time spent with parents. Many kids watch a screen when getting ready for school, during meals, between meals and before bed.</p> <p>Harvard T.H. Chan School of Public Health reports that extensive research proves a connection between TV watching and obesity among children and adults in countries around the world.</p> <p>Studies show that excess TV viewing in childhood predicts risk for obesity well into adulthood. For example, kids who have TV sets in their rooms are more likely to gain excess weight when compared to those who don’t have TVs. Furthermore, marketing of unhealthy foods and beverages also contributes to obesity.</p> <h4>Experts suggest these tips to limit screen time and increase activity:</h4> <ul> <li><strong>Remove any/all screens from bedrooms.</strong><br> Seventy-one percent of kids between the ages of 8 and 18 years have television sets in their rooms. Kids who have TVs in their rooms watch one-and-a-half more hours of TV than kids who don’t.</li> <li><strong>Eat without electronics.</strong><br> Research indicates that families who dine together are healthier, and children show better academic scores.</li> <li><strong>Enjoy screen time on weekends, versus weekdays.</strong><br> Sit down and watch television on the weekend as a family. Ideally, your family should watch two hours or less of TV each day.</li> <li><strong>Develop a family screen time rule.</strong><br> Families should discuss ways of limiting screen time. Come up with ideas for fun, family-oriented activities.</li> <li><strong>Enjoy physical activity after supper.</strong><br> Take a walk as a family, ride bike or engage in an outdoor game.</li> <li><strong>Dance with the kids.</strong><br> Turn the TV, tablet or phone off, turn up the music and have a dance-off.</li> <li><strong>Move about while watching television.</strong><br> Have a contest to see who can do the most pushups or jumping jacks during commercials.</li> </ul> <h4>Read more about slimming screen time:</h4> <ul> <li><a href="/hometown-health/featured-topic/5-ways-slimming-screen-time-is-good-for-your-health" target="_self" title="Opens in same window.">5 ways slimming screen time is good for your health</a></li> <li><a href="/hometown-health/speaking-of-health/6-tips-to-reduce-childrens-screen-time" target="_self" title="Opens in same window.">6 tips to reduce children's screen time</a></li> <li><a href="/hometown-health/speaking-of-health/are-video-games-and-screens-another-addiction" target="_self" title="Opens in same window.">Are video games and screens another addiction?</a></li> <li><a href="/hometown-health/speaking-of-health/children-and-screen-time" target="_self" title="Opens in same window.">Children and screen time: How much is too much?</a></li> </ul> <p><a href="/wellness/slim-your-screen-time" target="_self" title="Opens in same window."><strong>Register for Slim Your Screen Time</strong></a><strong> — a free at-home, self-guided program designed to help you improve your health by reducing screen time. Join at any time.</strong></p> <p>Anne Harguth is a registered <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">dietitian</a> in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</p><img src="/-/media/national-files/images/hometown-health/2021/child-jumping-on-sofa-holding-moms-hands.jpg?h=370&iar=0&w=660&sc_lang=en&hash=28F24636A43A905DEDA96194C1669741" alt="Child jumping on sofa holding moms hands" width="660" height="370" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Michele Halterman9/16/2024ADHD affects millions of children. Learn about the three subtypes of attention-deficit/hyperactivity disorder, treatment options and five behavioral strategies to help your child be successful.5 tips for managing ADHD in children<p>Does your child have difficulty focusing on an activity or display impulsive behavior? When symptoms are severe enough and cause ongoing problems in more than one area of your child's life, it could be a sign of a neurobehavioral disorder, such as <a rel="noopener" href="http://www.mayoclinic.org/diseases-conditions/adhd/home/ovc-20196177" target="_blank" title="Opens in a new window.">attention-deficit/hyperactivity disorder, or ADHD</a>.</p> <p>ADHD is a chronic condition that affects millions of children and often continues into adulthood. ADHD includes a combination of persistent problems, such as difficulty sustaining attention, hyperactivity and impulsive behavior.</p> <p>Children with ADHD also may struggle with low self-esteem, school anxiety, troubled relationships and perform poorly in school. Symptoms sometimes lessen with age. Some people never completely outgrow their ADHD symptoms. However, they can learn strategies to be successful.</p> <h2>ADHD subtypes</h2> <ul> <li><strong>Inattentive ADHD</strong><br /> Formerly referred to as ADD, people with inattentive ADHD display symptoms of inattention, but do not possess symptoms of hyperactivity or impulsivity.</li> <li><strong>Hyperactive/Impulsive ADHD</strong><br /> This subset of ADHD displays symptoms of impulsivity or hyperactivity but doesn't exhibit symptoms of inattention.</li> <li><strong>Combined</strong><br /> People with combined ADHD display symptoms of inattention, hyperactivity and impulsivity. This is the most common subset of ADHD.</li> </ul> <p>Learn more about the <a href="/hometown-health/speaking-of-health/what-is-adhd" target="_self" title="Opens in same window.">three different types of ADHD</a>.</p> <h2>Gender differences with ADHD</h2> <p>ADHD is more commonly diagnosed in boys than girls, but research into ADHD in adulthood suggests an almost equal balance between men and women. A lower diagnosis rate among females in childhood may be because girls with ADHD are more likely than boys to have the inattentive form of ADHD and less likely to show obvious problems.</p> <p>More than half of children who experience ADHD in childhood continue to <a href="/hometown-health/speaking-of-health/navigating-adhd-in-adulthood" target="_self" title="Opens in same window.">have symptoms as adults</a>. Some adults only recognize their ADHD after a child has been diagnosed and begin to see similar behavior in themselves. Some adults seek treatment because their lives spin out of control — financially, at work or at home.</p> <h2>ADHD treatment</h2> <p>While treatment won't cure ADHD, it can help a great deal with symptoms. Treatment typically involves medications and behavioral interventions. Early diagnosis and treatment can make a big difference in outcome.</p> <p>It's also essential to work with a therapist who specializes in ADHD to learn coping mechanisms — beyond medications — that can help with ADHD symptoms and behaviors. A therapist can enhance the effectiveness of the medication and give tools to empower those with ADHD using behavioral, psychological, social, educational and lifestyle interventions.</p> <h2>Behavioral strategies for managing ADHD</h2> <h3>Here are five behavioral strategies to help manage your child's ADHD:</h3> <h4>1. Give praise and rewards when rules are followed.</h4> <p>Children with ADHD often receive and expect criticism more than other children. This can affect their self-esteem. Some days, you might have to look for good behavior, but you should praise good behavior at least five times more often than you criticize bad behavior.</p> <h4>2. Give practical directions or commands.</h4> <p>Make eye contact or gently touch your child's arm or shoulder to get their attention. Give brief, simple steps and short commands that get to the point rather than multiple directions or wordy statements and questions.</p> <h4>3. Establish healthy habits.</h4> <p>If your child is on medication for ADHD, make sure they take it as prescribed. Contact your child's healthcare team if problems arise. Ensure your child is <a href="/hometown-health/speaking-of-health/sleep-an-essential-element-of-success-for-children" target="_self" title="Opens in same window.">getting enough sleep</a>, eating a well-balanced diet consisting of three meals, a snack and adequate fluids daily, and has an outlet for some form of daily exercise. These healthy habits will help your child to feel their best and help minimize ADHD symptoms.</p> <h4>4. Develop routines around homework and chores.</h4> <p>Work together to make a checklist of what needs to be done daily for your child to refer to, including such tasks as chores, getting ready for bed and preparing for school. Encourage your child to use a daily planner so they are aware of all homework assignments. Have an established time and location for doing homework, and use a timer to remind your child to show you how the homework is going two to four times per hour. Factor in brain breaks if your child needs them like movement between tasks or using an appropriate fidget.</p> <h4>5. Help your child build relationships, develop strong social skills and maintain friendships.</h4> <p>Be a good role model for the behavior you want your child to use. Factor in some special time three to five days a week with your child that is conflict-free and does not involve a screen to help maintain a <a href="/hometown-health/speaking-of-health/parenting-a-child-or-teen-with-adhd" target="_self" title="Opens in same window.">solid parent-child relationship</a>. Help your child develop at least one close friendship. With younger children, parents may need to take the lead arranging and hosting play dates or getting kids involved in activities with kids the same age. Get <a href="/hometown-health/speaking-of-health/helping-a-child-with-adhd-develop-social-skills" target="_self" title="Opens in same window.">tips for helping your child develop social skills</a>.</p> <h3>Watch this video about managing ADHD in children:</h3> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/_dhD6ZEpnxQ" title="Managing ADHD in children" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <p><em><a href="/providers/amanda-logan-cnp" target="_self" title="Opens in same window.">Amanda Logan</a> is a nurse practitioner in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><ul> <li>Effective hydration for maturing, dehydrated skin, and collagen building and maintenance</li> <li>Pharmacogenomics</li> <li>Skin care for all ages</li> <li>Using food as medicine for healthy gut, weight loss, and improving fatigue and inflammation</li> </ul>APRN, C.N.P.<p> I like to work with you and want your input. I want to know how we can work together to help you live your best life. Everyone is different and it is in the uniqueness that we can find solutions that are tailored to you. You are the captain of your ship, and I am your navigator. I will help guide and show you your options, but it is you who will ultimately decide your path.</p> <p>I will be open and honest when I see something that may be problematic, need further investigation or could use improvement. I am not opposed to alternative therapies; however, just as with anything you put in the body, even natural therapies have side effects and consequences that should be monitored. I am a big fan of mindfulness, meditating, gratitude, exercise and healthy eating as a basic foundation to good health. </p> <p>I am an avid reader. I read something related to the medical field at least daily, as well as something to stretch the imagination and keep my sense of childlike wonder. I am a huge Harry Potter fan and not ashamed to admit it. Some of my other favorite authors are Jeff Wheeler, Katherine Arden, Kate Quinn and countless others. I'm a huge Simpsons fan, and if I could guess what I was in a past life, it would have to be a dog. I love animals in general, but the best would have to be the dog. How better the world would be if we were all a little more like a dog.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Nursing, Bradley University</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul> <p class="telerik_paste_container" style="border-width: 0px; position: absolute; overflow: hidden; margin: 0px; padding: 0px; left: 3px; top: 66px; width: 1px; height: 1px;"> </p>Logan<img src="/-/media/shared-files/images/medical-professionals/full/mankato/amanda-logan-cnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=855113749ECDCE27DD0FF87769EE15A9" alt="Amanda Logan, C.N.P." width="280" height="280" DisableNVelocity="true" />{3D39AC94-41D4-46AA-9E8E-885783F8246E}Amanda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12858811Amanda Logan, C.N.P.1<img src="/-/media/national-files/images/hometown-health/2021/dad-and-child-washing-dish.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8480BD0D039DFCDE9EA99EA8044C13BD" alt="Dad and child washing dish" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Child DevelopmentWe all want our children to grow up happy and healthy. The reality is most all of them do — but at vastly different rates. Experts across Mayo Clinic Health System see thousands of children each year, and have the experience and resources to know what is normal and what may be cause for closer observation. This includes not only physical and motor skills development, but psychological and social skill advancement.Michele Halterman6/25/2024Confident children believe in themselves and can face new challenges without fear. Learn why these are essential for a happy life and how parents can communicate self-worth using these five messages.Practical ways to raise confident kids<p>As parents, it's only natural that you want to instill confidence in your kids. Confident children believe in themselves and can face new challenges without fear — essential factors for a happy and fulfilling life.</p> <p>Children's confidence depends on hearing specific messages, and parents are best positioned to send them. Confident children know they are worthy of being loved and feel a sense of belonging with their friends and family. Parents communicate this self-worth to their children through verbal and nonverbal messages every day.</p> <h2>Parents interested in increasing their children's self-worth can use these five messages as a starting point:</h2> <h3>1. I delight in being your parent.</h3> <p>Spend one-on-one time with your children doing what they love to do ― and let them lead ― for no other reason but to enjoy being with them. Give your children lots of physical affection in a sincere, natural and age-appropriate way.</p> <h3>2. Your self-worth depends not on what you do, but on who you are.</h3> <p>Praise your children for character traits rather than talents or achievements. Point out what is genuinely good and likable about who they are. When they misbehave, focus on the specific problem behavior instead of communicating that they are wrong. Praise character traits and discipline behavior.</p> <h3>3. You deserve to be treated well; when you are not, you are strong.</h3> <p>When children are hurt and it's not their fault, they need three things: emotional validation, the correct interpretation of what happened and to know they can do something about it. When children are hurt, do not simply feel sorry for them. Instead, work with them on practical ways they can stand up for themselves, such as using their words to stand up to a bully. If children know they deserve to be treated with respect and kindness, their self-worth will not be affected when someone is mean to them.</p> <h3>4. Your feelings are worth being known.</h3> <p>Children who can be their authentic selves will grow in self-confidence. Always encourage your children to show how they are feeling. When children are upset, they can work through it if their feelings are validated. So be a listener rather than a teacher. Try to see things from their perspective and then tell them that you see how they are feeling.</p> <h3>5. You can use your strength to meet challenges.</h3> <p>Let kids take age-appropriate risks to do what they're excited about, even if they might get hurt. If you don't, they might hear that you don't think they are strong enough to do it. Teach your children that they can make their own decisions. Giving them simple choices when they are young teaches them to be confident decision-makers.</p> <h2>Next steps:</h2> <ul> <li>Find a <a href="https://www.mayoclinichealthsystem.org/providers?service=Pediatrics%20and%20Adolescent%20Medicine&populateTracking=True" target="_self" title="Opens in same window.">Pediatric & Adolescent Medicine healthcare professional</a> near you.</li> <li>Get tips for <a href="/hometown-health/speaking-of-health/tips-for-preventing-summer-slide" target="_self" title="Opens in same window.">preventing "summer slide."</a></li> <li>Find more <a href="/topics/parenting" target="_self" title="Opens in same window.">articles about parenting</a>.</li> <li>In this video, learn why I enjoy caring for patients from birth through college age:<br /> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/w_CxtqBMBD0" title="Meet Maegen Storm" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> </li> </ul> <p><em><a href="/providers/maegen-storm-cnp" target="_self" title="Opens in same window.">Maegen Storm</a> is a nurse practitioner in <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">Pediatric & Adolescent Medicine</a> in <a href="/locations/faribault" target="_self" title="Opens in same window.">Faribault</a>, Minnesota.</em></p><ul> <li>Breastfeeding</li> <li>Health promotion of children</li> <li>Pediatric chronic diseases, i.e. asthma, ADHD, depression, anxiety</li> </ul>C.N.P.<p><strong>Education</strong></p> <ul> <li>Master of Nursing degree at Saint Catherine University, St. Paul, Minnesota</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Certified pediatric nurse practitioner</li> <li>Certified lactation consultant</li> </ul>Storm<img src="/-/media/shared-files/images/medical-professionals/full/faribault/maegen-storm-cnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=D28412CDBBE6AF6BDD77256E83CFB7E2" alt="Maegen Storm CNP" width="280" height="280" DisableNVelocity="true" />{68BA5C85-D987-4133-8B70-C32E52B1235A}Maegen<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15977226Maegen Storm CNP1<img src="/-/media/national-files/images/hometown-health/2021/kids-in-kitchen-with-parent.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EAC3295B827E34DA7811194AA427A14C" alt="Kids in kitchen with parent" width="660" height="370" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Child DevelopmentWe all want our children to grow up happy and healthy. The reality is most all of them do — but at vastly different rates. Experts across Mayo Clinic Health System see thousands of children each year, and have the experience and resources to know what is normal and what may be cause for closer observation. This includes not only physical and motor skills development, but psychological and social skill advancement.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller5/5/2021Nightmares can be scary. What can you do the next time your child awakens in the middle of the night with a nightmare? Be patient, calm and reassuring using these tips.Easing the fear of nightmares<p>Nightmares can be scary for children and their parents. Children usually begin having nightmares between the ages of 3 and 6. Nightmares usually start to decrease after age 10.</p> <p>The content of childhood nightmares varies with age. Younger children might have nightmares about monsters, while older kids have nightmares about school or difficulties at home.</p> <h2>Nightmare causes</h2> <h3>Nightmares can be caused by a number of things, including:</h3> <ul> <li>Stress from normal everyday life</li> <li>Large changes, such as a move or death in the family</li> <li>Lack of sleep </li> <li>Watching scary movies or reading scary books</li> </ul> <p>Occasional nightmares usually aren't causes for concern, and they can be discussed during a routine well-child visit. You may want to talk to your provider sooner if your child’s nightmares occur frequently and persist over time, routinely disrupting sleep, causing fear of going to sleep or causing daytime behavior problems.</p> <p>So what can you do the next time your child awakens in the middle of the night with a nightmare? Be patient, calm and reassuring.</p> <h3>Also, try these tips for more peaceful nights: </h3> <ul> <li><strong>Talk about the dream.</strong><br /> Ask your child to describe the nightmare. What happened? What made it scary? Then remind your child that nightmares aren’t real and can’t hurt you. </li> <li><strong>Put stress in its place.</strong> <br /> If your child seems anxious or stressed, talk about what’s bothering him or her. Read more about <a href="/hometown-health/speaking-of-health/fostering-resiliency-in-kids" target="_self" title="Opens in same window.">fostering resiliency in kids</a>. Also, <a href="/hometown-health/speaking-of-health/do-children-grieve" target="_self" title="Opens in same window.">if your child is grieving, learn ways to provide support</a>.</li> <li><strong>Provide company.</strong> <br /> Your child might feel more secure sleeping with a favorite stuffed animal, blanket or other comfort object. </li> <li><strong>Brighten up.</strong> <br /> Use a night light in your child’s room. If your child wakes up during the night, the light might be reassuring. Have the nightlight be as dim as possible so as not to interfere with sleep.</li> <li><strong>Open the doors.</strong> <br /> Leave your child’s door open at night so that he or she won’t feel alone. And leave your door open, too, so you can respond quickly if your child has a nightmare.</li> </ul> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2021/child-sleeping-with-teddy-bear.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9E0841C80DF152ED1DA5AD16C7201ED9" alt="Child sleeping with teddy bear" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller5/28/2021Experts recommend limiting children's screen time. Consider the effects of too much screen time, and discover how to reduce it using these simple steps.Children and screen time: How much is too much?<p>How much time does your child spend watching TV or movies, playing with a smartphone or computer, or enjoying video games? Although some screen time can be educational, it's easy to go overboard, especially during the COVID-19 pandemic.</p> <p>The <a rel="noopener" href="https://www.aap.org/en/" target="_blank" title="Opens in a new window.">American Academy of Pediatrics</a> discourages media use by children younger than 2 and recommends limiting older children's screen time to no more than one or two hours a day.</p> <h2>Too much screen time can be linked to:</h2> <ul> <li><strong>Obesity</strong><br /> The more TV and video your child watches, the greater his or her risk is of becoming <a rel="noopener" href="http://www.mayoclinic.org/diseases-conditions/childhood-obesity/basics/definition/con-20027428" target="_blank" title="Opens in a new window.">overweight</a>. Having a TV or other electronics in a child's bedroom increases this risk as well. Children can also develop an appetite for junk food promoted in ads, as well as overeat while watching on electronics. Learn more about <a href="/hometown-health/speaking-of-health/screen-time-and-body-weight-is-there-a-connection" target="_self" title="Opens in same window.">screen time and body weight</a>.</li> <li><strong>Irregular sleep</strong><br /> The more time spent watching on a screen, the more likely children are to have trouble falling asleep or have an irregular sleep schedule. Sleep loss can lead to fatigue and increased snacking.</li> <li><strong>Behavioral problems</strong><br /> Elementary students who spend more than two hours a day watching TV, playing video games or using a computer or smartphone are more likely to have emotional, social and attention problems. Also, exposure to video games is linked with an increased possibility of attention problems in children. Read <a href="/hometown-health/speaking-of-health/are-video-games-and-screens-another-addiction" target="_self" title="Opens in same window.">"Are video games and screens another addiction?"</a></li> <li><strong>Impaired academic performance</strong><br /> Elementary students who have TVs or other screens in their bedrooms tend to perform worse on tests than do those who don't have these in their bedrooms.</li> <li><strong>Violence</strong><br /> Too much exposure to violence through media can desensitize children to violence. As a result, children might learn to accept violent behavior as a normal way to solve problems.</li> <li><strong>Less time for play</strong><br /> Excessive screen time leaves less time for active, creative play.</li> </ul> <p>Your child's total screen time might be greater than you realized. Start monitoring it, and talk to your child about the importance of sitting less and moving more. Also, explain screen time rules — and the consequences of breaking them.</p> <p>Consider these<a href="/hometown-health/featured-topic/5-ways-slimming-screen-time-is-good-for-your-health" target="_self" title="Opens in same window."> five ways slimming screen time is good for your family's health</a>.</p> <h2>In the meantime, here are simple steps to reduce screen time:</h2> <ul> <li><strong>Eliminate background TV.</strong><br /> If the TV is turned on — even if it's just in the background — it's likely to draw your child's attention. If you're not actively watching a show, turn it off.</li> <li><strong>Keep TVs, smartphones and computers out of the bedroom.</strong><br /> Children who have electronics in their bedrooms watch more than children who don't have these in their bedrooms. Monitor your child's screen time and the websites he or she is visiting by keeping TVs and computers in a common area in your house.</li> <li><strong>Don't eat in front of a screen.</strong><br /> Allowing your child to eat or snack in front of electronic devices increases his or her screen time. The habit also encourages mindless munching, which can lead to weight gain.</li> </ul> <p>Get <a href="/hometown-health/speaking-of-health/6-tips-to-reduce-childrens-screen-time" target="_self" title="Opens in same window.">6 additional tips to reduce children's screen time</a>.</p> <h3>When your child has screen time, make it as engaging as possible:</h3> <ul> <li><strong>Plan what your child views.</strong><br /> Instead of flipping through channels, seek quality videos or programming. Consider using parental control settings on your TV and computers. Preview video games and smartphone applications before allowing your child to play with them.</li> <li><strong>Watch with your child.</strong><br /> Whenever possible, watch programs together and talk about what you see, such as family values, violence or drug abuse. If you see a junk food ad, explain that just because it's on TV doesn't mean it's good for you.</li> <li><strong>Record programs and watch them later.</strong><br /> This will allow you to fast-forward through commercials selling toys, junk food and other products. When watching live programs, use the mute button during commercials.</li> <li><strong>Encourage active screen time.</strong><br /> Have your child stretch or do yoga while watching a show. Challenge your family to see who can do the most jumping jacks during a commercial break. Choose video games that encourage physical activity.</li> </ul> <p>It can be difficult to start limiting your child's screen time. However, it's worth the effort. By creating new household rules and steadily making small changes in your child's routine, you can curb screen time and its potential effects.</p> <p><a href="/wellness/slim-your-screen-time" target="_self" title="Opens in same window."><strong>Register for Slim Your Screen Time</strong></a><strong> — a free at-home, self-guided program designed to help you improve your health by reducing screen time. Join at any time.</strong></p> <p><em><a href="/providers/jill-christensen-cnp" target="_self" title="Opens in same window.">Jill Christensen</a> is a nurse practitioner in <a href="/services-and-treatments/family-medicine">Family Medicine</a> in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><ul> <li>Adoption</li> <li>Behavioral and developmental pediatrics</li> <li>Chronic disease management </li> <li> Department of transportation (DOT) exams</li> <li>Diabetes mellitus</li> <li>Mental health – attention-deficit/hyperactivity disorder (ADHD)</li> <li>Newborn and infant care</li> <li>Preventive care and motivational interviewing</li> <li>Sports</li> <li>Telemedicine, care everywhere</li> </ul>APRN, C.N.P.<p>As a Mayo Clinic Health System family medicine provider, I have an established and coveted relationship with the rural and farming community, and I think of families as a bionet of person’s that take care of each other. I enjoy community health education and have done multiple presentations for different communities on sun protection, skin cancer, pediatric health and wellness, and diet education. </p> <p>I enjoy blogging about mental health, diabetes care and how people can navigate through tough times in life, such as the COVID-19 pandemic. I am largely reachable and communicate by phone, email, telemedicine and in-office visits. I enjoy meeting new faces, and connecting with families. </p> <p>My special interests lie in meeting the patient where they are in their health needs, working with their health priorities and guiding them through their care. I want my patients to understand to the best of their ability, their own personal health goals and diagnoses, and who they may seek for questions, care, referrals and follow-up. </p> <p>My personal interests include hobby farming, taking care of my loved ones, gardening, hunting, fishing and meeting new people.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Nursing, Family Nurse Practitioner Program, Minnesota State University-Mankato</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>Nurse Practitioner Residency Program, Mayo Clinic School of Graduate Medical Education</li> <li>Women's Health Rotation, Mayo Clinic Health System-Mankato</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Family Nurse Practitioner, American Academy of Nurse Practitioners</li> <li>Certified medical examiner, Department of Transportation (DOT) </li> <li>Nexplanon implant trained, Merck</li> <li>Preceptor for Nurse Practitioner students, Minnesota State University, Mankato</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Nurse Practitioners</li> <li>Golden Key Honor Society</li> <li>Minnesota Board of Nursing</li> <li>Mortar Board Honor Society</li> <li>Sigma Theta Tau, Nursing Affiliate Honor Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Christensen<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/jill-christensen-np.jpg?h=280&iar=0&w=280&sc_lang=en&hash=E486ED336C7F30C86357408497A2575E" alt="Jill Christensen NP" width="280" height="280" DisableNVelocity="true" />{F972C1E4-A740-4E1A-9126-21A8DA2A563E}Jill<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15458067Jill Christensen, C.N.P.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}<img src="/-/media/national-files/images/hometown-health/2021/child-sitting-with-tv-remote-in-hand.jpg?h=370&iar=0&w=660&sc_lang=en&hash=519EFD519AB2CA403CE812CDCB614166" alt="Child sitting with TV remote in hand" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Child DevelopmentWe all want our children to grow up happy and healthy. The reality is most all of them do — but at vastly different rates. Experts across Mayo Clinic Health System see thousands of children each year, and have the experience and resources to know what is normal and what may be cause for closer observation. This includes not only physical and motor skills development, but psychological and social skill advancement.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller5/13/2021Are you busy raising a family and not finding the time to exercise daily? You're not alone. Here's a few helpful tips for fitting in your workouts.Exercise daily and raise a family? Really?<p>You know you should exercise every day. You may even find yourself motivated to do just that. But you also have a family to raise and a profession to manage — not to mention evening recreational sports, afternoon clubs and weekend deadlines. How could you possibly fit it all in?</p> <h3>Here are a few helpful tips to do just that.</h3> <h4>Your motivation: Find your personal reason to get fit.</h4> <p>Motivation keeps former smokers avoiding the bad habit day after day. And motivation is what you need to keep pursuing your health goals day after day.</p> <p>Think of something that will really get you moving every day. Maybe it takes posting a picture from your healthier days on the fridge. Or perhaps you wish to keep up with the kids. Whatever it may be, make sure it gets you moving each and every time.</p> <h4>Gut check: Examine your goals.</h4> <p>Are your goals realistic? Can you accomplish each goal in a controlled and healthy manner? If not, rewrite your goals to make them more attainable over time.</p> <p>Learn how to <a href="/hometown-health/speaking-of-health/setting-smart-goals" target="_self" title="Opens in same window.">set SMART goals for success</a>.</p> <h4>Early bird: Try early-morning exercise.</h4> <p>Early-morning cardiovascular workouts are well-supported to improve concentration and energy for the rest of the day. They also may have the added benefit of improving sleep quality for some people.</p> <h4>Busy bird: Survey your schedule.</h4> <p>Not every schedule is identical. Do you have an opportunity before, during or after work for exercise? These carved-out moments do not need to be hourlong cardio-intense sessions. Even mild-intensity walks or several pushups on the office floor provide notable benefits over time.</p> <p>Grab ahold of that opportunity because you know you will feel a lot better afterward.</p> <h5>Try these short routines:</h5> <ul> <li><a href="/hometown-health/speaking-of-health/15-minute-workout-core" target="_self" title="Opens in same window.">15-minute core</a></li> <li><a href="/hometown-health/speaking-of-health/15-minute-workout-combo-exercises" target="_self" title="Opens in same window.">15-minute combination</a></li> <li><a href="/hometown-health/speaking-of-health/15-minute-workout-resistance-bands" target="_self" title="Opens in same window.">15-minute resistance band</a></li> </ul> <h4>Look forward: Do something you enjoy.</h4> <p>Motivation implies seeking something you want to pursue and you want to complete. Exercising can be of a fun, stress-relieving part of your daily.</p> <h4>The family that exercises together stays healthy.</h4> <p>When your family exercises together, you grow healthy together. Exercising as a family unit will improve family bonds, and you also will role model the importance of physical activity to your children.</p> <h4>Breathe it: Make exercise mandatory.</h4> <p>You simply must do it. Make exercise part of your routine. Schedule time each day.</p> <h4>Little steps: Exercise on your way to A, B and C.</h4> <p>Do you live close to work? Make your commute to work your daily dose of physical activity by biking or walking to work. Park at the edge of the parking lot, not the closest spot. Take the stairs, not the elevator.</p> <p>Consider adding <a href="/hometown-health/speaking-of-health/dont-just-sit-there-exercises-for-the-office" target="_self" title="Opens in same window.">stretches and exercises if you sit at a desk</a> much of your workday.</p> <h4>Just say no.</h4> <p>Look at your priorities and responsibilities. Eliminate unnecessary items so you can get your workout in. It's OK to say no sometimes.</p> <p>Learn more <a href="/topics/move-more" target="_self" title="Opens in same window.">ways to get and stay physically fit</a>.</p> <p><em><a href="/providers/trevor-rich-md" target="_self" title="Opens in same window.">Trevor Rich, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/mondovi" target="_self" title="Opens in same window.">Mondovi</a>, Wisconsin.</em></p> <p> </p><ul> <li>Academic medicine and community health education</li> <li>Community nutritional health and preventive wellness</li> <li>Critical access rural clinic and hospital care <ul> <li>Vasectomy counseling and referral service</li> <li>Contraceptive counseling and referral service, OCP prescription management</li> <li>Preconception care & planning, prenatal referral service</li> <li>Wound care and wound management</li> </ul> </li> <li>Rural athletic support</li> <li>Skilled nursing facility medical directorship</li> </ul>M.D.<p>I view my delivery of care to be shared. My role, above all else, is to be a source of evidence-based counseling, such that all my patients feel comfortable with their informed decisions about their health. Patients can expect my undivided attention and eagerness to clarify their questions.</p> <p>I’m a humble family man, who finds purpose in serving my community and neighbors.</p><p><strong>Education</strong></p> <ul> <li>Medical College of Wisconsin-Milwaukee</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Mayo Clinic Family Medicine Residency, Eau Claire</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Clozapine REMS Program</li> <li>MAT, Suboxone Waiver</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians </li> <li>Mayo Clinic Alumni Association</li> <li>Society of Teachers of Family Medicine</li> <li>The National Guard Association of the United States</li> <li>Wisconsin Academy of Family Physicians</li> <li>Wisconsin Medical Society</li> <li>Wisconsin National Guard Association, Inc.</li> </ul>Rich<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/trevor-rich-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=C35BEC1720C4B1DC110D068E43EFF155" alt="Trevor Rich, M.D." width="280" height="280" DisableNVelocity="true" />{DEC439E2-74BD-46D1-94B9-DB111539B3A8}Trevor<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20654405Family Medicine - Trevor Rich MD1{986C767E-E5DE-43F5-957F-B4212DB8E384}|{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}<img src="/-/media/national-files/images/hometown-health/2021/mother-and-child-exercising.jpg?h=370&iar=0&w=660&sc_lang=en&hash=FE7FA95B0009044F39D1459EFB42F769" alt="Mother and child exercising" width="660" height="370" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Dawn Haller6/4/2021Almost 133 billion pounds of food in the U.S. is wasted annually. Learn how to reduce food waste, and get a soup recipe to make with leftovers.7 ways to reduce food waste in your kitchen<p>Food choices affect your health and the environment. Between 30% and 40% of food in the U.S. is thrown out or wasted each year, according to the Department of Agriculture. That equals about 133 billion pounds and $161 billion.</p> <p>Food loss occurs at every step in the food supply chain from production to consumption. Some examples are spoilage during storage and transport, or exposure to insects and rodents, bacteria or mold. Sorting out blemished or imperfect produce results in loss, as does consumers buying more than they need or can consume. Not only is edible food wasted, but all the energy, fertilizer and land use that went into to producing that food is wasted as well.</p> <h2>Here are 7 ways you can reduce food waste in your kitchen:</h2> <h3>1. Take an inventory.</h3> <p>Take stock of your pantry, refrigerator and freezer before going to the store to prevent overbuying.</p> <h3>2. Create a meal plan.</h3> <p>Planning at least a few meals for each week is a great way to ensure you have healthy meals. It also prevents you from buying too much food because you feel like you need to be prepared for anything. Coordinate your meals so you aren't using completely different ingredients for every recipe. For example, plan to eat broccoli as a side one night and in a casserole the next.</p> <h3>3. Save and eat leftovers safely.</h3> <p>If you don't think you will be able to eat your leftovers within three days, store them in the freezer and label them. Keep your freezer organized so food doesn't get lost and then thrown out due to freezer burn.</p> <h3>4. Store food appropriately.</h3> <p>One of the biggest reasons I hear people say they don't eat fruits and vegetables is because "When I buy it, it ends up going bad, and I throw it out anyway." Start by only buying what you can eat in a week. Store greens with a paper towel in a plastic container in the crisper drawer, tomatoes and bananas on the counter, potatoes and onions in a cool, dark place and fresh herbs in a glass of water. Have some frozen fruits and vegetables on hand in case you eat all your fresh produce before your next grocery day.</p> <h3>5. Buy "ugly" foods.</h3> <p>Purchasing imperfect food refers to misshaped or oddly shaped fruits or vegetables, and it has never been easier. Some companies will deliver "ugly" foods to you with a monthly subscription. You also can start a relationship with a local farmer through a community-supported agriculture or farmers market to get your hands on some imperfect produce. Remember, don't purchase bruised or spoiled produce.</p> <h3>6. Compost.</h3> <p>Even vegetable peels don't have to go to waste. Backyard composting is a great way to keep food waste out of the landfill and provide nutrition for your garden. You also can find small composting containers that you can keep in your home.</p> <h3>7. Use leftovers creatively.</h3> <p>Find ways to use rather than toss food that isn't fresh. Vegetable scraps and peels can be made into soup stock. Apples or blueberries that are soft work perfectly cooked in oatmeal. You can even use stale bread to make croutons or an egg strata. Slightly wilted vegetables are great for soups or stir-fries. One of the best things about soup is you can make it out of pretty much anything.</p> <h4>If you aren't sure how to start experimenting with using soups to use up leftovers, start with this recipe:</h4> <h5>Make soup from any vegetable</h5> <p>Makes 4–6 servings</p> <ul> <li>1–2 pounds fresh or frozen vegetables</li> <li>Aromatics, such as an onion, a couple garlic cloves or leeks</li> <li>1–2 tablespoons olive oil</li> <li>4–6 cups low-sodium broth</li> <li>Seasonings to taste, such as pepper; cumin; chili powder; ginger; or dried herbs, including basil, sage, oregano and bay leaf.</li> <li>Leftover cooked meat, rice, pasta, quinoa or beans, optional</li> </ul> <p>Cut up the vegetables and aromatics. Heat olive oil in a pot over medium heat. Saute the aromatics for about 5 minutes or until fragrant and soft. Add vegetables, except for any delicate greens, and continue cooking for several minutes until softened slightly. Add seasonings now so the flavors blend well in the soup.</p> <p>Add 4–6 cups of broth and bring to a simmer. Turn the heat down to low and cover the pot. Cook for about 30 minutes. If you want to leave the vegetables intact, take the soup off the heat when vegetables are tender but still firm. If you want the vegetables soft for pureeing, keep cooking until they fall apart. Add delicate greens, such as spinach, a couple minutes before taking the soup off the heat.</p> <p>Once the vegetables are soft, you can puree the soup in a blender or with a stick blender. Rewarm gently after blending. When pureeing the soup, you can add flavor and creaminess by adding beans, tofu, coconut milk or plain yogurt.</p> <p>Once the soup has finished cooking, you can jazz it up more, especially if you're not pureeing it. Add leftover cooked pasta or rice, cooked ground turkey, diced chicken breast, a can of rinsed beans, chickpeas or tomatoes, and simmer until warmed through.</p> <p><em><a href="/providers/romi-londre-rdn" target="_self" title="Opens in same window.">Romi Londre</a> is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Eating disorders</li> <li>Enteral nutrition or tube feedings</li> <li>Weight management</li> </ul>RDN, CD<p><strong>Education</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Registered Dietitian Nutritionist</li> <li>Certified Nutrition Support Clinician </li> <li>Certificate of Training in Adult Weight Management</li> </ul> <div> </div>Londre<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/romi-londre-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7919B2F8260054ECC4308684471EEEDB" alt="Romi Londre RDN" width="280" height="280" DisableNVelocity="true" />Romi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15183670Romi Londre, RDN, CD1{2BEE5070-65FF-4406-9E59-103E06C5A535}<img src="/-/media/national-files/images/hometown-health/2021/food-in-containers.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BEE3BF285FE77ADCC91F6B2404DE8DFC" alt="Food in containers" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller6/30/2021Boating can create lifelong memories. Regardless of the type of boat you’re on, remember these basic safety rules for a day on the water.Boating this summer? Make safety your top priority<p>One of the most popular and fun activities of summer is spending time on the lakes and rivers in the area. Boating creates lifelong memories and gives us the opportunity to unplug, spend time together, learn new skills and explore new areas.</p> <h3>Whether your family uses a fishing boat, canoe, kayak or pontoon, you should remember these basic safety rules as you head out for a day on the water:</h3> <h4>Learn to swim.</h4> <p>Learning to swim is one of the most important ways to stay safe on the water. The American Academy of Pediatrics supports swimming lessons for most children ages 4 and older. However, lessons for children ages 1–4 could be appropriate, depending on how often they're exposed to water.</p> <p>Swimmers of all ages may be more familiar with pools than rivers and may not know what to do if caught in a current. Stay calm, float on your back, and when you come to a calmer area, flip over and swim diagonally toward shore with the flow of the current.</p> <h4>Wear a personal floatation device.</h4> <p>Even expert swimmers can get into trouble during an emergency. It's important to be sure everyone in a watercraft wears a U.S. Coast Guard-approved personal floatation device. Arm floaties and inflatable toys aren't a substitute and tend to give kids and families a false sense of security. Excellent, comfortable, easy-to-put-on models of personal floatation devices are available, so there's really no excuse not to wear one.</p> <h4>Be a weather watcher.</h4> <p>Weather in the Midwest can change quickly. Check the forecast before heading out and frequently while on the water. If you do get caught in a storm, navigate to the shore as quickly as possible.</p> <h4>Tell someone the details of your trip.</h4> <p>Tell your trip plan to a friend who's staying ashore. Share details about who's on the boat, where you'll be and how long you'll be gone.</p> <h4>Always operate your boat at a safe speed.</h4> <p>Waterways can become crowded during the summer. Slow down, stay alert and steer clear of larger vessels. Be sure to follow speed limits in "no wake" areas.</p> <h4>Respect buoys and other navigational aids.</h4> <p>They've been put in place to ensure your safety and the safety of other boaters and swimmers. If you're not familiar with them, the U.S. Coast Guard has a handy <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.uscgboating.org/images/486.PDF" target="_blank" title="Opens in a new window.">water navigation system guide</a>.</p> <h4>Leave alcohol on shore.</h4> <p>The risk of drowning or injury significantly increases when alcohol or drugs are involved.</p> <h4>Be sun savvy.</h4> <p>The sun's rays can be intense on the open water. Protect everyone with hats, sunglasses and sunscreen. Look for water-resistant, broad-spectrum sunscreen with a sun protection factor (SPF) of at least 30. Apply sunscreen generously and reapply every two hours, or more often if you're swimming or sweating.</p> <h4>Drink plenty of water.</h4> <p>Even when surrounded by water, it's possible to become dehydrated. Sitting in the sun can increase your body's temperature. Pack plenty of water for each person, and drink some water every 15 to 20 minutes to remain properly hydrated.</p> <p>While your family enjoys time on the water, these tips can ensure that everyone is safe and enjoys the time together.</p> <p><em><a href="/providers/jason-wray-raabolle-md" target="_self" title="Opens in same window.">Jason Wray-Raabolle, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em></p><ul> <li>Family medicine</li> <li>Obstetrics and gynecology</li> </ul>M.D.<p><strong>Medical School<br /> </strong>University of Minnesota, Duluth</p> <p><strong>Residency<br /> </strong>Waukesha Memorial Hospital, affiliated with the Medical College of Wisconsin</p> <p><strong>Certification<br /> </strong>Board Certified, Family Practice </p>Wray-Raabolle<img src="/-/media/shared-files/images/medical-professionals/full/owatonna/jason-wrayraabolle-md.jpg?h=280&iar=0&w=280&hash=ADD0AB50D60111BF3522B6DE68DE150C" alt="Jason WrayRaabolle MD" width="280" height="280" DisableNVelocity="true" />{D42EB393-BB16-4B26-B0D6-3F51B7E2C978}Jason<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13904248Jason Wray Raabolle MD1<img src="/-/media/national-files/images/hometown-health/2021/two-kids-fastening-life-jackets.jpg?h=370&iar=0&w=660&sc_lang=en&hash=94524F3908AA4169F107815A23EC232F" alt="Two kids fastening life jackets" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller4/24/2025When you boost your senses, you make eating more enjoyable. Find out how to incorporate citrus into your day with these easy recipes.Boost your senses with citrus fruits<p>Give your senses a boost this month, and enjoy the taste, smell and brightness citrus fruits have to offer.</p> <p>Citrus fruits, including oranges, lemons, limes, grapefruits and clementines, are an excellent source of vitamin C. And vitamin C supports your immune system, which plays a role in maintaining healthy skin, bones and blood vessels. Vitamin C also improves absorption of iron when consumed with plant-based sources of iron, such as beans, lentils, leafy green vegetables, tofu and blackstrap molasses.</p> <p>Citrus fruits contain soluble and insoluble fiber, both of which provide great benefits. Soluble fiber can support your cardiovascular health by reducing your <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/symptoms-causes/syc-20350800" target="_blank" title="Opens in a new window.">low-density lipoprotein</a>, or LDL or "bad," cholesterol levels, in turn reducing your risk of heart disease. <a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/fiber/art-20043983" target="_blank" title="Opens in a new window.">Insoluble fiber</a> supports your digestive system and can help alleviate constipation. Citrus fruits are also a source of potassium, thiamin, and trace amounts of other vitamins and minerals.</p> <p>Incorporating citrus into your day is easy, thanks to the tough outer rind and ability for most citrus fruits to be safely stored at room temperature for a few days. Try simply tossing an orange or a few small clementines into your bag for an on-the-go snack that doesn't require refrigeration. Grapefruit also makes a great addition to a leafy green salad, or try broiling a halved grapefruit with a sprinkle of brown sugar or drizzle of honey. Lemons and limes aren't often eaten whole, but they provide great flavor in fish, salad dressings, desserts and beverages.</p> <h3>Also, give these recipes a try:</h3> <h4>Avocado garden salad with lemon dressing</h4> <p>Serves 6</p> <p><strong>Salad mix</strong></p> <p>6 cups mixed greens, torn or chopped<br /> 1 medium tomato, chopped<br /> 5 green onions, copped <br /> 1 cucumber, peeled and chopped <br /> 1 avocado, peeled and sliced</p> <p><strong>Dressing</strong></p> <p>2 tablespoons lemon juice<br /> ½ teaspoon garlic powder<br /> ½ teaspoon ground black pepper <br /> ¼ teaspoons salt</p> <p>Mix salad greens, tomatoes, onions and cucumbers in a large bowl. In a small bowl, mix lemon juice, garlic powder, pepper and salt. Whisk with a fork. Poor dressing mixture over salad mixture and toss together. Arrange avocado slices on top of the salad and serve immediately.</p> <p>Nutritional per 1½-cup serving: 78 calories; 5 grams fat; 9 grams carbohydrate; 4 grams fiber; 2 grams protein; 124 grams sodium.</p> <p>(adapted from eatfresh.org)</p> <h4>Broiled grapefruit</h4> <p>Serves 4</p> <p>2 grapefruit, cut in half<br /> 8 teaspoons brown sugar</p> <p>Preheat oven to broil with oven rack 6 inches from the heat source. Place grapefruit halves cut, side up, onto baking sheet. Sprinkle each with 2 teaspoons brown sugar. Broil the grapefruit until the brown sugar has begun to melt and caramelize, approximately 8 minutes. Serve warm.</p> <p>Nutritional per ½-grapefruit serving: 100 calories; 0 gram fat; 25 grams carbohydrate; 2 grams fiber; 1 gram protein; 6 milligrams sodium.</p> <p><em>Tori Erickson is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Clinical Nutrition</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2021/citrus-fruits.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F5A301D0C75AE501296277D91E7E794F" alt="Citrus fruits" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller6/8/2021Cataracts can cause things to look foggy, and make reading or driving at night difficult. Learn when to make an eye exam appointment.Cataracts: What to look for<p>Are you finding it more difficult to read or, drive a car at night? Do you feel like you're looking through a fogged-up window?</p> <p>It could be <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/cataracts/symptoms-causes/syc-20353790" target="_blank" title="Opens in a new window.">cataracts</a> — the clouding of the normally clear lens of your eye.</p> <p>Cataracts are a normal aging change that happens to everyone. Cataract surgery is only performed when your cataracts affect your vision to the point that it interferes with your usual activities.</p> <p>Early on, most cataracts develop slowly, so you may not notice any vision changes. When you first notice changes, you might need stronger lighting and eyeglasses. In time, cataracts will eventually interfere with your vision.</p> <p>If your vision is impaired to the point it interferes with your usual activities, you might need <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/cataract-surgery/about/pac-20384765" target="_blank" title="Opens in a new window.">cataract surgery</a>, a safe, effective procedure.</p> <h2>Signs and symptoms of cataracts include:</h2> <ul> <li>Clouded, blurred or dim vision</li> <li>Increasing difficulty with vision at night</li> <li>Sensitivity to light and glare</li> <li>Need for brighter light for reading and other activities</li> <li>Seeing "halos" around lights</li> <li>Frequent changes in eyeglasses or contact lens prescriptions</li> <li>Fading or yellowing of colors</li> <li>Double vision in a single eye</li> </ul> <p>At first, a cataract may only affect a small part of your eye's lens and you may not notice any vision loss. But as the cataract grows larger, it clouds more of your lens and distorts the light passing through the lens. At this point, you may notice more symptoms.</p> <h3>See how a cataract affects your vision:</h3> <img alt="Cataract image" src="/-/media/national-files/images/hometown-health/2021/cataract-image.jpg?h=134&w=325&sc_lang=en&hash=77AD7D5A714F72279BBC2BF51E60CC4D" style="height: 134px; width: 325px;" /> <p>Normal vision (left) becomes blurred as a cataract forms (right).</p> <h2>Causes of cataracts</h2> <p>Aging or injury changes the tissue that makes up your eye's lens, causing cataracts to develop. Some genetic disorders that cause other health problems can increase your risk of cataracts.</p> <p>If you have other eye conditions; previous eye surgery; medical conditions, such as diabetes; or have taken steroid medications for a long period of time, you are at increased risk of developing cataracts. In addition, obesity, smoking, high blood pressure and drinking excessive amounts of alcohol can increase your risk of cataracts.</p> <h2>When to see a healthcare provider</h2> <p>If you notice any changes in your vision, make an appointment for an eye exam. If you experience sudden vision changes, such as double vision or flashes of light, sudden eye pain, or sudden headache, see your healthcare provider right away.</p> <p>If your healthcare provider determines that you have cataracts, you may be referred to an <a href="/services-and-treatments/ophthalmology">ophthalmologist</a>, or eye specialist, who can perform cataract surgery and help you decide when the surgery is right for you.</p> <p>Learn more about <a href="/topics/eye-health" target="_self" title="Opens in same window.">eye health</a>.</p> <p><em><a href="/providers/michael-garvey-md" target="_self" title="Opens in same window.">Michael Garvey, M.D.</a>, is an <a href="/services-and-treatments/ophthalmology" target="_self" title="Opens in same window.">ophthalmologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Comprehensive treatment of eye diseases</li> <li>Oculoplastics surgery</li> <li>Small-incision cataract surgery</li> </ul>M.D.<p>My patients can expect individualized care with a treatment plan specifically designed for their eye condition. I also encourage my patients to be involved in the design of the treatment plan. I believe it's important for my patients to have a solid understanding of their eye condition for successful treatment.</p> <p>I enjoy travel around the United States, Europe and Asia. But these days, free time is mostly spent with my two children.</p><p><strong>Education</strong></p> <ul> <li>Warren Alpert Medical School of Brown University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Transitional, Walter Reed Army Medical Center</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Ophthalmology, Walter Reed Army Medical Center</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Ophthalmology, American Board of Ophthalmology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Society of Cataract and Refractive Surgery</li> <li>New England Ophthalmology Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Ophthalmology, Mayo Clinic College of Medicine and Science</li> </ul>Garvey<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/michael-garvey-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=6D2A19B92B2DA6451A2E267C7B45D383" alt="Michael Garvey, M.D." width="280" height="280" DisableNVelocity="true" />Michael<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14328046Michael Garvey, M.D.1{C5680DDD-C649-4B63-AFCC-B52A244736B7}<img src="/-/media/national-files/images/hometown-health/2021/brown-eye-close-up.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B9897F53FACA486CEA69AA861D68394A" alt="Brown eye close up" width="660" height="370" DisableNVelocity="true" />Eye HealthYour eyes are responsible for providing you with vision, perhaps the most important of the senses. However, the eye is a delicate and complicated structure that needs protection. The ugly truth is that eye injuries can happen at any time and place.Dawn Haller6/10/2021How do you find calm and prioritize well-being in the midst of chaos? Watch a video presentation of two experts giving practical strategies to help you take a well-deserved break from stress, and discover calm and peace.Discovering calm in the chaos<p>Mayo Clinic Health System experts hosted a webinar to encourage women to prioritize their well-being.</p> <p>At this webinar, <a href="/providers/sarah-stinson-lpc" target="_self" title="Opens in same window.">Sarah Stinson</a>, a psychotherapist, presented "Become Aware." Her presentation focused on acknowledging the journey you have been on this past year, recognizing where you are now, and helping you explore where you want to go.</p> <p>Also, Bridget Berkland, a Human Resources manager, presented "Renew Your Well-Being." Berkland's presentation discussed how the COVID-19 pandemic has created many stressors and disrupted a sense of positive well-being. Her presentation provided practical well-being strategies and resiliency skills to help you take a well-deserved break from stress and discover calm in the chaos.</p> <h4></h4> <h2>View the webinar:</h2> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/wo1GiE7Bs4o" title="Renew Your Wellbeing webinar" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <h2>Presentation excerpts</h2> <h3>Sarah Stinson:</h3> <ul> <li>Today, my hope is that we can become aware. I want us to take a moment and get in touch with reflecting and remembering something that might have happened in the past 16 months. Allow yourself to be present to what we talk about to the emotions that come up to the skills and the gifts that we learned through this journey.</li> <li>I'm finding that women struggle with self-care, but more and more men are struggling with the same issues.</li> <li>When we explore our health over time — mentally, emotionally and physically — we see times in life where we really weren't doing self-care. These lessons I've learned throughout life remind me I need to stop, slow down and really find that balance in my life.</li> <li>Self-care is often defined as taking an active role in protecting one's well-being, happiness, and preserving or improving one's health. We can do so much self-healing if we just take the time. Self-care really prevents burnout and compassion fatigue.</li> <li>Remember that when we take care of ourselves, it increases our energy to do the things we want for ourselves and others. It actually gives us that extra momentum and fuel to do those things, and it helps us stay healthy.</li> <li>Most of us are under chronic stress, which is damaging because we're not getting a reprieve from it.</li> </ul> <p>Sarah also offered a number of self-care activities and techniques that can help you find calm.</p> <h3>Bridget Berkland:</h3> <ul> <li>Let's take a moment to reflect on our stories. What have you experienced over the past few months? Maybe your story contains changes at work or in your home environment. Maybe you moved to a remote work setting. Maybe your children went to virtual school. Maybe your story is about being in a health care setting, and you've experienced the stressors of patient care or the threat of the pandemic. Most of us experienced moments of isolation, which on their own have been stressful.</li> <li>Let's check in on stress. What number best describes where you are on the stress scale, zero meaning no stress and 4 meaning extreme stress? At the end of the day, evaluate how stressful the day was. We're so unaware of carrying all this stress. But there are resiliency tools we can incorporate to calm ourselves.</li> <li>A chronic state of stress can weaken the immune system, and increase the heart rate, blood pressure and stress hormones. We need to balance these effects by activating the parasympathetic nervous system, which builds a stronger immune system, slows the heart rate and breathing, decreases blood pressure and stress hormones, and brings calm.</li> <li>Resiliency skills, such as connection and compassion, are especially good to think of when we're in chaos and stress. It's calming to know that we're not alone.</li> </ul> <p>Bridget also discussed tools and strategies you can try for strengthening your resiliency skills and regaining power in your chaotic or stressful life circumstances.</p> <p>Each presentation was followed by a community Q&A session.</p> <h2>Learn more about well-being:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/tips-to-help-ease-anxiety" target="_self" title="Opens in same window.">5, 4, 3, 2, 1: Countdown to take control of anxiety</a></li> <li><a href="/hometown-health/speaking-of-health/can-expressing-gratitude-improve-health" target="_self" title="Opens in same window.">Can expressing gratitude improve your mental, physical health?</a></li> <li><a href="/hometown-health/speaking-of-health/mindfulness-meditation-improve-your-quality-of-life" target="_self" title="Opens in same window.">Mindfulness meditation: Improve your quality of life</a></li> <li><a href="/hometown-health/speaking-of-health/how-to-create-happiness" target="_self" title="Opens in same window.">How to create happiness</a></li> <li><a href="/hometown-health/speaking-of-health/tips-to-help-ease-anxiety" target="_self" title="Opens in same window.">Tips to help ease anxiety</a></li> <li><a href="/hometown-health/speaking-of-health/tips-to-keep-stress-from-hurting-your-heart" target="_self" title="Opens in same window.">Tips to keep stress from hurting your heart</a></li> </ul><img src="/-/media/national-files/images/hometown-health/2021/sitting-crosslegged-on-field-near-water.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2A908707081ECC400DC76827803A4695" alt="Sitting cross-legged on field near water" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Su Madson6/18/2021<p>Like so many aspects of life, COVID-19 complicated the relationship with food, body image, exercise routines, self-care and social media. Learn about the effects of COVID-19 and what to do if you're concerned about your eating patterns.</p>Eating disorders complicated by COVID-19<p>Like so many aspects of life, COVID-19 complicated the relationship with food, body image, exercise routines, self-care and social media. Add to that mix the isolation, anxiety and unpredictability generated by the pandemic, and it's no wonder that eating disorders experienced an upsurge during the past 18 months.</p> <p>Eating disorders don't discriminate by race, gender, age, size or socioeconomic status, and you can't necessarily tell if someone has an eating disorder just by looking. It's estimated that nearly 30 million people in the U.S. will struggle with an eating disorder during their life.</p> <p>Eating disorders are a medical illness ― not a choice, trend or fad. The most common eating disorder is binge eating. Unfortunately, eating disorders are also among the deadliest mental illnesses, second only to opioid overdose. However, they are treatable, if diagnosed and treated early.</p> <h4>COVID-19 complications</h4> <p>Eating disorders are complex and different for everybody. They often start with the desire to be healthy, but those efforts can go awry.</p> <h5>During the COVID-19 pandemic:</h5> <ul> <li>One way people could get a sense of control in their life was through eating — even if that eating pattern got out of control.</li> <li>Some sought to get healthier by losing weight and exercising more, but that weight loss and exercise became excessive. In some cases, it led to an eating disorder.</li> <li>Screen time increased exposure to "ideal" body images, whether they were slender or the "fit look," and spurred obsessive and often unhealthy approaches to achieve them.</li> <li>In some cases, people were exposed to weight-related criticism from friends or family members due to the quarantine, which may have increased shame around body image and food.</li> </ul> <p>For those already struggling with an eating disorder or those concerned that their eating was out of control, the pandemic made it difficult to seek services, since many programs were closed temporarily. Once they reopened, they had long waitlists.</p> <h4>Recovery journey</h4> <p>Complete recovery from an eating disorder is possible with treatment and time, and typically involves a multidimensional approach that includes psychotherapy; nutritional counseling; medical management; and possibly medication and integrative therapies, such as massage and yoga therapy.</p> <h5>If you feel like you're having an issue with food or body image, know you're not alone:</h5> <ul> <li>Check out online resources, such as the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.nimh.nih.gov/health/topics/eating-disorders/" target="_blank" title="Opens in a new window.">National Institute of Mental Health</a> and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.nationaleatingdisorders.org/help-support/contact-helpline" target="_blank" title="Opens in a new window.">National Eating Disorders Association</a>.</li> <li>Limit your social media consumption. In other words, go on a social media diet.</li> <li>Seek social connection with friends, neighbors, family and colleagues.</li> <li>Let someone know that you're struggling. Eating disorders thrive in secret.</li> <li>Do something every day that brings you joy, no matter how small.</li> <li>Contact your primary care provider.</li> <li>Seek care through in-person treatment or telemedicine.</li> </ul> <p><a href="/providers/sarah-stinson-lpc" target="_self" title="Opens in same window.">Sarah Stinson</a> is a psychotherapist in <a href="/locations/red-wing/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry and Psychology</a>. She works in <a href="/locations/red-wing/services-and-treatments/complementary-medicine" target="_self" title="Opens in same window.">Integrative Medicine and Health</a> in <a href="/locations/red-wing" target="_self" title="Opens in same window.">Red Wing</a>, Minnesota.</p><ul> <li>Eating disorders treatment and prevention</li> <li>Healing Touch</li> <li>Mindfulness</li> <li>Stress Management and Resiliency Training (SMART)</li> </ul>M.S., L.P.C., L.P.C.C.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Psychology, Winona State University</li> <li>Master's degree, Community Counseling, St. Cloud State University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Certified Healing Touch Instructor (CHTP/I)</li> <li>Certified Healing Touch Practitioner (CHTP/I)</li> <li>Certified Massage Therapist</li> <li>Licensed Professional Counselor, Minnesota and Wisconsin</li> </ul> <p><strong>Fellowship</strong></p> <li>Fellow, Academy of Integrative Health and Medicine (AIHM)</li>Stinson<img src="/-/media/shared-files/images/medical-professionals/full/red-wing/sarah-stinson.jpg?h=280&iar=0&w=280&sc_lang=en&hash=59889EC2825310D74211E2DC2531FB57" alt="Sarah Stinson" width="280" height="280" DisableNVelocity="true" />Sarah <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15830667Sarah Stinson, M.S., L.P.C., L.P.C.C.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2021/person-standing-on-scale.jpg?h=370&iar=0&w=660&sc_lang=en&hash=ED7968670C67F09423D0D10E5A0C3214" alt="Person standing on scale" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Dawn Haller6/21/2021Ready to switch to a more heart-healthy diet? Here's how to get started with the Mediterranean diet.Eating for your heart: The Mediterranean diet<p>Many different dietary plans are available, such as the dietary approaches to stop hypertension, or DASH; Flexitarian; Therapeutic Lifestyle Changes, or TLC; and Mind diets. But one of the most well-known is the Mediterranean diet.</p> <p>If you're looking for a heart-healthy eating plan, the Mediterranean diet might be right for you. This diet blends the basics of healthy eating with the traditional flavors and cooking methods of the Mediterranean.</p> <p>Health care providers became interested in the Mediterranean diet in the 1960s after observing a lower number of heart disease deaths in Mediterranean countries, such as Greece and Italy. Researchers found that the Mediterranean diet is associated with reduced risk factors for cardiovascular disease.</p> <p>The Mediterranean diet is one of the healthy eating plans recommended by the <a rel="noopener" href="https://www.dietaryguidelines.gov/" target="_blank" title="Opens in new window.">Dietary Guidelines for Americans</a> to promote health and prevent chronic disease. In addition to the heart benefits, the diet has been shown to reduce the risk of cancer, diabetes, dementia and obesity.</p> <h4>What is the Mediterranean diet?</h4> <p>The Mediterranean diet is more than a "diet." It's a heart-healthy eating plan. For most people, what is good for your heart is good for your brain and the rest of your body, too.</p> <p>The Mediterranean diet is a way of eating based on the traditional cuisine of countries bordering the Mediterranean Sea. While there is no single definition of the Mediterranean diet, it is typically high in vegetables, fruits, whole grains, beans, nuts and seeds, and olive oil.</p> <h5>The main components of Mediterranean diet include:</h5> <ul> <li>Daily consumption of vegetables, fruits, whole grains and healthy fats</li> <li>Weekly intake of fish, poultry, beans and eggs</li> <li>Moderate portions of dairy products</li> <li>Limited intake of red meat</li> </ul> <h4>Family meals</h4> <p>A big part of the Mediterranean way of life is to slow down and enjoy yourself. Sit at a table for at least two lunches or dinners per week. Take at least 20 minutes to enjoy those meals. And try to eat as many meals as possible with family and friends.</p> <h4>Plant-based, not meat-based</h4> <p>The foundation of the Mediterranean diet consists of vegetables, fruits, herbs, nuts, beans and whole grains. Meals are built around these plant-based foods. Moderate amounts of dairy, poultry and eggs are also central to the Mediterranean Diet, as is seafood. In contrast, red meat is eaten only occasionally.</p> <h4>Healthy fats</h4> <p>Healthy fats are a mainstay of the Mediterranean diet. They're eaten instead of less healthy fats, such as saturated and trans fats, which contribute to heart disease.<br /> Olive oil is the primary source of added fat in the Mediterranean diet. Olive oil provides monounsaturated fat, which has been found to lower total cholesterol and low-density lipoprotein, also known as LDL or "bad" cholesterol, levels. Nuts and seeds also contain monounsaturated fat.</p> <p>Fish are also important in the Mediterranean diet. Fatty fish, such as mackerel, herring, sardines, albacore tuna, salmon and lake trout, are rich in omega-3 fatty acids, a type of polyunsaturated fat that may reduce inflammation in the body. Omega-3 fatty acids also help decrease triglycerides, reduce blood clotting, and decrease the risk of stroke and heart failure.</p> <h4>What about wine?</h4> <p>The Mediterranean diet typically includes wine. However, it is an optional part of this eating plan. In moderate amounts, alcohol can reduce the risk of heart disease.</p> <p>Drinking more than the suggested amounts may increase your risk of health problems, including certain types of cancer. If you drink alcohol, choose wine as your primary drink. Red wine is a more of a Mediterranean choice than white wine, but white wine is fine, as well. Limit your intake to one glass per day and drink it with a meal.</p> <h4>If you're interested in trying the Mediterranean diet, these tips will help you get started:</h4> <ul> <li><strong>Eat more fruits and vegetables.</strong><br /> Aim for seven to 10 servings per day of fruit and vegetables.</li> <li><strong>Opt for whole grains.</strong><br /> Switch to whole-grain bread, cereal and pasta. Experiment with other whole grains, such as bulgur and farro.</li> <li><strong>Use healthy fats.</strong><br /> Try olive oil as a replacement for butter when cooking. Instead of putting butter or margarine on bread, try dipping it in flavored olive oil.</li> <li><strong>Eat more seafood.</strong><br /> Eat fish twice a week. Fresh or water-packed tuna, salmon, trout, mackerel and herring are healthy choices. Grilled fish tastes good and requires little cleanup. Avoid deep-fried fish.</li> <li><strong>Reduce red meat.</strong><br /> Substitute fish, poultry or beans for meat. If you eat meat, make sure it's lean and keep portions small.</li> <li><strong>Enjoy some dairy.</strong><br /> Eat low-fat Greek or plain yogurt and small amounts of a variety of cheeses.</li> <li><strong>Spice it up.</strong><br /> Herbs and spices boost flavor and lessen the need for salt.</li> </ul> <p>The Mediterranean diet is a delicious and healthy way to eat. Many people who switch to this style of eating say they'll never eat any other way.</p> <p><em>Teresa Scanlan is a <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">Cardiology</a> nurse practitioner in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a> and <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2021/salmon-on-wood-cutting-board.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0CE57A4D714270C94FE0D66E8982506C" alt="Salmon on wood cutting board" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller6/2/2021Balance issues, which can make you feel dizzy or unsteady, may be caused by damage to your central nervous system. Learn how and what can be done to steady your balance.Feeling off balance? A nerve condition may be to blame<p>Problems that affect balance can make you feel dizzy or as if the room is spinning and you're going to fall. At times, you may feel unsure or unsteady on your feet, as if your brain and legs are disconnected.</p> <p>Many body systems, including your brain, nerves, muscles, bones, joints, eyes, inner ear and blood vessels, must work together to maintain normal balance. When any of these systems aren't functioning well, you can experience balance problems. Occasionally, balance concerns are caused by issues with your central nervous system, including your brain, spinal cord and peripheral nerves.</p> <h2>Determine when your balance issues started</h2> <p>Many people dismiss balance issues as a normal part of aging. While this is true to an extent, any noticeable change in your balance is important to bring to the attention of your health care team. A rapid deterioration versus a gradual decline in balance is important information to determine the urgency needed to be evaluated by a health care provider.</p> <p>If you notice gradual changes, such as needing to hold the stair rail or grab the counter occasionally, you should contact your primary care provider. He or she can evaluate you for signs of more concerning symptoms. In some cases, it could be something simple, such as dehydration, or <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/vertigo/symptoms-causes/syc-20370055" target="_blank" title="Opens in a new window.">benign paroxysmal positional vertigo</a>, which can be treated in a few therapy sessions.</p> <p>If your symptoms are severe and dramatic ― for example, the inability to keep your balance suddenly with no previous concerns ― you could have a serious medical condition, such as a stroke or concussion. While rare, other primary brain problems leading to balance changes include tumors. These conditions require prompt medical attention and evaluation.</p> <h2>Nerve conditions that can affect balance</h2> <p>Many medical conditions can cause issues with balance, and several nerve conditions could be linked to balance concerns. Your nervous system sends information from your brain and spinal cord to the rest of your body.</p> <h3>If a part of this system is damaged, the signals can't be transmitted effectively, which leads to balance issues and falling. Here's how:</h3> <ul> <li><strong>Brain</strong><br /> A traumatic injury, such as a concussion or stroke, could cause you to feel off balance. A stroke or "mini stroke," also known as a transient ischemic attack, or TIA, can lead to an abrupt loss of balance, weakness on one side or speech problems. A brain tumor also can interfere with the connection between your brain and the nerves in your legs and feet, causing you to feel unsteady or weak.</li> <li><strong>Cervical and thoracic spine</strong><br /> Arthritis in your neck, upper and mid spine, also known as your cervical or thoracic spine, can compress your spinal cord. This is called spinal stenosis. When this occurs, the nerve signals don't travel efficiently from the brain to your feet and cause you to lose your balance. This spinal cord disease is called myelopathy, and it interferes with the signals between the brain and feet. Myelopathy can lead to hand weakness, and dexterity and balance issues. Often, people with this disease notice that they lose their balance if they close their eyes in the shower or cannot walk heel to toe in a straight line. They also can have clumsy hands, numbness and tingling, and sensation of shocks in their arms and legs.</li> <li><strong>Lumbar spine</strong><br /> Degeneration of your lumbar, or lower back, vertebrae can compress your nerve roots, which can cause significant pain, numbness, tingling, weakness or difficulty lifting the front part of your foot. These symptoms can lead to balance issues and a potential fall.</li> <li><strong>Peripheral nerves</strong><br /> The nerves outside of your brain and spinal cord can become damaged, which is called peripheral neuropathy. Weakness, numbness, pain and balance issues can be caused by peripheral neuropathy because it makes it difficult to determine where your body is relative to other objects or the ground.</li> </ul> <p>Typically, spinal stenosis or degeneration occurs slowly over time. However, your symptoms could progress quickly and affect your activities if you have a traumatic event like a fall or automobile accident.</p> <p>Also, people are busy and often learn to compensate for small changes in symptoms. Your body may continually compensate for months or even years until a fall or other event significantly affects your balance.</p> <h2>Treatment options for balance issues</h2> <p>If you are experiencing balance concerns, the No. 1 goal of treatment is to prevent you from falling. In many cases, your health care team will first look to conservative treatment measures. Such measures could include physical therapy or the use of a walking aid device. During this time, it's essential that you communicate to your health care team if you've had a fall, or experience new numbness, tingling, weakness or worsening symptoms.</p> <p>If your spinal cord is injured and you develop symptoms suddenly, the goal is to seek care immediately before you lose function. This could include spinal decompression surgery. If a tumor is causing your balance issues, you may require surgery, radiation or chemotherapy.</p> <h2>Learn more:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/5-common-misconceptions-about-vertigo-dizziness" target="_self" title="Opens in same window.">5 common misconceptions about vertigo, dizziness</a></li> <li><a href="/hometown-health" target="_self" title="Opens in same window.">Bride walks down the aisle after brain surgery</a></li> <li><a href="/hometown-health" target="_self" title="Opens in same window.">Surgery leads to a happy back, retirement</a></li> <li><a href="/hometown-health/speaking-of-health/what-is-spinal-fusion-and-does-it-work" target="_self" title="Opens in same window.">What is a spinal fusion, and does it work?</a></li> </ul> <p><a href="/providers/meghan-murphy-md" target="_self" title="Opens in same window."><em>Meghan E. Murphy, M.D.</em></a><em>, is a neurosurgeon in<a href="/locations/mankato" target="_self" title="Opens in same window."> </a><a href="/services-and-treatments/spine-care" target="_self" title="Opens in same window.">Spine Care</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Degenerative diseases of the spine (stenosis, spondylolisthesis, scoliosis, radiculopathy)</li> <li>Education of medical students and advanced practice providers (physician assistants and nurse practitioners)</li> <li>Mentorship of women pursuing the medical field and surgical specialties</li> <li>Metastatic disease of the brain and spine</li> <li>Spinal tumors</li> <li>Traumatic brain and spine injuries</li> </ul>M.D.<p>Medicine is my vocation. I feel that I have been called to serve others by helping address spinal and brain pathology that is impacting quality of life and potentially quantity of life. It is a joy to play a role in empowering my patients to achieve the quality of life they desire. </p> <p>You can expect my full attention and dedication to your symptoms and concerns at the time of our consultation. I will be honest in discussion of what I can or cannot offer you. If I am unable to recommend surgery that will benefit you — with benefits outweighing the risks — I will help ascertain the best next step and connect you with those resources. </p> <p>I grew up in Colorado and completed my education and subsequent training at Notre Dame, Georgetown, and Mayo Clinic.</p> <p> Family and faith are important to me. I have a wonderful husband with whom I have two young boys — being a boy mom definitely suits me. I also have a goofy golden retriever, and we all love to be outside and active. </p><p><strong>Education</strong></p> <ul> <li>Georgetown University School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Neurologic Surgery, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Neurologic Surgery, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Neurosurgery Spine Enfolded, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Neurological Surgery, American Board of Neurological Surgery</li> </ul> <p><strong>Membership</strong></p> <ul> <li>Alpha Omega Alpha Medical Honor Society</li> <li>Congress of Neurological Surgeons</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Neurosurgery, Mayo Clinic College of Medicine and Science</li> </ul>Murphy<img src="/-/media/shared-files/images/medical-professionals/full/mankato/meghan-murphy-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=488A8D1221A32E0ADEE87A1875CC8219" alt="Meghan Murphy MD" width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=28486638" target="_blank" title="Opens in new window.">Predictors of Discharge to a Nonhome Facility in Patients Undergoing Lumbar Decompression Without Fusion for Degenerative Spine Disease</a>, October 2017.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=27858534" target="_blank" title="Opens in new window.">Lumbar decompression in the elderly: increased age as a risk factor for complications and nonhome discharge</a>, March 2017.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=27908218" target="_blank" title="Opens in new window.">Risk factors for dural tears: a study of elective spine surgery</a>, February 2017.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=27866034" target="_blank" title="Opens in new window.">Micro vs. macrodiscectomy: Does use of the microscope reduce complication rates?</a>, January 2017.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=26838173" target="_blank" title="Opens in new window.">Unique cause of right hemispheric syndrome: Embolism of myocardium after open septal myectomy</a>, April 2016.</li> </ul>{65C398B7-CDF4-4A31-BA46-251A97B286EA}Meghan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15411991Meghan Murphy, M.D.1{4EA2A40E-3721-48EC-AFC9-E6D0E13BCDEC}<img src="/-/media/national-files/images/hometown-health/2021/trail-hiker-looking-up-off-to-side.jpg?h=370&iar=0&w=660&sc_lang=en&hash=36513DEA6257436D623EC465C4119E05" alt="Trail hiker looking up off to side" width="660" height="370" DisableNVelocity="true" />NeurosurgeryNeurosurgery treats disorders that impact any part of the nervous system, which may include the brain, spine or peripheral nerves. Conditions treated range from life-threatening brain tumors, to disorders impacting quality of life, such as back pain and carpel tunnel syndrome.Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.ArthritisArthritis is inflammation of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis.Dawn Haller6/25/2021Do people comment on the volume of your earbuds or TV? Does it seem like voices are too soft and everyone's mumbling? If so, it may be time to get your hearing checked.Is it time to get your hearing checked?<p>If you find yourself turning up the volume on your devices, there's a constant ringing or buzzing in your ears, restaurants seem too noisy, your friends' voices are too soft and everyone seems to be mumbling, it might be you and not them. And it may be time to get your hearing checked.</p> <h4>Causes and effects</h4> <p>Hearing loss, which affects people of every age, has a wide range of causes from an injury to a sustained loud working environment to genetics. Hearing loss isolates people from the people in their lives and their environment. It's also fatiguing.</p> <p>People with hearing loss work hard to hear what's being said. Research has shown that kids with hearing loss are more tired than those with normal hearing and even kids with chronic conditions. These findings correlate with adults too. There's also a link between hearing loss, stress levels and cognitive decline.</p> <h4>Getting screened</h4> <p>Unfortunately, once people are out of school, there are no regular screenings for hearing loss. The next time people may undergo preventive screening is when they start receiving Medicare. That's a long stretch of time when hearing loss may go undetected.</p> <p>If you're wondering about the quality of your hearing, you can ask to have it tested. You should have a baseline test at least by age 65. Most insurance covers routine hearing screening, and it can be performed in your primary care provider's office. They have the equipment because they screen kids all the time.</p> <p>Even if a patient is screened, research has found they wait an average of five to 10 years before they do anything to address the results. That's due to three main barriers: the stigma of wearing hearing aids — especially their mistaken association with being old — how much they cost and lack of insurance coverage.</p> <h4>Saying 'yes' to hearing aids</h4> <p>Basically, hearing aids increase your ease of hearing. Because they do the hard work of hearing, they can reduce levels of stress and fatigue. They also let you rejoin conversations and more fully enjoy your favorite activities.</p> <p>Today's hearing aids are a good blend of medical and physical. While in some ways they're similar to AirPods, headphones and Bluetooth, they go one step further by allowing you to customize your hearing. You now can adjust them with your cellphone, choosing their performance based on the environment, recharge them at night and much more. They're like personal, wireless headphones.</p> <p>While hearing aids aren't perfect, an audiologist can help you find the ones that best fit your lifestyle and needs. You can choose the fit and whether you like how they sound. And once you're fitted with hearing aids, if something doesn't feel right, the audiologist can adjust them.</p> <p>So don't spend five to 10 years suffering through hearing loss. Get screened and then, if needed, work with an audiologist to help you hear as well as possible.</p> <p><em><a href="/providers/katie-dease-aud" target="_self" title="Opens in same window.">Katie Kendhammer</a> is an <a href="/services-and-treatments/audiology" target="_self" title="Opens in same window.">audiologist</a> in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em></p><ul> <li>Amplification/hearing aids</li> <li>Audiometry</li> <li>Pediatrics</li> <li>Tinnitus</li> </ul>Au.D.<p><strong>Education</strong></p> <ul> <li>Doctor of Audiology, University of Wisconsin-Stevens Point</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Audiology</li> <li>Certificate of Clinical Competence, American Speech-Language-Hearing Association</li> <li>Hearing Instrument Dispenser</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Speech-Language-Hearing Association</li> </ul>Dease<img src="/-/media/shared-files/images/medical-professionals/full/mankato/katie-dease-aud.jpg?h=280&iar=0&w=280&hash=2A9E758AE48ADAA463D9362B7EE868C8" alt="Katie Dease, Au.D." width="280" height="280" DisableNVelocity="true" />{A4D89010-062B-42B7-830A-2F6D0A2BD079}Katie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15263924Katie Dease, Au.D.1{18E5E65E-45C8-4C48-BD32-A914794E2AA4}<img src="/-/media/national-files/images/hometown-health/2021/holding-record-album-and-sleeve.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9171101A29BBA4813F7DF41403C39989" alt="Holding record album and sleeve" width="660" height="370" DisableNVelocity="true" />Ear HealthAn audiologist specializes in evaluating and treating people of all ages with hearing loss, dizziness and balance disorders. Specialty audiology consultation is available for assessment and treatment of hearing loss, tinnitus, dizziness and balance disorders.Dawn Haller6/16/2021You've heard of implantable devices to treat medical conditions, but did you know there is a device to help treat urinary incontinence? Get answers to common questions about this treatment option.Nerve stimulation to treat urinary incontinence<p>Many people have heard of pacemakers and how they can be used to treat heart conditions. But did you know a similar implantable device is available to treat urinary incontinence?</p> <p><a href="/hometown-health/speaking-of-health/what-is-urge-incontinence" target="_self" title="Opens in same window.">Urinary incontinence</a>, or the loss of bladder control, is common. One of the most common types is urge incontinence, which is distinguished by a sudden, intense urge to urinate followed by an involuntary loss of urine. About <a href="/hometown-health/speaking-of-health/is-urine-incontinence-normal-for-women" target="_self" title="Opens in same window.">17% of women and 3% to 11% of men experience urge incontinence</a> at some point in their lives.</p> <p>Symptoms of incontinence can cause people to feel socially isolated, experience sexual inhibition, or become afraid to make social or travel plans. Careers and personal relationships are often affected.</p> <p>Fortunately, many treatment options can help, including sacral neuromodulation.</p> <h2>Here are answers to common questions about this treatment option:</h2> <h3>How long do you need to have symptoms before seeking treatment?</h3> <p>Talk with your primary care provider or OB-GYN if you have experienced symptoms of urinary incontinence for six months or longer. First and foremost, our approach is to try to understand what is contributing to your symptoms.</p> <h3>Do you need to try other treatment options first?</h3> <p>Yes, you'll usually try other treatment options first. Three categories of treatments are available for urinary incontinence, and the most appropriate option will depend on the cause of your symptoms.</p> <p>First-line treatments include conservative treatments, such as making lifestyle changes to train your bladder or physical therapy, including pelvic floor and Kegel exercises. Second-line treatments include medication therapy. The first medication was approved by the FDA in 2003 and many options became available since that time. Each person responds differently to medication therapy, so it's good to have options.</p> <p>The first two categories of treatment provide symptom relief for about 75% of people. By the time we are discussing a sacral neuromodulation procedure, you'll have tried and failed treatment options from the first two categories or couldn't tolerate the side effects.</p> <h3>How does sacral neuromodulation work?</h3> <p>With sacral neuromodulation, a small device is inserted under your skin in your lower back. Small wires, called leads, send low-level, mild electrical impulses to your sacral nerves.</p> <p>Located near the tailbone, these nerves help with sensation, and control the pelvic floor and the muscles related to bladder and bowel function. Bluetooth technology is used to control the device.</p> <p>Unlike medications and physical therapy, which target the muscles that control your bladder and bowel function, sacral neuromodulation can offer symptom relief by modulating your nerve signals.</p> <h3>Can I try sacral neuromodulation before committing?</h3> <p>Yes, you can try sacral neuromodulation before committing. That's one of the benefits of this procedure. We can "test drive" it to see if it will work for you.</p> <p>During the trial phase, a temporary device is placed on your back with local anesthetic. For four to seven days, you will record your symptoms in a bladder diary to evaluate the device's effectiveness. Overall, we are looking for at least a 50% reduction in your symptoms, but will also evaluate subjective measurements like your comfort level.</p> <h3>How is the device inserted?</h3> <p>A surgeon will implant the device in an operating room under sedation, similar to sedation used during a colonoscopy. A 2- to 3-inch incision will be made in your lower back, and the small device will be placed below your skin and above the muscle. You will be able to go home the same day as the procedure.</p> <h3>How big is the device?</h3> <p>Medical technology has made significant advances in recent years, and implantable medical devices have gotten smaller. The current device, which is about the size of a thumbnail drive, is smaller than most pacemakers. A new version is available that has a rechargeable battery that lasts about 15 years. These devices also are MRI-safe so you can have scans of your hips, back or legs in the future, if needed.</p> <h3>Will the device trigger a metal detector?</h3> <p>Yes, a sacral neuromodulation device will trigger a metal detector similar to a cardiac pacemaker or artificial joint. You will be given a card that can be used to disclose the device to officials.</p> <h3>How effective is sacral neurostimulation?</h3> <p>The effectiveness of sacral neuromodulation depends on a patient's age, with younger patients responding better to the treatment. Overall, about 70% to 85% of patients find relief from their urinary incontinence symptoms with sacral neurostimulation.</p> <h3>Will sacral neurostimulation change my digestive habits?</h3> <p>No. Sacral neuromodulation will not change your digestive habits or your digestive system. This treatment stimulates the sacral third nerve, which controls sensation of the bladder and bowel walls. It will not impact your digestive system at all.</p> <p>You don't just have to live with urinary incontinence symptoms. There are many treatment options available so talk with your primary care provider or OB-GYN about your symptoms.</p> <h4>Watch this video to learn more about urinary incontinence treatments including sacral neuromodulation therapy:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/HNIMJx5I-Ys" title="Urinary incontinence" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <h2>Learn more about incontinence:</h2> <ul> <li>Embarrassed no more: Nerve stimulation helps overcome fecal incontinence</li> <li><a href="/hometown-health/speaking-of-health/how-do-bladder-botox-injections-work" target="_self" title="Opens in same window.">How do bladder Botox injections work?</a></li> </ul> <p><a href="/providers/gokhan-anil-md" target="_self" title="Opens in same window.">Gokhan Anil, M.D.</a>, is an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> and specialist in pelvic medicine and reconstructive surgery in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a> and <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</p><ul> <li>Advanced laparoscopy and robotic surgery </li> <li>Fecal incontinence</li> <li>Minimally invasive pelvic surgery</li> <li>Overactive bladder </li> <li>Pelvic organ prolapse </li> <li> Sacral neuromodulation (Interstim) therapy</li> <li>Urinary incontinence</li> <li>Urogynecology</li> <li>Women's health</li> </ul>M.D.<p>I manage a patient-centric, collaborative practice and have a strong desire to heal and inspire hope to my patients. I strongly believe that there is no “doctor” without the “patient,” and I entrust my team to deliver the best care to meet the needs of our patients. </p> <p>In my free time, I love to travel with my family and read. I also enjoy problem solving. </p><p><strong>Medical School</strong></p> <ul> <li>University of Ankara Faculty of Medicine</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>Obstetrics & Gynecology, Baylor College of Medicine</li> <li>Obstetrics & Gynecology, West Virginia University - Charleston Division, Charleston Area Medical Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Obstetrics & Gynecology (ABOG)</li> <li>Female Pelvic Medicine & Reconstructive Surgery</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Obstetrics & Gynecology, Mayo Clinic College of Medicine and Science</li> </ul>Anil<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/gokhan-anil-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=6C4C4DE9D551A107FCA92ACD73B4EA64" alt="Gokhan Anil MD" width="280" height="280" DisableNVelocity="true" /><li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.liebertpub.com/doi/abs/10.1089/gyn.2021.0041" target="_blank" title="Opens in a new window">Intraoperative Genitourinary Injuries During a Hysterectomy: Risks, Management, and Mitigation Strategies</a>, May 2021</li>{0C431270-7870-45F2-83FE-F912E09A9495}Gokhan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14974142Gokhan Anil, M.D.1<img src="/-/media/national-files/images/hometown-health/2021/holding-cellphone-in-hand-in-kitchen.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4661293E2F47DA8B350063BFE4619365" alt="Holding cellphone in hand in kitchen" width="660" height="370" DisableNVelocity="true" />Urinary IncontinenceThe loss of bladder control is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that's so sudden and strong you don't get to a toilet in time. For most people, simple lifestyle changes or medical treatment can ease discomfort or stop urinary incontinence.Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Dawn Haller6/14/2021Pancreatic cancer is difficult to find early because it often doesn't cause symptoms until after it has spread to other organs. Learn about a minimally invasive procedure used to improve chances of survival.New option for earlier diagnosis, staging of pancreatic cancer<p><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/pancreatic-cancer/symptoms-causes/syc-20355421" target="_blank" title="Opens in a new window.">Pancreatic cancer</a> begins in the tissues of your pancreas — an organ in your abdomen that lies behind the lower part of your stomach. Your pancreas releases enzymes that aid digestion and produce hormones that manage your blood sugar.</p> <p>Pancreatic cancer is hard to find early when it's most curable. That's because it often doesn't cause symptoms until after it has spread to other organs.</p> <h4>Symptoms may include:</h4> <ul> <li>Abdominal pain that radiates to your back</li> <li>Loss of appetite or unintended weight loss</li> <li>Yellowing of your skin and the whites of your eyes (jaundice)</li> <li>Light-colored stools</li> <li>Dark-colored urine</li> <li>Itchy skin</li> <li>New diagnosis of diabetes or existing diabetes that's becoming more difficult to control</li> <li>Blood clots</li> <li>Fatigue</li> </ul> <p>While pancreatic cancer represents about 3% of all new cancer diagnosed each year, it accounts for about 7% of all cancer deaths. It has one of the lowest five-year survival rates of all cancers.</p> <h4>Endoscopic ultrasound for pancreatic cancer</h4> <p>But it's not all bad news, as the medical community is making advances to improve patients' chances of survival. Health care providers can now use a minimally invasive procedure to better understand the complexity or stage of pancreatic cancer.</p> <p>Endoscopic ultrasound uses high-frequency sound ways to produce a detailed image of the lining and walls of your digestive tract and nearby organs, including your pancreas. <br /> Previously, this type of advanced imaging only was available at large research-based medical facilities. Now patients have can get this high level of care closer to home, and I believe that expanded access will improve patients' experiences and results.</p> <h4>Endoscopic ultrasound helps health care providers:</h4> <ul> <li>Determine the extent, or stage, of cancer, if present.</li> <li>Obtain tissue samples from the tumor for diagnosis and genetic testing.</li> <li>Assess how deeply a tumor penetrates your abdominal wall.</li> <li>Determine if cancer has spread, or metastasized, to your lymph nodes or other organs.</li> <li>Evaluate abnormal findings from imaging tests, such as cysts of the pancreas.</li> <li>Permit precise targeting for delivering medication directly into the pancreas.</li> </ul> <p>Using this information, your health care team will determine what treatments are most likely to benefit you. Your treatment may include surgery, radiation or chemotherapy, or a combination of these treatments. These options are more effective when the cancer is discovered early.</p> <img alt="Endoscopic ultrasound pancreatic cancer" src="/-/media/national-files/images/hometown-health/2021/endoscopic-ultrasound-pancreatic-cancer.jpg?h=350&w=316&sc_lang=en&hash=4E96D5DE2ED91C927F6D0DA8C7F2DA69" style="height: 350px; width: 316px; float: right; margin-bottom: 5px; margin-left: 5px;" /> <h4>What to expect</h4> <p>During an endoscopic ultrasound procedure, you will be given medicine to help you relax. A gastroenterology physician will pass a thin, flexible tube called an endoscope through your mouth and digestive tract. A small ultrasound device, called a transducer, in the tube produces sound waves that create a precise image of the surrounding tissues. Then the endoscope is gradually withdrawn. Most patients tolerate the procedure well.</p> <h4>Other uses of endoscopic ultrasound</h4> <h5>Endoscopic ultrasound also can help evaluate:</h5> <ul> <li>Cancer of the colon, esophagus, lung, pancreas, liver or stomach, and ampullary and rectal cancers</li> <li>Lymphoma</li> <li>Barrett's esophagus</li> <li>Neuroendocrine tumors</li> <li>Pancreatitis and pancreatic cysts</li> <li>Bile duct stones</li> <li>Sarcoidosis</li> </ul> <p>Endoscopic ultrasound also can be used for therapy, including drainage of abscesses or cysts, treatment of pain in pancreatic cancer, or to create an access in patients with prior gastric bypass surgery for weight loss.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2021/couple-standing-together-looking-down.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B62B86C27525F30CD199BCC15047E2B3" alt="Couple standing together looking down" width="660" height="370" DisableNVelocity="true" />CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Dawn Haller6/11/2021Put a freeze on your chronic stuffy nose. Learn how nasal cryotherapy uses intense cooling to treat overactive nerves in your nose and sinus cavities, and helps with long-lasting symptom relief.Solve chronic stuffy nose with intense cooling<p>Do you feel like you are constantly reaching for a tissue because of a persistent dripping or stuffy nose? You don't need to live with this annoyance anymore. A new targeted treatment is available called nasal cryotherapy. This treatment uses intense cooling to help people with chronic rhinitis.</p> <h2>Chronic rhinitis</h2> <p>Chronic rhinitis is persistent nasal congestion, runny nose and postnasal drip with no apparent cause. While the exact cause is unknown, it's believed that overactive or out-of-balance nerves in the nose and sinuses send more signals than necessary to your brain. This causes your body to produce too much mucus, leading to runny or dripping nose. And your nasal and sinus tissues become inflamed, causing congestion.</p> <p>Symptoms are similar to allergies but with none of the usual evidence of an allergic reaction. Usually chronic rhinitis doesn't cause itchy nose, eyes or throat, as those symptoms are associated with allergies. When left untreated, rhinitis can be disruptive and annoying. It also increases your chances of developing inflammation or an infection of your sinuses.</p> <p>It is more common after age 20, and can be triggered by weather changes, odors or irritants in the air or certain foods. A diagnosis of chronic rhinitis is often made after an allergic cause is ruled out. This may require allergy skin or blood tests.</p> <h2>Nasal cryotherapy treatment</h2> <p>Nasal cryotherapy, also known as nasal cryoablation or cold therapy, is a noninvasive treatment to stop symptoms of chronic rhinitis. It uses an endoscope and cryotherapy device to freeze nerves in your nasal passages. When the cold temperature hits the nerves, the nerve signals are interrupted and no longer tell the nose to swell, drip and run. The interruption of the nerve signals provides long-lasting relief from runny or stuffy nasal symptoms. It is completed in your health care provider's office, and you can resume most regular activities the same day.</p> <p>During the procedure, you will sit in an examination chair, and the inside of your nose will be numbed. A probe with a camera will be placed into the back of your nose. Then the tip of the probe uses intense cooling ― between minus 4 and minus 148 F ― to treat the overactive nerves in your nose and sinus cavities.</p> <p>During the treatment, you will feel some pressure and a cold sensation in your nose. The treatment takes about five minutes, and most people can return to their regular activities the same day.</p> <h2>Results to expect</h2> <p>Initially after the procedure, you may have increased congestion for a short period of time. Most patients report a significant, long-lasting improvement in their symptoms two to six weeks after the procedure. Nasal cryotherapy can provide you with symptom relief for up to a year or longer.</p> <p>Talk with your primary care provider or ear, nose and throat provider if you believe nasal cryotherapy can help you.</p> <h3>In this video, learn about options for when noninvasive treatments no longer ease your sinus issues and you may be a candidate for surgery:</h3> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/PrKMosNToPw" title="Ask Mayo Clinic Health System: Sinus Surgery" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <h3>Learn more about issues that can cause nasal irritation:</h3> <ul> <li><a href="/hometown-health/speaking-of-health/unlocking-the-mystery-of-your-sinuses" target="_self" title="Opens in same window.">Unlocking the mystery of your sinuses</a></li> <li><a href="/hometown-health/speaking-of-health/say-goodbye-to-springtime-allergies" target="_self" title="Opens in same window.">Say goodbye to springtime allergies</a></li> </ul> <p><em><a href="/providers/quintin-cappelle-md" target="_self" title="Opens in same window.">Quintin Cappelle, M.D.</a>, is an <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">otorhinolaryngologist, and head and neck surgeon</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em> </p><ul> <li>Chronic ear disease</li> <li>Chronic sinusitis</li> <li>Ear tubes/tympanostomy tubes</li> <li>Endoscopic dacryocystorhinostomy (tear duct surgery)</li> <li>Head and neck cancer</li> <li>Hearing loss</li> <li>Nasal polyps</li> <li>Nose and sinus disease</li> <li>Parathyroid adenomas</li> <li>Parotid disease</li> <li>Salivary gland/parotid</li> <li>Thyroid nodules</li> <li>Thyroid/parathyroid disease</li> <li>Tonsillectomy and adenoidectomy</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Illinois at Chicago College of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Otolaryngology – Head and Neck Surgery, University of Illinois at Chicago Eye & Ear Infirmary</li> </ul> <p><strong>Membership</strong></p> <ul> <li>Head and Neck Surgery, American Academy of Otolaryngology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Otolaryngology, Mayo Clinic College of Medicine and Science</li> </ul>Cappelle<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/quintin-cappelle-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=AAB359B4BA7F1209F2C019BFA15FE31E" alt="Quintin Cappelle MD" width="280" height="280" DisableNVelocity="true" />{B48121EC-8A20-45D5-9673-3DDA968CB0D1}Quintin<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20279493Quintin Cappelle, M.D.1{18E5E65E-45C8-4C48-BD32-A914794E2AA4}|{E9B8BDBE-375B-4E7D-A1D2-2B64B5513AF7}<img src="/-/media/national-files/images/hometown-health/2021/smiling-person-blue-shirt-white-hat.jpg?h=370&iar=0&w=660&sc_lang=en&hash=DF961D1514CF6E7A47B795E0D212617C" alt="Smiling person wearing a blue shirt and white hat" width="660" height="370" DisableNVelocity="true" />Ear, Nose and Throat (ENT)Get information about symptoms, disorders and diseases affecting the ear, nose and throat, and related head and neck structures.Dawn Haller9/15/2025Good nutrition plays a key role in your overall health. Learn what micronutrients are critical for the growth and functions of immune cells, and try two recipes packed with nutrition.Support your immune function with good nutrition<p>One of the most valuable things you have is your health. As a dietitian, I have received numerous queries about recommended foods, supplements and diet patterns to boost immune function. While it is true that nutrition plays a large role in immune function, diet recommendations for the prevention of acute illnesses, like COVID-19 and other viruses, don't look a whole lot different than general guidelines for healthy eating.</p> <p>I'll start by saying that the concept of boosting the immune system through diet is flawed, as boosting refers to something that is stimulated above the normal level. A good diet cannot boost the immune system, but it's important to maintain a functional immune system by avoiding immunodeficiency due to malnutrition or micronutrient deficiencies.</p> <p>It's important to note that no single food or nutrient will prevent illness. Also, the immune system is incredibly complex and influenced by a variety of other factors, including stress level, age, sleep and other medical conditions.</p> <h3>A few key micronutrients have been identified as critical for the growth and function of immune cells, including:</h3> <ul> <li><strong>Iron</strong><br /> Iron is a component of enzymes critical for immune cell function. Sources include red meat, beans, nuts and fortified breakfast cereals.</li> <li><strong>Vitamin A</strong><br /> Vitamin A helps protect against infections by keeping skin and tissues in the mouth, stomach, intestines and respiratory system healthy. Sources include orange and red fruits, and vegetables like carrots, apricots and bell peppers.</li> <li><strong>Vitamin C</strong><br /> Vitamin C stimulates the formation of antibodies, and the production, function and movement of white blood cells. Sources include citrus fruits like oranges, grapefruit, strawberries and tomatoes.</li> <li><strong>Vitamin D</strong><br /> Vitamin D helps regulate antimicrobial proteins that can directly kill pathogens. Sources include sunlight; fatty fish, like salmon; egg yolks; and fortified dairy.</li> <li><strong>Vitamin E</strong><br /> Vitamin E works as an antioxidant to protect the integrity of cell membranes from damage caused by free radicals. Sources include seeds, nuts, vegetables oils and peanut butter.</li> <li><strong>Zinc</strong><br /> Zinc is needed for wound healing and supports immune response. Sources include meats, whole grains, milk, seeds and nuts.</li> </ul> <h3>Need a multivitamin or mineral supplement?</h3> <p>It's advised that people obtain the nutrients above from food rather than supplements, as foods contain more health-promoting benefits. For most, a balanced diet will supply adequate amounts of nutrition to maintain a strong immune system. However, certain populations, like pregnant people, the elderly and those who are critically ill, cannot eat a variety of nutritious foods or have increased nutrients needs. In these cases, vitamin and mineral supplements can help fill nutritional gaps.</p> <p>A general multivitamin or mineral supplement providing no more than 100% of your recommended daily allowance can be used and is generally safe for many people. Your health care provider may recommend further supplementation based on your lab values or medical status.</p> <p>Consult with your health care provider before beginning any supplement. Avoid "mega doses" or supplements that supply greater than 100% of your recommended daily allowance, as they often offer no additional benefit and can be harmful in some cases. Remember that supplements are not a substitute for a healthy diet, as they do not contain all the benefits in food.</p> <h3>If you're looking to try a new recipe that supplies nutrients needed for good immune function, consider one of these recipes:</h3> <h4>Grilled cod with crispy citrus salad</h4> <p>By Mayo Clinic staff<br /> Serves 2</p> <p>8 ounces cod<br /> 1 teaspoon olive oil<br /> 1½ cups chopped spinach<br /> 1½ cups shredded kohlrabi<br /> 1 cup diced celery<br /> 1½ cups shredded carrot<br /> 2 tablespoons chopped fresh basil<br /> 1 tablespoon chopped fresh parsley<br /> ¾ cup chopped red bell pepper<br /> 1 tablespoon minced garlic<br /> Zest and juice of 1 lemon<br /> Zest and juice of 1 lime<br /> Zest and juice of 1 orange<br /> 1 large grapefruit cut into segments <br /> 1 medium orange cut into segments <br /> Black pepper to taste</p> <p>Spray a grill or broiler pan with cooking spray. Turn on grill or heat broiler. Place cod on grill or broiler pan, and brush lightly with oil. Grill or broil 3 to 4 inches from heat for about 10 minutes, or until fish flakes easily with a fork. The fish should reach an internal temperature of 145 F. Set aside. In a large bowl, toss together remaining ingredients, except for grapefruit and orange segments. Divide salad between two plates. Top with cod and citrus pieces, and black pepper to taste.</p> <p>Nutritional per 4-ounce cod and 4 cups salad serving: 412 calories; 12 grams fat (2 grams saturated fat); 236 milligrams sodium; 50 grams carbohydrates; 26 grams protein; 13 grams fiber.</p> <h4>Roasted red pepper hummus</h4> <p>By Mayo Clinic staff<br /> Serves 16</p> <p>2 cups chickpeas<br /> 1 cup roasted red bell pepper, sliced, seeded<br /> 2 tablespoons white sesame seeds<br /> 1 tablespoon lemon juice<br /> 1 tablespoon olive oil<br /> 1¼ teaspoons cumin<br /> 1 teaspoon onion powder<br /> 1 teaspoon garlic powder<br /> 1 teaspoon kosher salt<br /> ¼ teaspoon cayenne pepper</p> <p>In a food processor, process all ingredients until smooth.</p> <p>Nutritional per 3-tablespoon serving: 53 calories; 2 grams fat (0 gram saturated fat); 126 milligram sodium; 7 grams carbohydrates; 2 grams protein; 2  grams fiber.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2021/fruits-and-vegetables-on-cutting-board.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D033A6CC56834BE975EC46E5A3E2BF6D" alt="Fruits and vegetables on cutting board" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Michele Halterman6/23/2023Independence Day has been celebrated with firework displays since the 1770s. Find out why you need to use extreme caution while using fireworks, and pick up some safety tips.Use caution with fireworks<p>Independence Day has been celebrated with firework displays since the late 1770s. Public shows are put on in large and small communities, and some families plan private celebrations as well. As you celebrate, remember to exercise extreme caution when using fireworks, which cause injuries and deaths every year.</p> <p>In 2021, the <a rel="noopener noreferrer" href="https://www.cpsc.gov/Safety-Education/Safety-Education-Centers/Fireworks" target="_blank" title="Opens in a new window.">Consumer Product Safety Commission</a> reported nine deaths related to fireworks and more than 11,500 injuries that were treated at emergency departments in the U.S. About 74% of these injuries occurred within a four-week period around Independence Day, from mid-June to mid-July.</p> <p>Overall, about 32% of all firework-related injuries were <a href="/hometown-health/speaking-of-health/ouch-ive-burned-my-hand" target="_self" title="Opens in same window.">burns</a>. Hands and fingers are the most commonly injured parts of the body, accounting for about 31% of cases. These types of injuries often occur when people hold lit fireworks. Sparklers can also cause burns to hands and arms, especially in small children.</p> <p>Eyes are especially susceptible to injury from fireworks. Eye wounds account for about 14% of fireworks-related injuries from the gunpowder, sulfur and charcoal that make up most fireworks.</p> <p>If an eye injury occurs, don't rinse, rub or apply pressure to the eye. This may cause irritants, such as charcoal or gunpowder, to move around the eye, leading to further damage. Instead, seek immediate medical attention.</p> <p>Fireworks are best left to professionals. If you choose to include fireworks in your private celebrations, confirm the type of fireworks that are allowed by your state and local ordinances.</p> <h2>Follow these safety tips when using fireworks:</h2> <ul> <li>Be sure to read and follow all safety information and instructions for proper use.</li> <li>Keep small children away from fireworks.</li> <li>Only use fireworks in an open area that is far from animals, buildings, brush or any combustible materials.</li> <li>Skip fireworks completely if your area is at a high, very high or extreme level of fire danger.</li> <li>Create a safety perimeter. For ground-based fireworks like fountains, have spectators view from at least 35 feet away. For aerial fireworks, this distance should be at least 150 feet.</li> <li>Keep pets indoors. This ensures their safety and reduces stress for you and your pets.</li> <li>Have a bucket of water nearby to cool used sparkler wires and extinguish other fireworks. Consider having a garden hose readily available to continually douse any accidental fires. </li> <li>Never allow anyone under the influence of alcohol or drugs to use fireworks.</li> <li>Light one device at a time.</li> <li>Never hold or place a body part over a lit firework.</li> <li>Never attempt to relight a device that did not ignite the first time.</li> <li>Once you light a firework, get away quickly. The warning labels on fireworks are there for a reason.</li> <li>Soak all used and unused fireworks in water for a few hours before discarding them to ensure they won't accidentally ignite during disposal.</li> <li>Consider safer alternatives to fireworks like party poppers, bubbles, silly string or glow sticks.</li> <li>Always call 911 in an emergency.</li> </ul> <p>Ashley Olson, D.O., is an Emergency Medicine physician in Mankato, Minnesota.</p><img src="/-/media/national-files/images/hometown-health/2021/fireworks-against-dark-blue-sky.jpg?h=370&iar=0&w=660&sc_lang=en&hash=AADCFE5B04996C65741902E36030C546" alt="Fireworks against dark blue sky" width="660" height="370" DisableNVelocity="true" />Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Dawn Haller6/15/2021Many personal care products claim to be natural, organic, free of synthetics and hypoallergenic. Learn what these mean to better understand what's really in the products.What are 'natural' personal care products?<p><em>By Mayo Clinic Health System staff</em></p> <p>What you put on your body is just as important as what goes into your body.</p> <p>With so many different claims on personal care product packages, such as "natural," "organic" and "free of synthetics," you may be left confused or misled about what's really in the products.</p> <h3>Here is what you should know about the most common claims:</h3> <h4>Natural</h4> <p>The term "natural" represents ingredients that are directly derived from nature and not created in a lab. The Food and Drug Administration (FDA) has never legally defined the term and has no regulations on its use.</p> <p>Sometimes natural ingredients are safer and better than synthetic alternatives. But many naturally occurring substances are not safe, and some are used as ingredients in personal care products. For example, clays may be contaminated with toxic heavy metals and certain additives can cause an allergic reaction.</p> <h4>Organic</h4> <p>The FDA regulates personal care products, but not the term "organic" for these products. Organic claims on cosmetics are regulated by the Department of Agriculture (USDA), but these regulations only apply to the agricultural ingredients used in personal care products.</p> <h5>The USDA allows two categories of certification to display its organic seal:</h5> <ul> <li><strong>100% organic</strong><br /> This certification indicates that a product contains only organically produced ingredients.</li> <li><strong>Organic</strong><br /> This certification signifies that at least 95% of a product's ingredients are organically produced and the remaining percentage of ingredients are on an approved list of substances.</li> </ul> <p>If a manufacturer claims a product to be organic, but that product does not carry an official seal, the product may not meet USDA organic standards.</p> <h4>Free of synthetics</h4> <p>A synthetic ingredient is anything synthetically derived, and neither found nor harvested directly from nature. A number of synthetic chemicals have been linked to cancer, hormone disruption, developmental disorders and other harmful health effects.</p> <p>Companies turn to synthetic versions of certain ingredients as a method of maintaining the safety and purity of their products. Synthetics ensure a product is always effective and identical each time it is made.</p> <h4>Hypoallergenic</h4> <p>Hypoallergenic cosmetics are products that manufacturers claim produce fewer allergic reactions than other cosmetic products. Consumers with hypersensitive skin, and even those with normal skin, may be led to believe that these products will be gentler to their skin than nonhypoallergenic cosmetics.</p> <p>However, no federal standards or definitions govern the use of the term "hypoallergenic."</p> <h4>How to choose healthier options</h4> <p>The best way to know what's in your products is by reading the list of ingredients.</p> <h5>Ingredients to avoid include:</h5> <ul> <li><strong>Butylated hydroxyanisole or butylated hydroxytoluene, or BHA or BHT, respectively</strong><br /> These preservatives are found in lipsticks, moisturizes and some food items.</li> <li><strong>Coal tar dyes</strong><br /> They are used as a colorant in hair dye and often labeled as "p-Phenylenediamine" or "CI" followed by a five-digit number.</li> <li><strong>Diethanolamine, or DEA</strong><br /> This is used to make products sudsy. It can be found in cleansers, soaps and shampoos.</li> <li><strong>Dibutyl phthalate, or DBP</strong><br /> This is a plasticizer found in nail polish.</li> <li><strong>Formaldehyde-releasing preservatives</strong><br /> These preservatives are known carcinogens. They also may be labeled as "DMDM hydantoin," "diazolidinyl urea," "imidazolidinyl urea," "methenamine," "quaternium-15" and "sodium hydroxymethylglycinate."</li> <li><strong>Parabens</strong><br /> These are found in many personal care products as a preservative. These are easily absorbed through the skin and are linked to a multitude of health risks, including cancer, endocrine disruption, reproductive toxicity, neurotoxicity and skin irritation.</li> <li><strong>Parfum or fragrance</strong><br /> According to the FDA, fragrance and flavors can be classified as a trade secret. Therefore, specific ingredients do not need to be disclosed on packaging.</li> <li><strong>Polyethlene glycols, or PEG compounds</strong><br /> These are used as thickeners in cream-based cosmetics. These compounds are synthetic chemicals that may be contaminated with a chemical identified as a probable carcinogen.</li> <li><strong>Petrolatum</strong><br /> This is also called mineral oil jelly, and it is used to lock in moisture on the skin. It often is contaminated by cancer-causing impurities.</li> <li><strong>Siloxanes</strong><br /> These silicone-based compounds can be found in cosmetics, deodorants, moisturizers, and facial treatments to soften, smooth and moisten. Some compounds associated with siloxanes are toxic, persistent and bioaccumulative, and they interfere with hormone function.</li> <li><strong>Sodium laureth sulfate, or SLS</strong><br /> SLS makes products sudsy and foamy. It can be found in cleansers, shampoos and shower gels. SLS can cause skin and eye irritation, and it is frequently contaminated with a known carcinogen.</li> <li><strong>Triclosan</strong><br /> Triclosan is an antibacterial agent. In 2016, the FDA banned triclosan from use in antibacterial soaps and hand washes, but it may still be found in other cosmetics including toothpaste, shave gel, deodorant, lotions and shampoo. Triclosan has been linked to hormone disruption and the emergence of bacteria-resistant superbugs.</li> </ul> <p>To help consumers buy products that are safe, Mayo Clinic experts have developed the SkinSafe app. The experts have done all the label reading for you, so when you buy and apply your lotions and creams, you can be more certain that the ingredients are safe.</p> <h4>Watch this video to learn more about the app:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/2GXCMBIYl0Y" title="Mayo Clinic Minute SkinSafe app" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p><img src="/-/media/national-files/images/hometown-health/2021/applying-moisturizer-on-cheek.jpg?h=370&iar=0&w=660&sc_lang=en&hash=05C7BCBA484DFD9FFFDA12751216AA18" alt="Applying moisturizer on cheek" width="660" height="370" DisableNVelocity="true" />Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Dawn Haller10/17/2024If your mammogram shows you have dense breast tissue, you may wonder what that means for you. Learn why breast density matters and how it may affect recommended breast cancer screening tests.What is dense breast tissue, and what do you need to know?<p>If a recent mammogram showed you have dense breast tissue, you may wonder what this means for your breast cancer risk. Healthcare professionals know dense breast tissue makes <a href="/hometown-health/speaking-of-health/advanced-breast-cancer-screening" target="_self" title="Opens in same window">breast cancer screening</a> more complex, and it increases the risk of breast cancer.</p> <h3>Here are answers to common questions about dense breast tissue:</h3> <h4>What is dense breast tissue?</h4> <p>Dense breast tissue refers to the appearance of breast tissue on a mammogram. It's a common finding identified in about 50% of women.</p> <p>Breast tissue is composed of milk glands, milk ducts and supportive tissue. These elements make up the dense tissue in the breast. Breasts also include fatty tissue, which is nondense tissue. When viewed on a mammogram, women with dense breasts have more dense tissue than fatty tissue.</p> <p>Nondense breast tissue appears dark and transparent on a mammogram. In contrast, dense breast tissue appears as a solid white area, which makes it difficult to see through.</p> <h4>How do doctors determine if you have dense breast tissue?</h4> <p>The radiologist who analyzes your mammogram determines the ratio of nondense tissue to dense tissue and assigns a level of breast density. The levels of density are described using a results reporting system called the Breast Imaging Reporting and Data System, which is provided by the American College of Radiology.</p> <h5>The levels of density are often recorded in your mammogram report using letters:</h5> <img alt="Breast density imaging categories" src="/-/media/national-files/images/hometown-health/2021/breast-density-imaging-categories.jpg?h=286&w=399&sc_lang=en&hash=ADE39843F662E3FA18CE4E0FD2CEB82E" style="height: 286px; width: 399px; float: right; margin-bottom: 5px; margin-left: 5px;"> <ul> <li><strong>A</strong> — This level indicates that the breasts are almost entirely composed of fat. About 1 in 10 women has this result.</li> <li><strong>B</strong> — Scattered areas of fibroglandular density indicate there are some areas of density, but most breast tissue is nondense. About 4 in 10 women have this result.</li> <li><strong>C</strong> — Heterogeneously dense indicates some areas of nondense tissue, but most breast tissue is dense. About 4 in 10 women have this result.</li> <li><strong>D</strong> — Extremely dense indicates that nearly all breast tissue is dense. About 1 in 10 women has this result.</li> </ul> <p>In general, women with breasts that are classified as heterogeneously dense or extremely dense ― levels C and D ― are considered to have dense breasts. About half of women undergoing mammograms have dense breasts.</p> <h4>What causes dense breast tissue?</h4> <p>It's not clear why some women have a lot of dense breast tissue and others do not. You may be more likely to have dense breasts if you:</p> <ul> <li><strong>Are younger</strong> — Your breast tissue tends to become less dense as you age, though some women may have dense breast tissue at any age.</li> <li><strong>Have a lower body mass index</strong> — Women with less body fat are more likely to have more dense breast tissue compared with women who are obese.</li> <li><strong>Take hormone therapy for menopause</strong> — Women who take combination hormone therapy to relieve signs and symptoms of menopause are more likely to have dense breasts.</li> </ul> <h4>Why does breast density matter?</h4> <p>Having dense breast tissue will not affect your daily life. However, it increases the chance that breast cancer may go undetected by a mammogram, since dense breast tissue can mask a potential cancer. It also increases your risk of breast cancer, though healthcare professionals aren't yet certain why.</p> <h4>What tests are recommended for breast cancer screening?</h4> <p>Most medical organizations recommend that women with an average risk of breast cancer consider regular mammogram testing beginning at age 40 and consider repeating the screening annually.</p> <p>Women with dense breasts but no other risk factors for breast cancer are considered to have a higher risk of breast cancer than average. Dense breast tissue makes it more challenging to interpret a mammogram, since cancer and dense breast tissue both appear white on a mammogram. Very dense breasts may increase the risk that cancer won't be detected on a mammogram.</p> <p>Despite concerns about detecting cancer in dense breasts, mammograms are still effective screening tools. The most common type of mammogram — digital mammogram — saves images of your breasts as digital files instead of film, allowing for more detailed analysis. This technology is more effective at finding cancer in dense breast tissue than older film mammography.</p> <h4>Are other tests more effective?</h4> <p>Additional tests carry additional risks and benefits, though MRI and molecular breast imaging have demonstrated superior cancer detection in women with dense breasts. You and your doctor may consider additional or supplemental testing based on your other risk factors and personal preferences.</p> <h5>Supplemental tests for breast cancer screening can include:</h5> <ul> <li><strong>3D mammogram, also known as breast tomosynthesis</strong><br> Tomosynthesis uses X-rays to collect multiple images of the breast from several angles. A computer synthesizes the images to form a 3D image of the breast. Many mammogram centers are transitioning to incorporate <a href="/hometown-health/speaking-of-health/3d-technology-provides-enhanced-breast-cancer-detection" target="_self" title="Opens in same window.">3D mammograms</a> as part of the standard mammogram technology.</li> <li><strong>Breast MRI</strong><br> MRI uses magnets to create images of the breast. An MRI doesn't use radiation. Breast MRI is recommended for women with a very high risk of breast cancer, such as those with genetic mutations that increase the risk of cancer.</li> <li><strong>Molecular breast imaging</strong><br> Molecular breast imaging uses a special camera ― a gamma camera ― that records the activity of a radioactive tracer. The tracer is injected into a vein in your arm. Normal tissue and cancerous tissue react differently to the tracer, which can be seen in the images produced by the gamma camera. Read a molecular breast imaging FAQ.</li> </ul> <p>Every test has pros and cons. Talk with your primary care provider about your breast cancer risk factors. Together, you can decide whether additional screening tests are right for you.</p> <p>Watch this video to learn about breast cancer screening options:</p> <p><iframe width="560" height="315" src="https://www.youtube.com/embed/xRH1EsOXyfU?si=wEpqU_E0aqcfX8_W" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin"></iframe></p> <h4>Learn more about breast cancer:</h4> <ul> <li><a href="/hometown-health/speaking-of-health/excuses-for-not-getting-a-mammogram" target="_self" title="Opens in same window">Excuses for not getting a mammogram</a></li> <li><a href="/hometown-health/speaking-of-health/medications-to-lower-breast-cancer-risk" target="_self" title="Opens in same window">Medications to lower breast cancer risk</a></li> <li><a href="/hometown-health/speaking-of-health/surgical-options-to-remove-breast-cancer" target="_self" title="Opens in same window.">Surgical options to remove breast cancer</a></li> <li><a href="/hometown-health/speaking-of-health/when-a-lump-is-more-than-a-lump" target="_self" title="Opens in same window">When is a lump more than a lump?</a></li> </ul> <p><em><a href="/providers/cameron-leitch-md" target="_self" title="Opens in same window"><em>Cameron Leitch, M.D.</em></a>, is a <a href="/services-and-treatments/radiology-and-imaging" target="_self" title="Opens in same window.">radiologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Breast</li> <li>Body</li> <li>Pulmonary</li> <li>Thoracic imaging</li> </ul>M.D.<p>It is an honor to be able to continue my involvement with world-class medical treatment and diagnosis, which is provided by Mayo Clinic. I also look forward to helping to continue innovation at the forefront of technology.</p> <p>I enjoy spending time with my family, fishing, and hockey.</p><p><strong>Medical School</strong></p> <ul> <li>University of North Dakota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Diagnostic Radiology, Mayo Clinic, Rochester, MN</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Breast Imaging, Mayo Clinic, Rochester, MN</li> </ul>Leitch<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/cameron-leitch-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=957902D01CDDDEB8CCCD4881017588FC" alt="Cameron Leitch, M.D." width="280" height="280" DisableNVelocity="true" />Cameron<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15735940Cameron Leitch, M.D.1<img src="/-/media/national-files/images/hometown-health/2021/dense-breast-tissue-imaging.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C34B691C01A103F438D5B0B4DAA5A000" alt="Dense breast tissue imaging" width="660" height="370" DisableNVelocity="true" />Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller6/17/2021Yoga is known to improve symptoms from chronic health conditions. Watch a video to learn sitting or standing yoga postures that can relieve muscle tension, reduce pain, increase energy and improve sleep.Yoga therapy: Relieve pain, manage stress<p>The practice of yoga is known to help with chronic health conditions such as diabetes, heart disease and chronic pain.</p> <p>Michele Hoffman, a certified yoga therapist at Mayo Clinic Health System, recently hosted a webinar to teach participants gentle yoga postures that can be performed while sitting on a chair or standing, as well as breathing practices and relaxation techniques that can relieve muscle tension, reduce pain, increase energy and improve sleep.</p> <h4>Watch this video to view the webinar:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/ADZvpmPGpIk" title="Yoga Therapy Relieve Pain Manage Stress" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <h4>Here are a few excerpts from the webinar, which was followed by a Q&A session:</h4> <ul> <li>Yoga therapy can help people recover from injuries and surgeries, manage chronic conditions, reduce or eliminate symptoms, and increase overall health and vitality.</li> <li>The good news is that anyone can do yoga. My teacher used to say that if you can breathe, you can do yoga. Everyone starts where they are, and the practice of yoga should be adapted to the needs of each person.</li> <li>When people think of yoga, most people think of the physical poses or stretching when in fact yoga has many tools to offer for healing body, mind and spirit. The tools of yoga include physical poses, breathing practices, meditation practices, hand gestures and a disciplined lifestyle of cultivating healthy habits.</li> <li>A general yoga class can ease your everyday aches and pains, and release stress. Yoga therapy goes further because a yoga therapist works with you to address your specific needs and goals while respecting any limitations you may be experiencing.</li> <li>The goals of yoga therapy are to eliminate, reduce or manage symptoms that cause suffering; improve function; help prevent the occurrence or reoccurrence of underlying causes of illness; help people move toward improved health and well-being; and help people change their relationship with their condition.</li> </ul> <p>Michele continues on to lead viewers through a 30-minute session of low-impact, seated yoga therapy followed by caring breath practice and guided relaxation.</p> <h4>Learn more about meditation and yoga:</h4> <ul> <li><a href="/hometown-health/speaking-of-health/mindfulness-meditation-improve-your-quality-of-life" target="_self" title="Opens in same window.">Mindfulness meditation: Improve your quality of life</a></li> <li><a href="/hometown-health/speaking-of-health/yoga-making-a-name-in-sports" target="_self" title="Opens in same window.">Yoga: Making a name in sports</a></li> <li><a href="/hometown-health" target="_self" title="Opens in same window.">Yoga therapy can help you heal, inside and out</a></li> </ul><img src="/-/media/national-files/images/hometown-health/2021/sitting-crosslegged-in-yoga-pose.jpg?h=370&iar=0&w=660&sc_lang=en&hash=228E9EC7C5A59A7AAB4985999BEDF726" alt="Sitting crosslegged in yoga pose" width="660" height="370" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Pain ReliefApproximately 50 million people in the U.S. live with chronic pain. If you experience chronic pain, you're not alone. Learn about the ways to deal with painful disorders, from at-home solutions to drug treatments, injectable or implantable therapies to surgery.Dawn Haller6/25/2021According to the American Cancer Society, 1 in 8 men will be diagnosed with prostate cancer. Here are 5 things you should know about prostate cancer and prostate specific antigen (PSA) tests.5 facts about prostate specific antigen (PSA) tests<p>According to the American Cancer Society, 1 in 8 men will be diagnosed with prostate cancer during his lifetime, and prostate cancer is the second leading cause of cancer death in American men. Here are five things you should know about prostate cancer and prostate specific antigen (PSA) tests.</p> <h4>1. Prostate cancer is silent for many men.</h4> <p>In most men, prostate cancer displays few early symptoms. Urinary symptoms, such as decreased force of urinary stream or nocturia (waking during the night because you need to urinate), are common in aging men; but, in general, these are not associated with prostate cancer. Symptoms such as bone pain, blood in urine or weight loss can be found if prostate cancer has spread.</p> <h4>2. Some men are at a greater risk for developing prostate cancer.</h4> <p>All men can develop prostate cancer. However, there are some risk factors that increase your likelihood. Older men are at increased risk. African American men and men with one or more close relatives who have had prostate cancer also are at increased risk. Your risk also will be higher if you have a close relative diagnosed with prostate cancer prior to age 55.</p> <h4>3. PSA tests do not diagnose prostate cancer.</h4> <p>A PSA test is a blood test used primarily to screen for elevated levels of the prostate specific antigen (PSA) released by the prostate. It can be elevated for a variety of reasons. PSA screening continues to be a highly debated, controversial topic among the medical community. It is important to note that PSA is not capable of diagnosing prostate cancer, but it is a screening test to help predict the risk of prostate cancer.</p> <p>There is no universally accepted threshold value above which total PSA is considered abnormal, as PSA values change depending on your age and race.</p> <h4>4. There are some downsides with a PSA test.</h4> <p>The actual PSA test has few side effects or risks. It requires a simple blood draw for evaluation in a lab. However, there are some potential downsides once the results are in. These could include:</p> <ul> <li>Elevated PSA levels can have other causes, such as benign prostate enlargement (benign prostatic hyperplasia) or prostate infection (prostatitis). These false positives are common.</li> <li>Some prostate cancers may not produce much PSA. It's possible to have what's known as a false negative. This is a test result that incorrectly indicates you don't have prostate cancer when you actually do.</li> <li>Follow-up tests to check out the cause of an elevated PSA test can be invasive, stressful, expensive or time-consuming.</li> <li>Living with a slow-growing prostate cancer that doesn't need treatment might cause stress and anxiety.</li> </ul> <h4>5. There are established screening guidelines for men of average risk of prostate cancer.</h4> <p>The American Urological Association has established guidelines for PSA tests to help health care providers and patients determine the best screening schedule. These guidelines are for men of average risk, and the goal is to reduce mortality associated with prostate cancer. The guidelines are:</p> <ol> <li><strong>Under age 40</strong>: Recommend against any PSA test because PSA levels can be elevated for other common reasons and leads to false positive test results.</li> <li><strong>Ages 40–54</strong>: No routine screening in men with average risk. However, men at higher risk may benefit from a PSA test. This could include African American men and those with a strong family history of prostate cancer.</li> <li><strong>Ages 55–69</strong>: The greatest benefit of screening appears to be in this age group. To reduce any potential harms of screening, a test interval of every two years or more may be preferred over annual testing. The decision to undergo PSA tests involves weighing the benefits against the potential harms associated with screening and treatment.</li> <li><strong>Ages 70+</strong>: Not recommended.</li> </ol> <p>Talk with your health care provider about the benefits, risks and limitations of a PSA test to determine the best screening option for you and your situation.</p> <p><em><a href="/providers/melissa-nissen-md" target="_self" title="Opens in same window.">Melissa Nissen, M.D.</a>, is an <a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">urologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Endoscopic and percutaneous nephrolithotomy</li> <li>Enlarged prostate / benign prostatic hyperplasia (BPH)</li> <li>General medical urology</li> <li>Kidney stones</li> <li>Male sexual dysfunction and erectile dysfunction</li> <li>Robotic surgery</li> <li>Steam therapy</li> <li>Ureteroscopy</li> </ul>M.D.<p>I believe that getting to know each patient as a person first helps me provide better care. My goal is to both listen to and partner with my patients to create medical plans that are best for them in a truly collaborative effort.</p> <p> When I’m not at the clinic, I enjoy spending time with my family and being outdoors. </p><p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Urology, Medical College of Wisconsin Affiliated Hospitals</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Urological Association</li> </ul>Nissen<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/melissa-nissen-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=9696F02A1DC255C727F421079A70BB34" alt="Melissa Nissen, M.D." width="280" height="280" DisableNVelocity="true" />Melissa<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15735931Melissa Nissen, M.D.1{83EB2AA2-1436-4DDC-B7BB-51F8E6A87FC9}|{BFAFB863-D571-4781-ADD9-1398B77B549E}<img src="/-/media/national-files/images/hometown-health/2021/senior-couple-cheek-to-cheek.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F31AD48D84CA2D31FEA5D5114B39E59D" alt="Senior couple cheek to cheek" width="660" height="370" DisableNVelocity="true" />Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Prostate HealthProstate cancer is the most common cancer diagnosed in men. You may have friends or family members who have been diagnosed with prostate cancer, and this may make you wonder about what you can do for prostate cancer prevention.Dawn Haller6/22/2021A pelvic exam is a regular part of a female wellness visit and a normal part of taking care of your body. Learn what to expect and how to prepare for this simple screen for cervical cancer and HPV.Preparing for your first pelvic exam<p>Setting up your appointment for your first pelvic exam, including a Pap test, can be nerve-wracking. Even though it's the most accurate way to screen for cervical cancer and <a href="/hometown-health/speaking-of-health/protecting-yourself-against-hpv">HPV</a>, the uncertainty of what it all entails can still leave questions.</p> <h4>Here are a few things you should know before your first exam:</h4> <ul> <li><strong>You should have your first Pap test at age 21.</strong><br> Regardless of your sexual activity, when you turn 21, it's time for your <a href="/hometown-health/speaking-of-health/when-should-a-female-start-seeing-a-gynecologist" target="_self" title="Opens in same window.">first Pap test</a>. If you have concerns about sexually transmitted infections, pelvic pain or vaginal discharge prior to 21, talk to your health care provider.</li> <li><strong>You don't need to reschedule if you have your period.</strong><br> In most cases, your Pap test can still be accomplished during your period. If you're uncomfortable with the thought of a pelvic exam during your period, you can reschedule your appointment.</li> <li> <strong>You should avoid some things beforehand.</strong><br> Two days before your Pap test, avoid intercourse, vaginal creams, suppositories, medicine and douches, as these may obscure abnormal cells.</li> <li><strong>Should you groom or not groom?</strong><br> However you take care of your body, you should keep doing it. It is important for you to feel comfortable during your first exam.</li> <li><strong>Use body image positivity.</strong><br> Your provider isn't judging how your body looks. Everyone and every body is different, and all women need these types of exams to promote health.</li> </ul> <h4>Here's what you'll encounter during your first exam:</h4> <ul> <li><strong>You'll put on a gown.</strong><br> You will fully undress and get into a hospital gown.</li> <li><strong>A breast exam will be first.</strong><br> You'll lie down on the exam table, where your provider will perform a standard breast exam. You or your provider may request a chaperone to be present.</li> <li><strong>A Pap test will be next.</strong><br> You will put your feet on the stirrups attached to the table to widen your legs. The provider will gently insert a tool called a speculum into your vagina. It looks similar to a duck bill and is used to spread the vagina slightly so the provider can collect a sample of cells from your cervix with a small soft brush. The Pap test usually lasts only a few minutes.</li> <li><strong>You can expect mild sensations.</strong><br> The test may be mildly uncomfortable. You may feel pressure in your abdomen or vagina that you may not have experienced before. However, it should never hurt. During this time, it's important to breathe and stay relaxed so the process is more comfortable.</li> <li><strong>An internal exam will follow.</strong><br> Your provider will insert two lubricated, gloved fingers into your vagina and press on your lower abdomen to check your uterus and ovaries.</li> </ul> <p>When you're done, your provider will let you know that you can dress, and he or she may give you a pad or some tissues, as it's normal to have slight spotting afterward. The cells collected from the Pap test are sent to the lab to be analyzed.</p> <h4>Consider these tips to mentally prepare for your exam:</h4> <ul> <li><strong>Use relaxation techniques or distraction.</strong><br> Relaxation techniques, such as deep breathing, guided imagery and <a href="/hometown-health/speaking-of-health/mindfulness-meditation-improve-your-quality-of-life" target="_self" title="Opens in same window.">mindfulness</a>, can be beneficial leading up to and during your exam. Also, throughout the exam, you can close your eyes, inhale through your nose for four seconds and then exhale through your mouth for four seconds. You may want to listen to music or watch a video to distract your mind. You also can bring a partner, family member or friend to talk to during the process.</li> <li><strong>Talk to your health care provider.</strong><br> Let your provider know you are nervous and explain how you are feeling. Ask as many questions as you need and seek advice on how to make the exam easier, such as different positions and using a smaller speculum to ease discomfort or pain. You can ask your provider to talk you through the exam step by step so that you are prepared for what is about to happen. If you have <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967" target="_blank" title="Opens in a new window.">posttraumatic stress disorder</a> or experienced sexual violence, or suffer from health anxiety, fear of the unknown or <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/body-dysmorphic-disorder/symptoms-causes/syc-20353938" target="_blank" title="Opens in a new window.">body dysmorphia</a>, it's important to let your provider know so he or she can help you through the exam.</li> <li><strong>Say "stop" if you are in pain.</strong><br> You are in control during your pelvic exam. You can ask your provider to stop at any time if you are uncomfortable or in pain.</li> <li><strong>Reward your efforts.</strong><br> Congratulate yourself on what you have achieved by doing something that makes you happy, such as going to lunch with a friend, watching a movie or reading a new book.</li> </ul> <p>It's important for your health to have a regular pelvic exam performed. If there are no concerns, you only need to get an exam once every three years.</p> <p>If you have any questions or concerns about a pelvic exam, you should speak with your health care provider.</p> <p><em><a href="/providers/bridget-glomski-md" target="_self" title="Opens in same window.">Bridget Glomski, M.D.</a>, and Hannah Miller, M.D., are resident physicians in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Geriatrics</li> <li>Lifestyle medicine</li> <li>Prenatal care</li> </ul>M.D.<p>I chose a career in family medicine because I truly believe in the power that comes from a strong patient-physician relationship. I look forward to serving this small community by taking advantage of the opportunity to develop relationships with my patients in order to best meet their needs.</p> <p>I grew up on a farm in Cadott, Wisconsin. I knew I wanted to practice medicine in rural Wisconsin. This brought me closer to home for my residency in Eau Claire and, ultimately, to my practice in Osseo.</p><p><strong>Education</strong></p> <ul> <li>University of Wisconsin School of Medicine and Public Health</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>Wisconsin Academy of Family Physicians</li> <li>Wisconsin Medical Society</li> </ul>Glomski<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/bridget-glomski-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7E9B4C588991F7B133427D41569FCCF5" alt="Bridget Glomsk, M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/33758161/" target="_blank" title="Opens in new window">"Double Trouble": Severe meningoencephalitis due to Borrelia burgdorferi and Powassan virus co-infection successfully treated with intravenous immunoglobulin</a>; March 2021.</li> </ul>Bridget<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21163111Bridget Glomski, M.D.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{FFD57D6A-3E3A-4808-8F93-B38864FDF469}<img src="/-/media/national-files/images/hometown-health/2021/gowned-person-on-clinic-exam-table.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E8FC3EA2E34062A807DB9C7ABD5BE079" alt="Gowned person on clinic exam table" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Dawn Haller10/4/2024People with anxiety disorders experience frequent, excessive anxiety, fear and panic that can interfere with daily activities. Learn 11 lifestyle changes and strategies that can make a difference.11 tips for coping with an anxiety disorder<p>Having occasional feelings of anxiety is a normal part of life, but people with anxiety disorders experience frequent and excessive anxiety, fear, terror and panic in everyday situations. These feelings are unhealthy if they affect your quality of life and prevent you from functioning normally.</p> <h2>Common symptoms of anxiety disorders include:</h2> <ul> <li>Experiencing a sense of impending panic, danger or doom</li> <li>Feeling helpless</li> <li>Feeling nervous</li> <li>Hyperventilation</li> <li>Increased <a href="/hometown-health/speaking-of-health/know-your-numbers-heart-rate" target="_self" title="Opens in same window">heart rate</a></li> <li>Obsessively thinking about the panic trigger</li> <li>Sweating</li> <li>Trembling</li> </ul> <p>These feelings of anxiety and panic can interfere with daily activities and be challenging to control. They are out of proportion to the actual danger and can cause you to avoid places or situations.</p> <p>You should see your healthcare professional if your anxiety is affecting your life and relationships. Your healthcare team can help rule out any underlying physical health issue before referring you to a mental health professional.</p> <p>While many people with anxiety disorders need psychotherapy or medications to get anxiety under control, lifestyle changes and coping strategies also can make a difference.</p> <h2>Here are 11 tips for coping with an anxiety disorder:</h2> <ol> <li><strong>Avoid alcohol and recreational drugs.</strong><br /> These substances can cause or worsen anxiety. If you can't quit on your own, see your healthcare team or find a support group to help you.</li> <li><strong>Eat healthy foods.</strong><br /> A healthy diet that incorporates vegetables, fruits, whole grains and fish may be linked to reduced anxiety, but more research is needed.</li> <li><strong>Identify triggers.</strong><br /> Learn what situations or actions cause you stress or increase your anxiety. Practice the strategies you developed with your mental health professional so you're ready to deal with anxious feelings in these situations.</li> <li><strong>Keep physically active.</strong><br /> Develop a routine so you're physically active most days of the week. Exercise is a powerful stress reducer that can improve your mood and help you stay healthy. <a href="/hometown-health/doctors-orders/need-to-exercise-start-slowly" target="_self" title="Opens in same window">Start slowly</a> and gradually increase the amount and intensity of your activities.</li> <li><strong>Learn about your disorder.</strong><br /> Talk to your healthcare team to discover what might be causing your specific condition and what treatments might be best for you. Involve your family and friends and ask for their support.</li> <li><strong>Make sleep a priority.</strong><br /> Do what you can to ensure you're getting enough sleep to feel rested. If you aren't sleeping well, talk with your healthcare professional.</li> <li><strong>Quit smoking and reduce or quit drinking caffeinated beverages.</strong><br /> <a href="/hometown-health/speaking-of-health/a-smokers-guide-to-quitting" target="_self" title="Opens in same window">Nicotine</a> and caffeine can worsen anxiety.</li> <li><strong>Socialize.</strong><br /> <a href="/hometown-health/speaking-of-health/overcoming-loneliness" target="_self" title="Opens in same window">Don't let worries isolate you</a> from loved ones or activities.</li> <li><strong>Stick to your treatment plan.</strong><br /> Take medications as directed. Keep therapy appointments and complete any assignments your therapist gives. Consistency can make a big difference, especially when it comes to taking your medication.</li> <li> <strong>Use stress management and relaxation techniques.</strong><br /> Visualization techniques, meditation and yoga are examples of <a href="/hometown-health/speaking-of-health/mindfulness-meditation-improve-your-quality-of-life" target="_self" title="Opens in same window">relaxation techniques</a> that can ease anxiety.</li> <li> <strong>Write in a journal.</strong><br /> Keeping track of your personal life can help you and your mental health professional identify what's causing you stress and what seems to help you feel better.</li> </ol> <p>Your worries may not go away on their own and could worsen over time if you don't seek help. See your healthcare team or a mental health professional before your anxiety worsens. It's easier to treat if you get help early.</p> <h2>Watch this video about lifestyle change and coping strategies for anxiety:</h2> <p><iframe width="560" height="315" src="https://www.youtube.com/embed/UexvVBbnetA?si=heTvuMHJl8EmG08W" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin"></iframe></p> <h2>Next steps to learn more about anxiety management:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/tips-to-help-ease-anxiety" target="_self" title="Opens in same window.">5, 4, 3, 2, 1: Countdown to take control of anxiety</a><a href="/hometown-health/speaking-of-health/tips-to-help-ease-anxiety" target="_self" title="Opens in same window."></a></li> <li><a href="/hometown-health/speaking-of-health/managing-high-functioning-anxiety" target="_self" title="Opens in same window">Behind the mask: Managing high-functioning anxiety</a></li> <li><a href="/hometown-health/speaking-of-health/9-ways-to-tame-anxiety-during-the-covid-19-pandemic" target="_self" title="Opens in same window">Building resilience: 9 ways to tame anxiety</a></li> <li><a href="/hometown-health/speaking-of-health/addressing-your-mental-health-by-identifying-the-signs-of-anxiety-and-depression" target="_self" title="Opens in same window">Identifying signs of anxiety and depression</a></li> <li><a href="/hometown-health/speaking-of-health/use-mindfulness-to-improve-well-being" target="_self" title="Opens in same window">Using mindfulness to improve well-being</a></li> </ul> <p><em><a href="/providers/siri-kabrick-cnp" target="_self" title="Opens in same window.">Siri Kabrick</a> is a nurse practitioner in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a>, Minnesota.</em></p><ul> <li>Adolescent mental health</li> <li>Anxiety</li> <li>Depression</li> <li>Women's health</li> </ul>APRN, C.N.P.<p>I partner with patients to identify the most effective treatment for their problem. I enjoy educating patients, dispelling myths and reducing stigma surrounding mental illness, and empowering patients to improve their quality of life. I strive to connect patients to resources that will have a positive impact on their recovery. I feel it's a privilege to have patients trust me with their mental health care.</p> <p>I am married to my loving and supportive husband, Chris. I have three daughters and two step-daughters, two sons-in-law and two grandsons. I enjoy quilting, scrapbooking, reading and playing piano. I am also a Girl Scout lifetime member, leader, volunteer and parent.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Adult Nurse Practitioner, St. Catherine University</li> <li>Psychiatric-Mental Health Nurse Practitioner, Rush University College of Nursing</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Adult Nurse Practitioner, American Nurses Credentialing Center</li> <li>Certified Nurse Practitioner, Minnesota Board of Nursing</li> <li>Psychiatric-Mental Health Nurse Practitioner, American Nurses Credentialing Center</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Psychiatric Nurses Association</li> <li>Minnesota Advanced Practice Registered Nurse Coalition/li> </li> <li>Sigma Theta Tau International Honor Society of Nursing</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Psychology, Mayo Clinic College of Medicine and Science</li> </ul>Kabrick<img src="/-/media/shared-files/images/medical-professionals/full/fairmont/siri-kabrick-aprn-cnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7965DA5263917445B7C76056099A7570" alt="Siri Heille CNP" width="280" height="280" DisableNVelocity="true" />{526482EA-708D-4175-8709-E97F91352839}Siri<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14288737Siri Kabrick, APRN, C.N.P.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2021/journaling-sitting-contemplating.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EF2BB920212F651AA950D8625B6C3293" alt="Person journaling while sitting and contemplating" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.AnxietyFeelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. Symptoms may start during childhood or the teen years and continue into adulthood. We have the experts who can help diagnose and treat anxiety concerns.Dawn Haller7/30/2021You know that ear, nose and throat (ENT) providers care for ear infections. But they treat a much wider range of conditions. Read about the 8 common conditions treated by ENT, ranging from tonsillitis to dizziness.8 reasons to visit an ENT specialist<p>Otorhinolaryngology is the medical specialty that focuses on consultation, diagnosis and treatment of ear, nose and neck disorders. Because otorhinolaryngology is hard to pronounce and even harder to spell, most patients refer to otorhinolaryngologists as ear, nose and throat, or ENT, providers.</p> <p>There are many reasons a person would benefit from an appointment with an ENT provider.</p> <h3>Here are the 8 most common conditions treated:</h3> <h4>1. Chronic ear infections</h4> <p>This condition is an infection in the air-filled space behind the eardrum. Some people are more prone to getting ear infections. Kids 6 months to 2 years are most susceptible to infections because of the size and shape of their middle ears and eustachian tubes.</p> <p>Often ear infections are a result of another illness that causes congestion and swelling, such as a cold, flu or allergies. Ear infections can be painful, and cause impaired hearing, fever, headache and loss of balance.</p> <p>If your child develops multiple ear infections, it may be time to talk with an ENT provider. Ear infections can affect their ability to hear clearly, so recurrent infections could result in speech, social and developmental delays.</p> <p>Ear tubes are a common treatment for chronic ear infections. During this procedure, an ENT surgeon creates a tiny hole in the eardrum to suction out fluid from the middle ear. Then a tiny tube is placed in the opening to ventilate the ear and prevent the buildup of fluid in the future. Usually, tubes remain in place for four to 18 months and will fall out on their own.</p> <h4>2. Hearing loss</h4> <p>If you find yourself turning up the volume on your devices or feel like voices are too soft or mumbling, it may be time to talk with an ENT provider about your hearing. ENT providers work together with audiologists to discover the cause of your hearing loss, ranging from ear infection and a buildup of earwax to ruptured eardrum or damage to your inner ear.</p> <p>Also, if you notice rapid hearing loss all at once or over a few days, you should be evaluated by an ENT provider and audiologist within a few days to a week after noticing the hearing loss. This may be related to what is called "sudden sensorineural hearing loss."</p> <h4>3. Dizziness or vertigo</h4> <p>Many body systems, including your inner ear, must work together to maintain balance. About 30% of people in the U.S. experience dizziness or vertigo at some point in their lives. It could be a short-term concern, such as occurring after standing up too quickly, when taking a medication or during a migraine.</p> <p>The most common cause of vertigo is when calcium crystals in your inner ear become dislodged from their normal position. This is called "benign paroxysmal positional vertigo." People often experience symptoms with changes in head position, such as bending over, looking up or rolling over in bed. An ENT provider can help develop a treatment plan to steady your footing and ease your symptoms.</p> <h4>4. Ringing in the ears</h4> <p>Tinnitus is commonly referred to as ringing in the ears. This is a recurrent ear or head noise with no external source that lasts longer than five minutes and happens more than once per week. For some people, tinnitus can be extremely bothersome and negatively affect the quality of their lives. While there is no cure for tinnitus, an ENT provider can help with many management strategies to decrease your perception of the ringing sound.</p> <h4>5. Chronic stuffy nose</h4> <p>Sinusitis occurs when your sinuses become swollen and inflamed. This swelling interferes with the way mucus normally drains and makes your nose stuffy. You may find it difficult to breathe through your nose, have discolored discharge from your nose or feel tender around the eyes. Long-lasting sinusitis, also called "chronic sinusitis," is classified by a history of sinus infections that don't respond to treatment or symptoms that last longer than three months.</p> <p>Common causes of chronic sinusitis include nasal polyps, deviated nasal septum, repeated respiratory infections, allergies or complications of other conditions. An ENT provider can help determine the best treatment option to help ease your symptoms including medications, antibiotics or surgery.</p> <h4>6. Chronic sore throat or tonsillitis</h4> <p>Tonsillitis is inflammation of the tonsils, two oval-shaped pads of tissue at the back of the throat. Symptoms include swollen tonsils, sore throat, difficulty swallowing and tender lymph nodes on the sides of the neck.</p> <p>Because appropriate treatment for tonsillitis depends on the cause, it's important to get a prompt and accurate diagnosis. Surgery to remove tonsils, once a common procedure to treat tonsillitis, is usually performed only when tonsillitis occurs frequently, doesn't respond to other treatments or causes serious complications.</p> <h4>7. Lumps in the neck/enlarged lymph nodes</h4> <p>Your lymph nodes, also called lymph glands, play a vital role in your body's ability to fight off infections. You have many lymph nodes in your head and neck. They can become swollen or feel tender, usually due to an infection from bacteria or virus.</p> <p>Most swollen lymph nodes get better on their own within a few weeks, but you should talk with an ENT provider if the lumps get bigger; are present for more than two weeks; feel hard or rubbery; appear for no apparent reason; are associated with chronic sore throat or voice changes; or you are experiencing a fever, night sweats or unexplained weight loss.</p> <h4>8. Sleep apnea</h4> <p>Sleep apnea is a serious condition where you repeatedly stop breathing or breathe shallowly while sleeping. When this happens, you may snore loudly or make choking noises as you try to breathe. Your brain and body become oxygen-deprived, and you may wake up. More than 18 million adults in the U.S. have sleep apnea, and many cases are undiagnosed.</p> <p>An ENT provider may request that you complete a sleep study to measure how well you sleep and how your body responds to sleep problems. This test can help your health care team find out if you have a sleep disorder, how severe it is and the best treatment option for you.</p> <p><em><a href="/providers/luke-andera-md" target="_self" title="Opens in same window.">Luke Andera, M.D.</a>, is a physician in <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">Ear, Nose & Throat</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Chronic ear disease</li> <li>Chronic sinusitis</li> <li>Ear tubes/tympanostomy tubes</li> <li>Endoscopic dacryocystorhinostomy (tear duct surgery)</li> <li>Head and neck cancer (lip, mouth, tonsil, throat, voice)</li> <li>Hearing loss</li> <li>Nasal polyps</li> <li>Nose and sinus disease</li> <li>Parotid disease</li> <li>Salivary gland/parotid</li> <li>Thyroid nodules</li> <li>Thyroid/parathyroid disease</li> <li>Tonsillectomy and adenoidectomy</li> </ul>M.D.<p>I am a native of Cresco, Iowa.</p><p><strong>Education</strong></p> <ul> <li>Wright State University Boonshoft School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Otolaryngology – Head and Neck surgery, Geisinger Medical Center</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Academy of Otolaryngology – Head and Neck Surgery</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Otolaryngology, Mayo Clinic College of Medicine and Science</li> </ul>Andera<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/luke-andera-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7E709A42F6E193B329E44B5FF5737641" alt="Luke Andera MD" width="280" height="280" DisableNVelocity="true" />{CCECDF11-8962-4146-A324-CAFE735B0C95}Luke<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20991193Luke Andera, M.D.1{18E5E65E-45C8-4C48-BD32-A914794E2AA4}<img src="/-/media/national-files/images/hometown-health/2021/hand-on-face-looking-at-computer-screen.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0E563AD2AC22C6A77B1BBE46C7813EC0" alt="Hand on face looking at computer screen" width="660" height="370" DisableNVelocity="true" />Ear, Nose and Throat (ENT)Get information about symptoms, disorders and diseases affecting the ear, nose and throat, and related head and neck structures.Ear HealthAn audiologist specializes in evaluating and treating people of all ages with hearing loss, dizziness and balance disorders. Specialty audiology consultation is available for assessment and treatment of hearing loss, tinnitus, dizziness and balance disorders.Dawn Haller7/29/2021As your family gears up for another school year, use this checklist to address the health and well-being of your children.Back-to-school checklist: Are your kids ready?<p>Shopping for supplies is an essential part of back-to-school preparations. It is exciting for kids to pick out a new backpack, lunch bag or pencil case as they make plans for the coming school year. As you and your family gear up for the start of another school year, be sure you also take time to focus on your kids' health and well-being.</p> <p>Tackling current health issues or concerns now and working to prevent new issues from taking you by surprise will help your children adjust to and succeed throughout the entire school year.</p> <h2>Use this checklist to guide you through addressing your kids' most important health needs:</h2> <h3>✔ Schedule a well-child visit</h3> <p>Most kids need a well-child visit with their provider every year from age 3 to 21. Once your children are of school age, some refer to the well-child visit as a school physical.</p> <p>Bring a list of questions to make the most of your children's appointment and ensure you have all the support you need to advocate for your children's overall health and well-being.</p> <h4>Be prepared to discuss any concerns you or your children have about:</h4> <ul> <li>Eating habits</li> <li>Sleep</li> <li>Developmental milestones</li> <li>Anxiety</li> <li>Mood or behavior</li> <li>Learning difficulties</li> <li>Digestion</li> <li>Overall physical growth</li> <li>Parenting challenges</li> </ul> <h3>✔ Update vaccines</h3> <p>Review your school's requirements and talk with your health care provider to ensure that your children's vaccines are up to date. Children can now be vaccinated for HPV at age 11, and the measles, mumps and rubella and chickenpox vaccines have been combined into one immunization. Also, ask about the COVID-19 vaccines that have received emergency use authorization for children 12 and older. Your children's health care provider can administer necessary vaccines during your appointment.</p> <h3>✔ Schedule an eye exam</h3> <p>Vision checks are performed during routine well-child visits with a primary care provider, usually between 6 months and 1 year old, again between 3 and 4 years old, and at regular intervals thereafter.</p> <p>Schedule an appointment with an optometrist or other eye health professional if your children appear to be squinting their eyes, can't read signs or identify shapes from a distance or tends to bring books or screens very close to the face. These could be signs of a vision problem.</p> <h3>✔ Schedule a dental appointment</h3> <p>Regular dental exams are an important part of preventive health care for people of all ages. Dental specialists say kids should brush their teeth, gums and tongue for two minutes twice a day and visit a dentist twice a year.</p> <h3>✔ Promote good sleep habits</h3> <p>Getting enough sleep is important for children's overall well-being, and ability to learn, play and socialize. Start promoting healthy sleeping habits with your children before the school year begins. If kids get regular exercise during the day and turn off electronic devices at least an hour before bedtime, they'll likely get a better night's rest.</p> <h3>✔ Talk about anxiety</h3> <p>Getting ready for a new school year can cause anxiety for some children, especially for those starting in a new school or transitioning from virtual to in-person classes this fall. You can help by reassuring your children that anxious feelings are normal and encouraging them to talk about what causes those feelings. When kids think about or practice doing the things that make them anxious, they can learn to better cope with their feelings. If anxiety is interfering with daily activities, it's time to talk with your children's health care provider.</p> <h3>✔ Brush up on hand-washing</h3> <p>A lot of kids together equals a lot of germs. The best way to prevent the spread bacteria and viruses is by washing your hands. It can be easy to for kids to forget when to wash their hands and to do so using the right technique. Help your kids clean up their hand-washing skills by practicing before school starts.</p> <h4>Here are a few tips:</h4> <ul> <li>Scrub hands together for 20 seconds using soap and warm water.</li> <li>Sing the "ABCs" song twice to be sure you scrub long enough. The scrubbing motion with soap removes the germs.</li> </ul> <p>Download a flyer about <a href="/-/media/local-files/eau-claire/documents/miscellaneous/how-to-wash-your-hands-color.pdf?sc_lang=en&hash=A091E5CD3A46CCA01E6507EF407474B4" target="_blank" title="Opens in a new window.">proper hand-washing technique</a> to post in your home as a reminder.<span style="color: #131313; font-family: 'Open Sans', Arial, sans-serif;"> </span></p> <p><em><a href="/providers/terri-nordin-md" target="_self" title="Opens in same window.">Teri Nordin, M.D.</a>, is a physician in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Maternity care, including deliveries at the hospital</li> <li>Medical education</li> <li>Pediatric care</li> <li>Women’s health</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Iowa Roy J. and Lucille A. Carver College of Medicine</li> </ul> <p><strong>Internship/Residency</strong></p> <ul> <li>Family Medicine, Rutgers-Robert Wood Johnson Medical School</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Maternity care, Rutgers-Robert Wood Johnson Medical School</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Family Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>Pisacano Leadership Foundation</li> <li>Society of Teachers of Family Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Nordin<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/terri-nordin-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=746184477F57E3BF501AEDA7D56F4FCC" alt="Terri Nordin, M.D." width="280" height="280" DisableNVelocity="true" />{7225EEB8-0AC2-4825-BCEF-B7E22114E97A}Terri<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16304497Terri Nordin, M.D.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}<img src="/-/media/national-files/images/hometown-health/2021/two-kids-with-backpacks-running-to-school.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0C1A99F0C9D282DBD50B69C86DA1CD21" alt="Two kids with backpacks running to school" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller7/15/2021Your child's eye health is an important part of his or her overall heath and ability to learn. Find out how to protect your child's vision with regular eye screenings and when to seek a comprehensive eye exam.Caring for your child's eyes<p>Newborns come into the world with vision that is mostly blurry. The visual system develops over time and is fully formed by the teen years.</p> <p>Regular eye screenings for children are recommended to ensure their eyes are healthy and they have no vision problems that could interfere with school performance and potentially affect their safety.</p> <p>Your child's vision can be screened by a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">family medicine physician</a>, <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">pediatrician</a>, <a href="/services-and-treatments/ophthalmology" target="_self" title="Opens in same window.">ophthalmologist</a> or another properly trained healthcare provider. The provider will screen your child for eye problems and refer to an ophthalmologist for a comprehensive exam, if needed.</p> <h2>When to schedule eye screenings</h2> <p>Eye screenings generally are included as part of a well-child visit.</p> <h3>The American Academy of Ophthalmology and the American Association for Pediatric Ophthalmology and Strabismus recommend this schedule:</h3> <ul> <li><strong>Newborn–12 months</strong><br /> Your child's health care provider will perform in-office screening tests, including inspection of the eyes and lids, and checking the pupil response and eye movement. The provider may refer your infant to an ophthalmologist if the baby is born prematurely, has signs of eye disease or a family history of childhood eye disease.</li> <li><strong>12‒36 months</strong><br /> At this appointment, a photo screening is done to look for focusing problems that could indicate your child is not seeing well with one or both eyes. Photo screening also detects risk factors for <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/lazy-eye/symptoms-causes/syc-20352391" target="_blank" title="Opens in a new window.">amblyopia</a>, or lazy eye, which is a reduction in vision in one or both eyes that prevents normal brain development of the visual system.</li> <li><strong>36 months–5 years</strong><br /> Your child's vision and eye alignment will be checked during this time. Your child may be referred to an <a href="/services-and-treatments/ophthalmology" target="_self" title="Opens in same window.">ophthalmologist</a> or optometrist if the screening shows signs of misaligned eyes, or strabismus; amblyopia; refractive errors; or other focusing problems.</li> <li><strong>5 years and older</strong><br /> At age 5, your child should be screened for visual acuity, or sharpness of vision, and eye alignment. Repeat this screening every one to two years after age 5.</li> </ul> <h2>Vision screening versus comprehensive eye exam</h2> <p>Vision screening is more efficient and cost-effective than a comprehensive examination on every child, which allows many more children to be examined. A comprehensive eye exam diagnoses eye disease. Only about 2% to 4% of children have an eye problem that requires treatment. In addition, problems occasionally are missed on a one-time comprehensive eye examination, so it's preferable to have several screenings performed over time.</p> <h2>When to seek a comprehensive exam</h2> <h3>Seek a comprehensive eye exam for your child if he or she:</h3> <ul> <li>Fails a vision screening.</li> <li>Has a vision screening that is inconclusive or cannot be performed.</li> <li>Is referred by a pediatrician or school nurse.</li> <li>Has a vision complaint or observed abnormal visual behavior, or is at risk for developing eye problems. Children with medical conditions, such as <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/down-syndrome/symptoms-causes/syc-20355977" target="_blank" title="Opens in a new window.">Down syndrome</a>; prematurity; <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/juvenile-idiopathic-arthritis/symptoms-causes/syc-20374082" target="_blank" title="Opens in a new window.">juvenile idiopathic arthritis</a>; <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/neurofibromatosis/symptoms-causes/syc-20350490" target="_blank" title="Opens in a new window.">neurofibromatosis</a>; or a family history of amblyopia, strabismus, <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/retinoblastoma/symptoms-causes/syc-20351008" target="_blank" title="Opens in a new window.">retinoblastoma</a>, congenital <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/cataracts/symptoms-causes/syc-20353790" target="_blank" title="Opens in a new window.">cataracts</a> or <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/glaucoma/symptoms-causes/syc-20372839" target="_blank" title="Opens in a new window.">glaucoma</a>, are at higher risk for developing pediatric eye problems.</li> <li>Has a learning disability, developmental delay, neuropsychological condition or behavioral issue.</li> </ul> <h3>How can the eye doctor tell how much my baby can see?</h3> <p>The doctor will use light to check your child's pupil response and assess how well your child can follow lighted toys and small objects. Sometimes the provider will use cards with different sizes of stripes on them called "preferential looking tests" to determine vision. Older children can play matching games with shapes or pictures on the eye chart. The eye doctor also will perform a thorough eye exam to look at all the structures of the eye that are important for vision.</p> <h3>What to expect at your child's eye appointment</h3> <p>The ophthalmologist will perform a vision assessment, as well as check the alignment of the eyes and the pupil response to light. Your child's pupils may be dilated with eyedrops to evaluate for a prescription for eyeglasses. Young babies also may need glasses.</p> <p>The doctor will use an instrument to shine light in the eye. This light gets reflected from the retina and helps determine the prescription. Pupil dilation also allows the doctor to examine the back of the eye, including the health of the optic nerve and retina. Additional tests may be needed, depending on symptoms and family history.</p> <p>These appointments may take up to one to two hours, especially if the eyes need to have dilating drops, so remember to come prepared with diapers and snacks. Also have your child's prior eyeglasses, if any, and eye history available, as well as your list of questions.</p> <p><em><a href="/providers/sasha-mansukhani-mbbs" target="_self" title="Opens in same window.">Sasha Mansukhani, M.B.B.S.</a>, is an <a href="/services-and-treatments/ophthalmology" target="_self" title="Opens in same window.">ophthalmologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><p>Research and education in:</p> <ul> <li>Childhood eye misalignment</li> <li>Lazy eye</li> <li>Double vision</li> <li>Optic nerve disorders</li> </ul>M.B.B.S.<p>We strive to provide high-quality care through my service and our excellent team. I help my patients and my pediatric patients’ parents better understand the eye condition and options for treatment. Together we form a management plan for improved eye alignment, vision and rehabilitation. For more complex conditions, I may engage other specialists to assist in the various aspects of care. I continue to find better and new ways to help our patients through research and education.</p> <p>In my spare hours, I enjoy spending time with my family, especially my delightful twin nephews. I like to hike, travel, play board games and paint with watercolors.</p><p><strong>Medical School</strong></p> <ul> <li>GS Medical College & King Edward Memorial Hospital, Mumbai, India</li> </ul> <p><strong>Internship</strong></p> <ul> <li>GS Medical College and King Edward Memorial Hospital, Mumbai, India</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Ophthalmology, TN Medical College & BYL Nair Hospital, Mumbai, India</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Pediatric Ophthalmology and Strabismus, Emory University, Atlanta, GA</li> <li>Pediatric Ophthalmology and Strabismus, Mayo Clinic, Rochester, MN</li> <li>Neuro-ophthalmology, Mayo Clinic, Rochester, MN</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Ophthalmology</li> <li>International Council of Ophthalmology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Ophthalmology, Mayo Clinic College of Medicine, Minnesota</li> </ul>Mansukhani<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/sasha-mansukhani-mbbs.jpg?h=280&iar=0&w=280&sc_lang=en&hash=586CEAFF3EE8A356FDE564ED0EFE5438" alt="Sasha Mansukhani, M.B.B.S." width="280" height="280" DisableNVelocity="true" />Sasha<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16107373Sasha Mansukhani, M.B.B.S.1{C5680DDD-C649-4B63-AFCC-B52A244736B7}<img src="/-/media/national-files/images/hometown-health/2021/child-and-parent-reading-a-book.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EF4C696EE8A8847092B15E20136C0C53" alt="Child and parent reading a book" width="660" height="370" DisableNVelocity="true" />Eye HealthYour eyes are responsible for providing you with vision, perhaps the most important of the senses. However, the eye is a delicate and complicated structure that needs protection. The ugly truth is that eye injuries can happen at any time and place.Dawn Haller3/24/2023Asthma is a common chronic condition in childhood. Having an asthma action plan is helpful so key adults in your child's life understand it and what to do in an emergency. Here's what to include.Create an asthma action plan for your child<p>Asthma is one of the most common chronic conditions of childhood. It affects about 6 million children and adolescents in the U.S. This condition causes the lungs and airways to become inflamed when exposed to certain triggers, such as environmental allergens, exercise, weather changes or catching a respiratory infection.</p> <p>Childhood asthma can cause bothersome daily symptoms that interfere with play, sports, school and sleep. It's a primary reason students school days, and it can be dangerous if unmanaged.</p> <p>If your child has asthma, developing an <a rel="noopener noreferrer" href="https://mcforms.mayo.edu/mc0100-mc0199/mc0135-01.pdf" target="_blank" title="Opens in a new window.">asthma action plan</a> is helpful. You can't be with your child all the time, so outlining a plan ensures that key adults in your child's life understand the condition and what to do in an emergency. Preventing asthma symptoms is better than treating them after they begin, and symptoms are much easier to manage if you start treatment early. With good asthma management, your child should be able to live a normal, active life.</p> <h2>Challenges kids with asthma face include:</h2> <ul> <li><strong>Hard to avoid asthma triggers in different environments</strong><br /> Children can more easily avoid asthma triggers while at home. Triggers are environmental, allergy or exercise situations that start an asthma episode. Children in school or other locations can't control their environment as easily and could be exposed to more asthma triggers.</li> <li><strong>Viral illnesses</strong><br /> More viral illnesses go around when children are around other people. especially in school. Viral illness can trigger exacerbations, and these illnesses are more common during the school year and in the winter.</li> <li><strong>Seasonal allergies</strong><br /> Autumn brings seasonal allergies, specifically to mold and ragweed pollen. Allergies can trigger more asthma episodes for children.</li> <li><strong>New activities and adults</strong><br /> Children may start new sports throughout the year and or have a new coach who does not know how to help a child avoid asthma triggers.</li> </ul> <h2>Asthma action plan</h2> <p>An <a rel="noopener noreferrer" href="https://mcforms.mayo.edu/mc0100-mc0199/mc0135-01.pdf" target="_blank" title="Opens in a new window.">asthma action plan</a> provides information and instruction on properly managing and responding to the condition. People with asthma should complete the plan with help from family members and their health care team.</p> <h3>For school-age children, an asthma action plan should include:</h3> <ul> <li>Emergency contact name and telephone number</li> <li>Health care team contact and telephone number</li> <li>Peak flow values</li> <li>Medication names, dosing and frequency</li> <li>Steps to take during an asthma episode</li> <li>Outline of when to seek emergency medical care</li> </ul> <h4>An asthma action plan uses a traffic light format to categorize asthma symptoms:</h4> <img alt="Asthma action plan" src="/-/media/national-files/images/hometown-health/2021/asthma-action-plan.jpg?h=225&w=225&sc_lang=en&hash=E80227BFE2E6322ABA702027DDBC03C1" style="width: 225px; height: 225px; float: right; margin-bottom: 5px; margin-left: 5px;" /> <ul> <li><strong>Green</strong><br /> When in this section, your child is not coughing or wheezing, and is able to sleep through the night and play without shortness of breath. You should continue to use preventive medications.</li> <li><strong>Yellow<br /> </strong>Your child enters this section if showing signs of a cold, experiencing some symptoms or was exposed to a known trigger. This section outlines additional medications, such as rescue inhalers, and when to call the child's health care team.</li> <li><strong>Red<br /> </strong>Your child is in this section when asthma symptoms are worsening quickly and immediate emergency medical care is required.</li> </ul> <p>A thorough plan ensures that all adults in your child's life, from the school nurse and bus driver to coach and grandparent, understand their unique experience with asthma and are on the same page with managing and responding to asthma episodes.</p> <p>Each person's experience with asthma is unique. Make sure your child has their own asthma action plan, rather than following someone else's or only telling the school nurse that your child has an inhaler. Take steps to complete and distribute the plan so your child can minimize episodes and have the best experience in daily activities.</p> <p><em><a href="/providers/john-wheeler-jr-md" target="_self" title="Opens in a new window.">John Wheeler Jr., M.D.</a>, sees patients in <a href="/services-and-treatments/immunology" target="_self" title="Opens in same window.">Allergy & Asthma</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Allergic rhinitis</li> <li>Asthma</li> <li>Food allergies</li> <li>Nasal polyps</li> </ul>M.D.<p>I enjoy hearing patients’ stories and working together with them to solve their allergy and immunology mysteries. I consider my approach relaxed and laid back, but I can provide intensity when the situation requires.</p> <p>I am also a pediatric allergy physician offering care for patients in Onalaska, Wisconsin.</p> <p>When I’m not in the office, you will find me in search of fresh air and sunshine.</p><p><strong>Education</strong></p> <ul> <li>Ben-Gurion University of the Negev</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Baystate Medical Center</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Allergy & Immunology, State University of New York</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Allergy and Immunology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Allergy, Asthma and Immunology</li> <li>American College of Allergy, Asthma and Immunology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Wheeler Jr.<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/john-wheeler-jr-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=8D1B98AB924C1BA6551E607E2933BC2A" alt="John Wheeler Jr., M.D." width="280" height="280" DisableNVelocity="true" />John<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14588161John Wheeler Jr., M.D.1{9D6C5FE2-E6DA-4A63-9DD8-CE124BD4E4B7}|{E9B8BDBE-375B-4E7D-A1D2-2B64B5513AF7}<img src="/-/media/national-files/images/hometown-health/2021/child-on-swing.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9080F8B210FD7E17932C2929D69DD4B4" alt="Child on swing" width="660" height="370" DisableNVelocity="true" />Allergy and AsthmaOur allergists provide care for your allergies, asthma and conditions that affect the immune system's ability to defend the body against foreign or abnormal cells. The main treatment goal is your satisfaction when your condition is under control and quality of life is improved.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller7/1/2021When you focus on heart health, you're not only benefitting your heart, you're improving other areas of your life. Get tips to keep your heart as healthy as it can be.Easy tips to improve your heart health<p>According to the Centers for Disease Control and Prevention (CDC), one in every four deaths in the U.S. is due to heart disease. It continues to be the leading cause of death for both men and women. That's more than 647,000 people each year. Take time to consider the following information and tips to ensure you're making efforts to keep your heart as healthy as can be.</p> <h2>Prevention</h2> <p>Start making basic lifestyle changes to reduce your risk of heart disease and subsequent issues.</p> <h3>These strategies benefit other areas of your life as well, so you're doing your entire body a favor by focusing on heart health:</h3> <ul> <li><strong>Avoid tobacco.</strong> <br /> If you currently smoke, chew tobacco, vape, or use other tobacco products, quit right away — your health care team can help. If you don't smoke now, keep it that way.</li> <li><strong>Drink alcohol in moderation, if at all.</strong><br /> Heavy alcohol use is detrimental to your heart health. Although some research indicates moderate consumption of certain alcoholic beverages may have positive health effects, limiting your intake to a maximum of one drink per day or abstaining from alcohol altogether is best.</li> <li><strong>Be active.</strong><br /> Try to do aerobic exercise for at least 20 to 30 minutes a day, three to five times per week. Work your way up to 150 minutes of cardio each week. Get your heart rate up by a simple activity like walking at a brisk pace. Your daily movement doesn't need to be overly strenuous.</li> <li><strong>Maintain a healthy weight.</strong><br /> Like your checkbook, your weight is a matter of deposits and withdrawals. You need to exercise regularly and <a href="/hometown-health/speaking-of-health/strategies-to-control-portions" target="_self" title="Opens in same window.">lower portion sizes</a> and calorie intake at meals to lose weight or maintain a healthy size. Simply put, to lose weight you must burn more calories than you consume.</li> <li><strong>Eat a nutritious diet.</strong><br /> Healthy and fresh food choices — such as vegetables, fruits, whole grains and legumes — lower your risk of obesity, heart disease and diabetes, as well as make you feel better than when you eat processed and junk food. Learn about <a href="/hometown-health/speaking-of-health/4-key-elements-of-a-heart-healthy-diet" target="_self" title="Opens in same window.">key elements of a heart-healthy diet</a>.</li> <li><strong>Control your risk factors.</strong><br /> Get physical examinations or checkups at least yearly. Doing so will help you monitor health conditions and allow your provider to examine you for <a href="/-/media/national-files/images/hometown-health/2021/know-your-numbers-blood-pressure.jpg" target="_self" title="Opens in same window.">high blood pressure</a>, or hypertension, <a href="/hometown-health/speaking-of-health/know-your-numbers-cholesterol" target="_self" title="Opens in same window.">high cholesterol</a> and diabetes. If you have these conditions, talk to your healthcare team about medicines and lifestyle changes to help you control them, which will lower your risk for heart disease.</li> </ul> <h2>Family history</h2> <p>While neglecting the prevention tips poses major risk factors, <a href="/hometown-health/speaking-of-health/know-your-numbers-family-health-history" target="_self" title="Opens in same window.">family history</a> — although uncontrollable — can be problematic. This makes staying on top of heart health increasingly important. A family history of heart disease puts you at an elevated risk, and you're even more susceptible if a male family member developed heart disease before age 55 or a female family member developed heart disease before age 65.</p> <h2>Complications of heart disease</h2> <p>Heart disease can result in significant complications and death. Complications include <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/heart-failure/symptoms-causes/syc-20373142" target="_blank" title="Opens in a new window.">heart failure</a>, <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/heart-attack/symptoms-causes/syc-20373106" target="_blank" title="Opens in a new window.">heart attack</a>, <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/stroke/symptoms-causes/syc-20350113" target="_blank" title="Opens in a new window.">stroke</a>, <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/aneurysms/symptoms-causes/syc-20354633" target="_blank" title="Opens in a new window.">aneurysm</a>, <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/peripheral-artery-disease/symptoms-causes/syc-20350557" target="_blank" title="Opens in a new window.">peripheral artery disease</a> and <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/sudden-cardiac-arrest/symptoms-causes/syc-20350634" target="_blank" title="Opens in a new window.">sudden cardiac arrest</a>.<br /> Use this information to put your heart at the forefront of your wellness improvement plan.</p> <p>If you have questions or concerns, contact your primary care provider. If you're experiencing a heart emergency, call 911 immediately.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2021/heart-healthy-salad-in-bowl.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3010C619C512C8D0C2F13ECFD7FD2D34" alt="Heart-healthy salad in bowl" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller6/27/2023High temperatures and humidity can cause serious health consequences for people with high blood pressure and heart disease. Learn warning signs that your body isn't keeping up with the heat.Effects of hot weather, humidity on blood pressure, heart<p>Weather can play a role in triggering certain health problems. High temperatures and high humidity are two factors that can cause serious health consequences for people with high blood pressure and heart disease.</p> <p>In summer weather, blood pressure can be affected by the body's attempts to radiate heat. <a href="/hometown-health/speaking-of-health/when-temps-rise-remember-these-heatstroke-prevention-tips" target="_self" title="Opens in same window.">High temperatures</a> and high humidity can cause more blood flow to the skin. This causes the heart to beat faster while circulating twice as much blood per minute than on a normal day.</p> <p>The greatest risks are when the temperature is above 70 degrees and the humidity is more than 70%. The higher the humidity, the more moisture in the air. Some people are at higher risk of being affected by humidity, including those who are over age 50, overweight, or have heart, <a href="/hometown-health/speaking-of-health/lung-health-tips-for-healthy-living" target="_self" title="Opens in same window.">lung</a> or kidney conditions.</p> <p>Heat and sweating also can lower the amount of fluid in the body, which can reduce blood volume and lead to dehydration. This can interfere with the body's ability to cool off and may create strain on the heart.</p> <p>When the body loses more fluid than is taken in, the body may not have enough <a href="/hometown-health/speaking-of-health/water-essential-to-your-body-video" target="_self" title="Opens in same window.">water</a> or other fluids to carry out its normal functions. Anyone can become dehydrated, and it can lead to serious complications for people at greater risk due to age, chronic conditions or outdoor activity like work or <a href="/hometown-health/speaking-of-health/keep-your-cool-while-exercising-in-the-heat" target="_self" title="Opens in same window.">exercise</a>.</p> <p>Other risk factors include:</p> <ul> <li>Adults with heart, lung and <a href="/hometown-health/speaking-of-health/5-nutrition-tips-to-maximize-your-workouts" target="_self" title="Opens in same window.">kidney problems</a></li> <li>Adults who take diuretics, sedatives or blood pressure medication</li> <li>People who follow a low-salt or low-sodium diet</li> <li>People who have a circulatory disease or problems with circulation</li> </ul> <p>People with a history of high blood pressure should <a href="/hometown-health/speaking-of-health/know-your-heart-health-numbers" target="_self" title="Opens in same window.">monitor their blood pressure</a> during heat waves. They also should drink plenty of fluids to stay hydrated, avoid the midday heat, eat a healthy diet, apply sunscreen if outdoors and wear a hat. In most cases, when in doubt, stay inside a cool environment in your home.</p> <h2>Warning signs that your body isn't keeping up with the heat include:</h2> <ul> <li>Cold, clammy skin</li> <li>Confusion</li> <li>Dizziness</li> <li>Disorientation</li> <li>Rapid pulse</li> <li>Excessive sweating or an inability to sweat</li> <li>Fatigue</li> <li><a href="/hometown-health/speaking-of-health/common-questions-about-headaches" target="_self" title="Opens in same window.">Headache</a></li> <li>Muscle cramps or spasms</li> <li>Nausea</li> <li>Swelling in your arms or legs</li> </ul> <p>If you or a loved one are exhibiting more than one or two of these symptoms, seek medical intervention immediately.</p> <h2>Heat and medication</h2> <p>Just like you should find ways to keep your body cool during high temperatures, you also should store your medications properly so they're not exposed to extreme heat. Some medications can become degraded during temperature changes, including insulin used for <a href="/hometown-health/speaking-of-health/how-to-live-well-with-diabetes" target="_self" title="Opens in same window.">diabetes management</a>.</p> <p>Store medication in a cool, dry place. If you store medications in a bathroom with a shower, on a window ledge or in a vehicle, keep the medication in the original container to help seal out excess heat and moisture.</p> <h3>Some medications can affect your ability to stay hydrated and respond to high temperatures, including those used to:</h3> <ul> <li>Treat high blood pressure, including beta blockers and diuretics</li> <li>Reduce <a href="/hometown-health/speaking-of-health/allergy-q-and-a" target="_self" title="Opens in same window.">allergy symptoms</a>, like antihistamines or decongestants</li> <li>Decrease psychiatric symptoms, such as antipsychotics</li> </ul> <p>Talk with your care team about concerns you may have regarding how your body responds to specific medications during high temperatures.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2021/on-dock-putting-kayak-in-water.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E6E9703C997CE066C7DCCC92945C683B" alt="Two people on a dock putting kayaks in the water" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller4/24/2025Are you weighing the health benefits of eggs? Learn what nutrients are packed inside the shell and how eggs can be a healthy, versatile choice for any meal of the day.Is it healthy to eat eggs every day? Crack open the facts<p>Every few years, questions arise about eggs. Are they good or bad for you? What about their protein and cholesterol content? How often can you eat them?</p> <p>Let's crack open the facts about these meals in a shell, starting with the nutritional breakdown.</p> <p>One egg contains:</p> <ul> <li>75 calories</li> <li>5 grams of fat</li> <li>6 grams of protein</li> <li>0 carbohydrates</li> <li>67 milligrams of potassium</li> <li>70 milligrams of sodium </li> <li>210 milligrams of cholesterol </li> </ul> <p>Eggs are also a great source of vitamins A, D and B12, as well as choline, a nutrient essential in many metabolic steps.</p> <h2>A closer look at cholesterol in eggs</h2> <p>Research shows that the cholesterol in eggs doesn't seem to negatively affect the human body compared with other sources of cholesterol.</p> <p>For example, people typically eat eggs with other foods high in salt, saturated fat and cholesterol such as bacon, cheese and butter. These foods are known to increase heart disease risk and you should eat them sparingly.</p> <p>An egg on its own is a nutritious option for breakfast, lunch or dinner. Most healthy people can eat up to seven eggs a week without affecting their heart health. Some choose to eat only the egg white and not the yolk, which provides some protein without the cholesterol.</p> <h3>Here's how eggs stack up nutritionally in dishes that feature eggs:</h3> <img alt="How eggs stack up nutritionally chart" src="/-/media/national-files/images/hometown-health/2022/how-eggs-stack-up-nutritionally-chart.jpg?sc_lang=en&hash=CD5F62A2610710A650EAD1A08F52223C" /> <p>Eggs can be a good addition to a healthy, well-balanced diet. Just remember when making an egg dish like an omelet, egg bake, bowl or toast, to watch out for those high-calorie, high-fat extras like cheese, bacon and butter. </p> <h2>Egg recipes for any meal</h2> <p>Eggs are a healthy choice for any meal of the day. Assemble this savory breakfast or dinner dish the night before. Remove from the refrigerator and let the casserole stand at room temperature while the oven preheats. Serve with fresh fruit or a tossed green salad.</p> <h3>Veggie egg bake</h3> <p>By Mayo Clinic Staff<br /> Serves 6</p> <p>1 cup frozen chopped spinach, thawed<br /> 4 large eggs<br /> 4 large egg whites<br /> 1 cup skim milk<br /> 1 1/2 teaspoons dry mustard<br /> 1 teaspoon dried rosemary or 1 tablespoon minced fresh rosemary<br /> 1/2 teaspoon salt-free herb-and-spice blend<br /> 1/4 teaspoon ground black pepper<br /> 6 slices whole-grain bread, crusts removed and cut into 1-inch cubes<br /> 1/4 cup chopped onion<br /> 1/2 cup diced red pepper<br /> 4 ounces thinly sliced reduced-fat Swiss cheese</p> <p>Heat oven to 375 F. Coat a 7-by-11-inch glass baking dish or a 2-quart casserole dish with cooking spray. Place the spinach in a strainer and press with the back of a spatula to remove excess liquid. Set aside. In a medium bowl, whisk together eggs, egg whites and milk. Add dry mustard, rosemary, spice blend and pepper; whisk to combine. Toss spinach, bread, onion and red pepper in a large bowl. Add egg mixture and toss to coat. Transfer to a prepared baking dish and push down to compact. Cover with foil. Bake for 30 minutes or until the eggs have set. </p> <p>Uncover and top with cheese. Continue baking for an additional 15 minutes or until the top is lightly browned. Transfer to a wire rack and cool for 10 minutes before serving.</p> <p>Nutritional per serving (3-by-3.5 inch square): 258 calories, 10 grams total fat, 137 milligrams cholesterol, 465 milligrams sodium, 25 grams carbohydrates, 3 grams fiber, 17 grams protein.</p> <p><em>Anne Harguth is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2024/egg-yolk-running-on-toast.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4EB432709D021E70CCB84BD602E7B29C" alt="Egg yolk running on toast" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller7/2/2021You want to keep hydrated in summer months, but many beverages contain unwanted calories and sugar. Learn how to create a healthy summer drink.Making low-sugar, high-impact summer drinks<p>Most drinks found in the grocery store today have at least a small amount of sugar in them, even if you don't taste it. Some drinks contain naturally occurring sugars like those found in milk. Other drinks have added sugar, like soda or iced tea. Finally, some drinks contain artificially sweetened components like as stevia or Splenda. Generally, all of these drinks are fine in moderation.</p> <p>During the hot summer months, people drink more beverages to remain hydrated. Yet these beverages can be a significant source of calories in your diet if you don't read your labels and do your homework.</p> <p>Fortunately, I have done that work for you so you can wake up your inner mixologist and go straight to drinking your low-sugar, high-impact drinks just in time for summer.</p> <h3>Here are three steps to creating a low-sugar, high impact drink:</h3> <h4>1. Pick your base.</h4> <p>Your base can really be any liquid. The most common are tap water, flavored or unflavored carbonated water, or flavored noncarbonated water. The most important aspect of the base is that it does not have added sugar.</p> <h4>2. Add your flavor.</h4> <p>There are a variety of flavor combinations available. You can add flavor with freshly squeezed or no-sugar added fruit juice or by mashing fruits or berries at the bottom of the glass. You may want to skip this step if you used a strongly flavored base.</p> <h4>3. Pick your add-ons.</h4> <p>You can add ingredients to make your drink picture-worthy. Add on complementary toppings to intensify the flavor and visual appeal of your drink. This could include a fruit slice on the rim, cut-up fruit in the drink, pineapple leaves for garnish or even a small amount salt on a small section of the rim.</p> <p>For example, if you wanted to create your own lemon-lime soda, you could start with plain carbonated mineral water as your base. Then you could add an ounce of freshly squeezed lime juice, and top it with lemon slices in the glass and on the rim.</p> <p>Explore different combinations to keep your palette interested and thirsty.</p> <p><em>Avery Erickson is a <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">dietetics</a> intern in <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2021/cucumber-and-watermelon-drink.jpg?h=370&iar=0&w=660&sc_lang=en&hash=32D810C331E3F117A6AA38555D4723B2" alt="Cucumber and watermelon drink" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller8/28/2023Most children need regular visits with their healthcare team from ages 3 to 21. Learn why it's a good idea to schedule a back-to-school physical now to ensure your child's physical and mental health.Schedule your child's back-to-school physical<p>Late summer often is busy with purchasing school supplies, finding new clothes and wrapping up summer vacations. This year, add scheduling your child's back-to-school physical to your list. Most kids need a well-child visit with their healthcare team every year from age 3 to 21. Once your children are of school age, some refer to the well-child visit as a school physical.</p> <h2>Getting a back-to-school physical done before summer ends is essential for many reasons, including:</h2> <h3>Monitoring developmental process</h3> <p>During a routine physical, your primary care professional will check all your child's body systems to ensure there are no apparent problems. This allows you to catch any issues early and get your child the best early intervention resources available before the school year starts.</p> <h3>Reviewing immunizations</h3> <p> A physical involves checking your child's immunization records to ensure that he or she is up to date with all <a rel="noopener" href="https://www.cdc.gov/vaccines/?CDC_AAref_Val=https://www.cdc.gov/vaccines/schedules/" target="_blank" title="Opens in a new window.">required immunizations</a>. Your child's school may require this information before the start of the new school year. Also, the Food and Drug Administration expanded the emergency use authorization for the Pfizer and Moderna COVID-19 vaccines for children ages 12 and up. Talk with your child's primary care professional about vaccinating your child against COVID-19.</p> <h3>Sharing safety information</h3> <p> Safe behaviors, such as wearing a helmet and using a seat belt, also may be discussed during your child's physical. These are good reminders that will keep your child safe as they move into the new school year.</p> <h3>Discussing athlete care</h3> <p> Student athletes may need additional discussion about nutritious eating, safe exercise practices or how to manage a physical condition while playing sports. Getting an injury checked early can help ensure your child is recovering properly, and ready to play sports and be active again for their sports season.</p> <h4>Athlete discussions may include:</h4> <ul> <li>Managing sports training</li> <li>Preventing injuries</li> <li>Returning to sports after a concussion</li> </ul> <p>Get more information about how our <a href="/topics/sports-medicine" target="_self" title="Opens in same window.">Sports Medicine</a> teams can help your child.</p> <h2>Get the most from a back-to-school physical</h2> <p>The best way to maximize the effectiveness of the school physical is to go in with a plan. Make a list of questions about your child's health. Do you have specific concerns about your child's health or development? Is your child falling behind in some way? Keep in mind that apparent cognitive or behavioral problems, such as being distracted or disruptive in class, can sometimes have physical origins, such as poor eyesight.</p> <h3>Think about these issues:</h3> <ul> <li>Has your child complained of pain, fatigue, dizziness or digestive problems?</li> <li>Has your child reached critical developmental milestones on time?</li> <li>Has your child experienced any learning difficulties or other classroom problems?</li> <li>Have your child's eating habits changed?</li> <li>Does your child seem anxious or depressed?</li> <li>How well does your child sleep?</li> </ul> <p>Your child's healthcare team likely will address many of these points through the physical. However, you will have time to ask questions during the exam to ensure you are fully supported in your child's overall health and well-being.</p> <p>View more resources on <a href="/topics/childrens-health-pediatrics" target="_self" title="Opens in same window.">children's health</a>.</p> <p><em><a href="/providers/sarah-scherger-md" target="_self" title="Opens in same window.">Sarah Scherger, M.D.</a>, is a <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">pediatrician</a> in <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>Johns Hopkins Bloomberg School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Department of Pediatric and Adolescent Medicine, Mayo Clinic</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Pediatrics, Mayo Clinic College of Medicine and Science</li> </ul>Scherger<img src="/-/media/shared-files/images/medical-professionals/full/austin/sarah-scherger-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=6AC1E8D2F4C9C1DBE14B11A7201385A8" alt="Sarah Scherger MD" width="280" height="280" DisableNVelocity="true" />Sarah<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15261310Sarah Scherger, M.D.1<img src="/-/media/national-files/images/hometown-health/2021/child-putting-school-supplies-in-backpack.jpg?h=370&iar=0&w=660&sc_lang=en&hash=DD65F5F58DB98676F332CCA912074ECC" alt="Child putting school supplies in backpack" width="660" height="370" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Back to SchoolFamily MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller7/9/2021Sciatica causes sharp, shooting lower back pain spreading down the leg. Learn about treatments and when to see your healthcare provider.Sciatica and radiculopathy: Peculiar names for shooting back, leg pain<p>Most people have heard of sciatica and may have experienced it at some point. <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/sciatica/symptoms-causes/syc-20377435" target="_blank" title="Opens in a new window.">Sciatica</a> refers to a sharp, shooting pain that runs from your lower back down the side or the back of your leg.</p> <p>Sciatica is named after the sciatic nerve, which is the largest nerve in your body. It is about the diameter of your little finger and composed of five nerve roots that start in your lower spine. These nerve roots combine to form this large nerve that branches from your lower back through your hips and buttocks and down each leg.</p> <h2>Causes</h2> <p>Despite the name, sciatica is not typically caused by a problem with the sciatic nerve. In most cases, it is caused by compression of one of the nerve roots that make up the sciatic nerve, usually the last lumbar nerve root ― L5 ― or the first sacral nerve root ― S1 ― as they exit the spine. The term "pinched nerve" is commonly used when describing the condition. The medical term for the condition is radiculopathy.</p> <p>The most common cause of radiculopathy is a <a rel="noopener" href="https://www.mayoclinichealthsystem.org/locations/eau-claire/services-and-treatments/neurosurgery/spine-conditions-and-treatments/herniated-disk" target="_blank" title="Opens in a new window.">herniated lumbar disc</a>. When disc material protrudes from the disc space into the spinal canal, it can compress a nerve root. Radiculopathy can be caused by an accident, injury or lifting a large amount of weight improperly. However, most commonly people cannot link the onset of their symptoms to any event. They simply wake up one day to pain radiating down one leg.</p> <p>Other causes of sciatica include <a rel="noopener" href="https://www.mayoclinichealthsystem.org/locations/eau-claire/services-and-treatments/neurosurgery/spine-conditions-and-treatments/spinal-stenosis" target="_blank" title="Opens in a new window.">lumbar stenosis</a>, which is narrowing of the spinal canal leading to pinching of the nerve root, and spondylolisthesis, which is a slip forward of one vertebra on another.</p> <h2>Symptoms</h2> <p>When a nerve root is compressed, people experience three general symptoms: pain, numbness and weakness. Not everyone will experience all three symptoms.</p> <p>Pain is the most common symptom, and it is usually a sharp, shooting pain along the nerve. It can vary widely, from a mild ache to a sharp, burning sensation or excruciating pain. Sometimes it can feel like a jolt or electric shock. It can be worse when you cough or sneeze, and prolonged sitting can aggravate symptoms. Usually only one side of your body is affected.</p> <p>If the last lumbar nerve root is being compressed ― L5 radiculopathy ― the pain generally runs down the outside of side of the leg. If the first sacral nerve root is being compressed ― S1 radiculopathy ― the pain normally radiates down the back of the leg.</p> <p>Numbness also is a common symptom. This can show as decreased sensation or tingling in the same way as sciatic pain. L5 radiculopathy is usually associated with numbness down the side of the leg and into the top of the foot. S1 radiculopathy typically results in numbness down the back of the leg into the outside or bottom of the foot.</p> <p>Weakness is another symptom of nerve root compression. However, it is less common than pain and numbness. This displays as decreased function in the muscles supplied by the nerve root that is compressed. For L5 radiculopathy, this is usually weakness with bending the foot back toward your head. When severe, this can cause a <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/foot-drop/symptoms-causes/syc-20372628" target="_blank" title="Opens in a new window.">foot drop</a> with the foot slapping the ground when you walk. For S1 radiculopathy, there can be weakness with flexing the foot forward, like pushing down on a gas pedal.</p> <h2>Treatments</h2> <h3>A range of treatments is available for radiculopathy, including:</h3> <ul> <li><strong>Activity modification</strong><br /> An important first step is to modify your activities, such as avoiding bending, lifting and twisting activities. This minimizes further irritation of the nerve root and allows your body to heal.</li> <li><strong>Medications</strong><br /> Over-the-counter medications, such as acetaminophen and ibuprofen, can effectively reduce pain. Your healthcare provider also may prescribe other medications, such as oral steroids, to reduce inflammation or a muscle relaxer if you are experiencing spasms in the muscles in your back. Generally, sciatic pain and radiculopathy are not treated with opioid pain medications.</li> <li><strong>Physical therapy and chiropractic therapy</strong><br /> These therapies also can effectively treat lower back problems, including radiculopathy.</li> <li><strong>Steroid injections</strong><br /> Some people find relief from targeted steroid injections into the lumbar spine directly around the nerve root that is irritated and compressed. Corticosteroid injections reduce pain by suppressing inflammation around the irritated nerve.</li> <li><strong>Surgery</strong><br /> This is an excellent treatment for L5 or S1 radiculopathy when other conservative, nonsurgical treatments have not worked. There are generally two reasons for surgery. The first is significant weakness, such as a foot drop. In these cases, the sooner pressure is off the nerve, the more likely you can fully recover. The second more common reason to have surgery is if conservative treatments have failed.</li> </ul> <p>Usually, the most conservative treatments are recommended first and more invasive treatments are only pursued if necessary. Most cases of L5 or S1 radiculopathy will resolve within a few weeks or months.</p> <h2>When to see your healthcare provider</h2> <p>Most cases of sciatica or L5 or S1 radiculopathy are resolved with time and activity modification so most people will not need to see their healthcare provider.</p> <p>Talk with your primary healthcare provider if your pain is severe or becomes progressively worse and is not relieved with over-the-counter medications, activity modifications or time.</p> <h3>You should seek immediate medical attention if:</h3> <ul> <li>Your pain follows a recent traumatic event, such as a car accident or fall from a ladder. It's important to have a medical evaluation to make sure you don't have a serious spine fracture or instability.</li> <li>You had a recent bacterial infection or are experiencing symptoms of infection like fevers, chills and night sweats. In this case, you should seek medical attention to make sure an infection hasn't spread to your spine.</li> <li>You have a history of cancer.</li> <li>You are losing, or have lost, the ability to use any of the muscles in your legs, walk, or maintain bowel or bladder control.</li> </ul> <p>The good news is that the symptoms of sciatica and L5 or S1 radiculopathy are treatable. Most people improve with time and appropriate treatment, and generally can avoid surgery.</p> <h4>Learn more:</h4> <ul> <li><a href="/hometown-health/speaking-of-health/6-most-common-types-of-chronic-pain-treated-by-neurosurgeons" target="_self" title="Opens in same window.">6 most common types of chronic pain treated by neurosurgeons</a></li> <li>Back pain basics</li> <li><a href="/hometown-health/speaking-of-health/feeling-off-balance-a-nerve-condition-may-be-to-blame" target="_self" title="Opens in same window.">Feeling off balance? A nerve condition may be to blame</a></li> <li><a href="/hometown-health/speaking-of-health/when-should-i-see-a-doctor-about-back-pain" target="_self" title="Opens in same window.">When should I see a doctor about back pain?</a></li> </ul> <p><em><a href="/providers/tk-schiefer-md" target="_self" title="Opens in same window.">T.K. Schiefer, M.D.</a>, is a <a href="/services-and-treatments/neurosurgery" target="_self" title="Opens in same window.">neurosurgeon</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Herniated discs</li> <li>Spinal deformity</li> <li>Spinal stenosis, also known as narrowing of the spinal canal</li> <li>Spondylolisthesis, also known as slipped vertebrae</li> <li>Traumatic brain injuries</li> <li>Traumatic spine injuries, such as fractures and spinal cord injury</li> <li>Tumors, spinal and brain</li> </ul>M.D. <p>I view the doctor-patient relationship as a partnership. We will work together to find solutions to treat your condition and improve your quality of life. </p> <p>Since we are working together, it is very important we are on the same page and develop a plan as a team. To help facilitate this, first, I will ask you questions to get details about what is going on. Second, I usually perform a neurological examination pertinent to your problem. Third, we typically review your imaging studies together to better understand the problem. Finally, we have an open and honest discussion about possible solutions and treatments, both surgical and non-surgical. </p> <p>Sometimes non-surgical treatments may be the best option. I only offer and recommend a surgery if I feel it is in your best interest and something I would recommend to one of my own family members. I also try to avoid “doctor jargon” and explain things so they are straight forward and easy to understand. I look forward to partnering together in your neurosurgical care. </p> <p>I am a husband and father of four children. I am very active in my church community and enjoy serving others. I am an Eagle Scout and worked as scoutmaster for my sons' troop for many years. I enjoy traveling, backpacking, being outdoors, staying physically fit and personal finance/investing.</p> <p><strong>Education</strong></p> <ul> <li>Mayo Clinic Alix School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Preliminary Surgery, Mayo Clinic College of Medicine and Science</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Neurologic Surgery, Mayo Clinic College of Medicine and Science</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Neurological Surgery</li> <li>Certificate in Clinical and Translational Science, Mayo Graduate School</li> <li>Silver Level Certification, Mayo Clinic Quality Academy</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Neurological Surgeons</li> <li>Congress of Neurological Surgeons</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Neurosurgery, Mayo Clinic College of Medicine and Science</li> </ul> Schiefer<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/tk-schiefer-md.jpg?h=200&iar=0&w=200&sc_lang=en&hash=5328718020A2786933F34ECF5D6846CB" alt="T.K. Schiefer, M.D." width="200" height="200" DisableNVelocity="true" /> <ul> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/25545552/" target="_blank" title="Opens in new window">In-hospital neurologic deterioration following fractures of the ankylosed spine: a single-institution experience</a>, May 2015.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/24476904/" target="_blank" title="Opens in new window">Significance of cochlear dose in the radiosurgical treatment of vestibular schwannoma: controversies and unanswered questions</a>, May 2014.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/22084629/" target="_blank" title="Opens in new window">Moving forward: advances in the treatment of movement disorders with deep brain stimulation</a>, November 2011.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/19929340/" target="_blank" title="Opens in new window">Importance of the vasculature in cyst formation after spinal cord injury</a>, October 2009.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/18423548/" target="_blank" title="Opens in new window">Epidermoids of the cerebellopontine angle: a 20-year experience</a>, December 2008.</li> </ul> {000BB0CC-A7F9-4570-B165-7B3E176167E9}T.K.<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14270005T.K. Schiefer, M.D. 1{4EA2A40E-3721-48EC-AFC9-E6D0E13BCDEC}|{993AF103-0FE1-4CF2-9F2A-3D064CDA9F32}<img src="/-/media/national-files/images/hometown-health/2021/bending-over-shoveling-dirt.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4BC6A6F2120BAD9AB8C31ED5B5348040" alt="Bending over shoveling dirt" width="660" height="370" DisableNVelocity="true" />NeurosurgeryNeurosurgery treats disorders that impact any part of the nervous system, which may include the brain, spine or peripheral nerves. Conditions treated range from life-threatening brain tumors, to disorders impacting quality of life, such as back pain and carpel tunnel syndrome.Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.Dawn Haller7/19/2021Spots are cute on Dalmatians but could cause alarm if you see them on your skin. Learn about a condition called hyperpigmentation that causes them and what you can do say goodbye to your spots.Seeing spots? Treating hyperpigmentation<p>Spots are cute on Dalmatians and important when playing the game Twister, but they could cause alarm if you see them on your skin.</p> <p>Hyperpigmentation is a term that describes a variety of skin conditions that produce dark patches. This is the result of your body producing an excess of melanin, the natural pigment that gives your skin its color. Patches could be limited to a small part of your body, such as your hands or face, or cover wide areas. In most cases, hyperpigmentation is not life-threatening or contagious. Yet it can be stressful or cause you to feel bad about your appearance.</p> <h4>Hyperpigmentation is common among adults, and there are a variety of causes, including:</h4> <ul> <li>Sun exposure</li> <li>Reactions to medical conditions, such as Cushing's disease</li> <li>Rashes</li> <li>Hormonal changes</li> <li>Blue light from screens and electronic devices</li> </ul> <h4>Melasma</h4> <p>The most common type of hyperpigmentation is called melasma. It appears as irregular patches of tan, brown or brown-gray pigmentation, usually on the face. Melasma is more common in women than men because of hormonal changes, and it occurs more often during pregnancy. Other common triggers include sun exposure and medications like as oral contraceptives.</p> <p>Melasma tends to get better with age because of hormone shifts that happen with the natural aging process. In addition, it appears to run in families, which points to a genetic component of this disorder.</p> <h4>Treatment</h4> <p>When hyperpigmentation first appears, it's important to see a dermatologist for a definitive diagnosis as your symptoms could be caused by other skin conditions. Once diagnosed, treatment seeks to decrease the production of pigment and remove areas of excess pigmentation that already have appeared. Overall, you should view hyperpigmentation treatment as a marathon, not a sprint. It can take weeks, or months to achieve results.</p> <h5>Here are a few options that you can discuss with your dermatologist:</h5> <ul> <li><strong>Retinols</strong><br /> Retinols chemically exfoliate your skin and help block the receptors that regulate how much pigment comes out of the skin. In addition, retinols can lighten your skin and improve the look of fine lines, wrinkles and discoloration.</li> <li><strong>Chemical peel</strong><br /> Chemical peels can help over time if the hyperpigmentation is related to sun exposure. Make sure your provider is experienced performing chemical peels, as these peels can cause too much inflammation in the skin, which could worsen hyperpigmentation.</li> <li><strong>Prescription medications</strong><br /> Depending on the cause of your hyperpigmentation, some medications can be prescribed by your dermatologist.</li> <li><strong>Laser therapies</strong><br /> Intense-pulsed light treatment is used for treating melasma using a broad spectrum of light to generate heat to target and remove pigment. Research shows that this treatment can improve in the short term, but relapse often is seen within three months.</li> </ul> <h4>Prevention</h4> <p>It's important that people with any kind of hyperpigmentation are diligent about their sun protection. Use a sunscreen with a sun protection factor (SPF) of 50 or higher every day. I encourage patients to put it on in the morning, at noon and again in the late afternoon.</p> <p>The best sunscreen option for hyperpigmentation is tinted with iron oxide, which blocks natural light more than a white sunscreen.</p> <p><em><a href="/providers/jennifer-kaus-dnp" target="_self" title="Opens in same window.">Jennifer Kaus</a> is a nurse practitioner in <a href="/services-and-treatments/dermatology" target="_self" title="Opens in same window.">Dermatology</a> in <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Cosmetics</li> <li>Skin cancer screening and treatments</li> </ul>C.N.P., D.N.P., A.P.N.P.<p>My goal is to deliver competent, thorough care for patients with dermatologic needs.</p> <p>I live with my wonderful husband and adorable son. We enjoy being outdoors, spending time with family and traveling.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, University of Wisconsin-Madison</li> <li>Master's degree, Winona State University</li> <li>Doctor of Nursing Practice, Viterbo University</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Dermatology, Lahey Hospital and Medical Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Family Nurse Practitioner, American Nurses Credentialing Center</li> <li>Dermatology Certified Nurse Practitioner, Dermatology Nurse Practitioner Certification Board</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Nurse Practitioners</li> <li>American Nursing Association</li> <li>Dermatology Nurses Association</li> <li>Society of Dermatology Nurse Practitioners</li> <li>Wisconsin Nurses Association</li> </ul>Kaus<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/jennifer-kaus-cnp-dnp-apnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=6AEA4A273BAE39B9D53379ADA8A44E8A" alt="Jennifer Kaus, C.N.P., D.N.P., A.P.N.P." width="280" height="280" title="Jennifer Kaus, C.N.P., D.N.P., A.P.N.P." DisableNVelocity="true" />Jennifer<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>19914661Jennifer Kaus, C.N.P., D.N.P., A.P.N.P.1{276FDCB2-F341-4C45-B04B-F71FB963B8CB}|{20D94572-B26A-4FB7-8C9D-7555CE785162}<img src="/-/media/national-files/images/hometown-health/2021/towel-on-head-touching-face.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5921303EF9CF00C3ADEBA4D187F70193" alt="Looking in mirror, towel covering head, touching face" width="660" height="370" DisableNVelocity="true" />Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Dawn Haller7/16/2021Most children experience abdominal pain from time to time. As a parent, it can be hard to decide if your child's abdominal pain is normal or the sign of something more serious. Here's how to know.Stomachache in children: How to know if it's serious<p>Most children experience abdominal pain from time to time. They may use terms like tummy ache, bellyache or stomachache to describe it.</p> <p>As a parent, it can be hard to decide if your child's abdominal pain is normal or the sign of something more serious. Indigestion or gastroenteritis? Anxious about something? Did they swallow a toy? Appendicitis? It can be difficult to know what to do.</p> <h3>Of the many potential causes of abdominal pain in children, the most common include:</h3> <h4>Indigestion</h4> <p> This is a general term that describes discomfort in children's upper abdomen. Common symptoms include pain or burning in the area between the breastbone and navel or bloating in the upper abdomen. Most of the time, indigestion will go away on its own and is not considered serious. Prepare smaller meals and try a bland diet. Talk with their health care provider if the discomfort persists.</p> <h4>Viral gastroenteritis (stomach flu)</h4> <p> This is an infection marked by watery diarrhea, abdominal cramps and pain, and nausea or vomiting. Seek medical attention if your child has a fever of 100.4 F or higher, bloody diarrhea, or has significant pain or discomfort. Most important is to stay well-hydrated.</p> <h4>Constipation</h4> <p> Constipated children have infrequent bowel movements or hard, dry stools. They may frequently complain of a stomachache, bloating or discomfort. Talk with their primary care provider if they don't want to eat, are losing weight, have bloody stools or are having repeated episodes of constipation.</p> <h4>Stress or anxiety</h4> <p> When children are stressed or anxious, their bodies release the hormone cortisol into the blood. This can trigger abdominal cramps and discomfort.</p> <h4>Appendicitis</h4> <p> Appendicitis is an inflammation of the appendix. It causes sudden pain that begins around the navel and then moves to the lower right abdomen. The pain worsens if children cough, walk or make other jarring movements. Appendicitis pain typically increases and eventually becomes severe. Appendicitis is a medical emergency, and these children should receive immediate medical attention.</p> <h4>Intestinal obstruction</h4> <p> An intestinal obstruction is a blockage that prevents food or liquid from passing through children's small intestine or colon. It could be caused by scar tissue, a twisting or narrowing of the intestine, or if they swallow an object. Common symptoms include abdominal pain that comes and goes, and is located around or below the navel; constipation; inability to pass gas; swelling of the abdomen; or vomiting. See immediate medical attention if children are suspected to have an intestinal obstruction.</p> <h4>With any abdominal pain, seek urgent medical attention if children have:</h4> <ul> <li>Pain so severe that they can't move without causing more pain</li> <li>Difficulty sitting sit or finding a comfortable position</li> <li>Fever</li> <li>Bloody stools</li> <li>Persistent nausea and vomiting</li> <li>Skin that appears yellow</li> <li>Severe tenderness when the abdomen is touched</li> <li>Swelling of the abdomen</li> </ul> <p>Make an appointment with your child's health care provider if their abdominal pain worries you or lasts more than a few days. In the meantime, find ways to ease the pain. For instance, prepare smaller meals if pain is accompanied by indigestion or encourage your child to drink plenty of water if pain is due to constipation.</p> <p><em><a href="/providers/timothy-slama-do" target="_self" title="Opens in same window.">Timothy Slama, D.O.</a>, is a physician in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a>, Minnesota.</em> </p><ul> <li>Dermatology</li> <li>Pediatrics</li> <li>Sports medicine</li> </ul>D.O.<p>I grew up 30 minutes from Fairmont. I'm married with three kids and coach tennis at the Fairmont High School. I'm also a medical consultant for public health in Martin and Faribault counties.</p><p><strong>Education</strong></p> <ul> <li>Des Moines University College of Osteopathic Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Iowa Lutheran Hospital, University of Iowa</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Iowa Lutheran Hospital</li> </ul> <p><strong>Certifications</strong> </p> <ul> <li>Family Medicine, American Board of Family Medicine</li> <li>Certified Medical Examiner, Department of Transportation</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Medical Association </li> <li>Minnesota Academy of Family Physicians</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Slama<img src="/-/media/shared-files/images/medical-professionals/full/fairmont/timothy-slama-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=FCCFA79564EA50EAAA4C53E2DE19802C" alt="Timothy Slama, D.O." width="280" height="280" DisableNVelocity="true" />{F6F9D4D2-2155-4F19-885A-FEFABCBBB330}Timothy <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15345599Timothy Slama DO1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}<img src="/-/media/national-files/images/hometown-health/2021/childs-head-on-lap.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B983971D97D6E53F0D519C53FD3875FF" alt="Child's head on lap" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Dawn Haller12/2/2022Several conditions — not just Alzheimer's disease — can cause memory loss in older adults. Find out why getting a prompt diagnosis and appropriate care is important.When to seek help for memory loss<p>Everyone forgets things at times. How often have you misplaced your cellphone or car keys? Have you ever forgotten the name of a person you just met?</p> <p>Some degree of memory problems and a modest decline in other thinking skills are common parts of aging. However, there's a difference between normal memory changes and memory loss associated with dementia, Alzheimer's disease and other related disorders. And some memory problems could be caused by other treatable conditions.</p> <h2>Memory loss and aging</h2> <p>It's normal to have minor memory loss as you age. This type doesn't prevent you from living a full, productive life. For example, you may occasionally forget an acquaintance's name but recall it later. You might misplace your glasses or need to write a list to remember tasks.</p> <p>These changes in memory can be irritating, but are normal and manageable. They don't disrupt your ability to work, live independently or maintain a social life.</p> <h2>Memory loss and dementia</h2> <p>Dementia isn't a specific disease. It's a group of symptoms that affect memory, reasoning, judgment, language and other thinking skills.</p> <p>Dementia usually begins gradually, worsens over time and interferes with a person's daily life, including working, managing daily tasks, social interactions and relationships.</p> <h3>Memory loss often is one of the first or more recognizable signs of dementia. Other early signs can include:</h3> <ul> <li>Asking the same questions repeatedly.</li> <li>Forgetting common words when speaking.</li> <li>Mixing words up, such as saying "bed" instead of "table."</li> <li>Taking longer to complete familiar tasks, like following a recipe.</li> <li>Misplacing items in inappropriate places, such as putting a wallet in a kitchen drawer.</li> <li>Getting lost while walking or driving in a familiar area.</li> <li>Having changes in mood or behavior for no apparent reason.</li> </ul> <h2>Mild cognitive impairment</h2> <p>Mild cognitive impairment involves a notable decline in at least one area of thinking skills, like memory. This decline is greater than the changes of aging and less than those of dementia. Having mild cognitive impairment doesn't prevent you from performing everyday tasks and being socially engaged.</p> <p>Researchers and physicians are still learning about mild cognitive impairment. For some people, the condition doesn't worsen, and they can remain independent. For others, mild cognitive impairment is an early symptom of Alzheimer's disease or another disorder causing dementia.</p> <h2>Reversible causes of memory loss</h2> <p>Many medical problems can cause memory loss or other dementia-like symptoms. Most of these conditions can be treated. Your health care team can screen you for conditions that cause reversible memory impairment.</p> <h3>Possible causes of reversible memory loss include:</h3> <ul> <li><strong>Medications</strong><br /> Certain medications or a combination of medications can cause forgetfulness or confusion.</li> <li><strong>Minor head trauma or injury</strong><br /> A head injury from a fall or accident — even if you don't lose consciousness — can sometimes cause memory problems.</li> <li><strong>Emotional disorders</strong><br /> Stress, anxiety or depression can cause forgetfulness, confusion, difficulty concentrating and other problems that disrupt daily activities.</li> <li><strong>Sleep disorders</strong><br /> Poor quality or insufficient sleep can cause mental fogginess and forgetfulness that can interfere with a person's daily life. Obstructive sleep apnea is a common example of a sleep disorder that causes cognitive impairment that can be reversed with treatment of the underlying problem. </li> <li><strong>Alcoholism</strong><br /> Chronic alcoholism can seriously impair mental abilities. Alcohol also can cause memory loss by interacting with medications.</li> <li><strong>Vitamin B12 deficiency</strong><br /> Vitamin B12 helps maintain healthy nerve cells and red blood cells. A vitamin B12 deficiency, common in older adults, can cause memory problems. Learn how to <a href="/hometown-health/speaking-of-health/maximize-memory-function-with-a-nutrient-rich-diet" target="_self" title="Opens in same window.">maximize memory function with a nutrient-rich diet</a>.</li> <li><strong>Hypothyroidism</strong><br /> An underactive thyroid gland, or hypothyroidism, can result in forgetfulness and other thinking problems.</li> <li><strong>Brain diseases</strong><br /> Although less common than other causes, a tumor or infection in the brain can cause memory problems or other dementia-like symptoms.</li> </ul> <h2>When to see your health care team</h2> <p>Talk with your health care team if you're concerned about memory loss or if a family member has brought up concerns about changes in your thinking. Sometimes the people who know you best will notice changes earlier than you will. It's good to have a family member or friend along to answer some questions based on observations.</p> <h3>Questions you may be asked may include:</h3> <ul> <li>When did your memory problems begin?</li> <li>What medications, including prescription drugs, over-the-counter drugs and dietary supplements, do you take and in what doses?</li> <li>Have you recently started a new drug?</li> <li>What tasks do you find difficult?</li> <li>What have you done to cope with memory problems?</li> <li>How much alcohol do you drink?</li> <li>Have you recently been in an accident, fallen or injured your head?</li> <li>Are you having difficulty sleeping? </li> <li>Have you recently been sick?</li> <li>Do you feel sad, depressed or anxious?</li> <li>Have you recently had a major loss, change or stressful event in your life?</li> </ul> <p>You may have a general physical exam, blood tests or brain imaging. These can help identify reversible causes of memory problems and dementia-like symptoms.</p> <p>You might be referred to a specialist who can diagnose dementia or memory disorders, such as a neurologist, psychiatrist, neuropsychologist or geriatrician. You may need additional testing, known as a neuropsychological test, to determine whether your thinking changes are normal for your age or not.</p> <h2>The importance of a diagnosis</h2> <p>Coming to terms with memory loss and the possible onset of dementia can be difficult. Some people try to hide memory problems, and some family members or friends compensate for a person's memory loss ― sometimes without being aware of how much they've adapted to the impairment.</p> <p>Getting a prompt diagnosis is important, even if it's challenging. Identifying a reversible cause of memory impairment enables you to get appropriate treatment.</p> <p>Also, an early diagnosis of mild cognitive impairment, Alzheimer's disease or a related disorder is beneficial because you can begin treatment, identify resources, settle legal matters and determine future care preferences.</p> <h3>Learn more about brain health: </h3> <ul> <li><a href="/hometown-health/speaking-of-health/5-tips-to-keep-your-brain-healthy" target="_self" title="Opens in same window.">5 tips to keep your brain healthy</a></li> <li><a href="/hometown-health/speaking-of-health/understanding-dementia-and-alzheimers-disease" target="_self" title="Opens in same window.">Understanding dementia and Alzheimer's disease</a></li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://connect.mayoclinic.org/blog/living-with-mild-cognitive-impairment-mci/" target="_blank" title="Opens in a new window.">Living with mild cognitive impairment</a></li> </ul> <p><a href="/providers/anne-shandera-ochsner-phd" target="_self" title="Opens in same window.">Anne Shandera-Ochsner, Ph.D.</a>, is a <a href="/services-and-treatments/neuropsychology" target="_self" title="Opens in same window.">clinical neuropsychologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</p><ul> <li>Mild cognitive impairment</li> <li>Neurodegenerative diseases</li> </ul>Ph.D., L.P.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Psychology, University of Montana</li> <li>Master's degree, Clinical Psychology, University of Kentucky</li> <li>Ph.D., Clinical Psychology–Neuropsychology Track, University of Kentucky</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Neuropsychology, Emory University School of Medicine</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Clinical Neuropsychology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Clinical Neuropsychology, American Board of Professional Psychology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Clinical Neuropsychology</li> <li>American Psychological Association</li> <li>International Neuropsychological Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Psychology, Mayo Clinic College of Medicine and Science</li> </ul>Shandera-Ochsner<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/anne-shanderaochsner-phd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=60CBFD40AA2C9CDEB64830A0A6B4B9D8" alt="Anne Shandera-Ochsner, Ph.D., L.P." width="280" height="280" DisableNVelocity="true" />Anne<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15896684Anne Shandera-Ochsner, Ph.D.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2021/mature-gray-hair-person-with-glasses.jpg?h=370&iar=0&w=660&sc_lang=en&hash=01A96338D218C91AED4E10581112E23D" alt="Mature, gray-haired person with glasses" width="660" height="370" DisableNVelocity="true" />AgingLife expectancy is 75 for males and 80 for females according to the National Center for Health Statistics. We'll help you keep you informed about potential issues with aging, and steps you can take to maintain your health and keep active.Dementia/Alzheimer's DiseaseDementia isn't a specific disease. Instead, dementia describes a group of symptoms affecting thinking and social abilities severely enough to interfere with daily functioning. Many causes of dementia symptoms exist. Alzheimer's disease is the most common cause of a progressive dementia. Dawn Haller7/13/2021When used correctly, antibiotics could be considered the life preservers of health care. But some bacteria are antibiotic-resistant and become a "superbug." Discover how you can reduce antibiotic resistance.Your role in stopping 'superbugs'<p>If a person is in danger of drowning, offering a life preserver is appropriate. However, if that person is surrounded by flames in a burning house, the life preserver would not be helpful. It may even make the situation worse.</p> <p>Antibiotics could be considered the life preservers of health care. When used appropriately, antibiotics can significantly benefit patients' health and well-being. Without antibiotics, more people could die from infections caused by injury, illness or exposure to infectious agents. However, antibiotics are not appropriate for every situation.</p> <h4>Antibiotic resistance</h4> <p>Bacteria and other infectious organisms can quickly adapt and become resistant to available antibiotics. When an antibiotic no longer affects a certain strain of bacteria, those bacteria are said to be antibiotic-resistant. Sometimes they are referred to as superbugs.</p> <p>Antibiotic resistance is one of the world's most pressing health problems. Over 30% of antibiotics prescribed in the U.S. are unnecessary or ineffective, according to the Centers for Disease Control and Prevention. Approximately 2 million infections from antibiotic-resistant bacteria ― superbugs ― occur in the U.S. each year, resulting in 23,000 deaths.</p> <p>The overuse of antibiotics, especially taking antibiotics when they're not the appropriate treatment, promotes antibiotic resistance.</p> <p>In addition, antibiotics are not benign. All have potential side effects, including diarrhea and nausea, or kidney and liver damage. Some side effects can be life-threatening, such as an allergic reaction, or cause hospitalizations. These side effects, in addition to antibiotic-resistant superbugs, contribute to rising costs in health care.</p> <h4>Antibiotic stewardship</h4> <p>Everyone has a role to play. At Mayo Clinic Health System, a team of experts is focused on ensuring the appropriate use of antibiotics, which is also called antibiotic stewardship. This team has implemented new treatment guidelines to ensure effective treatments for bacteria infections and reduce inappropriate use of antibiotics.</p> <h5>You also play a part in antibiotic stewardship. You can reduce the development of antibiotic resistance by:</h5> <ul> <li>Not pressuring your health care provider to give you a prescription for an antibiotic.</li> <li>Practicing good hygiene to avoid bacterial infections that need antibiotic treatment.</li> <li>Making sure you and your family receive recommended vaccinations. Some recommended vaccines protect against bacterial infections, such as diphtheria and whooping cough (pertussis).</li> <li>Reducing your risk of getting a foodborne bacterial infection. Don't drink raw milk, wash your hands and cook foods to a safe internal temperature.</li> <li>Using antibiotics only as prescribed by your health care provider. Take the prescribed daily dose and complete the entire course of treatment.</li> <li>Never taking leftover antibiotics for a later illness. They may not be the correct antibiotic and would not be a full course of treatment.</li> <li>Never taking antibiotics prescribed for another person.</li> </ul> <p>Antibiotic resistance use is a serious issue. When used incorrectly, bacteria become resistant to the antibiotic and become superbugs, which can require longer and even more intense courses of treatment.</p> <p>Trust your health care provider's advice and know that he or she is taking the necessary steps to put you back on the quickest path to ideal health.</p> <h4>Learn more about medications:</h4> <ul> <li><a href="/hometown-health/speaking-of-health/medication-disposal-safely-clean-out-your-medicine-cabinet" target="_self" title="Opens in same window.">Medication disposal: Why, how to safely clean out your medicine cabinet</a></li> <li><a href="/hometown-health/speaking-of-health/medication-synchronization-increases-prescription-efficiency" target="_self" title="Opens in same window.">Medication synchronization increases prescription efficiency</a></li> <li><a href="/hometown-health/speaking-of-health/over-the-counter-and-prescription-medication-safety" target="_self" title="Opens in same window.">Over-the-counter, prescription medication safety</a></li> <li><a href="/hometown-health/speaking-of-health/pharmacogenomics-getting-the-right-drug" target="_self" title="Opens in same window.">Pharmacogenomics: Getting the right drug</a></li> </ul> <p><em>Sara Ausman and Sarah Lessard are <a href="/services-and-treatments/pharmacy" target="_self" title="Opens in same window.">pharmacists</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin, respectively.</em></p><img src="/-/media/national-files/images/hometown-health/2021/looking-at-prescription-bottle.jpg?h=370&iar=0&w=660&sc_lang=en&hash=52DD25436DC1780DAB106095928D2F4F" alt="Looking at prescription bottle" width="660" height="370" DisableNVelocity="true" />Medication ManagementNearly 70% of Americans take at least one prescription drug, and more than half take two.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Dawn Haller7/1/2021Summer races are back and in full swing. If one is on your calendar, be sure to take necessary precautions to properly train and prepare your body for the demands of a race.Strategies for safe, successful summer race performance<p>Are you interested in competing in a summer race event? Make sure you are taking the necessary precautions to properly train and prepare your body for the physiological demands of a race. Although the slogan "couch to 5K" has a catchy ring to it, these kinds of programs can be somewhat misleading in that they may underestimate the time and training effort required to properly train and allow for the training-related adaptations to occur.</p> <p>When people jump from a sedentary lifestyle right into full-blown marathon training mode, they may expose themselves to an increased risk of injury. It takes time for the body to adapt to the stressors of training, particularly when it comes to bone or connective tissue-related adaptations. It is important to start with a low to moderate weekly training volume and slowly progress into longer distances over time.</p> <p>This brief overview of other training-related considerations will ensure safe and effective training:</p> <h4>Too much of a good thing?</h4> <p>There can be too much of a good thing. If training for a marathon, you don't need to run 26.2 miles every day. Generally, only one or two longer training sessions per week is needed to train for a long-distance event, such as a marathon. The remaining training sessions can be of shorter duration but perhaps at a higher intensity, such as high-intensity interval session (HIIT), which can completed in as little as 20 to 30 minutes.</p> <p>Cross-training can be another useful strategy to reduce overuse injuries while still getting the benefits of aerobic exercise. For example, if you are training for a half-marathon, instead of going out for an 8-mile run one day, you could instead swim, bike or use an elliptical so you are still training your cardiorespiratory system but are also allowing your body to recover from the repetitive running-related stresses to your lower body joints and musculature.</p> <h4>Acclimate to weather</h4> <p>Another important consideration for summer competitions is making sure your body has acclimated to warmer temperatures. Acclimatization typically requires a minimum of two to three weeks to occur. To fully acclimate it's important to actually train outside and be exposed to the warmer conditions rather than training inside in a comfortable setting.</p> <p>For race day, if the forecast is for an unusually hot and humid day, it's best to accept a slower race time and lower the intensity/pace rather than pushing through it and risking heat-related complications. Optimal racing conditions generally are around 55 F with low humidity, so don't expect to break any records if the heat index is in the 90s.</p> <h4>Hydration is key</h4> <p>Maintaining adequate hydration levels also is important when training and competing in the heat to maintain performance, and prevent dehydration and overheating. It is the No. 1 preventive strategy when it comes to preventing dehydration and associated risks of heat-related issues, such as heat exhaustion or heat stroke.</p> <p>The American College of Sports Medicine recommends that an individual consume at least 2 to 3 milliliters per pound of body weight four hours before a race. This is approximately 12 to 18 ounces for a 165-pound athlete. In addition, the athlete should consume another 8 to 12 ounces two hours prior to race start.</p> <p>Throughout a race, consuming 6 to 8 ounces every 10 to 15 minutes can help maintain hydration levels. Adding salt, electrolytes and carbohydrates or consuming sports beverages can help facilitate fluid absorption and provide an additional source of energy during the race. Following the race, consuming 2 to 3 ounces of fluid per pound of body weight lost via sweat can help rehydrate.</p> <h4>Time to recover</h4> <p>It's important to allow for adequate rest days or even multiple days of rest following an intense training session and certainly following competition before jumping right back into another race.</p> <p>It may be best to consult with a performance coach or exercise physiologist to develop a training program which incorporates variation in training volume, such as distance or mileage, and intensity from week to week leading up to a race event. This type of training program can provide appropriate levels of training-related stressors to stimulate needed physiological adaptations but also incorporate strategic periods of rest or reduced training to facilitate recovery and prevent overtraining-related problems. <span></span>This performance coach also can help determine an appropriate training program around multiple race events, and help with optimizing performance leading into race week and maximizing recovery following each race.</p> <p><a href="/providers/andrew-jagim-phd" target="_blank" title="Opens in a new window."><em>Andrew Jagim, Ph.D.</em></a><em>, is a <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">sports medicine</a> specialist who sees patients in <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Examining how different nutrition and exercise interventions influence health and performance — this interest applies to both the general population in regards to improve a person’s quality of life and prevent chronic disease in addition to improving the performance ability of elite athletes</li> </ul>Ph.D.<p><strong>Education</strong></p> <ul> <li>Master's degree, Human Performance, University of Wisconsin – La Crosse</li> <li>Ph.D., Kinesiology – Exercise Physiology Texas A&M University, College Station</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>International Society of Sports Nutrition</li> <li>National Strength and Conditioning Association</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Sports Medicine</li> <li>International Society of Sports Nutrition</li> <li>National Strength and Conditioning Association</li> </ul>Jagim<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/andrew-jagim-phd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=AA07F8D241D507CF3C0C9F28FC00E465" alt="Andrew Jagim PhD" width="280" height="280" DisableNVelocity="true" /><p>Dr. Jagim has authored or collaborated on numerous scholarly publications related to sports medicine. His topics have included:</p> <ul> <li>diets and nutrition</li> <li>workouts and training regimens</li> <li>sports injuries and treatment programs</li> <li>use and affects of drugs and supplements in sports</li> </ul> <p>His research has been published in numerous journals including International Journal of Exercise Science, Journal of Sports Science, Journal of Strength and Conditioning Research, Frontiers in Nutrition, International Society of Sports Nutrition, Journal of Neurosurgery and the Clinical Journal of Sports Medicine.</p>Andrew<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20772289Andrew Jagim, Ph.D.1{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2021/runner-drinking-bottled-water.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D29DD6332E04C7737D23FA6AF75A4B88" alt="Runner drinking bottled water" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Dawn Haller3/27/2023Over the past 20 years, Type 2 diabetes has been on the rise, especially in children. Screening is recommended based on certain risk factors. Read about lifestyle changes that can slow or stop diabetes.Can children develop Type 2 diabetes?<p>While Type 2 diabetes is more common in older adults, an increasing number of children have been diagnosed with the disease. <a href="/hometown-health/speaking-of-health/help-your-child-reach-healthy-weight" target="_self" title="Opens in same window.">Childhood obesity</a> is believed to be a driving force for this increase.</p> <p>Type 2 diabetes is a chronic disease that develops over time. It affects how the body uses sugar in the blood. This sugar, or glucose, is the primary energy source for the body's cells. </p> <p>After you eat food, specifically carbohydrates, <a href="/hometown-health/speaking-of-health/closing-the-loop-with-insulin-pumps" target="_self" title="Opens in same window.">the body needs insulin</a>, a hormone from the pancreas, to enable glucose to enter the cells and be used as energy. Insulin also is responsible for storing glucose to be used later.</p> <p>With <a href="/hometown-health/speaking-of-health/how-to-live-well-with-diabetes" target="_self" title="Opens in same window.">Type 2 diabetes</a>, a child's pancreas produces insulin, but not enough to meet the body's needs. In addition, the child's body may be unable to use insulin efficiently. This is called insulin resistance and differs from Type 1 diabetes, in which the pancreas produces little or no insulin.</p> <h2>Diabetes risk factors</h2> <p>Screening for Type 2 diabetes is recommended at the onset of puberty if your child is overweight and has at least two risk factors.</p> <h3>Risk factors that increase incidence among children include:</h3> <ul> <li><strong>Extra weight</strong><br /> An increase in fatty tissue is associated with increased insulin resistance.</li> <li><strong>Family history</strong><br /> The risk of Type 2 diabetes increases if a child has a parent or sibling with diabetes or a mother who had gestational diabetes while pregnant.</li> <li><strong>Gender</strong><br /> In youth, girls are more likely than boys to develop Type 2 diabetes.</li> <li><strong>Inactivity</strong><br /> Physical activity helps children control their weight and enables cells to be more responsive to insulin.</li> <li><strong>Low socioeconomic status<br /> </strong>Complex psychosocial environments create challenges to sustaining healthy lifestyles.</li> </ul> <h2>Preventing diabetes in children</h2> <p>Positive lifestyle choices can help prevent Type 2 diabetes, even if your child has biological relatives living with diabetes. These choices should be realistic, sustainable and adopted by everyone in the family.</p> <h3>Lifestyle changes that can slow or stop the progression of diabetes include:</h3> <ul> <li><strong>Food choices</strong><br /> Encourage your child to eat nutrient-dense foods, focusing on fruits, vegetables, low-fat dairy, whole grains and lean proteins. Limit intake of sugar-sweetened beverages, such as soda. <a href="/hometown-health/speaking-of-health/kids-in-the-kitchen-early-involvement-yields-oodles-of-fun" target="_self" title="Opens in same window.">Get your children involved</a> by taking them grocery shopping, having them help with meal preparation, and getting their input on recipes and meal choices.</li> <li><strong>Physical activity</strong><br /> Aim for at least 60 minutes of physical activity daily. Find <a href="/hometown-health/speaking-of-health/teens-and-exercise" target="_self" title="Opens in same window.">activities your child likes</a> to do, as the movement should be enjoyable and not viewed as a chore. Decrease sedentary time by striving to get up and move every 30 minutes. Go outside, throw a ball or ride a bike around the neighborhood. The options are endless.</li> </ul> <p> Your entire family can make lifestyle choices to help prevent Type 2 diabetes in your children. Model the behaviors you want them to see. The routines you create in your home today can stay with your children for a lifetime.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2021/two-kids-playing-video-games.jpg?h=370&iar=0&w=660&sc_lang=en&hash=AF5AF5C5DE18656365856CF89E282D47" alt="Two kids playing video games" width="660" height="370" DisableNVelocity="true" />DiabetesIf you have diabetes, no matter what type, it means you have too much glucose in your blood, although the reasons may differ. Too much glucose can lead to serious health problems.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Michele Halterman4/24/2025<p>Watermelon is a staple at many summertime picnics and gatherings around the country. While most people agree watermelon tastes good, a majority are unaware of the many health benefits this wonderful fruit contains.</p>The wonders of watermelon<p>Watermelon is a staple at many summertime picnics and gatherings around the country. While most people agree watermelon tastes good, a majority are unaware of the many health benefits this wonderful fruit contains.</p> <h4>Watermelon — the disease fighter</h4> <p>Did you know watermelon has more lycopene than any other fresh fruit or vegetable? Lycopene is an antioxidant linked to decreased risk of cancer, heart disease and age-related eye disorders.</p> <h4>Watermelon is nutritious</h4> <p>Watermelon is the perfect sweet treat that is nutritious and tasty.</p> <h5>One cup of watermelon contains:</h5> <ul> <li>46 calories</li> <li>12 grams of carbohydrates</li> <li>865 international units (IU) of vitamin A — (equates to .26 milligrams)</li> <li>12 milligrams of vitamin C</li> <li>170 milligrams of potassium</li> <li>0.1 milligrams of vitamin B6</li> <li>Zero fat, cholesterol or sodium</li> </ul> <p>Vitamin A is important for skin and eye health. Vitamin B6 helps your body break down the protein you eat, and is also important for the immune system and nerve function. Vitamin C helps strengthen the immune system and aids in the absorption of iron. Potassium is helpful in lowering blood pressure and is important for nerve function as well.</p> <h4>Watermelon hydrates</h4> <p>As its name states, 92% of watermelon consists of water. No wonder it's the most common melon eaten in America and is perfect for staying refreshed and hydrated on a hot summer day.</p> <h4>Many ways to eat watermelon</h4> <h5>In addition to eating watermelon as is, you also can try:</h5> <ul> <li>Lightly grilling (around two minutes on each side)</li> <li>Throwing in a blender for a refreshing beverage or smoothie</li> <li>Adding to a salad or stir-fry</li> <li>Pickling the rind</li> </ul> <h4>Searching for the perfect watermelon</h4> <p>When choosing a watermelon, look for one that is firm, symmetrical and heavy for its size. There should be a yellow spot on the underside as the result of sitting on the ground and ripening in the sun. If the spot is very pale or white, it may have been picked too soon and will not be ripe.</p> <a href="/providers/kristi-wempen-rdn" target="_self" title="Opens in same window."><em>Kristi Wempen</em></a><em> is a registered <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">dietitian-nutritionist</a> in <a rel="noopener" href="https://mayoclinichealthsystem.org/locations/mankato" target="_blank" title="Opens in new window">Mankato</a>, Minnesota.</em><ul> <li>Chronic kidney disease</li> <li>General health and wellness</li> <li>Weight management</li> </ul>RDN, LD<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Minnesota State University-Mankato</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Iowa State University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration</li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul> <p><strong>Membership</strong></p> <ul> <li>Academy of Nutrition and Dietetics</li> </ul>Wempen<img src="/-/media/shared-files/images/medical-professionals/full/mankato/kristi-wempen-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=BB7EFDC16603EA67B00B7CD0DBD528E1" alt="Kristi Wempen RDN" width="280" height="280" DisableNVelocity="true" />Kristi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14834341Kristi Wempen, R.D.N.1{2BEE5070-65FF-4406-9E59-103E06C5A535}<img src="/-/media/national-files/images/hometown-health/2021/two-children-eating-watermelon.jpg?h=370&iar=0&w=660&sc_lang=en&hash=41322C461C7954C06D0A9E228F230C68" alt="Two children eating watermelon" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Michele Halterman8/16/2023You may be surprised to find out you’re not drinking enough water. Learn why it’s essential to stay hydrated, how to know if you're drinking enough water and get tips for upping your water game.Tips for drinking more water<p>Water is essential for every cell in the body to function correctly. Water aids the digestive system, helps prevent constipation, flushes toxins from the body, promotes good kidney function, keeps your joints and muscles lubricated, supports healthier and younger-looking skin, and helps regulate body temperature.</p> <h2>How much water do you need?</h2> <p>Whether you prefer plain, sparkling or infused water, drink plenty every day. So how much water does an average adult in a temperate climate need?</p> <h3>Mayo Clinic recommends this minimum daily intake of water:</h3> <ul> <li><strong>Women</strong> — 11.5 cups, or 92 ounces</li> <li><strong>Men</strong> — 15.5 cups, or 124 ounces</li> </ul> <p>You lose water through breathing, perspiring, urine and bowel movements. You must continually replace your body's water supply by eating food and drinking beverages that contain water. About 20% of the daily intake of liquid comes from food and the rest from drinks.</p> <p>Anyone can become dehydrated, but certain people are at greater risk, including infants, young children and people who work or exercise outdoors. Even mild dehydration can leave you feeling tired and lacking energy.</p> <p>In addition, older adults are more likely to become dehydrated. As you age, your body's fluid reserve becomes smaller, your ability to conserve water is reduced and your thirst sense becomes less acute. These problems are compounded by chronic illnesses such as diabetes and dementia, and the use of certain medications. Older adults also can have mobility problems that limit their ability to obtain water for themselves.</p> <h2>How do you know if you're drinking enough water?</h2> <p>Your fluid consumption is adequate for your needs if you rarely feel thirsty and your urine is colorless or light yellow. To prevent dehydration, consider drinking water regularly with meals, throughout exercising and when you feel thirsty.</p> <p>Increasing your water intake may seem easy, but it can take a lot of work to remember to drink up.</p> <h3>Here are some tips for upping your water game:</h3> <ul> <li><strong>Flavor it.</strong><br /> Add fruit to your water. Lemons, limes and oranges are tried and true. Cucumber, watermelon, strawberries and herbs also are delicious options.</li> <li><strong>Tie it into a routine.</strong><br /> Drink a glass of water every time you brush your teeth, eat a meal or use the bathroom.</li> <li><strong>Eat it.</strong> <br /> Many fruits and vegetables have a high water content, including melon, cucumbers, lettuce and celery.</li> <li><strong>Track it.</strong><br /> Invest in a high-tech bottle that connects to your smartphone and records how much you drink. Or set an alarm as a reminder and track your intake in your calendar.</li> <li><strong>Challenge a friend.</strong><br /> Kick off a healthy competition with a friend or your kids to see who can meet their guzzling goal most often.</li> <li><strong>Take it to go.</strong><br /> Drinking enough water when you are the go can be challenging. Fill your water bottle before you leave home, and bring it along on your daily travels.</li> <li><strong>Alternate your drinks.</strong><br /> If you can't give up soda or juice completely, try alternating with water. Each time you finish a glass of water, switch to soda or juice and vice versa.</li> </ul> <p>Follow some of these tips to keep yourself and your loved ones properly hydrated.</p> <p><em><a href="/providers/liana-reiland-dnp" target="_self" title="Opens in same window.">Liana Reiland</a> is a nurse practitioner in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/mondovi" target="_self" title="Opens in same window.">Mondovi</a>, Wisconsin.</em></p><ul> <li>Health promotion</li> <li>Wellness</li> <li>Women's health</li> </ul>C.N.P., D.N.P., A.P.N.P.<p>In my free time, I enjoy camping, gardening, traveling, and spending time with family and friends.</p><p><strong>Education</strong></p> <ul> <li>Bachelor’s degree in Biology, University of Wisconsin-La Crosse</li> <li>Bachelor’s degree in Nursing, College of St. Scholastica</li> <li>Doctorate degree in Nursing, University of Wisconsin-Eau Claire</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Nurse Practitioner, American Association of Nurse Practitioners</li> </ul> <p><strong>Membership</strong></p> <ul> <li><strong></strong>Sigma Theta Tau International, Honor Society of Nursing</li> </ul>Reiland<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/liana-reiland-dnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=CF57AFA9038959EF421E3E9E4E494074" alt="Liana Reiland DNP" width="280" height="280" DisableNVelocity="true" />Liana<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15870553Liana Reiland, C.N.P., D.N.P., A.P.N.P.1<img src="/-/media/national-files/images/hometown-health/2021/lemons-and-limes-in-water-glass.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3E625537CFF3A9F3E7459252EC9731E8" alt="Lemons and limes in water glass" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller7/17/2024Men are less likely than women to have preventive screenings and regular exams. Learn why men should reconsider their reservations and avoid a treatable situation turning deadly.Men's health: Checkups, screenings key<p>Historically, men have been hesitant to seek medical attention when something seems wrong with their health. Also, men aren't as likely as women to have preventive screenings and checkups with their healthcare team. This is a problem because early detection of a medical issue is the best way to treat and manage it effectively.</p> <p>Why should you reconsider your reservations about seeing a healthcare professional? Delaying or avoiding a checkup or screening could lead to a treatable situation turning deadly.</p> <p>While you should get some screenings, such as HIV and hepatitis C, you should have other screenings for certain conditions and cancers regularly.</p> <p>Vaccines also are essential to prevent infectious diseases. Vaccinations for men are administered at different intervals throughout adulthood.</p> <h2>Regular physical exams</h2> <p>Males older than 50 should have a yearly physical exam, and those younger than 50 should have a physical exam every three to five years. Even if you're feeling healthy, a regular checkup with your healthcare team is an excellent way to validate your health or identify a problem in its early stages.</p> <p>Another thing to think about: Health isn't only physical. <a href="/hometown-health/speaking-of-health/trust-primary-care-provider" target="_self" title="Opens in same window.">Talk to your healthcare team</a> about your mental and emotional health. If you're struggling in those areas, effective help is available.</p> <h3>Screening can identify specific conditions and cancers, including:</h3> <h4>Abdominal aortic aneurysm</h4> <p>For men between 65 and 75 who have smoked more than 100 cigarettes in their lifetime, the U.S. Preventive Services Task Force recommends a one-time abdominal aortic aneurysm screening ultrasound. An abdominal aortic aneurysm is an enlarged area in the lower part of the aorta, the major blood vessel that supplies blood to the body. Because the aorta is the body's main supplier of blood, a ruptured abdominal aortic aneurysm can cause life-threatening bleeding. Men over 60 with a family history of abdominal aortic aneurysm should consider repeat screening at regular intervals.</p> <h4>Colon cancer</h4> <p>Colon cancer screening should begin at age 45 or 10 years prior to an age at which an immediate relative was diagnosed with colon cancer. For example, get screened at age 36 if your mother was diagnosed at age 46. A colonoscopy is a traditional, effective procedure to identify colon cancer or precancerous polyps. A more recent noninvasive option available is a <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/stool-dna-test/about/pac-20385153" target="_blank" title="Opens in a new window.">take-home test to screen for colon cancer</a>.</p> <p>Talk to your healthcare professional about which option is best for you.</p> <h4>Diabetes</h4> <p>If you're older than 45 or have a body mass index above 25, no matter your age, the American Diabetes Association recommends that you be screened for diabetes. <a href="/hometown-health/speaking-of-health/how-to-live-well-with-diabetes" target="_self" title="Opens in same window.">Type 2 diabetes</a> and prediabetes symptoms can happen slowly and may not be noticeable, so staying aware of your blood sugar levels and risk of developing diabetes is essential.</p> <h4>High blood pressure</h4> <p>A blood pressure reading is a good indication to many aspects of your health. High blood pressure can lead to many physical problems, especially those associated with the heart.</p> <p>You should have your blood pressure checked at least every two years. However, talk to your healthcare professional about having it checked more frequently if you have <a href="/hometown-health/speaking-of-health/know-your-heart-health-numbers" target="_self" title="Opens in same window.">high blood pressure</a> or are at risk of developing high blood pressure.</p> <h4>High cholesterol</h4> <p>Like high blood pressure, high cholesterol may pose serious risks to your health and well-being. Starting at age 18, men at average risk for heart disease should have a cholesterol screening every five years. If you have a family history of high cholesterol or heart attacks, smoke, eat a poor diet, are overweight, have diabetes, are physically inactive or older than 45, you may need more frequent testing.</p> <h4>Lung cancer</h4> <p>The U.S. Preventative Services Task Force recommends annual screening for lung cancer with a low-dose CT for adults ages 50 to 80 who have a 20-pack-per-year smoking history, currently smoke or have quit within the past 15 years. Screening can be stopped when a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy.</p> <h4>Prostate cancer</h4> <p>Many organizations advise men to be screened for prostate cancer starting at age 50. However, the subject is somewhat controversial, so the best course of action is to discuss what's best for you with your healthcare team.</p> <p>Do yourself and your family a favor by protecting your health with regular checkups and screenings.</p> <p><em><a href="/providers/mohammed-solaiman-md" target="_self" title="Opens in same window.">Mohammed Solaiman, M.D.</a>, is a physician in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/mankato">Mankato</a>, Minnesota.</em></p> <ul> <li>Adolescent medicine </li> <li>Cardiovascular disease </li> <li>Diabetes</li> </ul> M.D. <p><strong>Education</strong></p> <ul> <li>Dhaka Medical College</li> </ul> <p><strong>Residency </strong></p> <ul> <li>University of Manitoba</li> </ul> <p><strong>Certifications </strong></p> <ul> <li>American Board of Family Medicine</li> <li>Canadian Board of Family Medicine</li> <li>Certified medical examiner, Department of Transportation</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Solaiman<img src="/-/media/shared-files/images/medical-professionals/full/mankato/mohammed-solaiman-md.jpg?h=280&iar=0&w=280&hash=8ABED7E7C3E8AE044A855135CC2DEEE9" alt="Mohammed Solaiman MD" width="280" height="280" DisableNVelocity="true" /> {7AC41804-CA09-4C5A-AA32-063465438817}Mohammed <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14150981Mohammed Solaiman, M.D. 1{B3F96F77-F93E-41A4-AE4E-603045CDB443}<img src="/-/media/national-files/images/hometown-health/2022/bearded-person-with-glasses.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D20C15F59FEB069BBD8BBC9DF8A4A25C" alt="Bearded person with glasses" width="660" height="370" DisableNVelocity="true" />Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller8/23/2021Many restaurants offer takeout meals as a quick option for when you don't feel like cooking. Follow these 5 tips when you place your order to ensure it's safe to eat.5 tips for keeping takeout food safe to eat<p>Making healthy meal choices while juggling a busy schedule can be a challenge. Ordering takeout meals from a restaurant can be a convenient solution to this problem. Not only this, but they are an option for the days when you don't feel like cooking at home and a good way to support local businesses.</p> <p>While ordering takeout has its benefits, it also has its risks. Food that spends time outside of heating or cooling elements, like ovens, toaster ovens or refrigerators, can begin to grow harmful bacteria, which can then make you sick. However, this can be prevented by following a few simple safety measures.</p> <h3>Here are 5 tips to make sure your takeout meal is safe for you and your family:</h3> <h4>1. Keep your trip short.</h4> <p>The most important tip to remember is to reduce the amount of time between pickup and mealtime. To lower the chance of the food becoming contaminated, plan to eat your meal as soon as you return home. Refrigerate leftovers immediately after the meal is finished.</p> <h4>2. Keep foods of different temperatures separate.</h4> <p>Do your best to keep hot foods hot and cold foods cold. Ask the restaurant to package these items separately. For example, if you order a fish fry with sides, ask for the cold coleslaw to be packaged separately from the hot fish. If you need to travel more than 30 minutes, bring a few insulated coolers to maintain food temperatures. While coolers are effective at keeping food cold, they also can be used to maintain warmer temperatures.</p> <h4>3. Practice personal hygiene.</h4> <p>Exercise good personal hygiene by washing your hands frequently to prevent contamination of yourself or others. Wipe down kitchen utensils and surfaces frequently with a cleaning solution that contains bleach, and replace hand towels, washcloths and sponges daily. Finally, use separate utensils for tasting or sampling when you are cooking or dining with other people.</p> <h4>4. Rotate leftovers.</h4> <p>Takeout meals may result in leftovers. Store leftovers in an airtight container and label with the date. Depending on the food item, leftovers can safely be consumed for two or three days. Take inventory of items in your refrigerator frequently. Throw out leftovers that are more than a couple days old, and any foods that have expired. A good mantra to remember is "when it doubt, throw it out."</p> <h4>5. Reheat leftovers properly.</h4> <p>When you're ready to eat leftovers, reheat them on the stove, in a conventional oven or microwave until the internal temperature reaches 165 F (74 C). Slow cookers aren't recommended for reheating leftovers because these devices may not heat foods hot enough to kill bacteria. They may also reheat your foods too slowly and result in bacteria growth.</p> <p>The convenience of takeout can come at a nutritional price as well. Large portions of food filled with excess salt, fat and/or sugar prepared in less desirable ways can make meeting healthy eating goals more difficult.</p> <h4>Remember these tips when you are in a time crunch and order takeout for a quick meal:</h4> <ul> <li>Pair broiled or baked chicken with a vegetable or fruit and a healthy starch at home.</li> <li>Pick items that are baked, broiled or grilled instead of fried.</li> <li>Substitute fresh fruit or a salad for a side rather than fries.</li> <li>Ask for condiments, such as salad dressing, on the side so you can decide how much to add.</li> <li>Split a meal with someone else.</li> </ul> <p>By following these tips, your family can have healthy and safe meals as you juggle your full schedules.</p> <p><em>Kjersten Nett is a <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">registered dietitian</a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a> and <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2020/takeout-food-and-beverages.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F8CFC45A557C10B371A243B5BB22C50C" alt="Takeout food and beverages" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller8/11/2021Many jobs require standing most of the day, increasing the risk for varicose veins. Get 7 tips to ease symptoms and improve the health of your legs.Standing all day at work? 7 tips to lower varicose vein risk<p><em>By Mayo Clinic Health System staff</em></p> <p>Have you noticed large, tender veins in your legs? Do you experience aching or swelling in your legs at the end of the day? Do suffer from restless legs? Have you noticed changes in the color or texture of the skin near your ankles?</p> <p>If you have answered yes to any of these questions, you may have varicose veins or venous insufficiency.</p> <p>As the heart pumps blood, your body depends on thin-walled veins to return it. In the leg, gravity works against this flow. Muscle contractions of the leg act as a pump, helping this system. Tiny valves in these veins open as blood flows toward your heart, then close to stop blood from flowing back. If these small valves become damaged or weak, blood can flow backwards and pool in the vein, causing the veins to stretch or twist, leading to varicose veins.</p> <p>Some risk factors for varicose veins include age, sex, pregnancy, family history and trauma to the leg. Standing or sitting for an extended period can decrease blood circulation in your legs and increase your risk for developing varicose veins.</p> <p>Many careers, especially those in health care or factory work, require people to stand on their feet most of the day.</p> <h2>If you notice symptoms, try one or more of these 7 tips to improve the health of your legs:</h2> <h4>1. Change your position frequently.</h4> <p>Moving is better than standing still. Shift your weight often, and stretch or walk around least every 30 minutes, to keep the blood from settling in your veins.</p> <h4>2. Exercise regularly.</h4> <p>Make exercise a priority when not at work. Regular exercise can strengthen your heart and improve your circulation. Walking and yoga are great ways to encourage blood circulation in your legs.</p> <h4>3. Watch your weight. </h4> <p>Shedding extra pounds takes pressure off your veins. Losing just 10% of your body weight can make a difference.</p> <h4>4. Watch what you wear. </h4> <p>Avoid clothing that is tight around your waist, legs and groin area. Wear low-heeled shoes instead of high heels.</p> <h4>5. Don't smoke.</h4> <p>If you do, quit. Being smoke-free is good for your veins and overall health.</p> <h4>6. Wear compression stockings. </h4> <p>You can purchase compression stockings at most medical supply stores. Be sure to speak with your health care provider or pharmacist before you purchase stockings, as your legs should be measured for proper fit.</p> <h4>7. Elevate your legs. </h4> <p>Before or after work, raise your legs above your heart for 15 minutes.</p> <p>There are minimally invasive treatment options if your varicose veins do not respond to these tips. In the past, people with varicose veins were treated with vein stripping, a surgical procedure that produced long scars. Today's treatment options produce good results, both cosmetic and symptomatic, with little downtime and scarring.</p> <p>Radiofrequency or laser ablation uses heat or light to damage the vein and cause it to collapse and fade. Another option is sclerotherapy, which injects a solution through a small incision at in the ankle to cause the vein to collapse. After either procedure, most people can return to work the next day and see full results in two months.</p><img src="/-/media/national-files/images/hometown-health/2021/switching-heels-for-flats.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6FD66B6A6B8866B8ED2BEACB9DB66F1F" alt="Switching heels for flats" width="660" height="370" DisableNVelocity="true" />SurgeryHaving surgery is a major event in your life. We know this and make every effort to keep you as comfortable as possible, focusing on you as an individual. Our surgeons and staff work as a coordinated team treating a wide variety of illnesses ranging from simple to complex. We offer comprehensive, advanced care and service to every patient.Dawn Haller8/31/2021Anxiety in children is normal. It can help with motivation and avoiding danger. But if your child's anxiety seems excessive, use these tools to work through it, restore confidence and know when to seek professional help.9 tools for helping your child manage anxiety<p>Everyone is born with the ability to experience anxiety. The American Psychological Association defines anxiety as an emotion characterized by feelings of tension, worried thoughts and physical changes, such as increased blood pressure and heart rate.</p> <p>Anxiety is normal and will occur at various times throughout life. It is important to experience anxiety, as it helps recognize and respond to threats of danger and motivate the completion of tasks. For example, having anxiety while driving in a snowstorm is helpful because it leads to altered driving behaviors to safely arrive at the destination. Also, having anxiety before an important test is helpful because it motivates you to study. However, some people's experiences of anxiety can become excessive, ongoing and overwhelming, and lead to significant difficulty functioning in daily life. These are signs of an anxiety disorder.</p> <h2>Signs and symptoms of anxiety</h2> <p>Children and teenagers may have similar worries to adults, but also they may have excessive worries about performance at school or sporting events, fitting in, social experiences, safety, being on time, their future, natural disasters or other catastrophic events. Some signs of significant anxiety include fatigue; changes in sleep habits, such as sleeping too much or too little; irritability; anger; difficulties with concentration; lack of confidence; reassurance seeking; avoidance; and decreased grades.</p> <p>The most common physical symptoms present in children and teenagers who experience significant anxiety include stomachaches and headaches. They also can experience increased heart rate, rapid breathing, restlessness or jitteriness, trembling or feeling "twitchy," dizziness, diarrhea, nausea and chest tightness or pain.</p> <p>For many children, anxiety can develop as a paired association, which means the anxious symptoms become associated with something that does not typically elicit anxiety, such as a situation, event or object. For example, imagine a child being at school and experiencing a panic attack for the first time, which is the sudden onset of intense anxiety or fear that often includes a strong body response, such as increased heart rate, rapid breathing, feelings of going crazy or losing control. On this day, the child was stressed about a large presentation, but because of this panic attack, the child's brain may start to associate school with intense anxiety, especially if the child experience's another panic attack at school. Therefore, whenever the child goes to school or even thinks about going to school, the brain can perceive it as a threatening situation, which can trigger ongoing anxiety or frequent panic attacks.</p> <h2>Do's and don'ts to ease anxiety</h2> <p>Many tools can help your children work through anxiety. These are strategies licensed mental health clinicians use with people in therapy, and research has found these strategies to be beneficial in treating and managing anxiety.</p> <p>If you feel confident you can use these tools with your child — excellent. However, if you do not feel confident or want more support, consider talking with your child's primary care physician who may connect you with a mental health clinician for assistance. If needed, physicians or clinicians can use additional tools not listed here.</p> <h3>Do:</h3> <h4>1. Identify triggers. </h4> <p>A helpful first step is for you and your children to become aware of and recognize what causes them to feel intense anxiety. Once those triggers are identified, you can implement many of the tips below.</p> <h4>2. Validate and empathize.</h4> <p>Children's thoughts, emotions and experiences are real to them. No matter how you think or feel about their experiences, it is important for your children to feel heard, validated and understood. Empathize with your children, imagine what it is like to be in their shoes, and recognize and affirm that their thoughts, feelings and experiences are valid and important.</p> <h4>3. Challenge unhelpful thinking.</h4> <p>Ask your children to talk you through the thoughts they are experiencing that are unhelpful and causing them distress, such as "I am going to fail my test and then fail my class." Once you know what thoughts your children are telling themselves, you can work with them to identify more realistic, helpful thoughts. Ask questions to get them thinking about their situation differently and decrease their buy-in into their unhelpful thoughts, such as "Have you ever failed a test or class before" or "What have you done in the past to pass a test? Have you done those things now?"</p> <p>These questions allow children to think through all the evidence and come to conclusions independently. Self-realization is much more powerful than parents, teachers or peers telling children they will not fail. Once your child's unhelpful thoughts have been challenged, encourage them to develop a more realistic, helpful thought, such as "Although I feel like I may fail, I have prepared for this test and will perform my best" or "Even if I fail this test, that does not mean I will fail the class." Exaggerated ideas, such as "I will for sure pass and will do amazing," are unnecessary and typically not helpful, as most children do not buy in to these unrealistic notions.</p> <h4>4. Practice deep breathing.</h4> <p>Deep belly breathing is a tool to help calm down, refocus and think clearer. It increases oxygen levels in the bloodstream and decreases heart rate, breathing rate, muscle tension and stress level. Instruct your children to place their hands on their belly and chest. Tell them the goal is to take deep breaths with their bellies, which will lead to the hand on their belly moving up and down as air enters and leaves their bodies. When the hands on their chests are moving more, that means they are breathing with their chest. Encourage them to use their bellies to breath. Instruct them to take deep breaths slowly in through the nose, hold and then out slowly through their mouth. Repeat this several times. A fun way to guide this exercise includes pretending to smell a flower, and then blow bubbles or blow out birthday candles.</p> <h4>5. Break down tasks.</h4> <p>Break down tasks into smaller steps so the overall process feels less daunting. For younger children, have random rewards throughout the process to positively reinforce their behavior. For older children, provide positive praise and encourage them to reward themselves.</p> <h4>6. Role-play.</h4> <p>If your children are worried about specific situations, role-play those feared situations to help them prepare. Examples could include ordering at a restaurant, buying a movie ticket, asking a teacher for help or inviting friends over.</p> <h4>7. Build overall confidence.</h4> <p>Have your children perform tasks around the house to contribute to the family and build confidence. Offer your children opportunities to face challenges. It is important to praise their efforts and focus less on results. If they get stuck, ask your children about skills they used to overcome similar obstacles in the past.</p> <h3>Don't:</h3> <h4>8. Label emotions as bad.</h4> <p>Stay away from labeling their thoughts, emotions and experiences as good or bad. For example, do not say "It is bad to think you will fail." When children hear that, their thoughts are bad, they often then internalize this and think "I am bad."</p> <h4>9. Minimize anxiety.</h4> <p>Do not minimize your children's experiences and tell them to "Just do it" or "Suck it up." Their feelings of anxiety are real, and they are suffering. Although it is healthy to face things that cause anxiety, meeting children with empathy, compassion and kindness is more helpful and effective when facing feared things.</p> <p>Remember, you are not alone. You and your children do not have to navigate this alone. Your child's primary care physician wants to help all children thrive.</p> <p><em> <a href="/providers/deirdre-paulson-phd" target="_self" title="Opens in same window.">Deirdre Paulson, Ph.D.</a>, is a psychologist in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Anxiety — generalized, social, obsessions and compulsions, panic, phobias</li> <li>Chronic pain</li> <li>Depression</li> <li>Exposure with response prevention</li> <li>Health behavior change</li> <li>LGBTQI+ affirming care</li> <li>Post-traumatic stress disorder (PTSD)</li> <li>Vocational, or job, psychology</li> </ul>Ph.D.<p>I provide behavioral and mental health services in a primary care setting to adults, including completing brief diagnostic assessments and engaging in brief therapy. I approach therapy from a cognitive-behavioral lens, meaning my patients and I examine the relationships between thoughts, emotions, behaviors and body responses. I also incorporate positive psychology into my work with patients, as everyone possess great strength, not just distress, that we can highlight, pull from and utilize in our work together.</p> <p>I believe that the patient is the expert on themselves and their distressing symptoms, whereas I am the expert on how to assess and treat those distressing symptoms. Thus, a collaborative relationship combining our expertise is essential. I also believe that transparency is key. Therefore, I take time to walk my patients through the "why" behind my recommendations, and answer any questions or concerns, all while respecting any boundaries my patients have. Additionally, culture and diversity are critical and will always be acknowledged and incorporated.</p> <p>When not at work, I like to spending time with my family. We enjoy going for walks, attending farmers markets, doing things outside, reading books and eating ice cream.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Psychology, University of Wisconsin-River Falls</li> <li>Master's degree, Counseling Psychology, The University of Southern Mississippi</li> <li>Doctorate, Counseling Psychology, The University of Southern Mississippi</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Doctoral Psychology, William. S. Middleton Memorial Veterans Hospital</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Integrated Primary Care Behavioral Health, University of Minnesota-Twin Cities</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Behavioral and Cognitive Psychology, American Board of Professional Psychology (ABPP)</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Paulson<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/deirdre-paulson-phd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=0CC5C3257D38380C4AB226239ABCE9AC" alt="Deirdre Paulson, Ph.D." width="280" height="280" DisableNVelocity="true" />{4819BBE9-33EE-46BC-9E5C-FDB19532D980}Deirdre<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21414831Deirdre Paulson, Ph.D.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}|{2B88C934-922C-4130-B661-197B59D83899}<img src="/-/media/national-files/images/hometown-health/2021/child-parent-sitting-on-floor-talking.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2BDBD455D034E86A084EDA93C1FC8F65" alt="Child and parent sitting on floor, leaning against sofa and talking" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller8/5/2021Corn is one of the most versatile grains consumed worldwide. Now that roadside stands have an abundance of corn, learn about the health benefits, and how to choose and prepare it.Corn: A versatile, nutritious choice<p>Summer is here and the popular Midwest roadside sweet corn stands are open once again. Sweet corn is often a staple summertime food in the Midwest, as it's often part of a backyard barbecue, or families gathering to freeze or can sweet corn for the winter.</p> <p>In addition to the traditional sweet corn that many people love and enjoy here in the Midwest, corn is one of the most versatile grains consumed worldwide. It is a versatile food, as the entire plant can be used. The husks can be used to make tamales, silk to create medicinal tea, kernels for food, and stalks for livestock feed.</p> <p>Corn is used to make tortillas, tortilla chips, polenta, cornmeal, corn oil and more. Miniature ears of corn, known as baby corn, are used in appetizers, soups, chowders, stews and stir-fry dishes. Baby corn is particularly popular in Thai and Chinese recipes.</p> <p>An interesting fact that you may not know about corn is it comes in many different colors. Traditionally, corn is yellow or white, but it also can be red, black, blue, purple and orange.</p> <h4>Health benefits of corn</h4> <p>Corn has many health benefits. It consists primarily of insoluble fiber, which makes it a low-glycemic index food. This means it is a food that is digested slowly and doesn't cause an unhealthy spike in blood sugar.</p> <p>It also contains many B vitamins, as well as essential minerals, including zinc, magnesium, copper, iron and manganese. Since corn is considered a starchy vegetable, people with diabetes need to keep in mind that a half cup of corn, or a small ear of corn, contains 15 grams of carbohydrate and counts as one carbohydrate food choice.</p> <h4>Choosing and preparing corn</h4> <p>Corn can be roasted, boiled, broiled, steamed, grilled or microwaved. You can add it to stews, casseroles, salads or salsa. Try adding corn kernels to cornbread batter for enhanced texture and flavor.</p> <p>Fresh corn on the cob is best if cooked as soon as possible after picking. If you are hoping to preserve corn for the winter, you can parboil the ears of corn, cut the kernels off the cob, and freeze them in freezer-safe bags or containers to be used throughout the winter.</p> <h4>Corn challenge</h4> <p>If you’re accustomed to boiling your sweet corn, try a new cooking method. Sweet corn on the grill can be a delicious addition to your meal.</p> <h5>Consider giving this recipe a try:</h5> <h5>FIRE-ROASTED CORN SOUP</h5> <p>Servings: 4 (8-ounce serving size)</p> <p><strong>Ingredients</strong></p> <ul> <li>4 cups corn kernels</li> <li>1½ tablespoons olive oil</li> <li>3 cups chopped onion</li> <li>2 cups chopped carrots</li> <li>2 cups chopped celery</li> <li>2 teaspoons chopped garlic</li> <li>¼ cup all-purpose flour</li> <li>1 teaspoon cumin</li> <li>6 cups vegetable stock</li> <li>2 jalapeno peppers, minced</li> <li>1½ cups half-and-half</li> <li>1 teaspoon salt</li> <li>⅛ teaspoon white pepper</li> <li>1 tablespoon chopped parsley</li> </ul> <p><strong>Directions</strong></p> <p>Heat the oven to 500 F. Place the corn kernels on a baking sheet. Roast in the oven until they begin to caramelize, about 8 minutes.</p> <p>In a large soup pot, heat the oil over medium-high heat. Add the onion, carrots, celery and garlic, stirring constantly. Cook until the vegetables are soft and tender, about 5 minutes. Reduce heat and stir in the corn, flour and cumin. Mix until the flour is evenly dispersed.</p> <p>Add the vegetable stock and jalapenos, and let simmer for about 30 minutes. Stir in half-and-half, salt, pepper and parsley. Remove from heat and serve.</p> <p>Nutrition information per serving: 119 calories; 5 g fat (2 g saturated, 0 g transfat and 3g monounsaturated fat); 9 mg cholesterol; 184 mg sodium; 17 g carbohydrate; 2 g fiber; 5 g sugar; 3 g protein.</p> <p><em><a href="/providers/caitlin-terpstra-rdld" target="_self" title="Opens in same window.">Caitlin Terpstra</a> is a registered dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition Services</a> in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em></p>RDN, LD<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, St. Catherine University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>University of Wisconsin Hospital and Clinics</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Licensed Dietician</li> <li>Registered Dietitian</li> </ul>Terpstra<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/caitlin-terpstra-rd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=D56D6F5A2B6A4866353C6D74A8883157" alt="Caitlin Terpstra RD" width="280" height="280" DisableNVelocity="true" />Caitlin<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>19992149Caitlin Terpstra, RDN, LD1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2021/corn-on-the-cob-with-limes.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9EAABD0E5DADC84E5703945C48B8864B" alt="Corn on the cob with limes" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller8/19/2021Did anyone ever tell you not to cross your eyes because they might stay that way? Learn the facts about this and five other common eye health myths.Eye health: Myths and facts<p>Did anyone ever tell you not to cross your eyes because they might stick? Is that true?</p> <h3>Learn the facts about this and other common eye health myths:</h3> <h4>Myth: Reading in poor light will hurt your eyes.</h4> <p>Fact: Before the invention of electric light, most nighttime reading and other work was done by dim candlelight or gaslight. Reading in dim light today won't harm your eyes any more than it did your ancestors' eyes or any more than taking a photograph in dim light will damage a camera.</p> <h4>Myth: Using your eyes too much will 'wear them out.'</h4> <p>Fact: You wouldn't lose your sense of smell by using your nose too much or your hearing by using your ears too much. Your eyes were made for seeing. You won't lose your vision by using your eyes for their intended purpose.</p> <h4>Myth: Wearing eyeglasses that are too strong or have the wrong prescription will damage your eyes.</h4> <p>Fact: Eyeglasses change the light rays that your eyes receive. They do not change any part of the eye itself. Wearing glasses that are too strong or otherwise wrong for your eyes cannot harm your eyes — although it might result in a temporary headache. At worse, the glasses will fail to correct vision and make you uncomfortable because of blurriness. However, it will not result in damage to any part of your eye.</p> <h4>Myth: Wearing eyeglasses will weaken your eyes.</h4> <p>Fact: Eyeglasses worn to correct <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/nearsightedness/symptoms-causes/syc-20375556" target="_blank" title="Opens in a new window.">nearsightedness</a>, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/farsightedness/symptoms-causes/syc-20372495" target="_blank" title="Opens in a new window.">farsightedness</a>, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/astigmatism/symptoms-causes/syc-20353835" target="_blank" title="Opens in a new window.">astigmatism</a> or <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/presbyopia/symptoms-causes/syc-20363328" target="_blank" title="Opens in a new window.">presbyopia</a> will not weaken your eyes any more than they will permanently solve these types of vision problems. Glasses are simply external optical aids that correct vision for people who suffer from refractive errors. Exceptions are glasses given to children with <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/medical-professionals/pediatrics/news/strabismus-the-importance-of-timely-specialized-care/mqc-20452790" target="_blank" title="Opens in a new window.">crossed eyes (strabismus)</a> or <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/lazy-eye/symptoms-causes/syc-20352391" target="_blank" title="Opens in a new window.">lazy eye (amblyopia)</a>. These glasses are used temporarily to help straighten their eyes or improve vision. Not wearing such glasses in these instances may lead to permanently defective vision.</p> <h4>Myth: Crossing your eyes may make them permanently crossed.</h4> <p>Fact: Your eye muscles are meant to allow you to move your eyes in many different directions. Looking left, right, up or down will not force your eyes to stay permanently crossed. Crossed eyes result from disease, from an uncorrected refractive error, or from muscle or nerve damage, not from forcing your eyes into that position.</p> <h4>Myth: Having 20/20 vision means that your eyes are perfect.</h4> <p>Fact: The term "20/20" denotes a person with excellent central vision. However, they may have other types of vision, such as side vision, night vision or color vision, that might be imperfect. Some potentially blinding eye diseases, such as glaucoma or diabetic retinopathy, can take years to develop. During this time, they are harming parts of the inner eye, but the central vision can remain unaffected.</p> <p><em><a href="/providers/jennifer-garvey-md" target="_self" title="Opens in same window.">Jennifer Garvey, M.D.</a>, is an <a href="/services-and-treatments/ophthalmology" target="_self" title="Opens in same window.">ophthalmologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/sparta" target="_self" title="Opens in same window.">Sparta</a>, Wisconsin.</em></p><ul> <li>Basic oculoplastics (nonorbital) surgery</li> <li>Comprehensive treatment of ocular disease</li> <li>Small-incision cataract surgery</li> </ul>M.D.<p>Patients can expect a thorough evaluation and involvement in both decision-making and therapeutic planning. The most effective treatment occurs when patients are well-educated about their eye condition and involved in treatment plans. I'd like my patients to know that I place a priority on listening to their thoughts and concerns.</p> <p>I enjoy gardening, traveling, reading and playing with my two toddlers</p><p><strong>Education</strong></p> <ul> <li>Ohio State University Medical School</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Transitional, Walter Reed Army Medical Center</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Ophthalmology, Walter Reed Army Medical Center</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Ophthalmology, American Board of Ophthalmology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Society of Cataract and Refractive Surgery</li> <li>New England Ophthalmology Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Ophthalmology, Mayo Clinic College of Medicine and Science</li> </ul>Garvey<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/jennifer-garvey-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=71666E518B6D148CC9923A7E53E10A20" alt="Jennifer Garvey, M.D." width="280" height="280" DisableNVelocity="true" />Jennifer<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30056545Jennifer Garvey, M.D.1{C5680DDD-C649-4B63-AFCC-B52A244736B7}<img src="/-/media/national-files/images/hometown-health/2021/eye-glasses-up-close.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7FE734D75E3B8EB9DC24A7A8D136E012" alt="Eye glasses up close" width="660" height="370" DisableNVelocity="true" />Eye HealthYour eyes are responsible for providing you with vision, perhaps the most important of the senses. However, the eye is a delicate and complicated structure that needs protection. The ugly truth is that eye injuries can happen at any time and place.Dawn Haller8/16/2021Two U.S. programs give students with a disability equal access to education. Learn about the differences between plans, and the role of your child's primary care provider.Helping your child's education through an IEP or 504 plan <p>Two U.S. programs are designed to give students with a disability the assurance that they will receive equal access to public education and services. The Individualized Education Plan (IEP) is guided by the Individuals With Disabilities Education Act and a 504 Accommodation Plan is guided by the Americans With Disabilities Act.</p> <p>These programs can benefit children with disabilities ranging from hearing impairment and cerebral palsy to attention deficit hyperactivity disorder (ADHD) and dyslexia. Either program can meet your child's needs, and one is not better than the other. However, it is important to understand the differences, so you can advocate for your child's health and learning opportunities.</p> <h4>Program differences</h4> <p>IEP is a program that makes sure that a student with an identified disability receives specialized instruction and services while attending school. The student must be diagnosed with at least one of 13 specific disabilities written in the law, and that disability must negatively affect the student's performance in the classroom.</p> <p>Services could include occupational therapy, physical therapy, speech therapy or counseling. Disability categories with IEP include autism, blindness, intellectual disability, hearing impairment, specific learning disabilities, traumatic brain injuries and others.</p> <p>A 504 Accommodation Plan, often referred to as a 504 plan, is designed to make sure that a student with an identified disability receives accommodations to access school and achieve academic success. The definition of disability with a 504 plan is broader than with IEP. The student may not require specialized instruction, but he or she may need modifications or physical changes to the general classroom to succeed. Specialized instruction or services, such as physical or speech therapy, are not included in a 504 plan.</p> <h4>Program benefits</h4> <p>The biggest benefit of these programs is that they provide children, regardless of disability status, the opportunity to succeed in school. They ensure that free, appropriate public education is tailored to meet the needs of your student.</p> <p>There are other benefits, as well. When a child with a disability can remain in the classroom setting with peers, his or her identity is not solely defined by their diagnosis. The child's condition does not define them, and they can take part of the whole experience of being a kid. The programs also normalize inclusion in the classroom, and encourage conversation about our similarities and differences. This benefits all students ― not just those with a disability.</p> <h4>Primary care provider's role</h4> <p>Throughout your child's life, the goal of the primary care provider is to advocate for your child's health and safety.</p> <h5>If your child has a disability, the health care team will:</h5> <ul> <li>Diagnose the disability or refer to specialists, as necessary.</li> <li>Tailor treatment plans to your child's needs.</li> <li>Recommend behavioral or lifestyle modifications.</li> <li>Connect families to community tools and resources.</li> <li>Discuss what to expect in a school setting.</li> <li>Provide required documentation or referral for IEP or 504 plans.</li> </ul> <h4>Provider referral</h4> <p>Your child's provider can deliver the necessary documentation or referral for IEP or 504 plans. This could occur during an annual well-child visit or at a different appointment, depending on your child's disability.</p> <p>The process is more straightforward if your child's disability is a physical or genetic disorder known most of his or her life. This is because the family and care team has been working together over the child's life to advocate for his or her health.</p> <p>The process can be more complicated and time-intensive if there is a new diagnosis, such as ADHD or a learning disorder, and your child was not diagnosed at a younger age. Your health care provider and the school can guide you with what is needed for diagnosis. Additional appointments may be required, and your child's provider may coordinate with other people, such as day care providers or teachers, to get a perspective of what the child is like outside of the clinic or home.</p> <p>While the education system drives the processes for the IEP and 504 plans, parents or guardians must specifically ask for an evaluation and plan for their children. It can be a lot of work, and parents may need to strongly advocate for an evaluation. However, it's always worth the effort to give your child the best opportunity for education success.</p> <p><em><a href="/providers/michelle-botts-olson-md" target="_self" title="Opens in same window.">Michelle Botts Olson, M.D.</a>, is a resident physician, and <a href="/providers/kyja-stygar-md" target="_self" title="Opens in same window.">Kyja Stygar, M.D.</a>, is a physician, both in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Dermatologic procedures</li> <li>Joint injections</li> <li>Obstetrics, prenatal care and vaginal deliveries in the hospital</li> <li>Osteopathic medicine, osteopathic manipulation techniques</li> <li>Pediatric and newborn care</li> <li>Sports medicine</li> <li>Women's health, including contraception</li> </ul>M.D.<p>I practice full-spectrum family medicine and enjoy caring for the whole family and all their needs. I am trained in obstetric care. I am also trained in osteopathic medicine and offer osteopathic techniques. </p> <p>I would love to get to know you and your family!</p><p><strong>Education</strong></p> <ul> <li>Medical College of Wisconsin</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Family Medicine</li> <li>Distinction of Advanced Osteopathic Training in Family Medicine, American Osteopathic Association</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Academy of Osteopathy</li> <li>American Congress of Obstetricians and Gynecologists</li> <li>American Osteopathic Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Olson<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/michelle-olson-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=84F1801E8486415D92EB2A871A1E6E48" alt="Michelle Olson MD" width="280" height="280" DisableNVelocity="true" />Michelle<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30025342Michelle Olson, M.D.1{986C767E-E5DE-43F5-957F-B4212DB8E384}|{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}|{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}<ul> <li>Behavioral health</li> <li>Family medicine</li> <li>Gender-affirming care</li> <li>Pediatrics</li> <li>Prenatal care, including deliveries at the hospital</li> <li>Women's health</li> </ul>M.D.<p>I grew up in Eau Claire and returned to the area to be near family. I enjoy the outdoors with gardening, hiking, biking and kayaking.</p><p><strong>Education</strong></p> <ul> <li>Medical College of Wisconsin-Milwaukee</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Practice, UW Health Fox Valley</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>Society of Teachers of Family Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Stygar<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/kyja-stygar-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7E96C8C7EA40638FE2257BF7C24AC8E4" alt="Kyja Stygar, M.D." width="280" height="280" DisableNVelocity="true" />{1D673FAD-1DF2-4856-A86D-ED615A7310F2}Kyja<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12585912Kyja Stygar, M.D.1{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}|{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{61776FD2-05E8-47E9-AB55-EE465BD29A19}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}|{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}<img src="/-/media/national-files/images/hometown-health/2021/children-playng-finger-game.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6AEDBBBBB35D277CFED06A8C0EF349AB" alt="Children playng finger game" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller5/18/2023Love or loathe it, your nose is a key part of your visual identity. One of the most common nose deformities is a deviated septum. Here are answers to 10 common questions about this condition.Hit it on the nose: Deviated septum Q&A<p>Your nose is front and center on your face. It serves many functions, including humidifying and cleaning the air you breathe; delivering tone to your voice; and providing a sense of smell, which is important for taste, identification and memory. Love or loathe it, your nose is also a key part of your visual identity.</p> <p>One of the most common nose deformities is a deviated septum. About 70% to 80% of people have a septal deviation noticeable to an examiner. In many cases, the deviation is minor and causes no symptoms. A deviated septum that is moderate to severe, however, can lead to nasal obstruction and require treatment.</p> <h2>Here are answers to some common questions about this nasal condition:</h2> <h3>What is a deviated septum?</h3> <p>A deviated septum occurs when your nasal septum ― the thin wall between your nasal passages ― is displaced to one or both sides. In some people, the nasal septum is off-center and can make one or both nasal passages smaller. Depending on the severity of the deviation, it can reduce airflow, causing difficulty breathing through one or both sides of your nose.</p> <h3>What causes a deviated septum?</h3> <p>Some people are born with a deviated septum. This could be develop before birth or it may occur during delivery. Sometimes the cartilage of the septum can bend and deform with age. For others, their deviated septum is the result of an injury, such as bumping their nose while a toddler, during contact sports, an auto accident or rough play.</p> <h3>Could I have a deviated septum but not know it?</h3> <p>Yes, it's possible not to know that you have a deviated septum or other septal issues, especially if you are not experiencing any symptoms. Talk with your primary care provider if you are concerned about any nasal symptoms or the appearance of your nose.</p> <h3>What are the symptoms of a deviated septum?</h3> <h4>Signs and symptoms of septal issues, such as a deviated septum, include:</h4> <ul> <li><strong>Blockage of one or both nostrils</strong><br /> This blockage can make it difficult to breathe through the nostril or nostrils. You may notice this more when you have a cold or allergies that can cause your nasal passages to swell and narrow.</li> <li><strong>Nosebleeds</strong><br /> The surface of your nasal septum may become dry, increasing your risk of nosebleeds.</li> <li><strong>Noisy breathing during sleep</strong><br /> A deviated septum or swelling of the intranasal tissues can be one of the many reasons for noisy breathing during sleep.</li> <li><strong>Awareness of the nasal cycle</strong><br /> It's normal for the nose to alternate being obstructed on one side and then change to being obstructed on the other. This is called the nasal cycle. This cycle is normal, but being aware of the nasal cycle isn't typical and can indicate nasal obstruction.</li> <li><strong>Preference for sleeping on a particular side</strong><br /> Some people may prefer to sleep on a particular side to optimize breathing through the nose at night if one nasal passage is narrowed.</li> <li><strong>Crooked or uneven nose</strong><br /> In more severe cases, a deviated septum can change the external look of the nose, causing an uneven or crooked appearance.</li> </ul> <h3>Can deviated septums heal on their own?</h3> <p>No. Deviated septums will not heal over time. While this shouldn't be a concern if you are not experiencing symptoms, it's important to talk with your primary care provider if you are having issues. Don't wait for symptoms to resolve on their own.</p> <h3>Do deviated septums cause sinus infections?</h3> <p>The most common cause of upper respiratory tract infections are viruses, such as those that cause the common cold, whereas bacteria typically cause sinus infections. If you have a deviated septum, you may be more susceptible to nasal blockage, which could lead to developing nasal polyps. These are painless, noncancerous growths on the lining of your nasal passages or sinuses that make you more vulnerable to sinus infections in the future.</p> <h3>Do deviated septums cause headaches?</h3> <p>A deviated septum can cause a headache in addition to a blocked nose. This may occur when the septum contacts sensitive nasal tissue and causes pain along the sensory nerve leading to your brain.</p> <h3>Can medications help a deviated septum?</h3> <p>Often, the first treatment options for a deviated septum focus on managing symptoms with medication. You may be prescribed decongestants or nasal steroid sprays. These medications can reduce nasal tissue swelling to help with drainage and keep the airways on both sides of your nose open. It's important to follow the directions carefully, decongestants can cause dependency, side effects or worsen symptoms after you stop using them. Nasal steroid sprays can cause blood-tinged nasal mucus, which can be managed by applying petroleum jelly in the nostril before spraying.</p> <p>If you have seasonal allergies, your health care team may prescribe antihistamines that can prevent or lessen allergy symptoms, and help with drainage.</p> <h3>Can a nose job fix a deviated septum?</h3> <p>You may read about celebrities saying the reason they had a nose job, also called rhinoplasty surgery, was to correct a breathing problem. While this may be partially true, rhinoplasty alone does not correct a deviated septum.</p> <p>The most common surgery to correct a deviated septum is called a septoplasty. During this procedure, your nasal septum is straightened and repositioned in the center of your nose. This may require your surgeon to cut and remove parts of your septum, which are sometimes reinserted in the proper position. Septoplasty does not significantly change the shape or size of your nose, or correct other nasal or sinus conditions you may have, such as allergies.</p> <p>If you are interested in reshaping your nose, a rhinoplasty can be performed at the same time as a septoplasty. This surgical procedure modifies the bone and cartilage of your nose to change its size, shape or both.</p> <h3>Do deviated septums worsen with age?</h3> <p>Like the rest of your body, your nasal structures change over time. This may or may not make your deviated septum worse. Your symptoms could become more intense or bothersome, and you could see changes to the appearance of your nose as well.</p> <p>Talk with your <a href="/services-and-treatments/primary-care" target="_self" title="Opens in same window.">primary care</a> provider or an <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">ear, nose and throat</a> specialist if you are concerned about your nasal passages, or the shape or size of your nose.</p> <p><a href="/providers/gregory-jones-md" target="_self" title="Opens in same window."><em>Gregory Jones, M.D.</em></a><em>, is an <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">ear, nose and throat</a> specialist in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em></p><p>General pediatric and adult ENT<br /> Endoscopic nasal sinus surgery<br /> Cosmetic nasal surgery<br /> Head and neck tumor surgery (benign and malignant)</p>M.D.<p><strong>Training</strong></p> <p>Mayo Clinic School of Medicine, Rochester, Minnesota</p> <p><strong>Internship</strong></p> <p>General Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota</p> <p><strong>Residency</strong></p> <p>Otolaryngology Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota</p> <p><strong>Certification</strong></p> <p>American Board of Otolaryngology Head and Neck</p>Jones<img src="/-/media/shared-files/images/medical-professionals/full/owatonna/gregory-jones-md.jpg?h=200&iar=0&w=200&hash=77BEF4B2EBEB07D2911572C7C5C016AA" alt="Gregory Jones MD" width="200" height="200" DisableNVelocity="true" />Gregory<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>10226311Gregory Jones MD1<img src="/-/media/national-files/images/hometown-health/2021/harvesting-apple-tree.jpg?h=370&iar=0&w=660&sc_lang=en&hash=756FA9DAB03A70AF39ACEE34CAC838F2" alt="Harvesting apple tree" width="660" height="370" DisableNVelocity="true" />Ear, Nose and Throat (ENT)Get information about symptoms, disorders and diseases affecting the ear, nose and throat, and related head and neck structures.Plastic and Reconstructive SurgeryPlastic and reconstructive surgery provides services that not only include cosmetic or aesthetic surgery, but also surgical repair of congenital deformities, laser surgery, postsurgical reconstruction, such as breast, head and neck defects, and microsurgery.Dawn Haller8/17/2021If you need a breast biopsy after a breast exam indicates additional follow-up is required, it’s normal to feel anxious. Ease your mind with what you need to know and how to prepare.Preparing for your breast biopsy<p>"No news is good news." That's an appropriate adage when considering breast health. The best result after a mammogram is that nothing was found, or a routine self-exam only finds regular breast tissue. According to the saying, if something is abnormal, you would be told about it.</p> <p>That's why it's normal to feel anxious if you require follow-up care after a breast exam, especially if your health care provider refers you to a surgeon for a breast biopsy. This procedure removes a small sample of your breast tissue for laboratory testing. One way to ease your mind is to gather information so you know what to expect.</p> <h2>Breast biopsy basics</h2> <h3>A breast biopsy is a procedure to evaluate a suspicious area in your breast. It may be recommended if:</h3> <ul> <li>You or your health care provider feels a lump or thickening in your breast, and your care team suspects breast cancer may be present.</li> <li>Your mammogram shows a suspicious area in your breast.</li> <li>An ultrasound scan or breast MRI reveals a suspicious finding.</li> <li>You have unusual nipple or areolar changes, including crusting, scaling, dimpling skin or a bloody discharge.</li> </ul> <p>During your biopsy, a surgeon or radiologist will collect a sample of tissue that will be used to identify and diagnose abnormalities in the cells that make up breast lumps, other unusual breast changes or suspicious areas. The results of your biopsy can help determine whether you need additional surgery or other treatment.</p> <h2>Questions to ask</h2> <p>Before your biopsy, you may meet your health care provider in the clinic to discuss the procedure. This is a great time to ask questions and gather additional information.</p> <h3>Here are a few questions to consider asking:</h3> <ul> <li>What is the exact location of my biopsy?</li> <li>What type of breast biopsy procedure will be used?</li> <li>Will part of or the entire lump be removed?</li> <li>What type of anesthesia will be used, or will I be awake during the procedure?</li> <li>Will the biopsy leave a scar?</li> <li>How soon can I resume regular activities?</li> <li>What types of tests will be done to the tissue?</li> <li>How soon will I get the results?</li> </ul> <h2>Preparing for your biopsy</h2> <p>Before your breast biopsy, tell your health care provider about medications you are taking, about any allergies and if you are not able to lie on your stomach for an extended time.</p> <p>Wear a bra to your appointment. Your health care team may place a cold pack against the biopsy site after the procedure, and the bra can hold the cold pack in place and provide support for your breast.</p> <h2>Types of biopsy procedures</h2> <p>Several breast biopsy procedures are used to obtain a tissue sample from the breast.</p> <h3>Your health care provider may recommend a particular procedure based on the size, location and other characteristics of the breast abnormality:</h3> <ul> <li><strong>Fine-needle aspiration biopsy</strong><br /> This is the simplest type of breast biopsy and may be used to evaluate a lump. For the procedure, a thin needle is passed into the lump. The needle is attached to a syringe that can collect a sample of cells or fluid from the lump.</li> <li><strong>Core needle biopsy</strong><br /> This type of breast biopsy may be used to assess a breast lump that's visible on a mammogram, ultrasound, MRI or that your health care provider feels, or palpates, during a clinical breast exam. A radiologist or surgeon uses a thin, hollow needle device to remove small cores of tissue, about the size of a grain of rice, from the breast mass. An imaging technology is frequently used to visualize the area of interest so the tissue can be sampled accurately. This may include ultrasound, stereotactic (mammogram) or MRI. One or more small clips are placed into the biopsy site to mark where the tissue was taken from, and often a quick mammogram picture is taken after the biopsy.</li> <li><strong>Surgical biopsy</strong><br /> During a surgical biopsy, a portion or all of your breast mass will be removed to be examined. It is usually done in an operating room or clinic procedure room using local anesthetic to numb your breast, sometimes with sedation given through a vein in your hand or arm. If the breast mass can't be felt, a radiologist may use a technique called wire localization to map the route to the mass for the surgeon. During wire localization, the tip of a thin wire is positioned within the breast mass or just through it. This is usually done right before surgery. During surgery, the surgeon will attempt to remove the breast tissue of interest along with the wire.</li> </ul> <h2>After your breast biopsy</h2> <p>After your biopsy, you will be able to go home the same day to recover. You may have bandages, an ice pack, stitches, glue or other dressings. You will be given instructions about how to care for the biopsy site. In most cases, you will be able to resume usual activities the next day. Bruising and tenderness is common. Using ice frequently for the first one to two days and wearing a snug bra day and night for the first week can minimize bruising and swelling. You may take a nonaspirin pain reliever for discomfort, unless otherwise instructed by your health care provider.</p> <p>Waiting for your biopsy results can be difficult. It can take up to two weeks for all test results from the procedure to be available, and your care team will contact you as soon as possible.</p> <p>During this time, your breast tissue is sent to a lab where it is examined using a microscope and special procedures. If your breast biopsy reveals normal results or benign breast changes, your care team will contact you after confirming the results with the radiologist and pathologist. Sometimes a clear diagnosis is not possible from a sample or the pathology result does not line up with the imaging studies. In that case, you may need another procedure or surgery to obtain more tissue to further evaluate the area.</p> <p>If your results show that breast cancer is present, a pathology report will include information about the cancer itself, such as what type of breast cancer you have and additional information, such as whether the cancer is hormone receptor positive or negative. You and your care team can then develop a treatment plan that best suits your needs.</p> <p>Talk with your care team if you have any questions or concerns during your breast biopsy. Their goal is to ease any anxiety and provide compassionate care during this stressful time.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2021/mature-person-denim-shirt-leather-chair.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F4B727E1D6C693D18C7A53404E10B949" alt="Mature person wearing a denim shirt sitting on a leather chair" width="660" height="370" DisableNVelocity="true" />Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>SurgeryHaving surgery is a major event in your life. We know this and make every effort to keep you as comfortable as possible, focusing on you as an individual. Our surgeons and staff work as a coordinated team treating a wide variety of illnesses ranging from simple to complex. We offer comprehensive, advanced care and service to every patient.Dawn Haller8/9/2021The quest for a perfect body can take a heavy toll on your child. Learn how to help them develop and maintain a healthy body image and self-esteem.Promoting healthy body image in children, teens<p>Children and teens often face significant pressure to meet strict, unrealistic and harmful societal ideals around beauty, body build, weight and shape. The quest for a perfect body or appearance can take a heavy toll on confidence, as well as physical and mental health.</p> <p>Overall, the term "body image" is how people think, feel and perceive their own body. During adolescence, it can be difficult to maintain a healthy body image because of major physical and emotional changes, and social pressures, that occur during this phase of life.</p> <p>Children and teens who have negative thoughts about their bodies are at an increased risk of low self-esteem, depression, substance use, eating disorders, and unhealthy body weight, including being underweight or overweight. In addition, some teenagers might engage in risky behaviors that can affect their future opportunities, such as ignoring schoolwork or participating in illegal behaviors that lead to trouble with the law.</p> <h4>Talking about body image</h4> <p>Open communication with your child is essential to promoting a healthy body image.</p> <h5>When you discuss body image, you might:</h5> <ul> <li><strong>Use positive language.</strong><br /> In general, avoid making comments about the appearance of others' bodies. Rather, comment on an individual's personal characteristics, such as optimism, persistence and kindness. For example, when someone loses weight, statements are often made about how good they look. Instead of commenting on how their current body looks compared to their past body, compliment their hard work, dedicated effort and resiliency. Also, when talking about exercise, emphasize the gains from exercise: it improves health and strength, and avoid the losses: weight. Also, create an environment where there are no hurtful nicknames, comments or jokes based on a person's physical characteristics, weight or body shape.</li> <li><strong>Be a good role model.</strong><br /> How you talk about and approach your body can significantly affect your child. Avoid making common subtle, negative comments about your body, such as how your body does not fit your clothes or how your body is not good enough. Another healthy behavior to model includes taking part in activities with your children and not avoiding them due to how you perceive your body, such as taking photos. Also, do not skip meals, actively choose healthy food options and do not punish yourself for eating something considered unhealthy.</li> <li><strong>Explain the effects of puberty.</strong><br /> Make sure your child understands the pubertal changes they will undergo, and that weight gain is a healthy and a normal part of development.</li> <li><strong>Talk about media messages.</strong><br /> Social media, movies, TV shows, magazines and advertisements often send the message that only a certain body type or skin color is acceptable and that maintaining an attractive appearance is the most important goal. Even media that encourages being healthy, athletic or fit might depict a narrow body type — one that's toned and skinny. Due to constant exposure to these media images and messages, children and teenagers might try to meet ideals that do not exist in the real world. Therefore, talk with your child about all of this, allow your child to ask questions, and expose them to stories and images of people you perceive are healthy role models, no matter their body.</li> </ul> <h5>In addition to talking to your child, here are other strategies to encourage a healthy body image:</h5> <ul> <li><strong>Establish healthy eating habits.</strong><br /> Teach your teen how to eat a healthy, balanced diet. Offer a wide range of foods. Talk about how food fuels their bodies and avoid labeling foods as good or bad. Promote eating until full versus eating until all food is consumed.</li> <li><strong>Limit social media access.</strong><br /> Social media bombards teens with messages that may harm body image. Images they see may change how they perceive their own bodies, in addition to witnessing how others react to these images. Limit the amount of time on social media or the types of content they consume or post.</li> <li><strong>Promote physical activity.</strong><br /> Participating in sports and other physical activities, particularly those that do not emphasize a particular weight or body shape, can help promote a healthy self-esteem and a positive body image.</li> <li><strong>Encourage healthy friendships.</strong><br /> Friends who accept and support your child can be a healthy influence. In particular, friends who have healthy relationships with their own bodies can be a positive influence.</li> </ul> <h4>When to seek help</h4> <p>If you feel that your child is struggling with an unhealthy body image, consider talking to your child's primary care provider or a mental health professional. Additional support might give children the tools needed to counter social pressure and feel good about their body.</p> <p><em><a href="/providers/sasha-ulrich-md" target="_self" title="Opens in same window.">Sasha Ulrich, M.D.</a>, is a resident physician in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a>, and <a href="/providers/deirdre-paulson-phd" target="_self" title="Opens in same window.">Deirdre Paulson, Ph.D.</a>, is a psychologist in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> ― both in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Obstetrics and delivering newborns</li> <li>Pediatric care</li> <li>Prenatal care</li> <li>Procedures including contraception management (Nexplanon, IUD, vasectomy), joint/trigger point injections, mole removal/biopsy, cyst removal, suturing</li> <li>Women's health</li> </ul>M.D.<p>I strive to provide excellent, patient-centered and evidence-based care to all ages. I believe in creating a team with the patient to form treatment plans based on the patient's experience with their symptom/condition, lifestyle and current medical research and evidence. I approach clinical encounters with thorough, straightforward and nonjudgmental communication.</p> <p>As a lifetime Wisconsinite, I enjoy being active and outdoors, and spending time with loved ones. If I'm not working, you will find me hiking with my dogs, playing sports and games, or being involved with my family!</p><p><strong>Education</strong></p> <ul> <li>University of Wisconsin School of Medicine and Public Health</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Medical Association</li> <li>Society of Teachers of Family Medicine</li> </ul>Ulrich<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/sasha-ulrich-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=C99D51E3FFEBD01FB6BA83CE6C2B4FFB" alt="Sasha Ulrich, M.D." width="280" height="280" DisableNVelocity="true" /><p><a rel="noopener noreferrer" href=" https://pubmed.ncbi.nlm.nih.gov/36637846/" target="_blank" title="Opens in new window">Simulation-based medical education: Development of an assessment tool for novice use</a>, December 2022.</p>Sasha<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30025343Sasha Ulrich, M.D.1{986C767E-E5DE-43F5-957F-B4212DB8E384}|{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}<ul> <li>Anxiety — generalized, social, obsessions and compulsions, panic, phobias</li> <li>Chronic pain</li> <li>Depression</li> <li>Exposure with response prevention</li> <li>Health behavior change</li> <li>LGBTQI+ affirming care</li> <li>Post-traumatic stress disorder (PTSD)</li> <li>Vocational, or job, psychology</li> </ul>Ph.D.<p>I provide behavioral and mental health services in a primary care setting to adults, including completing brief diagnostic assessments and engaging in brief therapy. I approach therapy from a cognitive-behavioral lens, meaning my patients and I examine the relationships between thoughts, emotions, behaviors and body responses. I also incorporate positive psychology into my work with patients, as everyone possess great strength, not just distress, that we can highlight, pull from and utilize in our work together.</p> <p>I believe that the patient is the expert on themselves and their distressing symptoms, whereas I am the expert on how to assess and treat those distressing symptoms. Thus, a collaborative relationship combining our expertise is essential. I also believe that transparency is key. Therefore, I take time to walk my patients through the "why" behind my recommendations, and answer any questions or concerns, all while respecting any boundaries my patients have. Additionally, culture and diversity are critical and will always be acknowledged and incorporated.</p> <p>When not at work, I like to spending time with my family. We enjoy going for walks, attending farmers markets, doing things outside, reading books and eating ice cream.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Psychology, University of Wisconsin-River Falls</li> <li>Master's degree, Counseling Psychology, The University of Southern Mississippi</li> <li>Doctorate, Counseling Psychology, The University of Southern Mississippi</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Doctoral Psychology, William. S. Middleton Memorial Veterans Hospital</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Integrated Primary Care Behavioral Health, University of Minnesota-Twin Cities</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Behavioral and Cognitive Psychology, American Board of Professional Psychology (ABPP)</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Paulson<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/deirdre-paulson-phd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=0CC5C3257D38380C4AB226239ABCE9AC" alt="Deirdre Paulson, Ph.D." width="280" height="280" DisableNVelocity="true" />{4819BBE9-33EE-46BC-9E5C-FDB19532D980}Deirdre<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21414831Deirdre Paulson, Ph.D.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}|{2B88C934-922C-4130-B661-197B59D83899}<img src="/-/media/national-files/images/hometown-health/2021/parent-with-arm-around-child.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5334F36034EF762C9759352206C63653" alt="Parent with arm around child" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller8/10/2021Being a mom is hard. You care for everyone else and often neglect yourself. But self-care is essential. These quick tips can help you relieve stress and improve your wellness.Self-care tips for moms<p>Let's face it, being a mom is hard. There seems to be an endless list of tasks, errands, housework and kid's activities. This can become even more hectic if you balance a career outside the home. With so much time devoted to caring for one's family and exhaustion setting in, finding time for self-care seems to be the first thing left out of a busy schedule.</p> <p>Self-care is the practice of caring for one's own health, well-being and happiness. It is an essential component of stress relief and wellness. Making time for yourself may feel indulgent or selfish, but that is far from the truth. Even small acts of self-care or self-kindness can go a long way in decreasing the feelings of exhaustion, burnout, stress and even depression that busy mothers often feel.</p> <h4>Here are some quick tips for implementing self-care:</h4> <ul> <li><strong>Delegate and ask for help.</strong><br /> It's difficult to admit you may need help or can't accomplish everything on your own. An old adage says that it takes a village to care for a family, and this could not be more true. Find your village and ask for help. Accept help when offered. This may result in a few extra prized moments to focus on yourself. Don't be afraid to say no to commitments that don't interest you or you don't have time for.</li> <li><strong>Stay organized.</strong><br /> Keep a planner, calendar or list of upcoming appointments and tasks for yourself and family. Avoid stress from the unexpected, such as the school project that your child needs assistance to complete last minute. Prioritize tasks to prevent becoming overwhelmed. Start by completing the most time-consuming or less interesting tasks to get them out of the way first.</li> <li><strong>Focus on basic healthy lifestyle habits.</strong> <br /> Aim for seven to eight hours of sleep each night. Try for some daily physical activity each day, with a goal of 150 minutes total a week. Eat a healthy diet consisting of lean meats, low-fat dairy, fruits, vegetables and whole grains. Avoid sugary beverages, alcohol and high-fat foods. Drink six to eight cups of water daily.</li> <li><strong>Schedule your "me time."</strong><br /> Add a "date" with yourself to your calendar and protect it. For example, schedule a fitness class, lunch with a friend or coffee with a good book. Once the date is scheduled, try your best to keep it just as you would for any other appointment.</li> </ul> <p>The most important components of self-care are to be realistic and purposeful. If your schedule is hectic and chaotic, it may not be realistic to expect hours a week to focus on self-care activities. Start small with attainable expectations. For example, taking 10 minutes a day to focus on deep breathing, meditation or positive affirmations may be all that is realistic at this time. Build on the foundation you have made.</p> <p>Mom's health and well-being affect the entire family group. By incorporating self-care into your regular routine, you will become an even more amazing caregiver. You've got this, mom.</p> <p><em><a href="/providers/kristen-bowe-cnp" target="_self" title="Opens in same window.">Kristen Bowe</a> is a nurse practitioner in <a href="/services-and-treatments/family-medicine">Family Medicine</a> in <a href="/locations/new-prague">New Prague</a>, Minnesota.</em></p> <ul> <li>Adolescent/young adult care </li> <li>Anxiety </li> <li>Depression </li> <li>Preventive health and health promotion </li> <li>Women’s health</li> </ul> APRN, C.N.P., M.S.N. <p>I grew up in North Dakota. In my free time I enjoy being active outside and spending time with my family.</p> <p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Nursing, University of Mary</li> <li>Master's degree, Nursing, University of North Dakota</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Nurse Practitioner, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Nurse Practitioner, American Association of Nurse Practitioners</li> <li>Minnesota Nurse Practitioners</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul> Bowe<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/kristen-bowe-cnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=DDD60E3078F96AA42A4790C5A4499C60" alt="Kristen Bowe CNP" width="280" height="280" DisableNVelocity="true" /> Kristen<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14924315Kristen Bowe, APRN, C.N.P., M.S.N. 1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{2B88C934-922C-4130-B661-197B59D83899}|{C4130004-0F31-48C4-AC9F-A4350A75AB24}<img src="/-/media/national-files/images/hometown-health/2021/holding-cup-and-saucer-eyes-closed.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C193B2559D71A0430C4E071900FBA5C7" alt="Holding cup and saucer eyes closed" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Stress ManagementGuidance to help you reduce and manage daily stress.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller8/20/2021If you have aching or sharp shoulder pain, it may be your rotator cuff. If this sounds familiar, it may be time to consult with an orthopedic provider.Shoulder pain? It could be your rotator cuff<p>You reach up to grab something from the cupboard, and a pain shoots through your shoulder. You start to lift a heavy box, and there's that pain again. Same thing happens when you reach into your back pocket or sleep too long on your "bad" side.</p> <p>If this shoulder pain sounds familiar, it may be your rotator cuff. And it may be time to consult with an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic provider</a>.</p> <p>A rotator cuff is a group of muscles and tendons that allows rotation of the arm across or away from the body. It holds the ball and socket of the shoulder joint in place so surrounding muscles can do the work of lifting the arm.</p> <p>Rotator cuff injuries are common, and the risk for injury seems to increase with age. One research study took 100 people who said they had no problem with their shoulders and performed an MRI scan. In those patients, about half of those over 60 were found to have some degree of tear in their rotator cuff.</p> <p>Rotator cuff injuries are often caused by lifting something too heavy; performing overhead work that strains the shoulders; or by a fall, such as tripping on a rug, slipping on the ice or stepping off a ladder and landing on the arm or shoulder.</p> <h4>Treatment options</h4> <p>Your orthopedic provider will begin by taking a health history and performing a physical exam. In instances of a trauma or injury, the next step is often performing an MRI to determine the extent of the injury. Based on those findings, the provider will walk you through treatment options and help you decide what may be the best for you, ranging from steroid injections to physical therapy to surgery.</p> <p>Not all patients with a rotator cuff tear require surgery — at least initially. A large study of roughly 1,000 patients with rotator cuff injuries that developed over time revealed about three-quarters of those with chronic shoulder pain responded well enough with physical therapy that surgery wasn't needed.</p> <h4>Opting for surgery</h4> <p>However, with a more severe injury — where patients can't lift their arm or pain limits their activities — surgery is often needed. The repair surgery is almost always conducted arthroscopically, which is less invasive and allows patients to go home the same day. In this procedure, the surgeon inserts a tiny camera (arthroscope) and tools through small incisions to reattach the torn tendon to the bone. Rarely, a tendon transfer or reconstruction using donor tissue ― superior capsular reconstruction ― is required to give the patient the best chance at a good outcome.</p> <p>Following surgery, patients wear a sling for most of the day for four to six weeks. <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical therapy</a> starts at week four or six.</p> <h5>Here's what patients can expect during physical therapy:</h5> <ul> <li><strong>First phase</strong><br /> The first phase begins to restore motion. This is done by lifting the affected arm with the other hand or with a device, such as a pulley.</li> <li><strong>Active phase</strong><br /> After several weeks, the active phase begins and lasts four to six weeks. In this phase, patients start using the muscles to move their arm.</li> <li><strong>Strength-building phase</strong><br /> The strength-building phase begins at about month three. By six months, most patients have reached 90% of their range of motion and strength. Reaching full recovery and function can take up to a year, though many will feel fully recovered after several months.</li> </ul> <p>Whether through injections, physical therapy or surgery, your orthopedic provider's goal is to help you return to your regular activities without pain or limitations.</p> <p><em><a href="/providers/cory-stewart-md" target="_self" title="Opens in same window.">Cory Stewart, M.D.</a>, is an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgeon</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Acromioclavicular (AC) joint arthritis</li> <li>AC joint sprain</li> <li>Avascular necrosis</li> <li>Evidence-based use of biologic treatments, including platelet-rich plasma</li> <li>Labral tear</li> <li>Minimally invasive treatments for shoulder fractures</li> <li>Rotator cuff tears</li> <li>Shoulder and elbow-related injuries including cubital tunnel syndrome</li> <li>Shoulder arthritis</li> <li>Shoulder dislocation</li> <li>Shoulder instability/labral pathology</li> <li>Tendonitis</li> <li>Tennis elbow</li> </ul>M.D.<p>I want to empower patients to make decisions based on the best available evidence in recent orthopedic literature. I am committed to staying current on the latest advances and techniques in shoulder and upper extremity treatment, working with patients to explore minimally invasive treatment options, whenever possible.</p> <p>In my spare time, I enjoy hiking, biking, water sports, hockey, baseball and spending time with my wife and son.</p><p><strong>Education</strong></p> <ul> <li>Wayne State University School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, University of Chicago</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Shoulder & Elbow, Harvard University</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Orthopedic Surgeons</li> <li>American Shoulder and Elbow Society</li> <li>Mid-America Orthopaedic Association</li> <li>Wisconsin Medical Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Orthopedics, Mayo Clinic College of Medicine and Science</li> </ul>Stewart<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/cory-stewart-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=09B462074D65FD733408AAF7AD730952" alt="Cory Stewart, M.D." width="280" height="280" DisableNVelocity="true" />{8AEFBD4F-51CA-42E0-BF5B-593C1A2E3DD5}Cory<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20576056Cory Stewart, M.D.1{DEF55970-853F-4E96-9A4D-3413874FF059}<img src="/-/media/national-files/images/hometown-health/2021/chopping-wood-on-block.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9D5DD1812CB64E98EC22B8D336AF763B" alt="Chopping wood on block" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller7/7/2023Whether you plant a pot of tomatoes, tend rows of vegetables or love visiting a farmers market, now's the time to start savoring summer's bounty. Give these good-eating ideas a try.Start savoring your homegrown nutrition<p>There's something so satisfying about picking vegetables you've grown yourself. Whether your garden is a pot of herbs or tomatoes on the patio; rows upon rows of peas, carrots, potatoes, squash and sweet corn; or something in between, it's time to start harvesting and savoring your homegrown nutrition.</p> <p>Be sure to pick your crop at the peak of its freshness during cooler times of the day. Then it's time to put your produce to delicious use.</p> <h2>Need some ideas? Give these a try:</h2> <h3>No prep needed</h3> <p>Some veggies, like tomatoes or radishes, are delicious as a snack or part of a summery salad. Toss greens like lettuce, kale and spinach with sliced tomatoes, radishes, green onions and cucumbers with your favorite dressing. Make it a full meal by adding cooked chicken or a sliced hard-boiled egg. Cut herbs as you need them for seasoning meats, vegetables, salads, beverages and more.</p> <h3>Roasting</h3> <p>Just about any firm vegetable can be roasted, including beets, carrots, parsnips, squash, potatoes, radishes, green beans, bell peppers, eggplant, onions, cabbage and Brussels sprouts. Cut the vegetables into chunks, and toss with a little olive, sunflower or peanut oil, and balsamic vinegar. Then have fun with seasonings, which can be as simple as salt and pepper. Or try Italian seasoning; garlic; cinnamon; nutmeg; pumpkin spice; curry; chili powder; herbs, such as thyme, basil or oregano; or a salt-free option like Mrs. Dash.</p> <h3>Grilling</h3> <p>Make veggie packets. Cut up a blend of carrots, potatoes, onions, bell peppers, mushrooms, corn on the cob or summer squash. Fold into foil packets with salt, pepper, butter or oil. Seal and place on the grill next to whatever meat or fish is on the menu. Cook 25 to 30 minutes or until the vegetables are tender. Carefully open the packets to allow the hot steam to escape.</p> <p>Try cooking with a grill basket or making individual skewers. Cut small red potatoes in half; onions into quarters; green, red or yellow peppers into large chunks; and summer squash or zucchini into 1/2-inch thick slices. Add whole mushrooms and cherry tomatoes. Toss your vegetable combination with oil and seasonings, and transfer to a grill basket. Occasionally shake the basket or turn the veggies with tongs. Or thread the vegetables onto individual skewers, turning at least once so they cook evenly. Grill over medium heat until tender.</p> <h3>Air frying</h3> <p>If you have one of these appliances, cut an assortment of veggies into chunks, and toss with a tablespoon or two of oil, salt, pepper and seasoning mixes like Italian or herbes de Provence. Preheat your air fryer to 350 F, according to the manufacturer's instructions. Cook your vegetables for 10 minutes, stirring after five. For more firm vegetables like carrots, beets or potatoes, cook for 15 minutes, stirring every five minutes.</p> <h3>Spiralizing</h3> <p>Make vegetables more fun with a spiralizer. This easy-to-use kitchen tool turns zucchini, cucumbers, summer squash, butternut squash, carrots, beets and onions into the shape of noodles with the crank of a handle. Use the noodles in salads or cook in boiling water for one minute for a gluten-free pasta alternative.</p> <h3>Freezing</h3> <p>Cut up veggies like zucchini and carrots, freeze in zippered freezer bags and later blend into smoothies. Cut bell peppers and tomatoes in chunks or cut corn off the cob, place in bags and freeze for use in soups, stews and omelettes.</p> <p>Harvest the herbs from your patio or windowsill herb garden, tie them in bunches and hang upside down until thoroughly dry. Seal into zippered bags or glass containers to season your meals throughout the winter.</p> <p>If a garden or vegetable planter isn't in your plan this summer, you can visit your local farmers market for locally grown goodness. Find nearby markets in Minnesota and <a rel="noopener" href="http://www.wifarmersmarkets.org/" target="_blank" title="Opens in a new window.">Wisconsin</a>.</p> <p>This summery salad recipe from Mayo Clinic can be served warm or cold and features quinoa, an ancient grain rich in B vitamins and minerals. It also has antioxidants and heart-healthy monounsaturated fat. For a main-dish salad, top it with slices of grilled chicken breast or skewers of grilled shrimp.</p> <h3>Quinoa Salad</h3> <p>Serves 4</p> <p>1 cup quinoa<br /> 1 1/4 cups water<br /> 1 lemon, juiced (about 2 tablespoons)<br /> 1 garlic clove, minced<br /> 1/4 teaspoon ground black pepper<br /> 2 tablespoons olive or canola oil<br /> 1 large cucumber, seeded and cut into 1/2-inch pieces<br /> 1 pint cherry tomatoes, halved<br /> 1/3 cup chopped parsley<br /> 1/4 cup chopped red onion<br /> 1/2 cup reduced-fat feta cheese</p> <p>In a medium saucepan over high heat, bring quinoa and water to a boil. Reduce heat to medium-low and cover. Simmer for about 10 minutes or until the quinoa is tender. Remove quinoa from heat and let stand, covered, for 5 minutes. Then fluff quinoa with a fork and spread on a large, rimmed baking sheet to cool. In a small bowl, whisk lemon juice, garlic and pepper. Gradually whisk in oil. After the quinoa has cooled, transfer it to a large bowl, and add the dressing, cucumber, tomatoes, parsley and onion. Top with feta cheese and toss gently to mix.</p> <p>Nutrition analysis per 2-cup serving: 313 calories, 13 grams total fat, 10 milligrams cholesterol, 177 milligrams sodium, 40 grams carbohydrates, 6 grams dietary fiber, 9 grams protein</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2023/radish-bunch.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C1EFDD32B6D1F1A2CBD8F679094977DA" alt="Radish bunch" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller6/27/2023Peripheral arteries carry oxygenated blood to the arms, legs and brain. Just like coronary arteries, they can become diseased. Learn about the symptoms and treatments for peripheral artery disease.PAD: The other arterial disease<p>The body has two types of artery systems: the coronary artery system, which relates to the heart, and peripheral artery system, which involves the arteries carrying oxygenated blood to the arms, legs and brain.</p> <p>Just like coronary arteries, peripheral arteries can become diseased. This condition, called peripheral artery disease, or PAD, narrows arteries and reduces blood flow due to a buildup of fatty deposits on the artery walls. This can cause claudication, which is muscle pain and cramping when a person is active but usually disappears after a few minutes of rest.</p> <p>If this sounds familiar, take a few minutes to learn more about PAD.</p> <h2>Who's at risk for PAD</h2> <h3>People who smoke or have diabetes at any age are at the greatest risk for this condition. Other risk factors include:</h3> <ul> <li><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/obesity/in-depth/bmi-calculator/itt-20084938" target="_blank" title="Opens in a new window.">Body mass index</a> over 30</li> <li><a href="/-/media/national-files/images/hometown-health/2021/know-your-numbers-family-history.jpg" target="_self" title="Opens in same window.">Family history</a> of PAD, heart disease or stroke</li> <li><a href="/-/media/national-files/images/hometown-health/2021/know-your-numbers-blood-pressure.jpg" target="_self" title="Opens in same window.">High blood pressure</a></li> <li><a href="/-/media/national-files/images/hometown-health/2021/know-your-numbers-cholesterol.jpg" target="_self" title="Opens in same window.">High cholesterol</a></li> <li>Increasing age, especially if you are age 65 or older</li> </ul> <h2>Recognizing PAD symptoms</h2> <h3>In addition to claudication, other symptoms of PAD include:</h3> <ul> <li>Aching or cramping in the arms when knitting, writing or performing other manual task.</li> <li>Change in the color of your leg or arm</li> <li>Coldness of the lower leg or foot</li> <li>Sores on the toes, feet or leg that don't heal</li> <li>Weakening pulse in the foot</li> <li>Erectile dysfunction in men </li> <li>Hair loss</li> </ul> <p>If arteries in your brain are affected, symptoms may include dizziness, weakness in the arms and legs, or loss of consciousness.</p> <p>If you experience any of these symptoms, make an appointment with a cardiologist, who will conduct a physical exam and record your health history. The exam will include finding a pulse in the affected limb and comparing it with the pulse in the unaffected limb.</p> <h2>PAD treatment options</h2> <p>Cardiologists have a wide range of tools available, depending on the degree of your symptoms, to help you return to the activities you love. For example, if you can walk a few blocks with only mild pain, they may prescribe medications including aspirin, statins or blood thinners. They also may discuss ways you can modify your risk factors, such as quitting smoking; controlling blood pressure, cholesterol and diabetes; and increasing your activity level.</p> <p>If you have more significant symptoms, such as not being able to tolerate the pain when walking, a cardiologist typically will order a CT scan with contrast, an ultrasound or an angiogram to determine the location and degree of the blockage.</p> <p>To relieve the blockage, your cardiologist may refer you to a vascular medicine specialist or proceduralist who will conduct an arterial angioplasty. In this procedure, a tiny balloon is inserted into the artery and expanded, pushing the blockage into the arterial wall. At the same time, the balloon can leave behind a stent, which acts as a support for keeping the artery open. The stent itself may contain a drug that helps keep the artery open.</p> <p>To break up a blockage, the vascular proceduralist also may inject a clot-dissolving drug into the artery where the clot is located.</p> <p>An untreated blockage can progress and completely interrupt the flow of blood to the affected limb. This loss of blood supply can lead to severe pain even when a person is resting, ulcers, gangrene — and eventually could require amputation.</p> <h2>Prevention is the best treatment</h2> <p>If you have one or more risk factors, you can take action to prevent or stop the progression of PAD.</p> <h3>The best way is to adopt a healthy lifestyle by:</h3> <ul> <li>Avoiding certain over-the-counter cold remedies that contain <a rel="noopener" href="https://www.mayoclinic.org/drugs-supplements/pseudoephedrine-oral-route/before-using/drg-20067942" target="_blank" title="Opens in a new window.">pseudoephedrine</a>. These medications, which include Advil Cold and Sinus and Aleve-D Sinus and Cold, constrict your blood vessels and can increase your symptoms.</li> <li>Not smoking or <a href="/hometown-health/speaking-of-health/a-smokers-guide-to-quitting" target="_self" title="Opens in same window.">quitting</a> if you do smoke.</li> <li><a href="/hometown-health/speaking-of-health/eat-the-rainbow-for-good-health" target="_self" title="Opens in same window.">Eating the rainbow</a> by consuming a plentiful array of colorful fruits and vegetables.</li> <li><a href="/hometown-health/doctors-orders/need-to-exercise-start-slowly" target="_self" title="Opens in same window.">Exercising regularly</a>, aiming for 30 to 45 minutes several times a week. </li> <li>Keeping your blood sugar under control if you have <a href="/hometown-health/speaking-of-health/how-to-live-well-with-diabetes" target="_self" title="Opens in same window.">diabetes</a>.</li> <li>Maintaining a healthy weight.</li> <li>Managing your blood pressure and cholesterol levels.</li> </ul> <h2>Next steps:</h2> <ul> <li><a href="https://www.mayoclinichealthsystem.org/providers?service=Cardiology" target="_self" title="Opens in same window.">Find a cardiologist</a> near you.</li> <li><a href="https://www.mayoclinichealthsystem.org/providers?service=Vascular%20Medicine" target="_self" title="Opens in same window.">Find a vascular medicine specialist</a> near you.</li> <li>Discover how <a href="/services-and-treatments/cardiovascular-rehabilitation-and-services" target="_self" title="Opens in same window.">cardiac rehabilitation </a>can improve your vascular health.</li> <li><a href="/wellness/journey">Join our Journey to Wellness program</a> to improve your overall health and wellness.</li> </ul> <p><a href="/providers/michel-barsoum-md" target="_self" title="Opens in same window."><em>Michel Barsoum, M.B., Ch.B.</em></a><em>, is a <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiologist</a> and <a href="/services-and-treatments/vascular-medicine" target="_self" title="Opens in same window.">vascular medicine</a> specialist in <a href="/locations/chippewa-falls" target="_self" title="Opens in same window.">Chippewa Falls</a>, <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/rice-lake" target="_self" title="Opens in same window.">Rice Lake</a>, Wisconsin.</em></p> <ul> <li>Amyloidosis</li> <li>Aneurysms</li> <li>Carotid artery disease</li> <li>Peripheral artery disease</li> <li>Valve and coronary artery diseases</li> <li>Venous disorders, including varicose veins and blood clots</li> </ul> M.B., Ch.B. <p><strong>Education</strong></p> <ul> <li>University of Cairo-Egypt</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Sanford School of Medicine, University of South Dakota</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Vascular Medicine and Cardiology, Mayo Clinic College of Medicine</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Cardiology</li> <li>Internal Medicine</li> <li>Vascular Medicine</li> <li>Vascular Ultrasound</li> </ul> <p><strong>Membership</strong></p> <ul> <li>Fellow, Heart Failure Basic Science Research</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Barsoum<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/michel-barsoum-md.jpg?h=200&iar=0&w=200&sc_lang=en&hash=2D0F65B6CD4883F5C2A81125D313585C" alt="Michel Barsoum, M.D." width="200" height="200" DisableNVelocity="true" /> Michel<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14476029Michel Barsoum, M.B., Ch.B. 1{676428F6-179A-4C9B-9B23-5F1E40032A38}<img src="/-/media/national-files/images/hometown-health/2023/couple-walking-and-smiling.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5E0EEEED2DE97EF8CE1B5FD9B94A3E96" alt="Couple walking and smiling" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller8/12/2021About 29 million U.S. adults are diagnosed with a sinus infection annually. Clear up misconceptions with answers to 8 common sinus questions.Unlocking the mystery of your sinuses: Answers to 8 common questions<p>An empty space can be a lot of something. That's the story of your sinuses ― four pairs of air-filled interconnected cavities located between your eyes and nose. Along with the nasal passages in the nose, your sinuses produce and circulate mucus.</p> <p>While the sinuses are small, they can cause a lot of misery for some people. Your sinuses are connected to your external environments through the nasal passages, and your sinuses can be exposed to allergens, viruses, fungi and bacteria. This can lead to inflammation, congestion, excess mucus, pain, postnasal drip and swelling around your eyes, cheeks, nose or forehead. Each year, about 29 million U.S. adults are diagnosed with an infection in their sinuses, also called sinusitis.</p> <h3>There are many misconceptions about the sinuses, so here are answers to common sinus questions:</h3> <h4>1. How many sinuses do most people have?</h4> <img alt="Sinus illustration" src="/-/media/national-files/images/hometown-health/2021/sinus-illustration.jpg?h=351&w=306&sc_lang=en&hash=FFC00AFCC0D6725E6E9BDAF951BFB772" style="width: 306px; height: 351px; float: right; margin-bottom: 5px; margin-left: 5px;" /> <p>Most people have four pairs of sinus cavities in their heads ― or eight total. Two large frontal sinuses are located above your eyes and in your forehead. Two sphenoid and two ethmoid sinuses are set between your eyes and behind your nose. The largest two sinuses are the maxillary sinuses, and they are positioned under your eyes and behind your cheeks.</p> <p>A small number of people are born with fewer sinuses.</p> <p>The shape and size of your sinuses can be surgically modified, as is occasionally done for people who suffer from chronic sinusitis, or sinusitis that lasts 12 weeks or longer.</p> <h4>2. What causes a sinus infection?</h4> <p>Sinusitis happens when the tissues in your sinuses become inflamed and swollen. This interferes with drainage, causes mucus to build up, as well as congestion, pain and pressure around your eyes. Sinusitis can make it difficult to breathe. The most common cause of sinusitis is a virus, such as the common cold. They also can be caused by bacteria, allergies or fungi.</p> <h4>3. Will my sinus infection clear up on its own?</h4> <p>Most sinus infections get better with rest, time and home remedies, including nasal sprays, decongestants and pain relievers. Antibiotics have no effect on viruses ― the most common cause of sinus infections ― and would only be considered if you develop a bacterial infection.</p> <p>Normally, a bacterial infection diagnosis is not made until five to 10 days after the onset of symptoms.</p> <h5>The likelihood that you have a bacterial infection increases when:</h5> <ul> <li>Symptoms last seven days or more, particularly when symptoms initially improve and then worsen.</li> <li>Mucus is thick, and often yellow or greenish in color.</li> <li>There is facial or sinus tenderness, particularly if it's worse on one side of the face.</li> <li>Pain is present in the upper teeth and is worse on one side of the face.</li> </ul> <p>Sinusitis that lasts more than 12 weeks despite medical treatment is called chronic sinusitis.</p> <h4>4. Can an untreated bacterial sinus infection cause long-term issues?</h4> <p>If a bacterial sinus infection is not treated correctly, it could create a continual cycle of sinus blockage, pain and pressure. This happens because ongoing blockage in the sinuses can lead to more infections, which in turn leads to more blockage.</p> <p>Chronic inflammation and blockage also can cause nasal polyps to develop. These are soft, painless, noncancerous growths on the lining of your nasal passages or sinuses. Nasal polyps can cause complications because they block normal airflow and fluid drainage. They also can worsen asthma and obstructive sleep apnea, and make you more susceptible to sinus infections in the future. Treatments such as medication or surgery may be required.</p> <h4>5. How can I decide if I have a tooth infection or a sinus infection?</h4> <p>It can be hard to tell the difference between a tooth and sinus infection because the pain and pressure are in the same general area.</p> <p>The primary way is to identify where and when your pain first started. You likely have a sinus infection if your first symptoms started near your eyes and moved down your face. For example, you first had pain and pressure on your forehead and between your eyes, which later traveled down your face and caused teeth sensitivity. A tooth-related issue is likely if the first symptoms were teeth sensitivity or pain in the middle of your cheeks near your nostrils, and that pain then moved up toward your eyes.</p> <p>While an upper tooth infection can trigger a sinus infection or a sinus infection can trigger upper teeth sensitivity, sinus infections do not cause pain in your lower teeth or jaw.</p> <p>Call your dentist or primary care provider to be evaluated. You may need an X-ray or other images to determine the location of your infection.</p> <h4>6. Do blocked sinuses cause my eyes to water?</h4> <p>Generally speaking, blocked sinuses do not cause your eyes to water. Sinuses drain through your nasal cavity ― not through your eyes. Tear ducts near your eyes also drain through the nasal cavity, but they use a separate system from your sinuses.</p> <p>Occasionally, a tear duct can become blocked, leaving you with a watery, irritated eye. Allergies can cause watery eyes, along with sneezing and stuffy or runny nose.</p> <h4>7. Do blocked sinuses cause eye bags or puffiness?</h4> <p>Blocked sinuses typically do not cause eye bags or puffiness. Sinusitis does not cause pronounced puffiness or bags under your eyes. Often allergies can cause eye puffiness. Talk with your primary care provider or an allergist about treatment options.</p> <p>If you don't have a history of allergies, eye bags could be caused by an issue with the structure of the eye. As you age, your eyelids stretch and the muscles supporting them weaken. As a result, the fat that surrounds the eye can push forward and cause bags under the eye. An eyelid surgery, called a blepharoplasty, can remove the excess fat, skin and muscle to eliminate the bags.</p> <h4>8. Can a sinus infection cause an ear infection?</h4> <p>This is not as common as people may think. Most likely, a person develops a head cold, or viral rhinitis, which can cause both an ear infection and sinus infection. While they may occur at the same time, viral rhinitis is the cause. A sinus infection rarely causes an ear infection.</p> <p>If you suffer from chronic sinuitis or other sinus conditions, talk with your primary care provider or ear, nose and throat provider about treatment options to help.</p> <p><em><a href="/providers/quintin-cappelle-md" target="_self" title="Opens in same window.">Quintin Cappelle, M.D.</a>, is an <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">otorhinolaryngologist</a> and head and neck surgeon in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Chronic ear disease</li> <li>Chronic sinusitis</li> <li>Ear tubes/tympanostomy tubes</li> <li>Endoscopic dacryocystorhinostomy (tear duct surgery)</li> <li>Head and neck cancer</li> <li>Hearing loss</li> <li>Nasal polyps</li> <li>Nose and sinus disease</li> <li>Parathyroid adenomas</li> <li>Parotid disease</li> <li>Salivary gland/parotid</li> <li>Thyroid nodules</li> <li>Thyroid/parathyroid disease</li> <li>Tonsillectomy and adenoidectomy</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Illinois at Chicago College of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Otolaryngology – Head and Neck Surgery, University of Illinois at Chicago Eye & Ear Infirmary</li> </ul> <p><strong>Membership</strong></p> <ul> <li>Head and Neck Surgery, American Academy of Otolaryngology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Otolaryngology, Mayo Clinic College of Medicine and Science</li> </ul>Cappelle<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/quintin-cappelle-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=AAB359B4BA7F1209F2C019BFA15FE31E" alt="Quintin Cappelle MD" width="280" height="280" DisableNVelocity="true" />{B48121EC-8A20-45D5-9673-3DDA968CB0D1}Quintin<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20279493Quintin Cappelle, M.D.1{18E5E65E-45C8-4C48-BD32-A914794E2AA4}|{E9B8BDBE-375B-4E7D-A1D2-2B64B5513AF7}<img src="/-/media/national-files/images/hometown-health/2021/listening-with-headphones-lying-on-sofa.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6DFA8E9FA78148F4B66682704DAF7FB0" alt="Listening with headphones lying on sofa" width="660" height="370" DisableNVelocity="true" />Ear, Nose and Throat (ENT)Get information about symptoms, disorders and diseases affecting the ear, nose and throat, and related head and neck structures.Dawn Haller11/13/2024If you have pain or pressure in your forehead with nasal symptoms, you may think it's a sinus headache. But 90% of people with these symptoms are actually experiencing migraine headaches. Learn more.Your sinus headache may not be what you think<p>Nearly everyone experiences a headache at some point, and the pain can range from mild to debilitating.</p> <p>Sometimes, headaches are accompanied by pain and pressure in your brow and forehead and cause nasal symptoms. Many people associate sinus and nasal symptoms with a <a href="/hometown-health/speaking-of-health/will-my-sinus-infection-clear-up-on-its-own" target="_self" title="Opens in same window">sinus infection</a>, also called sinusitis, or with an upper respiratory infection, such as a cold. Someone may say that they're experiencing a sinus headache. But sinus and nasal symptoms often can signal something else: a migraine headache.</p> <p>The term "sinus headache" isn't an actual medical diagnosis. Studies show that 90% of people with <a href="/hometown-health/speaking-of-health/chronic-sinusitis-more-than-a-stuffy-nose" target="_self" title="Opens in same window">sinus headache symptoms</a> are experiencing migraine headaches.</p> <h2>Is your head pain from sinusitis or migraine?</h2> <p>Migraines and headaches from sinusitis are easy to confuse because the signs and symptoms of the two types of headaches may overlap. Also, migraine headaches affect people differently, and symptoms can change over time. That is why many people who have had migraine headaches in the past are surprised when they begin having <a href="/hometown-health/speaking-of-health/unlocking-the-mystery-of-your-sinuses" target="_self" title="Opens in same window">sinus and nasal symptoms</a> with a migraine headache.</p> <p>Sinusitis usually isn't associated with nausea or vomiting or aggravated by noise or bright light, which are all common features of migraines. Instead, it tends to occur after a viral <a href="/hometown-health/featured-topic/upper-respiratory-infection-season" target="_self" title="Opens in same window">upper respiratory infection</a> or cold and includes thick, discolored nasal mucus, decreased sense of smell, and pain in one cheek or upper teeth. </p> <p>Headaches due to sinus disease often last several days or longer, while migraines most commonly last hours to a day or two.</p> <h2>Previous misdiagnosis of headaches</h2> <p>Many people who assume they have headaches from sinusitis have been misdiagnosed and <a href="/hometown-health/speaking-of-health/3-reasons-why-you-did-not-receive-antibiotics-from-your-provider" target="_self" title="Opens in same window">prescribed an antibiotic</a> for sinusitis. In these cases, the antibiotics aren't necessary and could be harmful. </p> <p>Some people may feel better after they take an antibiotic because it may decrease inflammation in the sinuses caused by migraine headache or because they think the antibiotic is helping, known as the placebo effect.</p> <p>However, an antibiotic is not the correct treatment for a migraine headache.</p> <h3>These are a few ways you can tell whether your sinus and nasal symptoms are part of a sinus infection or part of a migraine headache:</h3> <table> <tbody> <tr> <td><strong>When you have a sinus infection</strong></td> <td><strong>When you have a migraine headache</strong></td> </tr> <tr> <td>You likely just had or have a cold.</td> <td>You do not have a cold.</td> </tr> <tr> <td>You have thick, colored nasal mucus.</td> <td>Any drainage from your nose is clear.</td> </tr> <tr> <td>You usually need to blow your nose and cannot smell well.</td> <td>Your sense of smell is not affected.</td> </tr> <tr> <td>You usually can function.</td> <td>Your symptoms tend to get worse with physical activity, such as walking or bending over.</td> </tr> <tr> <td> </td> <td>You may feel better after you lie down or sleep.</td> </tr> </tbody> </table> <p> </p> <h2>Risk factors for migraine headaches</h2> <p>Migraine headaches can affect anyone. However, they're more common in people between age 20 and 50. </p> <p>More than twice as many women as men have <a href="/hometown-health/speaking-of-health/what-are-the-stages-of-a-migraine" target="_self" title="Opens in same window">migraine headaches</a>. Women over 50 often have fewer and less severe migraine headaches than they had earlier in life. Sometimes, migraine headaches stop after menopause.</p> <p>Migraine headaches tend to run in families. Seventy-five percent of people with migraine headaches have a family history of migraine headaches.</p> <h2>Proper diagnosis</h2> <p>The cause of headaches can be challenging to determine. Your healthcare team will ask you questions about your headaches and perform a physical exam. You also may have a CT scan or MRI to help determine the cause of your headache. There are several ways to treat headaches, and your care team will work with you to find the best option for you.</p> <p>Talk with your primary care provider if your headache symptoms happen more than 15 days a month, over-the-counter pain medication doesn't work, or you miss school or work because of frequent headaches.</p> <h3>Call 911 if you have the worst headache of your life or a sudden, severe headache accompanied by any or all of these:</h3> <ul> <li>Confusion or trouble understanding speech</li> <li>Fainting</li> <li>High fever</li> <li>Numbness, weakness or paralysis</li> <li>Trouble seeing, speaking or walking</li> </ul> <p><em><a href="/providers/quintin-cappelle-md" target="_self" title="Opens in same window.">Quintin Cappelle, M.D.</a>, is an <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">otorhinolaryngologist</a> and head and neck surgeon in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin. <a href="/providers/scott-spritzer-do" target="_self" title="Opens in same window.">Scott Spritzer, D.O.</a>, is a <a href="/services-and-treatments/neurology" target="_self" title="Opens in same window.">neurologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em> </p><ul> <li>Chronic ear disease</li> <li>Chronic sinusitis</li> <li>Ear tubes/tympanostomy tubes</li> <li>Endoscopic dacryocystorhinostomy (tear duct surgery)</li> <li>Head and neck cancer</li> <li>Hearing loss</li> <li>Nasal polyps</li> <li>Nose and sinus disease</li> <li>Parathyroid adenomas</li> <li>Parotid disease</li> <li>Salivary gland/parotid</li> <li>Thyroid nodules</li> <li>Thyroid/parathyroid disease</li> <li>Tonsillectomy and adenoidectomy</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Illinois at Chicago College of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Otolaryngology – Head and Neck Surgery, University of Illinois at Chicago Eye & Ear Infirmary</li> </ul> <p><strong>Membership</strong></p> <ul> <li>Head and Neck Surgery, American Academy of Otolaryngology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Otolaryngology, Mayo Clinic College of Medicine and Science</li> </ul>Cappelle<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/quintin-cappelle-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=AAB359B4BA7F1209F2C019BFA15FE31E" alt="Quintin Cappelle MD" width="280" height="280" DisableNVelocity="true" />{B48121EC-8A20-45D5-9673-3DDA968CB0D1}Quintin<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20279493Quintin Cappelle, M.D.1{18E5E65E-45C8-4C48-BD32-A914794E2AA4}|{E9B8BDBE-375B-4E7D-A1D2-2B64B5513AF7}<ul> <li>Epilepsy and other neurological conditions</li> </ul>D.O.<p>In my spare time, I enjoy spending time with family and outdoor activities.</p><p><strong>Education</strong></p> <ul> <li>Doctor of Osteopathic Medicine, Midwestern University/Arizona College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Neurology, Mayo School of Graduate Medical Education, Mayo Clinic College of Medicine</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Epilepsy, Mayo School of Graduate Medical Education, Mayo Clinic College of Medicine</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Neurology, American Board of Psychiatry and Neurology</li> <li>Clinical Neurophysiology, American Board of Psychiatry and neurology</li> <li>Mayo Clinic Quality Fellow, Bronze Level</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Neurology</li> <li>American Epilepsy Society</li> <li>American Medical Association</li> <li>Wisconsin Medical Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Neurology, Mayo Clinic College of Medicine and Science</li> </ul>Spritzer<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/scott-spritzer-do.jpg?h=200&iar=0&w=200&sc_lang=en&hash=485562F16077B3B2D8830FB2B867D242" alt="Scott Spritzer, D.O." width="200" height="200" DisableNVelocity="true" />{612AFFD2-050B-4F69-BC9B-93F0A7051756}Scott<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15260917Scott Spritzer, D.O.1<img src="/-/media/national-files/images/hometown-health/2024/lady-picking-up-delivered-package.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A77EB3373AF287D9289FAA2D3627F872" alt="lady picking up delivered package" width="660" height="370" DisableNVelocity="true" />HeadacheHeadache is pain in any region of the head that feels like a sharp pain, throbbing sensation or dull ache. It may develop gradually or suddenly, and last for minutes or days.Ear, Nose and Throat (ENT)Get information about symptoms, disorders and diseases affecting the ear, nose and throat, and related head and neck structures.Dawn Haller8/6/2021Skin cancer is among the most common and preventable types of cancer. Learn how to protect your skin from the sun while you enjoy summer.3 sun safety reminders<p>Although your skin needs sun for vitamin D, it also needs to be protected from the sun's harmful ultraviolet rays. Those sunny rays, which may be appreciated after a long winter, also can cause skin cancer. Skin cancer is among the most common types of cancer in the U.S. and also the most preventable.</p> <p> As a physician and a father of three children, I often provide these sun safety reminders to patients and their families.</p> <h4>1. Choose the right sunscreen.</h4> <p>It's best to stay out of sunlight when the sun is most direct, usually between 10 a.m. and 3 p.m. But when you are in the sun, choosing a good sunscreen is critical.</p> <p>Don't get caught up in brand names, but don't choose the cheapest product. Go with a well-rated lotion or spray that has the right SPF for your needs. There is minimal extra protection for sunscreens that claim sun protection factor, or SPF, ratings higher than 50. Use a sunscreen with an SPF of 30 or 50 on your face, ears, nose and other areas of prolonged sun exposure, especially when you're spending the day at the pool or lake. Use SPF 15 or 30 for all other areas of the body that are exposed to the sun. Apply sunscreen every hour when playing or sweating in the sun, or playing at the pool. Waterproof sunscreen can last somewhat longer, but everyone's skin is different. One tip my wife uses is to set her phone alarm to go off every hour when we are at the pool as a reminder to reapply sunscreen. Babies 6 months and younger should not use sunscreen, so be sure to keep them covered or in a shady spot.</p> <p>There's been some concern recently as to the absorption of titanium oxide and zinc oxide found in most sunscreens. If these were absorbed would it be toxic to our bodies? Studies reveal these compounds do not get below the stratum corneum layer, which is one of the outer most skin layers, before naturally sloughing off. Most sunscreens are well-tolerated with no concerns for reactions due to absorption.</p> <p>Some sunscreens can cause allergic reactions to you or your child's skin. If this happens, remove immediately, and try a different or more natural brand of sunscreen. If you continue to have a worsening rash, or swelling of lips or throat, you need to be seen by a medical professional immediately.</p> <p>Another issue is some sunscreen can be irritating to the skin and cause dermatitis or photosensitivity over time. Many of these sunscreens contained para-aminobenzoic acid (PABA), but now this component is rarely used by sunscreen manufacturers.</p> <h4>2. Wear sunglasses.</h4> <p>Sunglasses can protect your eyes from the brightness of the sun, but make sure they're UV-filtered. Without that, you actually expose your eyes to the UV rays worse than if you weren't wearing sunglasses at all.</p> <h4>3. Wear a hat.</h4> <p>While hats do help when you and your family are outdoors, remember that baseball caps usually only protect the face but not your ears or neck, which are common areas skin cancers can develop later in life. Broad-brimmed hats are better but can be challenging with kids as they may not necessarily be something they want to wear. So, be sure to repeat applications of sunscreen to exposed areas.</p> <p>Using sunscreen and wearing clothing that protects you from the sun can greatly reduce your risk of developing skin cancer. Protect your skin to have a great summer.</p> <p><em><a href="/providers/graham-king-md" target="_self" title="Opens in same window.">Graham King, M.D.</a>, is a physician in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Community fitness outreach programs</li> </ul>M.D.<p>I enjoy caring for the health needs of families from prenatal care and pediatrics to adult medicine, and specialize in women's health and reproductive health. I focus on listening and hearing my patients, and forming partnerships with them in delivering their care.</p> <p>I am married to an elementary school teacher with four energetic boys who are active in community, school and sports. I enjoy playing guitar and piano, writing educational blogs and practicing healthful living. </p> <p>I am an 80s rock superfan and love going to concerts with my family and friends. I also enjoy Vikings, Twins, Wild and Maverick sports.</p><p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Mercy Hospital</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Sutter Health Family Medicine Residency Program</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Family Medicine</li> <li>Mayo Clinic Quality Fellow, Bronze Level</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Medical Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>King<img src="/-/media/shared-files/images/medical-professionals/full/mankato/graham-king-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=78048D61A3A60EF1DF00C06F2F6CCBEE" alt="Graham King MD" width="280" height="280" DisableNVelocity="true" />{46521252-3F34-48F2-80D2-338AA6DD4C22}Graham<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14899019Graham King, M.D.1<img src="/-/media/national-files/images/hometown-health/2019/mom-putting-suncreen-on-girls-nose.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2EAC2F66BE068540372B894118FE2F5D" alt="Mom putting sunscreen on girl's nose" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller9/19/2025Summertime can significantly change children's sleep habits. As your family prepares for a new school year, consider sleep routines and if your children are getting enough sleep.Is your child getting enough sleep?<p>Summertime can significantly change children's sleep habits, with later evening activities and the opportunity to sleep in during the mornings. As your family prepares for a new school year, it is important to consider your family's sleep routines and if children are getting enough sleep.</p> <p>Sleep is critical for children's overall well-being and growth, and their ability to learn, play and socialize. Set up your children for a positive learning experience this year by promoting healthy sleep habits before the school year begins.</p> <h4>Recommended amount of sleep</h4> <p>Children differ as to the amount of sleep needed, when they are naturally tired at night and when they wake up. Also, the amount of sleep children need varies by age.</p> <h5>Below are general guidelines by age group, keeping in mind that each child is different:</h5> <table> <tbody> <tr class="telerik-reTableHeaderRow-4"> <td class="telerik-reTableHeaderFirstCol-4"><strong>Age group </strong></td> <td class="telerik-reTableHeaderLastCol-4"><strong>Recommended amount of sleep in 24 hours</strong> </td> </tr> <tr class="telerik-reTableOddRow-4"> <td class="telerik-reTableFirstCol-4">4–12 months </td> <td class="telerik-reTableLastCol-4">12–16 hours, including naps </td> </tr> <tr class="telerik-reTableEvenRow-4"> <td class="telerik-reTableFirstCol-4">1–2 years</td> <td class="telerik-reTableLastCol-4">11–14 hours, including naps </td> </tr> <tr class="telerik-reTableOddRow-4"> <td class="telerik-reTableFirstCol-4">3–5 years </td> <td class="telerik-reTableLastCol-4">10–13 hours, including naps </td> </tr> <tr class="telerik-reTableEvenRow-4"> <td class="telerik-reTableFirstCol-4">6–12 years </td> <td class="telerik-reTableLastCol-4">9–12 hours </td> </tr> <tr class="telerik-reTableOddRow-4"> <td class="telerik-reTableFirstCol-4">13–18 years </td> <td class="telerik-reTableLastCol-4">8–10 hours </td> </tr> </tbody> </table> <br /> <h4>Signs of sleep deficit</h4> <p>Regularly getting the recommended amount of sleep is linked with better health for children and adults.</p> <h5>Look for these signs that children are not getting the necessary amount of sleep:</h5> <ul> <li>Lower engagement in activities</li> <li>Poor school performance</li> <li>Irritability or trouble managing emotions</li> <li>Sadness</li> <li>Lack of concentration or forgetfulness</li> <li>Headaches</li> <li>Nausea or upset stomach</li> <li>Trouble waking in the morning</li> </ul> <p>If inadequate sleep occurs over a prolonged period, kids can develop medical problems such as high blood pressure, and weight gain or obesity, as well as mental health issues, including depression and anxiety.</p> <h4>Set the stage for sleep success</h4> <p>Start a few weeks before school begins to shift your children back to a regular sleep schedule. Return to your children's nightly routine, such as brushing teeth, reading a book and then going to bed. If your children do not have a sleep routine yet, that's OK. It is never too late to start one. Sleep routines are important because they can help children go to bed earlier, fall asleep faster, experience fewer nighttime awakenings and sleep longer.</p> <h5>Here are a few other strategies to improve your children's quality of sleep:</h5> <ul> <li>Stick to the same bed and wake time each day.</li> <li>Encourage exercise during the day, but avoid overscheduling that leads to little downtime.</li> <li>Establish regular bedtime routines to help your children wind down.</li> <li>Keep bedrooms dark, cool and quiet.</li> <li>Avoid caffeine and sugary drinks in the afternoon and evening.</li> <li>Keep screens out of bedrooms including TVs, computers and mobile devices.</li> <li>Turn off screens at least one hour before bedtime.</li> <li>Ensure your children's bed is used only for sleeping, not for playing with toys, homework or watching TV.</li> </ul> <p>Finally, role modeling healthy sleep habits is an excellent way for your children to observe and learn. You can do this by reading a book or brushing your teeth with them, or practicing relaxation in the living room where they can see you before their bedtimes.</p> <p>If your children are having trouble sleeping, talk with a pediatrician, family medicine physician or mental health professional. They can work with you and your children to develop the best path to restore sleep and prevent further issues.</p> <p><em><a href="/providers/deirdre-paulson-phd" target="_self" title="Opens in same window.">Deirdre Paulson, Ph.D.</a>, is a psychologist in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Anxiety — generalized, social, obsessions and compulsions, panic, phobias</li> <li>Chronic pain</li> <li>Depression</li> <li>Exposure with response prevention</li> <li>Health behavior change</li> <li>LGBTQI+ affirming care</li> <li>Post-traumatic stress disorder (PTSD)</li> <li>Vocational, or job, psychology</li> </ul>Ph.D.<p>I provide behavioral and mental health services in a primary care setting to adults, including completing brief diagnostic assessments and engaging in brief therapy. I approach therapy from a cognitive-behavioral lens, meaning my patients and I examine the relationships between thoughts, emotions, behaviors and body responses. I also incorporate positive psychology into my work with patients, as everyone possess great strength, not just distress, that we can highlight, pull from and utilize in our work together.</p> <p>I believe that the patient is the expert on themselves and their distressing symptoms, whereas I am the expert on how to assess and treat those distressing symptoms. Thus, a collaborative relationship combining our expertise is essential. I also believe that transparency is key. Therefore, I take time to walk my patients through the "why" behind my recommendations, and answer any questions or concerns, all while respecting any boundaries my patients have. Additionally, culture and diversity are critical and will always be acknowledged and incorporated.</p> <p>When not at work, I like to spending time with my family. We enjoy going for walks, attending farmers markets, doing things outside, reading books and eating ice cream.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Psychology, University of Wisconsin-River Falls</li> <li>Master's degree, Counseling Psychology, The University of Southern Mississippi</li> <li>Doctorate, Counseling Psychology, The University of Southern Mississippi</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Doctoral Psychology, William. S. Middleton Memorial Veterans Hospital</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Integrated Primary Care Behavioral Health, University of Minnesota-Twin Cities</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Behavioral and Cognitive Psychology, American Board of Professional Psychology (ABPP)</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Paulson<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/deirdre-paulson-phd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=0CC5C3257D38380C4AB226239ABCE9AC" alt="Deirdre Paulson, Ph.D." width="280" height="280" DisableNVelocity="true" />{4819BBE9-33EE-46BC-9E5C-FDB19532D980}Deirdre<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21414831Deirdre Paulson, Ph.D.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}|{2B88C934-922C-4130-B661-197B59D83899}<img src="/-/media/national-files/images/hometown-health/2021/child-sleeping-in-bed.jpg?h=370&iar=0&w=660&sc_lang=en&hash=14DA5D4CA8C45E36D768E6523F52A677" alt="Child sleeping in bed" width="660" height="370" DisableNVelocity="true" />Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.SleepSleep is essential to good health. It's one of the body's basic needs. But, what do you do when you have troubles sleeping, or getting enough hours of sleep? Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Dawn Haller9/16/2021If you've been diagnosed with cancer, knowing what to expect can lower your stress level. Use these 11 suggestions to learn more about your diagnosis, and improve resilience and coping skills.11 tips for coping with a cancer diagnosis<p>Learning that you have cancer is a difficult experience. After your cancer diagnosis, you may feel anxious, afraid, angry or overwhelmed, and wonder how you can cope during the days ahead. This is normal and expected. Your diagnosis will likely be the focus of all your attention in the days and months to follow, and it will affect your daily routines and personal relationships.</p> <p>While each person's situation is different, there are common ways to approach a cancer diagnosis that can lower anxiety and improve your resilience and coping skills.</p> <h3>Here are 11 suggestions:</h3> <h4>1. Get the facts about your cancer diagnosis.</h4> <p>Information is power and no more so than after a cancer diagnosis. Gather as much basic, useful information about your cancer diagnosis as you need to make decisions about your care. Write down your questions and concerns for your health care team and bring the list with you to all appointments.</p> <h5>Consider asking:</h5> <ul> <li>What kind of cancer do I have?</li> <li>Where is the cancer?</li> <li>Has it spread?</li> <li>Can my cancer be treated?</li> <li>What is the chance that my cancer can be cured?</li> <li>What other tests or procedures do I need?</li> <li>What are my treatment options?</li> <li>How will the treatment benefit me?</li> <li>What can I expect during treatment?</li> <li>What are the side effects of the treatment?</li> <li>When should I call the doctor or my oncology provider?</li> <li>What can I do to prevent my cancer from recurring?</li> <li>How likely are my children or other family members to get cancer?</li> </ul> <p>Consider bringing a family member or friend with you to your first few appointments to help you remember what you hear. Ask that person to act as a scribe and write down the answers.</p> <p>You also might want to consider how much you want to know about your cancer. Some people want all the facts and details, so they can be very involved in the decision-making process. Others prefer to learn the basics and leave details and decisions to their health care providers. Think about which approach works best for you. Let your health care team know what you'd prefer.</p> <h4>2. Keep the lines of communication open.</h4> <p>Maintain honest, two-way communication with your loved ones, health care team and others after your cancer diagnosis. You may feel particularly isolated if people try to protect you from bad news or if you try to put up a strong front. If you and others express emotions honestly, you can all gain strength from each other.</p> <h4>3. Anticipate possible physical changes.</h4> <p>Now — after your cancer diagnosis and before you begin treatment — is the best time to plan for changes. Prepare yourself now so that you'll be better able to cope later.</p> <p>Ask your health care team what changes you should anticipate. If drugs will cause hair loss, gathering advice from image experts about makeup, wigs and head coverings may help you feel more comfortable and attractive. Insurance may help pay for wigs, prostheses and other adaptive devices.</p> <p>Members of cancer support groups may be particularly helpful in this area and can provide tips that have helped them and others.</p> <p>Also consider how treatment will affect your daily activities. Ask whether you can expect to continue your normal routine. You may need to spend time in the hospital or have frequent medical appointments. Arrange for a leave of absence from your normal duties if necessary.</p> <h4>4. Let friends and family help you.</h4> <p>Often friends and family are happy to run errands, provide transportation, prepare meals and help you with household chores. Learn to accept their help. Accepting help gives those who care about you a sense of contributing during a difficult time.</p> <p>Also encourage your family to accept help if it's needed. A cancer diagnosis affects the entire family and adds stress, especially to the primary caregivers. Accepting help with meals or chores from neighbors or friends can go a long way in preventing caregiver burnout.</p> <h4>5. Maintain a healthy lifestyle.</h4> <p>Maintaining a healthy lifestyle can improve your energy level. Choose a healthy diet consisting of a variety of foods and get adequate rest to help you manage the stress and fatigue of the cancer and its treatment.</p> <p>Exercise and participating in enjoyable activities also may help. Research suggests that people who maintain some physical exercise during treatment not only cope better, but also may live longer.</p> <h4>6. Review your goals and priorities.</h4> <p>Determine what's most important in your life. Find time for the activities that are valuable to you and give you the most meaning.</p> <p>If needed, try to find a new openness and honesty with loved ones. Share your thoughts and feelings with them. Cancer affects all your relationships. Candid communication can help lower anxiety and fear that cancer can cause.</p> <h4>7. Try to maintain your normal lifestyle.</h4> <p>Maintain your normal lifestyle, but be open to modifying it as necessary. Take one day at a time. It's easy to overlook this simple strategy during stressful times. When the future is uncertain, organizing and planning may suddenly seem overwhelming.</p> <h4>8. Consider how your diagnosis will affect your finances.</h4> <p>Many unexpected financial burdens can arise because of a cancer diagnosis. Your treatment may require time away from work or an extended time away from home. Consider the additional costs of medications, medical devices, traveling for treatment and parking fees at the hospital.</p> <p>Many clinics and hospitals keep lists of resources to help you financially during and after your cancer treatment. Talk with your health care team about your options.</p> <h5>Questions to ask include:</h5> <ul> <li>Will I have to take time away from work?</li> <li>Will my friends and family need to take time away from work to be with me?</li> <li>Will my insurance pay for these treatments?</li> <li>Will my insurance cover the cost of medications?</li> <li>How much will my out-of-pocket costs be?</li> <li>If insurance won't pay for my treatment, are there assistance programs that can help?</li> <li>Do I qualify for disability benefits?</li> </ul> <h4>9. Talk to other people with cancer.</h4> <p>Sometimes it will feel as if people who haven't experienced a cancer diagnosis can't fully understand how you're feeling. For many people, it is helpful to talk with others who have been in the same situation. Other cancer survivors can share their experiences and give insight into what you can expect during treatment.</p> <p>You may have a friend or family member who has had cancer or you can connect with other cancer survivors through support groups. Ask your health care team about support groups in your area or contact the American Cancer Society. Online message boards also bring cancer survivors together virtually. A good option is the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://csn.cancer.org/" target="_blank" title="Opens in a new window.">American Cancer Society's Cancer Survivors Network</a> or <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://connect.mayoclinic.org/" target="_blank" title="Opens in a new window.">Mayo Clinic Connect</a>.</p> <h4>10. Fight stigmas.</h4> <p>Unfortunately, some old stigmas associated with cancer still exist. Your friends may worry that your cancer is contagious. Co-workers may doubt you're healthy enough to do your job. Friends and acquaintances may withdraw for fear of saying the wrong thing, so ignore you or the situation completely. Many people will have questions and concerns.</p> <p>Determine how you'll deal with others' behaviors toward you. Most of the time, other people will take their cues from you. Remind friends that even if cancer has been a frightening part of your life, it shouldn't make them afraid to be around you.</p> <h4>11. Develop your own coping strategy</h4> <p>Just as each person's cancer treatment is individualized, so is the coping strategy. </p> <h5>Ideas to try include:</h5> <ul> <li>Practice relaxation techniques.</li> <li>Share your feelings honestly with family, friends, a spiritual adviser or a counselor.</li> <li>Keep a journal to help organize your thoughts.</li> <li>When faced with a difficult decision, list the pros and cons for each choice.</li> <li>Find a source of spiritual support.</li> <li>Set aside time to be alone.</li> <li>Remain involved with work and leisure activities as much as you can.</li> </ul> <p>What comforted you through rough times before your cancer diagnosis is likely to help ease your worries now, whether that's a close friend, religious leader or a favorite activity that recharges you. Turn to these comforts now, but also be open to trying new coping strategies.</p> <p><em>Sarah Lewis is a social worker and <a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">cancer guide</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2021/two-people-talking-looking-at-laptop.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B25F3176CE66B077EB61FA8F15B93D9E" alt="Two people talking looking at laptop" width="660" height="370" DisableNVelocity="true" />CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.Skin CancerSkin cancer — the abnormal growth of skin cells — most often develops on skin exposed to the sun. But this common form of cancer can also occur on areas of your skin not ordinarily exposed to sunlight.Lung CancerLung cancer is a type of cancer that begins in the lungs. It is the leading cause of cancer deaths in the U.S., among both men and women. Lung cancer claims more lives each year than do colon, prostate, ovarian and breast cancers combined. <br/><br/>Prostate HealthProstate cancer is the most common cancer diagnosed in men. You may have friends or family members who have been diagnosed with prostate cancer, and this may make you wonder about what you can do for prostate cancer prevention.Colorectal HealthGet screening and treatment for colorectal cancer symptoms, and learn about risk factors and prevention strategies.Dawn Haller9/30/2021Blood cancers remain a mystery. Here are answers to 9 common questions about one type of blood cancer called multiple myeloma.9 Q&A about multiple myeloma<p>Some types of cancer are well-known or understood by most people. It's easy to understand what areas of the body or organs are affected by breast, colon or lung cancers. However, blood cancers remain a mystery, are easily confused, or generate questions. One type of blood cancer is called multiple myeloma and let's clear up any confusion.</p> <h3>Here are answers to 9 common questions about this disease:</h3> <h4>1. What type of cancer is multiple myeloma?</h4> <p>Multiple myeloma is a cancer that forms in a type of white blood cell called a plasma cell. Healthy plasma cells help you fight infections by making antibodies that recognize and attack germs.</p> <h5>When healthy, your bone marrow grows blood cells, and each cell has a specific role:</h5> <ul> <li>Red blood cells deliver oxygen throughout the body.</li> <li>Platelets form blood clots to prevent bleeding.</li> <li>White blood cells help fight infection. Plasma cells are a type of white blood cell that produce protective antibodies.</li> </ul> <p>When people have multiple myeloma, cancerous plasma cells accumulate in the bone marrow and crowd out healthy blood cells. This is like weeds crowding out healthy plants in a garden. Rather than produce helpful antibodies, the cancer cells produce abnormal proteins that can cause complications.</p> <h4>2. How common is multiple myeloma?</h4> <p>Multiple myeloma is a relatively uncommon cancer, according to the American Cancer Society. In the U.S., the lifetime risk of being diagnosed with multiple myeloma is 1 in 132 or less than 0.75%. About 35,000 new cases will be diagnosed in 2021, with about 12,500 expected deaths.</p> <h4>3. What causes multiple myeloma?</h4> <p>It's not clear what causes multiple myeloma to develop. It's known that it begins with one abnormal plasma cell in your bone marrow, and the abnormal cell multiplies rapidly.</p> <p>Because cancer cells don't mature and then die as normal cells do, they accumulate, eventually overwhelming the production of healthy cells. In the bone marrow, myeloma cells crowd out healthy blood cells, leading to fatigue and an inability to fight infections.</p> <h5>Some factors that increase your risk of developing multiple myeloma include:</h5> <ul> <li><strong>Increasing age</strong><br /> Your risk of multiple myeloma increases as you age, with most people diagnosed in their mid-60s.</li> <li><strong>Being male</strong><br /> Men are more likely to develop the disease than women.</li> <li><strong>Black race</strong><br /> Black people are more likely to develop multiple myeloma than people of other races.</li> <li><strong>Family history of multiple myeloma</strong><br /> If a brother, sister or parent has multiple myeloma, you have an increased risk of the disease.</li> <li><strong>Personal history of a monoclonal gammopathy of undetermined significance</strong> <br /> Multiple myeloma almost always starts out as monoclonal gammopathy of undetermined significance, a benign condition marked by the presence an abnormal protein, known as monoclonal protein or M protein, in your blood. Therefore, having this condition increases your risk.</li> </ul> <h4>4. What are the symptoms of multiple myeloma?</h4> <p>Symptoms of multiple myeloma can vary and, early in the disease, there may be none.</p> <h5>Multiple myeloma reduces the amount of healthy blood cells in your body, which can lead to:</h5> <ul> <li>Fatigue</li> <li>Increased bleeding or bruising</li> <li>Bone pain</li> <li>Difficulty fighting infection</li> <li>Loss of appetite</li> <li>Unexplained weight loss</li> <li>Nausea</li> <li>Constipation</li> <li>Mental fogginess or confusion</li> </ul> <h4>5. What are the stages of multiple myeloma?</h4> <p>If tests indicate you have multiple myeloma, your health care provider will use the information gathered from the diagnostic tests to classify your disease as stage I, stage II or stage III. Stage I indicates a less aggressive disease, and stage III indicates the most aggressive disease.</p> <p>Your multiple myeloma also may be assigned a risk category, which indicates the aggressiveness of your disease.</p> <h4>6. Is there a cure for multiple myeloma?</h4> <p>Myeloma is not curable, but it is treatable. If you're experiencing symptoms, treatment can help relieve pain, control complications of the disease, stabilize your condition and slow the progress of multiple myeloma. A health care provider experienced in treating multiple myeloma will recommend a treatment plan based on your situation.</p> <h5>Some treatment options include:</h5> <ul> <li>Immunomodulatory drug therapy</li> <li>Antibody therapy</li> <li>Chemotherapy</li> <li>Radiation treatment</li> <li>Bone marrow or stem cell transplant</li> <li>Chimeric antigen receptor-T cell therapy</li> <li>Proteasome inhibitors</li> </ul> <p>If you have multiple myeloma but aren't experiencing any symptoms, you might not need treatment right away. This is also known as smoldering multiple myeloma. Also, immediate treatment may not be necessary for multiple myeloma that is slow-growing and at an early stage. However, your health care provider will regularly monitor your condition for signs that the disease is progressing.</p> <h4>7. Can multiple myeloma spread to other areas of the body?</h4> <p>Multiple myeloma can spread through the bloodstream to other areas of the body. This makes it more difficult to treat.</p> <h4>8. What's the difference between multiple myeloma, leukemia and lymphoma?</h4> <p>Multiple myeloma, leukemia and lymphoma are types of cancers that start in blood cells but affect different parts of the body. Generally, leukemia usually starts in the bone marrow, and affects blood and bone marrow, while lymphoma typically develops in and affects the lymphatic system. Multiple myeloma forms in a type of white blood cell called a plasma cell.</p> <h4>9. Are multiple myeloma and myeloma the same thing?</h4> <p>The terms multiple myeloma and myeloma are used interchangeably.</p> <p><em><a href="/providers/jonathan-ticku-md" target="_self" title="Opens in same window.">Jonathan Ticku, M.D.</a>, is an <a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">oncologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/tomah" target="_self" title="Opens in same window.">Tomah</a>, Wisconsin.</em></p><ul> <li>Thoracic oncology</li> </ul>M.D.<p><strong>Education </strong></p> <ul> <li>Kasturba Medical College of Manipal</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Orlando Regional Medical Center</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Hematology and Oncology, Orlando Regional Medical Center</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Internal Medicine, American Board of Internal Medicine</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Society of Clinical Oncology</li> </ul>Ticku<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/jonathan-ticku-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=DF6C40E2C95710CE6AA76FC8C092346E" alt="Jonathan Ticku, M.D." width="280" height="280" DisableNVelocity="true" />Jonathan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15997669Jonathan Ticku, M.D.1{0DD9D3C9-86C5-47FC-A2CF-8AEEA4717B70}|{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{BCFC3BDC-CF55-458E-A41C-9360527B6CCC}<img src="/-/media/national-files/images/hometown-health/2021/looking-at-poppy-garden.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F86EACE9F14C64B1A353508ED8491C1C" alt="Looking at poppy garden" width="660" height="370" DisableNVelocity="true" />CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Dawn Haller9/10/2021When you love milk, but it doesn't love you back, you may be lactose-intolerant. Take a closer look at this common condition, including causes, ways to minimize symptoms and how you still can eat well.A closer look at lactose intolerance<p>When you love milk, but it doesn't love you back, you may be lactose-intolerant. Lactose is the main carbohydrate, or sugar, found in dairy foods. It's a natural source of energy, but it requires a certain enzyme — lactase — to be digested.</p> <p>Most babies and children make enough lactase to enjoy dairy products without worry. Which is good, since dairy is an important source of calcium and protein for growing little ones. However, many adults lose the ability to produce lactase, causing lactose intolerance.</p> <p>It's also possible to become temporarily lactose-intolerant after a gastrointestinal illness.</p> <h2>When lactase is lacking</h2> <p>Without enough lactase in the small intestine, lactose isn't digested, which can lead to bloating and gas caused by bacteria in the large intestine breaking down the lactose. Some people experience abdominal cramping, nausea, diarrhea or even vomiting within 30 minutes to two hours after eating a food containing lactose.</p> <h2>Options for managing lactose intolerance</h2> <p>Dairy products or dairy alternatives are a convenient, versatile and delicious source of calcium. Three servings per day are recommended to meet the body's need for calcium.</p> <h3>Here are some options for getting enough calcium, while managing symptoms of lactose intolerance:</h3> <ul> <li>Eat only small only a small serving of a lactose-containing food. Avoid eating or drinking these foods on an empty stomach.</li> <li>Choose dairy products that tend to be naturally lower in lactose and better tolerated, including yogurt; ricotta cheese; cream cheese; and aged cheeses, such as Swiss, cheddar and Parmesan. Kefir, a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-minute-what-is-kefir/" target="_blank" title="Opens in a new window.">fermented milk drink</a> that contains beneficial probiotics, is another option.</li> <li>Try lactose-reduced, lactose-free or ultrafiltered cow's milk. Lactose-reduced cow's milk is widely available and may taste slightly sweeter than cow's milk because the lactose has been broken down into smaller carbohydrates. Lactose-free milk provides the same nutrition as regular milk, with 8 grams of protein, 25% of daily calcium and 90 calories per cup for skim milk. Ultrafiltered milks also may be lactose-free. This milk has less liquid and more solids, which makes it higher in protein and calcium than regular milk.</li> <li>Switch to a non-dairy "milk." Most of these products are fortified with calcium. However, they contain less protein than cow's milk. Soy milk is the closest in protein content, with 6–8 grams per cup. Most alternative milks, including almond, rice, cashew, coconut, oat and hemp, contain 0–3 grams of protein per cup. Some alternative milks have added protein. Be sure to choose unsweetened versions to avoid added sugar.</li> </ul> <h3>Whether you choose to use dairy or nondairy products, these recipes can help you meet your daily requirement of calcium — and eat well — while avoiding lactose:</h3> <h4>Carrot cake overnight oats</h4> <p>Serves 1</p> <p>½ cup rolled oats<br /> ⅔ cup skim milk<br /> ⅓ cup plain, nonfat Greek yogurt<br /> ¼ cup finely grated carrot<br /> 1½ teaspoons chia seeds<br /> 2 teaspoons maple syrup<br /> ½ teaspoon cinnamon<br /> ½ teaspoon vanilla extract<br /> 1 tablespoon pecans, chopped<br /> 1 tablespoon shredded coconut, unsweetened</p> <p>Mix all ingredients, except for the pecans and coconut, in a bowl or Mason jar. Top with pecans and coconuts, and cover with a lid. Refrigerate overnight and eat chilled.</p> <p>Nutrition information per serving: 395 calories, 12 grams fat, 3 grams saturated fat, 135 milligrams sodium, 55 grams carbohydrates, 9 grams fiber, 21 grams protein</p> <h4>Simple green smoothie</h4> <p>Serves 2</p> <p>2 cups fat-free kefir <br /> 2 cups frozen fruit<br /> 1 cup/handful fresh spinach or kale</p> <p>Place all ingredients in blender. Blend and serve.</p> <p>Nutrition per serving: 200 calories, 0 grams fat, 125 milligrams sodium, 30 grams carbohydrates, 4 grams fiber, 10 grams protein</p> <p><em><a href="/providers/romi-londre-rdn" target="_self" title="Opens in same window.">Romi Londre</a> is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Eating disorders</li> <li>Enteral nutrition or tube feedings</li> <li>Weight management</li> </ul>RDN, CD<p><strong>Education</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Registered Dietitian Nutritionist</li> <li>Certified Nutrition Support Clinician </li> <li>Certificate of Training in Adult Weight Management</li> </ul> <div> </div>Londre<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/romi-londre-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7919B2F8260054ECC4308684471EEEDB" alt="Romi Londre RDN" width="280" height="280" DisableNVelocity="true" />Romi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15183670Romi Londre, RDN, CD1{2BEE5070-65FF-4406-9E59-103E06C5A535}<img src="/-/media/national-files/images/hometown-health/2021/pouring-milk-into-fruit-cup.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E3E921002E3C5FC7B8B8AFF5990AA434" alt="At kitchen counter, pouring milk into cup with fruit" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller8/1/2024Almost 80% of adults say they have experienced back pain. Follow these steps to protect from further injury and ease your pain.Back pain basics and self-care tips<p>When it comes to back pain, there's good news and bad news.</p> <p>The good news is that back pain is rarely a sign of something serious and is often relatively short-lived. The bad news is that it's a common ailment for many adults. About 80% of adults experience pain in their back at some point in their lives.</p> <p>Nearly 90% of back pain cases are temporary, and people make a full functional recovery within 12 weeks of the onset of their symptoms.</p> <h2>What causes back pain?</h2> <h3>Some of the most common causes of back pain include:</h3> <h4>Arthritis</h4> <p>Lower back pain often is caused by osteoarthritis, or wear-and-tear arthritis, the most common type. Just as arthritis affects your knees, hips, wrists and shoulders, it also affects your spine. The spine has over 30 segments, each with four joints and discs, that can develop arthritis.</p> <p>The joints in your back can swell and become larger, similar to the symptoms of arthritis in the knuckles of the hand. This inflammation and enlargement can lead to a narrowing of the space around the spinal cord or nerve roots, a condition called spinal stenosis.</p> <p>Also, cartilage degenerates as you age, so bone-on-bone joint movement can cause pain with movement.</p> <h4>Bulging or ruptured disks</h4> <p>Disks are the cushioning between the bones in your spine that absorb impact, similar to the suspension on your car or a mountain bike. Disks can bulge or rupture and press on a nerve. Also, they can degenerate with time and lose the ability to provide cushion for average day-to-day impact, which can result in back pain.</p> <h4>Muscle or ligament strain</h4> <p>Repeatedly lifting heavy objects or twisting your back quickly can strain muscles and spinal ligaments. Carrying extra weight can strain your back, leading to pain.</p> <p>It's not always possible to pinpoint a reason for back pain. Back pain can sometimes be tracked to muscle strain from a fall or lifting something heavy. More commonly, people can't tie their pain to any specific activity or event.</p> <h2>When should you seek care for back pain?</h2> <p>Rarely, back pain may be a sign of something serious.</p> <h3>However, you should schedule an appointment with your healthcare team if you have pain that:</h3> <ul> <li>Accompanies unintended weight loss</li> <li>Arises with swelling, redness on your back and fevers, which could indicate an infection</li> <li>Causes weakness, numbness or tingling in one or both legs</li> <li>Follows a fall, blow to your back or another injury</li> <li>Happens during or after cancer treatment</li> <li>Is constant or intense, especially at night or when you lie down</li> <li>Occurs with new bowel or bladder control problems</li> <li>Spreads down one or both legs, especially if the pain extends below your knee</li> </ul> <h2>How can you find relief from back pain?</h2> <p>Although you may want to head to the couch when you're hurting, continued light activity and stretching can help in recovery.</p> <p>Doing regular activities and even light exercise is all right unless the activity worsens the pain. Recovering from an injury means a gradual increase in activity. Listen to your body and try to keep moving.</p> <p>Avoid actions that further stress your back, such as bending over to tie your shoes, twisting your entire body, bending from your waist or performing high-impact exercises.</p> <p>Rest, applying heat to the affected areas and over-the-counter pain medications, such as ibuprofen, naproxen or acetaminophen, might be enough to ease the pain. If your pain isn't better after several weeks, you may need to see your healthcare professional for an evaluation.</p> <h2>How can back pain be prevented?</h2> <p>The best way to avoid back pain is to prevent it by taking good care of your back.</p> <h3>Recommended activities include:</h3> <ul> <li><strong>Exercise.</strong><br /> Walking, swimming and other low-impact aerobic activities can strengthen your back.</li> <li><strong>Build muscle strength and flexibility.</strong><br /> Stretching your back and strengthening your back and core muscles can support and protect your back. Plank holds and push-ups are good ways to help build your core.</li> <li><strong>Sit, stand and lift correctly.</strong><br /> Avoid slouching and standing or sitting in one position for too long. When you need to lift something heavy, lift from your legs, not your back.</li> <li><strong>Maintain a healthy weight.</strong><br /> Carrying extra pounds strains back muscles.</li> <li><strong>If you smoke, quit.</strong><br /> Smoking reduces blood flow through the smaller blood vessels throughout your body and can reduce your body's ability to heal injuries.</li> </ul> <h2>Next steps</h2> <ul> <li>Find a <a href="https://www.mayoclinichealthsystem.org/providers?service=Spine%20Care" target="_self" title="Opens in same window.">spine care specialist near you</a>.</li> <li>Download an infographic with <a href="/-/media/national-files/documents/hometown-health/2019/back-pain-infographic.pdf?sc_lang=en&hash=849E7B9C9132C1BF1B61BD7528C25FEA" target="_blank" title="Opens in a new window.">tips for managing back pain</a>.</li> <li>Read <a href="/hometown-health/speaking-of-health/what-is-spinal-fusion-and-does-it-work" target="_self" title="Opens in same window.">eight common myths about back pain</a>.</li> <li>Watch a video about the common complaint of back pain:<br /> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/cIJtVeu-at8" title="common complaint of back pain" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> </li> </ul> <p><a href="/providers/meghan-murphy-md" target="_self" title="Opens in same window."><em>Meghan E. Murphy, M.D.</em></a><em>, is a neurosurgeon in <a href="/services-and-treatments/spine-care" target="_self" title="Opens in same window.">Spine Care</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Degenerative diseases of the spine (stenosis, spondylolisthesis, scoliosis, radiculopathy)</li> <li>Education of medical students and advanced practice providers (physician assistants and nurse practitioners)</li> <li>Mentorship of women pursuing the medical field and surgical specialties</li> <li>Metastatic disease of the brain and spine</li> <li>Spinal tumors</li> <li>Traumatic brain and spine injuries</li> </ul>M.D.<p>Medicine is my vocation. I feel that I have been called to serve others by helping address spinal and brain pathology that is impacting quality of life and potentially quantity of life. It is a joy to play a role in empowering my patients to achieve the quality of life they desire. </p> <p>You can expect my full attention and dedication to your symptoms and concerns at the time of our consultation. I will be honest in discussion of what I can or cannot offer you. If I am unable to recommend surgery that will benefit you — with benefits outweighing the risks — I will help ascertain the best next step and connect you with those resources. </p> <p>I grew up in Colorado and completed my education and subsequent training at Notre Dame, Georgetown, and Mayo Clinic.</p> <p> Family and faith are important to me. I have a wonderful husband with whom I have two young boys — being a boy mom definitely suits me. I also have a goofy golden retriever, and we all love to be outside and active. </p><p><strong>Education</strong></p> <ul> <li>Georgetown University School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Neurologic Surgery, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Neurologic Surgery, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Neurosurgery Spine Enfolded, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Neurological Surgery, American Board of Neurological Surgery</li> </ul> <p><strong>Membership</strong></p> <ul> <li>Alpha Omega Alpha Medical Honor Society</li> <li>Congress of Neurological Surgeons</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Neurosurgery, Mayo Clinic College of Medicine and Science</li> </ul>Murphy<img src="/-/media/shared-files/images/medical-professionals/full/mankato/meghan-murphy-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=488A8D1221A32E0ADEE87A1875CC8219" alt="Meghan Murphy MD" width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=28486638" target="_blank" title="Opens in new window.">Predictors of Discharge to a Nonhome Facility in Patients Undergoing Lumbar Decompression Without Fusion for Degenerative Spine Disease</a>, October 2017.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=27858534" target="_blank" title="Opens in new window.">Lumbar decompression in the elderly: increased age as a risk factor for complications and nonhome discharge</a>, March 2017.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=27908218" target="_blank" title="Opens in new window.">Risk factors for dural tears: a study of elective spine surgery</a>, February 2017.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=27866034" target="_blank" title="Opens in new window.">Micro vs. macrodiscectomy: Does use of the microscope reduce complication rates?</a>, January 2017.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=26838173" target="_blank" title="Opens in new window.">Unique cause of right hemispheric syndrome: Embolism of myocardium after open septal myectomy</a>, April 2016.</li> </ul>{65C398B7-CDF4-4A31-BA46-251A97B286EA}Meghan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15411991Meghan Murphy, M.D.1{4EA2A40E-3721-48EC-AFC9-E6D0E13BCDEC}<img src="/-/media/national-files/images/hometown-health/2021/stretching-while-sitting-on-yoga-mat.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D8F85E42736291E5831E8F2E43927369" alt="Stretching while sitting on yoga mat" width="660" height="370" DisableNVelocity="true" />Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.NeurosurgeryNeurosurgery treats disorders that impact any part of the nervous system, which may include the brain, spine or peripheral nerves. Conditions treated range from life-threatening brain tumors, to disorders impacting quality of life, such as back pain and carpel tunnel syndrome.Pain ReliefApproximately 50 million people in the U.S. live with chronic pain. If you experience chronic pain, you're not alone. Learn about the ways to deal with painful disorders, from at-home solutions to drug treatments, injectable or implantable therapies to surgery.Dawn Haller2/28/2024More than 40% of adults are unfamiliar with the dangers of sepsis, which occurs as a result of infection. Use this tool to recognize the signs and symptoms, and get immediate care.Consider T.I.M.E. when dealing with sepsis<p>Nearly 270,000 people in the U.S. die annually because of sepsis — more than the number of people who die from prostate cancer, breast cancer and AIDS combined. Yet more than 40% of adults are unfamiliar with the danger of sepsis.</p> <h2>What is sepsis?</h2> <p>Sepsis occurs from an infection and can quickly become life-threatening. When your body has an infection, the natural response is for the immune system to fight the infection. If the body creates too much of a response to the infection, inflammation can develop, triggering sepsis.</p> <p>Any type of infection that occurs anywhere in the body can lead to sepsis.</p> <h3><span style="font-size: 16px; color: #333333;">Infections that lead to sepsis most commonly occur in these parts of the body:</span></h3> <ul> <li><a href="/hometown-health/speaking-of-health/listen-to-your-bladder" target="_self" title="Opens in same window.">Bladder</a> and urinary tract</li> <li>Gallbladder and biliary  tract, which includes organs and ducts that make and store bile</li> <li>Lungs</li> <li>Skin</li> <li>Soft tissues like fat or muscles</li> </ul> <h2>Who is at risk of developing sepsis?</h2> <p>There is a myth that only people who have been hospitalized are at risk of developing sepsis. In fact, 87% of cases originate outside of the hospital setting. Another myth is that sepsis is rare and only affects people with preexisting conditions.</p> <h3>Anyone can develop sepsis, but at higher risk are:</h3> <ul> <li>Adults 65 or older</li> <li>Children under 12 months</li> <li>People with weakened immune systems</li> <li>People with chronic medical conditions, such as diabetes, lung disease, cancer and <a href="/hometown-health/speaking-of-health/5-nutrition-tips-for-chronic-kidney-disease" target="_self" title="Opens in same window.">kidney disease</a></li> <li>People who have had a recent hospitalization</li> <li>People who previously have had sepsis</li> </ul> <h2>What are the symptoms of sepsis?</h2> <h3>The acronym T.I.M.E. is a helpful tool for recognizing and remembering the signs and symptoms of sepsis:</h3> <ul> <li><strong>T: temperature</strong> — higher or lower than normal</li> <li><strong>I: Infection</strong> — signs and symptoms of an infection</li> <li><strong>M: Mental decline</strong> — sleepy, difficult to rouse, confused</li> <li><strong>E: Extremely ill</strong> — severe pain, discomfort, shortness of breath</li> </ul> <p>Suspected sepsis should be handled as an emergency by calling 911 and going to a hospital, like you would do with a suspected <a href="/hometown-health/speaking-of-health/what-should-i-do-if-i-might-be-having-a-heart-attack" target="_self" title="Opens in same window.">heart attack</a> or stroke. <a href="/services-and-treatments/nephrology" target="_self" title="Opens in same window.">Urgent response</a> and rapid, aggressive treatment increase the rate of survival.</p> <h3>Diagnosing sepsis</h3> <p>Symptoms of early sepsis can appear similar to other conditions and survival depends on pinpointing the source of infection. Blood and urine tests and imaging scans may be used to help identify the type and location of infection.</p> <p>People at risk of sepsis or who previously have had sepsis should be proactive in talking with their healthcare team about the possibility of sepsis when they are feeling ill.</p> <h2>How is sepsis treated?</h2> <p>Treating sepsis as early as possible is crucial to prevent it from worsening. Determining where the infection is and eliminating it is vital to keeping sepsis from progressing to severe sepsis or septic shock. Even with treatment, sepsis can progress to severe sepsis or septic shock causing organ damage.</p> <h3>Close monitoring and treatment for sepsis takes place in the hospital setting, typically with a combination of:</h3> <ul> <li>Antibiotics</li> <li>Intravenous fluids</li> <li>Other medications, which may include vasopressors, corticosteroids or pain relievers</li> <li>Supportive therapy, such as oxygen, kidney dialysis or mechanical ventilation</li> <li>Surgery, which may be needed to drain or remove the infection</li> </ul> <p>Many people who recover from sepsis return to the same level of activity they had before their bout with sepsis. Some people, especially those with weakened immune systems or chronic illnesses, may experience long-term effects.</p> <h2>How can sepsis risk be reduced?</h2> <p>Talk with your primary care provider to determine if you're at increased risk of developing sepsis.</p> <h3>Take these steps to reduce your risk:</h3> <ul> <li><strong>Prevent infections.</strong> <br /> If you have chronic conditions, follow your healthcare provider’s directions to manage the conditions. Get recommended vaccines.</li> <li><strong>Practice good hygiene.</strong><br /> <a href="/hometown-health/speaking-of-health/5-ws-of-healthy-hands" target="_self" title="Opens in same window.">Wash your hands</a> regularly with soap and water or an alcohol-based hand sanitizer. Clean and cover cuts until they're entirely healed.</li> <li><strong>Know the signs and symptoms.</strong> <br /> Temperature, infection, mental decline and an extremely ill feeling — T.I.M.E.—  are reasons to suspect sepsis and get help fast.</li> </ul> <p><a href="/providers/melissa-myers-md" target="_self" title="Opens in same window."><em>Melissa Myers, M.D.</em></a><em>, is a critical care specialist in <a href="/services-and-treatments/intensive-and-critical-care" target="_self" title="Opens in same window.">Intensive Care</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Community service</li> <li>Medical education</li> <li>Quality improvement and patient safety</li> <li>Sepsis</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Michigan State University College of Human Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Critical Care, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Critical Care Medicine, American Board of Internal Medicine</li> <li>Internal Medicine, American Board of Internal Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Alpha Omega Alpha Honor Medical Society</li> <li>American College of Chest Physicians</li> <li>Association of Physician Leadership in Care Management</li> <li>Society of Critical Care Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Myers<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/melissa-myers-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=579032569F6D7A292E9DE38883EB8C2F" alt="Melissa Myers MD" width="280" height="280" DisableNVelocity="true" />Melissa<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16088158Melissa Myers MD1<img src="/-/media/national-files/images/hometown-health/2021/container-gardening-with-succulents.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D9C23E40259FA3AFD155206CBA5CE08A" alt="Container gardening with succulents" width="660" height="370" DisableNVelocity="true" />Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Dawn Haller9/3/2021During the COVID-19 pandemic, national alcohol sales have increased more than 50%. Learn about the serious effects alcohol has on your well-being and body.What effect does alcohol have on your health — and your liver?<p>During the COVID-19 pandemic, national alcohol sales have increased 54%. A national survey in the September 2020 issue of JAMA revealed that people 18 and older were consuming alcohol more often. Another 2020 survey reported that people experiencing stress related to COVID-19 were drinking more alcohol and consuming it more often.</p> <p>While the pandemic has increased alcohol use, this isn't a new concern. Alcohol use disorders are among the most common substance use disorders worldwide.</p> <p>The <a rel="noopener noreferrer" href="https://www.samhsa.gov/data/release/2019-national-survey-drug-use-and-health-nsduh-releases" target="_blank" title="Opens in a new window.">2019 National Survey on Drug Use and Health</a> reveals that in the U.S.:</p> <ul> <li>Nearly 15 million people 12 and older had alcohol use disorder.</li> <li>Of people 18 and up, 85.6% reported they consumed alcohol at some point in their life.</li> <li>In adults, 25.8% reported binge drinking and 6.3% reported heavy alcohol use in the past month.</li> <li>For those 12 to 20, 7 million people, or 18.5% of this age group, reported drinking alcohol in the past month.</li> </ul> <h4>Effect on overall health, well-being</h4> <p>Consuming alcohol can significantly affect your health, as well as your overall well-being and safety. Alcohol is the third-leading preventable cause of death in the U.S., with 95,000 people dying each year from alcohol-related causes.</p> <h5>Between 2011 and 2015, the leading causes of death due to alcohol-related chronic conditions were:</h5> <ul> <li>Liver disease, including cirrhosis and cancer</li> <li>Heart disease, abnormal heart rhythms, hypertension and stroke</li> <li>Oral and upper digestive tract cancers</li> <li>Breast cancer</li> <li>Alcohol use disorder</li> </ul> <p>Long term, alcohol use can increase the risk of developing certain cancers, including colon, liver, esophagus, mouth and breast. Also, drinking alcohol doesn't protect from COVID-19 infection, since alcohol weakens the immune system and makes it difficult for the body to fight infections.</p> <p>Alcohol's affect extends beyond illness. People who consume alcohol at twice the binge drinking threshold ― that's five or more drinks for men and four or more for women in about two hours ― are 70 times more likely to have an alcohol-related emergency department visit. Alcohol-impaired driving fatalities accounted for one-third of all driving fatalities in 2019. The consequences of underage drinking include unintentional injuries; sexual assaults; alcohol overdose; and deaths, including motor vehicle crashes.</p> <h4>Effect on your liver</h4> <h5>Excessive alcohol consumption can significantly affect the liver and contribute to three types of liver disease:</h5> <ul> <li>Excessive buildup of fat in the liver, also known as fatty liver or hepatic steatosis</li> <li>Inflammation of the liver or alcoholic hepatitis</li> <li>Replacement of normal liver tissue by scared tissue or alcohol-related cirrhosis</li> </ul> <h4>Fatty liver</h4> <p>Almost all heavy drinkers develop fatty liver, which is the earliest stage of alcohol-related liver disease. Most people with fatty liver don't have symptoms, although they can have an enlarged liver or mild discomfort in the upper right side of the abdomen. This is a preventable disease, and it's reversible if treated early. The best treatment is for the patient to stop drinking.</p> <h4>Alcoholic hepatitis</h4> <p>About one-third of heavy drinkers develop alcoholic hepatitis, where the liver become inflamed and swollen, and liver cells are destroyed. This hepatitis varies in severity from mild to severe, and patients may have jaundice, fever, nausea and vomiting, and abdominal pain. The mild form can last for years and lead to more liver damage, unless the patient stops drinking. Severe alcoholic hepatitis occurs suddenly, usually after binge drinking, and it can be life-threatening. The only way to possibly prevent this hepatitis from worsening and improving life expectancy is to stop drinking.</p> <h4>Cirrhosis</h4> <p>Of heavy drinkers, 10%–20% develop cirrhosis, a serious condition that usually develops after 10 or more years of drinking. Because scar tissue builds up and replaces most of the liver cells, it's irreversible. While patients with early cirrhosis may not have any symptoms, this condition tends to progress and significantly damage the liver before it's detected.</p> <h5>Over time, patients develop:</h5> <ul> <li>Fatigue, weakness and muscle wasting</li> <li>Increased pressure in the liver</li> <li>Accumulation of fluids in the abdomen and legs</li> <li>Bleeding from veins of the esophagus</li> <li>Confusion, decreased concentration and changes in behavior</li> <li>Enlarged spleen</li> </ul> <p>Cirrhosis can lead to fatal liver failure or liver cancer. At this point, some patients may benefit from a liver transplant if they meet certain criteria. Complete abstinence from alcohol use is important.</p> <h4>Is there a safe level of drinking?</h4> <p>While moderation is key, it's a good idea for patients to review their alcohol use with their health care provider. How people react to the adverse effects of alcohol varies depending on age, gender, genetic background and other medical issues. Women tend to develop liver disease faster than men, despite consuming the same amount of alcohol over the same length of time.</p> <p>Beer and wine are not safer than spirits. Alcohol is alcohol, regardless of the type. One standard drink is equivalent to 12 ounces of beer, five ounces of wine or 1.5 ounces of spirits. All have the same amount of alcohol.</p> <h5>For patients without liver disease:</h5> <ul> <li>Moderate drinking is two drinks per day for men and one per day for women.</li> <li>Higher-risk drinking is three or more drinks per day for men and two or more drinks for women.</li> <li>Binge drinking is defined as consumption of five or more drinks within two hours for males or at least four drinks for women.</li> </ul> <p>If you're concerned about the effects of alcohol use on your health, contact your health care provider for help. Your provider also may refer you to a liver clinic, such as the one at Mayo Clinic Health System in Mankato or Mayo Clinic in Rochester, Minnesota, for further evaluation and management of alcohol-related liver disease.</p> <p><em>Omar Mousa, M.B.B.S., M.D., practices <a href="/services-and-treatments/gastroenterology-and-hepatology" target="_self" title="Opens in same window.">gastroenterology and hepatology</a> (digestive and liver care) in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota. He is affiliated with the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/liver-transplant/about/pac-20384842" target="_blank" title="Opens in a new window.">Liver Transplant Program at Mayo Clinic in Rochester</a>.</em></p><img src="/-/media/national-files/images/hometown-health/2021/holding-wine-glass-looking-out-window.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7A836D5137BF17AEC1F57F0704AA9E48" alt="Person holding wine glass, looking out window, large earrings, hair up" width="660" height="370" DisableNVelocity="true" />Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Substance AbuseInformation for helping those with alcohol and other drug abuse concerns.Dawn Haller9/28/2021Stress and lifestyle factors can lead to heartburn — a burning sensation or pain caused by acid reflux. Simple lifestyle modifications and medication can take the burn out of heartburn.Heartburn: What to do when the burn becomes a burden<p>A large meal followed by a nap, a spicy new recipe, or wearing tight-fitting clothing may cause infrequent heartburn, or the sensation of acid coming up into the throat, for some people. But when the burning pain happens frequently or disrupts normal activities, it's time to talk to your health care provider about heartburn.</p> <h4>Heartburn cause</h4> <p>A burning sensation, or pain or discomfort behind your breastbone, is known as heartburn. When stomach acid backs up into the esophagus, the tube that carries food from your mouth to your stomach, heartburn occurs.</p> <p>Normally, when you swallow, a band of muscle around the bottom part of the esophagus relaxes to allow food and liquid to move into the stomach. After eating or drinking, the muscle tightens again. If the muscles weaken or relax abnormally, stomach acid can flow back up into the esophagus, known as acid reflux, and cause heartburn.</p> <p>Some medications or conditions, such as central obesity, which is an excess accumulation of fat in the abdominal area, may affect the way the muscle tightens and allow for more acid to flow up into the esophagus.</p> <p>The lining of the esophagus is sensitive to acid because is not protected like the lining in the stomach. Typically, people who experience heartburn are affected when the acid from the stomach goes where it should not be or is not cleared from the food pipe in a timely manner.</p> <p>Symptoms also can develop if the protective mechanism of the lining of the gut is weakened, which may happen from use of over-the-counter medications such as nonsteroidal anti-inflammatory drugs like aspirin or ibuprofen.</p> <h4>Heartburn symptoms</h4> <p>Heartburn symptoms, such as a burning pain in the chest, usually occurs after eating or at night. You may notice pain increases when lying down or bending over.</p> <h5>People can experience different types of symptoms related to heartburn, including:</h5> <ul> <li><strong>Epigastric pain</strong><br> This is a burning sensation directly under the ribcage.</li> <li><strong>Globus sensation</strong><br> This is a feeling of a lump or fullness in the throat, dry cough or clearing the throat repeatedly.</li> <li><strong>Water brash</strong><br> This is hyper-salivation, or excess amount of saliva, which can cause halitosis, or bad breath, and increase risk of cavities.</li> <li><strong>Difficulty swallowing</strong><br> This could be caused by acid exposure over a prolonged time period.</li> </ul> <p>If heartburn and acid reflux happen more two or more times per week, and it interferes with daily activities, it is typically considered to be gastroesophageal reflux disease, or <a href="/hometown-health/speaking-of-health/take-the-burn-out-of-gerd" target="_self" title="Opens in same window.">GERD</a>. Your health care provider can diagnose GERD by evaluating symptoms or performing tests.</p> <h4>Heartburn treatment</h4> <p>Just as people experience different symptoms of heartburn, different treatment options can relieve symptoms.</p> <h5>Over-the-counter medications can relieve heartburn symptoms. Consider these types of medications:</h5> <ul> <li><strong>Antacids</strong><br> These medications provide quick relief to neutralize stomach acid, but they cannot heal an inflamed esophagus. Examples include Milk of Magnesia, Mylanta and Rolaids.</li> <li><strong>H-2-receptor antagonists, or H2RAs</strong><br> These types of medications do not act as quickly as antacids, but they may provide longer relief. Examples include famotidine (Pepcid), Tagamet and ranitidine (Zantac).</li> <li><strong>Proton pump inhibitors, or PPIs</strong><br> These medications can reduce stomach acid for up to 24 hours. Examples include lansoprazole (Prevacid 24HR) and omeprazole (Prilosec OTC).</li> </ul> <p>If over-the-counter treatments do not work or are needed continually, it is important to see your health care provider. Prescriptions or other treatment options may be an option.</p> <h5>Lifestyle modifications also can relieve heartburn symptoms. Consider these lifestyle modifications:</h5> <ul> <li><strong>Maintain a healthy weight.</strong> <br> Excess weight puts pressure on your abdomen, pushing up your stomach and causing acid to back up into the esophagus.</li> <li><strong>Avoid tight-fitting clothing.</strong><br> This can put pressure on your abdomen and muscle around the bottom of the esophagus.</li> <li><strong>Avoid laying down after a meal.</strong> <br> Wait at least three hours after a meal to lie down.</li> <li><strong>Avoid a late meal.</strong> <br> Plan the timing of meals to allow two to four hours before going to bed.</li> <li><strong>Eat smaller meals more frequently.</strong> <br> Avoid eating large meals that cause the stomach to expand.</li> <li><strong>Elevate the head of your bed.</strong> <br> If you experience heartburn at night or while sleeping raise the head of your bed 4 to 6 inches. This can be done by putting blocks under the legs at the head of the bed or by inserting a wedge between the mattress and box spring to elevate your body above the waist. Adding more pillows usually isn't effective as it can increase pressure on the stomach.</li> <li><strong>Avoid smoking.</strong><br> Try not to be around tobacco smoke.</li> <li><strong>Limit alcohol consumption.</strong><br> Drinking alcohol can irritate the esophagus and stomach.</li> <li><strong>Avoid nonsteroidal anti-inflammatory drugs.</strong><br> Avoid these medications unless recommended by your health care provider. Examples include aspirin, ibuprofen or naproxen.</li> <li><strong>Avoid foods that trigger heartburn.</strong> <br> Foods that trigger your heartburn may be different than others. Keep a journal to note what foods cause an increase in symptoms. Foods that are known to cause symptoms include spearmint, peppermint, tomatoes and tomato-based products, citrus fruits, caffeine, carbonated drinks, high fat foods, and spicy foods.</li> </ul> <p>Heartburn and acid reflux can affect people of all ages due to stress, lifestyle and other factors. When symptoms of heartburn become a burden, talk with your health care provider about the best way to control your symptoms.</p> <p><em>Harika Balagoni, M.B.B.S., specializes in <a href="/services-and-treatments/gastroenterology-and-hepatology" target="_self" title="Opens in same window.">gastroenterology and hepatology</a>, including digestive care, in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em> </p><img src="/-/media/national-files/images/hometown-health/2021/mixing-bowl-of-veggies-on-table.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CCC827F828089CC84D7B6AD4A6939BFE" alt="Mixing bowl of veggies on table" width="660" height="370" DisableNVelocity="true" />Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Dawn Haller9/1/2021Healthy eyes and vision are a critical part of your child's development. Regular eye screenings and exams can detect many vision problems early. Find out what to look for.Hidden signs of vision problems in children<p>Sometimes parents can tell if their child has a vision problem. The child may squint, hold reading material closely, experience headaches or complain about things appearing blurry. However, there are some less obvious signs of possible vision problems.</p> <h2>Here are four signs your child may have a vision problem:</h2> <h3>1. Your child has a short attention span.</h3> <p>Does your child quickly lose interest in games, projects or other lengthy activities? These types of activities require clear vision and can be difficult if your child has a vision problem.</p> <h3>2. Your child losing his or her place when reading.</h3> <p>Does your child have difficulty keeping track of the words when reading? Multiple vision issues could cause this, including a <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/lazy-eye/symptoms-causes/syc-20352391" target="_blank" title="Opens in a new window.">lazy eye</a>.</p> <h3>3. Your child avoids reading and other close activities.</h3> <p>Does your child avoid drawing, reading, playing games or taking part in other projects that require up-close focus? Your child may not be aware that the difficulty and frustration are related to vision.</p> <h3>4. Your child turns his or her head to the side.</h3> <p>When something is in front of your child, does your child turn his or her head to the side to see it better? This may be a sign of a refractive error, such as <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/nearsightedness/symptoms-causes/syc-20375556" target="_blank" title="Opens in a new window.">nearsightedness, or myopia</a>; <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/farsightedness/symptoms-causes/syc-20372495" target="_blank" title="Opens in a new window.">farsightedness, or hyperopia</a>; <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/astigmatism/symptoms-causes/syc-20353835" target="_blank" title="Opens in a new window.">astigmatism</a>; or a slight eye misalignment.</p> <h2>Why regular eye examinations are important</h2> <p>If your child feels tired and has trouble concentrating and learning, it could be due to a vision problem. Your child's success in school is closely tied to eye health and clear, comfortable vision. School requires intense visual involvement, regardless if in the classroom or learning from home. Physical education and sports also demand strong vision.</p> <p>Regular eye examinations are an important part of a child's overall health. An optometrist or ophthalmologist can find and treat vision problems early. The earlier your child is treated, the better off your child will be ― in and out of school.</p> <p><em><a href="/providers/misty-watters-od" target="_self" title="Opens in same window.">Misty Watters, O.D.</a>, is an <a href="/services-and-treatments/ophthalmology" target="_self" title="Opens in same window.">optometrist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a> and <a href="/locations/sparta" target="_self" title="Opens in same window.">Sparta</a>, Wisconsin.</em></p>O.D.<p><strong>Education</strong></p> <ul> <li>University of Missouri College of Optometry</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Optometric Association</li> <li>Gateway Optometric Association</li> <li>Wisconsin Optometric Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Ophthalmology, Mayo Clinic College of Medicine and Science</li> </ul>Watters<img src="/-/media/shared-files/images/medical-professionals/full/sparta/misty-watters-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=F6B14CF4C9D6C052C21C1ADEAEA7A1A9" alt="Misty Watters DO" width="280" height="280" DisableNVelocity="true" />Misty<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15903061Misty Watters, O.D.1<img src="/-/media/national-files/images/hometown-health/2021/child-holding-pencil.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7C864B1CB624D83B7C3BC3F325D418AA" alt="Child holding pencil, resting head on hand, curly hair" width="660" height="370" DisableNVelocity="true" />Eye HealthYour eyes are responsible for providing you with vision, perhaps the most important of the senses. However, the eye is a delicate and complicated structure that needs protection. The ugly truth is that eye injuries can happen at any time and place.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller9/21/2021Did you know that HPV infection increases risk of throat and mouth cancer? Learn about prevention, symptoms and treatment options.Connection between HPV infection and mouth, throat cancer<p>You may have heard about the connection between HPV infection and certain types of cervical cancer, but did you know there also is connection between HPV infection and a higher risk of throat and mouth cancer, as well?</p> <p>The Centers for Disease Control and Prevention (CDC) recommends that children 11–12 should be vaccinated for HPV before they are exposed to the virus.</p> <h4>What is HPV?</h4> <p>HPV is a viral infection that commonly causes skin growths or warts. It's the most common sexually transmitted infection in the U.S., with over 79 million infected. While it affects men and women, men are twice as likely to be diagnosed with oropharyngeal cancer.</p> <p>HPV infection occurs when the virus enters your body, usually through a cut, abrasion or small tear in your skin. The virus is transmitted sexually or through skin-to-skin contact. There are more than 100 types of HPV. In most cases, your body's immune system defeats an HPV infection before it creates warts, so it is easy to have HPV but not realize it.</p> <h4>Cancer connection</h4> <p>Some types of HPV infection cause warts, while some can cause different types of cancer. For example, nearly all cervical cancers are caused by HPV infection, and this is the most well-known connection. HPV can cause throat and mouth cancers, as well, which tend to be less aggressive than cancers in these areas that are unrelated to HPV.</p> <p>An HPV infection can infect the mouth and throat, and cause cancer of the oropharynx, which includes the back of the throat, base of the tongue and tonsils. About 54,000 adults in the U.S. are diagnosed with oral or oropharyngeal cancer each year.</p> <p>Men are twice as likely to be diagnosed oropharyngeal cancer, primarily due to common habits that increase their cancer risks, like tobacco use, excessive alcohol use and poor diet. Also, men are more likely to be exposed to toxic substances at work, which increases their risks.</p> <h4>Nonspecific symptoms</h4> <p>A challenge of diagnosing throat and mouth cancer is that many symptoms are common to other diseases or conditions, and not specific to the cancer. This includes a sore that won't heal, cough, sore throat, ear pain, difficulty swallowing or voice hoarseness. It is easy to believe that these symptoms are due to a common cold, seasonal allergies or an overzealous celebration.</p> <h4>HPV treatment options</h4> <p>Treatment options for oropharyngeal cancer vary, and they are based on many factors, such as the location and stage of your throat cancer, the type of cells involved, whether the cells show signs of HPV infection, your overall health, and your personal preferences. Your care team will discuss the benefits and risks of each option and work with you to determine the best plan for your case and goals.</p> <h5>Treatments can include:</h5> <ul> <li>Radiation therapy</li> <li>Surgery to remove cancer that has not spread to other areas</li> <li>Surgery to remove part of your throat, voice box or lymph nodes</li> <li>Chemotherapy</li> <li>Drug therapy</li> <li>Immunotherapy</li> </ul> <h4>Preventing throat, mouth cancers</h4> <h5>While there is no proven way to prevent throat and mouth cancers from occurring, you can take these steps to lower your risk:</h5> <ul> <li><strong>Get vaccinated for HPV.</strong> <br /> The CDC found that an estimated 92% of cancers caused by HPV could be prevented by vaccination. The CDC now recommends that all 11- and 12-year-olds receive two doses of HPV vaccine at least six months apart. Teens and young adults up to age 26 also can be vaccinated. Some adults ages 27 through 45 years may decide to get the HPV vaccine based on discussion with their health care providers. If you are unable to get vaccinated for HPV, you can lower your risk of HPV infection by limiting your number of sexual partners and using a condom or dental dam every time you have sex.</li> <li><strong>Don't smoke or use tobacco.</strong> <br /> If you smoke or use smokeless tobacco, quit. It can be difficult to stop, so talk with your health care team about smoking cessation strategies, such as medication, counseling and nicotine replacement products.</li> <li><strong>Drink alcohol in moderation, if at all.</strong><br /> If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink per day for women and up to two drinks per day for men.</li> <li><strong>Eat a diet full of fruits and vegetables.</strong> <br /> The vitamins and antioxidants in fruits and vegetables may reduce your risk of throat cancer. Eat a variety of colorful fruits and vegetables.</li> <li><strong>Use a respirator if around hazardous chemicals.</strong> <br /> Lower your exposure to chemicals by using a respirator and other personal protective equipment approved by the Occupational Safety and Health Administration.</li> </ul> <p>You should visit your health care provider if you notice any common respiratory symptoms that persist, such as cough, sore throat or swollen neck glands that won't go away.</p> <p><em><a href="/providers/gregory-jones-md" target="_self" title="Opens in same window.">Gregory Jones, M.D.</a>, is an <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">ear, nose and throat specialist</a> in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em></p><p>General pediatric and adult ENT<br /> Endoscopic nasal sinus surgery<br /> Cosmetic nasal surgery<br /> Head and neck tumor surgery (benign and malignant)</p>M.D.<p><strong>Training</strong></p> <p>Mayo Clinic School of Medicine, Rochester, Minnesota</p> <p><strong>Internship</strong></p> <p>General Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota</p> <p><strong>Residency</strong></p> <p>Otolaryngology Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota</p> <p><strong>Certification</strong></p> <p>American Board of Otolaryngology Head and Neck</p>Jones<img src="/-/media/shared-files/images/medical-professionals/full/owatonna/gregory-jones-md.jpg?h=200&iar=0&w=200&hash=77BEF4B2EBEB07D2911572C7C5C016AA" alt="Gregory Jones MD" width="200" height="200" DisableNVelocity="true" />Gregory<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>10226311Gregory Jones MD1<img src="/-/media/national-files/images/hometown-health/2021/drinking-from-mug-sitting-laptop.jpg?h=370&iar=0&w=660&sc_lang=en&hash=137F0E3844B1228B642B22BB81972E40" alt="Person drinking from mug while sitting and looking at laptop" width="660" height="370" DisableNVelocity="true" />Ear, Nose and Throat (ENT)Get information about symptoms, disorders and diseases affecting the ear, nose and throat, and related head and neck structures.CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Dawn Haller9/29/2021Love can make your heart feel all aflutter. But if you're feeling weakness, shortness of breath or chest discomfort, it may be atrial fibrillation. Learn more about this treatable condition.Is it love or atrial fibrillation?<p>Love can make your heart feel all aflutter. But along with that flutter, if you're feeling weak, fatigued, short of breath, and experiencing chest discomfort or frequent falls, it may not be love, but atrial fibrillation.</p> <p>So if it's not love, what causes that flutter of the heart?</p> <p>When the top chamber of the heart is pumping out of sync with the lower chamber, the heart may beat too fast and not squeeze properly. This condition, known as <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/atrial-fibrillation/symptoms-causes/syc-20350624" target="_blank" title="Opens in a new window.">atrial fibrillation</a> or afib, can lead to slower blood flow in the top chambers or atria of your heart, and create clots that may travel through the body and cause strokes and other issues. Plus, if the heart beats too fast for too long, the heart muscle itself may become weak, which is a type of heart failure.</p> <h4>Simple diagnosis</h4> <p>If your heart is suspected to be out of rhythm, also called arrhythmia, your health care provider can confirm the problem with an EKG. The Food and Drug Administration also has approved home devices, including smartwatches and portable monitors, that can diagnose atrial fibrillation at home.</p> <p>In addition, other tests for diabetes, thyroid issues or infectious diseases may be ordered so the cardiologist can better understand what is causing the arrhythmia. If atrial fibrillation is diagnosed early, it can be reversed more easily.</p> <h4>4 pillars of treatment</h4> <h5>Four pillars support the treatment of atrial fibrillation:</h5> <p><strong>1. Modify risk factors.</strong></p> <p>Key risk factors for atrial fibrillation include <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/obesity/symptoms-causes/syc-20375742" target="_blank" title="Opens in a new window.">obesity</a>, a sedentary lifestyle, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/high-blood-pressure-in-children/symptoms-causes/syc-20373440" target="_blank" title="Opens in a new window.">high blood pressure</a>, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444" target="_blank" title="Opens in a new window.">diabetes</a>, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631" target="_blank" title="Opens in a new window.">sleep apnea</a> and alcohol consumption. If these conditions are controlled, atrial fibrillation can be prevented, reduced or even reversed.</p> <h5>Here's what recent studies have found:</h5> <ul> <li>Australian researchers showed that if patients with a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/obesity/in-depth/bmi-calculator/itt-20084938" target="_blank" title="Opens in a new window.">body mass index (BMI)</a> over 27 lost 10% of their body weight, they lower their risk of atrial fibrillation by nearly 50% over five years.</li> <li>The same researchers demonstrated that if, in addition to losing weight, patients exercised more, they could reduce atrial fibrillation events by up to 76%.</li> <li>In patients undergoing ablation, a treatment to restore the proper rhythm, 80% were found to have sleep apnea.</li> <li>Consumption of even one alcoholic drink doubles a person's chance of developing atrial fibrillation. The risk increases with higher consumption. A 2020 study indicated that if patients who drank regularly stopped drinking, they could decrease atrial fibrillation recurrences by 20%.</li> </ul> <p><strong>2. Control heart rate.</strong></p> <p>Simple medications, such as beta blockers like metoprolol and atenolol; calcium channel blockers like verapamil and diltiazem; or digoxin can slow the heart rate to relieve symptoms and protect against further damage.</p> <p><strong>3. Prevent clots (anticoagulation).</strong></p> <p>Anticoagulants are medications used to thin the blood and prevent clots from forming. One anticoagulant is <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/drugs-supplements/warfarin-oral-route/description/drg-20070945" target="_blank" title="Opens in a new window.">warfarin</a>, which has been used for years. However, tremendous developments have been made in medications that make them simpler to use and don't require monitoring every few weeks. One of these newer oral anticoagulant agents is <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/drugs-supplements/apixaban-oral-route/description/drg-20060729" target="_blank" title="Opens in a new window.">apixaban</a> (Eliquis), which studies have shown to be twice as effective as aspirin in preventing strokes, with similar bleeding risks.</p> <p>Patients who can't be on an anticoagulant, such as someone who is at risk for falls or severe bleeding, can undergo a minimally invasive treatment called left atrial appendage occlusion to prevent strokes without the risk of bleeding.</p> <p><strong>4. Restore heart rhythm.</strong></p> <p>A cardiologist may determine that restoring the heart's proper rhythm is the best option for a patient. This procedure, called ablation, blocks abnormal electrical signals in the heart. In certain patients, it can be more effective than any medication. However, not everyone with atrial fibrillation is suited for ablation or will ever need it, including those over 65 with no symptoms and normal heart function. For them, heart rate control and anticoagulation are the best treatments.</p> <p>Keep in mind that all of these treatments are more risky and costly than not developing atrial fibrillation in the first place.</p> <h4>Future prevention, care</h4> <p>Mayo Clinic has developed artificial intelligence software that will assess an EKG of a patient's heart when it's in normal rhythm. This helps identify those who may develop atrial fibrillation later in life. By diagnosing atrial fibrillation in this "silent" phase, patients can be treated early to prevent heart damage and strokes.</p> <p>If you're feeling a flutter in your heart, or any other symptoms of atrial fibrillation, make an appointment with a cardiologist.</p> <p><em><a href="/providers/breno-pessanha-md" target="_self" title="Opens in same window.">Breno Pessanha, M.D.</a>, is a <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiologist</a> in <a href="/locations/faribault" target="_self" title="Opens in same window.">Faribault</a>, <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a> and <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Atrial fibrillation</li> <li>Cardiovascular disease prevention</li> <li>Chest pain</li> <li>Dyspnea (shortness of breath)</li> <li>Heart palpitations</li> <li>Valvular heart disease</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Federal Fluminense University in Niteroi, Brazil</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>Federal University of Rio De Janeiro, Brazil</li> <li>University of Illinois at Michael Reese Hospital in Chicago</li> <li>George Washington University Medical Center in Washington, D.C.</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li><strong></strong>George Washington University Medical Center in Washington, D.C.</li> </ul>Pessanha<img src="/-/media/shared-files/images/medical-professionals/full/owatonna/breno-pessanha-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=E738278F0705802FDB54080DA630C7BD" alt="Breno Pessanha MD" width="280" height="280" DisableNVelocity="true" />Breno<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13447700Breno Pessanha MD1<img src="/-/media/national-files/images/hometown-health/2021/senior-couple-dancing-holding-hands.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3F69E7DDF72A70FEF8D7B6955186CBDB" alt="Senior couple dancing and holding hands" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller9/24/2021Quicker recovery, reduced pain, more stability, better range of motion — learn how robotic knee or hip replacement delivers these outcomes.Robotic orthopedic surgery ups accuracy, patient satisfaction<p>Quicker recovery, less or no pain, more stability, and better range of motion — these are the best possible outcomes we want for our patients. Now orthopedic surgeons at Mayo Clinic Health System have another tool to help deliver these outcomes — robotic surgery.</p> <h3>Here are answers to questions our patients frequently ask about this option.</h3> <h4>Who qualifies for robotic surgery?</h4> <p>Unless your knee or hip is especially damaged from injury or arthritis, most patients are candidates for this surgery. For about 35% of patients, this is same-day surgery, followed by recovery at home.</p> <h4>Does a robot do the surgery?</h4> <p>No, the surgeon still performs the surgery with the assistance of a computer-controlled robotic arm.</p> <h4>How does it work?</h4> <p>Before surgery, a CT scan is performed on the ankle, knee and hip. The data from the scan is fed into the computer, creating precise measurements of angles, rotations, soft tissue and bone so the surgeon can position the components and make any adjustments virtually on the screen. The goal is to give patients a joint that feels as close to their natural knee or hip as possible. Once surgery is underway, the robotic arm will control the direction of the bone cuts, to an accuracy of .5 millimeter, according to the plan on the computer screen.</p> <h4>What are the benefits of robotic surgery?</h4> <p>The accuracy and consistency of the robotic arm, which is more precise than the human eye, decreases soft tissue damage and allows the surgeon to position the implant for the best stability, range of motion, less pain and quicker recovery.</p> <h4>What is the role of the patient?</h4> <p>As with traditional joint replacement, the patient and surgeon are partners in reaching the patient's goals and overall satisfaction with the results. For the patient, this may include physical therapy before surgery. After surgery, the patient is still responsible for working to reduce swelling, rebuild strength and regain range of motion.</p> <p><em><a href="/providers/ryan-foley-md" target="_self" title="Opens in same window.">Ryan Foley, M.D.</a>, practices <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedics</a>, <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgery</a> and <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">sports medicine</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota. <a href="/providers/charles-nolte-do" target="_self" title="Opens in same window.">Charles Nolte, D.O.</a>, practices <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedics</a> and <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgery</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Adolescent orthopedic surgery (sports medicine and fracture care)</li> <li>Arthroscopic surgery</li> <li>Fracture care</li> <li>Hand and wrist surgery</li> <li>Joint replacements</li> <li>Minimally invasive surgery</li> <li>Robotic assisted hip and knee arthroplasty</li> <li>Sports medicine</li> </ul>M.D.<p><strong>Medical School</strong></p> <ul> <li>Case Western Reserve University, Ohio</li> </ul> <p><strong>Residency </strong></p> <ul> <li>Orthopedic Surgery, Madigan Army Medical Center, Washington</li> </ul> <p><strong>Certifications </strong></p> <ul> <li>American Board of Orthopaedic Surgery</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Society of Military Orthopaedic Surgeons</li> <li>Fellow, American Academy of Orthopaedic Surgeons</li> </ul>Foley<img src="/-/media/shared-files/images/medical-professionals/full/mankato/ryan-foley-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=F9B0D84ECC2F8E0B3A9692A46B058BD4" alt="Ryan Foley MD" width="280" height="280" DisableNVelocity="true" />{8F6FAB48-1C93-4E98-81CB-C42ED82B7BAE}Ryan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16272498Ryan Foley, M.D.1 <ul> <li>Arthroscopic shoulder and knee reconstruction</li> <li>Minimally invasive knee replacement surgery</li> <li><a href="/locations/la-crosse/services-and-treatments/orthopedic-surgery/robotic" target="_self" title="Opens in same window.">Robotic orthopedic surgery</a></li> <li>Sports medicine</li> </ul> D.O. <p><strong>Education</strong></p> <ul> <li>Philadelphia College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, University of Medicine and Dentistry of New Jersey - Kennedy Health Division</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Osteopathic Board of Orthopedic Surgery</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Orthopedics,Mayo Clinic College of Medicine and Science</li> </ul> Nolte<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/charles-nolte-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=FF69E517C193FC0DC7C904A7F29C7E15" alt="Charles Nolte, D.O." width="280" height="280" title="Charles Nolte, D.O." DisableNVelocity="true" /> {689DC449-3878-4BC7-AB1B-31E67DE33D3C}Charles<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12982458Charles Nolte, D.O. 1{DEF55970-853F-4E96-9A4D-3413874FF059}<img src="/-/media/national-files/images/hometown-health/2021/senior-couple-walking-in-field.jpg?h=370&iar=0&w=660&sc_lang=en&hash=84CAA7115B65373A4542FDFB4FD8A203" alt="Senior couple walking in field while holding hands" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller9/8/2021Whether you've broken a bone, are dealing with a sports injury or arthritis is affecting your joints, find out why you should consider seeing an orthopedics specialist.Top 3 reasons to see an orthopedic provider<p>Whether you've broken a bone, are dealing with a sports or other musculoskeletal injury, or arthritis is hindering your joints, you may want to consider seeing an orthopedic provider.</p> <h3>The top three reasons you may want to make an appointment for a consultation with an orthopedic provider are:</h3> <h4>1. Specialization</h4> <p>Orthopedic providers specialize in treating bones, joints, muscles, ligaments and tendons. They see people of all ages when pain is affecting their quality of life and preventing them from doing the things they want to do. They work with patients with new injuries and those coping with chronic conditions, such as arthritis.</p> <h4>2. Treatment options</h4> <p>Orthopedic providers have a wide variety of options in their treatment toolbox. These options range from least invasive, such as physical therapy or medications, to more invasive, including injections or surgery.</p> <h4>3. Information to decide about care</h4> <p>These providers give patients information about treatment options so these patients can make decisions about their care. They walk through each option with patients, explaining what kinds of outcomes to expect. Together, the provider and patient formulate a plan, whether the patient is interested in treatment now or wants to prepare for it down the road.</p> <p>Typically, patients don't need to see their primary care provider before making an appointment with an orthopedic provider, although they may want to double-check their insurance to be sure it covers the consultation.</p> <p>At that first appointment, an orthopedic provider conducts a comprehensive exam, including health history, what the problem is, how long it's been bothering the patient, who they've seen for care, what treatments they've undergone and how those treatments have worked. The provider also will perform a physical exam and view any X-rays or MRIs to better understand the patient's concern.</p> <p>Sometimes patients just want to gather more information so they can go home and think about it, while others are ready to start treatment. When a patient is ready for treatment, the provider and patient form a plan. The plan usually includes a series of follow-up appointments, depending on whether the treatment solves the problem, or the condition progresses, and the patient needs to take the next step. The goal for providers is to get their patients back to the life they want to lead.</p> <p><em><a href="/providers/robert-cates-do" target="_self" title="Opens in same window.">Robert Cates, D.O.</a>, is an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgeon</a> and fellowship-trained physician in <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</em></p><ul> <li>Adult and pediatric care</li> <li>Knee injuries, such as cartilage injuries, meniscal tears, ACL tears, ligament tears and arthritis</li> <li>Shoulder and knee joint preservation and total joint replacement</li> <li>Shoulder injuries, such as rotator cuff tears, labral tears/shoulder instability, arthritis and shoulder fractures</li> <li>Sports medicine</li> </ul>D.O.<p>My philosophy is to provide outstanding patient care in an individualized fashion. Every patient is unique with regard to injury, activity level and goals.</p> <p>I will gather your history, perform a thorough exam, review all imaging and discuss treatment options - both nonsurgical and surgical. Together, you and I will formulate an individualized care plan. I believe this is essential to optimizing the outcomes and improving your quality of life. I will strive to make your experience the absolute best while always remembering that needs of the patient come first.</p><p><strong>Education</strong></p> <ul> <li>Doctor of Osteopathic Medicine, University of North Texas Health Science Center</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Orthopedic Sports Medicine, University of Iowa</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Orthopaedic Surgery</li> <li>Certified Strength and Conditioning Specialist</li> <li>National Strength and Conditioning Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Orthopedics, Mayo Clinic College of Medicine and Science</li> </ul>Cates<img src="/-/media/shared-files/images/medical-professionals/full/austin/robert-cates-do.JPG?h=280&iar=0&w=280&sc_lang=en&hash=63C2E704655A01B51DD915D898D0F91B" alt="Robert Cates DO" width="280" height="280" DisableNVelocity="true" />Robert<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15728790Robert Cates DO1{DEF55970-853F-4E96-9A4D-3413874FF059}|{7CBD4F38-8554-4F2D-B828-ADDCE770E65A}|{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2021/jumping-over-rocks-wooded-area.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F552B85811A2CEE5A0D012882E627046" alt="Jumping over rocks wooded area" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller9/13/2021Do you have a creaky knee, achy hip, wobbly ankle or grinding shoulder? Here are the top 5 reasons other patients make an appointment with an orthopedic surgeon to discuss joint replacement.Top 5 reasons for joint replacement<p>How long do you put up with a creaky knee, achy hip, wobbly ankle or grinding shoulder?</p> <h3>If you're wondering if it's time to do something about your problem joint, these are the top five reasons patients make appointments with an orthopedic surgeon to discuss a joint replacement:</h3> <h4>1. Pain</h4> <p>Across the board, pain, particularly from severe arthritis, is why patients say, "enough," and seek care. Pain underlies all other reasons, as well.</p> <h4>2. Certain fractures or injuries</h4> <p>It's common to treat hip fractures by replacing the joint. An injury may be the original cause for increased wear and tear on a joint to the point it needs to be replaced.</p> <h4>3. Joint destruction from various forms of arthritis</h4> <p>Rheumatoid and psoriatic arthritis, along with other inflammatory conditions, can lead to joint replacement. Medications can buy the patient time, but eventually the joint will become too damaged.</p> <h4>4. Degeneration due to wear and tear</h4> <p>Over time, a joint may wear out due to the demands of an occupation or stress, or strain from a regular activity or sport, or just age.</p> <h4>5. Difficulty with a needed or enjoyable activity</h4> <p>This may be movement needed for work; a daily activity, such as putting on socks or sweeping the floor; or something that gives you significant enjoyment, such as golfing, playing pickleball, hiking or swimming. The key here is needing the activity to live your life or liking it so much you don't want to give it up.</p> <p>A joint will never get so damaged that it can't be replaced, and joints are being replaced in patients of all ages. If you've reached the point where you don't want to put up with the pain anymore, and you want to get back to a needed or favorite activity, consider making an appointment to consult with an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgeon</a>.</p> <p><em><a href="/providers/jacob-ziegler-md" target="_self" title="Opens in same window.">Jacob Ziegler, M.D.</a>, is an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgeon</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p> <ul> <li>Direct anterior hip replacement</li> <li>Minimally invasive hip and knee replacement</li> <li>Partial knee replacements</li> <li>Robotic assisted hip and knee arthroplasty</li> </ul> M.D. <p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, University of Minnesota</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Adult Reconstruction, Insall-Scott-Kelly Institute for Orthopaedics and Sports Medicine</li> <li>Adult Reconstruction, NYU Langone Orthopedic Hospital-Hospital for Joint Diseases</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Orthopaedic Surgery</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Hip and Knee Surgeons</li> <li>Minnesota Orthopaedic Society</li> <li>Orthopaedic Trauma Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Orthopedics, Mayo Clinic College of Medicine and Science</li> </ul>Ziegler<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jacob-ziegler-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=EE50DD78035502A319D080295D6E695E" alt="Jacob Ziegler MD" width="280" height="280" DisableNVelocity="true" /> {9D2EDEA0-8D4B-411F-A2A2-06E925C765CC}Jacob <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20570325Jacob Ziegler, M.D. 1{DEF55970-853F-4E96-9A4D-3413874FF059}<img src="/-/media/national-files/images/hometown-health/2021/open-trail-hiking-using-poles-backpack.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8A1669E38AD432515298F1A2FE848E9E" alt="Open trail hiking using walking poles and wearing backpack" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller10/1/2021Your knee's built-in shock absorbers are designed to take a beating. But an everyday motion can result in a tear or other damage to the meniscus. When the happens, what should you do?Treating your knee's shock absorbers<p>Like a car, the human knee has built-in shock absorbers. They're crescent-shaped pads of cartilage inside the knee, with one on each side. Not only do these pads absorb the shocks of walking, running, jumping and squatting, they also provide stability. Each pad is called a meniscus, and it's designed to take a beating.</p> <p>But sometimes a fairly minor motion, such as twisting, getting into a car, landing awkwardly or squatting to lift a load, can tear the meniscus. Athletic injuries and arthritis also take their toll on the knee's shock absorbers.</p> <img alt="Torn meniscus illustration" src="/-/media/national-files/images/hometown-health/2021/torn-meniscus-illustration.jpg?h=358&w=360&sc_lang=en&hash=0AADC04347312838813AD507E34079F8" style="width: 360px; height: 358px;" /> <p>The signs of a torn meniscus are pain on the inside or outside of the knee, locking, clicking, swelling, and pain when squatting or going up and down stairs. If these symptoms appear, it's time to consult with an orthopedic specialist.</p> <h2>Cause and age determine treatment</h2> <p>The orthopedic specialist will ask patients the cause of the pain and examine their knee by gently twisting and bending, and locating areas of tenderness and pain. The exam is followed by an X-ray to rule out other injuries, look for degenerative changes from arthritis and identify other underlying conditions.</p> <p>Because the meniscus is tissue and not bone, it doesn't show up on X-rays, but arthritic changes do. Some patients may have a torn meniscus, but the primary cause of their pain is from arthritis. Rather than repair the meniscus, the patient receives treatment to relieve the arthritis pain. This may include activity modification, weight loss, physical therapy, anti-inflammatory medications and corticosteroid injections.</p> <p>However, if the meniscus is torn and causing locking and catching, an orthopedic surgeon may trim and smooth rough edges with arthroscopic surgery.</p> <p>Younger patients often tear a meniscus during sports activities. If their X-rays don't show arthritis, they may undergo an MRI, which can identify not only if the meniscus is torn, but also any other injuries inside the joint. If necessary, an orthopedic surgeon will arthroscopically repair or trim the meniscus to return the knee to its best function and reduce the chance of arthritis in the future.</p> <p>Recovery from surgery will depend on the procedure. If a meniscus repair is performed, it can require six to eight weeks on crutches or in a brace, followed by physical therapy to rebuild strength and help the knee heal well enough to withstand twisting and pivoting motions. It may be six to eight months before patients return to sports. Recovery from more minor arthroscopic procedures can be much shorter, with return to sports in a matter of weeks.</p> <p><em><a href="/providers/robert-cates-do" target="_self" title="Opens in same window.">Robert Cates, D.O.</a>, specializes in <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedics/orthopedic surgery</a> in <a href="/locations/austin">Austin</a>, Minnesota.</em></p><ul> <li>Adult and pediatric care</li> <li>Knee injuries, such as cartilage injuries, meniscal tears, ACL tears, ligament tears and arthritis</li> <li>Shoulder and knee joint preservation and total joint replacement</li> <li>Shoulder injuries, such as rotator cuff tears, labral tears/shoulder instability, arthritis and shoulder fractures</li> <li>Sports medicine</li> </ul>D.O.<p>My philosophy is to provide outstanding patient care in an individualized fashion. Every patient is unique with regard to injury, activity level and goals.</p> <p>I will gather your history, perform a thorough exam, review all imaging and discuss treatment options - both nonsurgical and surgical. Together, you and I will formulate an individualized care plan. I believe this is essential to optimizing the outcomes and improving your quality of life. I will strive to make your experience the absolute best while always remembering that needs of the patient come first.</p><p><strong>Education</strong></p> <ul> <li>Doctor of Osteopathic Medicine, University of North Texas Health Science Center</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Orthopedic Sports Medicine, University of Iowa</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Orthopaedic Surgery</li> <li>Certified Strength and Conditioning Specialist</li> <li>National Strength and Conditioning Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Orthopedics, Mayo Clinic College of Medicine and Science</li> </ul>Cates<img src="/-/media/shared-files/images/medical-professionals/full/austin/robert-cates-do.JPG?h=280&iar=0&w=280&sc_lang=en&hash=63C2E704655A01B51DD915D898D0F91B" alt="Robert Cates DO" width="280" height="280" DisableNVelocity="true" />Robert<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15728790Robert Cates DO1{DEF55970-853F-4E96-9A4D-3413874FF059}|{7CBD4F38-8554-4F2D-B828-ADDCE770E65A}|{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2021/kicking-soccer-ball-into-net.jpg?h=370&iar=0&w=660&sc_lang=en&hash=50BEF8BE5603FC23E589438000A6193D" alt="Kicking soccer ball into net" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller9/15/2021You may have heard about "healthy" bacteria called probiotics. Do they really help with gut health and digestive issues? Find out what to do before you start taking probiotics.What’s the deal with probiotics?<p>You may be hearing more and more about probiotics — supplements that contain "healthy" bacteria that claim to have multiple benefits, including helping with gut health and digestive issues. Probiotics are being marketed for specific conditions, including irritable bowel syndrome (IBS) or to demographic audiences, such as women or children. But do they really help?</p> <h4>What are probiotics?</h4> <p>Often referred to as "friendly" or "good" bacteria, probiotics help keep the normal healthy balance of bacteria in your gut — specifically the lining of the gut which includes the microbiome. We are learning more and more about the body's microbiome and how to maintain the balance of bacteria already growing there in addition to adding living bacteria into your system through probiotics. A healthy gut microbiome helps with digestion, boosts the immune system, contributes to blood sugar levels, and may even influence mood and mental health.</p> <h4>Where are probiotics found?</h4> <p>Probiotics can be found in multiple forms. </p> <h5>Bacteria-fermented foods are good sources of probiotics, including:</h5> <ul> <li>Active-culture yogurts</li> <li>Cheese</li> <li>Kefir</li> <li>Kimchi</li> <li>Kombucha</li> <li>Sauerkraut</li> </ul> <p>Probiotics also come in pill form with a variety of different strains or types, including acidophilus, lactobacillus or formulations targeted for different health benefits, such as gastrointestinal health or women's health.</p> <h4>Research on probiotics</h4> <p>Probiotics are under active research for a variety of different conditions. Right here at Mayo Clinic, the Mayo Clinic Center for Individualized Medicine is researching how our <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayo.edu/research/centers-programs/center-individualized-medicine/research/programs/microbiome" target="_blank" title="Opens in a new window.">individual microbiomes</a> may benefit from personalized probiotics.</p> <h5>Generally, there are a variety of areas of research for probiotics:</h5> <ul> <li>Gastrointestinal health — especially for people with certain infections or chronic conditions, such as Crohn's disease, ulcerative colitis and IBS, or for a serious infection called Clostridioides difficile (C. diff)</li> <li>Vaginal health</li> <li>Allergies — including skin conditions like eczema</li> </ul> <h4>What's the consensus? Are they beneficial?</h4> <p>There is no clear evidence that probiotics are beneficial. While many small studies have been conducted, there has been no standardized way to study probiotics and their effects, making it difficult to compare the results of different studies.</p> <p>Probiotics are not regulated by the Food and Drug Administration, which means the companies that make probiotics do not need to prove the product contains the ingredients listed on the bottle.</p> <h4>What should you do before taking probiotics?</h4> <p>Talk to your health care provider before starting a probiotic. People with very weak immune systems, such as those undergoing chemotherapy, should not take probiotics due to risk of infection. Your provider or a nutritionist can help identify a probiotic containing the bacteria strain based on the condition you wish to address.</p> <h4>Besides probiotics, what can I do to benefit my digestive and overall health?</h4> <p>Eat a varied diet of protein, grains, fruits and vegetables. Research has shown that a diet containing a variety of different foods is beneficial to our gut microbiome. Engage in regular physical activity. Studies have shown that a healthy diet and physical activity have separate, positive benefits on our overall wellness.</p> <p><em>Lisa Hayes, M.D., provides <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">family medicine</a> and <a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">prenatal care</a> in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2021/eating-probiotic-yogurt.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E897E4C9D1735A820BBD7B0371761668" alt="Eating probiotic yogurt" width="660" height="370" DisableNVelocity="true" />Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Michele Halterman8/1/2023Volunteers make a difference in the lives of others, but did you know volunteering also can benefit your health? Learn about three physical, mental and social benefits of donating your time and talents.Helping people, changing lives: 3 health benefits of volunteering<p>Volunteers make an immeasurable difference in people's lives and often serve to help others. Did you know that volunteering can benefit your health as well?</p> <p>The good news is that you don't need to be a philanthropist or senator to enhance or create change in your community. Volunteering makes an immeasurable difference in people's lives. Your actions, big or small, can help others and benefit your health.</p> <h2>Research has shown that volunteering offers significant health benefits, especially for older adults, including:</h2> <h3>1. Improves physical and mental health.</h3> <p>Volunteer activities keep people moving and thinking at the same time. Research has found that volunteering among adults, age 60 and over, provided benefits to physical and mental health. Volunteers report better physical health than nonvolunteers. Research also has shown that volunteering leads to lower rates of depression and anxiety, especially for people 65 and older.</p> <p>Volunteering reduces stress and increases positive, relaxed feelings by releasing dopamine. By spending time in service to others, volunteers report feeling a sense of meaning and appreciation, both given and received, which can have a stress-reducing effect.</p> <p>Reduced stress further decreases the risk of some physical and mental health problems, such has heart disease, stroke, depression, anxiety and general illness. In addition, people who volunteer have lower mortality rates than those who do not, even when controlling for age, gender and physical health.</p> <h3>2. Provides a sense of purpose and teaches valuable skills.</h3> <p>The work that volunteers provide is essential to everyday activities, giving volunteers a sense of purpose, especially when giving their time and talent in the areas they find meaningful. Older volunteers experience greater increases in life satisfaction and self-esteem.</p> <p>At Mayo Clinic Health System, volunteers serve as greeters and waiting room attendants, provide patient room information and directions, and help transport patients and patient items. Many volunteers use their craft skills to make prayer shawls, blankets, sweaters and hats, that typically are given to newborn babies and patients with cancer. Other services volunteers provide include working in the hospital gift shop, performing clerical duties for staff or offering pet therapy to patients through the Paws Force team.</p> <h3>3. Nurture new and existing relationships.</h3> <p>Volunteering increases social interaction and helps build a support system based on common interests. One of the best ways to make new friends and strengthen existing relationships is to participate in a shared activity.</p> <p>In many cases, volunteers have diverse backgrounds, which helps expand their social network and allows them to practice social skills with others.</p> <p>People volunteer for different reasons, such as exploring careers, sharpening skills, staying active during retirement, meeting new people and serving their communities. Yet all volunteers share a common desire to improve the health and welfare of people in their communities.</p> <p>Are you interested in becoming a volunteer? There is a wide variety of volunteer opportunities in every community, whether you're interested in youth, environmental, health, religious or community causes. Check with local nonprofit and cultural organizations, schools, faith communities, or hospitals for options.</p> <p>Or consider joining Mayo Clinic Health System's team of volunteers and making a difference in the lives of patients and staff. <a href="/volunteer" target="_self" title="Opens in same window.">Sign up to volunteer</a> at a location near you. Doing so will make a difference in the lives of your neighbors and friends — and also can improve your health.</p> <p><a href="/providers/angela-thoreson-licsw" target="_self" title="Opens in same window."><em>Angela Thoreson</em></a><em> is a licensed independent clinical social worker in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</em></p><ul> <li>Acceptance strategies</li> <li> Acceptance and commitment therapy (ACT therapy)</li> <li>Behavioral activation and modification</li> <li>Cognitive behavioral therapy (CBT)</li> <li>Cognitive behavioral therapy for insomnia (CBT-I)</li> <li>Cognitive processing therapy (CPT) for trauma</li> <li>Dialectical behavior therapy (DBT)</li> <li>Individuals with comorbidities, related health or addiction problems</li> <li>Mindfulness intervention</li> <li>Personality disorders</li> <li>Serious and persistent mental illness</li> <li>Stress management</li> </ul>L.I.C.S.W.<p>I provide psychotherapy at Mayo Clinic Health System in Albert Lea and in Austin. Although I work with patients of all ages, my primary focus is with adults. For more than the past decade, I have been involved in varying community-based settings and programs.</p> <p>I use compassion as I provide treatment to adults with serious and persistent mental illness. I believe that practical changes can lead to significant differences in a person’s life and well-being.</p><p><strong>Education</strong></p> <ul> <li>University of St. Thomas</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Licensed Independent Clinical Social Worker</li> </ul>Thoreson<img src="/-/media/shared-files/images/medical-professionals/full/austin/angela-thoreson-licsw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=EEF4CC56A9CE8F5595198A34517FF096" alt="Angela Thoreson, L.I.C.S.W." width="280" height="280" title="Angela Thoreson, L.I.C.S.W." DisableNVelocity="true" />Angela<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20185987Angela Thoreson, L.I.C.S.W.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}|{2B88C934-922C-4130-B661-197B59D83899}<img src="/-/media/national-files/images/hometown-health/2023/volunteers-picking-up-trash.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B74A02D5FB704A05A70FC173ACC1F482" alt="Volunteers picking up trash" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller8/22/2023Many college students struggle with depression or anxiety. As school resumes, talk about these conditions with your student, and brush up on symptoms and warning signs so you can step in with help.College students and depression: A guide for parents<p>Entering or returning to college is an exciting time for young adults. Students and parents hope for memorable experiences to last a lifetime. For many students, the years at college are a time of discovery and growth.</p> <p>But depression may get in the way.</p> <p>The rate of depression among college students is rising. In a 2021–2022 survey of students across 133 college campuses, 44% of students reported symptoms of depression and 15% reported seriously considering suicide in the past year.</p> <p>For both parents and students, knowing the risk factors and symptoms can help with the early identification and treatment of depression.</p> <h2>Symptoms of depression can include:</h2> <ul> <li>Anxiety and panic</li> <li>Difficulty with schoolwork</li> <li>Changes in eating or sleeping patterns</li> <li>Emotional outbursts, such as tearfulness, anger or irritability</li> <li>Lack of energy or fatigue</li> <li>Loss of interest in activities, such as clubs, sports or other social commitments</li> <li>Poor self-esteem</li> <li>Sense of <a href="/hometown-health/speaking-of-health/overwhelmed-by-anxiety" target="_self" title="Opens in same window.">being overwhelmed</a></li> <li>Thoughts of suicide or self-harm </li> <li>Unrealistic guilt</li> </ul> <h2>Why are young adults struggling?</h2> <p>Although the problems facing college students are complex. They  often feel intense pressure to succeed while still developing necessary life skills.</p> <p>The rising cost of education places additional stress on students and their families. Children are being pushed to their limits as early as elementary school. As a result, their mental health and well-being are suffering.</p> <p>Many middle and high school students have schedules rivaling top corporate executives, with an average day beginning at 6 a.m. and ending after 10 p.m. These demanding schedules leave many <a href="/hometown-health/speaking-of-health/is-your-child-getting-enough-sleep" target="_self" title="Opens in same window.">sleep deprived</a> with little time to develop basic independent living skills, such as doing laundry, cooking meals, managing money and accessing services to meet their needs. They do this all while figuring out, "Who am I?"</p> <p>These skill deficits compound as young adults go to college and face relationship challenges and heavy class schedules. They may also be living separately from their parents for the first time.</p> <p>Helping children find a balance between achievement and life's demands begins at home.</p> <h3>Here are tips for parents and children before college:</h3> <ul> <li><strong>Set a realistic view of the big picture.</strong><br /> Giving 100% at all times in all areas of life is unrealistic. Encourage students to focus on making the most of their college experience by forging positive relationships, creating fun memories and preparing for their future careers. </li> <li><strong>Build independent living skills at a young age.</strong><br /> Online resources are available to find age-appropriate chores for children to help you start the process.</li> <li><strong>Protect downtime or unstructured time for middle and high school students.</strong><br /> This is when students start to explore who they are.</li> </ul> <h2>What are the risk factors for college students?</h2> <p>Unfortunately, as many as 75% of students who struggle with depression are reluctant to seek help. This increases the risk of harmful outcomes, such as dropping out of college, poor academic performance, suicide and substance abuse.</p> <h3>College students may be exposed to many situations or risk factors that could trigger an episode of depression:</h3> <ul> <li>Comparison of academic, athletic or social performance to their peers</li> <li><a href="/hometown-health/speaking-of-health/how-teen-marijuana-use-impacts-brain-development" target="_self" title="Opens in same window.">Drug or alcohol use</a></li> <li>Family history of depression</li> <li>Fears of disappointing parents because of grades or career path</li> <li>Peer relationship difficulties</li> <li>Relationship breakup</li> <li>Sexual assault</li> <li>Sexual identity adjustment difficulties</li> <li>Stressful life events</li> </ul> <h3>Those at highest risk for depression and anxiety are:</h3> <ul> <li>Female students</li> <li>Low-income students</li> <li>Students of color</li> <li>Students who are caregivers for children or other adults</li> <li>Students who <a href="/hometown-health/speaking-of-health/support-kids-who-identify-as-lgbtq" target="_self" title="Opens in same window.">identify as LGBTQ</a>.</li> </ul> <h2>What are the warning signs of suicide?</h2> <p>Suicide is the second-leading cause of death in young people ages 20 to 24. While the factors that lead to suicide are multifaceted, being diagnosed with a mental illness like depression increases the risk.</p> <h3>These behaviors may indicate that students are thinking about suicide: </h3> <ul> <li>Displaying extreme mood swings</li> <li>Giving away possessions</li> <li>Increasing use of alcohol or drugs</li> <li>Ignoring class work or skipping classes</li> <li>Engaging in risky or self-destructive acts, such as using drugs or driving recklessly</li> <li>Saying goodbye to people as if they won't be seeing them again <p> </p> </li> <li>Showing anger or rage or expressing a desire to seek revenge</li> <li>Sleeping too little or too much</li> <li>Talking about <a href="/hometown-health/speaking-of-health/suicide-isnt-about-dying-its-about-perceived-relief" target="_self" title="Opens in same window.">suicide</a></li> <li>Talking about being a burden to others</li> <li>Talking about feeling trapped, hopeless or having no purpose</li> <li>Withdrawing from friends and wanting to be left alone</li> </ul> <p>This is not an exhaustive list. Be alert to behavior and personality changes that can provide clues to a student's well-being.</p> <h2>What can parents do to help students?</h2> <p>Parents often worry about how their child will react if they try to talk the signs and symptoms of depression. But it's crucial to have a conversation about your concerns.</p> <p>Be direct with your child. Give examples of symptoms you've noticed and explain why these examples worry you. Be patient, calm and empathetic in your communication.</p> <p>Students often believe they are to blame for their mental health concerns, which can lead to defensiveness or shutting down. To reduce the stigma, help students understand it's not their fault, and many young adults experience depression.</p> <p>If you have concerns, it's important to ask your students if they're considering suicide or self-harm. This won't put the idea in their heads. If your student is expressing thoughts about suicide, you must seek immediate medical attention.</p> <p>Many colleges and universities provide mental health services on campus. Your child's primary care provider has resources and can refer your student to a mental health counselor. Parents and students should have hope since many effective treatments for depression exist.</p> <p><a href="/providers/kristen-bowe-cnp" target="_self" title="Opens in same window."><em>Kristen Bowe</em></a><em> is a nurse practitioner in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/new-prague">New Prague</a>, Minnesota.</em></p> <ul> <li>Adolescent/young adult care </li> <li>Anxiety </li> <li>Depression </li> <li>Preventive health and health promotion </li> <li>Women’s health</li> </ul> APRN, C.N.P., M.S.N. <p>I grew up in North Dakota. In my free time I enjoy being active outside and spending time with my family.</p> <p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Nursing, University of Mary</li> <li>Master's degree, Nursing, University of North Dakota</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Nurse Practitioner, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Nurse Practitioner, American Association of Nurse Practitioners</li> <li>Minnesota Nurse Practitioners</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul> Bowe<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/kristen-bowe-cnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=DDD60E3078F96AA42A4790C5A4499C60" alt="Kristen Bowe CNP" width="280" height="280" DisableNVelocity="true" /> Kristen<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14924315Kristen Bowe, APRN, C.N.P., M.S.N. 1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{2B88C934-922C-4130-B661-197B59D83899}|{C4130004-0F31-48C4-AC9F-A4350A75AB24}<img src="/-/media/national-files/images/hometown-health/2021/college-student-glasses-backpack.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3BB62DB7912282C9DD3003D74FDC854A" alt="College student wearing glasses and backpack" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.DepressionDepression is a medical illness that causes a persistent feeling of sadness, loss of interest and, sometimes, physical symptoms. It's also called major depression, major depressive disorder and clinical depression.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Suicide PreventionSuicide is a major concern in the U.S. According to the Centers for Disease Control and Prevention, suicide was among the top nine leading causes of death for people ages 10–64 and the second leading cause of death for people ages 10–14 and 25–34. The positive news is that with the right information and willingness to reach out to someone in need, we all can help prevent suicide.<br /><br /><strong>If you are having suicidal thoughts, call the 988 Suicide and Crisis Lifeline at <a href="tel:988">988</a>, or chat at <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://988lifeline.org/" target="_blank" title="Opens in a new window.">988lifeline.org</a>.</strong>Dawn Haller10/8/2021We aren't programmed to go through life without rest, solitude or downtime. With everything going on, it’s easy to get blindsided by stress and burnout. Here are 5 tips for keeping burnout at bay.5 tips to keep burnout at bay<p>The pace of life today is crazy. Many people juggle multiple responsibilities — work, home life, caregiving and relationships. How many times have you felt like the demands, expectations and time pressure are exhausting and relentless?</p> <p>Humans aren't programmed to go through life without rest, solitude or downtime. The past 18 months have brought multiple changes or stress-inducing situations, including the COVID-19 pandemic; economic strain; racial unrest; political division; and environmental disasters, such as wildfires and hurricanes.</p> <p>With everything going on, it's easy to get blindsided by <a rel="noopener noreferrer" href="http://www.mayoclinic.org/healthy-lifestyle/stress-management/basics/stress-basics/hlv-20049495" target="_blank" title="Opens in a new window.">stress</a> and <a rel="noopener noreferrer" href="http://www.mayoclinic.org/healthy-lifestyle/stress-management/expert-blog/protect-yourself-from-burnout/bgp-20148078" target="_blank" title="Opens in a new window.">burnout</a>.</p> <h4>Burnout symptoms</h4> <p>It's important to beware of symptoms and acknowledge when your responsibilities start to become too much to handle. "Burnout" isn't a medical diagnosis, but generally it is feelings of depleted energy or exhaustion because of continual stress.</p> <p>The symptoms of stress can include headaches and muscle aches, upset stomach, fatigue, anxiety, irritability, lack of focus, overeating or undereating, angry outbursts, and social withdrawal. No one is superhuman. You need to recognize and respect your limits.</p> <p>Job burnout is a special type of work-related stress — a state of physical or emotional exhaustion that also involves a sense of reduced accomplishment and loss of personal identity.</p> <h4>If you think you may be experiencing burnout, ask yourself these questions:</h4> <ul> <li>Have you become cynical or critical?</li> <li>Do you drag yourself to work and have trouble getting started?</li> <li>Have you become irritable or impatient with others?</li> <li>Do you lack the energy to be consistently productive?</li> <li>Do you find it hard to concentrate?</li> <li>Do you lack satisfaction from your achievements?</li> <li>Do you feel disillusioned about your job or place in life?</li> <li>Are you using food, drugs or alcohol to feel better or to simply not feel?</li> <li>Have your sleep habits changed?</li> <li>Are you troubled by unexplained headaches, stomach or bowel problems, or other physical complaints?</li> </ul> <p>If you answered yes to any of these questions, you might be experiencing burnout.</p> <h4>Here are five tips for keeping burnout at bay:</h4> <h5>1. Ask yourself, "What's important now?" </h5> <p>Practice being present in the moment. If you're driving, pay attention to the road. If you're having dinner with a friend, be engaged and present. Don't play around with your phone. It's not only distracting, it's also disrespectful.</p> <h5>2. Quantify the commitment.</h5> <p>Before you agree to sit on a committee or host a dinner party, recognize that it means giving up time that can't be replaced. Anticipate that the time commitment probably will be longer than your initial estimate. Factor that into decisions about what's worth your time. Be willing to say no.</p> <h5>3. Make yourself unavailable.</h5> <p>It's OK and important to set aside time for yourself. Schedule it on your calendar, and don't let other responsibilities encroach on that time. This may mean saying no to some requests.</p> <h5>4. Seek support.</h5> <p>Whether you reach out to co-workers, friends or loved ones, support and collaboration can help.</p> <h5>5. Practice healthy habits.</h5> <p>Make sure you're getting enough sleep at night, eating healthy meals during the day and exercising regularly to help give you the energy to take on life's myriad of responsibilities.</p> <p><em><a href="/providers/tiffany-casper-do" target="_self" title="Opens in same window.">Tiffany Casper, D.O.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/tomah" target="_self" title="Opens in same window.">Tomah</a>, Wisconsin.</em></p><ul> <li>Pediatrics</li> <li>Skin conditions</li> <li>Women's health</li> </ul>D.O.<p><strong>Education</strong></p> <ul> <li>Doctor of Osteopathic Medicine, A.T. Still University – Kirksville College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Mercy Health System</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Medicine </li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Osteopathic Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Casper<img src="/-/media/shared-files/images/medical-professionals/full/tomah/tiffany-casper-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=1A30A61D9D6C113EA2C621F6A4AD3702" alt="Tiffany Casper DO" width="280" height="280" DisableNVelocity="true" />Tiffany<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15595587Tiffany Casper, D.O.1<img src="/-/media/national-files/images/hometown-health/2021/redhead-resting-head-on-hand.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E0E3A6A2181A129DE37E1F0531FB7BDC" alt="Redhead resting head on hand" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller10/28/2021About 4 in 5 U.S. adults experience back pain, with symptoms ranging from a minor inconvenience to debilitating. Read answers to 7 FAQ about low back pain.7 common low back pain FAQ<p>Back pain is a common ailment for many adults. About 80% of adults experience pain in their back at some point in their lives.</p> <p>The low back, also known as the lumbar region of the spine, consists of five vertebrae labeled L1 through L5. Many people simply refer to lumbar pain as low back pain.</p> <p><a href="/providers/tk-schiefer-md" target="_self" title="Opens in same window.">T.K Schiefer, M.D.</a>, a Mayo Clinic Health System <a href="/services-and-treatments/neurosurgery" target="_self" title="Opens in same window.">neurosurgeon</a> answers seven common questions about lumbar back pain.</p> <h4>1. What are some causes of low back pain?</h4> <p>A common cause of back pain is mechanical injury or issue, such as a muscle sprains or joint irritation. However, in many cases, there is no clear cause.</p> <p>"In the majority of cases of low back pain, there is no clear structural problem, and we never really find the cause," says Dr. Schiefer. "It's what we call musculoskeletal low back pain. It usually gets better on its own with time and some activity modification, and maybe some nonprescription pain medications like acetaminophen or ibuprofen."</p> <h4>2. Does having a strong core help prevent low back pain?</h4> <p>There are many things that people can do to lower their risk of developing low back pain, including using proper lifting techniques, not smoking and exercising regularly.</p> <p>"I think it is important to have a strong core and maintain a healthy body weight. The bottom line is the more strain that's on your spine, the more likely you are to have problems," says Dr. Schiefer. "If you have good core musculature that supports the spine, you are less likely to have problems. Likewise, if there's less excessive weight that your body is having to adjust for, then there's less strain on the spine as well."</p> <h4>3. Does back pain run in families?</h4> <p>Low back pain is a common problem and can be caused by different factors, so Dr. Schiefer doesn't believe there is a clear hereditary component to low back pain. However, some families do seem to have more back problems than others. This seems more likely to be related to the types of physical activities they take part in, body weight and overall health.</p> <h4>4. Will bed rest make my low back pain better?</h4> <p>"We don't typically recommend bed rest for lumbar spine problems anymore," says Dr. Schiefer. "Evidence has shown over time that bed rest actually makes the problem worse and can make it last for a longer time. Typically, we recommend that people just modify their activities and avoid things that exacerbate the pain, like blending, lifting and twisting activities."</p> <h4>5. I have osteoarthritis. Is lumbar back surgery an option for me?</h4> <p>Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide. It occurs when the protective cartilage that cushions the bones wears down over time.</p> <p>"Typically, we wouldn't recommend surgery on someone's back just for osteoarthritis," says Dr. Schiefer. "The normal wear and tear that people have on their spines over time does not respond well to surgery. When patients have back pain alone, in the absence of any deformity or any infection or any fracture, usually surgery is not the best treatment. Also, back pain is really what we call multifactorial, meaning a lot of different things are causing it."</p> <p>Surgery to correct one potential cause, such as osteoarthritis, for example, does not correct the other causes of lumbar pain.</p> <h4>6. I'm nervous about having surgery. What's the worst that could happen if I delay a recommended surgery?</h4> <p>It's common to feel nervous about the prospect of surgery. That's why it's important to talk with the surgeon to learn more about the procedure and get answers to your questions.</p> <p>"Some people feel like because they're coming to see the surgeon it means they going to have surgery. Really, I think the keyword there is the 'surgical consultation,'" says Dr. Schiefer. "My job as a surgeon is to help to assess the situation, look at the imaging and say, 'OK, here's what's going on and here are options.'"</p> <h5>Dr. Schiefer and his colleagues break down treatment options into three categories:</h5> <ul> <li><strong>Continued observation</strong><br /> This wait-and-see approach gives your back additional time to recover, and no surgery is planned.</li> <li><strong>Nonsurgical options</strong><br /> There are many treatment options that do not involve surgery, such as physical therapy, steroid injections, medications, chiropractic care, massage and others. Some people do well with weight reduction so there's less strain on the spine. Also, there have been studies that show a reduction in back pain in people who stop smoking.</li> <li><strong>Surgery</strong> <br /> Your surgeon will outline whether surgery will effectively treat your situation, the type of procedure and expected recovery time.</li> </ul> <p>"Based on these, we make the decision together," says Dr. Schiefer. "In some situations, for example when the patient has a history of cancer and there's a tumor on the spine or there is spinal instability, we really push for surgery because the consequences of not doing surgery are profound."</p> <p>Dr. Schiefer explains that the presence of a significant neurologic deficit is another time where a surgeon would advocate for a surgery. "If people have a foot drop, or their quadriceps are not working and they can't extend their leg, that's worrisome," he says. "If we don't fix that in a timely manner, then it could be permanent."</p> <h4>7. If you don't perform surgery, what else can help with low back pain?</h4> <p>Many nonsurgical treatment options can relieve low back pain.</p> <p>"We may refer patients to a physical therapist, and some people get good benefit from a chiropractor," says Dr. Schiefer. "Often, they'll also try a steroid injection. We'll try those treatments for up to eight to 12 weeks, usually to see if things get better on their own. The majority of people do, and they don't require surgery."</p> <p>Surgeons watch for some potential red flags, including a history of cancer, significant trauma, signs of infection or development of a neurologic deficit. "If over time things are getting worse or the person develops a neurologic deficit, then we say maybe it's time for surgery," says Dr. Schiefer.</p> <h3>Watch these videos featuring Dr. Schiefer to learn more:</h3> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/nO6Wwde7X38" title="Lumbar pain What is it" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p>   <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/koZ22GGj41M" title="Lower back pain treatment options" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p>   <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/vtiz3A-D2ZQ" title="Bed rest and back pain" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p>   <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/Uo8HIYI6oh" title="Core strength and back pain" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p>   <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/c_teaw2mXYU" title="Osteoarthritis and Back Pain" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p>   <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/aIXgbPWgFGY" title="Fear of back surgery" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p><img src="/-/media/national-files/images/hometown-health/2021/raking-fall-leaves.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E39B0C15AD21DA6F71B7689B8BCB63B2" alt="Raking fall leaves" width="660" height="370" DisableNVelocity="true" />Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.NeurosurgeryNeurosurgery treats disorders that impact any part of the nervous system, which may include the brain, spine or peripheral nerves. Conditions treated range from life-threatening brain tumors, to disorders impacting quality of life, such as back pain and carpel tunnel syndrome.Dawn Haller10/25/2021Whether you're stalking game, carrying on family tradition or enjoy being outdoors, don't let an accident or injury spoil the hunt. Learn how to aim for a safe hunting season.Aim for a safe, healthy hunting season<p>Whether it's the challenge of stalking big game, carrying on a family tradition or just enjoying one last outing in the great outdoors before winter, aim for a safe, healthy hunting season. No one wants their time in the woods or fields spoiled by an accident.</p> <p>While gunshot wounds would appear to be the biggest risk, the most common hunting accidents involve broken bones, or head or other injuries caused by falls from tree stands.</p> <h5>Studies show:</h5> <ul> <li>One-third of all hunters will fall from a tree stand.</li> <li>Bowhunters have higher rates of falls than firearm hunters.</li> <li>About 3,000 tree stand-related accidents in 2018 resulted in injuries, according to the Tree Stand Safety Awareness Foundation.</li> <li>A recent review of the University of Wisconsin Hospital and Clinics' trauma database revealed that over a 14-year period, 55% of injuries related to tree stands involved one or more spinal injuries.</li> </ul> <h4>What makes tree stands so treacherous?</h4> <p>Hunters climb into stands anywhere from up to 30 feet above the ground, often wearing wet, muddy, slippery boots — typically at dawn or dusk. That's a prescription for accidents happening.</p> <h5>To reduce the chance of a fall:</h5> <ul> <li>Before the season, hunters should check their tree stands for deterioration, paying special attention to straps and steps.</li> <li>Wear a safety harness and keep it attached to the tree the entire time the hunter is in the tree stand. Practice <a rel="noopener" href="https://www.deerassociation.com/practice-your-treestand-safety-technique-before-the-hunt/" target="_blank" title="Opens in a new window.">tree stand safety techniques</a>.</li> <li>Avoid alcohol.</li> <li>Carry a cellphone or two-way radio at all times.</li> <li>Before the hunting season, work on better balance by standing on one foot for 30 to 60 seconds without support. Closing the eyes and moving the head from side to side makes this exercise more difficult.</li> </ul> <h5>Watch this video to learn more about tree stand safety:</h5> <p><iframe width="560" height="315" src="https://www.youtube.com/embed/VkHabhxESbw" title="Tree stand safety" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <h4>Getting your body ready</h4> <p>While it's important to be sure your tree stand is in shape, it's also time to make sure your body is ready for the hunt.</p> <p><a href="/hometown-health/speaking-of-health/hunting-and-heart-attacks" target="_self" title="Opens in same window.">Heart attacks</a> also rank high among hunting perils. Hunting isn't a casual stroll through the woods or fields and can be one of the most strenuous activities a hunter experiences all year. In addition, hunters wear gear, which often weighs 25 pounds or more. To prepare, gear up and climb up and down the stairs. Difficulty breathing or lightheadedness might be a sign to check with a primary care provider or cardiologist — or rev up the cardio conditioning.</p> <p>Walking over rough terrain or dragging an animal carcass can increase heart rate significantly, which sometimes can cause changes in heart rhythm. These changes can make it hard for the heart to pump enough blood throughout the body and brain, leading to a life-threatening situation.</p> <p>To avoid muscle and joint injuries, warm up your muscles by stretching in your full hunting gear before hiking to the tree stand or blind. Work on your overall flexibility, especially upper back, chest and shoulders.</p> <h4>Practice hunting safety</h4> <p>Hunting draws on so many skill sets from correctly using a firearm or bow to properly field dressing an animal to safely driving an all-terrain vehicle. This season, put those skills into practice to ensure the hunt is successful and everyone comes home safely.</p> <p><em><a href="/providers/eric-grube-do" target="_self" title="Opens in same window.">Eric Grube, D.O.</a>, practices <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">emergency medicine</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p>D.O.<p><strong>Education</strong></p> <ul> <li>Des Moines University College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Emergency Medicine, Ohio University College of Osteopathic Medicine/Doctors Hospital</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Diplomate, American Osteopathic Board of Emergency Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Emergency Physicians</li> <li>American College of Osteopathic Emergency Physicians</li> <li>American Osteopathic Association</li> <li>Emergency Medicine Residency Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Emergency Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Grube<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/eric-grube-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=675A018230C252FDE2233C6BC7E1120D" alt="Eric Grube DO" width="280" height="280" DisableNVelocity="true" />Eric<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>10035150Eric Grube, D.O.1{FB3BB67A-14FA-4DDE-B183-F85C42E0B255}<img src="/-/media/national-files/images/hometown-health/2021/bow-hunting-from-tree.jpg?h=370&iar=0&w=660&sc_lang=en&hash=FD8C6163E459B8D50D8F2D58BF1D0E1D" alt="Bow hunting from tree" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Dawn Haller9/9/2025Can drinking alcohol in moderation be good for your health? It's possible, but you need to balance the risks and benefits. Learn more before you raise a glass.Balancing the risks, benefits of alcohol<p>Moderate intake of alcohol appears to have relatively low health risk for many people. However, alcohol consumption remains a challenging lifestyle factor to study, as most of what health care professionals know about its effects comes from observational research.</p> <p>To date, no long-term randomized trials of alcohol consumption have been completed. Also, multiple lifestyle factors are associated with patterns of alcohol use and can confound research results.</p> <p>It is possible that many of the health benefits and risk associated with alcohol consumption could be unrelated to the alcohol intake itself. Because of these factors, experts disagree on a safe or recommended amount of alcohol to consume.</p> <h4>Defining moderate alcohol use</h4> <h5>Moderate drinking is defined by the Dietary Guidelines for Americans 2020–2025 as:</h5> <ul> <li><strong>Females</strong><br /> Up to one drink per day, or no more than three drinks on any single day, and no more than seven drinks per week</li> <li><strong>Males</strong><br /> Up to two drinks per day, or no more than four drinks on any single day and no more than 14 drinks per week</li> </ul> <h5>A standard drink is typically defined as:</h5> <ul> <li>Beer: 12 fluid ounces (355 milliliters)</li> <li>Wine: 5 fluid ounces (148 milliliters)</li> <li>Distilled spirits (80 proof): 1.5 fluid ounces (44 milliliters)</li> </ul> <p>These recommendations pertain to people of legal drinking age. Many studies show significant risks for children under 21 who drink alcohol. Therefore, no amount of alcohol is recommended for this age group.</p> <p>Recommendations for safe alcohol intake is generally lower in females due to smaller body size; lower muscle mass; and lower levels of alcohol dehydrogenase, which is the enzyme that breaks down alcohol. People with specific medical conditions or those who take specific medications should avoid alcohol, as no level can be reliably regarded as safe.</p> <h4>Benefits and risks of moderate alcohol use</h4> <h5>Consider the benefits and risks of moderate alcohol use.</h5> <p><strong>Potential benefits:</strong></p> <ul> <li>Some studies have found that moderate drinkers had lower mortality rates, compared to abstainers or heavy drinkers.</li> <li>Research has found the risk of diabetes is lower in those who consume alcohol moderately.</li> <li>Several studies have displayed lower risk of dementia or decreased cognitive decline over time with mild to moderate alcohol intake.</li> <li>Moderate alcohol intake can reduce the risk of developing gallstones.</li> <li>Evidence suggests that mild to moderate alcohol consumption decreases the risk of coronary heart disease and cardiovascular mortality.</li> </ul> <p><strong>Potential risks:</strong></p> <ul> <li>Alcohol use has been associated with increased risk of several types of cancer, including breast, gastrointestinal, and head and neck cancers.</li> <li>Heavy alcohol use can increase the risk of liver disease.</li> <li>Heavy alcohol use increases the risk of acute and chronic pancreatitis.</li> <li>Alcohol intake is associated with increased risk of gout flare in patients who have gout.</li> <li>Intake of alcohol increases the risk of morbidity and mortality from trauma. Driving ability can be impaired with blood alcohol concentration as low as 0.02 percent. The legal driving limit is 0.08 percent.</li> </ul> <p>Some research suggests that wine provides the strongest protection against cardiovascular disease, possibly due to naturally occurring compounds known as flavonoids. However, other studies indicate that all alcoholic beverages offer cardioprotective benefits. Whether beverage type matters for other diseases remains uncertain, although most evidence suggests that it does not.</p> <p>People who do not drink should not start drinking alcohol for the sole purpose of its potential health benefits. Those who do choose to drink should do so in moderation. Talk with your health care provider to understand your specific risks and benefits regarding alcohol use.</p> <p><em>By Mayo Clinic Health System staff. </em></p><img src="/-/media/national-files/images/hometown-health/2021/glass-of-wine-with-salad.jpg?h=370&iar=0&w=660&sc_lang=en&hash=ED65EDCA4D6B23B92CFFD6F9DFD823C2" alt="Forking salad, glass of wine on table" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller11/16/2022Is it a myth or fact that chicken noodle soup can help you feel better when you are ill? Does vitamin C prevent illness? Check out myths and facts about immune-boosting nutrients.Fight off the flu with immune-boosting nutrients<p>It's flu season again, so most people <a href="/hometown-health/featured-topic/dont-skip-your-flu-shot-this-year" target="_self" title="Opens in same window.">get a flu shot</a> and strive to stay healthy. But can certain foods or supplements boost the immune system and help with that "staying healthy" goal? </p> <h2>Keep the immune system strong</h2> <h3>While having a healthy immune system is a plus during the season of colds and flu, consider these tips for keeping your immune system strong throughout the year:</h3> <h4>Focus on a balanced eating plan.</h4> <p>Don't skip meals, so your body stays well-fueled. Aim for five to nine servings of vegetables and fruits daily to provide those immune-boosting vitamins, minerals and antioxidants. A serving of fruit is one medium piece of fresh fruit, 1 cup of berries or melon, or 1/2 cup of canned fruit packed in its own juice. A serving of vegetables is 1/2 cup cooked or 1 cup raw. Getting these nutrients from foods versus vitamin or mineral supplements is always best. Many herbal remedies are marketed to help <a href="/hometown-health/speaking-of-health/7-ways-to-combat-coughs-and-colds" target="_self" title="Opens in same window.">fight colds</a> or shorten their duration, but check with a health care professional before taking any supplements or medications. And don't forget fluids. Remember to drink adequate fluids throughout the day. Plain water is best.</p> <h4>Crack down on spreading germs.</h4> <p>Good hygiene and hand-washing help prevent the spread of germs. Remember to wash produce before eating or using it in recipes. Clean glasses, forks, spoons and other utensils to reduce the spread and growth of bacteria.</p> <h4>Increase sleep, reduce stress.</h4> <p>Getting adequate sleep and managing stress can be just as important as healthy eating to prevent the flu.</p> <h5>Research demonstrates that lack of sleep and increased stress contribute to illness and overall poor health, so:</h5> <ul> <li>Adults should get seven to nine hours of sleep each day, while children need eight to 14 hours, depending on age.</li> <li>Healthy ways to cope with stress include meditating, listening to music or journaling.</li> <li>Physical activity is another strategy to manage stress and may reduce the risk of some chronic diseases that can weaken your immune system.</li> </ul> <p>Even if you eat healthily, get plenty of rest, drink adequate fluids and manage your stress, you may still <a href="/hometown-health/speaking-of-health/facts-about-flu" target="_self" title="Opens in same window.">catch the flu</a>. If so, your illness may not last as long, and you may not feel so bad.</p> <h2>Here are some myths and facts about immune-boosting nutrients:</h2> <h3>Fact: Chicken soup can help you feel better.</h3> <p>According to the National Institutes of Health, there are many healing benefits of chicken soup. Your favorite recipe likely has properties that fight inflammation, promote hydration and get mucus flowing. Drink plenty of liquids, such as water, broth or sports drinks with electrolytes.</p> <h3>Myth: Vitamin C can prevent illness.</h3> <p>When taken before cold symptoms start, vitamin C may shorten the duration, but it doesn't keep you from getting sick.</p> <h3>Myth: Dairy increases mucus production.</h3> <p>You may have heard that milk and other dairy products worsen congestion during an illness. Research has not proven this to be true.</p> <h2>Choose immune-boosting nutrients</h2> <h3>These nutrients play a role in immune health:</h3> <ul> <li><strong>Beta carotene</strong><br /> Beta carotene is found in plant foods, such as sweet potatoes, spinach, carrots, mangoes, broccoli and tomatoes.</li> <li><strong>Vitamin C</strong><br /> <a href="/hometown-health/speaking-of-health/add-citrus-colors-and-flavors-to-meals" target="_self" title="Opens in same window.">Vitamin C-rich foods</a> include citrus fruits, berries, melons, tomatoes, bell peppers and broccoli.</li> <li><strong>Vitamin D</strong><br /> Vitamin D is found in fatty fish and eggs. Milk and 100% juices fortified with vitamin D also are good sources.</li> <li><strong>Zinc</strong><br /> Zinc tends to be better absorbed from foods such as beef and seafood, but it's also found in plant-based sources, including wheat germ, beans, nuts and tofu.</li> <li><strong>Probiotics</strong><br /> <a href="/hometown-health/speaking-of-health/whats-the-deal-with-probiotics" target="_self" title="Opens in same window.">Probiotics</a> are good bacteria that promote health. You'll find them in cultured dairy products, such as yogurt, and in fermented foods, such as kefir and kimchi.</li> <li><strong>Protein</strong><br /> Protein comes from animal and plant sources, including milk, yogurt, eggs, beef, chicken, seafood, nuts, seeds, beans and lentils.</li> </ul> <h2>Stay well. In the meantime, here are some recipes incorporating immune-boosting foods:</h2> <h4>Chicken noodle soup with dill</h4> <p>Serves 6</p> <p>10 cups reduced-sodium chicken broth<br /> 3 medium carrots, diced<br /> 1 large stalk celery, diced<br /> 3 tablespoons minced fresh ginger<br /> 6 cloves garlic, minced<br /> 4 ounces whole-wheat egg noodles (3 cups)<br /> 4 cups shredded cooked skinless chicken breast (about 1 pound)<br /> 1 tablespoon chopped fresh dill<br /> 1 tablespoon lemon juice, or to taste</p> <p>Bring broth to a boil in a Dutch oven. Add carrots, celery, ginger and garlic; cook uncovered over medium heat until vegetables are just tender, about 20 minutes. Add noodles and chicken; simmer until the noodles are just tender, 8–10 minutes. Stir in dill and lemon juice.</p> <p>Nutrition per serving (1½ cups): 267 calories, 4 g total fat, 2 g saturated fat, 1 g monounsaturated fat, 0 g cholesterol, 38 g protein, 18 g carbohydrates, 2 g dietary fiber, 330 g sodium.</p> <h4>Tomato apple jam</h4> <p>Mayo Clinic Healthy Living Center<br /> Serves 4<br /> Serve as condiment with chicken steak, fish, fried eggs or toast.</p> <p>1 tablespoon olive oil<br /> 1 cup yellow onions, diced<br /> 1 teaspoon ground mustard seed<br /> ⅛ teaspoon cayenne pepper<br /> ⅛ teaspoon ground allspice<br /> ⅛ teaspoon ground cinnamon<br /> 2 cups tomatoes, peeled and diced<br /> 2 cups apples, unpeeled and diced<br /> ¼ cup apple cider vinegar<br /> ¼ cup sugar<br /> ¾ teaspoon salt (decrease if on sodium restriction)</p> <p>Heat olive oil in a pan over medium heat. Sautee onions for two minutes. Then add all the spices; toast and stir for two minutes. Add the tomatoes, apples, vinegar and sugar. Mix together and simmer over low heat for 20–30 minutes, stirring occasionally. Season to taste.</p> <p>Nutrition per serving (2 tablespoons): 24 calories, 0.5 g total fat, 0.1 g saturated fat, 0.3 g monounsaturated fat, 0 g cholesterol, 0.3 g protein, 5 g carbohydrates, 1 g dietary fiber, 48 g sodium.</p> <p><em><a href="/providers/kristi-wempen-rdn" target="_self" title="Opens in same window.">Kristi Wempen</a> is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window."></a><a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Chronic kidney disease</li> <li>General health and wellness</li> <li>Weight management</li> </ul>RDN, LD<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Minnesota State University-Mankato</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Iowa State University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration</li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul> <p><strong>Membership</strong></p> <ul> <li>Academy of Nutrition and Dietetics</li> </ul>Wempen<img src="/-/media/shared-files/images/medical-professionals/full/mankato/kristi-wempen-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=BB7EFDC16603EA67B00B7CD0DBD528E1" alt="Kristi Wempen RDN" width="280" height="280" DisableNVelocity="true" />Kristi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14834341Kristi Wempen, R.D.N.1{2BEE5070-65FF-4406-9E59-103E06C5A535}<img src="/-/media/national-files/images/hometown-health/2021/immune-boosting-food.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2A43BC877F037C55D90F8EB281E32170" alt="Immune boosting food" width="660" height="370" DisableNVelocity="true" />InfluenzaInfluenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza, commonly called the flu, is not the same as the stomach "flu" viruses that cause diarrhea and vomiting.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller10/27/2021Have you considered how family health history may affect future generations? Find out options for learning details about your baby's health with a genetic counselor.Genetic counseling for family planning, pregnancy<p>Making the decision to add a branch to your family tree is an important one. It may be a time for reflection when you think of parents, grandparents, aunts, uncles and other family members. But have you considered how the health history of you and your partner's families may affect future generations?</p> <p>While most babies will be born healthy, it's important to understand options for learning details about your baby's health.</p> <h4>Genetic counseling</h4> <p>A genetic counselor helps you understand complex genetic information and options available if genetic testing is performed. Genetic testing is part of the genetic counseling process, but it is not required to undergo genetic counseling.</p> <p>You can meet with a genetic counselor virtually using telehealth technology from the comfort of your home. This eliminates needing to travel to a hospital or clinic location, especially if you have other children at home.</p> <p>Your OB-GYN can refer you for genetic counseling if you are interested in learning about your and your partner's genes. You also may be referred if you have certain risk factors.</p> <h5>Risk factors include:</h5> <ul> <li>Being 35 or older</li> <li>Having a family history of genetic conditions</li> <li>Having a child affected by a genetic condition or birth defect</li> </ul> <p>An appointment with a genetic counselor includes a review of personal medical history and family health history. A family tree, called a pedigree, is created to document your family history.</p> <p>Gathering as much information as possible about your family's health history for you and your partner's maternal and paternal sides is helpful before meeting with the genetic counselor.</p> <h5>Relevant health history includes:</h5> <ul> <li>Any major health issues and age of diagnosis</li> <li>Chronic conditions</li> <li>Conditions that require care of a specialist</li> <li>Conditions that require medication</li> <li>Conditions they were born with or developed unexpectedly at a young age</li> <li>Country of ancestry</li> </ul> <p>Based on your family history, the genetic counselor will determine if testing is available and help you decide whether details gathered from testing would be beneficial to the pregnancy.</p> <p>With guidance from the counselor, you may decide not to pursue genetic testing based on family history. If testing is not warranted based on family history, screening options are available for genetic conditions that occur randomly or can hide in families.</p> <h4>Genetic testing</h4> <p>Genetic testing involves examining your DNA — the chemical database that carries instructions for your body's functions. Genetic testing can reveal genetic changes that can cause illness or disease.</p> <p>A positive result in genetic testing does not always mean the condition or disease will develop. And in some situations, a negative result doesn't guarantee the condition or disease is not present. A genetic counselor is a trusted partner each step of the way, helping interpret and navigate genetic test results.</p> <p>Genetic testing is available for women who are pregnant or planning a pregnancy. A genetic counselor can assist with information on how to gather cost estimates for laboratory testing regardless of whether insurance coverage is available.</p> <h4>Family planning</h4> <p>It's recommended to see a genetic counselor prior to pregnancy for testing to help with conception planning. During preconception counseling, carrier screening can be performed for over 200 inherited conditions that can hide in families. Genetic testing for you and your partner prior to pregnancy will show if inherited conditions are present in genes that could be passed on to your children.</p> <h5>Conditions include:</h5> <ul> <li>Cystic fibrosis</li> <li>Spinal muscular atrophy</li> <li>Sickle cell disease</li> <li>Tay-Sachs disease</li> <li>Fragile X syndrome</li> <li>Hemoglobin disorders</li> </ul> <p>Knowing your genetic risk can help determine risk for children to have the same condition. If you and your partner are unaffected carriers of a condition, the child has a 25% chance of having the same condition. When the potential for inherited conditions is determined before conception, there are ways to avoid passing on the affected genes. With natural conception, a genetic counselor can coordinate testing early in pregnancy or shortly after birth to gather this information. Being able to start treatment as early as possible is important with some of these conditions.</p> <h4>Prenatal or pregnancy</h4> <p>Genetic testing can be performed during pregnancy to screen for common conditions that occur randomly and are not passed on in families.</p> <h5>Conditions screened for in pregnancy include:</h5> <ul> <li>Down syndrome</li> <li>Trisomy 13 and 18</li> <li>Klinefelter syndrome</li> <li>Turner syndrome</li> <li>Neural tube defects, such as spina bifida or anencephaly</li> </ul> <p>Determining the risk can help you and your partner medically and emotionally prepare to have a child with a genetic condition. Testing includes an anatomic ultrasound or a blood test for you, which may include cell-free DNA screening. Prenatal screening tests usually are performed during the first or second trimester.</p> <p>Each step of the consultation, screening and testing process is done through collaboration and conversation between you and the genetic counselor. Your OB-GYN and other care team members are included so pertinent information is shared with those involved in your care and that of your baby during the pregnancy.</p> <p>The primary goal of genetic counseling is to provide information and support as you make informed decisions about your health and the health of your family.</p> <p><em><a href="/providers/rachel-keppers-ms-cgc" target="_self" title="Opens in same window.">Rachel Keppers</a> specializes in <a href="/services-and-treatments/medical-genetics" target="_self" title="Opens in same window.">genetics</a> or inherited diseases.</em></p><ul> <li>Cardiovascular genetics (familial hypercholesterolemia [high cholesterol and heart disease], dilated cardiomyopathy, hypertrophic cardiomyopathy, aortic aneurysm)</li> <li>Genetic testing (diagnostic testing, presymptomatic and predictive testing)</li> <li>Oncology (cancer) genetics (personal and family history of breast, ovarian, uterine, colon, prostate, melanoma, pancreatic cancer)</li> </ul>M.S., CGC<p>I specialize in genetic counseling for cancer and cardiac genetics. I see individuals with a personal or family history of cancer or certain cardiac conditions (i.e., high cholesterol, cardiomyopathy, aortic aneurysm).</p> <p>The main goal I have as I enter every patient appointment is patient empowerment. My role is to educate you on the option of genetic testing for you and your family. We will discuss the benefits, limitations and risks of genetic testing. I enjoy assisting in the decision-making process as you determine whether genetic testing is something you will find beneficial to you. I appreciate spending time with you and hearing your personal and family stories.This helps me to gather an idea of your goals and how genetic testing could aid in your health care.</p> <p>I joined Clinical Genomics in Eau Claire in June of 2020. I have enjoyed seeing the department grow through all health system sites. I appreciate the opportunity to offer genetic counseling services to individuals via video visits to allow patients to access care closer to home.</p> <p>I am originally from the south metro of Minnesota. My husband and I have lived in Eau Claire since May of 2020 and have enjoyed exploring all the awesome food, nature and Wisconsin culture the city has to offer. In my free time, I enjoy baking new treats, traveling to new places, and in the fall, continuing to humble myself as a natural-born Vikings fan.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Biology and Psychology, North Dakota State University</li> <li>Master's degree, Genetic Counseling, University of Minnesota-Twin Cities</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Genetic Counseling, Mayo Clinic School of Health Sciences</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Genetic Counseling, American Board of Genetic Counseling</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>National Society of Genetic Counselors</li> <li>Wisconsin Genetic Counselors Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Medical Genetics, Mayo Clinic College of Medicine and Science</li> </ul>Keppers<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/rachel-simon.jpg?h=280&iar=0&w=280&sc_lang=en&hash=3C66CDE23A6756DCCA406F1D7791CCD3" alt="Rachel Simon" width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/34514687/" target="_blank" title="Opens in new window">Differences in genetic counseling student responses to intense patient affect: A study of students in North American programs</a>, April 2022</li> </ul>Rachel<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21405336Rachel Keppers, M.S., CGC1{546684F5-41C6-4BEA-AD6B-DE3D7D6451C1}<img src="/-/media/national-files/images/hometown-health/2021/couple-gazing-outside.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4815294D0828EA6C8424045339043A22" alt="Couple gazing outside" width="660" height="370" DisableNVelocity="true" />Genetic TestingGenetic testing examines your DNA — the chemical database that carries instructions for your body's functions — to reveal changes or alterations in your genes that may cause illness or disease. <br/><br/>Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller10/18/2021Amid the COVID-19 pandemic, it's important to be vaccinated for COVID-19 and the flu. Learn why and how you can get both shots at the same time.Get your flu shot, COVID-19 vaccine at the same time<p><em>Updated Dec. 3, 2021</em></p> <p>Have you had your flu shot yet? The Centers for Disease Control and Prevention recommends that everyone over 6 months get a flu shot every season with rare exceptions.</p> <p>Now amid the COVID-19 pandemic, it's important to be vaccinated for COVID-19 and the flu. And you can get both shots at the same time.</p> <p>"In most places, flu starts circulating by November, December. So it's recommended that everyone complete their flu vaccine by October," says <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayo.edu/research/faculty/sampathkumar-priya-m-d/bio-00086534" target="_blank" title="Opens in a new window.">Priya Sampathkumar, M.D</a>., a Mayo Clinic infectious diseases specialist.</p> <p>During the COVID-19 pandemic, communities are on the verge of another flu season. This year, it's more important than ever to be vaccinated for influenza as soon as possible.</p> <p>"It's possible that the viruses that cause COVID-19 and the flu may spread in your community at the same time during flu season," says <a href="/providers/emily-majerus-pa" target="_self" title="Opens in same window.">Emily Majerus</a>, a physician assistant in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota, and the <a href="/services-and-treatments/mobile-health-clinic" target="_self" title="Opens in same window.">mobile health clinic</a>. "If this happens, people could become ill with COVID-19 and the flu at the same time. Getting vaccinated for both COVID-19 and the flu can reduce their spread."</p> <p>Flu cases were low in 2020. And health experts attribute that to the COVID-19 pandemic and the preventive measures put in place to reduce the spread of COVID-19.</p> <p>"We're afraid that with in a lot of places masking recommendations being relaxed that flu will spread more easily. And the fact that no one had flu last year means there's a lot more people who are vulnerable this year," says Dr. Sampathkumar.</p> <p>Flu and COVID-19 are caused by respiratory viruses and have similar symptoms.</p> <p>"It's very, very hard — almost impossible — to distinguish the two just based on symptoms, says Dr. Sampathkumar. “Some cases of COVID can be very mild and present exactly like the flu. Some cases of flu can be very severe and present like COVID. So really, the only way to know for sure when you have a respiratory illness is to get tested."</p> <p>The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices approved Moderna and Pfizer COVID-19 booster vaccinations for all adults. Mayo Clinic strongly recommends that all adults receive a COVID-19 booster vaccination as soon as possible if they are at least six months past their initial Moderna or Pfizer vaccination series, or at least two months past their initial Johnson & Johnson vaccination.</p> <p>And if you haven't been vaccinated for COVID-19 yet, or need a third or booster vaccination, you can get vaccinated for flu and COVID-19 at the same time.</p> <p>"The Food and Drug Administration has issued an emergency use authorization for the Pfizer COVID-19 booster vaccine six months after your completion of the initial vaccination series," says Emily. "And if you haven't been vaccinated for COVID-19 yet or need a third dose or a booster, you can get your flu shot and COVID-19 vaccination at the same time."</p> <h4>Watch this video with a COVID-19 update for long-term care facilities, including the delta variant, benefits of COVID-19 vaccines, concerns people may have about vaccine and preventive measures that can be taken to help stop the spread of COVID-19 in our communities:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/Y4vzfld8V20" title="COVID 19 update for long term care facilities" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2021/sitting-up-in-bed-blowing-nose.jpg?h=370&iar=0&w=660&sc_lang=en&hash=304FFF20EF11F9B4C87CCB61760FC9E1" alt="Sitting up in bed blowing nose" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. InfluenzaInfluenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza, commonly called the flu, is not the same as the stomach "flu" viruses that cause diarrhea and vomiting.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller10/26/2021We're bombarded with images of the perfect life. But striving toward an unrealistic level of perfection may be making us less happy and productive. Learn what you can do to turn down the perfection pressure.Not measuring up to impossible standards? Tackle the perfection fixation<p>From Pinterest to Instagram, Facebook to LinkedIn, magazine ads to the good old holiday letter, people are bombarded with images of the perfect family, job, trip, figure, outfit and even kids' curated bento boxes. But this striving toward an unrealistic level of perfection may be making people less happy and productive.</p> <p>Perfectionism — once seen as fairly positive — is finally getting attention for being a problem. Why? Because the combination of high personal standards, self-criticism and the sense of never quite measuring up can be toxic and damaging to people's overall mental health. A <a rel="noopener" href="https://www.apa.org/pubs/journals/releases/bul-bul0000138.pdf" target="_blank" title="Opens in a new window.">2016 study of college students</a> in the U.S., Canada and United Kingdom showed a 50% increase — from 9% to 18% — in the quest for perfection in less than 30 years.</p> <h2>Changing views of perfectionism</h2> <p>In the psychology field, perfectionism is seen mostly as getting in people's way of being successful. In small doses can help, but when it's a persistent pattern, it can be paralyzing.</p> <p>When the bar of perfection is impossibly high, it's much easier to either do nothing or do things 1,000%. Just by sheer math, that's unattainable. Setting this impossible expectation, either for yourself or for others, is a setup for burnout and failure.</p> <h2>Pitfalls of seeking the perfect 10</h2> <p>There's a dark side to perfectionism that strongly impacts people's physical and mental health. It's so normalized, and maybe even romanticized, that it's thought of as a part of being great. But at strong levels, perfectionism can reach a point where it's impairing people's ability to function on a day-to-day basis. It may be more similar to obsessive compulsive disorder or generalized anxiety disorder, and sometimes can even drive chronic pain and greater risk of heart disease.</p> <h2>Pressures to be the perfect parent</h2> <p>Social media is one influence amping up pressure on parents to be perfect. With people sharing only carefully chosen snippets and perfect images of their lives, it can seem like those are the examples to strive for. But fighting against those "shoulds" is a strong model that parents can give their children. If you truly value raising your kids to be flexible and have a healthy balance, then sometimes allowing them to wear their shirt backward or have food all over their face is stronger parenting than subscribing to the high bar of what we should and shouldn't be doing.</p> <p>People can help others see that, too, by not always talking only about their successes, but also by talking more openly about the struggles. Being real and accepting with each other can help really promote a culture of reality rather than perfectionism.</p> <h2>Perfectionism's impact on kids</h2> <p>Mental health providers are seeing kids who are setting themselves up for burning out by high school — and sometimes even by middle school — because they're working so hard and burning the candle at both ends to be the perfect student, athlete, friend and more. The concept of moderation — figuring out what things people need to pour themselves into 100% and what things they just need to do OK on — is a skill some kids must be taught. Perfectionistic teens probably would benefit from getting a B. As a result, they'll see the world doesn't crumble and realize they can still be happy, even if everything isn't perfect.</p> <h2>Countering the push to be perfect</h2> <p>Flexibility is a good thing. Doing things differently or spontaneously, trying to roll with situations as they come, not always having a plan, and just changing things up from time to time, can be doable ways to counter perfectionism.</p> <p>The flip side of perfectionism is the fear of not being good enough. As people start to face that fear, do things imperfectly and see the world keeps turning, it becomes easier to push back on perfectionism. Being afraid of failure and of not being the best works the same way. The more people face it, gradually they become more comfortable with showing and embracing the reality of their lives and not worrying so much about measuring up.</p> <p><em>By Mayo Clinic Health System staff</em></p> <p><em>Portions of this article were adapted from an interview with the <a rel="noopener" href="https://www.startribune.com/" target="_blank" title="Opens in a new window.">Minneapolis Star Tribune</a> on Oct. 3, 2021.</em></p><img src="/-/media/national-files/images/hometown-health/2021/looking-at-reflection-in-mirror.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BA368FD5055F85B8DBBC53419EC21C6E" alt="Looking at reflection in mirror" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller10/29/2024 Oatmeal may not be glamorous, but when it comes to a good-for-you breakfast, it checks all the boxes. It's nutritious, delicious and easy to make. Learn how to take it to the next level. What makes oatmeal the ideal breakfast for heart health and weight loss?<p>Oatmeal is a nutritious, inexpensive and versatile way to incorporate <a href="/hometown-health/speaking-of-health/4-key-elements-of-a-heart-healthy-diet" target="_self" title="Opens in same window">whole grains</a> into your diet and help you start your morning off right.</p> <p>Oats made history when they became the first food with a Food and Drug Administration health claim label in 1997. This claim was related to <a href="/hometown-health/speaking-of-health/easy-tips-to-improve-your-heart-health" target="_self" title="Opens in same window">heart health</a> and showed that intake of whole oat products decreased blood cholesterol levels.</p> <h3>What makes oats so healthy?</h3> <p>Oats contain a type of soluble fiber called beta-glucan, which lowers blood glucose and <a href="/hometown-health/speaking-of-health/know-your-numbers-cholesterol" target="_blank" title="Opens in a new window.">cholesterol</a> levels and reduces the risk of <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window">heart disease</a> and <a href="/hometown-health/speaking-of-health/diabetes-what-you-need-to-know-and-do" target="_self" title="Opens in same window">diabetes</a>. Beta-glucan also promotes healthy <a href="/hometown-health/speaking-of-health/good-bacteria-for-your-gut" target="_self" title="Opens in same window">gut bacteria</a> and intestinal health.</p> <p>Eating oatmeal regularly can have weight management benefits, too. One-half cup of rolled oats cooked in a cup of water has 165 calories, 4 grams of fiber and 6 grams of protein.</p> <p>Oats' fiber and protein content contribute to feeling full longer and slowing the release of blood glucose. They're also an excellent source of many <a href="/hometown-health/speaking-of-health/make-every-calorie-count-with-nutrient-dense-foods" target="_self" title="Opens in same window">vitamins and minerals</a>, including magnesium, copper, thiamine and zinc.</p> <h3>Know the different kinds of oats</h3> <p>You can find different kinds of oats in the grocery store, including steel-cut, rolled, quick and instant.</p> <p><strong>Steel-cut oats.</strong><br /> Also called Irish oatmeal, whole oat kernels are cut into two or three pieces with steel disks. Because these oats are the least processed, they contain the highest amount of fiber. Steel-cut oats take longer to cook, resulting in a creamy and chewy porridge. They also can be made in a slow cooker.</p> <p><strong>Rolled oats.</strong><br /> These oats are rolled flat to make them easier to cook. Most of the bran is removed, so they have slightly less fiber than steel-cut oats but take less time to cook.</p> <p><strong>Quick oats.</strong><br /> This variation of rolled oats is rolled thinner and cut into small pieces, so they cook even faster.</p> <p><strong>Instant oats.</strong><br /> These are the oats found in single-serve packets. They're typically flavored and can be added to hot water or cooked in the microwave for a few minutes. While instant oats cook the fastest, they usually have more added sugar and less fiber than other types of oats.</p> <h3>Taking oats to the next level</h3> <p>Oats have a nice flavor on their own, but if you're tired of plain oatmeal, here are a few ideas to try:</p> <ul> <li>Baked oatmeal is almost cake-like and is a great way to make a week's worth of breakfasts in one batch.</li> <li>To make your morning smoothie more filling, put 1/4 to 1/2 cup rolled oats in a blender and grind until fine. Stir into your smoothie for a breakfast with the staying power of oatmeal.</li> <li>Overnight oats are made with rolled or quick oats mixed with some type of milk and yogurt, then refrigerated overnight. In the morning, you'll have a cool, creamy oatmeal mixture to eat with fruit or add to a smoothie.</li> </ul> <p>You also can play with flavors and add-ins that increase protein and soluble fiber.</p> <p>Try adding these options to your oatmeal:</p> <ul> <li>Chopped dates, dried cranberries or applesauce</li> <li>Cocoa powder, a ripe banana and a couple of drops of vanilla extract</li> <li>Peanut butter and a few drops of vanilla</li> <li>Pinch of pumpkin pie spice</li> <li>Roasted pumpkin seeds and a swirl of nut butter or a dollop of Greek yogurt</li> <li>Sprinkle of chia seeds or ground flax</li> <li>Unsweetened coconut, chopped cashews or sliced almonds.</li> </ul> <h3>Healthy oatmeal recipes</h3> <p>These baked oatmeal and carrot-cake oatmeal recipes will get your morning off to a great start. Bake the oatmeal in the evening, refrigerate it and warm it up for breakfast. The carrot-cake oatmeal is loaded with calcium, protein, fiber and vitamin A. Chia seeds are high in heart-healthy soluble fiber and omega-3 fatty acids. Both oats and chia seeds provide soluble fiber, which lowers cholesterol levels. The small amount of carrots in this recipe provides 100% of your daily vitamin A and is good for your eyes and immune system.</p> <h4>Baked oatmeal</h4> <p>Mayo Clinic Staff<br /> Servings: 8</p> <p>1 tablespoon canola oil<br /> ½ cup unsweetened applesauce<br /> ⅓ cup brown sugar<br /> Egg substitute equivalent to 2 eggs, or 4 egg whites<br /> 3 cups uncooked rolled oats<br /> 2 teaspoons baking powder<br /> 1 teaspoon cinnamon<br /> 1 cup skim milk<br /> 1 cup fresh or frozen blueberries</p> <p>In a large bowl, stir together the oil, applesauce, sugar and eggs. Add the dry ingredients and milk. Mix well. Generously spray a 9-by-13-inch baking pan with cooking spray. Spoon the oatmeal mixture into the pan. Sprinkle blueberries evenly over the oatmeal. Bake uncovered at 350 F for 30 minutes. Serve with toppings of your choice from the ideas above.</p> <p>Nutritional per 3/4-cup serving (not including toppings): 205 calories, 4 grams total fat, 105 milligrams sodium, 36 grams carbohydrates, 3 grams fiber, 7 grams protein.</p> <h4>Carrot cake overnight oats</h4> <p>Mayo Clinic Staff<br /> Servings: 1</p> <p>½ cup rolled oats <br /> ⅔ cup skim milk<br /> ⅓ cup plain, nonfat Greek yogurt<br /> ¼ cup finely grated carrot<br /> 1½ teaspoons chia seeds<br /> 2 teaspoons maple syrup<br /> ½ teaspoon cinnamon<br /> ½ teaspoon vanilla extract<br /> 1 tablespoon pecans, chopped<br /> 1 tablespoon shredded coconut, unsweetened</p> <p>Combine all ingredients, except the pecans and coconut, in a bowl or Mason jar. Top with pecans and coconuts and cover. Refrigerate overnight and serve chilled.</p> <p>Nutritional per serving: 395 calories, 12 grams total fat, 135 milligrams sodium, 55 grams carbohydrates, 9 grams fiber, 21 grams protein</p> <p><em><a href="/providers/romi-londre-rdn" target="_self" title="Opens in same window">Romi Londre</a> is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window">Nutrition</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Eating disorders</li> <li>Enteral nutrition or tube feedings</li> <li>Weight management</li> </ul>RDN, CD<p><strong>Education</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Registered Dietitian Nutritionist</li> <li>Certified Nutrition Support Clinician </li> <li>Certificate of Training in Adult Weight Management</li> </ul> <div> </div>Londre<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/romi-londre-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7919B2F8260054ECC4308684471EEEDB" alt="Romi Londre RDN" width="280" height="280" DisableNVelocity="true" />Romi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15183670Romi Londre, RDN, CD1{2BEE5070-65FF-4406-9E59-103E06C5A535}<img src="/-/media/national-files/images/hometown-health/2021/oatmeal-almonds-blueberries.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4F9B4B4382727EE79BCAC1C71083AD6A" alt="Oatmeal with almonds and blueberries" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller6/2/2022Life is full of unpredictable changes and stressful situations. Children, especially teens, aren't likely to ask their parents to help them manage stress. Here's what to look for and how to help.Stressed out kids? Signs and strategies<p>Life is full of unpredictable changes. Some can be exciting and motivating, while others can lead to increased stress, poor health and anxious feelings.</p> <p>Stress is an automatic physical, mental and emotional response to challenging events. It's a normal part of everyone's life, including the lives of children.</p> <p>Children have faced many new and potentially stressful situations during the COVID-19 pandemic. For some, there have been changes in school and activity routines, family changes with moves or a parent's career disruption, and concerns over their health or the loss of a loved one.</p> <p>Children, especially teenagers, aren't likely to ask their parents to help them manage their stress. Sometimes, they don't even recognize that they are feeling stressed out.</p> <p>As a caregiver, you might notice something is off before they do. Helping your children manage their stress can lead to more balanced and healthier lives.</p> <h2>Signs of stress in children</h2> <p>Children aren't miniature adults, and they may express stress in different ways than you might expect.</p> <h3>Here are a few signs that your children may be stressed out or could use some extra support:</h3> <ul> <li><strong>Emotional outbursts or increased irritability</strong><br /> Stress leads to stronger feelings of anger and irritability. Your children may have emotional outbursts that are inconsistent with their previous behavior or the current situation.</li> <li><strong>Trouble sleeping</strong><br /> Worries and fears seem to come out during bedtime. Children who are stressed may have trouble falling or staying asleep, or start having nightmares.</li> <li><strong>Withdrawing from others</strong><br /> Children who are stressed may want to spend more time alone and not interact with friends or family.</li> <li><strong>Struggles with school</strong><br /> Significant changes in your children's school performance can be a sign of stress. Stress makes it harder for children to focus during the school day or when doing homework. Emotional outbursts and anger at school can cause trouble with friends and classmates.</li> <li><strong>Frequent headaches or stomachaches</strong><br /> When children are stressed or anxious, their bodies release the hormone cortisol into the blood. This can trigger abdominal cramps and headaches.</li> <li><strong>Increased defiance</strong><br /> Children under stress may feel angry or overwhelmed. They are seeking ways to get out of the situation that is causing them to feel uncomfortable. This can lead to defiant and stubborn behaviors.</li> </ul> <p>Remember that children's signs of stress can vary based on age, personality and coping skills. The key is to watch for drastic or sudden changes from your children's previous behaviors.</p> <h2>Managing defiance</h2> <p>Usually, children don't have a lot of power or control in their lives. They are told when to eat, when to sleep, how to act, what is appropriate to wear, what is appropriate to say and what they should learn. The list goes on.. Children know how to get a reaction out of and manipulate their parents. And sometimes saying no is the only control they feel they have that day.</p> <p>Sometimes there is a purpose for their misbehavior, such as to gain attention or get something they want. Other times, they might just be on autopilot because they are exhausted and their brains simply aren't able to regulate their emotions or actions anymore. They are exposed to different experiences throughout the day that parents might not even know about.</p> <p>Their brains are not developed until they are about 25 years old, and they might just not know how to process the day's experiences. Because of this, children's ability to respond relationally differs from adults, and they tend to respond emotionally and impulsively.</p> <p>As a parent or caregiver, it can feel exhausting when your children act defiantly.</p> <h3>Here are a few tips for managing children's defiant behaviors:</h3> <ul> <li><strong>Set expectations.</strong> <br /> Children thrive on routines and set expectations. Outline examples of behaviors you will and will not tolerate. When correcting children, tell them what you want them to do rather than what not to do. For example, instead of saying, "Stop chewing with your mouth open," try saying, "Please chew with your mouth closed."</li> <li><strong>Act, don't react.</strong> <br /> When children act defiant, the instinct to react is human. The expression of emotion also is human. Take a deep breath and calmly correct behavior. Don't mirror their anger level. Maintain calm and set clear expectations. Maintain consistency. For example, don't say yes to something just because you want the behavior to end. Rather, validate their emotion and  follow through with your set expectation. Remind yourself that your children are impressionable, and your words matter. They need to know it's OK to express their emotions respectfully.</li> <li><strong>Pick your battles.</strong> <br /> If their behavior is simply irritating but not dangerous or illegal, try to ignore it. The moment they do something positive, complement them. Sometimes children simply want a reaction, so try to react to the positive behaviors instead of the negative.</li> <li><strong>Focus on two or three behaviors only.</strong> <br /> Children may feel overwhelmed or inadequate if you try to correct every concerning behavior. A focused approach will get better and quicker results in improved behaviors.</li> </ul> <h2>Coping with stress</h2> <h3>While all stress cannot be eliminated, you can prevent excess stress from affecting your children's lives by:</h3> <ul> <li><strong>Establishing and keeping routines</strong><br /> With many simultaneous changes, children need to be able to count on something that's going to be the same most of the time. That's why routines are so important. If your family wasn't routine-orientated before, now is a good time to implement daily routines to provide structure and support. You could start a new bedtime habit or strive to have supper together a few nights a week to provide consistency at home for your children.</li> <li><strong>Finding times to talk</strong><br /> Children tend to have a difficult time starting a difficult or uncomfortable conversation. Find times to talk to your children when you are doing something together. This could include when you are making meals. Invite them to join you in the kitchen. Find time to sit at the table to eat together. If you are driving somewhere, that is also a good time. Children tend to share more when they do not have to look straight at you or feel pressured to talk about their feelings or experiences.</li> <li><strong>Encouraging a return to previous activities</strong><br /> During the pandemic, many children's activities were delayed or canceled. After going a long time with little social contact, some kids have anxiety about returning to activities they previously enjoyed. Depending on your local health recommendations, encourage your children to try a new or previous favorite activity or sport again. If your children resist, set a timeline to reevaluate their feelings. For example, ask your children to try the activity for two weeks before making any final decision. It's good for them, and most will find they enjoy it once they get going again.</li> <li><strong>Allowing choices</strong><br /> Children have few choices. Allow them to have some choices when appropriate. This might include what to eat for supper, what to watch on TV, what game to play and so on.</li> <li><strong>Finding humor in daily life</strong><br /> A good laugh doesn't just lighten a mood, it also activates and relieves the body's stress response. Find ways to laugh with your kids by watching comedies, reading comics or jokes, playing games, and helping each other find the humor in daily life.</li> <li><strong>Playing as a family</strong><br /> Get physically active with your kids and find ways to play as a family. Put on music and dance in the kitchen, go for a bike ride after dinner, or play games as a family. These activities can reduce how stress affects you and your children.</li> <li><strong>Encouraging healthy diet and sleep habits</strong><br /> Tired or hungry kids are rarely happy. Make sure that your children's diet includes a mix of fruits and vegetables, whole grains and lean proteins to keep them full and focused. A lack of sleep can trigger overreaction or emotional outbursts, so follow a bedtime routine to make sure your children get enough sleep each night. Encourage good sleeping habits of shutting of the TV, turning off the phones and putting away electronics. Allow time to transition from the activity of the day to becoming ready for bed. The body naturally creates melatonin, but the body needs to know that it is nighttime. Try dimming the lights and having them do something that does not stimulate their mind. This could include reading a book, writing in a journal or doing something that does not have a light on it.</li> <li><strong>Practicing deep breathing together</strong><br /> <a href="/hometown-health/speaking-of-health/mindfulness-meditation-improve-your-quality-of-life" target="_self" title="Opens in same window.">Deep breathing</a> is a great way to reduce stress levels. Help your children practice by taking deep breaths in for a count of five seconds, hold for two seconds and release to a count of five seconds. If your children feel anxious, try this simple exercise to unstick the mind from the worry setting.</li> <li><strong>Enlisting help of children's teachers</strong><br /> With kids back in classrooms, take the opportunity to check in with their teachers. Ask how your children are doing, if they are making friends, or if the teacher is noticing any problems between your children and other students. Often, children won't tell their parents about issues they have at school, as they may feel embarrassed. Sometimes parents are surprised to learn their children are being bullied at school. Teachers and school staff can be your eyes and ears when your children are not with you.</li> <li><strong>Managing your mental health</strong><br /> It's hard to be an effective parent if you struggle with your mental health. Take steps to keep <a href="/hometown-health/speaking-of-health/5-tips-to-keep-burnout-at-bay" target="_self" title="Opens in same window.">burnout and stress</a> at bay in your life.</li> </ul> <p><em>Tonia LaCore is a licensed social worker in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2021/parent-and-child-on-swing.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C416EFA8E951E204D9B2F5AD3CD63F4D" alt="Parent and child on swing" width="660" height="370" DisableNVelocity="true" />Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Stress ManagementGuidance to help you reduce and manage daily stress.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller10/29/2021Few people look forward to having a colonoscopy, and scheduling was a manual, time-intense process. Learn how a team used AI to streamline the process and reduce wait time.Transforming colonoscopy scheduling with AI<p>Very few people look forward to having a screening colonoscopy. Even though a colonoscopy is considered the gold standard for the early detection of colon cancer, some people put off having the procedure. Any barrier in the process could be viewed as an excuse to skip it completely.</p> <h4>Barriers to scheduling</h4> <p>Some people are concerned about the preparation required. Others may not be able to take time away from daily obligations due to the sedation or anesthesia used during the procedure.</p> <p>Sedation and anesthesia are levels on a spectrum of consciousness during a colonoscopy. With regular sedation, a patient can respond to verbal or physical stimuli but has little or no memory of the procedure. With general anesthesia, a patient is completely unconscious during the procedure.</p> <p>Each option has benefits and risks. Some patients do not tolerate regular sedation, which means they need to repeat the preparation and screening under a higher level of anesthesia.</p> <p>Finally, scheduling a colonoscopy has been a labor-intensive process, leading to wait times of weeks or months.</p> <p>Nurses and health care providers manually reviewed each patient's health history and anesthesia guidelines to determine which patients were best suited for sedation and which required anesthesia instead. This manual and subjective process delayed patients' ability to schedule their procedures.</p> <p>This was a challenge because timely scheduling of colonoscopies is critical to prevent and catch colorectal cancer early. In its earliest stages, colon cancer is small, less likely to have spread and might be easier to treat. Regular screening can even prevent colon cancer, as precancerous polyps can be removed during the procedure before they have a chance to develop into cancer.</p> <h4>Building an intelligent and automated option</h4> <p><a href="/providers/sushil-garg-mbbs" target="_self" title="Opens in same window.">Sushil Garg, M.B.B.S.</a>, a Mayo Clinic Health System gastroenterologist, and Amy Szymoniak, a Mayo Clinic Health System operations manager, knew there had to be a better way. They reviewed the anesthesia guidelines and also reviewed literature and applied that for determining the patients who should get sedation or anesthesia and also who might fail with regular sedation. Using this information, their team developed a way to pull data from patients' health record to determine the correct sedation for screening colonoscopies.</p> <p>The new process standardized the type of sedation necessary for each patient and removed subjectivity. It was quicker than before and a big step in the right direction, but the team knew they could improve it further.</p> <p>Enter Mayo Clinic Health System's Artificial Intelligence and Bioinformatics and Cohort Knowledge Intelligence Solutions teams, which are dedicated to finding ways to use data, artificial intelligence (AI) and technology to improve health. The teams built on the previous work and streamlined the decision-making process with an intelligent and automated method using information already in each patient's health record. With this work, decisions could be made within one day versus many days.</p> <p>"When Dr. Garg and team implemented the new process, the time it took for a nurse to collect the necessary patient information went from four minutes to zero, as the process was automated. And the amount of time for the provider to review each case was reduced from five minutes to two," says <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/chaudhry-rajeev-m-b-b-s-m-p-h/bio-20053259" target="_blank" title="Opens in a new window.">Rajeev Chaudhry, M.B.B.S.</a>, Community Internal Medicine. "Most importantly, the percentage of patients who now can have a gastrointestinal procedure performed with moderate sedation increased from 39% to 64%, resulting in 150 more patients being accommodated per month, and significantly improving access and care for the patients."</p> <p>This increased efficiency for making the right decision and improved patient access is exactly the point, says Zan Degen, vice chair of Administration at Mayo Clinic Health System in Northwest Wisconsin.</p> <p>"By identifying specific guidelines within the process, we have a much easier time prioritizing patients and avoiding delays in scheduling," says Degen. "This greatly improves the time it takes to identify if a patient has noncancerous or cancerous polyps, which will greatly decrease the time before treatment, if needed, begins."</p> <h4>Benefits for all Mayo Clinic patients</h4> <p>This process, which is aligned with Mayo Clinic's values of Teamwork and Innovation, is being shared widely to improve access and the health of all patients. Mayo Clinic uses one health record across locations, so it will benefit patients regardless of where they receive care.</p> <p>This is an example of how Mayo Clinic Health System brings the power of Mayo Clinic to rural communities. It also illustrates collaboration and the sharing of discoveries across Mayo. In this case, using AI to transform care to the patients and communities Mayo serves, according to <a href="/hometown-health/transforming-healthcare/leader-finds-fit-in-community" target="_self" title="Opens in same window.">Prathibha Varkey, M.B.B.S.</a>, president of Mayo Clinic Health System.</p> <p>"This application exemplifies what we can accomplish for Mayo's 'Bold. Forward.' strategic plan, especially when teams from different disciplines and areas come together to work on a common cause," she says.</p> <p><em>Mayo Clinic Health System staff bring the knowledge and expertise of Mayo Clinic to communities in southern Minnesota, western Wisconsin and northeastern Iowa to ensure patients receive world-class health care close to home. Our care teams use advanced technology to identify trends; develop new procedures, diagnostics and next-generation care models; advance medicine; and provide healing today and in the future.</em></p><img src="/-/media/national-files/images/hometown-health/2021/couple-hiking-up-hill-backpacks.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2CF2F1F12E1A8E96C6A26DEECD6E4DB8" alt="Middle-age couple hiking up hill wearing backpacks" width="660" height="370" DisableNVelocity="true" />Transforming HealthcareExpert insight into using innovative technology to identify trends and develop procedures, diagnostics and next-generation care models to advance medicine, and provide healing today and in the future.Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Dawn Haller10/21/2021You don't need to tolerate loss of bladder control. Learn about lifestyle changes and treatment options to improve urinary incontinence.Solve, don't settle: Treatment for urinary incontinence<p>The loss of bladder control can feel uncomfortable and embarrassing. While nearly 1 in 3 women may experience incontinence, it does not have to be a normal part of life. From lifestyle changes and medication to physical therapy and minimally invasive surgery, a variety of successful treatment options are available to fit your needs and lifestyle.</p> <p>OB-GYN providers <a href="/providers/alison-grajkowski-md">Alison Grajkowski, M.D.</a>, and <a href="/providers/sarah-suarez-pac" target="_self" title="Opens in same window.">Sarah Suarez</a>, physician assistant, discussed incontinence, the causes of incontinence and treatment options in a recent webinar.</p> <h4>Watch the webinar:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/GiSHULYrHMs" title="Treatment for urinary incontinence" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <h4>Here are a few highlights from the webinar, which was followed by a Q&A session:</h4> <ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/urinary-incontinence/symptoms-causes/syc-20352808" target="_blank" title="Opens in a new window.">Urinary incontinence</a> is any involuntary leakage of urine ― the two most common types being stress and urge incontinence.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/stress-incontinence/symptoms-causes/syc-20355727" target="_blank" title="Opens in a new window.">Stress incontinence</a> is loss of urine with physical activity or movement such as coughing, laughing or sneezing. About 1 in 3 women over 45 have stress incontinence.</li> <li>Urge incontinence is the sudden urge to go to the bathroom that's so severe that people may leak on the way to the bathroom or when pulling down their clothes to go to the bathroom. About 15% of women of all ages have urge incontinence.</li> <li>Many lifestyle and dietary changes help improve urge incontinence, including changes related to caffeine, carbonated beverages, citrus, tobacco, alcohol and consumption of artificial sweeteners. Scheduling bathroom breaks, participating in pelvic floor physical therapy, fully emptying the bladder when voiding, and performing Kegel exercises also can help.</li> </ul> <h4>Dr. Grajkowski talked about several treatments, including the pros and cons of each:</h4> <ul> <li>Botox can be injected into bladder muscles to paralyze them, which allows a person to hold more urine in the bladder. This temporary procedure can decrease urge symptoms.</li> <li>Nerve stimulation can help control the nerves and is thought to change the messaging to the bladder. A needle is placed near the nerve, and small electrical pulses are sent to the nerve. This temporary procedure can decrease urge symptoms.</li> <li>Sacral nerve stimulation is when a device is surgically implanted near the spine and a battery is surgically implanted into the buttocks area. This is considered a last line of help for urge incontinence.</li> <li>Physical therapy can teach techniques to use the muscles that can prevent stress incontinence symptoms.</li> <li>A pessary is a nonsurgical device that goes inside the vagina and provides support to vaginal tissue displaced by pelvic organ prolapse to reduce pressure when you're coughing, laughing and sneezing.</li> <li>Urethral bulking agents are injected around the urethra to provide temporary support to reduce stress incontinence symptoms.</li> <li>A urethral sling is a medical-grade permanent mesh that is placed under the urethra to provide support. This is considered a last line of help for stress incontinence.</li> </ul> <p>Dr. Grajkowski and Suarez continued the discussion, reviewing urinary incontinence.</p> <p><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN services</a> are available in many communities across Mayo Clinic Health System.</p><img src="/-/media/national-files/images/hometown-health/2021/smiling-head-leaning-on-hand.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6A04DDA74EF350BD9CDD48A9452E3BE3" alt="Smiling person with head leaning on fisted hand" width="660" height="370" DisableNVelocity="true" />Urinary IncontinenceThe loss of bladder control is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that's so sudden and strong you don't get to a toilet in time. For most people, simple lifestyle changes or medical treatment can ease discomfort or stop urinary incontinence.Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Dawn Haller4/24/2025Chronic inflammation can damage your body, but eating a combination of healthy foods can reduce its effects. Learn what foods to choose when you shop.Want to reduce chronic inflammation? Start with your grocery list<p>Flip through a magazine or your news feed, and you'll probably see a story about anti-inflammatory foods. But why is inflammation bad, and what does food have to do with it?</p> <p>Inflammation is part of the body's response to infection or injury. Damaged tissue releases chemicals that tell white blood cells to start repairing the damage. Inflammation can start at a low level, spread throughout the body and become chronic.</p> <p>Chronic inflammation can damage the body. It plays a role in the buildup of plaque in your arteries, increasing your risk of heart disease and stroke. It's also associated with a higher risk of cancer, diabetes and other chronic conditions.</p> <h2>How food can hurt or help your body</h2> <p>The choices you make at the grocery store can affect the inflammation in your body. Scientists are still unraveling how food affects inflammatory processes, but they know a few things:</p> <ul style="list-style-type: disc;"> <li><a href="/hometown-health/speaking-of-health/processed-foods-what-you-should-know" target="_self" title="Opens in same window">Processed and ultra-processed foods</a>, like deli meats, energy drinks and sweetened cereals, can release inflammatory messengers that raise the risk of chronic inflammation. </li> <li>Anti-inflammatory foods tend to be the same as those that keep you healthy in other ways.</li> <li>Foods, like fruits and veggies, help the body fight against oxidative stress, which can trigger inflammation.</li> </ul> <h2>Add more of these foods to your grocery list</h2> <p>Choosing foods to reduce chronic inflammation is about variety. Specific components in food work together to reduce inflammation. That's why no specific food makes your diet anti-inflammatory. It's the sum of what you eat every day.</p> <p>Overall, eat a <a href="/hometown-health/speaking-of-health/eat-the-rainbow-for-good-health" target="_self" title="Opens in same window">rainbow of fruits, veggies</a>, whole grains and legumes ― all of which have the anti-inflammatory nutrients your body needs. Fresh, simple ingredients are best since overprocessing may significantly change the nutritional content of foods.</p> <p>You can start building an anti-inflammatory grocery list with:</p> <ul> <li>Beverages such as <a href="/hometown-health/speaking-of-health/tips-for-drinking-more-water" target="_self" title="Opens in same window">water</a>, herbal and green teas, and coffee.</li> <li><a href="/hometown-health/speaking-of-health/add-citrus-colors-and-flavors-to-meals" target="_self" title="Opens in same window">Citrus fruits</a> such as oranges, grapefruit and pomelos.</li> <li>Cruciferous vegetables including broccoli, cauliflower, cabbage, kohlrabi, turnips and radishes.</li> <li>Deep blue or purple foods such as <a href="/hometown-health/speaking-of-health/the-power-of-blueberries" target="_self" title="Opens in same window">blueberries</a>, blackberries, plums and Concord grapes.</li> <li>Deep orange, yellow, red and dark green foods such as <a href="/hometown-health/speaking-of-health/pumpkin-loaded-with-scary-good-nutrients" target="_self" title="Opens in same window">pumpkin</a>, sweet bell peppers, tomatoes, carrots, <a href="/hometown-health/speaking-of-health/the-many-types-and-health-benefits-of-kale" target="_self" title="Opens in same window">kale</a>, spinach, Swiss chard, arugula and endive.</li> <li>Nuts, including walnuts and almonds, and seeds like <a href="/hometown-health/speaking-of-health/chia-seeds-pack-nutritional-punch" target="_self" title="Opens in same window">chia</a>, <a href="/hometown-health/speaking-of-health/flaxseed-is-nutritionally-powerful" target="_self" title="Opens in same window">flax</a> and hemp.</li> <li>Onions.</li> <li><a href="/hometown-health/speaking-of-health/tips-for-eating-more-plant-proteins" target="_self" title="Opens in same window">Plant-based proteins</a>, including dried beans, lentils, lentil pasta and soy.</li> <li>Spices and herbs, including ginger, garlic, <a href="/hometown-health/speaking-of-health/brighten-dark-days-with-sunny-turmeric" target="_self" title="Opens in same window">turmeric</a>, cardamom, black pepper, cinnamon and rosemary.</li> <li>Whole grains, such as wheat, oats, rye, buckwheat, millet, quinoa and brown rice.</li> </ul> <h2>Trim these foods from your list</h2> <p>Gradually reduce inflammation-promoting foods from your daily meals while trying some alternatives.</p> <p>Start by trimming these foods from your grocery list:Fried foods such as french fries, chips and donuts. Bake your French fries with the skin, try kale chips or use an <a href="/hometown-health/speaking-of-health/reasons-to-love-your-new-air-fryer" target="_self" title="Opens in same window">air fryer</a>.</p> <ul> <li>Processed meats like hot dogs, sausage, bacon and red meat. Try <a href="/hometown-health/speaking-of-health/tips-for-eating-more-plant-proteins" target="_self" title="Opens in same window">meatless meats</a> or use meat as a side rather than a main dish.</li> <li>Refined carbohydrates such as white bread, rice, pasta and pastries. For a start, mix white and brown rice, white and whole-wheat pasta, or sweet with unsweetened cereal.</li> <li>Shortening, lard and margarine, and foods made with these fats. Use all types of fats in small amounts, and choose <a href="/hometown-health/speaking-of-health/fast-facts-on-fats-and-heart-health" target="_self" title="Opens in same window">healthier oils</a> such as olive, canola or avocado.</li> <li>Sugar-sweetened sodas, fruit drinks, sweetened teas and flavored coffees. Replace with sparkling mineral water, infused water, unsweetened tea and coffee.</li> </ul> <h2>Building meals with your new grocery list</h2> <p>These ideas can help you start building meals with anti-inflammatory foods:</p> <ul> <li><strong>Breakfast</strong><br> Start the day with oatmeal topped with berries, an apple or a fruit smoothie.</li> <li><strong>Lunch</strong><br> Toss together a salad of dark greens, beans, and colorful fruit and vegetables then sprinkle with nuts or seeds.</li> <li><strong>Dinner</strong><br> Fill half your plate with colorful vegetables, one of the remaining quarters with whole grains and the other quarter with a lean protein.</li> </ul> <p>Another way to combine anti-inflammatory benefits is with the <a href="/hometown-health/speaking-of-health/whats-the-big-deal-about-the-mediterranean-diet" target="_self" title="Opens in same window">Mediterranean diet</a>, which is typically high in fruits, vegetables, whole grains, olive oil and plant-based proteins and low in red meat.</p> <p>Food isn't the only way to reduce inflammation in the body. Boost the results of what you eat by maintaining a healthy body weight, since weight loss is anti-inflammatory. Also, get 30 minutes of physical exercise each day and manage stress.</p> <p><em>Susan Block is a dietitian in </em><em><a href="/services-and-treatments/diabetes-education" target="_self" title="Opens in same window">Diabetes Education</a></em><em> in <a href="/locations/bloomer" target="_self" title="Opens in same window">Bloomer</a> and <a href="/locations/chippewa-falls" target="_self" title="Opens in same window">Chippewa Falls</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2021/produce-aisle-shopping.jpg?h=370&iar=0&w=660&sc_lang=en&hash=61AF99500BB8DA09118E4A3AAE4670C3" alt="Produce aisle shopping" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller10/25/2021Hearing the words "head lice" may make you want to scratch your head. Knowing how to prevent and treat head lice can ease your family's scratching.The itchy truth: What to know about head lice<p>You may have the urge to scratch an itch in your hair when you hear about head lice. The tiny insects like to move in and make their home in clean hair while feeding on blood from the human scalp. Knowing how to prevent and treat head lice can ease your family's scratching.</p> <p>Getting head lice isn't a sign of poor hygiene or unclean surroundings. Head lice prefer clean hair to attach and lay their eggs.</p> <p>Another common misconception is that head lice can jump or fly from one person to another. Head lice only crawl, most often leading to transmission through direct head-to-head contact.</p> <p>Indirect transmission is less common, but it can occur through sharing of items, such as hats and scarves, brushes and combs, hair accessories, headphones, and pillows and towels.</p> <p>Storing clothing items in proximity also can lead to indirect transmission. Sharing school locker or hook space, or hanging multiple hats or scarves in the same place, could result in indirect transmission.</p> <p>However, good news for the four-legged members of the family: Family pets, such as dogs and cats, do not contribute to the spread of head lice.</p> <h4>Head lice stages</h4> <h5>The three stages in the head lice life cycle are:</h5> <ul> <li><strong>Nits</strong><br /> Eggs of head lice are called nits. Nits are clear or whitish bumps that attach to the hair shaft close to the scalp. After a female head louse attaches the nit to a hair shaft, it takes about a week for the nit to hatch. Nits are often mistaken for dandruff, they do not brush off hair as dandruff does.</li> <li><strong>Nymphs</strong><br /> After a nit hatches, it is called a nymph. Nymphs are like adult lice, but they're smaller in size. It takes about a week for a nymph to grow into an adult louse.</li> <li><strong>Adults</strong><br /> Adult head lice are about the size of a sesame seed, and they are yellow or gray in color. They have six legs. Adult head lice can live for three to four weeks. A female louse lays six to 10 eggs per day.</li> </ul> <p>Head lice do not carry disease in any stage of life.</p> <h4>Head lice detection</h4> <p>Intense itching on the scalp and neck could indicate the presence of head lice. Sensations of something crawling or moving in the hair also could be a sign of head lice. To determine if head lice are present, look for signs of nits attached to the hair shaft. If it comes off the hair easily, it is most likely not a nit, but dandruff or hair product residue.</p> <p>If head lice or nits are found, every member of the family should be checked. It is also important to notify your child's school, day care or playmates, as anyone who comes in close contact with someone with head lice should be examined.</p> <h4>Treating head lice</h4> <p>Thorough treatment of head lice is necessary to ensure all lice have been eliminated. This includes removing head lice from hair and any personal items that may have been infested.</p> <h5>Consider these ways to eliminate head lice:</h5> <ul> <li><strong>Lice-killing shampoo</strong><br /> Several over-the-counter shampoos designed to kill head lice. Shampoos only kill adult lice ― not nits ― so follow product instructions and repeat in seven to 10 days, if directed.</li> <li><strong>Comb hair with fine-toothed comb</strong><br /> Use a fine-toothed comb every two to three days to remove nits or lice after shampooing. Check the comb for signs of nits or lice, and wipe the comb after each small section of hair.</li> <li><strong>Disinfect combs and brushes</strong><br /> Soak combs and brushes in hot, soapy water after each use.</li> <li><strong>Wash belongings of person affected by lice</strong><br /> Wash bedding, stuffed animals, clothes, hats, towels and other personal items in hot, soapy water. Dry items on high heat. A temperature greater than 130 degrees Fahrenheit can kill head lice and nits.</li> <li><strong>Store items that cannot be washed</strong><br /> Because head lice can live for up to three days off the body, store items not able to be washed in an airtight bag for several weeks.</li> <li><strong>Vacuum furniture</strong><br /> Vacuum carpets, mattresses, pillows, furniture, car upholstery and car seats.</li> <li><strong>Essential oils</strong><br /> Tea Tree oil can be mixed in with shampoo to help prevent head lice infestation.</li> <li><strong>Head lice clinics</strong><br /> A head lice clinic, which specializes in lice treatment, may be located near you.</li> <li><strong>Prescription treatments</strong><br /> Your health care provider may prescribe stronger prescription shampoo if over-the-counter shampoos do not work. Talk with your health care provider if you cannot eliminate head lice with at-home treatments.</li> </ul> <p><em><a href="/providers/maegen-storm-cnp" target="_self" title="Opens in same window.">Maegen Storm</a> is a nurse practitioner in <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">Pediatric & Adolescent Medicine</a> in <a href="/locations/faribault" target="_self" title="Opens in same window.">Faribault</a>, Minnesota.</em></p><ul> <li>Breastfeeding</li> <li>Health promotion of children</li> <li>Pediatric chronic diseases, i.e. asthma, ADHD, depression, anxiety</li> </ul>C.N.P.<p><strong>Education</strong></p> <ul> <li>Master of Nursing degree at Saint Catherine University, St. Paul, Minnesota</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Certified pediatric nurse practitioner</li> <li>Certified lactation consultant</li> </ul>Storm<img src="/-/media/shared-files/images/medical-professionals/full/faribault/maegen-storm-cnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=D28412CDBBE6AF6BDD77256E83CFB7E2" alt="Maegen Storm CNP" width="280" height="280" DisableNVelocity="true" />{68BA5C85-D987-4133-8B70-C32E52B1235A}Maegen<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15977226Maegen Storm CNP1<img src="/-/media/national-files/images/hometown-health/2021/toddler-running-hair-blowing.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A5D8B758B45173C5533DB2E94228C556" alt="Toddler running, hair blowing" width="660" height="370" DisableNVelocity="true" />Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Michele Halterman10/7/2021Do you always feel tired or not like "you" anymore? Have you lost interest in hobbies that you used to love? Learn about depression, and get tips to help you feel more like yourself.Could you be depressed?<p>Although we all experience grief and sadness, <a href="/topics/depression" target="_self" title="Opens in same window.">depression</a> can be much more than that. An estimated 10% percent of the U.S. population suffers from some type of depression, so know that you aren't alone.</p> <p>More than just a bout of the blues, depression isn't a weakness and you can't simply "snap out" of it. Depression may require long-term treatment. But don't get discouraged. There are ways to cope and manage if you feel that depression is taking over your life.</p> <h2>Signs of depression</h2> <p>Although depression may occur only once during your life, people typically have multiple episodes.</p> <h3>During these episodes, symptoms occur most of the day, nearly every day and may include:</h3> <ul> <li>Constant negative thoughts</li> <li>Feeling of hopelessness, emptiness, sadness or tearfulness</li> <li>Feeling tired or having less energy</li> <li>Low mood</li> <li>Overly self-critical or low self-regard</li> <li>Thoughts of self-harm or suicide </li> <li>Withdrawing from friends, relatives or work</li> <li>Loss of interest or pleasure in most or all normal activities</li> <li>Sleep disturbances, including insomnia or sleeping too much</li> <li>Difficulty thinking, concentrating, making decisions or remembering things</li> </ul> <p>For many people with depression, symptoms usually are severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities or relationships with others. Some people may feel generally miserable or unhappy without really knowing why.</p> <h2>Prevention</h2> <h3>There's no sure way to prevent depression but these strategies may help:</h3> <ul> <li>Eat nutritious foods with plenty of fruits and vegetables</li> <li>Exercise every day for at least 20–30 minutes</li> <li>Get 7–8 hours of sleep each night</li> <li>Keep thoughts balanced and positive </li> <li>Take a Vitamin D daily supplement</li> <li>Take steps to control stress</li> <li>Reach out to family and friends, especially during times of crisis</li> </ul> <h2>Treatment</h2> <p>Medications and psychotherapy are effective for most people with depression. Your primary care doctor or psychiatrist can prescribe medications to relieve symptoms. However, many people with depression also benefit from seeing a psychiatrist, psychologist or other mental health professional.</p> <p>If you have severe depression, you may need a hospital stay, or you may need to participate in an outpatient treatment program until your symptoms improve.</p> <h4>If you are thinking about self-harm or suicide, seek professional help immediately. </h4> <p><strong>There are resources available for you, such as calling or texting <a href="tel:988">988</a> for the 988 Suicide and Crisis Lifeline or calling <a href="tel:911">911</a>.</strong></p> <p>Depression is nothing to be ashamed of and is treatable. Talk with your health care provider or a mental health professional if you are concerned you may be depressed. The nonprofit organization Mental Health America also offers a<a rel="noopener noreferrer" rel="noopener noreferrer" href="https://screening.mhanational.org/screening-tools/depression/" target="_blank" title="Opens in a new window."> free, confidential online depression screening</a>. </p> <h4>For more information about depression and tips to help you feel more like yourself, watch this video:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/5rcqL1YCay0" title="Depression" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p><em><a href="/providers/daniel-lynch-lpc" target="_self" title="Opens in same window.">Dan Lynch</a> is a licensed professional counselor in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Anxiety</li> <li>Behavioral disorders in adolescents</li> <li>Cognitive behavioral therapy</li> <li>Depression and mood disorders</li> <li>Individual, couple and family therapy</li> <li>Obsessive/compulsive disorders</li> <li>Parent/child relational problems, parenting</li> <li>Post-traumatic stress and readjustment counseling for veterans</li> <li>Schema therapy</li> </ul>L.P.C.<p>I specialize in patients ages 13 and older.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, American History, University of Wisconsin-Madison</li> <li>Master's degree, Guidance & Counseling, University of Wisconsin-Stout</li> </ul>Lynch<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/daniel-lynch-lpc.jpg?h=200&iar=0&w=200&sc_lang=en&hash=E64D119CCC4137E32BB8749F98FDB229" alt="Daniel Lynch, L.P.C." width="200" height="200" DisableNVelocity="true" />{EEF947FC-BFEE-405C-B7CF-EFA26002446B}Daniel<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13469088Daniel Lynch, L.P.C.1<img src="/-/media/national-files/images/hometown-health/2021/looking-out-window.jpg?h=370&iar=0&w=660&sc_lang=en&hash=DCCEE845C3CAEE640E4AA715A4177584" alt="Looking out window" width="660" height="370" DisableNVelocity="true" />DepressionDepression is a medical illness that causes a persistent feeling of sadness, loss of interest and, sometimes, physical symptoms. It's also called major depression, major depressive disorder and clinical depression.ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Suicide PreventionSuicide is a major concern in the U.S. According to the Centers for Disease Control and Prevention, suicide was among the top nine leading causes of death for people ages 10–64 and the second leading cause of death for people ages 10–14 and 25–34. The positive news is that with the right information and willingness to reach out to someone in need, we all can help prevent suicide.<br /><br /><strong>If you are having suicidal thoughts, call the 988 Suicide and Crisis Lifeline at <a href="tel:988">988</a>, or chat at <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://988lifeline.org/" target="_blank" title="Opens in a new window.">988lifeline.org</a>.</strong>Dawn Haller9/25/2023Farmers spend countless hours in combines, tractors, trucks and other equipment in fields during the harvest season. Remember a few safety practices, and pick up a new tip to avoid a severe injury.Farm safety first: Tips for preventing injuries during harvest<p>Farmers can spend countless hours in combines, tractors, trucks and other equipment in fields and on roads. Living and working on a farm can be rewarding. However, it also can be dangerous, especially during harvest time.</p> <p>People involved in agriculture need to be well-prepared and safe. Powerful machinery, isolated jobs and long hours during harvest increase the risk of farm-related injuries and fatalities.</p> <h2>Remembering a few safety practices and picking up a new tip or two can help make farming as safe as possible. Consider these tips:</h2> <ul> <li><strong>Carry a first aid kit with a tourniquet.</strong><br /> Do you have a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/first-aid/first-aid-kits/basics/art-20056673" target="_blank" title="Opens in new window.">first aid kit</a> with a tourniquet? If not, you really should. <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/fathers-day-gift-tourniquet-comes-in-handy/" target="_blank" title="Opens in new window.">These tools save lives and limbs</a>. Uncontrolled bleeding from arms and legs is the most preventable cause of death in injured patients. It's important to control and stop the bleeding.</li> <li><strong>Create a plan.</strong><br /> Share with your family or team where and how long you plan to work, and set ongoing check-in times so someone knows you're OK.</li> <li><strong>Follow safety recommendations.</strong><br /> While farming may not be a fashion show, having the right clothing and protective equipment is important. Wear sturdy shoes with proper grip and as well as use noise protection products, such as earmuffs, around loud equipment. Avoid wearing baggy clothing or loose jewelry that could get pulled into moving parts. When using chemicals or pesticides, wear gloves, eye protection and a respirator.</li> <li><strong>Gear up with proper clothing and protection.</strong><br /> While farming may not be a fashion show, having the right clothing and protective equipment is important. Wear sturdy shoes with proper grip and as well as use noise protection products, such as earmuffs, around loud equipment. Avoid wearing baggy clothing or loose jewelry that could get pulled into moving parts. When using chemicals or pesticides, wear gloves, eye protection and a respirator.</li> <li><strong>Remain hydrated, and don't skip meals.</strong><br /> Dehydration and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/hypoglycemia/basics/definition/con-20021103" target="_blank" title="Opens in new window.">hypoglycemia</a>, or low blood sugar, can be more dangerous than many realize. Ensure you drink plenty of water and eat consistent, nutritious meals throughout the day.</li> <li><strong>Stay rested.</strong><br /> Being overly tired creates an impaired mental state comparable to intoxication. Most farmers wouldn't consider operating their equipment while drunk, but many still work 20-hour days during harvest. Don't sacrifice your well-being for the sake of efficiency.</li> <li><strong>Take breaks.</strong><br /> It's important to reset and refocus from time to time. Take regular breaks to give your body and mind a chance to recuperate.</li> <li><strong>Use sunscreen.</strong><br /> UV rays from the sun can cause skin damage, even in autumn. The American Academy of Dermatology recommends using sunscreen with an SPF of at least 30. Use sunscreen even on cloudy or cool days because damage from the sun's rays still can occur.</li> <li><strong>Work during daylight hours.</strong><br /> The more hours you put in after dark, the greater your risk of injury. Do the bulk of your work while the sun is still up.</li> </ul> <h2>Importance of tourniquets</h2> <p>One of the most lifesaving tools on any farm is a tourniquet. Accidents can happen without warning, and a person with uncontrolled bleeding can die within five minutes. That's why it's critical to control and stop bleeding as soon as possible.</p> <h3>Learn how to use a tourniquet:</h3> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/gufWXaljyII" title="How to use a Tourniquet in an Emergency" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <p>Tourniquets are inexpensive, easy to use and small to store in a truck, combine, workshop or other locations around the farm. Always keep a first aid kit with a tourniquet close at hand when working on the farm or in the fields.</p> <p>Harvest season is a memorable time filled with hard work and family traditions. But it also can be dangerous if you don't take the proper precautionary measures. Remember these tips to stay safe, healthy and happy on the farm and in the field.</p> <p> <a href="/providers/kyle-elliott-cnp" target="_self" title="Opens in same window."><em>Kyle Elliott</em></a><em> is a nurse practitioner in the <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">Emergency Department</a> in <a href="/locations/st-james" target="_self" title="Opens in same window.">St. James</a>, Minnesota.</em></p><ul> <li>Critical care medicine</li> <li>Shared decision making</li> <li>Ultrasound</li> </ul>APRN, C.N.P.<p><strong>Education</strong></p> <ul> <li>University of Arkansas for Medical Sciences, Little Rock</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Emergency Medicine, Mayo Clinic College of Medicine and Science, Minnesota</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Association of Critical-Care Nurses </li> <li>American Nurses Credentialing Center </li> <li>Board of Certification for Emergency Nursing</li> </ul>Elliott<img src="/-/media/shared-files/images/medical-professionals/full/mankato/kyle-elliott-cnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=991AA733335F9C287054DBACC9749F36" alt="Kyle Elliott CNP" width="280" height="280" DisableNVelocity="true" />Kyle<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16354702Kyle Elliott, APRN, C.N.P.1<img src="/-/media/national-files/images/hometown-health/2021/farmer-in-tractor-cab.jpg?h=370&iar=0&w=660&sc_lang=en&hash=DB8C1DED68C6D2C69F45177ED4AE6E3A" alt="Farmer in tractor cab" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Dawn Haller10/20/2021Are you of average risk for breast cancer? What exactly does that mean? Should you have a mammogram, and if so, how often? Here are answers to 8 common questions about this important screening.8 FAQ about mammography screening for women of average risk<p>Are you of average risk for breast cancer and what does that mean? Should you have a mammogram, and if so, how often?</p> <h3>Read 8 FAQ about breast screenings and recommendations:</h3> <h4>1. Does mammography really save lives?</h4> <p>Yes, mammography saves lives. Mayo Clinic supports mammogram screening because systematic reviews of randomized trials have found a significant 15% to 20% reduction in breast cancer mortality with mammographic screening for women 40–69.</p> <h5>Mammograms are not perfect, and there are potential downsides, including:</h5> <ul> <li><strong>A false positive result</strong><br /> This is when the mammogram shows an unusual result, but after additional testing, it turns out to not be cancer.</li> <li><strong>Overdiagnosis</strong><br /> This occurs when a mammogram discovers cancer, but it would have never caused harm. It is important to note that while some cancers are not harmful due to tumor biology, there is no way to know whether a cancer will progress, so all cancers detected are treated. Overdiagnosis leads to some patients receiving treatment for a cancer that, if undiscovered, would not have caused harm.</li> </ul> <p>Some studies show that fewer lives are saved by screening among women in the 40–49 age group, the risk-to-benefit analysis is controversial, and the screening recommendations for this age group vary among medical societies.</p> <h4>2. At what age should screening mammograms begin?</h4> <p>All major professional groups making recommendations about breast cancer screening endorse routine screening with mammography for women starting at 50 and older. There is debate about routine screening for women 40–49, with some groups encouraging shared decision-making with patients because of trade-offs of benefits and harm.</p> <p>At Mayo Clinic, health care providers offer screening mammography, beginning at 40 for women at average risk of breast cancer. Average risk of breast cancer means women with no family history of breast cancer and no other risk factors for breast cancer. Women with a family history of breast cancer or other risk factors for breast cancer require an individualized approach to screening.</p> <h4>3. What age can screening mammograms stop?</h4> <p>The recommendations vary among professional organizations. Some recommend discontinuing at 74, while others recommend assessing life expectancy. If life expectancy is less than five to 10 years, screening can be discontinued.</p> <h4>4. How often should mammograms be performed?</h4> <p>The recommended frequency of mammography is variable among professional organizations. In general, government-sponsored groups, such as the U.S. Preventive Services Task Force, recommend screening every two to three years, while medical societies recommend screening every one to two years.</p> <p>This variation is related to balancing the benefits and harm of mammography. The longer intervals are associated with less harm from false alarms and overdiagnosis, and they also lead to slightly fewer lives saved.</p> <h4>5. How does dense breast tissue affect a mammogram?</h4> <p>Women with dense breast tissue but no other risk factors for breast cancer are considered to have a higher risk of breast cancer than average. The presence of dense breast tissue on mammography decreases the sensitivity of mammography since cancer and dense breast tissue both appear while on a mammogram. Additional screening tests, such as breast MRI, molecular breast imaging and 3D mammogram, are available that can improve the detection of cancer in women with increased breast density.</p> <h4>6. Can I skip my mammogram if I don't have a family history of breast cancer?</h4> <p>Most women who develop breast cancer have no family history of breast cancer. The biggest risk factors are being female and increasing age. Because we have no control over the two biggest risk factors, it's important to have your mammogram. It is even more important for women who are at higher risk because of a known family history or other factors to get yearly mammograms.</p> <h4>7. Why do mammograms squeeze my breasts?</h4> <p>During a mammogram, your breast is compressed to decrease the breast thickness and prevent motion to make abnormalities more apparent. Fortunately, the compression only lasts for a few seconds. It may help to schedule your mammogram at a time of the month when your breasts are less tender.</p> <h4>8. What is a 3D mammogram?</h4> <p>Digital breast tomosynthesis, also known as 3D mammography, is the latest evolution of digital mammography, producing 3D images that allow breast tissue to be viewed in individual segments. This allows health care providers to evaluate glandular tissue in greater detail, which decreases your chance of getting a call to come back for another screening to confirm findings. This technology is commonly used across Mayo Clinic as a screening tool for breast cancer.</p> <p>I recommend that you discuss your personal risk for breast cancer, and the benefits, risks and limitations of screening mammogram, with your health care provider. While not all professional organizations agree on specific breast cancer screening guidelines, most emphasize working with your health care provider to determine what's right for your situation.</p> <p><em><a href="/providers/fadi-yahya-md" target="_self" title="Opens in same window.">Fadi Yahya, M.D.</a>, is an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a> and <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</em></p><ul> <li>Incontinence</li> <li>Infertility evaluation and treatment</li> <li>Menstrual disorders</li> <li>Pelvic pain and endometriosis</li> <li>Prolapse of pelvic organs, including uterus, bladder, rectum and bowel</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>American University of Beirut</li> <li>Master of Healthcare Administration, University of Southern California</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Obstetrics and Gynecology, American University of Beirut</li> <li>Riverside Regional Medical Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Obstetrics and Gynecology, American Board of Obstetrics & Gynecology</li> <li>Minimally Invasive Gynecologic Surgery Focused Practice Designation, American Board of Obstetrics & Gynecology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Obstetrics and Gynecology, Mayo Clinic College of Medicine and Science</li> </ul>Yahya<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/fadi-yahya-md.jpg?h=280&iar=0&w=280&hash=E736BD0910ABE8C3992BE5C3A07ABB0C" alt="Fadi Yahya, M.D." width="280" height="280" DisableNVelocity="true" />{668BC882-2740-41A2-AD6E-97954A90F269}Fadi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15562000Fadi Yahya, M.D.1<img src="/-/media/national-files/images/hometown-health/2021/raking-lawn-wearing-gloves.jpg?h=370&iar=0&w=660&sc_lang=en&hash=80897C9605FC58AB1F7D7736797676DD" alt="Raking lawn wearing gloves" width="660" height="370" DisableNVelocity="true" />Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller11/23/2021The technology is amazing, and there’s definitely a “cool” factor, but is an activity tracker for everyone? If you’re considering one for yourself or as a holiday gift, here are 5 things to keep in mind.Activity trackers: 5 things to consider<p>The technology is amazing, the various features can provide a wealth of information about your health, and there's definitely a "cool" factor. But is an activity tracker for everyone?</p> <p>Activity trackers range from basic devices to ones loaded with features, and they’re available at prices to fit about every budget.</p> <h3>If you're considering one for yourself or as a holiday gift, here are 5 things to keep in mind:</h3> <h4>1. Tracking the right metrics</h4> <p>Before investing in an activity tracker, talk with your health care provider. There may be some health metrics that would be more beneficial to track than others. There's also the chance for information overload and confusion that could lead to unneeded assessments.</p> <h4>2. Ease of use</h4> <p>Although some activity trackers have more features and require more setup than others, most are simple to use. After you've set up the device, just strap it on your wrist or clip to your shirt and go. Look for a tracker with a display that can be read in different levels of lighting and is comfortable to wear.</p> <h4>3. Extras</h4> <p>The amount of information you want to collect may influence your choice of device. Most activity trackers calculate time spent in an activity and distance traveled. Some also can monitor your heart rate, oxygen level, sleep quality and length, and calorie intake and the number burned while active. If you're a swimmer, look for a waterproof model that also tracks your activity in the water.</p> <h4>4. Support</h4> <p>Activity trackers can help you set and reach goals by giving cues and rewards to encourage healthy behaviors. They can even provide social support through apps or websites. Many allow you to upload your data to a computer, smartphone or apps so you can electronically track your progress.</p> <h4>5. Accuracy</h4> <p>Recent studies show decent reliability, especially with the newer, more advanced devices.</p> <h4>Using your activity tracker</h4> <p>Once it's set up, your activity tracker can become a partner and strong motivator in reaching your health goals. To integrate it into your activity routine, establish a baseline. For instance, go about your day and note how many steps you walked. Then set short-term goals, such as adding another 1,000 steps. These short-term goals become the building blocks to long-term goals, such as walking 6,000 steps a day. Track your progress, and as you meet your goals, set new ones.</p> <h4>Kids and activity trackers</h4> <p>As a parent, you're the best judge of whether your child is old enough and mature enough to reap the benefits of an activity tracker. Some kids may tire of it, while others may think it's the best gift ever. These devices can get kids moving, but some experts note they can take the fun out of play or even underscore body image issues. It's something to consider before investing in one.</p> <p><em><a href="/providers/craig-bennett-md" target="_self" title="Opens in same window.">Craig Bennett, M.D.</a>, is a physician in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/holmen" target="_self" title="Opens in a new window.">Holmen</a>, Wisconsin.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Bennett<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/craig-bennett-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=1AA898E471A0E4CB1DD67A55CB4E8BE6" alt="Craig Bennett MD" width="280" height="280" DisableNVelocity="true" />Craig<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13302124Craig Bennett, M.D.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}<img src="/-/media/national-files/images/hometown-health/2021/wrist-watch-activity-trackers.jpg?h=370&iar=0&w=660&sc_lang=en&hash=60F88FF30EBF7131380AF9577AB82D13" alt="Wrist watch activity trackers" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller11/19/2021Two-thirds of people with gallstones don't experience any symptoms. But when gallstones cause a blockage, signs and symptoms can occur. Find out what symptoms to watch for and simple steps to reduce your risk.Answers to 5 common questions about gallstones<p>Pouring warm maple syrup over freshly cooked waffles is a great way to start the morning. But you may be familiar with the crystallization that can occur with maple syrup. Similarly, hardening, or crystalizing, in digestive fluid deposits can form in the gallbladder causing <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/gallstones/symptoms-causes/syc-20354214" target="_blank" title="Opens in a new window.">gallstones</a>.</p> <h4>1. What is the purpose of the gallbladder?</h4> <p>The gallbladder is a small, pear-shaped organ below the liver on the right side of your abdomen. The gallbladder holds digestive fluid, called bile, that's released into the small intestine, and that bile helps your body absorb fats, cholesterol and certain vitamins.</p> <p>Of the several types of gallstones, the most common is the cholesterol gallstone, which develops due to too much cholesterol combining with bile. Cholesterol stones appear yellow in color.</p> <p>The second type of gallstone is formed when bile contains too much bilirubin, a chemical produced when the body breaks down red blood cells, creating dark brown or black stones.</p> <p>Rarer types of gallstones are calcium carbonate and fatty acid calcium stones.</p> <h4>2. Can I have gallstones if I don't have symptoms?</h4> <p>Two-thirds of people with gallstones do not experience any symptoms. Learning gallstones are present may be an incidental finding on an ultrasound performed for another diagnostic reason.</p> <p>Gallstones that don't cause symptoms typically do not need treatment. Of people with gallstones, 15%‒25% may develop symptoms over the next 10‒15 years.</p> <p>If gallstones lodge in a duct and cause a blockage, signs and symptoms can occur, and they will last from a few minutes to several hours.</p> <h5>Symptoms can include:</h5> <ul> <li>Upper right quadrant pain in the abdomen</li> <li>Pain in the center of your abdomen, below the breastbone</li> <li>Back pain between the shoulders</li> <li>Pain in the right shoulder</li> <li>Nausea</li> <li>Vomiting</li> </ul> <p>These symptoms may increase 20‒30 minutes after eating.</p> <h4>3. What causes gallstones?</h4> <h5>Many factors lead to the formation of gallstones, including:</h5> <ul> <li>Bile containing too much cholesterol or bilirubin</li> <li>Genetics</li> <li>Slow small bowel transit</li> <li>Bile becoming concentrated due to the gallbladder not emptying completely</li> </ul> <h4>4. Are women more likely to develop gallstones?</h4> <p>Gallstones are more likely to develop in certain people. Women are twice as likely as men to experience gallstones.</p> <h5>Other factors may increase your risk of gallstones, including:</h5> <ul> <li>Being over 40</li> <li>Being overweight</li> <li>Being pregnant</li> <li>Having diabetes</li> <li>Having a family history of gallstones</li> <li>Losing weight rapidly</li> <li>Eating a high-fat diet</li> <li>Having Crohn's disease</li> <li>Having liver cirrhosis</li> </ul> <h4>5. If I have a gallbladder attack, will I need surgery?</h4> <p>People who experience symptoms from gallstones in the gallbladder typically require gallbladder removal surgery.</p> <p>If the gallstones leave the gallbladder and block the bile duct ― a tube that connects the liver, gallbladder and small bowel ― a special endoscopy procedure, called endoscopic retrograde cholangiopancreatography, may be needed to remove the stones.</p> <p>A right upper quadrant <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/abdominal-ultrasound/about/pac-20392738" target="_blank" title="Opens in a new window.">ultrasound</a> can be performed to detect gallstones. An ultrasound detects stones better than a CT scan. An endoscopic ultrasound can detect even small stones in the bile duct and gallbladder. The presence of stones can be a reason to be evaluated by a gastroenterologist or surgeon for treatment. This may include removal of stones from the bile duct, placement of a stent or removal of the gallbladder ― called a <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/cholecystectomy/about/pac-20384818" target="_blank" title="Opens in a new window.">cholecystectomy</a>.</p> <p>Gallstones also can still develop in the bile duct after a cholecystectomy.</p> <h5>You can reduce the risk of gallstones with simple steps:</h5> <ul> <li><strong>Don't skip meals.</strong><br /> Be consistent with meal times each day. Skipping meals or fasting increases the risk of gallstones.</li> <li><strong>Lose weight slowly.</strong><br /> Aim to lose 1 or 2 pounds a week if you want to lose weight. Rapid weight loss increases the risk of gallstones.</li> <li><strong>Eat a high-fiber diet including healthy fats.</strong><br /> High-fiber foods include a variety of fruits and <a href="/hometown-health/speaking-of-health/start-savoring-your-homegrown-nutrition" target="_self" title="Opens in same window.">vegetables</a>. Fish and nuts contain unsaturated, healthy fats.</li> <li><strong>Maintain a healthy weight.</strong><br /> Work to maintain a healthy weight through <a href="/hometown-health/speaking-of-health/does-exercise-help-you-lose-weight" target="_self" title="Opens in same window.">exercise</a> and good diet.</li> </ul> <p>Talk with your health care provider about occasional or continuous symptoms that may be related to gallstones.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2021/healthy-salad-in-a-bowl.jpg?h=370&iar=0&w=660&sc_lang=en&hash=DDFA27190C6641E18920550CF1B0DD5E" alt="Healthy salad in a bowl" width="660" height="370" DisableNVelocity="true" />Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Dawn Haller11/16/2021Occasional nosebleeds, especially during winter, are a minor annoyance. But how do you know when it's serious and requires emergency medical care? Watch for these 3 signs, and get prevention and self-care tips.Nosebleeds: From minor annoyance to serious situation<p>Many people have occasional nosebleeds, especially during the winter. It is exactly what it sounds like: bleeding from the inside of your nose. Nosebleeds can range from minor to a major flow. They are more common in children and older adults, and during dry winter months.</p> <p>Although most nosebleeds are not serious and only a minor annoyance, the sight of blood can be frightening. It's hard to gauge how much blood a person is losing during a nosebleed, and it often looks more serious than it actually is.</p> <h4>Nosebleed causes</h4> <p>Your nose is lined with many small blood vessels, especially on the septum, which is in the center of your nose dividing your right and left nasal cavities. These blood vessels are close to the surface of the lining on your nose, and help humidify and warm the air you breathe. They can easily become irritated or be injured. The most common causes of nosebleeds are mucosal irritation from dry air or digital manipulation.</p> <p>When your nasal membranes dry out, they are more susceptible to bleeding. Lower humidity in the winter is why nosebleeds are more common then.</p> <p>Other causes could include nasal or sinus infections, allergies, blood-thinning medications, deviated septum, foreign body in the nose or trauma to the nose. In general, nosebleeds are not a symptom of high blood pressure.</p> <h4>Preventing nosebleeds</h4> <p>Keeping the lining of your nose moist is the best way to prevent nosebleeds. Have a humidifier at the bedside to add moisture to the air and drink plenty of water to remain hydrated. Use a cotton swab to gently apply a thin coating of petroleum jelly or K-Y Jelly to the inside of your nose. Saline nasal sprays also can be used to moisten the nasal membranes.</p> <p>Don't shame or embarrass children for picking their noses. Instead, explain how this behavior can spread germs, and teach them about nose-blowing and using a handkerchief or tissue. Or teach them to use saline to rinse their noses, rather than picking at nasal obstructions. Trimming their fingernails short also can discourage nose-picking.</p> <p>People who use supplemental oxygen to breath can be at risk for nosebleeds because the nasal prongs can cause trauma to, or irritate, the inside of their noses. In this situation, two recommendations are to humidify the oxygen or switch to an oxygen mask instead of the nasal prongs. Nasal saline sprays also can help.</p> <h4>Self-care tips</h4> <h5>If you or your child has a nosebleed, follow these tips to treat it at home:</h5> <ul> <li><strong>Don't be afraid to make a mess.</strong> <br /> Put a towel on the floor or your clothes to protect them, but don't tip your head back to protect items around you. For many people, this is their first instinct because they don't want the blood pooling in their noses to gush out. However, this movement causes the blood to drain to the back of the throat and possibly cause the person to swallow the blood.</li> <li><strong>Sit leaning forward with elbow to knee.</strong> <br /> Leaning forward will help you avoid swallowing blood. Blood can be irritating to your stomach, making you nauseous. Retching or vomiting increases pressure in your nasal cavities and may lead to increased bleeding. Also, do not lie flat or put your head between your knees.</li> <li><strong>Pinch your nostrils.</strong> <br /> Use your thumb and index finger to tightly pinch both nostrils shut. This should be done at the soft part of your nose. Breathe through your mouth. Watch the clock and continue to pinch for 15 minutes before checking if the bleeding has stopped. This maneuver puts pressure on the nasal septum where most nosebleeds start and, hence, often slows the flow of blood. Pinching the bridge of your nose is futile, as the nasal bones at the level of the bridge of your nose are not compressible.</li> <li><strong>Spray a nasal decongestant in your nose.</strong> <br /> If you are still having profuse bleeding after pinching the nose for 15 minutes, liberally spray an over-the-counter nasal decongestant, such as Afrin, into the nostrils. This medication causes the blood vessels in your nose to constrict and can help with bleeding.</li> </ul> <p>Remember that most nosebleeds stop after a few minutes.</p> <p>If bleeding persists after the measures outlined above ― two rounds of pressure and use of decongestant nasal spray ― then go to the emergency department for further evaluation. To prevent further bleeding episodes, don't pick or blow your nose, don't bend down for several hours, and avoid strenuous or vigorous activity. Keep your head higher than the level of your heart.</p> <h4>When to seek care</h4> <p>In general, most nosebleeds are not serious, and they should stop on their own.</p> <h5>However, you should seek emergency medical care if a nosebleed:</h5> <ul> <li>Interferes with breathing</li> <li>Causes dizziness, vomiting, choking, headache or tiredness</li> <li>Lasts longer than 30 minutes with bright red blood, even after pinching the nostrils and using a nasal decongestant</li> </ul> <h5>People with the following underlying health conditions also should seek emergency care if they develop a nosebleed:</h5> <ul> <li>Known significant bleeding or clotting disorder</li> <li>Low platelet counts due to conditions such as leukemia or lymphoma, or due to chemotherapy</li> <li>Kidney failure</li> <li>Severe liver disease</li> </ul> <p>Don't drive yourself to an emergency department if you're losing a lot of blood. Call 911 or your local emergency number, or have someone drive you.</p> <p>Talk to a health care provider if you or your child is having frequent nosebleeds, even if you can stop them easily. It's important to determine the cause of frequent nosebleeds.</p> <p><a href="/providers/fareeda-hussain-md" target="_self" title="Opens in same window.">Fareeda Hussain, M.D.</a>, is an <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">ear, nose and throat</a> physician in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a> and <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</p><ul> <li>Ear and hearing-related conditions, including chronic ear disease and cochlear implantation</li> <li>Head and neck endocrine surgeries, including thyroid and parathyroid issues</li> <li>Nonsurgical ear molding</li> <li>Outer ear deformities</li> <li>Pediatric ENT conditions</li> <li>Salivary gland disorders, including parotid masses</li> <li>Sinus and nasal disorders</li> </ul>M.D.<p>I enjoy practicing collaborative, individualized medicine, and including my patients in shared decision-making. I greatly value team care — when the patient, nurses and schedulers all are intimately involved in ensuring we work as a well-functioning team to deliver high-quality care.</p> <p>I grew up in Sri Lanka and moved to Minnesota for college. I did my undergraduate training at Winona State University, then several years of research at Mayo Clinic prior to completing medical school.</p> <p>In my free time, I enjoy being with my family, traveling and staying active.</p><p><strong>Education</strong></p> <ul> <li>Mayo Clinic Alix School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Otolaryngology and Head and Neck Surgery, University of Minnesota</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Head and Neck Surgery, American Academy of Otolaryngology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Otolaryngology-Head and Neck Surgery</li> <li>American Academy of Otolaryngology-Head and Neck Surgery, Women in Otolaryngology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Otolaryngology, Mayo Clinic College of Medicine and Science</li> </ul>Hussain<img src="/-/media/shared-files/images/medical-professionals/full/mankato/fareeda-hussain-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7E1879B82EFF6247427737390FB8C652" alt="Fareeda Hussain MD" width="280" height="280" DisableNVelocity="true" /><ul> <li><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Detection+of+colorectal+serrated+polyps+by+stool+DNA+testing%3A+comparison+with+fecal+immunochemicaltesting+for+occult+blood+(FIT)" target="_blank" title="Opens in new window.">Detection of colorectal serrated polyps by stool DNA testing: comparison with fecal immunochemical testing for occult blood (FIT)</a>, January 2014</li> <li><a href="https://www.ncbi.nlm.nih.gov/pubmed/23347191" target="_blank" title="Opens in new window.">Stool DNA testing for the detection of colorectal neoplasia in patients with inflammatory bowel disease</a>, March 2013</li> <li><a href="https://www.ncbi.nlm.nih.gov/pubmed/23804918" target="_blank" title="Opens in new window.">Surgical Repair of Tetralogy of Fallot at Age 83</a>, October 2012</li> <li><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Sole+abnormalities+of+chromosome+7+in+myeloid+malignancies%3A+Spectrum%2C+histopathologic+correlates%2C+and+prognostic+implications" target="_blank" title="Opens in new window.">Sole abnormalities of chromosome 7 in myeloid malignancies: Spectrum, histopathologic correlates, and prognostic implications</a>, July 2012</li> </ul>{1026DEB5-A821-4F7A-8AA8-A61170A07A2C}Fareeda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14791757Fareeda Hussain, M.D.1{E9B8BDBE-375B-4E7D-A1D2-2B64B5513AF7}|{18E5E65E-45C8-4C48-BD32-A914794E2AA4}<img src="/-/media/national-files/images/hometown-health/2021/holding-tissues-to-nose.jpg?h=370&iar=0&w=660&sc_lang=en&hash=63969666F30E6F71D4F71ABBD7E99D84" alt="Holding tissues to nose" width="660" height="370" DisableNVelocity="true" />Ear, Nose and Throat (ENT)Get information about symptoms, disorders and diseases affecting the ear, nose and throat, and related head and neck structures.Dawn Haller11/11/2021Most people with back pain don't require surgery, but there are situations when it's the best option. Get answers to 7 FAQ about low back surgery, including signs that it may be necessary.Q&A: Surgery for low back pain<p>Low back pain is common, with about 80% of adults experiencing it at some point in their lifetimes. Fortunately, most people find relief from the pain with time, activity modifications, physical therapy or other nonsurgical treatments. For others, surgery is the best treatment option to improve the quality of their lives.</p> <p>It's common to feel nervous about the prospect of surgery. That's why it's important to talk with the surgeon to learn more about the procedure and get answers to your questions.</p> <p><a href="/providers/tk-schiefer-md" target="_self" title="Opens in same window.">T.K Schiefer, M.D.</a>, a Mayo Clinic Health System <a href="/services-and-treatments/neurosurgery" target="_self" title="Opens in same window.">neurosurgeon</a>, answers seven questions about surgery to correct low back pain.</p> <h4>1. How do you know when surgery is needed for low back pain?</h4> <p>"Usually we would try to exhaust all of our treatments that are nonsurgical first," says Dr. Schiefer. This could include activity modification, taking nonprescription pain medications and time.</p> <p>"With time, however, if things are not going well, and especially if there's some pain going down one of the legs, there may be a need for surgery in the future," says Dr. Schiefer. "But even at that point, we still wouldn't just jump to surgery. We probably try some physical therapy first ― maybe a steroid injection into the spine to see if that will settle down some of the inflammation that's causing the pain in that nerve root ― and then see where we're at from there."</p> <p>There are situations where surgery is the best option, including if the person has a history of cancer and it's spread to the spine, significant spinal instability, or if there is a new neurologic deficit. "One of the most common deficits is when the nerve root that gets pinched in the lumbar spine affects how we bend back our foot. That's called a foot drop," says Dr. Schiefer. "And in those cases with neurologic deficit, we say we probably need to move to surgery so that the deficit isn't permanent."</p> <h5>In this video, Dr. Schiefer explains when to know if you need lower back surgery:</h5> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/yuIUQY8dsbY" title="ower Back Pain – When is Surgery Needed?" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <h4>2. What type of surgery can correct low back pain?</h4> <p>The type of surgical procedures will vary based on the cause of the low back pain. Dr. Schiefer explains that if the person has a disc rupture or herniation, surgeons can remove a small part of the bone to access the disc fragment and remove it, to create space and relieve the pressure. This is called a diskectomy or laminectomy. These procedures take 30 to 60 minutes. Many patients can go home the same day.</p> <p>"However, as we age, there's more wear and tear on the spine, and sometimes there are more problems. Sometimes there's a slip of one vertebra on another. That's called 'spondylolisthesis,' and that may require more extensive surgery," says Dr. Schiefer. "Sometimes there's problems at multiple levels that may require more extensive surgery. The more surgery we do, the longer people have to stay in the hospital and the longer it takes to recover."</p> <h4>3. What is a lumbar fusion?</h4> <p>A lumbar fusion is a common type of surgery that can help with spine problems in certain situations and is performed to stabilize the spine.</p> <p>"We're causing two bones to grow or fuse together," says Dr. Schiefer. "Instead of using a cast, we'll usually use screws and rods to connect the segments we want to grow together and fuse."</p> <p>During the procedure, your surgeon may place a type of bone substance to bridge the gap between two levels so they will fuse together with time. The bone graft may come from a bone bank or your own body, typically your pelvis.</p> <h5>In this video, Dr. Schiefer explains what a lumbar fusion is and when it's a good surgical option:</h5> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/9fWscowRTSc" title="Lumbar Fusion" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <h4>4. Will a lumbar fusion affect daily activity?</h4> <p>Spinal fusion is a safe procedure, but it changes the way the spine moves.</p> <p>"Fusions do have consequences. Our lumbar spine is mobile, and there are multiple bones and multiple segments," says Dr. Schiefer. "When you fuse one or more segments together, you take away some mobility there."</p> <p>Lumbar fusion can place additional stress and strain on the vertebrae above and below the fused portion. This may increase the rate at which those adjacent segments wear out. This is called adjacent segment disease.</p> <p>"In younger patients, there's a good chance in their lifetime they may require further fusion surgeries for those adjacent segments," says Dr. Schiefer.</p> <h4>5. What is a bulging disc? Do these always require a surgery to correct?</h4> <p>The low back, also known as the lumbar region of the spine, consists of five vertebrae labeled L1 through L5.</p> <p>"In between those bones, there are discs that are softer than bone and are a bit like shock absorbers," says Dr. Schiefer. "With time, there can be some strain on those discs. Sometimes those discs will start to bulge and not be quite as contained in their normal space."</p> <p>Dr. Schiefer explains that many people have bulging discs, but they do not experience back or leg pain. These people don't require surgery.</p> <p>“It's not necessarily normal because that's not how we were born; but over time, this tends to happen to most people," he says. "Does it always need surgery? No, it definitely does not always need surgery."</p> <h4>6. Are there minimally invasive procedure options, and what are the benefits?</h4> <p>There are minimally invasive surgery options for lumbar surgery. These use multiple, small incisions to perform the procedure versus an open procedure, which uses larger incisions to access the spine.</p> <p>"There are pros and cons to each, but we do both surgeries, and they are considered routine surgeries for us in our neurosurgical practice," says Dr. Schiefer. "The big advantages for minimally invasive procedures can be less operative time, less blood loss and quicker recovery."</p> <h5>In this video, Dr. Schiefer explains the types of minimally invasive procedures for lower back pain and how often he performs them:</h5> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/SWUvqDatHxw" title="Minimally Invasive Lumbar Spine Procedures" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <h4>7. What are some possible risks or complications with low back surgery?</h4> <p>Surgery on the low back is safe.</p> <p>"Most of the back surgeries we do are not high-risk surgeries. Catastrophic complications are extremely uncommon, and it is low risk," says Dr. Schiefer.</p> <p>The most common complication is disc recurrence. This occurs when a person has a herniated disc that is placing pressure on a nerve root. During the surgery, a portion of the disc material is removed to remove the pressure. A disc recurrence happens when a new disc fragment herniates after surgery.</p> <p>"The medical literature says there's about a 10% to 20% chance that you might have more disc material come out after surgery and push on the nerve again causing a recurrent problem," says Dr. Schiefer. "That means 80% to 90% of people do just fine and don't have a recurrent problem, but 10% to 20% do have another problem, which may require another surgery."</p> <h5>In this video, Dr. Schiefer discusses the risks of low back surgery:</h5> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/GQ8ggyUUxtY" title="Risks with Low Back Surgery" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p><ul> <li>Herniated discs</li> <li>Spinal deformity</li> <li>Spinal stenosis, also known as narrowing of the spinal canal</li> <li>Spondylolisthesis, also known as slipped vertebrae</li> <li>Traumatic brain injuries</li> <li>Traumatic spine injuries, such as fractures and spinal cord injury</li> <li>Tumors, spinal and brain</li> </ul>M.D. <p>I view the doctor-patient relationship as a partnership. We will work together to find solutions to treat your condition and improve your quality of life. </p> <p>Since we are working together, it is very important we are on the same page and develop a plan as a team. To help facilitate this, first, I will ask you questions to get details about what is going on. Second, I usually perform a neurological examination pertinent to your problem. Third, we typically review your imaging studies together to better understand the problem. Finally, we have an open and honest discussion about possible solutions and treatments, both surgical and non-surgical. </p> <p>Sometimes non-surgical treatments may be the best option. I only offer and recommend a surgery if I feel it is in your best interest and something I would recommend to one of my own family members. I also try to avoid “doctor jargon” and explain things so they are straight forward and easy to understand. I look forward to partnering together in your neurosurgical care. </p> <p>I am a husband and father of four children. I am very active in my church community and enjoy serving others. I am an Eagle Scout and worked as scoutmaster for my sons' troop for many years. I enjoy traveling, backpacking, being outdoors, staying physically fit and personal finance/investing.</p> <p><strong>Education</strong></p> <ul> <li>Mayo Clinic Alix School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Preliminary Surgery, Mayo Clinic College of Medicine and Science</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Neurologic Surgery, Mayo Clinic College of Medicine and Science</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Neurological Surgery</li> <li>Certificate in Clinical and Translational Science, Mayo Graduate School</li> <li>Silver Level Certification, Mayo Clinic Quality Academy</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Neurological Surgeons</li> <li>Congress of Neurological Surgeons</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Neurosurgery, Mayo Clinic College of Medicine and Science</li> </ul> Schiefer<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/tk-schiefer-md.jpg?h=200&iar=0&w=200&sc_lang=en&hash=5328718020A2786933F34ECF5D6846CB" alt="T.K. Schiefer, M.D." width="200" height="200" DisableNVelocity="true" /> <ul> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/25545552/" target="_blank" title="Opens in new window">In-hospital neurologic deterioration following fractures of the ankylosed spine: a single-institution experience</a>, May 2015.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/24476904/" target="_blank" title="Opens in new window">Significance of cochlear dose in the radiosurgical treatment of vestibular schwannoma: controversies and unanswered questions</a>, May 2014.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/22084629/" target="_blank" title="Opens in new window">Moving forward: advances in the treatment of movement disorders with deep brain stimulation</a>, November 2011.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/19929340/" target="_blank" title="Opens in new window">Importance of the vasculature in cyst formation after spinal cord injury</a>, October 2009.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/18423548/" target="_blank" title="Opens in new window">Epidermoids of the cerebellopontine angle: a 20-year experience</a>, December 2008.</li> </ul> {000BB0CC-A7F9-4570-B165-7B3E176167E9}T.K.<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14270005T.K. Schiefer, M.D. 1{4EA2A40E-3721-48EC-AFC9-E6D0E13BCDEC}|{993AF103-0FE1-4CF2-9F2A-3D064CDA9F32}<img src="/-/media/national-files/images/hometown-health/2021/back-pain-hand-holding-lower-back.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7CA4D05F399DDDAC2EF033360321EC08" alt="Hand holding lower back because of back pain" width="660" height="370" DisableNVelocity="true" />NeurosurgeryNeurosurgery treats disorders that impact any part of the nervous system, which may include the brain, spine or peripheral nerves. Conditions treated range from life-threatening brain tumors, to disorders impacting quality of life, such as back pain and carpel tunnel syndrome.Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.Dawn Haller11/24/2021Working from home offers flexibility and less or no commuting, but you may feel disconnected and have trouble separating work and home. Get 3 tips for maintaining your well-being while coping with teleworking challenges.Is telework working for you? 3 tips for coping in the telework age<p>Telework has become more common during the COVID-19 pandemic. Approximately 71% of people whose work responsibilities could be completed remotely were teleworking, according to data from the Pew Research Center that was published near the end of 2020.</p> <p>Of course, not all career paths allow for telework. For example, health care workers providing direct patient care may not have a telework option. Also, data indicate that lower income workers and people with less than a college education are less likely to telework.</p> <p>Overall, however, the landscape of the workforce has been altered significantly during the pandemic, and many people are wondering how to best navigate the new normal of teleworking.</p> <p>First, it's important to pay attention to the potential advantages and disadvantages of telework. This gives you the best chance to get full benefit from the positives of telework and cope with the challenges.</p> <p>Some potential advantages of telework include flexibility in hours, greater ease in balancing work and family responsibilities, potential cost savings, and shorter or no commute time. These benefits may help explain why data indicate that over half of people whose work can be done remotely report that they would like to continue teleworking, even after the COVID-19 pandemic.</p> <p>On the other hand, disadvantages of telework can include feeling less connected with co-workers, struggling with motivation, feeling isolated or lonely and having difficulty getting away from work at the end of the day. Also, telework may present specific challenges for certain groups. For example, parents of minor children are more likely to report interruptions while teleworking.</p> <p>Although it's not known exactly how teleworking affects mental health, what is known is that changes in day-to-day routines and ongoing uncertainties of the pandemic could affect emotional well-being. Studies show that symptoms of depression, anxiety, trauma and insomnia have increased during the pandemic.</p> <h3>Here are 3 healthy ways to cope with some of the challenges of teleworking and maintain your well-being:</h3> <h4>1. Keep track of how you are doing.</h4> <p>Pay attention to how you're feeling throughout the day. Sitting in front of a screen for hours on end can be draining. Be intentional about checking in with your body and mind, and ask yourself "What do I need right now?" Maybe it's a glass of water, a stretch or simply a deep breath. Try to allow yourself to refuel throughout the day, even in small ways. When the workday is over, try to create a purposeful shift away from your desk or computer to create a boundary for yourself between work and home. This may look like taking a brief walk at the end of your workday to unwind before transitioning to your evening activities.</p> <h4>2. Find creative ways to connect with others.</h4> <p>If you're feeling disconnected from co-workers, be intentional about making time to socialize throughout the workday. This could be scheduling a 15-minute break for each of you to take a walk around your own block while chatting on the phone. Consider using workplace chat services, such as Microsoft Teams or Skype for Business, to stay connected about projects or schedule a brief daily Zoom check-in. Outside of work, make time to schedule safe activities with friends and family. Different things will be helpful for different people to help enhance feelings of connection. Experiment with what may work for you.</p> <h4>3. Communicate regularly with your supervisor or manager.</h4> <p>The shift to telework is relatively new to most, leaders included. Talk with your supervisor or manager about things you each see as working well, areas for improvement, and opportunities for adjustment or advancement in the workplace. Be open and honest about your experience and ideas, and receptive to feedback and trying new things.</p> <p>The shift to telework at the beginning of the COVID-19 pandemic was sudden and swift. Even months later, people are adjusting to the changes of the telework world. Following these tips can help you continue to adapt and promote overall well-being.</p> <p>Sometimes you may need additional help and support during times of stress. Talk to your primary care provider if you are struggling. Together, you can review potential treatment options. Most mental health providers and clinics offer in-person and teletherapy visits.</p> <p>Visit the <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.adaa.org/" target="_blank" title="Opens in a new window.">Anxiety & Depression Association of America or Association</a> or <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.abct.org/" target="_blank" title="Opens in a new window.">Behavioral and Cognitive Therapies</a> websites for information on evidence-based treatments for depression, anxiety, trauma and insomnia, and <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">find a therapy location</a> near you.</p> <p><em>Anne Roche, Ph.D., and Sydney Kelpin, Ph.D., are clinical psychology fellows, and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/sawchuk-craig-n-ph-d-l-p/bio-20085911" target="_blank" title="Opens in a new window.">Craig Sawchuk, Ph.D.</a>, is a clinical psychologist in Primary Care in Rochester and Kasson's <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/providers/craig-sawchuk-phdlp/" target="_blank" title="Opens in a new window.">Division of Integrated Behavioral Health</a> at Mayo Clinic in Rochester, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2021/teleworking-with-dog-on-lap.jpg?h=370&iar=0&w=660&sc_lang=en&hash=24F912DAEC8921C6F6B4D483516A72D3" alt="Teleworking with dog on lap" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller7/5/2023Plant-based foods are full of fiber and nutrients that may help prevent chronic illness and are good protein sources. Learn ways to add them to your diet, and get a delicious veggie and bean recipe.Tips for eating more plant-based proteins<p>Plant-based foods are full of fiber and nutrients that may help prevent cancer, heart disease, diabetes and many other chronic illnesses. They also can help maintain a healthy weight.</p> <h2>Consider these tips if you're trying to add more plant proteins to your meals.</h2> <h3>What are plant proteins?</h3> <p>The <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.aicr.org/cancer-prevention/food-facts/aicrs-new-american-plate/" target="_blank" title="Opens in a new window.">New American Plate guidelines</a> from the American Institute for Cancer Research recommend filling at least two-thirds of your plate with plant-based foods like whole grains, vegetables, fruits and legume beans, and the remaining third with meat- or plant-based foods.</p> <h4>Examples of whole-food sources of plant proteins include:</h4> <ul> <li>Edamame</li> <li>Green peas</li> <li>Legumes, such as garbanzo, kidney, black, pinto or cannellini beans</li> <li>Lentils</li> <li>Nutritional yeast </li> <li>Nuts and nut butter</li> <li>Quinoa</li> <li>Seeds</li> <li>Seitan (wheat gluten-based), tofu and tempeh (both soy-based)</li> </ul> <p>In addition, processed plant-based meat alternatives, including "meat" balls, burgers, crumbles, "chicken" tenders and "fish" filets, have come a long way in texture and flavor. But it's not clear if replacing animal protein with processed plant-based meat alternatives provides the same benefit as whole-food, plant-based protein options.</p> <h3>How do I add plant-based proteins to my diet?</h3> <h4>To increase whole-plant proteins, start with what's familiar:</h4> <ul> <li>If meat has traditionally been the star of a soup, stew, salad, casserole or lasagna, increase ingredients like vegetables, nuts or legume beans as you reduce the amount of meat in the recipe.</li> <li>Look for plant-based protein recipes with familiar sauces commonly paired with meat proteins. Buffalo, marinara, barbecue, tikka masala, honey mustard and sweet-and-sour sauces all pair well with plant-based proteins.</li> <li>Try traditional recipes from Greece, India, Italy, Mexico and Asia, which include many plant-based proteins.</li> </ul> <h4>To enhance the texture and flavors of plant-based dishes:</h4> <ul> <li>Add a heartier texture with mushrooms, jackfruit, eggplant, carrots or artichoke hearts.</li> <li>Create savory (umami) flavor by adding dried tomatoes; winter squash, such as butternut or acorn; mushrooms; sweet potatoes; olives corn; or toasted nuts.</li> <li>Slowly sauté onions in olive oil to develop a brown color and caramelized flavor.</li> <li>Increase the amount and variety of herbs, spices and garlic in a dish.</li> </ul> <p>Whether you're vegetarian-curious, adopting Meatless Mondays or avoiding animal products, you can benefit from adding more plants and plant-based proteins to your diet. </p> <p>Try this main dish bowl to showcase fresh vegetables from your garden or farmers market. It's loaded with vitamins A, C and K, and high in fiber and protein.</p> <h4>Southwest veggie and bean bowl</h4> <p>By Mayo Clinic staff<br /> Serves 6</p> <p>2 teaspoons canola oil<br /> 1 cup chopped red onion<br /> 2 cups chopped green bell pepper<br /> 1 chili pepper of your choice, minced<br /> 2 cloves garlic, minced<br /> 1 cup diced sweet potato<br /> 1 cup chopped tomato<br /> 1 cup brown rice<br /> 1/2 cup green lentils<br /> 1/2 cup red lentils<br /> 1 tablespoon ground cumin<br /> 1 tablespoon fresh ground pepper<br /> 1 tablespoon red wine vinegar<br /> 2 cups no-salt-added vegetable stock<br /> 2 cups water<br /> 4 cups chopped kale<br /> 1 cup cooked black beans<br /> 2 tablespoons minced fresh cilantro<br /> 4 lime wedges</p> <p>In a large sauté pan, heat canola oil over medium-high heat. Add onion, peppers, garlic, sweet potato and tomato. Cook for 10-15 minutes until the onions begin to look translucent. Add rice, lentils, spices, vinegar, stock and water. Bring to a boil and reduce to a simmer. Cover and cook for 45 minutes.</p> <p>To serve, toss with kale, black beans and cilantro. Garnish with lime wedges.</p> <p> Nutrition per serving (about two cups): 376 calories, 4 grams total fat, 1 gram saturated fat, 67 milligrams sodium,<strong> </strong>68 grams total carbohydrates, 15 grams fiber, 18 grams protein</p> <p><em>Susan Leifer is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Clinical Nutrition</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2023/mushroom-cap-dish.jpg?h=370&iar=0&w=660&sc_lang=en&hash=65EB2C3E902DA72396ACBE8BFDE8AFE2" alt="Mushroom cap dish" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller11/8/2021If you're bothered by drooping eyelids or are losing your peripheral range of vision, upper eyelid surgery may be a solution for you. An ophthalmologist answers questions about this common surgery.7 common questions about upper eyelid surgery<p>If you're bothered by drooping eyelids or are losing your peripheral range of vision, upper eyelid surgery may be a solution for you.</p> <h3>Here are answers to 7 questions about this common surgical procedure.</h3> <h4>1. Why do droopy eyelids develop?</h4> <p>As you age, the skin along your eyelid can stretch and the muscles that raise the eyelid weaken over time. For some, droopy eyelids can result from an injury or disease, such as diabetes, Horner syndrome, Myasthenia gravis, stoke, tumor and swelling in the eyelid. Droopy upper eyelids can occur to one or both of your eyelids.</p> <h4>2. What are the symptoms of droopy eyelids?</h4> <p>A common symptom of droopy eyes is a loss of the usual field of vision, especially the upper and outer parts of your field of vision. Usually, this change occurs gradually, and you may start to have trouble driving, experience blurred vision while watching TV, frequently waking into objects or be unaware of objects on one side of your vision.</p> <p>An optometrist or ophthalmologist can test your visual field and determine if you are experiencing visual defects due to the shape or position of the eyelids.</p> <p>Other symptoms could be extremely dry or watery eyes or people telling you that you look tired due to baggy or sagging appearance of your eyelids.</p> <h4>3. Can young children have droopy eyelids?</h4> <p>Babies can be born with droopy eyelids, which also is called congenital ptosis. The child may lift his or her eyebrows or tilt the head back to be able to see.</p> <p>Droopy eyelids that completely or partially block a child's vision could result in permanent vision loss. An ophthalmologist should evaluate this. Surgery on young children to correct droopy eyelids is generally performed in the preschool years.</p> <h4>4. How is eyelid surgery performed?</h4> <p>Blepharoplasty is the type of surgery that repairs droopy eyelids. An ophthalmologist or a plastic and reconstructive surgeon can perform this surgery.</p> <p>During the surgery, the surgeon makes an incision in the natural fold of your eye, and removes excess skin, muscle and possibly fat along your upper eye lid. The incision is hidden in the eyelid's natural crease.</p> <p>The procedure is performed as a same-day surgery, which means your recovery is done comfortably at home.</p> <p>Blepharoplasty can reduce or eliminate visual field problems, in addition to making the eyes appear younger and more alert.</p> <h4>5. What are the risks for an eyelid surgery?</h4> <p>Talk to your surgeon about the surgical risks, and weigh the benefits and risks, to help you decide is the procedure is right for you. As with any surgery, there are possible risks.</p> <h5>Risks include:</h5> <ul> <li>Infection and bleeding</li> <li>Dry, irritated eyes</li> <li>Difficulty closing your eyes or other eyelid problems</li> <li>Noticeable scarring</li> <li>Injury to eye muscles</li> <li>Skin discoloration</li> <li>The need for a follow-up surgery</li> <li>Temporarily blurred vision or, rarely, loss of eyesight</li> <li>Risks associated with surgery in general, including reaction to anesthesia and blood clots</li> </ul> <h4>6. When should you expect results?</h4> <p>After surgery, you may experience blurred vision from the lubricating ointment applied to your eyes, watering eyes, light sensitively, double vision, or some pain or discomfort. Bruising and swelling will occur. This will generally subside in 10 to 14 days.</p> <p>Scars from the surgical cuts may take months to fade. During this time, it's important to protect your delicate eyelid skin from too much sun exposure.</p> <p>Most people are satisfied with the results and see an improvement in their visual field. Results for some people may last a lifetime.</p> <h4>7. Is eyelid surgery covered by insurance?</h4> <p>Insurance coverage depends on whether the surgery repairs a condition that impairs your vision. If you have the surgery only to improve your appearance, insurance won't cover the cost.</p> <p>Upper eyelid surgery is a common procedure to restore a more open appearance to the eyes and restore visual field in men and women. Talk with your primary care provider or ophthalmologist if you are concerned about excess eyelid skin or your visual field.</p> <h4>Learn more:</h4> <h5>Watch this video about what to expect with an eyelid lift:</h5> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/C4O5r1rYChs" title="What to expect with an eyelid lift" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <ul> <li>Read how <a href="/services-and-treatments/plastic-and-reconstructive-surgery" target="_self" title="Opens in same window.">eyelid surgery gave patient a better view</a>.</li> <li>Learn more about <a href="/topics/eye-health" target="_self" title="Opens in same window.">eye health</a>.</li> </ul> <p><em><a href="/providers/michael-garvey-md" target="_self" title="Opens in same window.">Michael Garvey, M.D.</a>, is an <a href="/services-and-treatments/ophthalmology" target="_self" title="Opens in same window.">ophthalmologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Comprehensive treatment of eye diseases</li> <li>Oculoplastics surgery</li> <li>Small-incision cataract surgery</li> </ul>M.D.<p>My patients can expect individualized care with a treatment plan specifically designed for their eye condition. I also encourage my patients to be involved in the design of the treatment plan. I believe it's important for my patients to have a solid understanding of their eye condition for successful treatment.</p> <p>I enjoy travel around the United States, Europe and Asia. But these days, free time is mostly spent with my two children.</p><p><strong>Education</strong></p> <ul> <li>Warren Alpert Medical School of Brown University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Transitional, Walter Reed Army Medical Center</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Ophthalmology, Walter Reed Army Medical Center</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Ophthalmology, American Board of Ophthalmology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Society of Cataract and Refractive Surgery</li> <li>New England Ophthalmology Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Ophthalmology, Mayo Clinic College of Medicine and Science</li> </ul>Garvey<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/michael-garvey-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=6D2A19B92B2DA6451A2E267C7B45D383" alt="Michael Garvey, M.D." width="280" height="280" DisableNVelocity="true" />Michael<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14328046Michael Garvey, M.D.1{C5680DDD-C649-4B63-AFCC-B52A244736B7}<img src="/-/media/national-files/images/hometown-health/2021/sitting-in-field-of-grass.jpg?h=370&iar=0&w=660&sc_lang=en&hash=110CF0250412DD676BDB445A0E36DC98" alt="Sitting in field of grass" width="660" height="370" DisableNVelocity="true" />Eye HealthYour eyes are responsible for providing you with vision, perhaps the most important of the senses. However, the eye is a delicate and complicated structure that needs protection. The ugly truth is that eye injuries can happen at any time and place.Plastic and Reconstructive SurgeryPlastic and reconstructive surgery provides services that not only include cosmetic or aesthetic surgery, but also surgical repair of congenital deformities, laser surgery, postsurgical reconstruction, such as breast, head and neck defects, and microsurgery.Dawn Haller12/13/2021Certified nurse-midwives care for women during pregnancy and beyond. One certified nurse-midwife describes the special connection she forms with an expectant mother welcoming a new baby to the family.The role of a certified nurse-midwife: Embracing nine months and beyond<p>Bringing <a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">midwifery care</a> to a community is an integral part of obstetrics and gynecological care. Most of this care has been and will continue to be with women who are pregnant. Certified nurse-midwives are highly specialized, advanced practice providers who care for women autonomously as their primary obstetrical provider. An important aspect of midwifery is meeting women and their support person at the first prenatal visit, sharing their excitement or possibly listening to their fears and anxieties about an unexpected pregnancy. It’s learning about her story and what’s important to her and her family.</p> <p>The pregnancy itself is affected by all aspects of a woman’s life history and lifestyle. This includes what the expectant mother does, her support system, diet and moods, and how her body is working. I want to know what hurts, what is worrying her and what resources might be helpful to her. While I’m gathering information about how her baby is growing or what her blood pressure is, I also want to know if she feels safe, or if she is anxious or depressed. I want to know when other events in her life are impacting how she feels about the pregnancy. I want to be there to support and help her develop her own inner strengths.</p> <p>Pregnancy and birth are an amazing part of a woman’s life, and to be given a role in this journey is such an incredible gift. Seeing a nervous, but excited, woman begin a pregnancy develop to become a confident, loving mother is a rewarding part of what I do. Witnessing parents embrace their newborn child for the first time will never get old. Being present at the baby’s birth is an amazing experience. To see a father wipe a tear from his eye after seeing his child being born brings tears of joy to all in the room.</p> <p>Care from a midwife continues after birth into the postpartum period and with annual visits to help women manage their health concerns. I listen deeply to how their lives are changing, whether it’s relationships, new jobs and plans for future children or not. My role is to support women where they are, and help them identify their health goals and take steps to achieve those goals. Sometimes this is about better mental health and well-being; sometimes, it means making different lifestyle choices. I believe that women are intuitive and know what might work best for them to live a healthier life. My goal is to help women sort it all out and support them in their choices.</p> <p>Being a certified nurse-midwife has meant developing countless meaningful relationships with women and their families. We laugh together, cry together and share in the greatest moments of what life has to offer.</p> <p><em><a href="/providers/gina-lee-cnm" target="_self" title="Opens in same window.">Gina Lee</a> </em><em>is a <a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">certified nurse-midwife</a> in <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/red-wing" target="_self" title="Opens in same window.">Red Wing</a>, Minnesota.</em></p><ul> <li>Community health and wellness</li> <li>Obstetrics</li> <li>Women's health</li> <li>Family planning and contraception</li> <li>Adolescent pregnancy</li> </ul>C.N.M.<p >I grew up in southeast Minnesota and recently returned to the area after many years on the East Coast and volunteering for two years in the Peace Corps. It was at my Peace Corps site in Mozambique that I became interested in public and maternal health. And I haven’t looked back! I have worked in many different roles within birth settings including as a doula, a labor and delivery nurse and now as a certified nurse midwife. I look forward to not only serving women and families in this community, but becoming a part of it as well.</p><p><strong>Education</strong></p> <ul> <li>Bachelor of Arts, University of Minnesota, Minneapolis</li> <li>Bachelor of Science in Nursing, Johns Hopkins School of Nursing, Baltimore, Maryland</li> <li>Masters of Science in Nursing, Johns Hopkins School of Nursing, Baltimore, Maryland</li> <li>Post-Master’s Certificate of Nurse Midwifery, Shenandoah University, Winchester, Virginia</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Midwifery Certification Board</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Nurse Midwives</li> </ul>Lee<img src="/-/media/shared-files/images/medical-professionals/full/red-wing/gina-lee-cnm.JPG?h=280&iar=0&w=280&sc_lang=en&hash=0E1F3D2D6EA083B19A99DB572441FA80" alt="Gina Lee CNM" width="280" height="280" DisableNVelocity="true" />{E38692A1-AAA7-4662-87D0-34A9BA3A3DE1}Gina<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30028260Gina Lee CNM1<img src="/-/media/national-files/images/hometown-health/2021/pregnant-folding-baby-clothes.jpg?h=370&iar=0&w=660&sc_lang=en&hash=566358ED0E0281273B75FD30C4DF5DF5" alt="Pregnant woman folding baby clothes on sofa" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller10/11/2024 <p>Suicide is a growing public health crisis. An important step in prevention is to dispel myths that affect public perception. Get the facts on these 8 common myths about suicide.</p> 8 common myths about suicide <p>Suicide is a growing public health crisis. According to the National Institute of Mental Health, it's the 11th-leading cause of death overall, with more than 48,000 suicides in 2021 in the U.S. It's the second-leading cause of death for people 10–14 and 25–34, and the third-leading cause of death for people 15–24.</p> <p>Even though suicide isn't predictable, it can be preventable by addressing social, cultural and environmental risk factors. Myths and misconceptions about mental health shape people's beliefs and attitudes about suicide, which can be a significant barrier to seeking help for themselves and their loved ones.</p> <h2>Here are eight common myths about suicide:</h2> <h3>Myth 1: Talking about suicide increases the chance a person will act on it.</h3> <p><strong>Fact:</strong> Talking about suicide may reduce, rather than increase, suicidal ideation. It improves mental health-related outcomes and the likelihood that the person will seek treatment. Opening this conversation helps people find an alternative view of their existing circumstances. If someone is in crisis or depressed, asking if they are thinking about suicide can help, so don't hesitate to start the conversation.</p> <h3>Myth 2: People who talk about suicide are just seeking attention.</h3> <p><strong>Fact:</strong> People who die from suicide have often told someone about not wanting to live anymore or that they don't see the future. It's always important to take it seriously when somebody talks about feeling suicidal.</p> <p>It's important to be kind and sensitive and ask direct questions, including:</p> <ul> <li>"Are you thinking about hurting yourself?"</li> <li>"Are you thinking about suicide?"</li> <li>"Do you have access to weapons or other objects to harm yourself?"</li> </ul> <h3>Myth 3: Suicide can't be prevented.</h3> <p><strong>Fact:</strong> Suicide is preventable but unpredictable. Most people who contemplate suicide often experience intense emotional pain, hopelessness and have a negative view of life or their future. Suicide is a product of genes, mental health illnesses and environmental risk factors. Interventions targeted to treat psychiatric and substance-use illnesses can save lives.</p> <h3>Myth 4: People who take their own lives are selfish, cowardly or weak.</h3> <p><strong>Fact:</strong> People don't die of suicide by choice. Often, people who die of suicide experience significant emotional pain and find it difficult to consider different views or see a way out of their situation. Even though the reasons behind suicide are quite complex, suicide is commonly associated with psychiatric illnesses, such as depression, anxiety, bipolar disorder, schizophrenia and substance use.</p> <h3>Myth 5: Teenagers and college students are the most at risk for suicide.</h3> <p><strong>Fact:</strong> The suicide rate for this age group is below the national average. The age groups with the highest suicide rate in the U.S. are women 45–64 and men 75 and older. Although certain groups may be at higher risk, suicide is a problem among all ages and groups.</p> <h3>Myth 6: Barriers on bridges, safe firearm storage and other actions that reduce access to lethal methods of suicide don't work.</h3> <p><strong>Fact:</strong> Limiting access to lethal means of harm, such as firearms, is one of the most straightforward strategies to decrease the chances of suicide. Many suicide attempts are a result of impulsive decisions. Separating someone from a lethal means could provide a person with some time to think before harming themselves.</p> <h3>Myth 7: Suicide always occurs without warning.</h3> <p><strong>Fact:</strong> There are almost always warning signs before a suicide attempt.</p> <h4>Here are a few common signs:</h4> <ul style="list-style-type: disc;"> <li>Being preoccupied with death, dying or violence.</li> <li>Changing regular routine, including eating or sleeping patterns.</li> <li>Developing personality changes or being severely anxious or agitated, particularly when experiencing some of the warning signs listed above.</li> <li>Doing risky or self-destructive things, such as using drugs or driving recklessly.</li> <li>Feeling trapped or hopeless about a situation.</li> <li>Getting the means to take your own life, such as buying a gun or stockpiling pills.</li> <li>Giving away belongings or getting affairs in order when there is no other logical explanation for doing this.</li> <li>Having mood swings, such as being emotionally high one day and deeply discouraged the next.</li> <li>Increasing use of alcohol or drugs.</li> <li>Saying goodbye to people as if they won't be seen again.</li> <li>Talking about suicide — making statements such as, "I'm going to kill myself," "I wish I were dead" or "I wish I hadn't been born."</li> <li>Withdrawing from social contact and wanting to be left alone.</li> </ul> <h3>Myth 8: Talk therapy and medications don't work.</h3> <p><strong>Fact:</strong> Treatment can and does work. One of the best ways to prevent suicide is by getting treatment for mental illnesses, such as depression, bipolar illness or substance abuse, and learning ways to cope with problems. Finding the best treatment can take some time, but the proper treatment can significantly reduce the risk of suicide.</p> <h4>If a friend or loved one talks or behaves in a way that makes you believe they might attempt suicide, don't try to handle the situation alone:</h4> <ul> <li><strong>Encourage the person to call a suicide hotline number.</strong><br> In the U.S., call the 988 Suicide and Crisis Lifeline at <a href="tel:988">988</a> or chat at <a rel="noopener" href="https://988lifeline.org/" target="_blank" title="Opens in a new window.">988lifeline.org</a> to reach a trained counselor. Call <a href="tel:988">988</a> and press "1" to reach the Veterans Crisis Line.</li> <li><strong>Get help from a trained professional as quickly as possible.</strong> <br> The person may need to be hospitalized until the suicidal crisis has passed.</li> </ul> <p>You're not responsible for preventing someone from taking their own life, but your intervention may help them see that other options are available to stay safe and get treatment.</p> <h2>Watch this video that debunks common myths about suicide.</h2> <p><iframe width="560" height="315" src="https://www.youtube.com/embed/L-qcIOJaUlw?si=h6PCsHqQocm41tB4" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin"></iframe></p> <p><em><a href="/providers/pravesh-sharma-md" target="_self" title="Opens in same window.">Pravesh Sharma, M.D.</a>, is a child and adolescent <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">psychiatrist</a> and substance use researcher in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p> <ul> <li>Adolescent addiction psychiatry</li> <li>Cannabis use disorder and its complex interrelationship with psychotic symptoms</li> <li>Community psychiatry</li> <li>Suicide prevention</li> <li>Systems of care</li> </ul>M.D.<p>Meeting patients where they are, and educating the community and youth about mental health disorders are an important component of patient care.</p> <p>In my free time, I enjoy cooking, travelling, biking, reading, and watching movies.</p><p><strong>Medical School </strong></p> <ul> <li>Rajiv Gandhi Medical College, Thane, Maharashtra, India</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Adult/General Psychiatry, Texas Tech University Health Sciences Center</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Child and Adolescent Psychiatry, Johns Hopkins School of Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Child and Adolescent Psychiatry</li> <li>American Psychiatric Association</li> </ul>Sharma<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/pravesh-sharma-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=0F964036343201B2B10E1D1C1CC3942F" alt="Pravesh Sharma, M.D." width="280" height="280" DisableNVelocity="true" />Pravesh<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20777116Psychiatry + Psychology - Pravesh Sharma MD1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2021/couple-sitting-closely.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1B6BB25909F23DCF20C42B92D37E5CF5" alt="Couple sitting closely" width="660" height="370" DisableNVelocity="true" />Suicide PreventionSuicide is a major concern in the U.S. According to the Centers for Disease Control and Prevention, suicide was among the top nine leading causes of death for people ages 10–64 and the second leading cause of death for people ages 10–14 and 25–34. The positive news is that with the right information and willingness to reach out to someone in need, we all can help prevent suicide.<br /><br /><strong>If you are having suicidal thoughts, call the 988 Suicide and Crisis Lifeline at <a href="tel:988">988</a>, or chat at <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://988lifeline.org/" target="_blank" title="Opens in a new window.">988lifeline.org</a>.</strong>Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller12/1/2021Oranges, lemons, limes, grapefruit and tangerines are among the juicy citrus fruits that can be a healthy addition to any diet. Learn about the health benefits, and try these colorful, delicious recipes using citrus.Add citrus colors, flavors to meals<p>Citrus fruits are not only juicy and refreshing, they're extremely healthy. Lemons, oranges, limes, grapefruit, tangerines and pomelos are just a few of the juicy fruits classified as citrus.</p> <p>Like tangerines, clementines are a type of mandarin. They look like tangerine fruit, but they're not quite the same. Tangerines and clementines are the second largest cultivated group of citrus fruit after sweet oranges, which include larger-sized varieties, including navel and blood oranges. Both tangerines and clementines are sweet and easy to peel. Clementines look like tangerines, but they're a little smaller, and their skins are brighter, shinier and smoother. They're even sweeter in flavor.</p> <h4>Health benefits</h4> <p>Citrus fruits earn their classification because they contain flavonoids, which are thought to have anti-cancer properties. Citrus also has many other health benefits. They contain lots of fiber and vitamin C, as well as other vitamins and minerals.</p> <p>It's always best to eat the whole fruit versus the juice, as juice doesn't have any fiber. Fiber makes you feel fuller longer. Also, more energy is used to digest whole fruit versus juice. Citrus fruits are naturally low in calories, fat-free, high in water content and contain less than 60 calories per serving.</p> <p>Weight loss might be the first thing many people think of when they hear the word "grapefruit." The so-called grapefruit diet implies that the fruit has some sort of fat-melting property that enhances weight loss. While this is not the case, grapefruit can be an important part of a sensible weight-loss plan. In a single serving, grapefruit calories come out to just 52, and the water and fiber content of the fruit help you to feel full.</p> <h4>Citrus and drug interference</h4> <p>Grapefruit and certain other citrus fruits, such as Seville oranges, can interfere with several kinds of prescriptions. Many drugs are metabolized with the help of a vital enzyme called CYP3A4 in the small intestine. Grapefruit juice can block the action of CYP3A4, so instead of being metabolized, more of the drug enters the blood and stays in the body longer. The result is too much drug in your body.</p> <p>The severity of the interaction can differ depending on the person, drug, and amount of grapefruit or grapefruit juice you drink. Talk to your health care provider, pharmacist or other health care provider, and read any information provided with your prescription or over-the-counter drug to find out.</p> <p>Citrus fruits can be incorporated into your everyday diet by adding slices of citrus to salads, eating the fruits on their own as a snack or preparing a citrus salsa.</p> <h4>Try some of these recipes:</h4> <h5>CITRUS DIJON VINAIGRETTE</h5> <p>Servings: 16</p> <p>2 tablespoons Dijon mustard<br /> 1 cup extra-virgin olive oil<br /> ½ cup rice wine vinegar<br /> 2 tablespoons fresh parsley, chopped<br /> 3 fluid ounces agave nectar<br /> ¼ teaspoon salt<br /> ¼ teaspoon black pepper<br /> Zest of ½ a lemon<br /> Zest of ½ an orange<br /> Juice from 1 orange</p> <p>Place all ingredients in a Mason jar. Place a cover on the jar and shake until all the ingredients are well-blended. Place the dressing in the refrigerator and chill for 24 hours. This dressing will last for 2 weeks in the refrigerator.</p> <p>Nutrition information per 2-tablespoon serving: 145 calories; 14 g fat (10 g monounsaturated fat; 2 g saturated fat); 0 mg cholesterol; 95 mg sodium; 7 g carbohydrate.</p> <h5>ORANGE QUINOA SALAD</h5> <p>Servings: 10</p> <p>2 fluid ounces orange juice<br /> 2 tablespoons olive oil <br /> 1 tablespoon agave nectar<br /> ¼ teaspoon salt<br /> ¼ teaspoon pepper<br /> 3 cups quinoa, cooked (or 1 cup dry)<br /> ½ cup green onions<br /> ½ cup dried cranberries or cherries<br /> 15 ounces mandarin oranges, canned in juice and drained; also can use 2 clementines, peeled and sectioned. <br /> ¼ cup sliced almonds, toasted</p> <p>For the dressing, combine the first five ingredients in a small bowl and whisk until well-blended. Prepare quinoa as directed on package. Remove from heat and cool. When cooled, add onions, dried fruit, oranges and dressing, and mix gently until combined.</p> <p>Nutritional information per ½-cup serving: 145 calories; 5 g fat; 0.5 g saturated fat (3 g monounsaturated fat; 1 g polyunsaturated fat); 0 mg cholesterol; 65 mg sodium; 24 mg carbohydrate; 2 g fiber; 3 g protein.</p> <h5>CITRUS SALAD</h5> <p>Servings: 4</p> <p>2 oranges<br /> 1 red grapefruit<br /> 2 tablespoons orange juice<br /> 2 tablespoons olive oil<br /> 1 tablespoon balsamic vinegar<br /> Sweetener, as desired<br /> 4 cups spring greens<br /> 2 tablespoons nuts, such as peanuts, walnuts, sliced almonds or pecans</p> <p>Peel and section the oranges and grapefruit. In a separate bowl, whisk together the orange juice, olive oil and vinegar. Add sweetener to taste. Pour the mixture over the fruit segments and toss gently to coat evenly. To serve, divide the spring greens among individual plates. Top each with the fruit and dressing mixture, and sprinkle each with ½ tablespoon nuts. Serve immediately.</p> <p>Nutritional information per 1-cup salad and ½-cup fruit serving (using pine nuts and no sweetener): 166 calories, 10 g fat (1 g saturated fat; 6 g monounsaturated fat); 0 mg cholesterol; 11 mg sodium; 17 g carbohydrate; 3 g fiber; 2 g protein.</p> <p>(Recipes from <a rel="noopener noreferrer" href="https://www.mayoclinic.org/" target="_blank" title="Opens in a new window.">mayoclinic.org</a>)</p> <p>Paula Przywojski is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Clinical Nutrition</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</p><img src="/-/media/national-files/images/hometown-health/2021/lemons-limes-oranges-grapefruit.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F29B007E4CE5AF87038A4F6D4AE46947" alt="Lemons, limes, oranges, grapefruit" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller12/29/2021Lorin Divine is a string musician incorporating music into his role as a nurse with the Mayo Clinic Advanced Care at Home Program. Learn how his music helps patients.Mayo Clinic Advanced Care at Home bringing comfort, joy<p>When you think about nurses, thoughts often turn to professional skills, medical knowledge and ability to care for people with varying conditions. Of course, nurses have outside interests and talents that don't tend to find their way into the workplace.</p> <p>Lorin Divine, a nurse for the Mayo Clinic Advanced Care at Home Program, has found a way to bridge those two worlds.</p> <p>Lorin is a string musician in scrubs who has incorporated music into varying roles across Mayo Clinic Health System. He has made a reputation for himself as the nurse who plays the ukulele.</p> <p>And he's kept a similar tune in his latest role.</p> <h4>Chords, comfort, connection</h4> <p>Lorin says music was an important part of his childhood, and he continued sharing his musical talents while serving in the U.S. Army, playing the guitar alongside chaplains overseas. He continued to pursue music throughout college, exploring music therapy and voice.</p> <p>He earned a bachelor's degree in nursing and began working as a float nurse. Now he works as a nurse with the Mayo Clinic Advanced Care at Home Program.</p> <p>"Music has always been an important part of my life," says Lorin. "I always knew that music would play a role, regardless of whatever career path I took."</p> <p>In his current role, he says music provides comfort and connection.</p> <p>"I choose to bring my instrument with me to work in hopes that I can help calm and comfort patients when there is a need," he says. "Caring for patients provides me the opportunity to build human connections with them through music."</p> <h4>House concerts and more</h4> <p>The Mayo Clinic Advanced Care at Home Program is a new model of care that delivers innovative, comprehensive and complex care to patients. Patients with conditions previously managed in a hospital can transition to a home setting, and receive high-quality, virtual and in-person care and recovery services.</p> <p>Under the direction of Mayo Clinic physicians, the program offers comprehensive and restorative health care services, including infusions, skilled nursing, medications, laboratory and imaging services, behavioral health, and rehabilitation services from a network of paramedics, nurses and support team members.</p> <p>Lorin is one of many medical professionals across Mayo who are part of this program.</p> <p>When he worked as a float nurse, Lorin often would get a call to help with a patient who was agitated, confused, disoriented or combative. Music offered a different way to get through to patients.</p> <p>His music provides comfort and ease from whatever is causing the patient discomfort. In lighter moments, Lorin has been bedside to celebrate patients' birthdays or provide entertainment and play favorite songs.</p> <p>As part of the Mayo Clinic Advance Care at Home Program, Lorin plays music during IV infusions or just to spread cheer.</p> <h4>Music and medicine</h4> <p>When asked about his favorite moment as a nurse, Lorin recalls a patient encounter that not surprisingly had a musical twist.</p> <p>"We were having trouble with a patient who didn't normally have delirium but was very agitated, and they needed treatment to calm them," Lorin says. "They were confused and disoriented. I was asked to sit with them, converse and offer music. In this case, music helped to calm them out of a delirious state. By the end of the night, they told me that their experience in a delirious state was a nightmare and eventually ended up feeling like a vacation due to personal bedside care and offering of music. This patient knew that they were out of sorts and agitated but wasn't able to control it."</p> <p>Lorin is of the thousands of nurses across Mayo who give their talents to patients daily. In his case, music is another tool he can use to provide comfort and joy.</p> <p>"Lorin brings a unique skill set, and an ability to care for and connect with his patients," says Kasey Peissig, nurse manager for the Mayo Clinic Advanced Care at Home Program. "As nurses, we are trained in both the art and science of nursing to care for our patients. Lorin's ability to incorporate music into his care exemplifies our profession's ability to provide individualized and holistic care to the health care practice. His previous professional and life experiences make him a well-rounded nurse, allowing him to connect with patients in a wide variety of ways ― music being one of them."</p> <h4>Watch this video of Lorin playing for a patient:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/5bscel2I6iA" title="Lorin Divine" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p><img src="/-/media/national-files/images/hometown-health/2021/lorin-divine.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BBC33C096A56036752C45FD508C65EB2" alt="Lorin Divine" width="660" height="370" DisableNVelocity="true" />Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller12/23/2021Does starting a workout routine seem overwhelming with your busy schedule and long to-do list? Get 5 simple tips for a realistic workout routine.5 simple ways to fit a workout into any schedule<p>Life can be busy, especially during the holiday season. It's hard to find time to complete your to-do list, along with focusing on your fitness and well-being.</p> <p>While there are plenty of sources for quick, at-home workouts, tips on how to become a morning person or how to stop pressing snooze when it is time for your 5 a.m. workout, finding the time to complete the workouts saved on your Pinterest board, Facebook page or YouTube channel can be difficult. If you're like many people, you find more comfort staying in your bed rather than taking part in a 5 a.m. workout, or sipping another cup of coffee for a midday energy boost rather than getting natural endorphins from a workout.</p> <p>The most common excuse to avoid exercise is "I don't have time." Considering the 24 hours in a day, eight hours are recommended for sleep for adults. That leaves 16 hours for activities, including work, daily tasks and distractions.</p> <p>It's likely you can find 10 to 15 minutes from the distractions, including TV watching, online shopping or browsing social media channels throughout the day to be active for the benefit of your health.</p> <h3>Sticking to these 5 tips might be the answer to a realistic workout routine catered to your busy life:</h3> <h4>1. Plan ahead.</h4> <p>Planning allows you to look at your daily schedule and identify ideal times to work out. Plan to succeed by bringing your shoes, an extra jacket and mittens for a walk during your lunch break. Carry your gym bag, including shower supplies, in your vehicle. Planning to work out increases the likelihood to complete the task by finding a way to fit it in rather than finding an excuse to skip a workout.</p> <p>Without a specific plan, finding time for a workout seems like more of a hassle. This behavior results in a missed opportunity or a validated excuse to skip the workout.</p> <p>People who don't have a plan typically don't accomplish their goal. Make sure you plan in advance to guarantee success in your workout goals.</p> <h4>2. Schedule it.</h4> <p>Once you've planned your workout, schedule it. Write your exercise time in your planner, create a calendar entry with an automatic reminder or reserve your spot in the spin class. Consider your workout time to be as important as a work meeting or dental appointment. Once you've allotted the time, you avoid using "I don't have time" as an excuse.</p> <p>From an early age, most people are used to keeping a schedule. When your day is planned, you're more likely to keep the scheduled activities, resulting in the physical and mental benefits of exercise. You've set yourself up for success.</p> <h4>3. Allot 10 minutes, three times a day.</h4> <p>A common misconception is the more time you spend working out, the more results you will see. Aim for a goal of 30 minutes of activity, five days per week. The 30 minutes daily does not need to be consecutive. Consider splitting the time into 10- or 15-minute segments throughout your day.</p> <p>A workout is a workout, no matter how long or short. Allow yourself 10 minutes to get your heart rate up. Use breaks in your day to go for a walk, do pushups or jumping jacks, and you'll benefit from the activity.</p> <h4>4. Do the little things.</h4> <p>Taking the stairs instead of the elevator is a great way to aid in weight loss. Try parking further away from the door every time you park. Small tactics add up to big results.</p> <p>The short activities you do throughout your day will significantly affect your fitness goals. In addition, participating in short activities throughout the day keeps workouts from feeling overwhelming.</p> <h5>Here are a few ideas for maximizing your daily movement:</h5> <ul> <li>Take the stairs instead of the elevator.</li> <li>Complete 10 pushups when you wake up in the morning.</li> <li>Do jumping jacks, squats or burpees during commercial breaks while watching TV.</li> <li>Replace a daily distraction, such as scrolling on social media, with an activity like walking around your neighborhood.</li> <li>If you <a href="/hometown-health/speaking-of-health/dont-just-sit-there-exercises-for-the-office" target="_self" title="Opens in same window.">sit at a desk</a> for work, get out of your chair every 20 minutes to do calf raises or stretch. Set an alarm to keep you moving throughout the day.</li> </ul> <h4>5. Let yourself experiment.</h4> <p>An intense workout routine and eating plan is not something to begin on a whim. This can cause you to quit as quickly as you start. You will be less successful if you make the decision to exercise and change your nutrition impulsively. It is crucial to find a workout and nutrition plan you enjoy and can continue long term.</p> <p>Allow time to experiment with different workout routines and activities. Start slowly and reflect on how you feel. Discover workouts and exercises you enjoy during this experimental time. Identify personal fitness goals and realistic nutrition plans.</p> <p>Aside from consistency, one of the most important factors for seeing results happens through good nutrition. Nutrition is key. While experimenting with physical activities and exercise schedules, explore different nutrition plans. Find a plan that works for you and your goals, as well as your palate.</p> <p>Finally, you may understand that consistent physical activity and good nutrition lead to results, but knowledge alone is not enough. Intrinsic motivation is a necessary component for success.</p> <p>Find your motivation and remind yourself daily of your goals when presented with excuses to skip a workout or have extra dessert. You won’t regret the workouts you do. You will regret the workouts you skip. Use these five tips to stay motivated and accomplish your goals.</p> <p><em><a href="/providers/alecia-gende-do" target="_self" title="Opens in same window.">Alecia Gende, D.O.</a>, specializes in <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">sports medicine</a> in <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Exercise and movement</li> <li>Female athletes</li> <li>Sports injuries</li> <li>Teaching</li> <li>Ultrasound-guided procedures</li> <li>Women's musculoskeletal health</li> </ul>D.O.<p>I practice collaboratively with my patients, offering an explanation of their situation and a few options for workup and management. I try to empower my patients to make informed decisions regarding their care. </p> <p>My goals are to optimize overall well-being and to see more than just a sports injury or musculoskeletal complaint. I will treat the whole person, working to get them back to their goals, whether that is playing organized sports, golfing, recreational running, weightlifting or being able to play with their kids or grandkids.</p> <p>I enjoy time outdoors, working on our farm and with my family. For my own fun and fitness, I enjoy CrossFit, running, weightlifting, walking, hiking, hunting and anything outdoors.</p><p><strong>Education</strong></p> <ul> <li>Midwestern University Chicago College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Emergency Medicine, University of Iowa Hospitals & Clinics</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Primary Care Sports Medicine, University of Iowa Hospitals & Clinics</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Emergency Medicine</li> <li>American Association Women Emergency Physicians</li> <li>American College of Emergency Physicians</li> <li>American College of Sports Medicine</li> <li>American Institute of Ultrasound in Medicine</li> <li>American Medical Society for Sports Medicine</li> <li>Emergency Medicine Residents Association (EMRA)</li> <li>Veterans of Foreign Wars</li> </ul> <p><strong>Academic Appointments</strong></p> <ul> <li>Assistant Professor of Emergency Medicine, Mayo Clinic College of Medicine and Science</li> <li>Assistant Professor of Orthopedics (Orthopedic Surgery), Mayo Clinic College of Medicine and Science</li> </ul>Gende<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/alecia-gende-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=5BCB6FFA652C592FF31686030603223C" alt="Alecia Gende DO" width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/37208055/" target="_blank" title="Opens in a new window.">Acute hemorrhage on the playing field</a>, July 2023.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/33585801/#:~:text=Conclusion%3A%20Preliminary%20findings%20indicate%20a,requiring%20referral%20to%20a%20cardiologist." target="_blank" title="Opens in a new window.">Use of electrocardiographic screening to clear athletes for return to sports following COVID-19 infection</a>, April 2021.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/33306518/" target="_blank" title="Opens in new window. ">Ultrasound in trauma and other acute conditions in sports, Part II</a>, December 2020.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/30908326/" target="_blank" title="Opens in a new window.">Delayed-union of acetabular stress fracture in female gymnast: Use of teriparatide to augment healing</a>, September 2020.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/29560061/" target="_blank" title="Opens in a new window.">Educator toolkits on Second Victim Syndrome, mindfulness and meditation, and positive psychology: The 2017 Resident Wellness Consensus Summit</a>, March 2018.</li> </ul>{D57FF1AB-3266-4374-BBD1-D222CFB57AA6}Alecia<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21428671Alecia Gende, D.O.1{7746ADF8-715B-4593-8AAB-55D7F0467848}|{FB3BB67A-14FA-4DDE-B183-F85C42E0B255}<img src="/-/media/national-files/images/hometown-health/2021/workout-at-home-hand-weights.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A4C2CA75F32E880422D1518DEEA51836" alt="Workout at home using hand weights" width="660" height="370" DisableNVelocity="true" />Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Dawn Haller12/10/2021The holidays dish up a festive plateful of temptations. These 6 at-home strategies can help you maintain your healthy habits.Healthy holidays: 6 tips for maintaining good habits<p>The holidays dish up a triple whammy of wintry weather, irresistible foods and stress, which can cause even the strongest-willed person to reach for another festive goodie.</p> <h3>These six tips for at-home strategies can help you maintain your healthy habits throughout the holidays:</h3> <h4>1. Embrace eating in.</h4> <p>Try to prepare more meals at home, even though the temptation may be to order carryout. Start by having the ingredients for healthy meals at hand. When shopping, fill most of your cart with foods from the perimeter of the store, such as fresh or frozen fruits and vegetables, lean meats, fish, seafood, eggs and low-fat dairy. Add in healthy middle-of-the-store items, including whole-wheat pastas, grains, seeds, nuts, beans and wild or brown rice. Make a meal look festive by covering half of your plate with fruits and vegetables.</p> <h4>2. Don’t skip breakfast.</h4> <p>A balanced breakfast is an integral part of any daily diet. For kids, breakfast is necessary to provide energy for the brain and body. Skipping breakfast — or any meal for that matter — doesn’t help adults either. Studies show that those who eat balanced meals throughout the day have a higher metabolism and better appetite control.</p> <h4>3. Jettison the juice.</h4> <p>Most juices contain added sugar, providing unnecessary calories to your child’s diet. Kids benefit much more from fresh fruits and vegetables, which offer natural sweetness, along with fiber — and they’re fun to eat. This advice applies to adults too. That fruit smoothie may appear to be a nutritious snack, but with a calorie count often reaching 300–500, you may want to reach for a high-fiber, satisfying piece of fruit instead, and save the smoothie calories for a special splurge.</p> <h4>4. Stay active.</h4> <p>Exercise is the secret to holding the (waist)line when holiday indulgences beckon. Choose fun, aerobic activities, such as ice skating or sledding with friends and family, and incorporate them into your winter plans. If you prefer a warm fire to cold winds, seek out indoor activities, like shooting baskets at your local gym, working out on exercise equipment, challenging yourself with exercise-based video games, DVD workout programs or jumping rope with your kids.</p> <h4>5.Strive for balance.</h4> <p>Combining healthy foods, regular exercise and adequate sleep will help you build and restore your energy reserves and reduce stress. The outcome? You’ll feel better and more grounded to withstand the rush of the holidays.</p> <h4>6. When in doubt, ask an expert.</h4> <p>If one of your New Year’s resolutions is to be more active, consider scheduling a physical with your health care team before you get started. A registered dietitian can provide nutritional guidance that addresses the unique needs of your body and lifestyle.</p> <p>Get more tips on <a href="/hometown-health/speaking-of-health/10-healthy-holiday-tips" target="_self" title="Opens in same window.">healthy holiday celebrations</a>.</p> <p><em>Anne Harguth is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2021/parent-and-child-making-healthy-food.jpg?h=370&iar=0&w=660&sc_lang=en&hash=025329DDE451BFC947F946B442AA36EB" alt="Parent and child making healthy food" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller12/21/2021Virtual prenatal care enables you to take an active role with a unique experience from Mayo Clinic OB Nest. Find out if this program is a good fit for your pregnancy journey.Is virtual prenatal care from OB Nest right for you?<p>Finding out you’re expecting a new baby is an exciting time for a family. After the initial rush of emotions, you may find yourself with many questions. How do I find the safest car seat? Should the nursery have a theme? When do I need to visit my health care provider for prenatal care? Is virtual prenatal care an option for me?</p> <p>At your first obstetrics visit with Mayo Clinic Health System, you and your health care provider will discuss Mayo Clinic OB Nest, a virtual prenatal care option, to determine if you are a candidate for the program. It is important to ask questions if you are interested in participating.</p> <h3>Three questions to start the discussion with your health care provider include:</h3> <h4>1. How does the Mayo Clinic OB Nest program work?</h4> <p>You can take an active role in your prenatal care with a unique pregnancy experience from Mayo Clinic OB Nest. Women with low-risk pregnancies can save time and travel with fewer clinic visits while receiving comprehensive support.</p> <p>Convenient online and telephone appointments replace approximately every other in-person clinic visit. This is helpful for people with busy schedules by eliminating travel time to appointments, reducing child care needs for siblings and decreasing time away from work for prenatal care.</p> <h4>2. How will I stay in touch with my provider and care team?</h4> <p>Throughout your pregnancy, you will listen to your baby’s heartbeat with a fetal Doppler and measure your blood pressure at home. Health information gathered from this equipment will be shared with your obstetrics nurse during Connected Care visits.</p> <p>Connected Care visits include scheduled phone calls or messaging on <a href="/patient-online-services" target="_self" title="Opens in same window.">Patient Online Services</a>, Mayo Clinic Health System’s online patient portal.</p> <h5>Information provided to the nurse includes:</h5> <ul> <li>Your current weight</li> <li>Your blood pressure reading</li> <li>Baby’s heart rate</li> <li>Medication and allergy changes</li> <li>Questions or concerns</li> </ul> <p>Between visits, your care team is monitoring pregnancy progression, reviewing your care plan and helping schedule future appointments. Certain types of care, including ultrasounds and lab tests, still need to be done in person.</p> <p>Answers to your questions or concerns are available by phone and through the patient portal, which enables you to send questions directly to your care team anytime.</p> <h4>3. How do I know if OB Nest is a good option for my pregnancy?</h4> <p>Most women with low-risk pregnancies qualify for this program. If you have had a previous pregnancy that was considered high risk or complicated, OB Nest might not be the best type of care for you. You and your provider can discuss your specific prenatal needs and assess the care plan that works for you.</p> <p>The goal is to give women who are pregnant options that work best for their lifestyle and personal preference. Some women prefer in-person visits. If this is the case for you, the OB Nest program may not be a good fit.</p> <p>In my experience, my patients enjoy the OB Nest program. The combination of Connected Care and in-person visits with the same level of access to your health care team may be a first step in the pregnancy journey for you and your growing family.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2021/pregnant-woman-using-laptop.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EDE037104CB5097FDA8594F7467EC0C2" alt="Pregnant woman using laptop" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Prenatal CareOB-GYN and Family Medicine providers offer exactly the care you need for starting or growing your family, including pregnancy planning and prenatal care.Get Tools to Live Your HealthiestIt’s never too early — or too late — to plan ahead for health. By making preventive care for you and your family a healthy habit, you’ll help improve your well-being. Be sure to connect with your healthcare provider to discuss any further questions that you may have about your health.Dawn Haller12/6/2021Do you know to tell if your makeup products are expired? Learn how often you should be replacing your favorites and the risks associated with using expired makeup.Risks of using expired makeup<p>A common misconception is expired makeup is safe to use, but this isn't always the case. Risks are associated with using expired makeup including, clogged pores and bacterial growth. It's important to be mindful of how long your makeup has been in storage so you can avoid these potential health hazards.</p> <p>Your skin may react to product ingredients if they have reached their expiration date. This could lead to redness or irritation. If bacteria get into an open container or onto a brush, they can multiply rapidly and cause breakouts or other infections.</p> <p>Mold is another common issue with old cosmetics because moisture builds up inside containers over time, leading to mold growth. This mold growth can trigger breakouts or other irritations.</p> <p>Another risk of using expired makeup is a change in the color of the product over time. This is particularly relevant for foundation products. The longer the foundation is kept after purchase, it can oxidize. This oxidation can change the color. If you notice your favorite beige color foundation taking on a slightly more orange color, it may be expired.</p> <p>Using your sense of smell also is a way to tell if your makeup is expired. This method works well with foundation and mascara. If the product has an odd smell, or a different smell than when you first bought it, throw it out.</p> <p>If your foundation starts to separate into layers, or your mascara wand gets dry, you may want to reconsider using these products. Do not add water to your mascara to increase the moisture, as this can escalate the bacteria-producing capabilities.</p> <p>In general, makeup typically lasts one year from the manufactured date before expiring.</p> <h2>It's difficult to know just by looking at a product when it expires, so here are some helpful guidelines to keep in mind:</h2> <ul> <li>Mascara and liquid eyeliner typically are considered safe to use for three months. Liquid products used near the eye have an increased risk of spreading bacteria.</li> <li>Pencil-style eyeliners, gel eyeliners and lip pencils can be used for up to a year.</li> <li>Water-based foundation typically is good for a year, while oil-based foundation is good for about 18 months.</li> <li>Consider replacing cream-based foundation or blushes every six months to a year.</li> <li>Powder products, if stored properly and free from moisture, are good for up to two years.</li> <li>Lipstick is good for one to two years, and lip gloss can be used for six months to 1 year.</li> </ul> <p>Minimizing the spread of bacteria in makeup starts with using clean applicator brushes. The brushes used to apply your makeup should be washed every seven to 10 days to avoid bacteria growth.</p> <p>Following guidelines for expiration of makeup products is the first step in protecting yourself against any potential health risk from your cosmetics.</p> <p><em><a href="/providers/amanda-logan-cnp" target="_self" title="Opens in same window.">Amanda Logan</a> is a nurse practitioner in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><ul> <li>Effective hydration for maturing, dehydrated skin, and collagen building and maintenance</li> <li>Pharmacogenomics</li> <li>Skin care for all ages</li> <li>Using food as medicine for healthy gut, weight loss, and improving fatigue and inflammation</li> </ul>APRN, C.N.P.<p> I like to work with you and want your input. I want to know how we can work together to help you live your best life. Everyone is different and it is in the uniqueness that we can find solutions that are tailored to you. You are the captain of your ship, and I am your navigator. I will help guide and show you your options, but it is you who will ultimately decide your path.</p> <p>I will be open and honest when I see something that may be problematic, need further investigation or could use improvement. I am not opposed to alternative therapies; however, just as with anything you put in the body, even natural therapies have side effects and consequences that should be monitored. I am a big fan of mindfulness, meditating, gratitude, exercise and healthy eating as a basic foundation to good health. </p> <p>I am an avid reader. I read something related to the medical field at least daily, as well as something to stretch the imagination and keep my sense of childlike wonder. I am a huge Harry Potter fan and not ashamed to admit it. Some of my other favorite authors are Jeff Wheeler, Katherine Arden, Kate Quinn and countless others. I'm a huge Simpsons fan, and if I could guess what I was in a past life, it would have to be a dog. I love animals in general, but the best would have to be the dog. How better the world would be if we were all a little more like a dog.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Nursing, Bradley University</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul> <p class="telerik_paste_container" style="border-width: 0px; position: absolute; overflow: hidden; margin: 0px; padding: 0px; left: 3px; top: 66px; width: 1px; height: 1px;"> </p>Logan<img src="/-/media/shared-files/images/medical-professionals/full/mankato/amanda-logan-cnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=855113749ECDCE27DD0FF87769EE15A9" alt="Amanda Logan, C.N.P." width="280" height="280" DisableNVelocity="true" />{3D39AC94-41D4-46AA-9E8E-885783F8246E}Amanda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12858811Amanda Logan, C.N.P.1<img src="/-/media/national-files/images/hometown-health/2021/applying-mascara.jpg?h=370&iar=0&w=660&sc_lang=en&hash=21284CC3638646848C3EFB260515534D" alt="Applying mascara" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Dawn Haller10/16/2024When days become shorter and colder with less sunlight, you may experience mild winter blues. However, seasonal affective disorder is more than feeling sad during certain months of the year.Seasonal affective disorder: More than feeling sad <p>During certain seasons of the year, you may notice changes in your energy level, sleep and interest in activities. </p> <p><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651" target="_blank" title="Opens in a new window.">Seasonal affective disorder</a>, or SAD, is a type of depression that is related to the changes in seasons. Symptoms typically appear in the fall, continue through the winter months and eventually go away in the spring or summer.</p> <p>Affective disorders are mood disorders that have an impactful change in emotions and affect. Affective disorders significantly affect feelings and responses to emotions. </p> <h2>What are the possible causes of SAD?</h2> <p>While the exact cause is unknown, it may be linked to the reduced amount of sunlight affecting the natural chemicals like serotonin and <a href="/hometown-health/speaking-of-health/melatonin-use-in-children" target="_self" title="Opens in same window">melatonin</a> in your body that determine mood and energy levels and regulate sleep.</p> <p>SAD is not simply a case of the <a href="/hometown-health/speaking-of-health/seasonal-affective-disorder-not-just-the-winter-blues" target="_self" title="Opens in same window">winter blues</a>, a condition that is more mild and common. SAD symptoms are severe enough to make it difficult to function in social, work and home environments.</p> <h2>How does SAD differ from other types of depression?</h2> <p>SAD has a seasonal pattern, with recurring episodes happening more predictably during certain seasons — most commonly during the winter months. SAD can have a predictable pattern to depression, which is helpful for the management of the disorder.</p> <p>The criteria for diagnosing SAD are similar to diagnosing major depression, with the seasonal pattern as a key indicator.</p> <h2>Who is most at risk for experiencing symptoms of SAD?</h2> <p>People who live in the northern half of the U.S., where daylight hours are shorter and there is less sunlight, are more at risk for SAD. It's estimated that about 1 in 20 people in the northern half of the U.S. could have symptoms suggestive of SAD.</p> <p>While a person is not born with SAD, it's believed to run in families. It's more common in women, as are all depressive disorders.</p> <h2>What symptoms indicate seasonal affective disorder?</h2> <p>On average, SAD will last about five months of the year. Typically, <a href="/hometown-health/speaking-of-health/seasonal-affective-disorder-explained" target="_self" title="Opens in same window">symptoms </a>will develop in October and worsen around the end of <a href="/hometown-health/speaking-of-health/how-to-manage-daylight-saving-time" target="_self" title="Opens in same window">daylight saving time</a>, followed by a more drastic decline in November. January and February tend to be the months with the most severe <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007" target="_blank" title="Opens in a new window.">symptoms of depression</a>.</p> <h3>Symptoms of seasonal affective disorder to watch for include:</h3> <ul> <li>Difficulty concentrating</li> <li>Feeling persistently tired and fatigued, including feeling a loss of energy nearly every day of the affected months</li> <li>Feelings of worthlessness</li> <li>Losing interest in things you would typically enjoy, such as hobbies and social activities</li> <li>Persistently feeling down or sad</li> <li>Sleep disturbances, which could include hypersomnia (sleeping too much) or <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/insomnia/symptoms-causes/syc-20355167" target="_blank" title="Opens in a new window.">insomnia</a> (difficulty falling asleep)</li> <li>Thoughts of <a href="/hometown-health/speaking-of-health/suicide-crisis-develop-safety-plan" target="_self" title="Opens in same window">suicide</a></li> <li>Weight changes, including weight gain or weight loss</li> </ul> <h2>Are there treatments available for SAD?</h2> <h3>Light therapy</h3> <p>Bright <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/light-therapy/about/pac-20384604" target="_blank" title="Opens in a new window.">light therapy</a> is considered an effective treatment for SAD. Research suggests that around half of people who use a bright light therapy box have good results with symptom reduction.</p> <p>It's essential to meet with a healthcare professional familiar with bright light therapy to determine the type of device needed to be effective, how to correctly set it up and the length of time required in front of a light box.</p> <p>Generally, the light box should provide an exposure of 10,000 lux of light and emit as little UV light as possible. The typical recommendation is to use the light box within the first hour of waking up in the morning for 20–30 minutes.</p> <p>Some light boxes emit white light, and others emit blue light. There is no advantage to one color. </p> <p>Talking with your healthcare team before using a light box is crucial if your skin or eyes are sensitive to light due to a medical condition or medication.</p> <h3>Medications</h3> <p>An antidepressant prescribed by a healthcare professional can be an effective treatment option.</p> <h3>Physical activity</h3> <p>Research has shown that exercising for 20 minutes at least three days a week has similar effectiveness to taking an antidepressant. Being active can help with serotonin production and boost your mood. <a href="/hometown-health/speaking-of-health/tips-for-cold-weather-training" target="_self" title="Opens in same window">Exercising outdoors</a> during daylight hours increases the effectiveness of the activity.</p> <h3>Cognitive behavioral therapy (CBT)</h3> <p>CBT is an effective treatment for SAD and clinical depression. CBT helps people learn how to manage their symptoms of depression or reduce the severity of the symptoms. Talk with your primary care provider about CBT and how to find a provider skilled at delivering CBT for depression or anxiety.</p> <p>Because SAD is tied to the changing seasons, the onset can be predicted, which sets a person up to better manage their symptoms. If you have SAD, there are preventive measures that you can put in place and steps you can begin taking before major depression develops.</p> <h4>Remember these tips:</h4> <ul> <li><strong>Be physically active.</strong><br /> Exercise helps relieve stress and anxiety. It's essential to <a href="/hometown-health/speaking-of-health/winter-weather-are-falls-and-slips-avoidable" target="_self" title="Opens in same window">stay active during winter</a>, even if you are tempted to become less active during colder months.</li> <li><strong>Get outside.</strong><br /> Spend 15 to 20 minutes outside when the sun is out. If the weather allows, take a walk outside during the lunch hour when the sun is at its peak. Sunlight helps adjust your body's internal clock.</li> <li><strong>Make your environment bright.</strong><br /> Open the window blinds and allow sunlight into your home. Sit near a window while at home or work.</li> <li><strong>Prioritize sleep.</strong> <p>Go to bed and wake at the same time every day, with the goal of getting seven to nine hours of <a href="/hometown-health/speaking-of-health/5-ways-to-get-better-sleep" target="_self" title="Opens in same window">restful sleep</a>. Excessive napping and oversleeping beyond your typical schedule can disrupt your circadian rhythm. </p> </li> <li><strong>Stay connected to friends and family.</strong><br /> Decreased mood can lead to a behavior of staying home and isolating. Engaging with friends, staying in a routine, and getting active at home and outside of the home are essential.</li> <li><strong>Take care of your body and mind.</strong><br /> Eat regular, healthy meals. Avoid drugs and alcohol, which can make depression worse. Manage stress with practices like deep breathing, <a href="/hometown-health/speaking-of-health/mindfulness-meditation-improve-your-quality-of-life" target="_self" title="Opens in same window">mindfulness and meditation</a>.</li> </ul> <p>If you have a history of SAD, talk with your healthcare team about a plan to better manage your mood during the winter months.</p> <h4>Watch this video to learn more about the type of depression linked to seasonal changes.</h4> <p><iframe width="560" height="315" src="https://www.youtube.com/embed/1Ujh9hHJ-hA?si=RIgPvQtbPJ1yZYQq" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin"></iframe></p> <p><em><a href="/providers/janice-schreier-lcsw" target="_self" title="Opens in same window.">Janice Schreier</a> is a clinical therapist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Anxiety</li> <li>Attention deficit hyperactivity disorder</li> <li>Bipolar disorders</li> <li>Chemical dependency</li> <li>Depression</li> <li>Eating disorders</li> <li>Facilitates social skills groups for adolescents with autism spectrum disorders</li> <li>Individual, family and group therapy</li> <li>Obsessive-compulsive disorders</li> <li>Post-traumatic stress disorder</li> <li>Reactive attachment disorder</li> <li>Trauma</li> <li>Treatment for children 7–17 and young adults</li> </ul>L.C.S.W.<p><strong>Education</strong></p> <ul> <li>Addiction Counseling, Viterbo University</li> <li>Bachelor's degree, Social Work, University of Wisconsin-La Crosse</li> <li>Master's degree, Social Work, University of Wisconsin-Milwaukee</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Autism Spectrum Disorders</li> <li>Licensed Clinical Social Worker, Substance Abuse Specialty</li> </ul>Schreier<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/janice-schreier-msw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=42215A8A31EDEE2903AC5F89E6D23B11" alt="Janice Schreier MSW" width="280" height="280" DisableNVelocity="true" />Janice<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15449963Janice Schreier, L.C.S.W.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2021/senior-person-looking-out-window-in-winter.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B152515B54B5B114DBE36A61E48A0F40" alt="Senior person looking out window in winter" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.DepressionDepression is a medical illness that causes a persistent feeling of sadness, loss of interest and, sometimes, physical symptoms. It's also called major depression, major depressive disorder and clinical depression.Dawn Haller1/25/2024An enlarged prostate is a common condition as men get older. Read about a safe, effective and minimally invasive treatment option that uses bipolar energy to resolve uncomfortable urinary symptoms.Effective, energetic treatment for enlarged prostate<p>An enlarged prostate, also called <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/benign-prostatic-hyperplasia/symptoms-causes/syc-20370087" target="_blank" title="Opens in a new window.">benign prostatic hyperplasia</a>, or BPH, is a common condition as men get older. By age 60, about 30% of men show moderate to severe symptoms of BPH; by age 80, it is 50%. An enlarged prostate gland can cause uncomfortable urinary symptoms, such as a weak urine stream, a stream that starts and stops, frequently getting up at night to urinate, or nocturia, and inability to empty the bladder.</p> <p>There are multiple treatment options for BPH, ranging from behavior medications to medications and surgery. One minimally invasive options patients may be considering is bipolar enucleation of the prostate, or BipolEP.</p> <h2>If you are considering BipolEP treatment, here's what you need to know:</h2> <h3>Prostate anatomy</h3> <p>The prostate is a small organ that sits beneath the bladder. The urethra, the tube that drains the bladder, runs through the middle of the prostate.</p> <p>Early in a man's life, the prostate is roughly the size of a walnut or a small tangerine. Often, around age 50, the prostate increases in size. For some men, this change closes off the urethra and makes it more difficult for them to empty their bladder.</p> <p>The prostate has two parts: the adenoma and capsule. The adenoma is the inner part that surrounds urethra. It's the part of the prostate that grows as men get older. The capsule is the outer part of the prostate and doesn't change in size over the course of life. A good analogy is to think of an orange. The peel represents the capsule, and the fruit represents the adenoma.</p> <h3>Removal of prostate tissue with enucleation</h3> <p> Using the orange analogy, enucleation aims to remove the fruit, or adenoma, from the inside while leaving the peel (the capsule) behind. This technique results in a wide-open channel for the urine to pass out of the bladder.</p> <h4>Ways to perform a prostate enucleation include:</h4> <ul> <li>Through a large abdominal incision, or open simple prostatectomy</li> <li>Through several small abdominal incisions, or robotic-assisted simple prostatectomy</li> <li>Through the urethra without any incisions, or transurethral</li> </ul> <h3>History of transurethral enucleation</h3> <p>In 1983, Japanese surgeons performed the first transurethral enucleation. However, once they freed the adenoma from the prostate, they still had to make an incision to remove the tissue from the bladder. Imagine peeling an orange and leaving the segments floating in the bladder.</p> <p>The procedure became more common after the invention of the morcellator in the late 1990s. This medical device is used to cut tissue into smaller pieces and allows the surgeon to remove prostate tissue through the urethra.</p> <h3>Transurethral enucleation of the prostate</h3> <h4>Transurethral enucleation can be performed with different of energy sources:</h4> <ul> <li><strong>HoLEP</strong><br /> A commonly used energy source is the holmium laser. This is called a holmium laser enucleation of prostate, or HoLEP.</li> <li><strong>BipolEP</strong><br /> Another option is with bipolar energy, called BipolEP. It can be performed on any size prostate. This is the best procedure for patients who have larger prostates, usually over 80 milliliters, or who unable to void their bladders without a catheter. Also, patients who have been offered an open surgery because their prostate is too large may benefit from BipolEP.</li> </ul> <p>Both procedures achieve the same result in removing the adenoma.</p> <h3>Procedure</h3> <p>BipolEP is performed in an operating room under either general or spinal anesthesia. During the procedure, a urologist inserts a specialized scope into the urethra. Using bipolar energy, the urologist enucleates all adenoma tissue, then cuts it into smaller pieces using the morcellator before easily removing it through the urethra. This procedure leaves the capsule intact and restores the urinary flow through the urethra. The length of the procedure depends on the prostate size but typically ranges from 45 minutes to two hours.</p> <p>At the end of the operation, the patient receives a catheter and stays at the hospital overnight for bladder irrigation. For most patients, the catheter is removed the morning after surgery when their ability to urinate is tested.</p> <h3>Patient benefits</h3> <p>Because BipolEP doesn't require an incision, patients recover faster and have a lower risk of infections and bleeding. In most cases, the catheter can be removed the day after the operation. In contrast, open or robotic surgeries require patients to use a catheter use for several days.</p> <p>Because a BipolEP procedure can be performed on any size prostate, it can help a wide range of patients. Finally, enucleation completely removes the adenoma, providing longer-lasting results compared to other surgical options.</p> <h3>Recovery</h3> <p>Patients need to limit strenuous physical activity for two weeks and drink plenty of fluids. Most people can resume normal activities after two weeks but may still see occasional bits of tissue or bleeding in their urine after heavy activity.</p> <p>Most instances of urinary incontinence improve in the first three months after the procedure. Patients receive education on <a href="/hometown-health/speaking-of-health/kegels-are-for-men-too" target="_self" title="Opens in same window.">Kegel exercises</a>, and physical therapy focuses on strengthening the pelvic floor.</p> <p>Some urinary symptoms like urinary urgency, urinary frequency or nocturia may worsen for a few weeks after surgery as the bladder and prostate heal. These symptoms improve with time.</p> <p>Other side effects are generally mild and comparable to <a href="/hometown-health/speaking-of-health/mens-health-how-is-benign-prostatic-hyperplasia-treated" target="_self" title="Opens in same window.">other BPH treatments</a>. The risk of bleeding and infection is low. However, patients with smaller prostates have a higher rate of scar tissue formation after this procedure.</p> <p>Talk with your primary care provider and make an appointment if you're having trouble urinating and are looking for treatment strategies.</p> <p>Next steps:</p> <ul> <li><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Find a urologist near you.</a></li> <li>Read about <a href="/hometown-health/speaking-of-health/treatment-options-for-men-with-urinary-leakage" target="_self" title="Opens in same window.">treatment options for urinary leakage</a>.</li> <li>Learn <a href="/hometown-health/speaking-of-health/the-rainbow-of-urine-colors" target="_self" title="Opens in same window.">what's typical and what's not when it comes to urine color</a>.</li> <li>Read <a href="/hometown-health/speaking-of-health/steam-therapy-for-enlarged-prostate" target="_self" title="Opens in same window.">how steam therapy is used to treat enlarged prostate</a>.</li> </ul> <p> </p><img src="/-/media/national-files/images/hometown-health/2021/bearded-senior-looking-out-window.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EB99E2387C279A4976DCCD3DC70C4A07" alt="Bearded senior looking out window" width="660" height="370" DisableNVelocity="true" />Prostate HealthProstate cancer is the most common cancer diagnosed in men. You may have friends or family members who have been diagnosed with prostate cancer, and this may make you wonder about what you can do for prostate cancer prevention.Dawn Haller12/17/2021It seems like something out of a sci-fi movie — using a vibrating needle to deliver ultrasonic energy directly to a damaged tendon. Learn about a no-surgery treatment to heal tendon pain.Vibrating energy waves ease joint pain<p>It sounds like a medical treatment out of a science fiction movie: using a vibrating needle to deliver ultrasonic energy directly to a damaged tendon. Fortunately, no movie magic or special effects are needed because this treatment isn't a fantasy. It's reality.</p> <p>"Ultrasonic tenotomy is an exciting treatment option for people who suffer from tendon pain," says <a href="/providers/jacob-erickson-do" target="_self" title="Opens in same window.">Jacob Erickson, D.O.</a>, a Sports Medicine physician at <a href="/locations/onalaska" target="_self" title="Opens in same window.">Mayo Clinic Health System in Onalaska</a>, Wisconsin. "Mayo Clinic physicians helped to develop the system, using the Tenex health TX tissue removal system, to treat tendon problems such as calcific tendinopathy or chronic tendon pain without the need for traditional surgery."</p> <h4>Conditions treated</h4> <p>About 4,000 tendons are in the human body. These thick fibrous cords attach muscle to bone. Tendinopathy refers to thickening and disorganization of a tendon that can result in pain.</p> <h5>The most common tendon problems are:</h5> <ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/tennis-elbow/symptoms-causes/syc-20351987" target="_blank" title="Opens in a new window.">Tennis elbow</a>, or common extensor tendinopathy</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/golfers-elbow/symptoms-causes/syc-20372868" target="_blank" title="Opens in a new window.">Golfer's elbow</a>, or common flexor tendinopathy</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/patellar-tendinitis/symptoms-causes/syc-20376113" target="_blank" title="Opens in a new window.">Jumper's knee</a>, or patellar tendinopathy</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/symptoms/shoulder-pain/basics/definition/sym-20050696" target="_blank" title="Opens in a new window.">Shoulder impingement</a>, or calcific tendinopathy</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/achilles-tendinitis/symptoms-causes/syc-20369020" target="_blank" title="Opens in a new window.">Achilles pain</a>, or Achilles tendinopathy</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/symptoms-causes/syc-20354846" target="_blank" title="Opens in a new window.">Plantar fasciitis</a> or plantar fasciopathy</li> </ul> <p>"In most cases, tendinopathy is treated with rest, time, physical therapy and medications to reduce the pain," says Dr. Erickson. "But if it is persistent and doesn't respond to these options, you should talk with your health care team about other possibilities like ultrasonic tenotomy."</p> <h4>How ultrasonic tenotomy works</h4> <p>Dr. Erickson explains that before ultrasonic tenotomy, imaging tests, such as <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.mayoclinic.org/tests-procedures/ultrasound/basics/definition/prc-20020341" target="_blank" title="Opens in a new window.">ultrasound</a> or <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.mayoclinic.org/tests-procedures/mri/home/ovc-20235698" target="_blank" title="Opens in a new window.">MRI</a>, are performed to determine the location and extent of the degenerated tissue. Once the specially trained physician has a clear picture of what’s going on, he or she uses ultrasound guidance to insert the specialized needle tip attached to ultrasound energy and saline irrigation through a 3-millimeter incision in the skin down to the tendon.</p> <p>"The device’s oscillating tip uses ultrasonic energy that precisely targets and debrides the damaged tissue directly ahead of it," says Dr. Erickson. "At the same time, a built-in inflow-outflow fluid system irrigates and aspirates the broken down, or emulsified, tissue."</p> <p>Once all the degenerated tissue is cleared away, the device is removed, and the incision is closed with adhesive skin tape and a pressure bandage.</p> <p>"Compared to traditional surgery, patients can return to their normal activities much faster," says Dr. Erickson. "Healing will continue for several months following the procedure, but generally patients can resume most activities within four to six weeks following their treatment."</p> <p>Many patients have had good results after the treatment. However, Dr. Erickson stresses that the procedure is not for everyone. "This treatment will not work if the tendon is completely torn," he says. "The procedure is designed to remove a small portion of bad tendon tissue and stimulate the body's healing response. In those cases, surgery is the only option. Talk with your health care provider about all the appropriate options for your situation."</p><img src="/-/media/national-files/images/hometown-health/2021/swinging-golf-club-orange-shirt.jpg?h=370&iar=0&w=660&sc_lang=en&hash=482A00C75BBB73BB0654419AC2EB6BA7" alt="Swinging golf club orange shirt" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller12/3/2021Women often put the health care needs of others before their own. In this webinar, two Mayo Clinic physicians discuss the importance of preventive and self-care, and share an inspirational message.Personally speaking: Women, self-care and well-being<p><a rel="noopener" href="https://www.mayoclinic.org/biographies/horn-jennifer-l-m-d/bio-20054753" target="_blank" title="Opens in a new window.">Jennifer Horn, M.D.</a>, regional chair of clinical practice, Mayo Clinic Health System in Southeast Minnesota, and <a rel="noopener" href="https://www.mayoclinic.org/biographies/gazelka-halena-m-m-d/bio-20055416" target="_blank" title="Opens in a new window.">Halena Gazelka, M.D.</a>, a Mayo Clinic anesthesiologist, hosted a webinar that highlighted the importance of preventive measures to take care of yourself.</p> <p>Dr. Horn presented "Prevention and Wellness for Women in Today's World." Dr. Gazelka presented "Things My Mother Never Told Me," sharing a personal health care journey and inspirational message about the importance of taking care of your overall well-being.</p> <h2>Here are a few highlights from the webinar, which included a Q&A session:</h2> <ul> <li>According to the <a rel="noopener" href="https://www.cdc.gov/womens-health/" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention</a>, the leading causes of death in women in the U.S. include heart disease; cancers of all types; chronic lower respiratory disease, such as asthma, emphysema and chronic bronchitis; and stroke.</li> <li>Your health is affected by social determinants of health, which are conditions in the environment where you are born, live, learn, work, play, worship and age. They affect your health conditions and quality-of-life outcomes and risks. It's because of this that Mayo Clinic staff ask questions pertinent to the social determinants of health at appointments.</li> <li>Mayo Clinic also conducts a mental health screening at every appointment, which evaluates for alcohol use, depression, anxiety and intimate partner violence.</li> <li>Understanding your full health and social picture helps providers better treat health issues. Treatment and resources may vary if a patient is homeless and living in a car, is abused at home or has severe depressions, for example.</li> <li>Screenings are not one-size-fits-all, and depend on risk factors and social determinants of health.</li> <li>Health care providers recommend many screenings for women, such as screenings for breast, cervical and colorectal cancers. They also screen for diabetes, cholesterol, blood pressure, lung cancer, bone health, tobacco use, and HIV and sexually transmitted infections ― all based on risk factors.</li> </ul> <p><strong>After exploring preventive screening, Dr. Gazelka shared about her personal health journey and highlighted the importance of preventive screenings, stating:</strong></p> <blockquote>I've always followed the rules. When my internist told me to do certain things for preventive care, I did them. In the shower in March 2021, I found a very, very, very tiny, firm nodule. I ignored it to see if it would go away, forgot about it and felt it again weeks later through my T-shirt. I had a biopsy, and I sat alone and read my own pathology report in my office the next day: invasive breast cancer. This had to be some kind of mistake, I thought.</blockquote> <h3>Watch the video to hear the rest of Dr. Gazelka's cancer journey:</h3> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/fu16Btxm5rA" title="Prevention and Wellness for Women in Today's World" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p>The Women and Well-Being Program is offered to the community free of charge as one of many ways Mayo Clinic Health System responds to the health needs of the community. For more information, visit Mayo Clinic Health System's <a href="/about-us/community-engagement" target="_self" title="Opens in same window.">Community Engagement page</a>.</p><img src="/-/media/national-files/images/hometown-health/2021/enjoying-coffee-mug-outdoors.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2CC807F794CA4520E50325550A250613" alt="Enjoying a cup of coffee sitting outdoors" width="660" height="370" DisableNVelocity="true" />Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Stress ManagementGuidance to help you reduce and manage daily stress.ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller1/25/2022Fifty million U.S. adults don't get enough sleep. Read 8 Q&A to discover how a sleep study can shed light onto what's happening during the dark of night.8 common sleep study questions<p>Sleep is important to your physical, emotional and mental health. Many people experience trouble sleeping at some point, and more than 50 million U.S. adults are considered poor sleepers.</p> <p>Chronic sleep loss can affect your health, safety and quality of life. It leads to slowed thinking, poor memory, less motivation, drowsiness and irritability. The good news is that many sleep disorders can be diagnosed and managed successfully.</p> <h3>Here are answers to 8 common questions about sleep studies:</h3> <h4>1. Why do I need a sleep study?</h4> <p>Your health care provider has referred you for a sleep study because you are having trouble getting a restful night's sleep. A sleep study, also called a polysomnography or sleep evaluation, can determine if you are suffering from a sleep disorder like sleep apnea or restless leg syndrome. The study also provides information on which treatment option is right for you.</p> <h4>2. How is the test completed?</h4> <p>A sleep study involves overnight monitoring of your breathing and other bodily functions during sleep. When you arrive, a technologist will attach wires, or leads, to you. These are used to monitor your breathing, brain waves, oxygen saturation, pulse and leg movements. Some of the leads are glued in place, and the glue is dried with pressurized air. Soft bands will be put around your stomach and chest to measure your breathing.</p> <p>When you're ready to go to sleep, a technologist will connect your leads to a monitoring device. A device will be placed on your face to measure your airflow. It may have short tubes going into your nose. A clip will be attached to your ear or finger to measure your oxygen levels. A small microphone will be clipped to your pajamas so your snoring can be recorded.</p> <p>The technologist will go to a nearby control room and monitor you throughout the night. A video camera will record your sleep study. The technologist will note if he or she feels there's something in your movements or breathing your physician should review.</p> <p>During the night, the technologist may come into your room and ask you to change to a different sleeping position to see if that affects your symptoms. If it appears you have even mild obstructive sleep apnea, the technologist may help you try a continuous positive airway pressure machine for a portion of the night.</p> <h4>3. Where will I be sleep?</h4> <p>Sleep study rooms are set up like a hotel and usually are in a quiet area of the hospital. You have a private room, some of which include a TV. The technologist will monitor you from a nearby control room.</p> <h4>4. Can I bring my own pajamas and pillow?</h4> <p>Yes. You may bring items you use for your bedtime routine, including pajamas, a robe, slippers and reading material that may help you fall asleep. You also should bring any medications you may need during your sleep study.</p> <h4>5. How long does the test take?</h4> <p>In most cases, you will arrive to the sleep center in the evening and your test will take place overnight. A full night's sleep isn't required to obtain accurate polysomnography results, but you will remain in the lab until around 6 a.m. the next day. Don't worry if you can't fall asleep as easily or sleep as well during your sleep study as you do at home, as this usually doesn't affect the test results.</p> <h4>6. What is monitored during the sleep study?</h4> <h5>While you sleep, a technologist monitors your:</h5> <ul> <li>Brain waves</li> <li>Eye movements</li> <li>Heart rate</li> <li>Breathing pattern</li> <li>Blood oxygen level</li> <li>Body position</li> <li>Limb movement</li> <li>Snoring and other noise you may make as you sleep</li> </ul> <p>These measurements are recorded on a continuous graph. The results help your sleep physician determine if treatment may improve the quality of your sleep.</p> <h4>7. How soon will I get my sleep study results?</h4> <p>In most cases, your follow-up appointment with your sleep physician is scheduled within a few days after your sleep study. During this appointment, your physician will review your results and recommend treatment options, if necessary. You also can review your sleep study results in <a href="/patient-online-services" target="_self" title="Opens in same window.">Patient Online Services</a>, Mayo Clinic Health System's patient portal.</p> <h4>8. Will my insurance cover my sleep study or treatment?</h4> <p>Most health insurance plans, including Medicare and Medicaid, cover sleep studies and positive airway pressure therapy devices. Plans vary in coverage, so you should check with your insurance carrier for details and to determine if prior authorization is required.</p> <p><em>Rachel Ziegler, M.D., is a physician in <a href="/services-and-treatments/neurodiagnostics" target="_self" title="Opens in same window.">Sleep Medicine</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a> and <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2022/sleeping-on-side-in-bed.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0C867953E00A00D7A2C61C36B1DAD4DE" alt="Sleeping on side in bed" width="660" height="370" DisableNVelocity="true" />SleepSleep is essential to good health. It's one of the body's basic needs. But, what do you do when you have troubles sleeping, or getting enough hours of sleep? Dawn Haller1/10/2022Women's health experts discuss breast cancer, preventive measures, and advancements in personalized medicine and breast cancer treatment. Watch the webinar now.Prioritize your health: Breast cancer risk, treatment<p>Nearly 1 in 8 U.S. women are diagnosed with breast cancer in their lifetime. From lifestyle changes and preventive screening options to genetic counseling and personalized cancer treatment options, you can prioritize your breast health in many ways.</p> <p>In a webinar, <a href="/providers/caroline-clune-md">Caroline Clune (Wilker), M.D.</a>, and <a href="/providers/m-kathleen-christian-md" target="_self" title="Opens in same window.">M. Kathleen Christian, M.D.</a> ― both Mayo Clinic Health System Breast Care Center physicians ― discussed breast cancer, preventive measures, and advancements in personalized medicine and breast cancer treatment.</p> <h4>Watch the webinar:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/CciCP5KiZHo" title="breast cancer webinar" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <h4>Here are a few highlights from the webinar, which was followed by a Q&A session:</h4> <ul> <li>Breast cancer survival rates have increased, largely due to early detection and prevention.</li> <li>It's likely that breast cancer is caused by a complex interaction of your genetic makeup and lifestyle.</li> <li>Risk factors you cannot change include increasing age, early onset of your menstrual period, late onset of menopause, late age of first childbirth, a history of chest wall radiation, family history, genetic mutations, a benign breast disease and an increased breast density on a mammogram.</li> <li>Risk factors you can change that can reduce the risk of breast cancer include obesity, a sedentary lifestyle, an unhealthy diet, alcohol use and smoking.</li> <li>Providers review these risk factors to assess your risk and discuss options for risk reduction and prevention, as well as screening for early detection. One plan does not fit all. Understanding and collating all the risk factors with models and calculators can individualize your path for breast cancer screening and prevention.</li> <li>Breast cancer treatment is becoming much more individualized. Health care providers look at the characteristics of individual cancer cells; how advanced the cancer is when it's diagnosed; and characteristics of the patient related to age, family history and other health issues to minimize the invasiveness of treatment and find the right balance of treatment.</li> <li>The presenters discuss technological advances related to the ability to target lymph nodes and reduce the long-term effects of scarring with lymph node removal; surgical techniques that include plastic surgeons to better preserve a normal breast appearance; new ways of evaluating chemotherapy to prevent overtreatment and side effects; improved screening related to gene mutations in addition to BRC1 and BRC2; advances in combination drug treatments; and treatment targeted to a growth hormone that allows a cancer to keep itself growing and getting bigger.</li> <li>Treatments being investigated include detection through blood proteins, treating small cancers with a freezing or heat-type therapy technology, imaging enhancements and enhancing that tumor genomic profiling to better identify specific behaviors of the cancer cells to better target treatment.</li> <li>The future of breast cancer treatment is bright.</li> </ul> <p>Mayo Clinic Health System offers <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window."></a><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">breast cancer care</a> in many communities across the Midwest.</p><img src="/-/media/national-files/images/hometown-health/2022/looking-at-tablet-grey-sweater.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1CBE8787B635ACDBEA48359AFD3FE031" alt="Looking down at tablet, wearing a grey sweater" width="660" height="370" DisableNVelocity="true" />Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller1/12/2022Since ancient times, golden-yellow turmeric has been used in dishes and as a dye and health treatment. Now it's poised to be a top food trend in 2022. Try it in one of these recipes.Brighten dark days with sunny turmeric<p>Since ancient times, turmeric, a golden-yellow spice, has been used in dishes and dyes, and as a health treatment. Now it's poised to be one of the top food trends in 2022.</p> <p>Turmeric root is related to ginger, and it can be dried, ground or used fresh. It's frequently found in Indian (think curry) and Middle Eastern dishes.</p> <p>Many studies are looking into the health benefits of the main bioactive compounds in turmeric — turmeric and curcumin. Findings show these compounds may reduce inflammation, although in doses much higher than amounts used in cooking. Promising evidence also suggests that turmeric may improve hay fever symptoms, reduce triglyceride levels and risk of heart disease, and improve knee pain from osteoarthritis.</p> <p>However, results have been conflicting, and some research shows that turmeric's effects aren't as significant in humans as in test tubes or animals. Despite claims to the contrary, no evidence suggests that turmeric can prevent or treat COVID-19.</p> <p>While turmeric is an ingredient in food, it's also considered a natural supplement. Talk with your provider before starting any natural supplements that may interact with medications or have unfavorable side effects. For example, turmeric in large doses can act like a blood thinner, causing bleeding or dangerously enhancing the effects of blood-thinning medications.</p> <h2>To brighten the dark days of winter, try one of these recipes from Mayo Clinic staff made with sunny turmeric:</h2> <h3>Yellow lentils with spinach and ginger</h3> <p>Serves 4</p> <p>Perfect for a lively, colorful main or side dish. To make it a meal, serve with tangerine slices and warm pita bread.</p> <p>1 teaspoon white or black sesame seeds<br /> 1 tablespoon olive oil<br /> 1 shallot, minced<br /> 1 teaspoon ground ginger<br /> ½ teaspoon curry powder<br /> ½ teaspoon ground turmeric<br /> 1 cup yellow lentils, picked over, rinsed and drained<br /> 1½ cups vegetable stock, chicken stock or broth<br /> ½ cup light coconut milk<br /> 2 cups baby spinach leaves, stemmed and chopped, or 1 cup frozen chopped spinach, thawed<br /> ½ teaspoon salt<br /> 1 tablespoon chopped fresh cilantro</p> <p>Toast only the white sesame seeds by placing them in a small, dry saute or frying pan over medium heat. Cook briefly, shaking the pan often and watching carefully to prevent burning. Remove the seeds from the pan as soon as they begin to turn brown. Set aside.</p> <p>In a large saucepan, heat the olive oil over medium heat. Add the shallot, ginger, curry powder and turmeric. Cook, stirring, until the spices are fragrant, about 1 minute.</p> <p>Add the lentils, stock and coconut milk. Raise heat to medium-high and bring to a boil. Reduce heat to low, cover partially, and simmer until the lentils are tender but still firm, about 12 minutes. The mixture should be brothy; add a little water if needed.</p> <p>Stir in the spinach, cover and simmer for about 3 minutes longer. The lentils should still hold their shape. Uncover and stir in the salt. Serve hot, garnished with the cilantro and toasted white or untoasted black sesame seeds.</p> <h3>Curried carrot soup</h3> <p>Serves 6</p> <p>Accompany the soup with a green salad and crusty whole-grain bread for a complete meal.</p> <p>1 tablespoon olive oil<br /> 1 teaspoon mustard seed<br /> ½ yellow onion, chopped (about ½ cup)<br /> 1 pound carrots, peeled and cut into ½-inch pieces<br /> 1 tablespoon plus 1 teaspoon peeled and chopped fresh ginger<br /> ½ jalapeno, seeded<br /> 2 teaspoons curry powder<br /> ½ teaspoon ground turmeric<br /> 5 cups low-sodium chicken stock, vegetable stock or broth<br /> ¼ cup chopped fresh cilantro (fresh coriander), plus leaves for garnish<br /> 2 tablespoons fresh lime juice<br /> ½ teaspoon salt (optional)<br /> 3 tablespoons low-fat sour cream or fat-free plain yogurt<br /> Grated zest of 1 lime</p> <p>In a large saucepan, heat the olive oil over medium heat. Add the mustard seed. When the seeds just start to pop, after about 1 minute, add the onion and sauté until soft and translucent, about 4 minutes. Add the carrots, ginger, jalapeno and curry powder, and sauté until the seasonings are fragrant, about 3 minutes. Add 3 cups of stock, raise the heat to high and bring to a boil. Reduce heat to medium-low and simmer, uncovered, until the carrots are tender, about 6 minutes.</p> <p>Fill blender or food processer no more than one-third full with hot soup to avoid splashes. Puree until smooth. Return soup to the saucepan and stir in the remaining 2 cups stock. Return soup to medium heat and reheat gently. Just before serving, stir in the chopped cilantro and lime juice. Season with the salt, if desired. Ladle into warmed individual bowls. Garnish with a drizzle of yogurt, a sprinkle of lime zest and cilantro leaves.</p> <p><em><a href="/providers/romi-londre-rdn" target="_self" title="Opens in same window.">Romi Londre</a> is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Eating disorders</li> <li>Enteral nutrition or tube feedings</li> <li>Weight management</li> </ul>RDN, CD<p><strong>Education</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Registered Dietitian Nutritionist</li> <li>Certified Nutrition Support Clinician </li> <li>Certificate of Training in Adult Weight Management</li> </ul> <div> </div>Londre<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/romi-londre-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7919B2F8260054ECC4308684471EEEDB" alt="Romi Londre RDN" width="280" height="280" DisableNVelocity="true" />Romi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15183670Romi Londre, RDN, CD1{2BEE5070-65FF-4406-9E59-103E06C5A535}<img src="/-/media/national-files/images/hometown-health/2022/ground-turmeric.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1DA45887915087C4F3617DF93AFD7FBC" alt="Ground turmeric" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller1/13/2022There are discouraging trends in the prevalence of sexually transmitted infections. Get the facts about the most common types, the potential long-term health consequences and what you can do to protect yourself and partners.Current sexually transmitted infection trends<p>The topic of sexually transmitted infections also called sexually transmitted diseases or STDs, may be uncomfortable to discuss, but it should be addressed directly. This is especially true given some discouraging trends and the prevalence of sexually transmitted infections locally and across the nation.</p> <p>In 2018, 26 million cases of sexually transmitted infections were diagnosed in the U.S., with nearly half of these diagnoses among those age 15 to 24, according to the <a rel="noopener" href="https://www.cdc.gov/sti/php/communication-resources/prevalence-incidence-and-cost-estimates.html#:~:text=CDC%20estimates%20indicate%20about%2020,billion%20in%20healthcare%20costs%20alone." target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention</a> (CDC).</p> <p>This is despite robust sex education programs taught in public schools and the availability of birth control, and testing and treatment, for high-risk age groups. Teens and young adults are more likely to use long-acting birth control to prevent unplanned pregnancy, but this can lead to a more relaxed approach on condom and other barrier use, thereby resulting in greater transmission of sexually transmitted infections.</p> <h2>Types of sexually transmitted infections</h2> <p>Sexually transmitted infections are generally acquired by sexual contact. The bacteria, viruses or parasites that cause sexually transmitted infections may pass from person to person in blood, semen, or vaginal and other bodily fluids.</p> <h3>These are the most common sexually transmitted infections:</h3> <ul> <li><strong>Chlamydia</strong><br /> This is the most frequently reported sexually transmitted infection in the U.S., and it is caused by bacteria. It is spread through exchange of bodily fluids. Most of the time, the person with chlamydia has no symptoms, or simply discomfort and discharge, but chlamydia can lead to more serious health problems if left untreated.</li> <li><strong>Herpes</strong><br /> This sexually transmitted infection is caused by a virus and can present as painful open sores on the genitals. It is spread through exchange of bodily fluids when lesions are present. It is caused by herpes type 2, or HSV-2. Herpes type 1, or HSV-1, causes cold sores, and is not considered a sexually transmitted infection.</li> <li><strong>Human immunodeficiency virus (HIV)</strong><br /> This virus is passed through the exchange of bodily fluids by contact with an infected partner. If untreated, HIV can develop into acquired immunodeficiency syndrome (AIDS).</li> <li><strong>Human papilloma virus (HPV)</strong><br /> HPV is a viral infection that can cause genital warts. These unsightly lesions are found around the genitals and anus. HPV can be easily transmitted from partner to partner. There are more than 100 varieties of HPV, and some can lead to cancer.</li> <li><strong>Gonorrhea</strong><br /> Gonorrhea is caused by bacteria through the exchange of bodily fluids. It is commonly spread with chlamydia.</li> <li><strong>Syphilis</strong><br /> This bacterial infection starts as painless open sores on the genitals, mouth or anus, and it is spread by contact with open lesions of an infected partner.</li> </ul> <p>This list is not comprehensive. The CDC maintains a complete <a rel="noopener" href="https://www.cdc.gov/sti-statistics/about/?CDC_AAref_Val=https://www.cdc.gov/std/statistics/default.htm" target="_blank" title="Opens in a new window.">list of sexually transmitted infections and statistics</a> about them.</p> <h2>Long-term health consequences</h2> <p>Why do we care so much about sexually transmitted infection prevention? First, because it's important to slow the spread.</p> <p>Much like what has been seen with the COVID-19 pandemic, when people do their part to protect their partners and themselves, they can lower the spread of diseases that can significantly affect everyone.</p> <h3>Also, some sexually transmitted infections can cause long-term health consequences, including:</h3> <ul> <li><strong>AIDS</strong><br /> As it progresses, HIV can develop into AIDS. In the past, patients would usually die of AIDS complications. Now many treatments are available that allow a long, normal and otherwise healthy life. These treatments require daily medicine, and some have significant side effects. These developments should never be viewed as a reassurance, as prevention is always the best method.</li> <li><strong>Cervical changes or cancer</strong><br /> HPV is the leading cause of cervical changes, and it can lead to cervical cancer. It can cause abnormal tissue growth in some young women, and they need cancer prevention treatments like a procedure that freezes the surface of the cervix or a loop electrosurgical excision procedure, or LEEP, that removes a portion of the cervix. These treatments are effective for removing abnormal tissue, but they are painful. Healing can be painful, as well. The LEEP procedure could cause pregnancy complications like an early opening of the cervix.</li> <li><strong>Infertility</strong> <br /> Undiagnosed chlamydia and gonorrhea can result in an infection in the genitals that can move into the uterus or the fallopian tubes. A sexually transmitted infection can lead to scarring that can make in challenging to get pregnant or result in infertility.</li> <li><strong>Lifelong infection</strong><br /> Once a person contracts herpes type 2, they have the virus for life. It cannot be cured. From then on, the goal is to suppress sores that develop and not spread sores to others, or a child if sores are present during vaginal delivery.</li> <li><strong>Neurologic changes</strong> <br /> If untreated, syphilis can cause permanent neurologic changes, including chronic joint pain, muscle pain, brain changes, confusion, illusions and chronic headaches. It also can damage the heart and other organs.</li> </ul> <h2>Preventing sexually transmitted infections</h2> <p>What can you do to keep from getting a sexually transmitted infection? How can you stop a sexually transmitted infection from spreading?</p> <h3>Recommendations can be controversial, and I will try to address everything to include those that are very sexually conservative to the open of sex practices:</h3> <ul> <li><strong>Practice abstinence</strong><br /> This is not having any sexual activity with other people. If you want a 100% guaranteed way not to acquire or transmit disease, no sexual contact is the only option. This includes not taking part in genital-to-genital, oral-to-genital or oral-to-oral sexual contact, especially if sores are present around the mouth or lips.</li> <li><strong>Practice mutual monogamy</strong><br /> Being in a relationship where both partners are fully tested before sexual contact and remain monogamous with each other greatly reduces the transmission of sexually transmitted infections. Using condoms, which is highly recommended even if testing results are negative, reduces the risk even more.</li> <li><strong>Get vaccinated</strong><br /> The HPV vaccination is a great way to prevent the risk of HPV infection. The CDC recommends that all 11- and 12-year-olds receive two doses of HPV vaccine at least six months apart. This is the best age to get vaccinated to protect against the virus before a person is exposed through sexual activity. Children as young as 9 can be vaccinated, as well. Research has shown that the two-dose schedule is effective for children under 15. Teens and young adults who begin the vaccine series later ― from ages 15 to 26 ― should receive three doses of the vaccine.</li> <li><strong>Use condoms and dental dams consistently and correctly</strong><br /> The correct use of these types of barrier methods can greatly reduce the transmission of sexually transmitted infections. Always plan for proper use when taking part in sexual activity. When you leave your home, most people bring their phones, wallets, driver's license and credit cards. Why not condoms? Condom material breaks down over time, so make sure that it isn't expired. Also, confirm that you are using condoms approved by the Food and Drug Administration to prevent sexually transmitted infections.<br /> <br /> Outdated misconceptions and opinions are common obstacles to the correct use of condoms. Some people claim that condoms lessen sensation or smell strange. Many new, quality condoms are advertised as ultrathin and increased sensation. Flavors make them more palatable, especially when taking part in oral sex. Some people claim that there isn't a good time to put on a condom during the heat of passion. If they choose, women can put a female condom in place hours before sexual activity. Also, demonstrating your concern for your partner's health by using a condom can be an aphrodisiac.<br /> <br /> Dental dams are incredibly effective and used in many areas of the country. They are placed over the genitals or anal area during a sex act and create a barrier from bodily fluid transfer. They also come in flavors and scents. Couples, in which on partner has known genital warts or herpes, find dams help lower the risk of transmission.</li> </ul> <p>Talk with your primary care provider about sexually transmitted infection testing and treatments.</p> <p><em><a href="/providers/graham-king-md" target="_self" title="Opens in same window.">Graham King, M.D.</a>, is a physician in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Community fitness outreach programs</li> </ul>M.D.<p>I enjoy caring for the health needs of families from prenatal care and pediatrics to adult medicine, and specialize in women's health and reproductive health. I focus on listening and hearing my patients, and forming partnerships with them in delivering their care.</p> <p>I am married to an elementary school teacher with four energetic boys who are active in community, school and sports. I enjoy playing guitar and piano, writing educational blogs and practicing healthful living. </p> <p>I am an 80s rock superfan and love going to concerts with my family and friends. I also enjoy Vikings, Twins, Wild and Maverick sports.</p><p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Mercy Hospital</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Sutter Health Family Medicine Residency Program</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Family Medicine</li> <li>Mayo Clinic Quality Fellow, Bronze Level</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Medical Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>King<img src="/-/media/shared-files/images/medical-professionals/full/mankato/graham-king-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=78048D61A3A60EF1DF00C06F2F6CCBEE" alt="Graham King MD" width="280" height="280" DisableNVelocity="true" />{46521252-3F34-48F2-80D2-338AA6DD4C22}Graham<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14899019Graham King, M.D.1<img src="/-/media/national-files/images/hometown-health/2022/holding-mug-and-cellphone-in-kitchen.jpg?h=370&iar=0&w=660&sc_lang=en&hash=961E39187666BD77ED62ADA47B4FB5CF" alt="Holding mug and looking at cellphone while in the kitchen" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller1/24/2022There are telltale signs your child may have picked up hand, foot and mouth disease. Find out how to spot these signs and what you can do to help prevent the spread.Hand, foot and mouth disease common in children<p>Your children have been fussier than usual, running low-grade fevers and refusing to eat breakfast. So you check them out, and find sores on their tongue and some red, blister-like bumps on the tops of their feet. What could this be?</p> <p>You may be seeing signs of hand, foot and mouth disease, which is a common viral infection, especially among children in a group child care setting. It can occur any time of the year but more often in the summer and fall. While there's no specific treatment, you can take steps to reduce your children's risk of infection.</p> <h2>Know how to spot the signs</h2> <p>You may notice the start of the infection with fever, followed by sores in the mouth or a rash on the hands and feet. The mouth sores tend to be painful, but the rash usually isn't painful.</p> <h3>Hand, foot and mouth disease may cause some or all of these symptoms:</h3> <ul> <li>Fever</li> <li>Sore throat</li> <li>Feeling unwell</li> <li>Blister-like lesions or sores that may appear on the tongue, gums and inside of the cheeks</li> <li>A red rash that does not itch but may blister on the palms, soles and possibly the buttocks</li> <li>Irritability in infants and toddlers</li> <li>Loss of appetite</li> </ul> <p>Most children will experience a minor illness for seven to 10 days that can be treated at home. It's important to ensure your children get enough to drink to prevent dehydration. Get creative with foods and beverages that may ease pain, including ice pops, ice cream or sherbet, and soft foods that don't require much chewing. Avoid acidic food, like fruit drinks, soda and spicy food.</p> <p>If sores in the mouth keep your children from drinking fluids or symptoms worsen, contact your children's health care provider.</p> <h2>Help prevent the spread</h2> <p>Hand, foot and mouth disease is typically spread through the fecal-to-oral path due to inadequate hand-washing. It also can spread from the mouth, respiratory tract or fluid from an open sore.</p> <p>To reduce the risk of infection, avoid hugging, kissing or sharing objects until your children are symptom-free. Teach them to sneeze into their bent elbow or cover their mouth and nose when they cough or sneeze.</p> <p>Any member of the family can get hand, foot and mouth disease, including older children and adults.</p> <h3>Other steps to prevent the spread of the infection include:</h3> <ul> <li><strong>Make hand-washing a priority.</strong> <br /> <a href="/hometown-health/speaking-of-health/clean-up-your-hand-washing-skills" target="_self" title="Opens in same window.">Wash your hands</a> frequently and thoroughly, especially after going to the restroom or changing a diaper. Always wash your hands before preparing food and eating. Use hand wipes or gels treated with germ-killing alcohol if soap and water are not available.</li> <li><strong>Clean and disinfect shared spaces and items.</strong><br /> Clean high-traffic areas and surfaces first with soap and water, then with a diluted solution of chlorine bleach and water. In your home or child care centers, shared items, such as toys, should be cleaned regularly, since the virus can live on these objects for days.</li> <li><strong>Teach good hygiene.</strong><br /> Show your children how to keep themselves clean. If your children are old enough to understand, explain why it's best not to put their fingers, hands or other objects in their mouths.</li> <li><strong>Keep contagious people away from others.</strong><br /> Because hand, foot and mouth disease is highly contagious, those with the illness should limit their exposure to others while they have active signs and symptoms. Keep children out of child care or school until their fever is gone and mouth sores have healed. If you have the illness, stay home from work.</li> </ul> <h2>In this video, learn about another common, contagious virus that affects kids and adults alike: pink eye or conjunctivitis:</h2> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/Z_REzv459q8" title="Ask Mayo Clinic Health System: Pinkeye - Symptoms & Causes" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <p><em><a href="/providers/luke-crance-pac" target="_self" title="Opens in same window.">Luke Crance</a> is a physician assistant in <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">Emergency Medicine</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a> and <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Emergency medicine</li> </ul>P.A.-C.<p>When my patients come to see me they can expect a relaxed and welcoming environment where evidence-based medicine is met with team care and shared decision making. My patient’s values are always respected. </p> <p>Coming from a small town in South Dakota, I understand the importance of community and family. I enjoy being in the outdoors, hunting, hiking, and traveling. Cooking and trying new foods is a favorite pastime and I would love to discuss food at any visit.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Biology, University of South Dakota</li> <li>Master's degree, Physician Assistant Studies, University of Wisconsin-La Crosse</li> </ul> <p><strong>Certification</strong></p> <ul> <li>National Commission on Certification of Physician Assistants</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Physician Assistants</li> <li>Wisconsin Academy of Physician Assistants</li> </ul>Crance<img src="/-/media/shared-files/images/medical-professionals/full/mankato/luke-crance-pac.jpg?h=280&iar=0&w=280&sc_lang=en&hash=1D8ABFE06838086AE7B13040F582ED87" alt="Luke Crance PAC" width="280" height="280" DisableNVelocity="true" />Luke<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20980582Luke Crance, P.A.-C.1{FB3BB67A-14FA-4DDE-B183-F85C42E0B255}|{CDA27FD1-23E5-4D31-BD85-567A48B862F7}<img src="/-/media/national-files/images/hometown-health/2022/toddler-playing-with-dinosaur-toy.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E7D2F5606C04FECA796CEEA57B1E16EA" alt="Toddler playing with dinosaur toy" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller1/27/2022Kindness is more than feeling grateful. Learn how intentional acts of kindness can positively impact your life and create a happier, healthier you.Kindness in action brings healthy rewards<p>You may have heard uplifting stories about acts of kindness ― an anonymous donor paying off school lunch accounts for students, a passerby donating a large sum of money in a charity collection bucket, or people rallying to save victims during storms or natural disasters. Hearing about acts of kindness makes people feel good.</p> <p>Frequently, gratitude and kindness go together, but they are different concepts. Gratitude is a quality or feeling of being grateful or thankful. You can express gratitude for people and things in your life. Gratitude is personal and inward-facing; whereas, kindness is expressed outwardly. Kindness involves helpful, generous or considerate actions without an expectation of anything in return. Often acts of kindness are simple, free, positive and healthy.</p> <p>Acts of kindness have been shown to increase self-esteem and feelings of empathy and compassion. Kindness can increase your sense of connectivity with others, which can directly affect loneliness, improve low mood and enhance relationships in general.</p> <p>Set a goal to be kinder to others through an intentional act of kindness each day. Make a special effort to extend kind words to a neighbor. Give a large tip to your server. Pick up litter on the sidewalk. Hold the elevator for someone or donate to a charity.</p> <h5>Look for ways to demonstrate kindness to all aspects of your life, including:</h5> <ul> <li>Family</li> <li>Friends</li> <li>Co-workers</li> <li>Community or neighborhood</li> <li>Environment</li> <li>Social or religious organizations</li> <li>School</li> <li>Yourself</li> </ul> <p>As you spread your kindness, you might just experience what research has confirmed: Generosity can be contagious. That's because the act of helping others activates the part of your brain that makes you feel pleasure. It also releases a hormone called oxytocin that helps modulate social interactions and emotion. That is, the higher your oxytocin levels, the more generous you may be.</p> <p>Like anything else, acts of kindness get easier with practice. Focus on performing one small act each day. Write in a journal what you did and how it made you feel. Combine this with a daily <a href="/hometown-health/speaking-of-health/can-expressing-gratitude-improve-health" target="_self" title="Opens in same window.">gratitude journal</a> to record reasons to feel thankful. Brainstorm other ways to demonstrate kindness to others or partner with your family or friends on a grander act of kindness.</p> <p>Consider joining Mayo Clinic Health System's <a href="/wellness/kindness" target="_self" title="Opens in same window.">Kickstart Kindness program</a> to start your kindness journey. The program offers many ideas of how to extend kindness. You may just find a happier, healthier you.</p> <p><em><a href="/providers/sarah-strahm-np" target="_self" title="Opens in same window.">Sarah Strahm</a> is a nurse practitioner in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Depression and anxiety</li> <li>Holistic nursing</li> <li>Well-child and adolescent care</li> <li>Wellness promotion</li> </ul>C.N.P., A.P.N.P.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Nursing, University of Wisconsin, Eau Claire</li> <li>Master's degree, Nursing, University of Wisconsin, Eau Claire</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Nurse Practitioner, American Nurses Credentialing Center</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Strahm<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/sarah-strahm-np.jpg?h=280&iar=0&w=280&sc_lang=en&hash=C034147AA59B79822B3582C240DE5D33" alt="Sarah Strahm, N.P." width="280" height="280" DisableNVelocity="true" />{429278E8-B533-4451-8276-5E5A4BFDEC1E}Sarah<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13599356Sarah Strahm, C.N.P., A.P.N.P.1<img src="/-/media/national-files/images/hometown-health/2022/tying-raffia-on-flower-bouquet.jpg?h=370&iar=0&w=660&sc_lang=en&hash=528F100220CC0CFB4D4B0D74E2E318DC" alt="Tying raffia on flower bouquet" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller1/19/2022Memory lapses and modest decline in thinking skills are common with age. How do you know it's a sign of something more? Learn what to watch for and get tips for coping with memory loss.Memory lapses: Normal aging or something more?<p>Have you ever walked into a room and forgot why you entered? Lost the name of an acquaintance you met a few years ago? Forgot the name of a tool in your shop?</p> <p>Memory lapses and modest decline in thinking skills are common as you age. There's a difference, however, between normal changes in memory and memory loss associated with neurodegenerative conditions, such as Alzheimer's disease and Lewy body dementia. And some memory problems are the result of treatable conditions.</p> <h4>Memory continuum</h4> <p>Think of memory function as running on a continuum, with each person's memory and cognitive functioning falling somewhere along it. Some people have sharp memories and can recall even the smallest details, while others struggle to remember big events.</p> <h5>Memory changes can be viewed as movement along this continuum.</h5> <ul> <li><strong>Minor changes</strong><br /> Minor changes in memory as a person ages are considered normal. This includes misplacing reading glasses or occasionally having difficulty finding the right word. These situations are common and within the range of normal memory changes. These types of lapses don't interfere with daily life and aren't considered signs of dementia.</li> <li><strong>Mild cognitive impairment</strong><br /> This change is a larger movement along the memory continuum. Mild cognitive impairment occurs if a person is experiencing memory changes in addition to cognitive changes, such as thinking or reasoning skills. These changes are more than what is expected for the person's age but less than a person who is diagnosed with dementia. People with mild cognitive impairment can live alone, and the impairment does not significantly interfere with their daily lives. Symptoms could include short-term memory problems, repeating conversations and questions, and increased reliance on lists. However, people with mild cognitive impairment usually can manage their own finances, medications and household chores, and drive without concern.<br /> For some people, mild cognitive impairment does not worsen. Their memory and function remain constant for the rest of their lives. For others, it is an early symptom of a neurodegenerative condition, such as Alzheimer's disease. Health care providers can't predict which people will remain constant and who will decline over time.</li> <li><strong>Dementia</strong><br /> Dementia is not a specific disease, but rather a group of symptoms that affects memory, thinking and social abilities severely enough to interfere with daily life. While dementia has a negative connotation, it really means that a person's brain function is impaired enough that the person cannot live alone and requires help with some daily tasks. Often, memory loss that disrupts daily life is one of the first or more recognizable signs of dementia.</li> </ul> <h5>Other early signs can include:</h5> <ul> <li>Asking the same questions repeatedly.</li> <li>Forgetting common words when speaking.</li> <li>Mixing words up, such as saying "bed" instead of "table."</li> <li>Taking longer to complete familiar, simple tasks, such as operating a microwave or washing machine.</li> <li>Unable to perform complex tasks with many steps, such as following a recipe or playing a board game.</li> <li>Misplacing items in inappropriate places, such as putting a wallet in the refrigerator.</li> <li>Getting confused while walking or driving in a familiar area.</li> <li>Transposing numbers, such as when balancing a checkbook or dialing a telephone number.</li> <li>Limiting participation in conversations.</li> </ul> <h4>Causes of dementia</h4> <p>Some causes of dementia or dementia-like symptoms can be reversed with treatment. People with thyroid problems, problems absorbing vitamin B12, sleep apnea, hearing loss or hydrocephalus, or are experiencing side effects to medications, could develop dementia-like symptoms. A thorough medical assessment can determine the cause and if treatment will reverse symptoms.</p> <p>Other causes of dementia are neurodegenerative, which is damage to, or loss of, nerve cells and their connections in the brain. This type of dementia cannot be reversed. Common causes include Alzheimer's disease, vascular dementia and Lewy body dementia.</p> <h4>What you can do</h4> <p>If you are concerned about your memory loss or the memory loss of a loved one, the first step is to schedule an appointment with a memory care expert. Alzheimer's disease and other neurodegenerative conditions cannot be diagnosed by completing a one-time memory test.</p> <p>During a thorough evaluation, your health care provider will review all symptoms, medications and health history. Then your health care provider will rule out other factors that could worsen the symptoms. For example, a person may not be taking part in conversation or asking the same questions repeatedly because of significant hearing loss. Likewise, a person may be struggling with concentration because of chronic sleep apnea or depression.</p> <h5>After a dementia diagnosis, here are other things that caregivers can do to help:</h5> <ul> <li><strong>Encourage independence and purpose</strong><br /> Every person wants to contribute and feel purposeful. Often, family members want to take over tasks from their loved one after a dementia diagnosis. But families should try to keep their loved ones active and performing daily activities as long as they possibly can. You may need to modify the activity to allow your loved one to continue to contribute. For example, your loved one with dementia may be familiar with unloading the dishwasher but struggles with remembering where each item is stored. Labeling cabinet doors is an easy way to modify the activity, and this gives the person a sense of independence.</li> <li><strong>Foster social interaction</strong><br /> Research has shown that regular social interaction slows cognitive decline. However, when people start to have memory problems, they often pull back socially to avoid embarrassment. Schedule social time with a small, safe group who is familiar with the loved one's diagnosis. Then the person with dementia doesn't need to worry or feel self-conscious about repeating stories or asking questions.</li> <li><strong>Discuss preferences</strong><br /> Some people with dementia want to know if they have already asked a question or be gently reminded. This could agitate others. Ask the person with dementia which option is preferred and recognize that this could shift as conditions change. Identify a way to confirm that the person with dementia would like help. A simple nod or finger flick could signify that it is OK to lend support or assistance.</li> <li><strong>Create a predictable and soothing environment</strong><br /> Establishing and strengthening routine habits and minimizing memory-demanding tasks can make life easier for the person with dementia and the caregiver. Keep a loved one's keys, wallet and regularly used items in the same place. Label cabinet doors and write instructions for using appliances. Post a large calendar in a common area to track daily schedules and appointments. Remove excess clutter, while keeping photos and sentimental objects nearby, to create a restful environment.</li> <li><strong>Encourage exercise</strong><br /> Your loved one may not be able to run a marathon anymore, but regular movement improves blood flow, moderates mood and improves sleep. Gardening, walking and dancing are low-impact, safe activities for many people with dementia.</li> <li><strong>Plan healthy meals</strong><br /> People with dementia may forget to eat, lose interest in preparing meals or not eat a healthy combination of foods. Plan <a href="/hometown-health/speaking-of-health/maximize-memory-function-with-a-nutrient-rich-diet" target="_self" title="Opens in same window.">nutritionally dense meals</a> that are rich in fruits, vegetables, whole grains and legumes, fish, healthier fats, and herbs or seeds so that every calorie is beneficial.</li> </ul> <p><em><a href="/providers/kari-mongeon-wahlen-cns" target="_self" title="Opens in same window.">Kari Mongeon Wahlen</a> is clinical nurse specialist in <a href="/services-and-treatments/neurology" target="_self" title="Opens in same window.">Neurology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em> </p><ul> <li>Alzheimer’s disease</li> <li>Dementia and dementia with Lewy bodies </li> <li>Essential tremor and other movement disorders</li> <li>Parkinson’s disease</li> </ul>APRN, CNS<p>I would describe myself as a very warm person who likes to get to know my patients from a more holistic perspective as I feel it helps me provide comprehensive and individualized care. </p> <p>I view being a healthcare provider as a privilege. I approach each patient as an individual and believe working with them as a team is one of the best ways to participate in meeting their health and wellness goals.</p> <p>My personal interests include all things Minnesota sports, singing and playing piano and guitar, musicals, movies and spending time at the pool watching two of my children swim competitively. </p><p><strong>Education</strong></p> <ul> <li>Master's degree, Nursing, University of Mary</li> <li>Postgraduate certificate, Health Care Informatics, University of Phoenix</li> <li>Clinical Nurse Specialist, Saint Francis Medical Center College of Nursing</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Adult/Gerontology clinical nurse specialist, American Nurses Credentialing Center</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Neurology</li> <li>Health Information and Management Systems Society</li> <li>Movement Disorders Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Neurology, Mayo Clinic College of Medicine and Science</li> <li>Instructor in Nursing, Mayo Clinic College of Medicine and Science</li> </ul>Mongeon-Wahlen<img src="/-/media/shared-files/images/medical-professionals/full/mankato/kari-mongeon-wahlen-cns.jpg?h=280&iar=0&w=280&sc_lang=en&hash=8058969FD87D33997326A938B80437B9" alt="Kari Mongeon-Wahlen, APRN, CNS" width="280" height="280" DisableNVelocity="true" />Kari<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14801159Kari Mongeon-Wahlen, C.N.S.1{84749020-F092-4F95-A217-669CCCD77721}<img src="/-/media/national-files/images/hometown-health/2022/wearing-glasses-looking-down.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0E4D7EFC32CBF8F94BF0676EE7D79FAE" alt="Wearing glasses looking down" width="660" height="370" DisableNVelocity="true" />AgingLife expectancy is 75 for males and 80 for females according to the National Center for Health Statistics. We'll help you keep you informed about potential issues with aging, and steps you can take to maintain your health and keep active.Dawn Haller1/21/2022Pain medication options are available to women in labor, whether they have a midwife or a physician. Learn about your options.Pain management options with midwifery<p>A common misconception when planning a delivery with a midwife is that pain management options are not available for labor.</p> <p>All pain medication options are available to women, whether they have a midwife or a physician. Choosing the type of medication that works best to meet your needs is an important factor when considering pain management options.</p> <h2>Comfort measures without medication</h2> <p>You can use comfort measures and labor support during childbirth with the help of your labor partner or coach. Comfort measures can enhance the effects of anesthetic or medications you choose for labor.</p> <h3>Comfort measures used during labor may include:</h3> <ul> <li>Listening to your favorite playlist</li> <li>Soft lighting with battery-operated candles or strand of lights</li> <li>Hydrotherapy with a bathtub or shower</li> <li>Breathing in a pattern</li> <li>Changing position through walking, sitting or rocking in a chair</li> <li>Using a labor ball</li> <li>Counterpressure with a tennis ball</li> <li>Diffusing or applying essential oils</li> <li>Bringing a blanket, pillow or laboring gown</li> </ul> <h2>Comfort measures with medication</h2> <h3>Options for pain management during labor may be based on how labor is progressing, including:</h3> <ul> <li><strong>Continuous labor epidural</strong><br /> A needle is placed in the lower back to allow a catheter to be passed through to the epidural space. The catheter provides a continuous infusion of a combination of local anesthetic and narcotic medication. Women who receive this type of epidural maintain the ability to feel touch and pressures while relieving the pain of labor.</li> <li><strong>Intrathecal narcotic</strong><br /> If labor is progressing quickly, a one-time injection in the lower back provides a rapid loss of feeling below the waist. This type of medication usually lasts two to four hours, and it is used for women who have advanced cervical dilation and may deliver soon.</li> <li><strong>IV narcotic</strong><br /> This pain management option may be used by women who are not sure if they want an epidural. IV narcotics are administered through an IV in a vein up to three times during labor. This can help women relax in between contractions and make contractions more tolerable.</li> <li><strong>Nitrous oxide</strong><br /> Commonly known as laughing gas, this odorless and tasteless gas is inhaled through a hand-held mask during labor. The gas takes effect within a few minutes to dull the pain and reduce anxiety, but it does not eliminate the pain. It can be used once as needed or continuously during labor.</li> </ul> <h2>Planning ahead</h2> <p>Whether you plan to use pain management options for labor, taking a childbirth education class is a good step to learn more about your options. Classes are available to teach women and their labor coach how to cope with labor pain. If your birth plan includes your preference and goal for pain management, your labor coach and the care team can support you in that path during labor.</p> <p>Being familiar with the options for pain management and asking questions will help you select the option that works best for your needs. Your care team can provide the care and support to help you manage your comfort during labor.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/pain-management-in-midwifery_blog.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9C732FA17AF451669DEF30609642EB38" alt="Pregnant woman reading a book" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Prenatal CareOB-GYN and Family Medicine providers offer exactly the care you need for starting or growing your family, including pregnancy planning and prenatal care.Dawn Haller9/21/2025Does the thought of using an air fryer intimidate you? With these tips, you'll get acquainted your new appliance, and soon you'll wonder what you did without it.Reasons to love your new air fryer<p>Have you recently added an air fryer to your kitchen? While air fryers are having a moment, and everyone is raving about them, a new appliance can be a bit intimidating. With these tips you'll get acquainted with your air fryer, and soon you, too, will be singing its praises.</p> <h4>New name, old tech</h4> <p>While the name "air fryer" is relatively new, the concept isn't. Air fryers contain a fan that circulates hot air at high speed, which produces a crisp, golden crust similar to deep-fat frying. Essentially, they're little countertop convection ovens marketed with a new name. Traditional convection ovens have been in wide use since the 1940s.</p> <h4>Health benefits</h4> <p>Because air fryers use hot air and a fan, usually just a spritz of cooking oil is needed. That makes air frying a lower-in-fat-and-calories alternative to deep-fat frying. Air fryers significantly reduce cooking time and tend to give off less heat, which makes them ideal for hot-weather cooking.</p> <h4>Beyond crispy foods</h4> <p>Air fryers are for more than just crisping up foods. Use them for roasting vegetables, cooking meats and baking cookies. Some air fryers are equipped with accessories such as pizza pans, grilling trays and cake barrels. Manufacturers also offer "multicookers" that combine air fryer, toaster oven and pressure cooker all in one.</p> <h4>Recipes to get you started</h4> <p>These recipes are perfect for air frying. If you don't have an air fryer, they also work in a convection oven, but the cooking time may vary.</p> <h5>Air-fried coconut shrimp</h5> <p>Serves 4</p> <p>Shrimp<br /> 1/2 cup all-purpose flour<br /> 1 1/2 teaspoons black pepper<br /> 2 large eggs<br /> 2/3 cup unsweetened flaked coconut<br /> 1/3 cup panko (Japanese-style breadcrumbs)<br /> 12 ounces medium peeled, deveined raw shrimp, tail-on (about 24 shrimp)<br /> 1/2 teaspoon kosher salt<br /> Cooking spray</p> <p>Sauce:<br /> 1/4 cup honey<br /> 1/4 cup lime juice<br /> 1 serrano chile, thinly sliced<br /> 2 teaspoons chopped fresh cilantro (optional)</p> <p>Stir together flour and pepper in a shallow dish. Lightly beat eggs in a second shallow dish. Stir together coconut and panko in a third shallow dish. Holding each shrimp by the tail, dredge shrimp in flour mixture, making sure not to coat tail; shake off excess. Dip in egg, allowing any excess to drip off. Dredge in coconut mixture, pressing to adhere. Coat shrimp well with cooking spray. Place half of the shrimp in the air fryer basket, and cook at 400 F until golden, 6 to 8 minutes, turning shrimp over halfway through cooking. Season with ¼ teaspoon salt. Repeat with remaining shrimp and salt. While shrimp cook, whisk together honey, lime juice and serrano chile in a small bowl. Sprinkle shrimp with cilantro, if desired. Serve with sauce.</p> <p><em>(Recipe from Cooking Light)</em></p> <h5>Air-fryer roasted cauliflower</h5> <p>Serves 4</p> <p>6 cups cauliflower florets<br /> 2 tablespoons olive oil<br /> 2 teaspoons ground coriander<br /> 1/2 teaspoon salt<br /> 2 tablespoons chopped parsley<br /> 1/2 teaspoon lemon zest<br /> 11/2 tablespoons lemon juice<br /> Cooking spray</p> <p>Combine cauliflower, oil, coriander and salt in a large bowl; toss well to coat. Lightly coat air-fryer basket with cooking spray. Add the cauliflower to the basket. Cook at 360 F for 10 minutes. Open the air fryer; lightly toss the cauliflower to redistribute. Continue cooking until cauliflower is golden brown and crispy around the edges, 8 to 12 minutes. Return the cooked cauliflower to the large bowl; add parsley, lemon zest and lemon juice. Toss to coat evenly.</p> <p><em>(Recipe from Eating Well)</em></p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2022/chicken-in-air-fryer.jpg?h=370&iar=0&w=660&sc_lang=en&hash=56D0D1439F9A1C4E1BDCBF0634DB2E24" alt="Chicken in air fryer" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller9/16/2025Robotic surgery has become increasingly popular in the U.S. and with good reason. It combines increased surgical precision and flexibility with shorter recovery time and less pain. Find out if it's a good option for you.Robotic surgery increases precision, shortens recovery<p>When you hear the word "robot," you may think of a humanoid machine that can carry on a conversation with you or is plotting to take over society. While you may see that in movies, everyday robots are less dramatic and more helpful.</p> <p>In many situations, robots perform repetitive actions, such as vacuuming or pulling products in a warehouse. They also increase the precision of complex actions, including plasma welding or surgical procedures.</p> <p>Robotic surgery has been around since the 1990s. Over the past 15 years, robotically assisted surgeries have become increasingly popular in the U.S. Robotic surgery offers increased surgical precision, visualization and flexibility for surgeons, and shorter recovery time and less pain for patients.</p> <h2>What is robotic surgery?</h2> <p>No need to be alarmed. The robot isn't operating on its own. Instead, the surgeon uses a robotic platform as a tool during the procedure, like other equipment and technology. The surgical robot has interactive arms that serve as extensions of the surgeon's hands. These arms are equipped with surgical tools and cameras. They can suture, dissect, clamp and manipulate tissue.</p> <p>During surgery, the surgeon makes a few small incisions, similar to laparoscopic surgery, and inserts the interactive arms. The surgeon maneuvers the robotic arms next to the operating table using two master controls. The console gives the surgeon a high-definition, 3D view of the surgical site.</p> <p>Robotic surgery usually is performed in this minimally invasive manner. While less common, it also can be used in traditional open surgical procedures.</p> <h3>Conditions treated using robotic surgery include:</h3> <ul> <li>Adrenal mass</li> <li>Appendicitis</li> <li>Bladder cancer</li> <li>Colorectal cancer</li> <li>Gallbladder diseases</li> <li>Gastrointestinal cancer</li> <li>Hernia repair (incisional, umbilical and inguinal)</li> <li>Hysterectomy</li> <li>Kidney disease</li> <li>Lung mass</li> <li>Prostate cancer</li> <li>Small bowel obstruction</li> <li>Uterine fibroids</li> <li>Weight-loss surgery</li> </ul> <h2>Benefits of robotic surgery</h2> <p>The primary benefit of robotic surgery for patients is faster recovery. This allows patients to return to daily activities sooner than with standard open or laparoscopic surgery. In addition, robotic surgeries have fewer surgical complications and result in smaller, less noticeable scars. Finally, patients lose less blood during the procedure and report less pain after. Most patients who had robotic surgery are happy with their results.</p> <p>For surgeons, a surgical robot enhances precision, flexibility and control during the operation, and allows them to better see the surgical site, compared with traditional techniques. The robotic arms have a greater range of motion than the human wrist, so surgeons can successfully navigate hard-to-reach areas with less disturbance to surrounding tissues. This speeds recovery and lessens the pain of surgery for the patient. Robotic surgery makes delicate and complex procedures possible that may have been difficult or impossible with other methods. Finally, it's more comfortable for the surgical team because the robot does the stretching and bending necessary to access difficult surgical sites. This can reduce injury risk and extend the life of a surgeon's career.</p> <p>Robotic surgery isn't an option for everyone. It's important to talk with your surgeon about the benefits and risks of robotic surgery and how it compares to open or other minimally invasive surgery.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2022/surgeon-performing-robotic-surgery.jpg?h=370&iar=0&w=660&sc_lang=en&hash=30B50CD43D146D5130D7E78BB60976B3" alt="Surgeon performing robotic surgery" width="660" height="370" DisableNVelocity="true" />SurgeryHaving surgery is a major event in your life. We know this and make every effort to keep you as comfortable as possible, focusing on you as an individual. Our surgeons and staff work as a coordinated team treating a wide variety of illnesses ranging from simple to complex. We offer comprehensive, advanced care and service to every patient.Dawn Haller1/20/2022If you injure your ankle or knee, should you wear a brace to support the joint? A brace can help or hinder your recovery. Here are three questions to consider.To brace or not to brace: What's the best answer?<p>If you injure your ankle or knee, should you wear a brace to support the joint? The answer depends on whether it's the ankle or knee, the severity of the injury, and your goals for the level of activity you want to regain.</p> <h2>If you're wondering if a brace would help or hinder your recovery, here are 3 questions to consider:</h2> <h3>1. Why use a brace?</h3> <p>Braces range from a simple neoprene sleeve to a complex hinged device. They provide support and warmth, relieve aches and pains, help prevent injury, and aid in healing. It's important to choose the brace that's right for you.</p> <p>An athletic trainer, physical therapist, or sports medicine or orthopedic provider can make recommendations for your situation.</p> <h3>2. When should an ankle brace be worn?</h3> <p>If you've injured your ankle, like twisting it as you step off a curb, wearing a brace after the accident can provide support and stability, and give you confidence that your ankle will support you. But as the injury heals, you should gradually work toward not needing it anymore.</p> <p>You may want to continue bracing for high-level activities, like playing basketball or tennis, working out or shoveling snow, but let the ligaments and muscles around your ankle naturally strengthen and heal during lower-level, every day activities. If you're an athlete, save the brace for high-level competitions and practices.</p> <h3>3. How about a knee brace?</h3> <p>Many of the same reasons to brace apply to the knee, too. However, many injuries that cause knee pain actually are related to muscle control at the hip or ankle, so bracing the knee potentially doesn't have the same impact on healing.</p> <p>If you have early onset, mild arthritis in your knee, a neoprene sleeve can provide support, compression and warmth. These simple braces can be worn as long as they continue to provide relief. Some athletes wear a sleeve or tights that go below the knee for compression and comfort.</p> <p>However, if you've injured your knee, such as a torn ACL, rely on your surgeon's guidance. Typically, a complex knee brace is worn for the first year. After that, a brace usually isn't needed for low-level activities. Keep in mind it can take up to two years to return to baseline stability. Once you're returned to full function, you can stop wearing a brace.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/crouching-tying-shoelaces.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1FFA6EFD9F853AA93A646AFE95E72E0C" alt="Crouching on sidewalk in winter, tying shoelaces" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller1/7/2022It may start with an occasional twinge in your hip or a catch in your knee, but becomes an ongoing ache. Learn how to find relief for aching joints.What you need to know about aching joints<p>It may start with an occasional twinge in your hip or a catch in your knee. Then you notice that actions you took for granted — climbing stairs, going for a long walk or squatting down to pick up a grandchild — take that twinge to an ongoing ache. Before you know it, you're avoiding those activities.</p> <p>More than likely, the culprit is osteoarthritis. This is the most common form of arthritis, and typically the result of wear and tear on your joints. It also may be caused by an old injury that 20 or 30 years later has come back to haunt you. For some people, it runs in the family.</p> <p>Osteoarthritis is the loss of the smooth coating on the end of your bones called cartilage. Cartilage allows your joints to move easily and without pain. As the cartilage thins, the bones start rubbing together, causing inflammation and pain.</p> <h2>Here are 5 things you need to know about finding relief:</h2> <h3>1. Maintain a healthy weight.</h3> <p>Excess weight puts greater strain and pressure on your joints. Even modest decreases in your weight can make a big difference in the pain you experience.</p> <h3>2. Stay active.</h3> <p>When it comes to joints, motion is the lotion to keep them working smoothly. Rather than jogging or playing tennis, choose low-impact activities like biking, walking and swimming. Pool exercise is a great option, providing buoyancy that takes strain off your joints; resistance of the water builds strength.</p> <h3>3. Take advantage of medications and injections.</h3> <p>Over-the-counter drugs, such as acetaminophen, ibuprofen and naproxen, can keep pain under control. There are also a variety of prescription anti-inflammatory medications that your health care provider can prescribe. Steroid injections into your joint can reduce inflammation and pain. Gel injections provide lubrication for smoother action.</p> <h3>4. Consider replacement surgery.</h3> <p>Usually, medications and injections become less effective over time as the osteoarthritis progresses. At that point, it's time to talk with your provider and a surgeon about replacing the joint. Today's joint replacement and rehabilitation, while still invasive and time-consuming, have advanced so that within a couple of months, you're back enjoying the activities that bring value to your life.</p> <h3>5. Don't keep putting it off.</h3> <p>While just about any knee or hip can be replaced, when a knee becomes extremely stiff, it's difficult to regain the best range of motion. Also, once the cartilage wears away, the bones begin to rub on each other, and you may experience bone loss.</p> <p>Treating osteoarthritis is all about maintaining the quality of life you want. If you can accomplish that without surgery, great. But if you are a candidate for joint replacement, you can choose the time that's right for you.</p> <p><em><a href="/providers/kariline-bringe-md" target="_self" title="Opens in same window.">Kariline Bringe, M.D.</a>, is an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgeon</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Adult reconstructive surgery</li> <li>Muscle sparing anterior total hip replacement</li> <li>Orthopedic trauma care which includes fracture care</li> <li>Primary and revision hip and knee replacement</li> <li><a href="/locations/la-crosse/services-and-treatments/orthopedic-surgery/robotic" target="_self" title="Opens in same window.">Robotic orthopedic surgery</a></li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Mayo Clinic Alix School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, University of Washington</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Adult Reconstruction, Carilion Clinic</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Orthopaedic Surgery</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Orthopedic Surgeons </li> <li>American Association of Hip and Knee Surgeons</li> </ul> <p>Academic Appointment </p> <ul> <li>Instructor in Orthopedics, Mayo Clinic College of Medicine and Science </li> </ul>Bringe<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/kariline-bringe-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B82E94878EE1907FB0BB50353742D357" alt="Kariline Bringe, M.D." width="280" height="280" DisableNVelocity="true" />{5C37287E-52DE-4384-94B2-B531BF0A7E09}Kariline<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15285901Kariline Bringe, M.D.1{DEF55970-853F-4E96-9A4D-3413874FF059}<img src="/-/media/national-files/images/hometown-health/2023/person-holding-leg-joint.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5216A4453A9A03BC8C1EDF9B3A32672B" alt="Person holding leg joint" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.ArthritisArthritis is inflammation of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis.Dawn Haller11/25/2024The long nights of winter can get you down, but they also offer magical ways to be active outdoors and lift your mood. Explore the dark with these ideas.Winter night fun: Ways to embrace the season and beat the winter blues<p>As winter settles in, shorter days and colder nights can feel dull, often <a href="/hometown-health/speaking-of-health/seasonal-affective-disorder-more" target="_self" title="Opens in same window">causing mood changes</a> and bringing on the winter blues for many. But the mystery of winter nights also offers opportunities for fun, joy, connection, warmth and adventure through outdoor activities.</p> <p>Here are some ways to turn winter nights into an enchanting experience, manage the winter blues and stay safe.</p> <h2>Winter fun ideas for chillier regions</h2> <p>Dressing appropriately is the key to embracing nighttime winter fun in <a href="/hometown-health/speaking-of-health/watch-out-for-winter-health-mishaps" target="_self" title="Opens in same window">colder climates</a> based on the activity and weather. This may include layers, a hat and mittens or gloves. Don't forget to check the weather forecast.</p> <h3>Give these activities a try:</h3> <p><strong>Hiking.</strong><br /> Many parks maintain trails for winter hiking and offer guided nighttime nature events. Wear appropriate footwear or strap on snowshoes. Stick to well-marked trails and take along water and a flashlight.</p> <p><strong>Ice skating or sledding.</strong><br /> Many cities offer outdoor rinks and designated sledding spots. Neighborhood hills or a DIY backyard rink can provide nearby fun. Check that rinks are well-maintained and choose sledding hills free of obstacles. Inspect your skates and sleds before using them and don't forget to wear helmets.</p> <p><strong>Play tag or build snow creations.</strong><br /> Playing in the snow brings laughter and exercise. Dress in layers to keep warm and dry, and take breaks indoors to warm up and avoid frostbite.</p> <p><strong>Playground discovery.</strong><br /> Playgrounds are fun year-round, even in winter. Try swinging or rolling snowballs down the slides for a new twist on winter playground fun. Watch for icy patches on equipment, and ensure the area is well-lit to avoid slips or falls in the dark.</p> <p><strong>Stargazing.</strong><br /> Winter nights often offer clearer skies, making it ideal for stargazing. Bring a blanket, download a star map app on your phone to enhance your viewing knowledge and pack warm beverages. Dress warmly, bring a flashlight, and let someone know your location if you're venturing to a remote spot.</p> <h2>Winter night fun in warmer regions</h2> <p>For those in warmer climates, winter nights offer unique opportunities to celebrate without the snow.</p> <strong> </strong> <h3>Here are a few ideas:</h3> <p><strong>Beach bonfire or sunset picnic.</strong><br /> Grab some blankets, pack snacks or an easy meal, and bring hot drinks to enjoy the evening. If you're setting up a bonfire, use designated fire pits and follow any local guidelines. Remember to bring flashlights or lanterns, and always pack out what you bring in to leave the area clean.</p> <p><strong>Evening hike.</strong><br /> Winter months offer cooler evenings that are perfect for exploring local trails. Many parks organize guided night hikes or special stargazing events. Stick to familiar trails and bring plenty of water, as nights in the desert or arid areas can be drier than expected. Always carry a flashlight or headlamp, and let someone know your hiking route.</p> <p><strong>Holiday light boat parade.</strong><br /> Many coastal or lakeside communities organize holiday light boat parades with boats decorated in festive lights. Bundle up and be sure to bring a flashlight to navigate docks and dark areas safely.</p> <p><strong>Nighttime zoo or garden lights tour.</strong><br /> Many zoos and botanical gardens offer night tours during the holiday season, with sparkling lights and seasonal decorations throughout. Wear comfortable shoes and keep kids close by. Use designated paths and trails.</p> <p><strong>Outdoor movie night.</strong><br /> Set up a projector and screen in your backyard or a park. Relax with blankets, popcorn and hot chocolate or cider. Check the weather forecast for rain or wind and ensure everyone wears warm layers of clothing. Safely set up any heaters or lanterns.</p> <h2>8 tips for managing the winter blues</h2> <p>There are a variety of ways to <a href="/hometown-health/speaking-of-health/seasonal-affective-disorder-not-just-the-winter-blues" target="_self" title="Opens in same window">manage the winter blues</a>.</p> <h3>These eight tips can help:</h3> <p><strong>Be active.</strong><br /> Physical activity boosts mood and energy. Aim to be active for at least 150 minutes a week, or 30 minutes five days a week.</p> <p><strong>Develop a routine.</strong><br /> A daily routine can provide structure and a sense of normalcy.</p> <p><strong>Embrace sunlight.</strong><br /> Maximize exposure to natural light by spending time outside during the day or using a light therapy box.</p> <p><strong>Foster connections.</strong><br /> Social interactions with family or friends, even virtually or in small gatherings, can help alleviate feelings of isolation.</p> <p><strong>Practice mindfulness.</strong><br /> Activities like meditation, mindful walking or yoga can relieve stress and improve mental well-being.</p> <p><strong>See a therapist.</strong><br /> Working with a therapist can provide a safe space to process feelings, build resilience and develop coping skills for lifting your mood.</p> <p><strong>Think about supplements.</strong><br /> Supplements like vitamin D, omega-3 fatty acids and B vitamins may help boost energy, support mood and brain health, and promote overall wellness during the winter months.</p> <p><strong>Try medications.</strong><br /> For some, winter blues can be persistent and pervasive. If other strategies aren't helping, consider talking to your healthcare team about medication options or adjustments to your current treatment plan.</p> <h2>Embrace winter for its mental and physical health benefits</h2> <p>With a bit of creativity and simple safety steps, you can make the most of winter nights and manage the winter blues. Whether you're bundled up enjoying the stars or zipping down a lighted sledding hill, let the magic of winter lift your spirits. Stay safe, stay warm and enjoy the mental and physical health benefits winter can bring.</p> <p><a href="/providers/aicha-katty-np" target="_self" title="Opens in same window."><em>Aicha Katty</em></a><em> is a nurse practitioner in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em></p><ul> <li>Community/public health</li> <li>Mental health and wellness</li> <li>Women’s health</li> </ul>D.N.P.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Nursing, The College of St. Scholastica</li> <li>Doctor of Nursing Practice, Winona State University</li> </ul> <p><strong>Internships</strong></p> <ul> <li>Allina Health, Cambridge, Minnesota</li> <li>Fairview Health Services, Woodbury, Minnesota</li> <li>Allina Health, Richfield, Minnesota</li> <li>Apple Valley Medical Center, Apple Valley, Minnesota</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Family Nurse Practitioner, American Academy of Nurse Practitioners</li> <li>Public Health Nurse</li> <li>Psychiatric Mental Health Nurse Practitioner, American Psychiatric Nurses Association</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Nurse Practitioners</li> <li>American Psychiatric Nurses Association</li> <li>Minnesota APRN Coalition</li> <li>Minnesota Board of Nursing</li> <li>Sigma Theta Tau International Honor Society of Nursing</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Katty<img src="/-/media/shared-files/images/medical-professionals/full/owatonna/aicha-katty-np.JPG?h=280&iar=0&w=280&sc_lang=en&hash=F6C5BE407BB09E4A03DFAA2EEC73C1B7" alt="Aicha Katty NP" width="280" height="280" DisableNVelocity="true" />Aicha<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21597332Aicha Katty DNP1<img src="/-/media/national-files/images/hometown-health/2022/winter-night-snow-trail.jpg?h=370&iar=0&w=660&sc_lang=en&hash=59E1CFA29A53CFB34175E684349285B8" alt="Winter night snow trail" width="660" height="370" DisableNVelocity="true" />Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller2/15/2022Do you have a stuffy or blocked nose even when you're otherwise feeling well? You may have a nasal obstruction. Learn about a new treatment option using an absorbable nasal implant.Absorbable implant to open blocked airways<p>Front and center on your face, your nose is an important and complicated structure, with its bone, cartilage, skin and sinuses. It serves many functions, including filtering, humidifying and warming the air you breathe, and providing a sense of smell that is important for taste, odor identification and memory. When your nose is congested, it is difficult to breathe, and taste also may be adversely affected.</p> <p>For some people, the stuffy or blocked nose feeling doesn't go away, even when they otherwise feel healthy. They may be affected by a condition called nasal obstruction. Now a minimally invasive targeted treatment is available to increase airflow and reduce that stuffy feeling.</p> <h2>Nasal obstruction</h2> <p>Nasal obstruction occurs when the airflow through your nose is blocked in some way. This could be caused by swelling of your nasal passages due to a cold; allergies; or exposure to irritants, such as smoke or dust. Other people experience nasal obstruction because of a structural issue. A common structural cause of restricted nasal breathing is internal nasal valve collapse.</p> <p>Structurally, the internal nasal valve is the narrowest part of the nasal passageway and is about 1 centimeter inside the nostrils. Internal nasal valve collapse can be caused by poorly positioned or weak cartilage. Just a small amount of narrowing can significantly restrict airflow.</p> <p>You could develop a nasal valve collapse if you have a deviated septum, have had a nasal injury or facial paralysis. More often, it is simply an anatomical variant. Nasal valve collapse can worsen or cause more symptoms with age due to the weakening of connective tissue.</p> <p>Nasal obstruction can cause uncomfortable symptoms and feeling like your nose is blocked or stuffed up all the time. It can lead to chronic headaches, dental decay, bad breath, difficulty breathing while exercising and poor sleep quality. It also can exacerbate snoring.</p> <p>Nasal valve collapse symptoms are often attributed to other conditions, such as allergies, viral illness or sinusitis. Unlike those conditions, nasal valve collapse doesn't resolve after the illness is over or change during the seasons. It is also easily overlooked during a nasal exam, as other factors frequently contribute to the nasal obstruction, and looking in the nose with a speculum or otoscope bypasses the internal nasal valve.</p> <h2>Nasal implant treatment</h2> <p>An absorbable nasal implant, also known as Latera, is a new, minimally invasive treatment option for nasal obstruction caused by internal nasal valve collapse. It uses a 2-centimeter absorbable implant to increase airflow and relieve symptoms.</p> <p>The first step is to schedule a consultation with an otorhinolaryngologist to determine if you would benefit from the procedure. People who have found exterior nasal strips beneficial in reducing symptoms are likely good candidates for an absorbable nasal implant.</p> <p>During the procedure, you will sit in an examination chair, and the inside of your nose will be numbed with a local anesthetic. A hollow tube containing the implant is inserted into the outside wall of the nose. When the tube's tip reaches its target, typically the area just below where eyeglasses rest, the implant is released in its supporting position and the tube is removed. The implant is made of polydioxanone, which has been used in absorbable sutures and other medical applications for decades.</p> <p>If you are scheduled for the procedure, plan for a one-hour appointment and ask your otorhinolaryngologist if you will need someone to drive you home. During the treatment, you will feel some pressure and minor discomfort.</p> <p>You can resume regular activities the next day. You may have mild bruising and inflammation, but these issues should resolve quickly. You and others will not be able to see the implant through your skin, and it will not change the shape of your nose.</p> <p>Over the next 18 months, the implant will be absorbed by your body and replaced with naturally occurring collagen in your body. This results in continued support of the lateral nasal wall and airflow.</p> <p>An absorbable nasal implant is not appropriate for everyone with nasal obstruction. A consultation with an otorhinolaryngologist will help determine the best treatment option to address the causes of your obstruction. For example, if you have a deviated septum and nasal valve collapse, both issues may need to be treated to resolve the obstruction.</p> <h2>Expected results</h2> <p>In a clinical study, patients still experienced a reduction in nasal symptoms two years after the procedure was performed.</p> <h3>Patients reported experiencing:</h3> <ul> <li>Reduced nasal congestion or stuffiness</li> <li>Less trouble breathing through the nose</li> <li>Improved ability to get enough air through the nose during exercise or exertion</li> <li>Reduced nasal blockage or obstruction</li> <li>Less trouble sleeping</li> </ul> <p>Talk with your primary care professional or otorhinolaryngologist if you have nasal obstruction and think an implant can help.</p> <p><em><a href="/providers/david-valencia-md" target="_self" title="Opens in same window.">David Valencia, M.D.</a>, is an <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">otorhinolaryngologist </a>and head and neck surgeon in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a> and <a href="/locations/prairie-du-chien" target="_self" title="Opens in same window.">Prairie du Chien</a>, Wisconsin.</em></p><ul> <li>Chronic ear disease</li> <li>Chronic sinusitis</li> <li>Ear tubes/tympanostomy tubes</li> <li>Endoscopic dacryocystorhinostomy (tear duct surgery)</li> <li>Head and neck cancer (lip, mouth, tonsil, throat, voice)</li> <li>Hearing loss</li> <li>Nasal polyps</li> <li>Nose and sinus disease</li> <li>Osteosclerosis</li> <li>Parathyroid adenomas</li> <li>Parotid disease</li> <li>Salivary gland/parotid</li> <li>Thyroid nodules</li> <li>Thyroid/parathyroid disease</li> <li>Tonsillectomy and adenoidectomy</li> </ul>M.D.<p>I believe my role as an ear, nose and throat (ENT) surgeon is to listen to and educate my patients regarding their diagnosis, so they are able make decisions that are right for them. I tend to be direct, with the goal of ensuring that my patients understand their options and obtain answers to all their questions. Our team strives to ensure our patients have an exceptional experience and feel respected while in our care. </p> <p>I'm a husband, father of four, brother, doctor, avid DIYer and tool enthusiast. I've built and remodeled houses, shingled countless roofs, raised pigs and thrown many bales. I enjoy learning new skills, such as welding, wood turning and building jungle gyms. A day with my family is always a great day.</p><p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Head and Neck Surgery, American Board of Otolaryngology</li> </ul> <p><strong>Membership</strong></p> <ul> <li>Head and Neck Surgery, American Board of Otolaryngology</li> </ul> <p><strong>Academic Appointment </strong></p> <ul> <li>Instructor in Otolaryngology, Mayo Clinic College of Medicine and Science</li> </ul>Valencia<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/david-valencia-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=3236916E09B41CEF7753164CA290FB8C" alt="David Valencia MD" width="280" height="280" DisableNVelocity="true" />{590BF78D-96A4-4850-BDA2-0CBBACEE44F6}David<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14071444David Valencia, M.D.1{18E5E65E-45C8-4C48-BD32-A914794E2AA4}|{E9B8BDBE-375B-4E7D-A1D2-2B64B5513AF7}<img src="/-/media/national-files/images/hometown-health/2022/face-upward-eyes-closed-knit-hat.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D360D09746ED63C5B87D283058252BF3" alt="Face upward to the sky with eyes closed, wearing a knit hat" width="660" height="370" DisableNVelocity="true" />Ear, Nose and Throat (ENT)Get information about symptoms, disorders and diseases affecting the ear, nose and throat, and related head and neck structures.Dawn Haller2/4/2022From white to milk to dark chocolate, consumers have a delicious array to choose from. But all chocolates are not created equal. Learn why your heart loves dark.Choose dark chocolate for your heart<p>Certain holidays just call for chocolate: Valentine's Day, Easter, Passover, Halloween, Christmas, Passover and others. From white to milk to dark chocolate, consumers have a delicious array to choose from.</p> <p>But all chocolates are not created equal.</p> <p>Research continues to point to dark chocolate as having many health benefits, including a lower risk of heart disease and diabetes, preventing blood clots, improving memory, lowering cholesterol and even preventing some types of cancer.</p> <p>Dark chocolate contains 50%–90% cocoa solids, which are rich in plant chemicals called flavanols. These flavanols support the production of nitric oxide, which relaxes blood vessels and improves blood flow, according to the Harvard T.H. Chan School of Public Health. They also increase insulin sensitivity, which may eventually reduce the risk of diabetes. The National Foundation for Cancer Research found that flavanols may reduce the risk of skin cancer and improve overall skin health.</p> <p>However, dark chocolate is a high-calorie food, containing about 150–170 calories per ounce. It also contains saturated fat, which may affect cholesterol levels. Research suggests the benefits of flavanols outweigh the risks of higher cholesterol.</p> <p>But, remember, chocolate is a treat. Enjoy it in moderation for the greatest health benefits.</p> <p>Make dark chocolate your choice when shopping for heart-healthy holiday treats and throughout the year.</p> <h4>Try these recipes for make-at-home dark chocolate indulgences:</h4> <h5>Dark chocolate-dipped fresh fruit</h5> <p>6-ounce carton raspberries, washed<br> 6-ounce carton blackberries, washed<br> 16-ounce carton strawberries, washed, leaves cut off<br> 1 apple, cut, cored, peeled<br> 1 banana, peeled, sliced<br> 1 10-ounce bag dark chocolate melting wafers</p> <p>Prepare fruit, pat dry. Line a baking sheet with waxed or parchment paper. Put melting wafers in microwave-safe bowl. In the microwave, heat the chocolate at 30-second intervals, stirring in between each interval until wafers are melted. Using a fork, dip the fruit and place on the parchment-lined baking sheet. Allow the chocolate to harden at room temperature, or to speed things up, place in the refrigerator for 10–15 minutes. Serve individually or on wooden skewers.</p> <h5>Nut and fruit bark</h5> <p>1 pound dark chocolate, coarsely chopped<br> 1 teaspoon instant espresso powder (optional)<br> 1/2 cup dried cherries, cranberries or blueberries<br> 1/2 cup macadamia nuts, chopped<br> 1/2 cup cashews, chopped<br> 1/2 teaspoon coarse sea salt, optional<br> <br> Line the bottom and sides of a 15x10x1-inch baking pan with foil. Set aside. In a microwave-safe bowl, heat chocolate at 30-second intervals, stirring between intervals until chocolate is melted. Stir in espresso powder and half the fruit and nuts. Spread into prepared pan, top with remaining fruit and nuts. Sprinkle with salt if desired. Refrigerate for 30 minutes or until firm. Break into pieces, and store in an airtight container.</p> <p><em>Anne Harguth is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2022/eating-heart-shaped-dark-chocolate.jpg?h=370&iar=0&w=660&sc_lang=en&hash=851D0B5F30E1B48EDC81759643AAD9E6" alt="Eating heart shaped dark chocolate" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller2/11/2022Cyberbullying is a greater risk for children when they're physically isolated, harder to identify and avoid, and just as damaging as face-to-face bullying. These tips can help protect your child.Cyberbullying: Tips to protect kids<p>Technology, including texting, social media and online gaming, is pervasive and essential, even for kids and teens. While social media can be a great way for kids to connect, these apps and websites also can be avenues for cyberbullying.</p> <p>Cyberbullying is a pattern of repeatedly sending or spreading threatening or mean messages, rumors or embarrassing photos by electronic methods. Cyberbullying is a greater risk as kids and adolescents use technology more, especially when they're physically isolated, such as during the COVID-19 pandemic.</p> <p>It can be harder to identify cyberbullying and just as damaging as face-to-face bullying. And since it can happen 24/7, cyberbullying is harder to avoid.</p> <p>Approximately 15% of students have experienced cyberbullying in the previous year, according to the Center for Disease Control and Prevention's most recent Youth Risk Behavior Surveillance System report.</p> <h4>These tips can help protect your children:</h4> <ul> <li><strong>Educate.</strong><br /> Teach and model for your children that it's just as important to treat others with respect online as it is in person. Instruct your children not to respond to cyberbullying messages. Encourage them to block anyone who takes part in cyberbullying, and keep evidence of cyberbullying and share the evidence with you.</li> <li><strong>Set expectations.</strong><br /> Establish rules about phone and internet use, including what types of platforms, apps and sites are off limits. Let your children know that you may look at their devices if you have concerns. Help them set up appropriate location and privacy settings. Let them know it's unacceptable to participate in cyberbullying.</li> <li><strong>Monitor.</strong><br /> With their advance knowledge, view the sites your children use and follow your children on social media.</li> <li><strong>Know the signs.</strong><br /> Warning signs of cyberbullying include seeming depressed or upset after spending time online and trying to avoid school or social situations.</li> <li><strong>Document.</strong><br /> Write down dates, times and nature of concerning messages. Take screenshots of cyberbullying messages in case you need to report the behavior. Don't forward or respond to cyberbullying messages.</li> <li><strong>Offer reassurance.</strong> <br /> Assure your children you want to keep them safe and won't take away their devices if they report cyberbullying. Support your children, even if the content of the cyberbullying or your child's initial response is uncomfortable or embarrassing. Help your children offer support if they witness others being cyberbullied.</li> <li><strong>Report.</strong><br /> Be willing to contact school officials or website service providers if cyberbullying persists. Report evidence of criminal activity to law enforcement, such as threats of violence or sexually explicit material involving minors. Consult your state laws and law enforcement for guidance.</li> </ul> <p>Visit <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.stopbullying.gov/index.html" target="_blank" title="Opens in a new window.">stopbullying.gov</a> for more resources, tips and information about all types of bullying. Another excellent resource is <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.healthychildren.org/English/family-life/Media/Pages/default.aspx" target="_blank" title="Opens in a new window.">healthychildren.org</a>, a website from the American Academy of Pediatrics.</p> <p><em><a href="/providers/emily-daligga-md" target="_self" title="Opens in same window.">Emily Daligga, M.D.</a>, sees patients in <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">Pediatric & Adolescent Medicine</a> and <a href="/services-and-treatments/internal-medicine" target="_self" title="Opens in same window.">Internal Medicine</a> in <a href="/locations/zumbrota" target="_self" title="Opens in same window.">Zumbrota</a>, Minnesota.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>Case Western Reserve University School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Indiana University School of Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Daligga<img src="/-/media/shared-files/images/medical-professionals/full/red-wing/emily-daligga.JPG?h=200&iar=0&w=200&sc_lang=en&hash=D8C44283AA0699C2789793DFD4D331F7" alt="Emily Daligga" width="200" height="200" DisableNVelocity="true" />Emily <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15829189Emily Daligga, M.D.1<img src="/-/media/national-files/images/hometown-health/2022/teen-using-cellphone.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9095AE6551E93832AFE1276F173E1099" alt="Teen using cellphone" width="660" height="370" DisableNVelocity="true" />Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller2/17/2022A cancer diagnosis is life-altering. Watch a symposium, made possible through a sponsorship from the Lloyd and Ardis Peterson Family Foundation, to learn how diet and humor can affect a cancer journey.Diet, humor and a cancer journey<p>A cancer diagnosis is life-altering for patients, families and caregivers. Each fall, the Annual Lloyd & Ardis Peterson Cancer Symposium is held to help those affected by cancer. This symposium is made possible through a sponsorship from the Lloyd and Ardis Peterson Family Foundation.</p> <p>The fall 2021 symposium's theme was "Diet, Humor and a Cancer Journey."</p> <p>Rose Prissel, a Mayo Clinic dietitian, presented "Diet and Cancer," discussing several nutritional aspects related to cancer, including:</p> <ul> <li>Tips to help caregivers better care for a loved one who is experiencing eating-related difficulties due to cancer or treatment</li> <li>Unintentional weight loss, poor appetite, shortness of breath, dehydration, improving nutritional intake, meal size and frequency, and avoiding nausea and constipation</li> </ul> <p>Keynote speaker Brenda Elsagher, author, certified humor professional and colorectal cancer survivor, presented "Life, Lessons and Laughter," a humorous account of her personal cancer experience.</p> <p>Brenda was diagnosed with colorectal cancer at 39. At that time, she was a mother of a 5-year-old and a 3-year-old, and had been married for six years. No one in her family had ever had cancer, and she doubted that she had cancer.</p> <p>In October 1995, she went to the doctor for a pain in her butt. She thought she had hemorrhoids.</p> <p>While she says that nobody wants to have their butt checked, it's important if you have a pain in the butt. The first doctor looked and said there was a hemorrhoid, and that maybe another doctor should take a quick look. Brenda wanted a second opinion, and this doctor thought it could be a tumor and wanted to perform a biopsy.</p> <p>During the rectal exam, she said to the doctor, "It's kind of a gross job you got there." He replied, "It might be gross, but it saves lives."</p> <p>When she was diagnosed with cancer, she came up with two goals:</p> <ul> <li>Go to college (and she still hasn't graduated)</li> <li>Become a comedian (so she took a comedy course)</li> </ul> <p>She then entered the Twin Cities Funniest Person Contest, where 150 people tried out. To her surprise, she won the contest.</p> <p>She notes that during her 20 years as a hairstylist, no one had talked to her about having pain in his or her butt, or Crohn's disease, ulcerative colitis or bowel diseases. People talk about breast cancer, but not about the importance of colonoscopies.</p> <p>After a seven-hour surgery and having her insides rearranged, Brenda says she has learned a lot about how humor has affected her cancer journey.</p> <h4>Learn about the rest of Brenda's inspirational account of her cancer journey by watching the symposium:</h4> <p><iframe width="560" height="315" src="https://www.youtube.com/embed/LCCM1Dd61co" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <p><a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">Cancer services</a> are available at Mayo Clinic Health System in communities across the Midwest.</p> <p>Mayo Clinic Health System thanks the Peterson family for their continued generosity to provide cancer education.</p><img src="/-/media/national-files/images/hometown-health/2022/child-piggyback-with-adult.jpg?h=370&iar=0&w=660&sc_lang=en&hash=80EF0154296129D3FCD361E3ED307DAD" alt="Child piggyback with adult" width="660" height="370" DisableNVelocity="true" />CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Dawn Haller2/1/2022Knowing and understanding key heart numbers can help determine your risk for developing heart disease or stroke. Learn the numbers you need to know.Know your heart health numbers<p>Knowing and understanding key heart numbers — blood pressure, cholesterol and heart rate, along with your family history — allow you and your health care team to determine your risk for developing heart disease, stroke and peripheral artery disease.</p> <p>But what are these key heart numbers?</p> <p>First is <a href="/hometown-health/speaking-of-health/know-your-numbers-blood-pressure" target="_self" title="Opens in same window.">blood pressure</a>. This is a measure of how hard your blood pushes against your arteries as it moves through your body. <a href="/-/media/national-files/images/hometown-health/2021/know-your-numbers-blood-pressure.jpg" target="_self" title="Opens in same window.">High blood pressure</a> occurs when the force of your blood against the walls of your blood vessels is consistently too high.</p> <h4>Your blood pressure reading will fall into one of these four categories:</h4> <ul> <li><strong>Normal</strong><br /> Blood pressure readings of less than 120/80 millimeters of mercury, or mmHg</li> <li><strong>Elevated</strong><br /> Readings consistently ranging from 120–129 systolic and less than 80 mmHg diastolic</li> <li><strong>Hypertension stage 1</strong><br /> Readings ranging from 130–139 systolic or 80–89 mmHg diastolic</li> <li><strong>Hypertension stage 2</strong><br /> Readings consistently ranging at 140/90 mmHg or higher</li> </ul> <p>High blood pressure is harmful because it makes the heart work harder and less efficiently. You can have high blood pressure for years without experiencing any symptoms. Fortunately, high blood pressure can be easily detected. And once you know you have high blood pressure, you can work with your health care professional to control it.</p> <p>The second important number you should know is your <a href="/hometown-health/speaking-of-health/know-your-numbers-cholesterol" target="_self" title="Opens in same window.">cholesterol</a>. This waxy substance is found in all your cells and travels throughout your body in your blood. Cholesterol comes from two sources: your liver and the foods you consume.</p> <p>Cholesterol can join with other substances to form a thick, hard deposit on the inside of your arteries, making arteries less flexible. Sometimes these deposits can break suddenly and form a blockage that causes a heart attack or stroke.</p> <p>When you have high cholesterol, you have too much low-density lipoprotein cholesterol, often called LDL or "bad cholesterol" and not enough high-density lipoprotein cholesterol, or HDL or "good cholesterol." There are no symptoms for high cholesterol.</p> <h4>Normal or healthy levels of cholesterol differ, depending on your age and sex:</h4> <ul> <li><strong>People 19 and younger</strong><br /> LDL cholesterol is less than 110 milligrams and HDL is more than 45 milligrams.</li> <li><strong>Men 20 and older</strong><br /> LDL cholesterol is less than 100 milligrams and HDL is more than 40 milligrams.</li> <li><strong>Women 20 and older</strong><br /> LDL cholesterol is less than 100 milligrams and HDL is more than 50 milligrams.</li> </ul> <p>Your health care professional may recommend more frequent testing if initial results were abnormal, if you have a family history of early onset heart disease, or if you have a personal history of obesity or diabetes.</p> <p>The third number to understand is your <a href="/hometown-health/speaking-of-health/know-your-numbers-heart-rate" target="_self" title="Opens in same window.">heart rate</a> or pulse.</p> <p>This is the number of times your heart beats per minute. Your resting heart rate is the heart pumping the lowest amount of blood you need because you're not exercising. If you are sitting or lying down ― and you're calm, relaxed and aren't ill ― your heart rate is normally between 60 and 100 beats per minute.</p> <p>Your target heart rate is the minimum heart rate to reach the level of energy necessary to give your heart a good workout. To find your target heart rate, the first step is determining your maximum heart rate.</p> <p>Your maximum heart rate is 220 minus your age. Your target heart rate for moderate exercise is about 50%–85% of your maximum heart rate.</p> <p>Many wearable activity trackers can monitor your heart rate when you exercise and periodically throughout the day.</p> <p>Finally, understanding your family's heart and overall health history is key to understanding your overall risk of heart disease.</p> <p>Outlining your <a href="/hometown-health/speaking-of-health/know-your-numbers-family-health-history" target="_self" title="Opens in same window.">family health history</a> can help you and your health care professional understand if you have an increased risk for developing certain conditions that are present in your family. If you are at risk, you may be able to take preventive measures to decrease your risk or undergo genetic testing to clarify your risk.</p> <p>While you can't change your genes, you can control some aspects of your environment, such as diet, physical activity level and tobacco use. That's why it's so important to live a healthy life, regardless of your personal and family health history.</p> <p><em>By Mayo Clinic Health System Staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/hugging-someone-from-behind.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F0018B4B6278027314B990868456C8BA" alt="Hugging someone from behind" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller2/18/2022Low back pain can range from intense to a dull ache. Learn about eight spinal conditions, the pain you could experience and when it's time to schedule an appointment.Not all low back pain is the same<p>Your back is made up of 30 bones stacked in a column surrounded by muscles and ligaments. It allows you to stand, walk, bend, sit and twist. It connects other parts of your skeleton and supports your spinal cord and nerve roots. Nearly every movement you make involves your back in some manner. This constant movement and support mean that your back is susceptible to strain and stress.</p> <p>About 80% of adults in the U.S. will experience low back pain at some point. Not all back pain is the same and symptoms can vary widely, ranging from intense, shooting or pinching pain to a dull, ongoing ache.</p> <p>Occasionally, a person with back pain can pinpoint the exact time it started, like when attempting to lift a heavy object or after a fall. More commonly, no specific trigger or event led to the pain.</p> <p>Understanding the causes of back pain, along with the symptoms, can help you and your healthcare team determine the best treatment options for you.</p> <h2>Here are the most common causes of back pain:</h2> <h3>Muscle or ligament strain</h3> <p>Strains are usually caused by a single event, such as using poor body mechanics to lift a heavy object. Carrying more weight and certain repetitive motions also can strain muscles and spinal ligaments in your back.</p> <p>Strains feel like a sudden stabbing, localized pain. This pain worsens when you contract the muscle or twist. Redness, swelling and bruising can occur. The pain can be intense and significantly affect daily activities. Occasionally, people state that they have "thrown out" their backs. In most cases, they have a muscle or ligament strain.</p> <h3>Bulging disk</h3> <p>Disks act as cushions between the bones, or vertebrae, in your spine. The material inside a disk can bulge and press on a nerve.</p> <p>It is possible and fairly common to have a bulging disk without pain. Pain from a bulging disk usually occurs in the low back and radiates into the hips, buttocks or legs. It is often worse with activity and feels better when resting.</p> <h3>Herniated disk</h3> <p>A herniated disk results when a tear in the tough outer layer of allows some of the inner disk material to protrude outward. Herniated disks also are called ruptured disks or slipped disks, although the whole disk does not rupture or slip.</p> <p>Many people have no pain from a herniated disk. But compared with a bulging disk, a herniated disk is more likely to cause pain because it protrudes farther and is more likely to irritate nerve roots. Depending on where the herniated disk is, it can result in pain, numbness or weakness in one or both legs. They usually affect only one side of the body.</p> <h3>Sciatica</h3> <p>Sciatica is named after the sciatic nerve, which is the largest nerve in your body. It most commonly occurs when a herniated disk, bone spur on the spine or spinal stenosis compresses part of the nerve. This causes inflammation, pain and often some numbness in the affected leg.</p> <p>Sciatica is a sharp, shooting pain that runs from your low back down the side or back of your leg. Typically, sciatica affects only one side of your body. Although the pain associated with sciatica can be severe, most cases resolve with nonoperative treatments in a few weeks.</p> <h3>Arthritis</h3> <p>Low back pain often is caused by osteoarthritis, the most common type of arthritis. Arthritis can lead to a narrowing of the space around the spinal cord or nerve roots, a condition called spinal stenosis. It occurs most often in the low back and neck. When this occurs in the low back, the most common symptoms are pain in both legs, tingling, numbness and sometimes muscle weakness. Symptoms are usually brought on by standing for a long time or walking longer distances.</p> <h3>Degenerative disk disease</h3> <p>As you age, the disks between your vertebrae begin to shrink and lose their softer qualities. This narrows the space between the vertebrae and can make your spine less flexible.</p> <p>Degenerative disk disease does not always cause symptoms. If it does, symptoms vary widely in nature and severity. Generally, pain comes and goes over a long time. It may feel better when you change positions or walk, and worsen when you sit, bend or twist.</p> <h3>Spondylosis</h3> <p>Spondylosis is a general term for age-related wear and tear on the bones in your spine. As disks dehydrate and shrink, bone spurs can develop where your vertebrae meet.</p> <p>Bone spurs are common. More than 85% of people over 60 are affected by them. Most bone spurs cause no symptoms or pain. You might not know you have bone spurs until revealed on imaging of your spine.</p> <h3>Skeletal irregularities</h3> <p>Back pain can occur if your spine curves abnormally or if the bones are not stacked directly on top of each other (a "slipped" vertebral body). Abnormal curves or slipped vertebral bodies can sometimes contribute to back pain.</p> <h2>When to schedule an appointment</h2> <p>Most low back pain — even when severe — goes away on its own in six to eight weeks with self-care, such as resting from heavy lifting, applying heat or ice, using over-the-counter pain medications and stretching. <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical therapy</a> can provide tremendous relief from back and limb pain, and oftentimes people do not need additional imaging or evaluation with these measures.</p> <p>Talk with your healthcare professional if your back pain occurs after a fall or another injury, or you have a history of cancer.</p> <h3>In addition, schedule an appointment if you have any of these back pain symptoms:</h3> <ul> <li>Constant or intense pain, especially at night or when you lie down.</li> <li>Spreads down one or both legs.</li> <li>Causes weakness, numbness or tingling in one or both legs.</li> <li>Occurs with a fever, swelling or redness on your back.</li> <li>Occurs with unintended weight loss.</li> <li>Occurs with new bowel or bladder control problems.</li> </ul> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/hands-on-lower-back.jpg?h=370&iar=0&w=660&sc_lang=en&hash=19177CEA133E419D9468DC100B4419FD" alt="Hands on lower back" width="660" height="370" DisableNVelocity="true" />NeurosurgeryNeurosurgery treats disorders that impact any part of the nervous system, which may include the brain, spine or peripheral nerves. Conditions treated range from life-threatening brain tumors, to disorders impacting quality of life, such as back pain and carpel tunnel syndrome.Dawn Haller2/10/2022Simply helping toddlers down a step or playing by swinging them by their arms or hands can cause nursemaid's elbow. Learn more about this common childhood injury and how to prevent it.Nursemaid's elbow: Just a little tug can cause it<p>Sometimes all it takes is a little tug — when you're helping toddlers down a step, pulling them back from a dangerous situation, lifting them into a high chair, or playing by swinging them by their arms or hands. The next thing you know, they're holding their arm close to their side and not wanting to use or bend it due to pain. It may be a condition called nursemaid's elbow.</p> <p>The term "nursemaid's elbow" harks back to the days when a nursemaid or nanny was common. A better name today might be babysitter's elbow.</p> <p>It's also known as radial head subluxation and happens when the annular ligament in the elbow is displaced by being pulled. Young children's elbows are much more flexible than those of adults. So it's easier for younger elbows to become dislocated, and it can take little force to cause nursemaid's elbow. It's a common injury for children ages 1 to 4, but can happen from birth to age 7.</p> <p>If you suspect nursemaid's elbow, immediately seek medical attention. A health care professional can treat nursemaid's elbow by gently moving the arm, which quickly relieves discomfort and restores arm movement. Surgery is seldom required unless there's a fracture or the dislocation isn't quickly treated.</p> <p>Once a child has had nursemaid's elbow, it can happen again. That's why it's important to avoid swinging, tugging or pulling children by the hands or arms. Always lift them by grasping them under their armpits. Dislocated elbows also can happen during play or sports, when breaking a fall or during activities like tumbling.</p> <h4>Learn more:</h4> <ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/dislocated-shoulder/symptoms-causes/syc-20371715" target="_blank" title="Opens in a new window.">Dislocated shoulder symptoms and causes</a></li> <li><a href="/hometown-health/speaking-of-health/how-safe-is-your-nursery" target="_self" title="Opens in same window.">How safe is your nursery?</a></li> <li><a href="/hometown-health/speaking-of-health/winter-weather-are-falls-and-slips-avoidable" target="_self" title="Opens in same window.">How to avoid winter slips and falls</a></li> <li><a href="/hometown-health/speaking-of-health/is-your-injury-a-sprain-or-break" target="_self" title="Opens in same window.">Is your injury a sprain or break?</a></li> <li><a href="/hometown-health/speaking-of-health/play-its-good-for-your-familys-health" target="_self" title="Opens in same window.">Play! It's good for your family's health</a></li> </ul> <p><em><a href="/providers/sara-okelly-pac" target="_self" title="Opens in same window.">Sara O'Kelly</a> is a physician assistant in <a href="/services-and-treatments/urgent-care" target="_self" title="Opens in same window.">Urgent Care</a> in <a href="/locations/menomonie" target="_self" title="Opens in same window.">Menomonie</a>, Wisconsin.</em></p>P.A.-C.<p>In my spare time, I enjoy spending time with family and friends, running, biking, weight lifting, playing volleyball and reading.</p><p><strong>Education </strong></p> <ul> <li>Bachelor's degree, Biomedical, University of Wisconsin-La Crosse</li> <li>Master's degree, Physician Assistant, Des Moines University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Physician Assistant, National Commission on Certification of Physician Assistants</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Physician Assistants</li> <li>Wisconsin Academy of Physician Assistants</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Orthopedics, Mayo Clinic College of Medicine and Science</li> </ul>O'Kelly<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/sara-okelly-pac.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B71E8B1D779CF3140FD4B121942C4AF5" alt="Sara O'Kelly, P.A.-C." width="280" height="280" DisableNVelocity="true" />Sara<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15006069Sara O'Kelly, P.A.-C.1{DEF55970-853F-4E96-9A4D-3413874FF059}<img src="/-/media/national-files/images/hometown-health/2022/dog-child-and-parent-looking-out-door.jpg?h=370&iar=0&w=660&sc_lang=en&hash=FCC0EC20948CC2F0878A36270287E38B" alt="Dog, child and parent looking out a door window" width="660" height="370" DisableNVelocity="true" />Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Dawn Haller2/28/2022A trusting relationship does more than just feel good. Learn how trusting the expert advice of your primary care provider can improve your health.During uncertain times, trust your primary care provider<p>The relationship between patients and their health care team is the foundation of safe, effective health care. Critical to this relationship is trust. Patients need to be able to trust their health care team with their lives and know that this team is putting their needs first.</p> <p>A solid trusting relationship does more than just feel good. It also improves patient outcomes. A 2017 study found that patients who trusted their health care team report healthier behaviors, fewer symptoms, higher quality of life and greater satisfaction with their treatment.</p> <p>During the COVID-19 pandemic, trust became even more important. Information about the virus and safety recommendations have been ever-evolving. It can be difficult to keep track of what's fact, what's fiction and the right action for you and your family. During times of uncertainty, turn to and trust the expert advice of your primary care provider.</p> <h4>Role of a primary care provider</h4> <p>The term primary care provider can seem like a general, slightly vague term. What does it mean?</p> <p>A primary care provider is a health care professional who specializes in diagnosing, treating and preventing a wide variety of conditions. Your primary care provider can be a physician, nurse practitioner or physician assistant. This professional provides care for most nonemergent, routine health care needs.</p> <p>The primary care provider's goal is to deliver the care that's right for you — not use a one-size-fits-all approach. Tailored health care is easier and better for you when you have a meaningful and trusting relationship with your provider.</p> <h4>Focus on prevention</h4> <p>Benjamin Franklin said, "An ounce of prevention is worth a pound of cure." He was talking about fire protection, but his words can apply to health too. It's much easier to prevent a disease than it is to treat one. Staying up to date on vaccinations and screenings can help you stay healthy and catch health problems early when they're easiest to treat.</p> <p>Your primary care provider will suggest screenings and vaccinations to keep you healthy. Primary care providers give about half of all vaccines in the U.S. and have the expertise to explain the benefits and answer any questions.</p> <p>A trusting relationship with your primary care provider has been vital during the COVID-19 pandemic. Your primary care provider can recommend ways to keep you protected from the virus, including getting vaccinated for COVID-19. Some patients have said they trust their primary care providers to treat them if they get infected with COVID-19, but they are hesitant to follow the same providers' recommendation to be vaccinated for COVID-19. This presents a care disconnect.</p> <p>Unfortunately, one reason for this could be the misinformation and myths circulating about COVID-19 vaccines. If you have questions about COVID-19 vaccines, don't search for answers on Google or social media. Instead, get the facts from your primary care provider or a reputable source like <a rel="noopener" href="https://www.mayoclinic.org/" target="_blank" title="Opens in a new window.">Mayo Clinic</a>.</p> <p>Your primary care provider knows your health history and risk factors, has reviewed vaccine safety and efficacy data, and is focused on keeping you healthy during the pandemic. This professional makes fact-based recommendations that put your health care needs first, especially when preventing a serious, potentially life-threatening disease like COVID-19.</p> <h4>Diagnosis and treatment</h4> <p>Primary care providers care for patients over a long period of time, often years. Because of this, they are trained to notice health changes and diagnose a wide range of diseases and conditions. They also work with an expert team that provides a well-rounded approach to your health care.</p> <p>Your primary care provider is trusted to diagnose and treat patients during the COVID-19 pandemic. Your primary care provider, along with colleagues in the hospital settings, are at the frontlines of the pandemic. They have seen it all and are equipped to make data-driven treatment plans to care for you.</p> <p>If needed, your primary care provider can coordinate care with a specialist. This person will monitor your updated medical history and status, and follow up with test results, provide meaningful explanations and describe the next best steps in your health care.</p> <h4>Selecting a trusted primary care provider</h4> <p>If you haven't already, consider doing some research and picking a primary care provider who's right for you. The continuity of care you'll receive and the familiarity you'll experience will help you get the care that's best for you.</p> <h5>Choose a primary care provider who:</h5> <ul> <li>Makes you feel comfortable discussing health topics.</li> <li>Answers your questions.</li> <li>Communicates well, speaking in terms you can understand.</li> <li>Suggests ways to improve your health.</li> <li>Recommends screenings and exams appropriate for your age and sex.</li> <li>Treats common illnesses and injuries.</li> <li>Involves you as a partner in your care — asks what you think, listens to your concerns and expects you to follow through with action when required.</li> <li>Explains the options when you need treatment.</li> <li>Offers referrals to qualified specialists when necessary.</li> <li>Is board-certified, indicating additional training after medical school, and has passed an exam in a medical specialty.</li> </ul> <h5>Primary care includes these specialties:</h5> <ul> <li><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></li> <li><a href="/services-and-treatments/internal-medicine" target="_self" title="Opens in same window.">Internal Medicine</a></li> <li><span style="color: #333333;"><a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">Pediatrics & Adolescent Medicine</a></span></li> </ul> <p>Learn about <a href="/providers" target="_self" title="Opens in same window.">Mayo Clinic Health System's providers</a>.</p> <p><em><a href="/providers/timothy-van-gelder-md" target="_self" title="Opens in same window.">Timothy Van Gelder, M.D.</a>, is a Family Medicine physician in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em></p><ul> <li>Full scope of family medicine</li> <li>Obstetrics and gynecology</li> <li>Pediatrics</li> <li>Sports medicine</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Iowa Carver College of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Mayo Clinic Family Medicine Residency Program</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Medicine, American Board of Family Medicine</li> <li>Mayo Clinic Quality Fellow, Silver Level</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Van Gelder<img src="/-/media/shared-files/images/medical-professionals/full/owatonna/timothy-van-gelder-md.jpg?h=280&iar=0&w=280&hash=E4A8C2F0A2D5A0DF5A6D853380378B02" alt="Timothy Van Gelder MD" width="280" height="280" DisableNVelocity="true" />Timothy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14920891Timothy Van Gelder, M.D.1<img src="/-/media/national-files/images/hometown-health/2022/smiling-person-grey-sweatshirt.jpg?h=370&iar=0&w=660&sc_lang=en&hash=734138B06A3397412C11793EE8D18569" alt="Smiling person wearing grey sweatshirt" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller2/9/2022While most winter sports lovers aren't in the same league as Olympians, their care has some things in common. Learn about those similarities from a U.S. Ski Jumping Team physician.Winter sports care for Olympians, everyday enthusiasts<p>Every four years, elite athletes from around the globe gather for the Winter Olympics to compete on skates, sleds and skis. They push their bodies and their skills to the limit with hopes of standing among the medal winners. Despite their rigorous training, they're subject to a host of injuries — and so are everyday winter sports enthusiasts.</p> <p>As a team physician for U.S. Ski Jumping, I provide medical support at one or more World Cup competitions a year. These are events that qualify athletes for the next Winter Olympics. Not only do team doctors provide basic medical care, but also they serve as a liaison with the local health system in case of medical emergencies.</p> <p>Ski jumping athletes attempt to maximize speed going down the jump by maintaining a squatting position to minimize air resistance. At the end of the jump is a gentle ramp where they take off. This involves explosive force throughout the body — core, hips, knees and ankles — as the athletes propel themselves up and out and literally fly. Back and leg pain, as well as stress on the knees, are some of the more common issues team physicians manage.</p> <p>While most winter sports lovers don't intentionally seek to fly through the air, their care does have some things in common with that of U.S. Ski Jumping Team athletes, including:</p> <h4>Goals</h4> <p>An elite ski jumper's goals are all competition-based, which may mean pushing through pain or injury to meet those goals. A youth winter athlete's goals may be competitive, as well, but the main focus is on ensuring they grow into healthy adults who can enjoy their sport for a lifetime. Older recreational winter athletes' goals may be to regularly participate in their sport to maintain their fitness, health and mental well-being.</p> <h4>Time</h4> <p>Time is a factor in the care for all athletes, regardless of age or ability. Where are they in the competitive or recreational season? When is the next competition? Is the athlete in training for or at an actual event?</p> <p>Time sets the pace for treatment and injury management. An injury will be treated differently if it occurs four months, four days or four hours from the event, or at the start of the winter sports season.</p> <h4>Overall health and well-being</h4> <p>Overall health and well-being are considered for elite and recreational sports enthusiasts alike. While most recreational athletes are fairly healthy, few are as tuned into their health and well-being as U.S. Ski Team athletes.</p> <p>Sleep, nutrition, mental health and training are priorities for Team USA athletes every day. This gives them an advantage in healing everything from the common cold to bouncing back after an appendectomy. Sleep, nutrition, mental health and preparation are just as important for everyday winter athletes.</p> <h4>Severity of illness or injury</h4> <p>The severity of illness or injury affects the care of all athletes. Propelling oneself off a steep ramp and flying around 50 mph to land gracefully in a lunge position can lead to significant and potentially devastating injury if things go wrong. On-site care can be complicated for many reasons, ranging from language to coordinating with the local health care system. This is where the team physician really steps up.</p> <p>At home, someone who is badly injured would receive care at the local emergency department before they're seen in the clinic.</p> <p>Treating athletes on the world stage is challenging and rewarding, but as you can see, it has many similarities to treating recreational winter athletes. Go Team USA!</p> <p><em><a href="/providers/alecia-gende-do" target="_self" title="Opens in same window.">Alecia Gende, D.O.</a>, practices <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">sports medicine</a> and <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">emergency medicine</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Exercise and movement</li> <li>Female athletes</li> <li>Sports injuries</li> <li>Teaching</li> <li>Ultrasound-guided procedures</li> <li>Women's musculoskeletal health</li> </ul>D.O.<p>I practice collaboratively with my patients, offering an explanation of their situation and a few options for workup and management. I try to empower my patients to make informed decisions regarding their care. </p> <p>My goals are to optimize overall well-being and to see more than just a sports injury or musculoskeletal complaint. I will treat the whole person, working to get them back to their goals, whether that is playing organized sports, golfing, recreational running, weightlifting or being able to play with their kids or grandkids.</p> <p>I enjoy time outdoors, working on our farm and with my family. For my own fun and fitness, I enjoy CrossFit, running, weightlifting, walking, hiking, hunting and anything outdoors.</p><p><strong>Education</strong></p> <ul> <li>Midwestern University Chicago College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Emergency Medicine, University of Iowa Hospitals & Clinics</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Primary Care Sports Medicine, University of Iowa Hospitals & Clinics</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Emergency Medicine</li> <li>American Association Women Emergency Physicians</li> <li>American College of Emergency Physicians</li> <li>American College of Sports Medicine</li> <li>American Institute of Ultrasound in Medicine</li> <li>American Medical Society for Sports Medicine</li> <li>Emergency Medicine Residents Association (EMRA)</li> <li>Veterans of Foreign Wars</li> </ul> <p><strong>Academic Appointments</strong></p> <ul> <li>Assistant Professor of Emergency Medicine, Mayo Clinic College of Medicine and Science</li> <li>Assistant Professor of Orthopedics (Orthopedic Surgery), Mayo Clinic College of Medicine and Science</li> </ul>Gende<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/alecia-gende-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=5BCB6FFA652C592FF31686030603223C" alt="Alecia Gende DO" width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/37208055/" target="_blank" title="Opens in a new window.">Acute hemorrhage on the playing field</a>, July 2023.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/33585801/#:~:text=Conclusion%3A%20Preliminary%20findings%20indicate%20a,requiring%20referral%20to%20a%20cardiologist." target="_blank" title="Opens in a new window.">Use of electrocardiographic screening to clear athletes for return to sports following COVID-19 infection</a>, April 2021.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/33306518/" target="_blank" title="Opens in new window. ">Ultrasound in trauma and other acute conditions in sports, Part II</a>, December 2020.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/30908326/" target="_blank" title="Opens in a new window.">Delayed-union of acetabular stress fracture in female gymnast: Use of teriparatide to augment healing</a>, September 2020.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/29560061/" target="_blank" title="Opens in a new window.">Educator toolkits on Second Victim Syndrome, mindfulness and meditation, and positive psychology: The 2017 Resident Wellness Consensus Summit</a>, March 2018.</li> </ul>{D57FF1AB-3266-4374-BBD1-D222CFB57AA6}Alecia<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21428671Alecia Gende, D.O.1{7746ADF8-715B-4593-8AAB-55D7F0467848}|{FB3BB67A-14FA-4DDE-B183-F85C42E0B255}<img src="/-/media/national-files/images/hometown-health/2022/cross-country-skier-on-trail.jpg?h=370&iar=0&w=660&sc_lang=en&hash=40FC376C4AFD79B6634AE0CBC4BF9147" alt="Cross-country skier on trail" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Dawn Haller2/17/2022February can be a happy time with loved ones. It also may be so emotionally stressful that it feels like your heart is breaking. Learn more about broken heart syndrome.Your heart can break from stress<p>February is awash in Valentine's Day hearts, but it's also American Heart Month — a reminder to pay attention to our physical hearts.</p> <p>For some, February is a happy time with a friend, partner or loved one. For others, the month may be emotionally stressful. This emotional stress ― whether it's brought on by grief, anger, loss or death of a loved one; domestic abuse or arguments; or physical illness or surgery ― can be so bad that it feels like your heart is breaking.</p> <p>And in a way, it is.</p> <p>This condition is broken heart syndrome, also known as takotsubo or stress-induced cardiomyopathy. It affects just part of the heart, temporarily disrupting its usual pumping function. The rest of the heart continues to work properly or may even squeeze, or contract, more forcefully.</p> <p>With treatment, broken heart syndrome usually reverses itself in days or weeks.</p> <h2>Here are some answers to common questions about broken heart syndrome:</h2> <h3>How does stress lead to broken heart syndrome?</h3> <p>Emotional stress can increase the level of stress hormones, such as cortisol, which play a major role in stress-induced heart failure, although it's not known exactly why or how.</p> <h3>Who is most affected?</h3> <p>This condition occurs more commonly in women after menopause. However, it also affects young women, as well as men. People with anxiety or depression also are at higher risk. Heart disease remains the No. 1 killer for men and women, so people of all ages should take it seriously.</p> <h3>What are the symptoms?</h3> <h4>Broken heart syndrome mimics a heart attack, and like a heart attack, chest pain is the most common symptom. Other symptoms include:</h4> <ul> <li>Shortness of breath</li> <li>Loss of consciousness or fainting</li> <li>Rapid or irregular heartbeats, or palpitations</li> </ul> <p>If you experience persistent chest pain, don't wait until it's too late. Call 911.</p> <h3>What's the difference between broken heart syndrome and a heart attack?</h3> <p>Usually, people with broken heart syndrome don't have coronary artery disease or blocked heart arteries. A health care professional will evaluate the cause and determine appropriate care.</p> <h3>How is broken heart syndrome treated?</h3> <p>Treatment can require special heart medicines. With these medications, the heart muscle usually recovers quickly without permanent damage. However, broken heart syndrome can recur after another stressful event.</p> <h3>How can broken heart syndrome be prevented?</h3> <p>Heart medications may be needed to prevent another episode. It's also important to manage emotional stress.</p> <h4>Learn some simple techniques to incorporate into your daily life from the American Heart Association:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/qGKQs8V_tfM" title="Steal your me time back from stress" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/-5xg3eOZK74" title="5 4 3 2 1 CALM" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <h4>Other ways to address stress include:</h4> <ul> <li>Increasing physical activity</li> <li>Taking part in relaxation exercises</li> <li>Practicing mindfulness meditation, spirituality and religion</li> <li>Seeking professional help from a mental health worker or psychiatrist</li> <li>Making dietary changes</li> <li>Reducing alcohol use</li> <li>Stopping smoking</li> <li>Monitoring your heart health</li> </ul> <p>Also, know your numbers for blood pressure, blood glucose and cholesterol.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/two-people-hugging-close-up.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B423ED753DC7A3593C51FA71FF989362" alt="Two people hugging close-up" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller3/22/2022Massage is a great way to pamper yourself. It’s also used to treat some health conditions and restore function. If you’ve never tried it before, learn about the many physical and mental benefits.Benefits of massage therapy<p>Massage used to only be available at high-end spas or health clubs. Some people viewed it as a luxury for the wealthy or a code word for illegal activities. Now massage is widely available and viewed as an important tool in promoting mental and physical health.</p> <p>Massage is a general term for pressing, rubbing and manipulating your skin, muscles, tendons and ligaments. Massage may range from light stroking to deep pressure. It's generally considered part of integrative medicine.</p> <p>Massage is increasingly being offered along with standard treatment for a wide range of medical conditions and situations. If you have never tried massage, read on to learn about its many benefits.</p> <p>A common misconception about massage is that it's only part of a spa day and intended for pampering yourself. While this may be true for some people, it is most frequently a tool for stress reduction and pain relief.</p> <h4>Some specific conditions that massage can help include:</h4> <ul> <li>Anxiety</li> <li>Depression</li> <li>Digestive disorders</li> <li>Fibromyalgia</li> <li>Headache</li> <li>Insomnia</li> <li>Nerve pain</li> <li>Postoperative care</li> <li>Scar tissue</li> <li>Soft tissue strains and injuries</li> <li>Sports injuries </li> <li>Temporomandibular (TMJ) disorders</li> </ul> <h4>Physical benefits</h4> <p>For most patients, massage therapy is an important part of specific medical treatment plans to help them return to daily activities. For example, massage therapy is helpful after joint replacement surgery or injury.</p> <h5>Physical benefits of massage include:</h5> <ul> <li>Improved circulation</li> <li>Decreased muscle stiffness</li> <li>Decreased joint inflammation</li> <li>Better quality of sleep</li> <li>Quicker recovery between workouts</li> <li>Improved flexibility </li> <li>Less pain and soreness</li> <li>Strengthened immune response</li> </ul> <h4>Mental benefits</h4> <p>Massage also has many mental health benefits. Even people who are focused on the physical benefits say they feel less stressed after getting a massage.<strong><br /> </strong></p> <h5>Other mental benefits include:</h5> <ul> <li>Lower stress levels</li> <li>Improved relaxation</li> <li>Improved mood</li> <li>Decreased anxiety</li> <li>More energy </li> <li>Increase feeling of wellness</li> </ul> <h4>After a massage</h4> <p>It's common to feel relaxed, tired or even sore after a massage. This is because your muscles are being worked by the massage therapist. After a massage, it may feel like you completed a workout. It is possible to experience a headache or nausea after a massage.</p> <p>Some people think that massage must hurt to help. But a massage doesn't need to be painful to be effective.</p> <p>If your massage therapist is pushing too hard, ask for lighter pressure. Occasionally you may have a sensitive spot in a muscle that feels like a knot. It's likely to be uncomfortable while your massage therapist works it out. But if it becomes painful, speak up. Most serious problems come from too much pressure during a massage.</p> <h4>Finding a massage therapist</h4> <p>Like choosing other health care professionals, it's important to be a conscious consumer when selecting a massage therapist. Ask your primary care provider or someone else you trust to recommend a reputable business or therapist.</p> <h5>Don't be afraid to ask a potential massage therapist questions such as:</h5> <ul> <li>Are you licensed, certified or registered?</li> <li>What is your training and experience?</li> <li>How many massage therapy sessions do you think I'll need?</li> <li>What's the cost, and is it covered by health insurance?</li> </ul> <p>A skilled therapist has a vast toolbox of techniques that can be incorporated based on your needs, and he or she will respond and modify these techniques based on your feedback. </p> <p>Massage therapy is safe and effective for people of all ages. It's not only a feel-good way to indulge or pamper yourself. It's a powerful tool to help you take charge of your health and well-being, whether you have a specific health condition or are looking for a stress reliever.</p> <p><em><a href="/providers/ivy-conrad-mssgl" target="_self" title="Opens in same window.">Ivy Conrad</a> is a licensed <a href="/services-and-treatments/massage-therapy" target="_self" title="Opens in same window.">massage therapist</a> in <a href="/locations/red-wing" target="_self" title="Opens in same window.">Red Wing</a>, Minnesota.</em></p><ul> <li>All types of massage</li> <li>Trigger point therapy</li> <li>Acupressure</li> <li>Flexibility training (PNF stretching)</li> <li>Reflexology</li> <li>Reiki, and hot stone therapy</li> </ul>M.S.S.G.-L.<p><strong>Education</strong></p> <ul> <li>Therapeutic Massage Therapy diploma, Minnesota State Technical College-Southeast, Red Wing, Minnesota</li> <li>Licensed Massage Therapist</li> </ul>Conrad<img src="/-/media/shared-files/images/medical-professionals/full/red-wing/ivy-conrad-mssgl.jpg?h=280&iar=0&w=280&sc_lang=en&hash=0A871A0C1C50C5AA6AD9CA4A2D781B94" alt="Ivy Conrad, Massage Therapist" width="280" height="280" DisableNVelocity="true" />Ivy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15828531Ivy Conrad M.S.S.G.-L.1<img src="/-/media/national-files/images/hometown-health/2022/arm-lifted-hand-on-shoulder.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1F8F80FEAD7DA6EB3234807C5752694A" alt="Person lifting arm with opposite hand on shoulder" width="660" height="370" DisableNVelocity="true" />Integrative MedicineUnderstanding total health, not just of the body, but of the mind and the spirit, enhances the natural healing process allowing you to feel more empowered, have more energy and experience tranquility.Stress ManagementGuidance to help you reduce and manage daily stress.Dawn Haller3/29/2022Monitoring and responding to blood sugar levels can be a heavy burden for people living with diabetes. Learn about the benefits of a hybrid closed loop insulin pump.Closing the loop with insulin pumps<p>There is significant responsibility when living with diabetes. It affects all aspects of a person's life and health. And monitoring and adjusting to blood sugar levels can feel like a never-ending task.</p> <p>As technology advances, new products are available to help patients with diabetes. A hybrid closed-loop insulin pump is a new tool to manage the disease and make life a bit easier for people living with diabetes.</p> <p>Our bodies are designed with a closed-loop communication between sensors that check blood sugar levels and the pancreas, which responds to these levels using the hormones insulin and glucagon. Insulin lowers blood sugar levels while glucagon raises it.</p> <p>It's helpful to think of the foot pedals in a car: the gas and the brake. Insulin acts like the brakes and lowers blood sugar. Glucagon is like the gas pedal and raises blood sugar.</p> <p>The pancreas automatically adjusts how much insulin or glucagon to make depending on the blood sugar. This loop between the pancreas and blood sugar isn't working correctly in people with diabetes. Instead, people who have diabetes frequently must check their blood sugar and determine how much insulin medication to take.</p> <h4>Insulin pumps</h4> <p>An insulin pump is a small, computerized device worn outside of the body that delivers insulin under the skin. A hybrid closed loop insulin pump attempts to mimic the body's natural communication loop by linking with a secondary device called a continuous glucose monitor, or CGM, sensor and automatically adjusting some of the insulin delivered based on continually monitored blood sugar levels.</p> <p>The term "hybrid" is used because it is not a full closed loop. Although the system can monitor blood sugars and adjust insulin based on the data, it needs to be adjusted manually when a person eats a meal or if there is a sudden rise in blood sugar. It has been approved for use by people with Type 1 and Type 2 diabetes.</p> <p>In contrast to this, open loop insulin delivery systems rely on people checking blood sugars frequently often by pricking their finger multiple times daily and using that information to determine how much insulin to take. </p> <h4>Benefits</h4> <h5>Research has shown that hybrid closed loop insulin pumps provide many benefits for people living with diabetes, including:</h5> <ul> <li><strong>Reduced risk of low blood sugars</strong><br> Clinical trials have shown that hybrid closed loop insulin pumps reduce the risk of low blood sugar. When used with a continuous glucose monitor, an insulin pump can turn itself off or adjust the amount of insulin that it's giving the person depending on the trend in the blood sugar.<br> <br> If the pump starts to notice that blood sugar is trending downward, it'll turn itself off or reduce the insulin. This reduces the risk of having low blood sugar, which can be a detrimental event.</li> <li><strong>Reduced disease burden</strong><br> One of the reasons why living with diabetes can be tiring is the number of decisions that need to be made each day. How much insulin should you give yourself? How do you modify your insulin based on what you're going to eat? Will exercising longer affect your blood sugar? Should you inject insulin now or later?<br> <br> An insulin pump is not going to answer all those questions or solve all problems, but it significantly reduces some of the decision-making needed. By automatically adjusting background or basal insulin for people with diabetes, it can reduce decision fatigue and improve quality of life.<br> <br> It's also useful for people who have an unpredictable activity schedule or work hours, since it releases a constant flow of insulin into the body, preventing the effects on blood sugar that can occur when occasionally forgetting to inject a long-acting insulin shot.</li> <li><strong>Improved monitoring and response to trends</strong><br> All hybrid closed loop insulin pumps will monitor blood sugar trends over time. Many display the information on a mobile app that can be shared with family, friends and health care professionals. This information helps make treatment decisions and identify triggers to spikes or drops in blood sugar levels. It also helps from a safety perspective, particularly in children with diabetes. Parents can receive alarms and intervene if the child's blood sugar is particularly low or high.</li> </ul> <h4>Considerations</h4> <h5>There are a few things to think about when deciding if a hybrid closed loop insulin pump is right for you, such as:</h5> <ul> <li><strong>Your comfort with technology</strong><br> A sense of comfort with technology and willingness to learn the system is important for success. The system uses advanced technology, which means user errors or technology failures are possible. People considering this system need to understand what the pump is doing so they can step in and manually adjust insulin if the system isn't working as expected.</li> <li><strong>Your comfort with adjusting</strong><br> The system is designed to be adjusted and calibrated by the patient over time. People cannot just set it on autopilot and expect it to work perfectly. People who have reliably checked blood sugar levels and are invested in managing diabetes will have greater success.</li> <li><strong>Tube or tubeless</strong><br> There are two general categories of hybrid closed loop insulin pumps available: those that use insulin tubes and others that are tubeless. Pumps that use tubing connect the reservoir of insulin to a catheter that's inserted under the skin. Tubeless pumps connect directly under the skin without any tubing to a reservoir. Consider which option may be best for your situation and comfort level. People who live an active lifestyle, have an active job or are prone to tube damage may benefit more from a tubeless pump.</li> <li><strong>Existing continuous glucose monitoring system</strong><br> Some pumps work with specific continuous glucose monitors and not others. If a person has been using a glucose monitor with success, it makes the sense to add a pump that is compatible with the existing system.</li> <li><strong>Interface design</strong><br> Some pumps use a touch screen. Some use only a remote controller, either as a separate device or via an app. And others have physical buttons. Finding a system that is familiar and comfortable for each person increases compliance and ease of use.</li> </ul> <p>Hybrid closed loop insulin pumps are exciting new tools that can significantly improve into the health and wellness of people living with diabetes. Talk with your health care professional about if a hybrid closed loop insulin pump is right for you.</p> <p><em>Omar El Kawkgi, M.B., B.Ch., is an <a href="/services-and-treatments/endocrinology" target="_self" title="Opens in same window.">endocrinologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2022/holding-earbuds-in-ears-fitness-watch.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8782D4C23EB1FDE0D3B8B36998F75785" alt="Holding earbuds in ears, wearing fitness watch" width="660" height="370" DisableNVelocity="true" />DiabetesIf you have diabetes, no matter what type, it means you have too much glucose in your blood, although the reasons may differ. Too much glucose can lead to serious health problems.Dawn Haller3/18/2022Every day, your brain takes in information through multiple sources. When there's too much to process, you may feel cognitive overload. Learn how it can affect you and how to counter it.Cognitive overload: When processing information becomes a problem<p>The brain is the most complex organ in the body. It controls the function of vital organs like the heart to beat and lungs to move oxygen. The brain coordinates movement of your arms and legs to walk, dance or hug someone. And the brain creates memories and feelings that enable you to interact with family and friends.</p> <p>The brain can process a certain amount of information presented in different methods. The brain processes the information you gather each day from reading a newspaper, following directions on a map and having a conversation with a friend.</p> <p>When there is too much information to process, you may feel cognitive overload. This happens when you reach a point of paralysis of information — not being able to process and then act on what is heard.</p> <h4>External factors</h4> <p>More information than ever is available at your fingertips through TV, the internet and social media channels. Depending on your preferred style of communication, receiving information in multiple ways can produce cognitive overload.</p> <p>If you are overwhelmed by more information than your brain can receive, you may develop frustration and detachment from the details your brain is processing.</p> <h4>Internal behaviors</h4> <p>Cognitive overload also can occur from your internal memory sources. Think about your current knowledge of a particular topic that has been gathered from your education, experiences and interactions with others.</p> <h5>Start with questions such as:</h5> <ul> <li>What do you understand about the topic from your current knowledge or experiences?</li> <li>How does the topic affect you based on your individual characterizations, such as age, gender or geographical location?</li> <li>How does the topic make you feel or act?</li> </ul> <h4>Reactions to cognitive overload</h4> <h5>You may respond to cognitive overload in different ways based on external factors and internal behaviors, including:</h5> <ul> <li><strong>Paralysis</strong><br /> Being unable to deal with a topic or issue because it's more complex than you're able to manage.</li> <li><strong>Anger</strong><br /> If information doesn't fit with the way you think or feel, you may become angry at having your feelings or beliefs challenged. Repeated attempts to address a topic may lead to feelings of upset or anxiousness.</li> <li><strong>Passivity</strong><br /> Simply going along with others is a way of dealing with cognitive overload. Forming an opinion on a topic may feel overwhelming, while following someone else's lead is the easiest way to cope.</li> <li><strong>Understanding</strong><br /> You may process information by relying on input from trusted sources, such as your health care team. Increasing your knowledge of a topic can be exciting when you are confident in the validity of the information. Look for ways to gather details in your preferred learning style, whether that’s visual, auditory or written.</li> </ul> <h4>Listen to your body</h4> <p>Watch for cues that are a sign to slow down or step back from actions affecting your well-being. Increased stress, fatigue, and frustration with your normal daily activities can indicate cognitive overload is affecting your actions. If reading the newspaper daily is a daunting task, look for alternate ways to stay up to date on relevant news you want to know.</p> <h5>Counter feelings of cognitive overload with these tips:</h5> <ul> <li>Find trusted sources for information.</li> <li>Write down the things on your mind.</li> <li>Research on reliable websites like <a rel="noopener noreferrer" href="https://www.mayoclinic.org/" target="_blank" title="Opens in a new window.">mayoclinic.org</a>.</li> <li>Visit with your health care team if you have questions.</li> </ul> <p>If you can process a piece of information daily with a sense of calm, curiosity and understanding, your ability to cope is not being challenged. If you're experiencing a pathological process that is interfering with your ability to enjoy life and do things you need to do and enjoy, it's time to seek care or talk with someone about those feelings.</p> <p><em><a href="/providers/christopher-schimming-md" target="_self" title="Opens in same window.">Christopher Schimming, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><ul> <li>General adolescent and adult medicine</li> <li>Geriatrics</li> <li>Preventive medicine</li> </ul>M.D.<p>My patients will find that I use a cooperative approach — using evidence-based guidelines and recommendations, blended with their own personal values — to create a care plan that is specific to them. I present a lot of information and education during visits, and support shared decision making. Medications are used as required, but I also strongly encourage my patients to pursue appropriate and healthy lifestyle choices.</p> <p>I am married with three great kids. I enjoy reading good fiction, music, hiking, camping and local sports. New jokes are always welcome!</p><p><strong>Education</strong></p> <ul> <li>University of Iowa Carver College of Medicine</li> </ul> <p><strong>Residency </strong></p> <ul> <li>Family Medicine, MercyOne North Iowa</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Family Medicine</li> </ul>Schimming<img src="/-/media/shared-files/images/medical-professionals/full/mankato/christopher-schimming-md.jpg?h=280&iar=0&w=280&hash=42B4794E4C5934246D19F143779428EF" alt="Christopher Schimming MD" width="280" height="280" DisableNVelocity="true" />{2FD53C97-1256-45ED-9438-C8C90468C31A}Christopher<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15276660Christopher Schimming, M.D.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}<img src="/-/media/national-files/images/hometown-health/2022/holding-coffee-cup-to-upper-chest.jpg?h=370&iar=0&w=660&sc_lang=en&hash=DC58D42D5AFB91C7EFDB74D7E1D3DA65" alt="Young person holding coffee cup to upper chest" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller3/3/2022A complication of diabetes is restricted blood flow to your feet. Follow these steps to develop a daily foot care routine to minimize infection and injury.Diabetes: 4 steps to put your best foot forward<p>If you're among the millions of people in the U.S. diagnosed with diabetes, you've probably learned about the importance of managing your medications, adapting your diet and incorporating activity into your lifestyle. But what do you know about foot care?</p> <p>One of the complications of diabetes is restricted blood flow to the legs and feet. That's why it's important to have a podiatrist on your care team. Podiatrists are doctors who specialize in conditions of the foot and ankle, including complications related to diabetes. Working closely with your podiatrist can reduce the risk of developing foot and ankle issues, such as neuropathic ulcers, infections, nerve and bone damage ― and even amputations.</p> <p>If you don't have any diabetes-related foot and ankle complications, it's still recommended that you see your podiatrist every year.</p> <h5>During this visit, your podiatrist will help you put your best foot forward by:</h5> <ul> <li>Performing a comprehensive foot evaluation.</li> <li>Testing for diabetic peripheral neuropathy.</li> <li>Discussing preventive measures, such as foot care and diabetic shoes and inserts.</li> </ul> <p>You should see your podiatrist every six months, or as needed, if you've been diagnosed with peripheral neuropathy or have a personal history of a diabetes-related complications.</p> <p>In addition to examinations by a health care professional, developing a daily at-home foot care routine is an important aspect of managing foot health.</p> <h3>This four-step routine can minimize serious infections and injuries:</h3> <h4>1. Pick a time of day.</h4> <p>Picking a specific time of day can help you form a routine. Try taking a few minutes when you get home from work or before going to bed.</p> <h4>2. Begin with your socks.</h4> <p>People with peripheral neuropathy may not feel an injury when it takes place. When you take off your socks, look for any signs of infection or injury, such as dried blood or yellowish-brown drainage.</p> <h4>3. Examine your feet.</h4> <p>Next, examine your feet, including the tops, bottoms and toes. If you aren't able see the bottoms of your feet, ask a family member, friend or caregiver to help. Look for any cuts, scratches, ulcers, blisters, dryness, redness, warmth, swelling or pain. Also check your toenails for any discoloration, thickness or ingrown borders. If you find any of these issues, make an appointment with your podiatrist to discuss diagnoses and treatment.</p> <h4>4. Wash your feet.</h4> <p>To reduce the chance of infection, wash your feet with warm water and soap, but avoid soaking. Be sure to dry them thoroughly when finished.</p> <p>Once you've gotten in the groove of your new foot care routine, it will seem like second nature. The key to keeping your best foot forward is catching an injury early and treating it appropriately.</p> <p><em><a href="/providers/stephanie-kvas-dpm" target="_self" title="Opens in same window.">Stephanie Kvas, D.P.M.</a>, is a <a href="/services-and-treatments/podiatry" target="_self" title="Opens in same window.">podiatrist</a> in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a> and <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><ul> <li>Ankle arthroscopy</li> <li>Arthritic conditions</li> <li>Bunion surgery</li> <li>Community education and outreach</li> <li>Community health and wellness</li> <li>Diabetic wound care</li> <li>Flatfoot reconstruction</li> <li>Hammertoe surgery</li> <li>Limb salvage</li> <li>Pediatric foot and ankle conditions</li> <li>Reconstructive foot and ankle surgery  </li> <li>Sports injuries</li> <li>Traumatic fracture care</li> </ul>D.P.M. <p>I am committed to developing a meaningful patient-doctor relationship with each of my patients. I encourage patients to take an active role in their medical care and work with them to select a treatment plan that is right for them. </p> <p>As a Minnesota native, I'm exceptionally excited to join Mayo Clinic Health System in New Prague. My extensive training in reconstructive foot and ankle surgery has prepared me for my role as a surgical podiatrist at Mayo Clinic Health System. </p> <p>I look forward to providing foot and ankle care to the region and being an active member of the community. </p><p><strong>Education</strong></p> <ul> <li>Midwestern University Arizona College of Podiatric Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Podiatric Medicine & Surgery, Reconstructive Rearfoot/Ankle, Hennepin County Medical Center</li> </ul> <p><strong>Certification</strong></p> <ul> <li>State of Minnesota Board of Podiatric Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Foot and Ankle Surgeons</li> <li>American Podiatric Medical Association</li> <li>Minnesota Podiatric Medical Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Podiatric Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Kvas<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/stephanie-kvas-dpm.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A7F1FBFFDD180559BD4211C661476E99" alt="Stephanie Kvas DPM" width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Utilization+of+Fluorescence+Microangiography+in+Pediatric+Acute+Compartment+Syndrome%3A+A+Case+Report" target="_blank" title="Opens in new window. ">Utilization of Fluorescence Microangiography in Pediatric Acute Compartment Syndrome: A Case Report</a>, January 2020</li> <li><a rel="noopener noreferrer" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Utilization+of+Fluorescence+Microangiography+in+Pediatric+Acute+Compartment+Syndrome" target="_blank" title="Opens in new window. ">Utilization of Fluorescence Microangiography in Pediatric Acute Compartment Syndrome: A Case Report</a>, February 2019</li> </ul>{ED85D0D4-A69F-4AFC-8DF7-CC90B84DFB35}Stephanie <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21681643Stephanie Kvas, D.P.M.1{D170DE7F-251A-4290-9CC3-0A9B8D67B28A}<img src="/-/media/national-files/images/hometown-health/2022/feet-walking-down-steps.jpg?h=370&iar=0&w=660&sc_lang=en&hash=FE6688F628546FCC740EC0E179CB1930" alt="Feet walking down steps" width="660" height="370" DisableNVelocity="true" />Foot HealthPodiatry is a branch of medicine devoted to the study of diagnosis, medical and surgical treatment of disorders of the foot, ankle and lower extremity.DiabetesIf you have diabetes, no matter what type, it means you have too much glucose in your blood, although the reasons may differ. Too much glucose can lead to serious health problems.Dawn Haller3/30/2022If you're being treated for cancer, food provides fuel for your body. Get diet tips for managing side effects that can affect your appetite, taste and nausea.Diet tips during cancer treatment<p>The foods we eat act as fuel for our bodies. They give strength and stamina to power through the day. At no time is this more important than when a person is undergoing treatment for cancer.</p> <p>While lifesaving or life-preserving, chemotherapy and radiation treatments can take a toll on a person's body and significantly affect their diet.</p> <p>For example, chemotherapy not only kills rapidly dividing cancer cells, but also it can destroy fast-growing healthy cells. This may cause nausea or appetite changes, leading patients to consume fewer calories than needed. Other treatments can cause uncomfortable dry mouth, diarrhea or constipation. Fortunately, these side effects can be overcome and thereby improve nutrition during treatment.</p> <h4>Weight changes</h4> <p>One of the things patients and caregivers ask about is weight changes during treatment. Generally, if a patient loses more than 3 pounds in one week, it's important to discover if the loss was intentional or unintentional. If it's intentional, the patient's care team will discuss why this is occurring and make sure treatment plans are going well.</p> <p>If the weight loss is unintentional, it's important to seek out the cause and provide support. It's important to avoid a rapid decline in weight because muscle tissue is being broken down during treatment. This can lead to further loss of the patient's stamina.</p> <h4>Poor appetite</h4> <p>The cause of weight loss that patients report most frequently is poor appetite. This is a common side effect during cancer treatment.</p> <p>To improve nutrition during this time, it helps to plan for small, frequent meals. That can be daunting because patients and caregivers may not have the energy to make multiple meals each day.</p> <p>One way to get around this is to reserve a portion of what would have been normally eaten during breakfast, lunch and dinner for a fourth small meal. This makes it easier to plan and schedule additional meals with less work.</p> <h5>Here are other ways that caregivers can help a loved one who is experiencing weight loss due to poor appetite:</h5> <ul> <li>Gently remind the loved one to eat small, frequent meals and snacks throughout the day.</li> <li>Offer starchy foods and high-protein foods together. For example, a piece of toast and cheese stick.</li> <li>Keep cool drinks and juices within reach. Drinking between meals keeps the person hydrated while avoiding filling up on liquids during mealtimes.</li> <li>Create pleasant settings for meals and eat together. Light a candle or place the table near a window to enjoy the view.</li> <li>Choose high-calorie foods or nutrition supplement drinks.</li> </ul> <h4>Nausea</h4> <p>Damage to the stomach and intestinal lining during cancer treatment can cause nausea and vomiting. Many medications are available that control nausea and provide relief.</p> <h5>Patients and caregivers also can do other things to ease this side effect through diet, including:</h5> <ul> <li>Choose easily digestible foods, such as refined carbohydrates like white bread and potatoes. Avoid high-fiber, high protein foods, as these foods take longer to digest.</li> <li>Eat small, frequent meals to avoid overloading the stomach.</li> <li>Gradually sip clear liquids between meals, being careful not to gulp excess air.</li> <li>Avoid foods with strong smells. If needed, cook foods outdoors to minimize smells.</li> <li>Use plastic, wood or bamboo utensils.</li> <li>Take medications as prescribed.</li> </ul> <h4>Dry mouth</h4> <p>Some cancer treatments and medications can cause dehydration and decreased saliva production. This leads to uncomfortable dry mouth.</p> <h5>Follow these tips to prevent sores and cavities:</h5> <ul> <li>Increase fluid intake.</li> <li>Create extra saliva by chewing gum or sucking on hard candy or ice chips.</li> <li>Eat soft foods like avocado, applesauce or eggs.</li> <li>Use balm to keep lips moist.</li> <li>Suck on sugarless candy or chew sugarless gum. Avoid mentholated candy.</li> </ul> <h4>Taste changes</h4> <p>Dry mouth and a general decrease in saliva can change the way that foods taste. In some cases, a complete lack of taste can make foods unappealing.</p> <h5>If this occurs, try these tips:</h5> <ul> <li>Chew gum or suck on hard candy to change the flavor in the mouth.</li> <li>Increase amount of seasoning in foods.</li> <li>Use nonmeat protein sources, like tofu, beans or lentils, if meat is unappealing.</li> <li>Use plastic, wood or bamboo utensils and dishes.</li> <li>Make foods that look and smell appealing.</li> </ul> <h4>Sore throat or mouth</h4> <p>A side effect of some chemotherapy and radiation treatments is a sore throat or mouth. This can make eating and drinking uncomfortable and painful.</p> <h5>Follow these tips:</h5> <ul> <li>Eat foods and drinks at a moderate temperature. Very hot or cold foods can be irritating.</li> <li>Choose soft, bland foods like mashed potatoes or bananas.</li> <li>Avoid spicy or acidic foods.</li> <li>Use topical numbing cream if sores are present.</li> <li>Use a blender to smooth out foods.</li> <li>Take pain medication before mealtimes.</li> <li>Keep mouth clean and lips moist.</li> <li>Rinse mouth before and after meals with plain water.</li> </ul> <h4>Diarrhea and constipation</h4> <p>Bowel changes are unpleasant but common side effects in people receiving treatment for cancer. Diarrhea may just be an uncomfortable problem, or a sign of something more serious. Diarrhea also can lead to other problems, such as severe dehydration. Chemotherapy, pain medications, dehydration or being less active can cause constipation.</p> <h5>Patients should modify their diets and behaviors if they start to experience:</h5> <ul> <li><strong>Diarrhea</strong> <ul> <li>Eat small, frequent meals and snacks.</li> <li>Choose soft, low-fiber foods.</li> <li>Avoid caffeine.</li> <li>Limit alcohol.</li> <li>Limit dairy products.</li> <li>Drink plenty of room temperature fluids but less with meals and more between meals.</li> <li>Take medications as prescribed. Ask your health care team before using any over-the-counter diarrhea medication.</li> <li>Avoid extremely hot meals. Hot or very warm meals can increase the speed food moves through your digestive system.</li> </ul> </li> <li><strong>Constipation</strong> <ul> <li>Drink plenty of fluids, at least 64 ounces per day.</li> <li>Eat prunes or drink prune juice.</li> <li>Keep regular mealtimes.</li> <li>Increase activity.</li> <li>Use a stool softener.</li> </ul> </li> </ul> <p>It's important to do what you can to maintain calorie, protein and fluid intake during cancer treatment. Following dietary guidelines carefully helps patients maintain strength and stamina during treatment.</p> <p>Keep in mind that in some cases, such as advanced cancer, eating may not affect the outcome of your illness or treatment. In these situations, trying to follow specific dietary guidelines, such as adhering to a low-sodium or low-fat diet, may not be practical.</p> <p>Talk with your care team about what you can expect during treatment and how long symptoms could last. Discuss all your symptoms with your health care team, especially those that affect your diet.</p> <h4>Watch the annual Lloyd & Ardis Peterson Cancer Symposium to gather more diet tips and hear from author Brenda Elsagher, who offers a humorous account of her personal cancer experience:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/LCCM1Dd61co" title="Lloyd and Ardis Peterson Cancer Symposium" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p><em>Rose Prissel is a Mayo Clinic dietitian in Rochester, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2022/wearing-head-scarf-holding-coffee-cup.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EF58DF25EE30D0BBFE685E96DB4C49BA" alt="Person wearing head scarf, holding coffee cup while outdoors" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Dawn Haller3/4/2022Taking collagen, turmeric and melatonin is popular now, but that doesn’t mean they're right for you. Ask yourself these 3 questions before you take a supplement.Do supplements help or hurt gut health?<p>Multivitamins and mineral supplements are the most common type of <a rel="noopener noreferrer" href="https://www.cdc.gov/nchs/products/databriefs/db399.htm" target="_blank" title="Opens in a new window.">dietary supplement</a> used by adults, according to the Centers for Disease Control and Prevention. The use of supplements increases with age.</p> <p>While dietary supplements may seem popular, that does not mean they are right for you, given your health or medical history. Many supplement ingredients can interact with medications and allergies. <br> The Food and Drug Administration (FDA) does not regulate dietary supplements in the same way as prescription and over-the-counter drugs. This means supplements have not been reviewed for safety or effectiveness before being sold.</p> <p>Most people decide to take supplements to improve health, lose weight or treat a certain condition. Collagen, prebiotics and probiotics, <a rel="noopener noreferrer" href="https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/brighten-dark-days-with-sunny-turmeric" target="_blank" title="Opens in a new window.">turmeric</a> and melatonin are among the most common supplements used. It’s important to consult with your health care team before taking a supplement.</p> <h3>If you take a supplement, ask yourself these questions:</h3> <h4>1. Is the supplement helpful?</h4> <p>Although multivitamin and mineral supplements are common for adults, it's important to consider if a supplement has a nutritional benefit. Most nutrients can be obtained through <a href="/hometown-health/speaking-of-health/support-your-immune-function-with-good-nutrition" target="_self" title="Opens in same window.">good nutrition</a>.</p> <h4>2. How long have you been taking the supplement?</h4> <p>Your health care team can use blood tests to check if your vitamin levels are normal. If a deficiency is found, a supplement may be used briefly to normalize the level.</p> <h4>3. Have you had side effects?</h4> <p>If you're having symptoms such as diarrhea, abdominal pain or elevated liver enzymes, review your medications and supplements with your health care team. If a supplement is not necessary, stopping its use for a period of time could determine if it is causing the symptoms. Working together with your health care team can ensure supplements do not harm your body.</p> <h4>If you determine that a supplement is benefitting you, be a savvy shopper with these tips:</h4> <ul> <li><strong>Is it too good to be true?</strong><br> If a supplement claims to be 100% safe or work better than a prescription, be aware that this information is not verified by the FDA. Supplements cannot claim to cure or prevent disease in marketing materials.</li> <li><strong>Take time for research.</strong><br> Use trusted sources, such as the National Institutes of Health, Department of Agriculture and FDA, to gather information about a supplement. A recommendation from a friend or family member does not mean a supplement is safe for you.</li> <li><strong>Natural products are not necessarily safe.</strong><br> Terms such as "natural," "holistic" and "organic" may be included on labeling to imply a product is healthy. Being labeled "natural" does not guarantee a product could not cause harm.</li> </ul> <p>New supplements are being marketed every day. Being cautious and talking to your health care team before taking a supplement can protect your health, and avoid unintentional side effects and damage to your body.</p> <p><em>Amanda Yurick is a physician assistant in <a href="/services-and-treatments/gastroenterology-and-hepatology" target="_self" title="Opens in same window.">Gastroenterology and Hepatology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2022/person-with-tweed-hat-wearing-glasses.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F5AC240CE8D3FCF2499E4E643BD29F2F" alt="Person with tweed hat wearing glasses" width="660" height="370" DisableNVelocity="true" />Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Dawn Haller3/7/2022<p>Colon cancer is the No. 3 cancer diagnosed in the U.S. Polyps are a key culprit, but often don't cause symptoms. In this Q&A, learn 6 things you should know about polyps.</p>Polyps: Colon cancer culprits<p>Colon cancer is the third most common cancer diagnosed in the U.S., with about 50,000 people dying each year from this disease. Polyps are one of the key culprits in colon cancer. Since they don't often cause symptoms, it's important to have regular screening tests, such as a colonoscopy. Polyps found in the early stages usually can be removed safely and completely.</p> <h3>In this Q&A, learn more about polyps:</h3> <h4>1. What is a polyp?</h4> <p>Typically, a polyp is an abnormal growth in the lining of the colon that protrudes into the colon. The colon is made up of four layers, and polyps can be made of more than one layer.</p> <p>Screening methods like a <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/colonoscopy/about/pac-20393569" target="_blank" title="Opens in a new window.">colonoscopy</a> or<a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/flexible-sigmoidoscopy/about/pac-20394189" target="_blank" title="Opens in a new window."> flexible sigmoidoscopy</a> can directly visualize polyps, while stool testing checks for the presence of blood or abnormal DNA shed by these polyps.</p> <h4>2. Why do polyps form?</h4> <p>Polyps form when the body's methods for controlling cell growth falter. Polyps don't develop for any one reason. However, certain mutations need to happen for a polyp to develop. Polyps can become cancerous.</p> <p>Some people may be predisposed to developing a polyp. It could be genetics or chronic injury to a cell from conditions like ulcerative colitis or Crohn’s disease. Lifestyle also can affect polyp development, including eating foods like red meat, smoking tobacco and drinking alcohol.</p> <h4>3. Are all polyps precancerous?</h4> <p>Not all polyps are precancerous or cancerous. Sometimes the nature of a polyp can be distinguished based on how it looks during a colonoscopy. But only removal for examination under a microscope by a pathologist can accurately determine if a polyp is precancerous.</p> <h4>4. What are precancerous polyps?</h4> <p>Precancerous polyps are those that can become cancerous over time if they aren't removed. The most common polyps are tubular adenomas, sessile serrated adenomas and hyperplastic polyps. These names are based on what the polyps' cells look like under a microscope. Tubular and sessile serrated adenomas generally are considered precancerous.</p> <h4>5. If polyps are taken out, do I need another colonoscopy?</h4> <p>Yes. Even if your colonoscopy showed no polyps or if all polyps were taken out, you can still develop new polyps in the future. That's why it's important to have a colonoscopy whenever your health care professional recommends it. The timing of your next colonoscopy usually depends on the number and size of the polyps removed.</p> <h4>6. When should I get screened?</h4> <p>Most people should begin screening for colorectal cancer after turning 45 and then continue getting screened at regular intervals.</p> <h5>However, you may need to be tested earlier than 45, or more often than others, if:</h5> <ul> <li>You or a close relative have had colorectal polyps or colorectal cancer.</li> <li>You have an <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/symptoms-causes/syc-20353315" target="_blank" title="Opens in a new window.">inflammatory bowel disease</a>, such as Crohn’s disease or ulcerative colitis.</li> <li>You have a genetic syndrome such as <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/familial-adenomatous-polyposis/symptoms-causes/syc-20372443" target="_blank" title="Opens in a new window.">familial adenomatous polyposis</a> (FAP) or <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/lynch-syndrome/symptoms-causes/syc-20374714" target="_blank" title="Opens in a new window.">hereditary nonpolyposis colorectal cancer</a> (Lynch syndrome).</li> </ul> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2022/hand-and-eye-neck-tattoo.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E149AC0B1530BCD5E16877CCC4A26C01" alt="Hand and eye neck tattoo" width="660" height="370" DisableNVelocity="true" />Colorectal HealthGet screening and treatment for colorectal cancer symptoms, and learn about risk factors and prevention strategies.Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Dawn Haller3/25/2022A common treatment for kidney cancer is to surgically remove the mass. Learn how robotic surgery can remove kidney cancer with less pain and faster recovery while preserving kidney function.Preserving kidney function with robotic surgery<p>Some things come in a perfect pair. Shoes, gloves, wings and doves.</p> <p>And kidneys.</p> <p>These two bean-shaped organs filter and remove waste, minerals and fluids from the blood. Like other organs, cancer can begin in the kidneys. If this occurs, a common treatment is to surgically remove the mass. Robotic surgical techniques can remove kidney cancer with less pain and faster recovery while preserving kidney function.</p> <h4>Kidney cancer basics</h4> <p>Kidney cancer is the eighth most common type of cancer diagnosed in the U.S. each year. About 76,000 new cases were diagnosed in 2021.</p> <p>The number of kidney cancer cases seems to be increasing. This rising number is felt to be from increasing use of imaging tests, like CT scans, that are used more often. These imaging tests may lead to incidental discovery of a kidney mass.</p> <p>Not all kidney masses are cancer, and about half of small masses are benign. The likelihood that a mass is cancer increases with the size of the mass.</p> <p>Unfortunately, kidney cancer doesn't have many signs or symptoms in early stages.</p> <h5>Over time, symptoms could develop including:</h5> <ul> <li>Blood in the urine</li> <li>Back or flank pain that doesn't go away</li> <li>Loss of appetite</li> <li>Unexplained weight loss</li> <li>Fever or chills</li> <li>Fatigue</li> </ul> <h4>Partial robotic nephrectomy</h4> <p>A mainstay kidney cancer treatment is surgery to remove the mass. In the past, surgeons removed the entire kidney. This was more painful for the patient due to a larger incision. This incision also required a long recovery time and increased use of narcotic pain medication.</p> <p>Now robotic surgery option is available for most patients.</p> <p>A partial robotic nephrectomy, also called kidney-sparing surgery, removes a kidney mass and leaves the remaining healthy kidney tissue in place. The amount of remaining kidney tissue depends on the size and location of the mass. The goal is to minimize the effects on kidney function while achieving a surgical cure — that is no need for chemotherapy or radiation after surgery.</p> <p>During the procedure, the surgeon makes a few tiny incisions and inserts interactive robotic arms. The surgeon maneuvers the robotic arms at a console next to the operating table. The robotic arms are equipped with surgical tools and cameras allowing removal of the kidney mass. A pathologist analyzes the mass to confirm the diagnosis and stage of cancer.</p> <p>If the cancer is contained, surgery is the only treatment needed. This occurs in about 97% of kidney cancer cases for small masses. Chemotherapy, radiation or immunotherapy may be needed if the cancer has spread to other areas of the body.</p> <h4>Benefits of partial robotic nephrectomy</h4> <p>Partial robotic nephrectomy has many benefits. The most important is that it preserves the kidney and its function in a minimally invasive fashion. People can live with only one kidney, but it is better to have two when possible in case of an accident, injury, or deterioration in kidney function with age or comorbidities. It also reduces the risk of complications or the need for dialysis in the future.</p> <p>Another benefit of robotic surgery compared to traditional open surgery is faster recovery. Most patients remain in the hospital for one night, compared to three or four days with traditional open surgery. They can return to daily activities sooner and have smaller, less noticeable scars.</p> <p>Partial robotic nephrectomy surgery isn't an option for everyone. Your surgeon will recommend the best option for you based on your overall health, and the location and size of the kidney mass.</p> <p><em><a href="/providers/scott-pate-md" target="_self" title="Opens in same window.">Scott Pate, M.D.</a>, is a <a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">urologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/prairie-du-chien" target="_self" title="Opens in same window.">Prairie du Chien</a>, Wisconsin.</em></p><ul> <li>Minimally invasive, office-based procedures for benign prosthetic hyperplasia (BPH)</li> <li>Minimally invasive surgeries for urologic cancer (prostate, kidney, bladder, adrenal, testicular)</li> <li>MRI/ultrasound fusion biopsies for detection of prostate cancer</li> <li>Robotic surgery</li> </ul>M.D.<p>I deliver modern and evidence-based care to men, women and children with urologic concerns. I work to put myself in the patient’s shoes and empower patients to share in decision making by describing the condition in everyday terms and discussing options in depth. I strive to treat patients like family during this decision-making process.</p> <p>You will find me around the community with my family, exercising, biking and enjoying our wonderful outdoors.</p> <p><strong>Education</strong></p> <ul> <li>University of Iowa Carver College of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>University of Kansas Medical Center</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Urology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Urological Association</li> <li>Kansas Urological Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Urology, Mayo Clinic College of Medicine and Science</li> </ul>Pate<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/scott-pate-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=62A8D4B57A98B6C869440327EE4278B9" alt="Scott Pate MD" width="280" height="280" DisableNVelocity="true" />{AA62C0B7-2A25-411B-AEF6-CEEB87C4A150}Scott<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15927202Scott Pate, M.D.1{BFAFB863-D571-4781-ADD9-1398B77B549E}|{83EB2AA2-1436-4DDC-B7BB-51F8E6A87FC9}<img src="/-/media/national-files/images/hometown-health/2022/yellow-jacket-grey-knit-hat.jpg?h=370&iar=0&w=660&sc_lang=en&hash=DC83304236CCF5DBFF778F18DF980B1D" alt="Person wearing yellow jacket and grey knit hat" width="660" height="370" DisableNVelocity="true" />Kidney HealthYour kidneys are responsible for filtering waste and excess fluids from your body. So when kidney functionality decreases, harmful amounts of fluid and waste can build up in your body. In most cases, you can prevent or manage kidney issues by making healthy, kidney-conscious decisions.CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Dawn Haller3/16/2022Delirium is a type of confusion that occurs suddenly and without warning. Learn who's at greatest risk, signs and what you can do to help your loved ones.Recognizing and responding to delirium<p>Delirium is a type of confusion that occurs suddenly and without warning. When people have delirium, they may have trouble focusing or paying attention. They also may feel groggy and drowsy, or act or say things out of character. Delirium can be a warning signal that someone is not feeling well.</p> <p>It's important to recognize delirium because it may signal an underlying problem. An infection may be starting, like a urinary tract infection, or something else that needs medical attention. It is important to seek help when you notice these signs.</p> <h4>Delirium risk factors</h4> <p>Certain factors increase the risk of experiencing delirium. Any decline in thinking or memory increases the risk of delirium. People who have multiple chronic illnesses, like diabetes and sleep apnea, are at a higher risk. Older adults with dementia are at a higher risk, but it can affect people of all ages. Some children also experience delirium during critical illness and when waking up from anesthesia.</p> <h4>Signs and symptoms of delirium</h4> <p>People who develop delirium may act abnormally and feel more drowsy or sleepy than usual. They have trouble focusing or are easily distracted. They may ask you to repeat what you said multiple times or appear not to have heard you.</p> <p>Sometimes in delirium, people may not remember the date, time, where they are or why they are in that location. They may recall memories from the past or appear to see or hear things that are not present. They may not recognize familiar faces and be agitated and restless.</p> <p>Any of these signs are signs of delirium that require medical attention. Delirium symptoms can come and go, lasting for a little while or a long while.</p> <h4>Delirium in the hospital</h4> <p>Being hospitalized is a risk factor for delirium. The hospital can be an unfamiliar or scary place for some people, especially loved ones who have memory problems, are older or have existing health problems. For example, a loved one can be hospitalized for a heart attack, but then develop delirium. This increases the risk for other problems while in the hospital, including an infection or a fall, leading to a longer hospital stay.</p> <p>Family and friends may notice quicker if their loved ones are not acting like themselves. The health care team may be meeting patients for the first time and may not know them as well as close friends and relatives. If your loved one starts to show signs of delirium, it's important to alert the health care team.</p> <h4>How to help</h4> <p>You can take steps if you notice that loved ones are showing signs of delirium. Reassure them so they know they are safe. Remind them of the time, date, where they are located and what is going on. This is called "reorientation."</p> <p>You can distract and stimulate their brains by talking with them, telling stories or reminiscing over favorite memories. It may be helpful to show them familiar photos or bring familiar objects like a favorite pillow or books.</p> <p>If glasses or hearing aids are used at home, bring these items to the hospital. Keeping someone's sleep-wake routine is important. Being active during the day with physical activity and conversation, and then sleeping at night will help. Things to help sleep include a hot beverage before bedtime, earplugs or eye masks, soothing music or a back rub.</p> <p>Learn more about <a rel="noopener noreferrer" href="https://mcforms.mayo.edu/mc4200-mc4299/mc4204.pdf" target="_blank" title="Opens in a new window.">delirium in the hospital</a> and visit the <a rel="noopener noreferrer" href="https://americandeliriumsociety.org/patients-families/what-is-delirium/" target="_blank" title="Opens in a new window.">American Delirium Society website</a>.</p> <p><em>Heidi Lindroth, Ph.D., is a Mayo Clinic nurse scientist, and <a href="/providers/margaret-paulson-do" target="_self" title="Opens in same window.">Margaret Paulson, D.O.</a>, is a hospitalist in Menomonie, Wisconsin.</em></p><ul> <li>Cardiology</li> <li>Infectious diseases</li> <li>Liver disease</li> </ul>D.O.<p>In my spare time, you will usually find me outdoors with my family or friends sledding, going for a run or enjoying a picnic in the park.</p><p><strong>Education</strong></p> <ul> <li>Midwestern University</li> </ul> <p><strong>Internship & Residency</strong></p> <ul> <li>Internal Medicine, Banner Good Samaritan Medical Center</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Internal Medicine</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American College of Physicians</li> </ul>Paulson<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/margaret-paulson-do.JPG?h=280&iar=0&w=280&sc_lang=en&hash=FC8C11A9AD36C306CFC18729CF2BC3A1" alt="Margaret Paulson, D.O." width="280" height="280" DisableNVelocity="true" />Margaret<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14668947Margaret Paulson, D.O.1<img src="/-/media/national-files/images/hometown-health/2022/close-up-of-holding-hands.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F65999612948DE1AB67950A35A3ADB38" alt="Close up of holding hands" width="660" height="370" DisableNVelocity="true" />Dawn Haller3/14/2022The nervous system receives and relays sensory information like vision, sound, smell, taste, touch and pain. Learn about the differences between the central and peripheral nervous systems, and if damaged nerves can be repaired.Treating, repairing the body's electrical system<p>The nervous system is a complex and wide-reaching network of nerve cells called neurons. Their connections, called synapses, reach all areas of the body. The nervous system receives and relays sensory information like vision, sound, smell, taste, touch and pain.</p> <p>The nervous system is fragile. It can be damaged, and it heals with great difficulty, if at all. This affects the brain's ability to communicate with your muscles and sensory organs. Nervous system injuries can be painful, and cause weakness, tingling, numbness and even changes in blood circulation.</p> <p>All the neurons in your body start and end in your brain or spinal cord. The brain and spinal cord make up the central nervous system, which is usually what first comes to mind for many people.</p> <p>The peripheral nervous system, on the other hand, connects the central nervous system with your internal organs, muscles and sensory tissues. These nerves fire muscles; sense temperature; and control your heart, lungs and other involuntary functions essential to life. To put it simply, neurons are like electrical wires that are lined on the outside by special cells that provide insulation. Each neuron has a head called the cell body and a long tail called an axon. The head is connected to the spinal cord or brain, and the tail connects to a muscle or organ.</p> <h4>Central nervous system injuries</h4> <p>Injuries to the spinal cord or brain can happen in an instant. They can be caused by an auto accident, sports injury, fall, stroke, ruptured brain aneurysm, lack of oxygen, gunshots or an explosive blast. These injuries are often called traumatic brain injuries or traumatic spine injuries.</p> <p>Injured nerve cells in the central nervous system typically do not regenerate. However, this part of the nervous system can reorganize in response to an injury. This is called "plasticity." Luckily, the brain has a lot of built-in redundancy. Simply put, when one area loses function, other undamaged areas of the brain can take over. For example, if a stroke causes an area of brain damage, other parts of the nervous system can take over the lost function of the damaged area. The chance of recovery is greatest in patients 40 and younger after a traumatic brain injury.</p> <p>Neurosurgeons can't alter the primary injury suffered by the brain or spinal cord, but they can prevent secondary damage from occurring. Surgical procedures can relieve pressure on the spinal cord and brain. This prevents damage from progressing to other areas.</p> <h4>Peripheral nervous system injuries</h4> <p>Injuries to the peripheral nervous system can happen slowly over time or in an instant. Accidents, falls and sports can cause injuries. Repetitive microtrauma, such as carpal tunnel syndrome, also can cause nerve damage. Other causes of nerve injury include diabetes, radiation, alcoholism, viral illnesses, birth trauma, surgery, autoimmune reactions and certain hereditary conditions.</p> <h5>Three types of peripheral nervous system injuries are:</h5> <ul> <li><strong>Neuropraxia</strong> <br> This is the mildest and most common type of nerve injury. The nerve itself is intact and merely stunned. Any resulting numbness, weakness or loss of function is temporary, and most people make nearly a complete recovery with rest and time. Surgery is rarely needed.</li> <li><strong>Axonotmesis</strong> <br> This is a partial nerve injury. The outer nerve sheath is intact, but the neurons within are damaged. Nerve cells can regenerate and grow back at a rate of about an inch a month, but recovery is typically incomplete and slow.</li> <li><strong>Neurotmesis</strong><br> This is a complete nerve injury, where the nerve sheath and underlying neurons are severed. If there is an open cut, a neurosurgeon can see the cut nerve ends at surgery and repair this. If the gap is less than 2 centimeters, the nerve ends may be sutured together, provided they come together easily. Larger gaps may need artificial conduits or nerve grafts to fill the defect. Surgery is almost always needed.</li> </ul> <p>Stretch injuries are the most encountered pattern of nerve damage. These may result from a fall, a birth injury, a motor vehicle accident, a surgical procedure or workplace injury. All three types of nerve injuries detailed above also can occur or in combination with one another. Most people improve within three to six months, but surgery may be needed based on the lack of clinical improvement and other tests, including an ultrasound and electromyography.</p> <p>The chance of nerve regeneration is greater within the peripheral nervous system. This is because these neurons have a different lining, or sheath, made up of Schwann cells. The central nervous system does not have these cells. Schwann cells can help damaged nerves regenerate and restore function. On average, damaged nerves can grow back at a rate of about 1 inch per month or 1 millimeter per day.</p> <p>Surgery is needed if there is significant scar tissue or a gap between cut nerve ends. Neurolysis is a surgical procedure that removes scar tissue from around and sometimes from within the nerve to improve its function. Direct nerve repair or primary neurorrhaphy involves suturing cut nerve ends together with ultrafine sutures or glue. Nerve grafting repairs larger gaps that are bridged with nerves harvested typically from the patient's leg, cadaver nerves or synthetic conduits that may be lined with biological factors to enhance nerve regeneration.</p> <p>Neurotization or nerve transfers involve sacrificing a healthy nerve by severing it and using it as a source of neurons to hot-wire a more important damaged nerve close to its entry into the paralyzed muscle. This bypasses scarring at the level of injury and reduces the time taken to reenergize the muscle. A neurosurgeon can use one or more procedures to repair damaged nerves.</p> <p>Nerve surgery isn't right for every patient. These procedures are most successful in younger patients who are in good overall health. Patients who are obese; smoke; or have diabetes, poor circulation or undergone radiation therapy previously fare worse.</p> <h4>Complex regional pain syndrome</h4> <p>This is a rare but severe form of chronic pain that affects a limb. The pain is out of proportion to the severity of the initial injury.</p> <p>Type 1 complex regional pain syndrome may occur after an injury that did not directly damage the limb or nerves therein, such as after a stroke or heart attack. Type 2 complex regional pain syndrome occurs after a crush injury to a limb and direct nerve damage there. This poorly understood condition likely involves inflammation and hypersensitivity at the level of the peripheral and central nervous systems.</p> <p>Symptoms include extreme burning or throbbing pain, sensitivity to touch, changes in skin color, skin temperature and swelling. Physicians aren't sure why this occurs in some people and not others. A multidisciplinary team of health care professionals is needed to treat this rare and agonizing condition.</p> <p>Peripheral nerve injuries can be treated nonoperatively with rest, physical therapy, desensitization techniques and medications to numb the pain while allowing the nerve to grow back. Surgical procedures have evolved over the years and produce excellent results in carefully selected patients with paralyzed muscles, pain, numbness and lost function.</p> <p><em>Manish Sharma, M.B.B.S., is a <a href="/services-and-treatments/neurosurgery" target="_self" title="Opens in same window.">neurosurgeon</a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a>, <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a> and <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2022/young-adult-playing-guitar.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0750A6D61830AB422D734C9F2E5A9C11" alt="Young adult playing guitar" width="660" height="370" DisableNVelocity="true" />NeurosurgeryNeurosurgery treats disorders that impact any part of the nervous system, which may include the brain, spine or peripheral nerves. Conditions treated range from life-threatening brain tumors, to disorders impacting quality of life, such as back pain and carpel tunnel syndrome.Dawn Haller3/1/2022Nearly everyone deals with acne, which can appear anywhere you have oil glands on your skin, including your chest. Learn how chest acne develops and what you can do to prevent or treat it.What to do about chest acne<p>Acne is a skin condition that nearly everyone deals with at some point in their lives. It's caused by the accumulation of dead skin cells that block your pores and leads to an abundance of a specific type of bacteria present on the skin called propionibacterium acne. As a result, your skin becomes inflamed and causes whiteheads, blackheads or pimples to form.</p> <p>Unfortunately, acne has no boundaries. It's more common for teenagers, but it can affect people of all ages, and about equally between men and women. Acne also can appear anywhere you have oil glands in your skin, so it can occur on your back, face, stomach or chest.</p> <h2>Chest acne develops the same way as other acne, but some factors can affect its formation, including:</h2> <ul> <li>Using skin care products that prevent or hinder water loss</li> <li>Friction from clothing</li> <li>Excessive sweating</li> </ul> <p>Chest acne isn't the result of poor hygiene. It's not caused by dirty skin and can actually be made worse with harsh soap or chemicals and rough scrubbing.</p> <h2>Other factors that worsen acne include:</h2> <ul> <li><strong>Certain medications</strong><br /> Examples include corticosteroids, testosterone or lithium.</li> <li><strong>Hormones</strong><br /> Hormonal changes related to puberty and pregnancy can cause your glands to produce more oil and lead to more acne.</li> <li><strong>Diet</strong><br /> Some studies suggest that skim milk, chocolate and foods high in carbohydrates can worsen acne. Rather than restricting these foods completely, limit your consumption, if desired.</li> <li><strong>Stress</strong><br /> When your body is under stress, it produces hormones called androgens that affect various parts of the body, including the skin. In the skin, these hormones may stimulate hair follicles and oil glands, leading to more inflammation and development of acne.</li> </ul> <p>There are many treatments available for chest acne to help you avoid skin scars, make acne less noticeable and lower the emotional stress caused by the acne. Use gentle scrubs and noncomedogenic creams so skin pores don’t get clogged. Over-the-counter body washes that include salicylic acid and benzoyl peroxide can provide some relief of mild inflammatory acne. Avoid coarse or rough body scrubs, since they're traumatic to the skin.</p> <p>If over-the-counter products aren't working, talk with your health care provider about topical and oral medications that can help you manage your acne.</p> <p><em><a href="/providers/amanda-logan-cnp" target="_self" title="Opens in same window.">Amanda Logan</a> is a nurse practitioner in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><ul> <li>Effective hydration for maturing, dehydrated skin, and collagen building and maintenance</li> <li>Pharmacogenomics</li> <li>Skin care for all ages</li> <li>Using food as medicine for healthy gut, weight loss, and improving fatigue and inflammation</li> </ul>APRN, C.N.P.<p> I like to work with you and want your input. I want to know how we can work together to help you live your best life. Everyone is different and it is in the uniqueness that we can find solutions that are tailored to you. You are the captain of your ship, and I am your navigator. I will help guide and show you your options, but it is you who will ultimately decide your path.</p> <p>I will be open and honest when I see something that may be problematic, need further investigation or could use improvement. I am not opposed to alternative therapies; however, just as with anything you put in the body, even natural therapies have side effects and consequences that should be monitored. I am a big fan of mindfulness, meditating, gratitude, exercise and healthy eating as a basic foundation to good health. </p> <p>I am an avid reader. I read something related to the medical field at least daily, as well as something to stretch the imagination and keep my sense of childlike wonder. I am a huge Harry Potter fan and not ashamed to admit it. Some of my other favorite authors are Jeff Wheeler, Katherine Arden, Kate Quinn and countless others. I'm a huge Simpsons fan, and if I could guess what I was in a past life, it would have to be a dog. I love animals in general, but the best would have to be the dog. How better the world would be if we were all a little more like a dog.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Nursing, Bradley University</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul> <p class="telerik_paste_container" style="border-width: 0px; position: absolute; overflow: hidden; margin: 0px; padding: 0px; left: 3px; top: 66px; width: 1px; height: 1px;"> </p>Logan<img src="/-/media/shared-files/images/medical-professionals/full/mankato/amanda-logan-cnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=855113749ECDCE27DD0FF87769EE15A9" alt="Amanda Logan, C.N.P." width="280" height="280" DisableNVelocity="true" />{3D39AC94-41D4-46AA-9E8E-885783F8246E}Amanda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12858811Amanda Logan, C.N.P.1<img src="/-/media/national-files/images/hometown-health/2022/dark-curly-hair-facing-window.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6F548BD67F4404553CBBF87E87DB7C72" alt="Person with dark, curly hair facing sunny window" width="660" height="370" DisableNVelocity="true" />Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller4/18/2022Receiving a serious health diagnosis is a moment you likely will not forget. Follow these tips to lower anxiety and improve your coping after a difficult diagnosis.8 tips for coping with a serious diagnosis<p>At some moments in life, time seems to stand still. This could occur when you gaze at a beautiful vista, are mesmerized by a song or hear the words "I love you" for the first time. When reflecting on that time, you may remember details vividly and the realization that life would be different moving forward.</p> <p>The apparent stretching of time can occur during terrible news and after a loved one's death or during a national tragedy. It could occur if you receive an unexpected serious health diagnosis, like being told you have cancer, heart disease, Alzheimer's disease or diabetes.</p> <p>Having a serious, potentially life-threatening illness will affect every aspect of your life. You may feel afraid, angry or overwhelmed. You may have feelings of loss over changes to your independence, privacy, health and expected future. You may worry about how it will affect your relationships, finances, work and the activities you enjoy. All these feelings are normal.</p> <p>Every person responds differently to a serious health diagnosis, and each situation is unique.</p> <h2>Here are 8 common ways to approach a difficult diagnosis that can lower anxiety and feelings of loss while improving your coping skills:</h2> <h3>1. Get the facts about your health condition.</h3> <p>Your health care team can provide or recommend reputable resources that will explain your diagnosis and treatment options. Knowledge is power, and understanding the facts will help you have two-way conversations with your health care team about your care.</p> <p>Write down questions and concerns for your health care team, and bring your list to each appointment.</p> <h3>2. Express your feelings.</h3> <p>Denial, fear, anxiety and anger are normal emotions when presented with bad news. Give yourself time to process these emotions. Share your feelings with family members and friends, or consider seeking professional help. You also can try writing down your thoughts in a journal.</p> <h3>3. Set up a support network.</h3> <p>Often friends and family are happy to prepare meals, provide transportation or help with household chores. Accepting help allows those who care about you to contribute during a difficult time. It also lowers the burden and stress on caregivers and other family members.</p> <p>Your support network also could include others who have the same diagnosis. It can help to hear their personal stories, coping strategies and firsthand experience with treatment options. Look for organized support groups in your community, such as those hosted by the Alzheimer's Association, American Cancer Society, American Heart Association or local public health departments. Many support groups have virtual meeting options, as well.</p> <h3>4. Focus on healthy habits.</h3> <p>Maintaining a healthy lifestyle can improve your energy level. Choose a healthy diet consisting of a variety of foods and get adequate rest to help you manage stress and fatigue. Exercise and participating in enjoyable activities also may help.</p> <p>Talk with your health care team about the best exercise options for you.</p> <h3>5. Set realistic goals.</h3> <p>Expecting too much of yourself can lead to frustration and feelings of failure. Decide whether you can accomplish the tasks and activities you plan to include in your day. Learn to say no to things when you have no time or energy.</p> <h3>6. Concentrate on what brings you meaning and purpose.</h3> <p>Many people have found that receiving a serious health diagnosis helped bring into focus the people and things that are most important in their lives. Find time for the people and activities that are personally rewarding and meaningful. Stay connected, or reconnect, with family and friends, especially those who have a positive, optimistic outlook on life. Volunteer work or helping someone in need can remind you that you can continue to make a difference.</p> <h3>7. Focus on your abilities, not limitations.</h3> <p>Try not to compare your situation with the way things used to be. This can produce "all-or-nothing thinking" — the idea that if you cannot do something exactly as before you can no longer do it at all.</p> <p>Modify or change your activities instead. For example, you may not be able to play 18 holes of golf any longer, but you could still enjoy nine holes while riding a golf cart. Or consider reducing your work hours or finding a different job if your previous routine is a challenge.</p> <h3>8. Use various coping strategies.</h3> <p>What comforted you through rough times before your diagnosis is likely to ease your worries now, whether that's a close friend, religious leader or a favorite activity that recharges you.</p> <h4>Turn to these comforts now, but also be open to trying new coping strategies like:</h4> <ul> <li>Practicing meditation or deep breathing exercises</li> <li>Writing in a journal</li> <li>Seeking professional mental health help</li> <li>Taking part in mentally stimulating activities, like reading or crossword puzzles</li> <li>Leaning on your faith or spirituality</li> <li>Remaining involved with work and leisure activities as much as you can</li> </ul> <p>Adopting these healthy coping strategies can make your life more enjoyable and satisfying. Talk with your health care team if you have questions about your condition and what to expect before, during and after treatment.</p> <p><em><a href="/providers/christopher-schimming-md" target="_self" title="Opens in same window.">Christopher Schimming, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><ul> <li>General adolescent and adult medicine</li> <li>Geriatrics</li> <li>Preventive medicine</li> </ul>M.D.<p>My patients will find that I use a cooperative approach — using evidence-based guidelines and recommendations, blended with their own personal values — to create a care plan that is specific to them. I present a lot of information and education during visits, and support shared decision making. Medications are used as required, but I also strongly encourage my patients to pursue appropriate and healthy lifestyle choices.</p> <p>I am married with three great kids. I enjoy reading good fiction, music, hiking, camping and local sports. New jokes are always welcome!</p><p><strong>Education</strong></p> <ul> <li>University of Iowa Carver College of Medicine</li> </ul> <p><strong>Residency </strong></p> <ul> <li>Family Medicine, MercyOne North Iowa</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Family Medicine</li> </ul>Schimming<img src="/-/media/shared-files/images/medical-professionals/full/mankato/christopher-schimming-md.jpg?h=280&iar=0&w=280&hash=42B4794E4C5934246D19F143779428EF" alt="Christopher Schimming MD" width="280" height="280" DisableNVelocity="true" />{2FD53C97-1256-45ED-9438-C8C90468C31A}Christopher<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15276660Christopher Schimming, M.D.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}<img src="/-/media/national-files/images/hometown-health/2022/middle-aged-curly-hair-beard-stubble.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4BB7B258180AFF113DE7022938D621D8" alt="Middle-aged person with curly hair and grey beard stubble" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller4/28/2022Chia seeds are an excellent source of fiber and omega-3 fatty acids. Learn how these small, but mighty, seeds can help with weight loss and decrease your risk of developing diabetes or heart disease.Chia seeds pack nutritional punch<p>Chia seeds are small round seeds, and can be black, brown and white in color. They are harvested from a flowering plant in the mint family known as Salvia hispanica. It's native to parts of Mexico and Guatemala. Edible chia seeds are closely related to the chia plants made popular by Chia Pets, but they are not the same seed.</p> <p>A gel forms around the chia seed when mixed with liquid, which gives chia beverages their distinctive texture. Chia seeds can absorb up to 12 times their weight in liquid, which makes them useful in keeping baked goods moist.</p> <h2>Chia seed benefits</h2> <p>Chia seeds have many nutritional benefits. They are high in omega-3 fatty acids and fiber. Chia provides a similar amount of omega-3 fatty acids as ground flaxseed in the form of alpha linolenic acid, or ALA. They can help with weight loss.</p> <p>Chia seeds are an excellent source of fiber, which can improve heart health, reduce cholesterol levels and promote intestinal health. Fiber takes longer to digest and makes you feel satisfied longer, which is how it can help with weight loss and decrease your risk of developing diabetes or heart disease. Eating a diet rich in fiber also is shown to protect against colorectal cancer.</p> <p>One serving of dried chia seeds is about 2.5 tablespoons. This has 140 calories, 5 grams of protein, 10 grams of fiber, 12 grams of carbohydrate and 9 grams of fat, of which 8 grams are heart-healthy fats.</p> <h2>Using chia seeds</h2> <p>Grocery stores stock a variety of chia seeds. Products that contain chia seeds include chia pudding, chia kombucha and granola with chia seeds.</p> <p>Chia seeds have a mild flavor and can easily be added to many foods you already enjoy. Try adding whole or ground chia seeds to smoothies, juices, milk, yogurt, oatmeal, pancakes or a granola bar recipe. Try them sprinkled on salads or cereal, baked into muffins or breads, or made into chia pudding using the recipe below.</p> <h3>These recipes provide about one-third of your recommended daily amount of fiber:</h3> <h4>Overnight chocolate chia seed pudding</h4> <p>Serves 4</p> <p>1½ cups almond milk<br /> ⅓ cup chia seeds<br /> ¼ cup unsweetened cocoa powder <br /> 4 tablespoons maple syrup <br /> ½ teaspoon ground cinnamon (optional)<br /> ½ teaspoon vanilla extract</p> <p>Add all ingredients except chia seeds to a mixing bowl and whisk vigorously to combine. Mix in chia seeds until well-combined. Let rest covered in the refrigerator overnight. The pudding can be stored covered in the refrigerator for 2–3 days. Serve chilled with desired toppings, such as fruit or a dollop of whipped topping.</p> <p>Nutrition information per serving: 165 calories, 8 grams fat, 1 gram saturated fat, 75 milligrams sodium, 25 grams carbohydrates, 9 grams fiber, 4 grams protein</p> <h4>Carrot cake overnight oats</h4> <p>Serves 1</p> <p>This oatmeal is loaded with calcium, protein, fiber and vitamin A. The amount of carrot in this recipe provides 100% of your vitamin A for the day, which is good for your eyes and immune system.</p> <p>½ cup rolled oats<br /> ⅔ cup skim milk<br /> ⅓ cup plain, nonfat Greek yogurt<br /> ¼ cup finely grated carrot<br /> 1½ teaspoons chia seeds<br /> 2 teaspoons maple syrup<br /> ½ teaspoon cinnamon<br /> ½ teaspoon vanilla extract<br /> 1 tablespoon pecans, chopped<br /> 1 tablespoon shredded coconut, unsweetened</p> <p>Mix all ingredients, except for the pecans and coconut, in a bowl or Mason jar. Top with pecans and coconuts, and cover with lid. Refrigerate overnight and eat chilled.</p> <p>Nutrition information per serving: 395 calories, 12 grams fat, 3 grams saturated fat, 135 milligrams sodium, 55 grams carbohydrates, 9 grams fiber, 21 grams protein, 100% daily value vitamin D, 36% daily value calcium</p> <p><em><a href="/providers/romi-londre-rdn" target="_self" title="Opens in same window.">Romi Londre</a> is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Eating disorders</li> <li>Enteral nutrition or tube feedings</li> <li>Weight management</li> </ul>RDN, CD<p><strong>Education</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Registered Dietitian Nutritionist</li> <li>Certified Nutrition Support Clinician </li> <li>Certificate of Training in Adult Weight Management</li> </ul> <div> </div>Londre<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/romi-londre-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7919B2F8260054ECC4308684471EEEDB" alt="Romi Londre RDN" width="280" height="280" DisableNVelocity="true" />Romi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15183670Romi Londre, RDN, CD1{2BEE5070-65FF-4406-9E59-103E06C5A535}<img src="/-/media/national-files/images/hometown-health/2022/chia-seeds-in-jar-fruit-granola.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E3464829AD41E782CF8B53451BFECB7B" alt="Chia seeds in jar mixed with yogurt, fruit and granola" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller4/14/2022It’s easy to put off making important decisions in life, especially documenting your health care wishes. But doing so can bring peace of mind and lead to better future health outcomes.Don't leave your health decisions to chance<p>It's easy to put off making important decisions in life, especially health care decisions. They can be uncomfortable and complex. Yet taking time to discuss and document your health care wishes can bring peace of mind and lead to better health outcomes in the future.</p> <h2>It's easy to procrastinate</h2> <p>There are so many things to do every day, an almost-limitless amount of "low hanging fruit" items to cross off the list. It's easy to put off thinking about your health care wishes.</p> <p>There are many more enjoyable things to plan and ponder, while considering your health care wishes can feel like a chore. When given a choice between planning a vacation or outlining your end-of-life wishes, it's easy to pick the more fun, less distressing task.</p> <p>You also may procrastinate because you believe these decisions can wait for a more appropriate time in the future. Unfortunately, the right time and circumstances never seem to line up.</p> <h2>Documentation of your wishes</h2> <p>Thinking through and documenting your health care wishes tells your family and health care team what kind of care you want if you are too ill to express your wishes yourself. This could occur if you're terminally ill, seriously injured, in a coma, in the late stages of dementia or near the end of life.</p> <p>Some decisions that you should document include when you want to be resuscitated by CPR, when and for how long you want to be placed on a mechanical ventilator, or if you want to be fed through a feeding tube.</p> <p>Record your wishes in a legal form called an <a rel="noopener noreferrer" href="https://mcforms.mayo.edu/mc2100-mc2199/mc2107-14.pdf" target="_blank" title="Opens in a new window.">advance directive</a>. This document isn't just for older adults. Anyone over 18, regardless of state of health, can complete an advance directive. It's only activated if or when you are incapacitated and cannot make health care decisions.</p> <p>One type of advance directive, a <a rel="noopener noreferrer" href="https://mcforms.mayo.edu/mc2100-mc2199/mc2107-20.pdf" target="_blank" title="Opens in a new window.">power of attorney for health care</a>, is preferred because it makes your care wishes known and designates a person to make decisions for you if you cannot speak for yourself. This person is called a "health care agent."</p> <h3>When selecting your health care agent, remember this story:</h3> <blockquote>Two leaders pondered a difficult decision and were united in their approach. But soon, the second leader started to second guess the decision. The first leader said to the second, "Now is not the time to be a fence straddler."</blockquote> <p>As you select your health care agent, pick a person you trust to follow your wishes and hold firm to the decisions.</p> <p>You can update an advance health care directive or power of attorney for health care at any time, such as after a new diagnosis, a change in marital status or if your thoughts about end-of-life care evolve.</p> <h2>Get better outcomes</h2> <p>Procrastinating health care decision-making is a serious matter, so the sooner you begin, the better the potential outcome.</p> <p>In some cases, life can be prolonged using advanced technology like ventilators, vasopressors and surgery. It's great to be an educated health care consumer and understand the available treatment options, but it's also important to remain objective, and listen to and heed the advice of your health care team.</p> <p>If your health care team is unsure of your wishes, they may insist on prolonging care or performing invasive treatments on your behalf. These actions can have serious negative side effects and result in low quality of life.</p> <p>Documenting your wishes early ensures that you will get the medical care you want and need while avoiding unwanted heroic measures that may be harmful. It also relieves unnecessary suffering, and eases your family and friends of decision-making burdens during moments of crisis or grief. What a gift this is for them.</p> <h2>Tips for difficult decisions</h2> <p>These conversations and decisions are not easy, but they are important.</p> <h3>Here's my advice on tackling difficult decisions with your family and friends:</h3> <h5>Don't kick the can down the road.</h5> <p>Sometimes getting started is the hardest part. Years ago, I drove a vehicle with a manual three-speed transmission on the column. Unlike the automatic engines found in cars today, you could give this car a small push downhill to start the engine. In the same way, some people just need a little push to get started.</p> <p>Perhaps you feel the day will never come that you face a serious injury or illness or that you will die in your sleep. But nearly every family is affected by a serious illness or injury at some point. If decisions are put off and not documented, a well-intentioned but uninformed family member could make decisions that don't align with your wishes. I have found this to be the case on many occasions. A rolling snowball in the form of unmet health care decision-making can lead to a big mess that can become a proverbial avalanche if left unheeded.</p> <h5><strong>Don't decide to do nothing.</strong></h5> <p>Inaction is still an action. If you refuse to make difficult decisions in health care, you are still deciding, but it's much riskier. It's like gambling on a roulette wheel. You don't know where the ball is going to stop. Instead of taking action to improve your odds, you are just hoping for a good outcome.</p> <p>You take control by expressing your wishes and choosing a responsible health care agent in an advance directive. These actions guide your roulette ball by adding flappers on the wheel that align with your desires. Doing so can make the difference between comfort or chaos for you, your health care team and your family.</p> <h5>Keep points simple yet specific.</h5> <p>As you complete your advance directive, you will be advised to consider all options. This can feel overwhelming. The key is to keep it simple because there is no way you can cover every possible scenario.</p> <p>Too often, advance directives are too generic or too detailed. I recommend a happy medium where some key themes are outlined and cover a myriad of scenarios. Keep it simple when you can.</p> <h5>Let professionals guide you.</h5> <p>When you are ready, find a health care professional to guide you through completing an <a rel="noopener noreferrer" href="https://mcforms.mayo.edu/mc2100-mc2199/mc2107-14.pdf" target="_blank" title="Opens in a new window.">Advance Directive booklet</a>. Social workers and chaplains in health care organizations, along with faith leaders, community service workers in local communities and volunteers, are trained to assist you. Your primary care provider also can assist. These professionals will help you work through the decisions, but they won't tell you what to do.</p> <p>Advanced planning and outlining your wishes before you need the care gives you the opportunity to communicate your wishes with your family. Talk with them about your advance directive and health care wishes, along with your rationale behind the decisions. Give a copy to your health care agent and health care team.</p> <p>It's prudent to be a well-informed patient as you outline your health care wishes. They are not only life decisions, but also they're life-altering.</p> <h3>Helpful links:</h3> <ul> <li><a rel="noopener noreferrer" href="https://www.nhpco.org/" target="_blank" title="Opens in a new window.">National Hospice and Palliative Care Organization</a></li> <li><a rel="noopener noreferrer" href="http://www.mayo.edu/pmts/mc2100-mc2199/mc2107-14.pdf" target="_blank" title="Opens in a new window.">Advance Health Care Planning: Making Your Wishes Known booklet</a></li> <li><a rel="noopener noreferrer" href="https://mcforms.mayo.edu/mc2100-mc2199/mc2107-20.pdf" target="_blank" title="Opens in a new window.">Power of Attorney for Health Care form</a></li> </ul> <p><em>Chaplain William Creech is a clinically trained, board-certified chaplain in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2022/person-curly-grey-hair-hoop-earrings.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2E9BD1DD3BAAE2BFA98D6A841A4F4D8D" alt="Person with short, curly grey hair, wearing hoop earrings" width="660" height="370" DisableNVelocity="true" />Palliative CarePalliative care offers pain and symptom management, and emotional and spiritual support when you face a chronic, debilitating or life-threatening illness.HospiceThe Hospice program believes that the highest quality of living is achieved when the family unit and Hospice team together offer hope, opportunity, support, presence, individualized care, comfort and encouragement.<br/><br/>AgingLife expectancy is 75 for males and 80 for females according to the National Center for Health Statistics. We'll help you keep you informed about potential issues with aging, and steps you can take to maintain your health and keep active.Dawn Haller4/24/2025Food budget getting squeezed? These tips can help you save money without pinching your healthy eating goals.Eating healthy on a budget<p>With food prices rising, your grocery bill may be giving you sticker shock. But you shouldn't toss your healthy eating goals because your food budget's getting squeezed. Now is a great time to pick up — or brush off — some smart-shopping and meal-planning skills. These skills can save money while buying and preparing healthy food for your family.</p> <h2>Start at home</h2> <p>Before you head to the store or place your online order, take time to plan and think ahead. Menu planning is a great way to make sure you're eating a balanced diet and meeting your nutritional needs. And, as every frugal cook knows, planning ahead can save time and money, not only at the store, but also during the busy work and school week.</p> <h3>Here's how to get started:</h3> <ul> <li>Take an inventory of what you have in the pantry, fridge and freezer. Buying duplicates, unless it's a great deal, can pinch your wallet and lead to food waste.</li> <li>Pull out your recipe files or cookbooks for those healthy meal ideas.</li> <li>Plan your menus for the week. These don't have to be set in stone, but they help you draw up a shopping list and plan for how leftovers can be part of another meal. For example, extra seasoned chicken for Taco Tuesday can become the topping for a taco salad on Wednesday.</li> <li>Make a list. Check what ingredients you'll need for each meal, as well foods to have on hand for snacks and treats.</li> <li>Scan store ads for deals. Clip only those coupons that apply to the items on your list.</li> </ul> <h2>At the store</h2> <h3>Once you get to the store or pull up your online ordering form, these tips can help you shop smarter and eat healthy:</h3> <ul> <li>Eat a snack or meal before you shop. When you're hungry, everything looks so tempting.</li> <li>Avoid shopping alone since that can lead to impulse buying. Also, having older children along can teach them lifelong skills.</li> <li>Stick to your list.</li> <li>Steer clear of prepackaged convenience items, which typically are more expensive and provide fewer nutrients, compared to home-prepared. To maintain your healthy eating, money-saving goals, also limit sodas, chips, sugary cereals, crackers and convenience meals.</li> </ul> <h3>These detailed tips can help you when shopping in each food group:</h3> <ul> <li><strong>Grains</strong> <ul> <li>Buy 100% whole grain. When grains are on sale, stock up and freeze them.</li> <li>Oatmeal is a healthy, inexpensive whole grain with no added salt or fat.</li> <li>Rice also is inexpensive. Brown rice is a healthier option, compared to white.</li> <li>Whole-grain noodles are also healthy and typically inexpensive.</li> </ul> </li> <li><strong>Fruits and vegetables</strong> <ul> <li>Farmers markets and local food stands often have the best prices.</li> <li>Shop for items in season and buy only what you need.</li> <li>Use fresh produce quickly to prevent spoiling and food waste.</li> <li>Keep frozen fruits and vegetables on hand. They're often cheaper than fresh fruits and vegetables and can work in a wide range of recipes</li> </ul> </li> <li><strong>Protein</strong> <ul> <li>Look for meats on sale.</li> <li>Choose lean meats and lean cooking options, like broiling and grilling.</li> <li>Buy a larger pack. Use one portion and freeze the rest for another meal.</li> <li>Consider adding more meatless meals to your menus with tasty bean-based dishes. Beans are inexpensive and a great source of protein and fiber.</li> </ul> </li> </ul> <p>This rice-and-beans salad can be served as a main dish, side or a weekday lunch. Use no-salt-added canned beans instead of salted ones to cut the sodium content by half. Check your farmers market for early spring green onions and parsley.</p> <h2>Rice and Beans Salad</h2> <p>Makes 10 ¾-cup servings</p> <p>1½ cups uncooked brown rice<br /> 3 cups water<br /> ½ cup chopped fresh parsley<br /> ½ cup chopped green onions or shallots (about 2 shallots or several green onions) <br /> 15-ounce can unsalted garbanzo beans<br /> 15-ounce can unsalted dark kidney beans<br /> ¼ cup olive oil<br /> ⅓ to ½ cup rice vinegar to taste</p> <p>Place rice and water in stockpot. Cover and cook over medium heat until rice is tender, about 45 to 50 minutes. Cool to room temperature. Stir in the remaining ingredients. Chill 2 hours or longer.</p> <p><em>Anne Harguth is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition Counseling and Education</a> in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2022/cutting-yellow-pepper-on-board.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B1E1659B759A5EDC7328A4A123BCD4CD" alt="Cutting yellow pepper on board" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller8/12/2025Cancer can affect the way you feel, think and act. Learn common emotions felt by cancer survivors, and gather tips for emotional recovery.Emotional recovery after cancer treatment<p>From the moment you are diagnosed with cancer, your life is forever changed. It can affect the way you feel, think and act. You could feel many emotions including shock, guilt, anger, fear, sadness and depression. These emotions are expected, and your health care team is ready to support you.</p> <h2>During diagnosis and treatment</h2> <p>Every person is unique, and the way emotions are processed from the time of cancer diagnosis to treatment will vary. You may feel shock when you hear that you have cancer. Some people go into overdrive, gathering details, and the reality of the diagnosis doesn't sink in right away. Other people may feel anxious, angry or sad, or grieve a change in the direction of their lives.</p> <p>It is common to feel a mix of emotions. Your health care team understands that this may lead to difficulty retaining the information you receive. They will encourage you to bring a support person to your appointments for an extra set of ears.</p> <p>During this time, your health care team will answer your questions, provide resources and develop a treatment plan tailored to you. They will support you emotionally every step of the way.</p> <h2>Recovery and beyond</h2> <p>Your emotional state may shift after you complete the active treatment phase, such as completion of surgery, radiation or chemotherapy. You'll likely be eager to return to a more normal life, but you also may feel anxious about leaving the safety net of frequent contact with your health care team. You may ask "Now what?"</p> <p>At this time, you may be offered the opportunity for a cancer survivorship care plan visit. During this visit, you will receive a summary of your cancer journey, and an outline of your diagnosis, treatments received, expected side effects, resources available and recommendations for ongoing surveillance.</p> <p>A health care professional will discuss your plan and ask you how you are feeling physically and emotionally. This professional can be a touch point for you during your cancer recovery, and connect you to resources and answer your questions.</p> <h2>Emotional changes due to cancer</h2> <p>Cancer is a physical disease, but it can significantly affect your emotional health.</p> <h3>Survivorship differs with each person; yet, many survivors share these common emotions:</h3> <ul> <li><strong>Grief</strong><br /> We often think of grief as only occurring when a loved one dies. But it's common to feel significant grief after a cancer diagnosis and subsequent treatment. One can grieve the loss of time that was dedicated to treatment; a planned future; normal sensations following a mastectomy; or previous body image, like changes in hair or breasts.</li> <li><strong>Fear and anxiety</strong><br /> These emotions are normal and part of the body's automatic physiologic reaction. You may feel nervous about an uncertain future or lingering side effects. Cancer survivors may fear cancer recurrence and worry that every ache or pain is a sign that your cancer is back. In addition, financial and family pressures can affect your emotions, as well.</li> <li><strong>Sadness or depression</strong> <br /> Lingering feelings of sadness can interfere with your daily life, but they should improve with time. For some people, these feelings persist and lead to depression requiring medical attention.</li> <li><strong>Anger</strong><br /> Many cancer survivors feel a sense of anger. Cancer may change many parts of your life, including relationships, as well as school, work and retirement plans. Anger is a normal response to those changes. It is important to express your anger in a healthy way. Talk about the way you are feeling with someone you trust.</li> <li><strong>Loneliness</strong> <br /> You might feel as if others don't understand what you've been through. This can affect relationships and lead to loneliness. Friends and family might be unsure how best to help you and some people may even be afraid of you because you've had cancer.</li> </ul> <h2>Tips for emotional recovery</h2> <h3>Talk with your health care team about ways to improve your resilience and emotional health. Some tips include:</h3> <ul> <li><strong>Manage stress levels.</strong> <br /> A cancer journey could be the most stressful time in your life. Lean on the <a href="/topics/stress-management" target="_self" title="Opens in same window.">stress management</a> techniques you used prior to your diagnosis. Exercise, spending time outdoors, meditation or using creative outlets can help lower stress and cope with your emotions. <a rel="noopener" href="https://www.mayoclinic.org/departments-centers/integrative-medicine-health/sections/overview/ovc-20464567" target="_blank" title="Opens in same window.">Online programs</a> also can teach you strategies to manage stress and develop resilience.</li> <li><strong>Get enough sleep.</strong> <br /> Your emotions are better regulated when you get enough sleep. Disrupted or poor-quality sleep can make you feel irritable and increase any negative feelings. It also decreases energy and could make you less excited about good news or events in your life. Stick to a regular schedule and practice <a href="/hometown-health/speaking-of-health/5-ways-to-get-better-sleep" target="_self" title="Opens in same window.">good sleep hygiene</a> to improve your sleep.</li> <li><strong>Seek support.</strong> <br /> Sometimes talking with friends and family can help. If you feel they don't understand your perspective, look for a support group for cancer survivors. This can be a safe place to share your feelings and hear from others who are going through a similar experience. Your health care team may refer you to a therapist or other professional who can help you sort through your emotions and come up with ways to deal with your feelings.</li> <li><strong>Go to all follow-up appointments.</strong> <br /> You may fear the worst when it's time for a follow-up appointment or test. Don't let that stop you from going. Use this time to ask questions about signs, symptoms and side effects that you are experiencing.</li> </ul> <p>Recovering from cancer treatment pertains to your physical and emotional well-being. Take time to acknowledge your emotions during your cancer journey. Know that your emotions are unique and will evolve over time. Remember the ways that cancer has made you a stronger person and know that you are more than the scars that cancer has left behind.</p> <p><em><a href="/providers/mariah-koenen-pac" target="_self" title="Opens in same window.">Mariah Koenen</a> is a physician assistant in <a href="/locations/la-crosse/services-and-treatments/radiology-and-imaging" target="_self" title="Opens in same window">Interventional Radiology</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Benign breast disease</li> <li>Breast cancer survivorship</li> <li>Dense breast tissue and supplemental screening</li> <li>Elevated breast cancer risk and breast cancer-related genetic mutations</li> <li>High-risk breast lesions, including atypical hyperplasia and lobular carcinoma in situ</li> <li>Outpatient breast surgery</li> </ul>P.A.-C., P.A.<p>I care for patients with complex medical and surgical needs. I closely support the surgical breast practice. My practice philosophy focuses on providing high-quality medical care and meeting the needs of the patient.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Biochemistry, University of Wisconsin-La Crosse</li> <li>Master's degree, Physician Assistant Studies, Northern Arizona University</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Academy of Physician Assistants</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Surgery, Mayo Clinic College of Medicine and Science </li> </ul>Koenen<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/mariah-koenen-pa.jpg?h=280&iar=0&w=280&sc_lang=en&hash=231E7AB1D03357CD766A8518E754D539" alt="Mariah Koenen PA" width="280" height="280" DisableNVelocity="true" />Mariah<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15428257Mariah Koenen, P.A.-C.1<img src="/-/media/national-files/images/hometown-health/2022/hugging-for-comfort.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7C2D4B1E35BA34977B3503873026EB2B" alt="Hugging for comfort" width="660" height="370" DisableNVelocity="true" />CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.Dawn Haller4/11/2022Flaxseed is tiny, but it's health benefits are big: fiber, omega-3 fatty acid and antioxidant protection. Plus, it's easy to amp up everyday foods like oatmeal with flaxseed.Flaxseed: Tiny nutritional powerhouse<p><a rel="noopener noreferrer" href="https://www.mayoclinic.org/drugs-supplements-flaxseed-and-flaxseed-oil/art-20366457" target="_blank" title="Opens in a new window.">Flaxseed</a> may be small, but its health benefits are big. This tiny nutritional powerhouse contains numerous good-for-you components.</p> <h2>Key nutrients of flaxseed are:</h2> <ul> <li><strong>Alpha-linolenic acid, an omega-3 fatty acid</strong><br /> <a rel="noopener noreferrer" href="https://www.mayoclinic.org/drugs-supplements-fish-oil/art-20364810" target="_blank" title="Opens in a new window.">Omega-3 fatty acids</a> are good fats that may lower total cholesterol and low-density lipoprotein, or LDL or bad, cholesterol levels; reduce inflammation; and reduce the risk of certain cancers.</li> <li><strong>Fiber</strong> <br /> Fiber can relieve constipation, control cholesterol levels and keep you feeling full longer.</li> <li><strong>Lignans</strong><br /> Lignans provide antioxidant protection.</li> </ul> <p>For the most health benefit, flaxseed must be ground or crushed so the body can access the omega-3-containing oil. Flaxseed is available whole or ground as flaxseed meal. Whole seeds may be less expensive and can be ground using a coffee grinder or food processor. Store flaxseed meal in the refrigerator in an airtight, opaque container to prevent spoiling.</p> <h2>Adding flaxseed to your diet</h2> <p>While there's no specific recommendation for flaxseed, 1–2 tablespoons per day is considered a healthy amount. One tablespoon of ground flaxseed contains 37 calories and 2 grams of polyunsaturated fat, including the omega-3 fatty acids, 0.5 gram of monounsaturated fat and 2 grams of dietary fiber.</p> <h3>To include flaxseed in your diet:</h3> <ul> <li>Stir ground flaxseed into baked goods, such as muffins, cookies and quick breads.</li> <li>Add to hot or cold cereals.</li> <li>Sprinkle on top of yogurt or into smoothies.</li> <li>Mix into chili, sauces or gravies, or hide them in burritos and lasagna.</li> </ul> <h2>Flaxseed muffins</h2> <p>These flaxseed muffins give meals a delicious and nutritional boost.</p> <p>Servings: 12</p> <p>1 cup bran cereal<br /> 1 teaspoon vanilla<br /> ⅔ cup skim milk<br /> 2 teaspoon cinnamon<br /> 1¼ cups flour<br /> ¼ teaspoon salt<br /> ½ cup ground flaxseed<br /> ½ cup packed brown sugar<br /> ½ cup finely shredded carrot<br /> 2 eggs (substitute ½ cup egg whites)<br /> ¾ cup chopped apple<br /> 1 tablespoon canola oil<br /> 3 teaspoons baking powder</p> <p>Heat the oven to 375 F. Place a paper baking cup in each well of a pan for 12 regular-size muffins. Spray only the bottoms of baking cups with cooking spray. The muffins will stick if the baking cups aren't sprayed.</p> <p>Place the cereal in a resealable food storage plastic bag. Seal the bag and crush the cereal with a rolling pin, meat mallet or use a food processor.</p> <p>In a large bowl, combine crushed cereal and milk. Let the mixture stand about five minutes until the cereal is softened. Stir in the remaining ingredients. Divide the batter evenly among muffin cups.</p> <p>Bake 22–25 minutes or until the toothpick inserted in the center comes out clean. Immediately remove the muffins from the pan and place on a cooling rack. Serve warm. To store, wrap them tightly and keep in the freezer for two months.</p> <p>Nutrition information per serving: Calories, 200; total fat, 8 grams (saturated, 1 gram; monounsaturated, 2 grams; polyunsaturated, 5 grams); sodium, 280 milligrams; total carbohydrates, 28 grams; dietary fiber, 7 grams; sugar, 10 grams; protein, 6 grams.</p> <p><em><a href="/providers/allyn-wergin-rdn" target="_self" title="Opens in same window.">Allie Wergin</a> is a <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">dietitian</a> in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Bariatric surgery</li> <li>Diabetes management</li> <li>Oncology</li> <li>Weight management</li> </ul>RDN<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, St. Catherine University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration </li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul>Mahowald<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/allyn-wergin-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=74F690ED261F537AA65B66929A3356D1" alt="Allie Mahowald, RDN" width="280" height="280" DisableNVelocity="true" />{9209F8EC-1016-41AA-985F-014D9B877417}Allie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15971546Allyn Mahowald, RDN1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2022/oatmeal-with-berries-and-flaxseed.jpg?h=370&iar=0&w=660&sc_lang=en&hash=093C44D7E4290E9BCBE8D0DBAE0F5A64" alt="Oatmeal with berries and flaxseed" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller4/20/2022After sitting all winter, it's time to get your bike, skateboard, scooter and safety gear ready to roll as the weather warms. Follow these tips for a safe, fun and active outdoor season.Get ready to wheel into spring<p>As the snow melts and the days get warmer, are you ready to wheel into spring on your bike, skateboard or scooter?</p> <h2>Before you hit the streets, sidewalks and skate parks, here are some tips to keep in mind:</h2> <h3>Check your equipment.</h3> <p>After sitting all winter, your bike, scooter or skateboard may need to be cleaned up or tuned up. Check out your ride to make sure tires are inflated and wheels turn freely, and it's in generally good condition.</p> <h3>Wear a helmet ― and make sure it fits.</h3> <p>Whenever you're wheeling about, you should wear a helmet to protect your head. It should sit low and level on your forehead — not tipped back on your head.</p> <p>Adjust the straps so it fits snugly. Only one finger should fit between your chin and the straps. If the helmet moves when you move your head, tighten the straps. If it doesn't sit down on your head, it's time to get a new one.</p> <h3>Don't forget protective guards and pads.</h3> <p>If you take a tumble off a skateboard or scooter, your knees, elbows and wrists can take a beating. Strap on knee and elbow pads, and wrist guards, so you can enjoy a full season of fun.</p> <h3>Know the safety basics.</h3> <p>While your feet can get you around just fine, bikes, skateboards and scooters do it faster. They also require more skill.</p> <h4>These are the basics for staying safe:</h4> <ul> <li>Make sure you know how to turn, control your speed and stop.</li> <li>Use bike trails and lanes whenever possible.</li> <li>Follow the rules of the road. Learn about hand signals and how to use them. Obey all traffic signs, and ride with the traffic.</li> <li>Don't use your skateboard, bike or scooter on sidewalks.</li> <li>Watch for changes in trails or street conditions, such as water, potholes, cracks, rocks, sand or other debris. Avoid wet or oily surfaces. When in doubt, slow down.</li> <li>Follow skate park rules, and don't skate where it's not allowed.</li> <li>Remember, cars may not see you, so keep a sharp eye out for them.</li> <li>Stick to daylight hours — you're easier to see and so is the road or trail</li> <li>Never ride with more than one person on a skateboard.</li> <li>Don't text or use earbuds so you're always aware of your surroundings.</li> <li>Avoid "skitching" — holding onto the side or rear of a moving vehicle — while riding a skateboard. It's a bad accident waiting to happen.</li> </ul> <h3>Have fun.</h3> <p>Bikes, skateboards and scooters not only get you around, they also get you outside. They're good exercise, a way to learn new skills, have a good time and spend time with friends.</p> <p><em><a href="/providers/jason-wray-raabolle-md" target="_self" title="Opens in same window.">Jason Wray-Raabolle, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em></p><ul> <li>Family medicine</li> <li>Obstetrics and gynecology</li> </ul>M.D.<p><strong>Medical School<br /> </strong>University of Minnesota, Duluth</p> <p><strong>Residency<br /> </strong>Waukesha Memorial Hospital, affiliated with the Medical College of Wisconsin</p> <p><strong>Certification<br /> </strong>Board Certified, Family Practice </p>Wray-Raabolle<img src="/-/media/shared-files/images/medical-professionals/full/owatonna/jason-wrayraabolle-md.jpg?h=280&iar=0&w=280&hash=ADD0AB50D60111BF3522B6DE68DE150C" alt="Jason WrayRaabolle MD" width="280" height="280" DisableNVelocity="true" />{D42EB393-BB16-4B26-B0D6-3F51B7E2C978}Jason<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13904248Jason Wray Raabolle MD1<img src="/-/media/national-files/images/hometown-health/2022/mountain-biking-on-trail.jpg?h=370&iar=0&w=660&sc_lang=en&hash=48E37E3C9CA56603C48EC753A33D8414" alt="Mountain biking on trail" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller4/25/2022Cancer can change a person's body permanently, and side effects can linger for months or years. Discover some of the common physical side effects survivors experience and ways to manage symptoms.Lasting physical side effects of cancer<p>Cancer and cancer treatments can change how you look and feel about your body. Active treatment is a physically intense journey that can alter your body permanently. You may have scars, changes to your hair and skin, or even lose a body part. Your weight and strength can fluctuate substantially.</p> <p>Some physical side effects can continue for months or years after diagnosis and treatment. Some changes will be noticeable to other people, while others will not. The good news is that treatments and resources are available that can lessen the effects of some side effects. Healthy lifestyle habits can make a difference, as well.</p> <h2>Physical changes due to cancer</h2> <p>Enduring side effects are usually related to the types of cancer treatment you had. For many patients, treatment includes surgery, chemotherapy or radiation. These treatments can cause dramatic and rapid physical changes. Endocrine or hormone therapy also are common treatments, although side effects from those treatments may be more subtle or slower to emerge.</p> <h3>Despite the wide variability in treatments, survivors share some similarities in physical changes and challenges, such as:</h3> <ul> <li><strong>Fatigue</strong> <br /> Persistent fatigue is the most common side effect caused by cancer and cancer treatment. It's usually described as feeling tired, weak or exhausted, and may not improve even with rest. It can occur occasionally and last just a short time or could last several months after your treatment. Fatigue is a challenge to treat because there aren't many approved medications available and other factors often contribute, like pain, sleep disruptions or emotional stress.</li> <li><strong>Surgical site pain or scarring</strong> <br /> Depending on the type of surgery performed, you may struggle with discomfort, lymphedema (swelling) and nerve pain. Surgical scars take time to heal and may be prominent or noticeable immediately after treatment. Fortunately, surgical techniques have improved, which has lessened lasting side effects and pain from surgery.</li> <li><strong>Hormonal changes</strong> <br /> Physical changes can happen because some chemotherapy treatments may move premenopausal women into menopause abruptly. For cancers that are sensitive to hormones, endocrine or hormone therapy is used to reduce the risk that cancers will recur. Some women opt to undergo treatment to stop their ovaries from producing hormones as part of their endocrine therapy. These treatments change hormone levels in your body temporarily or permanently. Some side effects that could last beyond treatment include hot flashes, joint symptoms, sexual health changes, sleep changes, headaches, weight gain and memory changes.</li> <li><strong>Changes in activity levels</strong><br /> You may find your range of motion or mobility is restricted after surgery. Or you might stop exercising due to side effects from chemotherapy or radiation. Fatigue also can limit your ability to perform daily activities and move around. This may improve with time and physical therapy.</li> </ul> <p>Symptoms and side effects can be temporary or permanent. How long they last depend on many factors like types of treatments, symptoms during treatment, age, and type and stage of cancer.</p> <h2>Tips for physical recovery</h2> <h3>You can improve your strength and stamina during cancer treatment and recovery by taking these steps:</h3> <ul> <li><strong>Remain physically active.</strong> <br /> We encourage patients during and after treatment to remain as active as possible. It's the "use it or lose it" philosophy, so the more active you are during treatment, the less you need to do during recovery. Exercise may strengthen your immune system, provide more strength and endurance, and improve your mental health. Vigorous exercise isn't necessary. Most people feel significant physical and emotional benefits from regular 15-minute walks or short but intense bursts of activity. Talk with your healthcare team about the types of exercise that are safe for you.</li> <li><strong>Eat a heart-healthy diet.</strong> <br /> It's important to eat a well-balanced, heart-healthy diet for general health and to decrease the risk of cancer. A healthy diet focuses on lean meats, whole grains, fruits and vegetables, while limiting processed or sugary foods. Also, drink plenty of water to remain hydrated and try to limit your alcohol use.</li> <li><strong>Get enough sleep.</strong> <br /> Fatigue can worsen if you aren't getting quality sleep each night. Prioritize your sleep by establishing a regular sleep routine and making your bedroom a quiet sanctuary.</li> <li><strong>Manage stress levels.</strong><br /> Cancer, like all serious illnesses, produces lots of stress. Chronic stress can weaken your immune system and increase feelings of fatigue. Try relaxation and meditation techniques to manage stress. Ask for help from family and friends during and after treatment. Participate in a local support group and schedule social activities to interact with others.</li> </ul> <h2>Survivorship care plan</h2> <p>A person who has had cancer often is called a survivor. Cancer survivorship is a way of describing a person's journey through cancer, from diagnosis and active or maintenance treatments, to recovery and observation. Family members, friends and caregivers also are considered part of the survivorship experience, as cancer has wide-reaching effects on your support network, as well.</p> <p>A cancer survivorship care plan can be an important part of your cancer journey. The plan seeks to help you manage side effects and other practical concerns after cancer treatment. It is a road map of your cancer journey and what you might expect as you focus on healing. It also can outline available resources to aid in your recovery after treatment.</p> <p>Talk with your healthcare team about a cancer survivorship care plan. Remember that resources are available to help you cope as a cancer survivor. It is essential to keep in contact with your healthcare team about any symptoms you experience. Treatments often are available that can help.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/young-person-with-long-reddish-hair.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F4EE4D8457705157D726C85004B50853" alt="Close-up of young person with long reddish hair looking to their left" width="660" height="370" DisableNVelocity="true" />CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Dawn Haller4/6/2022Occasional day or nighttime leaks are common for children after potty training. For children with persistent bowel and bladder issues, physical therapy provides treatment options to help.Physical therapy benefits children with bowel, bladder issues<p>Most children learn to use the bathroom during the toddler years. Toilet training typically happens when children can tell you their diaper is wet, show interest in using the bathroom or have a dry diaper for longer periods of time. For most children, this happens around ages 3 or 4.</p> <p>As children grow, it's common to have occasional day or nighttime leaks, or constipation. But for some children, leaking from the bowel or bladder, or persistent <a href="/hometown-health/speaking-of-health/qa-constipation-in-children" target="_self" title="Opens in same window.">constipation</a>, can negatively affect daily activities and mental health.</p> <p>When children reach school age, having control of bowel and bladder function is an important part of social interactions. Teenagers experiencing nighttime accidents may avoid sleepovers or overnight activities away from home due to concern of having an accident while sleeping. Younger children may fear using the bathroom during school, which increases the likelihood of accidents. Some children withhold urine or stool, which can lead to serious medical concerns.</p> <h2>How does constipation affect children?</h2> <p>Children have a smaller abdomen and pelvis area than adults. As the rectum and colon fill with stool, it can press on or block the bladder from emptying completely during urination. It also can limit the amount of urine the bladder can hold. The stool may push on the bladder, causing it to squeeze and leak, which children will not be able to control or stop.</p> <p>Constipation often is multifactorial, and can be difficult for parents and caregivers to identify.</p> <h3>Children may be constipated, even if they have regular bowel movements, if any of these are true:</h3> <ul> <li>Stool stains or streaking are seen in the child's underwear when doing laundry.</li> <li>Child's abdomen appears distended.</li> <li>Child must strain to have a bowel movement.</li> <li>Child has <a href="/hometown-health/speaking-of-health/6-helpful-tips-for-managing-urinary-retention-and-incontinence" target="_self" title="Opens in same window.">frequent urination</a> or feels unable to empty the bladder.</li> <li>Child has regular abdominal pain that is relieved with a bowel movement.</li> <li>Resolving constipation may reduce or eliminate nighttime bladder leaking.</li> </ul> <h2>What treatment options are available for bowel and bladder issues in children?</h2> <p>Talk with your children's health care team if you have concerns about bowel and bladder function. A referral to physical therapy is a resource available to help with bowel and bladder issues in children.</p> <h3>Physical therapy may help your children with these issues:</h3> <ul> <li>Day and nighttime leaks from the bowel or bladder</li> <li>The need to frequently pass urine</li> <li>The sudden, unexpected need to have a bowel movement or pass urine</li> <li>Stress incontinence, and leaking urine when sneezing, coughing, laughing or playing</li> <li>A bowel that does not empty all the way</li> <li>Holding urine or stool and delaying using the bathroom</li> <li>Constipation</li> <li>Frequent urinary tract infections</li> <li>Urinary reflux</li> </ul> <p>A physical therapist can evaluate your child's breathing to ensure your child is using abdominal breathing rather than chest breathing. Using abdominal breathing allows the diaphragm to extend below the ribs causing the pelvic floor to descend. When the diaphragm raises, the pelvic floor is activated to go up and create pelvic contractions.</p> <p>Pelvic floor therapy includes Kegel exercises to create awareness for contracting and releasing the pelvic floor to enable the bladder to empty fully. Children who do not relax the pelvic floor can't empty the bladder when going to the bathroom. This leads to feeling the need to urinate frequently or causing an accident. Pediatric pelvic floor therapists are specifically trained to help teach children how to coordinate and strengthen these muscles.</p> <p>Other techniques include a special abdominal massage for children with constipation to increase stool motility, core strengthening exercises and biofeedback to help children coordinate contraction and relaxation of the pelvic floor.</p> <p>Throughout your child's care, you can expect a comprehensive team approach, including caregivers, the child, their primary care provider, physical therapist, and other specialists in urology and gastroenterology. Success in treatment requires a collaborative approach and is only as successful as the support and effort of the whole team.</p> <h2>What can I do if my child is embarrassed and does not want to talk about the issues?</h2> <p>Bowel and bladder issues in children are more common than people may realize. There is a hesitancy to discuss these issues with family and friends, particularly as children get older.</p> <p>Reassure your children they are experiencing a medical condition and help is available for bowel or bladder issues that affect daily activities or cause feelings of embarrassment in social situations. Your children's health care team can provide education and referral to physical therapy.</p> <h3>Bladder and bowel physical therapy can help your child learn about these things:</h3> <ul> <li>How the bowel and bladder work</li> <li>Healthy bathroom habits and toilet use</li> <li><a href="/hometown-health/speaking-of-health/healthy-weight-in-children-starts-with-healthy-habits" target="_self" title="Opens in same window.">Healthy eating</a> and drinking habits. Milk, chocolate, citrus, spicy foods and certain artificial flavoring can irritate the bladder</li> <li>How to manage constipation</li> <li>A personal exercise program</li> <li>Sensory training</li> <li>School and social considerations, such as taking a change of clothes to school</li> </ul> <h2>How can I help my children prepare for bowel and bladder therapy?</h2> <p>First, if your children are motivated to have the leaks stop, it may improve the results of the therapy. Support from parents at therapy sessions and at home is important to reinforce education and skills learned in therapy. Encourage your children to ask questions and become educated about the medical condition.</p> <p>Remind your children that the therapy care plan is individualized for their specific needs. Just like homework from school, practice the new skills or healthy bowel and bladder habits introduced during therapy at home.</p> <h2>When can I expect my children to stop having bowel or bladder leaks?</h2> <p>Every child is different. Depending on the bowel or bladder issue affecting your children and the length of time your children have had leaks, it may take several weeks to months to see improvements. Most children complete the program in six to eight months.</p> <p>Working on the physical therapy techniques at home, as well as at physical therapy sessions, can improve results. Discuss bathroom habits and tips with teachers and day care providers to reinforce proper use during time away from home.</p> <p>Don't wait until your child "grows out of it" to address bowel and bladder issues. Education, lifestyle and diet modification, and proven treatment techniques can resolve, or significantly decrease, occurrence of bowel and bladder issues affecting children.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/child-smiling-braided-ponytail.jpg?h=370&iar=0&w=660&sc_lang=en&hash=43EDABC15E965AD0262CF0A993776322" alt="Child with a braided ponytail smiling" width="660" height="370" DisableNVelocity="true" />Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Urinary IncontinenceThe loss of bladder control is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that's so sudden and strong you don't get to a toilet in time. For most people, simple lifestyle changes or medical treatment can ease discomfort or stop urinary incontinence.Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Dawn Haller4/27/2022Don't let joint pain sideline your exercise goals. Two sports medicine experts offer steps for starting and maintaining regular exercise despite those aching knees and shoulders.Staying active with joint pain<p>When you're active or upping your exercise goals, the last thing you want is to be sidelined with joint pain. Joint pain affects people at all stages of life from student athletes to seniors. Pain can be a big barrier to not only maintaining a regular exercise program, but also getting started. These strategies can help keep you active.</p> <h2>Assess where you're at</h2> <p>A good first step if you want to start a regular routine or up your exercise goals is to check with your primary care provider or see a sports medicine specialist who can assess your overall fitness level, general mobility and if you have current injuries or pain.</p> <p>They also may conduct a functional movement screening to evaluate how you move and pinpoint specific issues. For example, you may have decreased range of motion in a hip or shoulder, or are stronger on one side than the other. This screening can identify specific rehabilitative exercises that can be done along with your regular exercise program. These exercises help your body move safely, perform exercises correctly, and reduce the risk for injury or make symptoms worse.</p> <p>These findings will help build a program that's going to be safe and effective for you and let you exercise as pain-free as possible.</p> <h2>Build a successful exercise routine</h2> <p>Whatever your level of fitness, a good exercise routine should be sustainable. Regular exercise provides a host of health-related benefits, including reducing risk of cardiovascular disease, managing weight, maintaining strength and flexibility, and supporting bone health.</p> <h3>It also should encompass a combination of activities:</h3> <ul> <li>Cardio, which increases heart rate and improves your overall cardiovascular fitness. This includes vigorous walking, swimming, biking, playing pickleball, or taking a dance or water fitness class.</li> <li>Strength, which builds and strengthen muscles, improves overall function and improves performance in the gym, as well as activities of daily living. Strength activities include weight training, working with resistance bands, climbing stairs and exercises such as pushups, situps and squats.</li> <li>Flexibility, which stretches muscles and ligaments and promotes range of motion. Stretching, yoga, tai chi and Pilates all focus on flexibility.</li> </ul> <p>And finally, regular exercise doesn't mean just going to the gym, taking a class or following an online exercise program. It also means moving throughout the day, especially to break up periods of sitting. This unstructured exercise may be sweeping the floor, walking in place by your desk or doing some simple stretches when you first get up or before you go to bed.</p> <h4>Customize exercise to you</h4> <p>Sore muscles after exercising, especially if people are new to exercise and working on increasing their activity level, are normal. But sharp or ongoing pain may indicate an injury or chronic problem.</p> <h4>Some points to keep in mind are:</h4> <ul> <li>Ease your way into a new exercise program. Try not to go from 0 to 100 overnight, since that may increase your risk of injury.</li> <li>Listen to your body. Don't overdo it. Take a break or tone down your activity for the rest of the day.</li> <li>Keep a small problem small. If you're feeling recurring pain, get it checked out.</li> <li>Build in time to recover between activity sessions. Our bodies need this time to rebuild and repair.</li> </ul> <p>Another strategy is to work with a physical therapist, sports medicine specialist or trainer to determine the right and wrong way to do an exercise, or strengthen muscles to support a particular movement or joint. For example:</p> <ul> <li>If you suffer from low-back pain and are not able to perform a traditional barbell back squat exercise, you could do a modified version: either a split squat (one leg at a time) or rear-foot-elevated squat. These variations target the same muscle groups, but apply external resistance in the form of dumbbells or kettlebells at your side instead of on your back.</li> <li>If you have knee pain, using a reverse lunge or hex-bar squat helps reduces stress on your knees and allows you to target the same muscle groups.</li> <li>If you aren't able to perform pushups or variations of the bench press without pain in your upper body, switching to a neutral grip position can reduce stress on the shoulder. Make sure to align the arms in a 45-degree angle with your torso to reduce stress on the shoulder and minimize pain.</li> </ul> <p>Working with an exercise specialist can help you develop a plan that is specific to you and your abilities.</p> <p>When joint pain begins to restrict the activities you love, it's time to consult with an orthopedic specialist. Together, you'll map out a plan for treatment to keep you moving and enjoying life. Orthopedic providers have a wide variety of options in their treatment toolbox. These options range from least invasive, such as physical therapy or medications, to more invasive, including injections or surgery. Their goal is to get patients back to the lives they want to lead.</p> <h2>Break down barriers</h2> <h3>Joint pain is just one barrier to regular exercise. Others include:</h3> <ul> <li><strong>Time</strong><br /> To start and maintain regular exercise, people need to carve time out of their schedules. Recent research shows that even short 5- to 15-minute workouts throughout the day can provide health and fitness benefits. Finding these little pockets of time and a consistent workout can go a long way.</li> <li><strong>Knowing where to start</strong><br /> Doing an online search for workout programs can yield overwhelming results. Once again, sports medicine specialists can provide guidance toward a program that best fits your goals. The choice of workouts should be ones you enjoy and can stick with.</li> <li><strong>Motivation</strong><br /> Whether it's getting started or keeping going, lack of motivation can sink workout resolutions. One successful strategy is to review goals as a reminder of why you want to exercise, whether it's to keep up with the grandkids, feel better or lose weight.</li> <li><strong>Being realistic</strong><br /> Build a foundation by setting goals that can be accomplished in small segments, with each building on the next. For example, if you're just starting, a walk around the block might be a first step, not signing up for a 5K.</li> </ul> <p>The benefits of regular exercise are both physical and mental. Make sure you play the long game when it comes to your exercise program. Find a style of exercise that works for you long-term and that you can incorporate into your daily life.</p> <h4>For more information on creating an exercise routine, the importance of a strong core, issues for youth athletes and more, check out this video with these two sports medicine experts:</h4> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/FK8W_ynA_FU" title="Staying active with joint pain" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p><em><a href="/providers/jacob-erickson-do" target="_self" title="Opens in same window.">Jacob Erickson, D.O.</a>, and <a href="/providers/andrew-jagim-phd" target="_self" title="Opens in same window.">Andrew Jagim, Ph.D.</a>, are specialists in <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">Sports Medicine</a> in Onalaska, Wisconsin.</em></p><ul> <li>Minor trauma</li> <li>Musculoskeletal/sports ultrasound</li> <li>Office procedures</li> <li>Preventive medicine</li> <li>Sports/musculoskeletal medicine</li> </ul>D.O.<p><strong>Medical Degree</strong></p> <ul> <li>Kirksville College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo College of Medicine and Science</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Sports Medicine, University of Iowa</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Medical Association</li> <li>American Osteopathic Association</li> <li>American Society of Sports Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor, Family Medicine, Mayo Clinic Alix School of Medicine</li> </ul>Erickson<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/jacob-erickson-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=E94E476103713CA50775C5FD045B05EB" alt="Jacob Erickson DO" width="280" height="280" DisableNVelocity="true" />{C6B5FA43-E21E-423A-A349-342C8DCCBC31}Jacob<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15534570Sports Medicine - Jacob Erickson DO1{7746ADF8-715B-4593-8AAB-55D7F0467848}<ul> <li>Examining how different nutrition and exercise interventions influence health and performance — this interest applies to both the general population in regards to improve a person’s quality of life and prevent chronic disease in addition to improving the performance ability of elite athletes</li> </ul>Ph.D.<p><strong>Education</strong></p> <ul> <li>Master's degree, Human Performance, University of Wisconsin – La Crosse</li> <li>Ph.D., Kinesiology – Exercise Physiology Texas A&M University, College Station</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>International Society of Sports Nutrition</li> <li>National Strength and Conditioning Association</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Sports Medicine</li> <li>International Society of Sports Nutrition</li> <li>National Strength and Conditioning Association</li> </ul>Jagim<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/andrew-jagim-phd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=AA07F8D241D507CF3C0C9F28FC00E465" alt="Andrew Jagim PhD" width="280" height="280" DisableNVelocity="true" /><p>Dr. Jagim has authored or collaborated on numerous scholarly publications related to sports medicine. His topics have included:</p> <ul> <li>diets and nutrition</li> <li>workouts and training regimens</li> <li>sports injuries and treatment programs</li> <li>use and affects of drugs and supplements in sports</li> </ul> <p>His research has been published in numerous journals including International Journal of Exercise Science, Journal of Sports Science, Journal of Strength and Conditioning Research, Frontiers in Nutrition, International Society of Sports Nutrition, Journal of Neurosurgery and the Clinical Journal of Sports Medicine.</p>Andrew<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20772289Andrew Jagim, Ph.D.1{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2022/hands-holding-knee-joint-walking-path.jpg?h=370&iar=0&w=660&sc_lang=en&hash=43873FFA748A1B583F5A149F697128D3" alt="Hands holding knee joint while on gravel walking path" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller4/7/2022Wondering how your older children will react to a new baby? Check out these tips for preparing siblings to ensure a happy homecoming.Older sibs? Tips for new baby's happy homecoming<p>Bringing a newborn home is different the second time around. With your first baby, you're focused on how to care for this new family member. With the second, you're wondering how your older child will react to a new sibling.</p> <p>The time to prepare for a homecoming that's happy for your newborn and his or her big brother or sister, is while you're pregnant.</p> <h2>Here are some ideas to prepare your child for a new baby's homecoming:</h2> <ul> <li><strong>Talk with your child.</strong> <br /> Using age-appropriate words, explain how the baby is growing and when it will arrive. Also, let your child know the baby won't be a playmate for a while, and will eat, sleep and cry most of the time. Let your child know that when the baby comes, you'll be away for a little while, but someone will provide care until you get back.</li> <li><strong>Make any moves now.</strong> <br /> If you need to move your child to another room, set up the room sooner rather than later so your child has time to adjust. Involve your child in choosing colors and arranging his or her toys and clothes.</li> <li><strong>Time toilet training.</strong> <br /> If possible, potty train your child before the baby is born. If your child isn't ready yet, try beginning the process after your new baby has been home for a few months.</li> <li><strong>Let books and photos tell the story.</strong> <br /> Choose age-appropriate picture books about babies, families, brothers and sisters, and look through them with your child. Go through your child's baby book, family album or pictures on your phone showing them as a baby and your own brothers and sisters. Tell the story of your child's birth and homecoming.</li> <li><strong>Encourage involvement.</strong> <br /> Consider giving your child a baby doll he or she can care for, just like you will care for the baby. Bring your child along when you shop for baby supplies.</li> </ul> <h2>Once your baby arrives, smooth the homecoming by:</h2> <ul> <li>Having your child come to the hospital or birth center for a short visit. While there, let someone else hold the baby so both parents can cuddle your child.</li> <li>Giving your child a gift from the baby such as a T-shirt that reads "Big Brother" or "Big Sister."</li> <li>Taking your child on a special outing to a park or to get ice cream to celebrate the baby's birth.</li> <li>Asking your older child to help care for the baby, such as bringing you a diaper.</li> <li>Making sure your older child gets plenty of attention. When photos and videos are being taken, include him or her, as well as shoot some solo.</li> <li>Keeping a few small gifts on hand to give your older child if friends or family bring gifts for the baby.</li> </ul> <p>Just like you learned about your first baby, your child will need to learn about the newborn. Older children, stressed by all the changes happening around them, may take out frustrations on the baby.</p> <h2>Here are some tips for handling sibling frustration with the new baby:</h2> <ul> <li>If your child tries to harm the baby, it's time to talk about appropriate behavior.</li> <li>Give your older child extra attention.</li> <li>Involve your child in caring for the baby, such as while you're bathing or changing the newcomer. Have your child sing or read to the baby.</li> <li>Praise your child when he or she acts lovingly toward the baby.</li> <li>Supervise your child and the baby. Don't leave your newborn alone with a sibling or other loved one younger than age 12.</li> </ul> <p>If you're breastfeeding, your child may hover around to see what's going on. Explain what you're doing and answer any questions. If you breastfed your older child, say you did the same thing for him or her. Consider involving your child in the breastfeeding routine, such as getting you a pillow. Encourage him or her to cuddle with you while you nurse. Or keep your child entertained with toys, a workbook, music or audiobook.</p> <p>No one plans on their newborn having a health issue. Explain to your child that the baby is sick and you're worried. If you don't say something, your child will sense something is wrong.</p> <p>A new sibling will change your family in so many ways. As your older child adjusts, reassure him or her of your love. Explain that he or she has an important role to play now, too — that of big brother or big sister.</p> <p><em><a href="/providers/amy-down-do" target="_self" title="Opens in same window.">Amy Down, D.O.</a>, is a <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">pediatrician</a> in <a href="/locations/cannon-falls" target="_self" title="Opens in same window.">Cannon Falls</a> and <a href="/locations/red-wing" target="_self" title="Opens in same window.">Red Wing</a>, Minnesota.</em></p><ul> <li>Breastfeeding</li> <li>Newborn and infant care</li> </ul>D.O.<p><strong>Education</strong></p> <ul> <li>Kirksville College of Osteopathic Medicine</li> <li>Special Emphasis in Family Medicine, Mercy General Health Partners</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Pediatrics, Marshfield Clinic/St. Joseph Hospital</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Pediatrics, American Board of Pediatrics</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Academy of Pediatrics</li> </ul>Down<img src="/-/media/shared-files/images/medical-professionals/full/red-wing/amy-down-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=6AA405C0FC87168BA7FE2DC4DBD9990E" alt="Amy Down DO" width="280" height="280" DisableNVelocity="true" />{CFDAE692-E220-4313-9B23-69E1B45B3AC7}Amy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12962732Amy Down, D.O.1{61776FD2-05E8-47E9-AB55-EE465BD29A19}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}<img src="/-/media/national-files/images/hometown-health/2022/toddler-kissing-head-of-baby.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1B07AF786CBD9B54B1A72F81D8A99D44" alt="Toddler kissing head of baby" width="660" height="370" DisableNVelocity="true" />Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller5/11/2022Eating for two during pregnancy doesn't mean eating twice as much food for nine months. Instead, learn how to eat twice as well to support your baby’s growth and development.Eating twice as well during pregnancy<p>You may have heard the saying "eating for two" during pregnancy. But a healthy diet during pregnancy does not mean you eat twice as much. Think instead about eating twice as well to support your baby's growth and development.</p> <p>What you eat during pregnancy can affect pregnancy-related issues, such as nausea, morning sickness, heartburn and constipation. Developing healthy eating habits during pregnancy will make it easier to maintain nutritious eating after the baby arrives.</p> <h2>Carry good food principles through pregnancy</h2> <p>The basic principles of healthy eating recommended for everyone also apply to pregnant people. You don't need to eat more calories each day until the start of the second trimester. Through the remainder of the pregnancy, you need only about 300 more calories each day if you are already eating a well-balanced diet. The additional calories should come from nutritious foods.</p> <h3>Consider these principles of healthy eating:</h3> <ul> <li>Eat plenty of vegetables, fruits and whole grains.</li> <li>Choose lean protein and low-fat dairy products.</li> <li>Eat a variety of foods over three meals or divide them into five or six smaller meals.</li> <li>Snack on healthy food if you are hungry between meals.</li> <li>Limit or avoid foods that are high in <a href="/hometown-health/speaking-of-health/are-you-consuming-too-much-sugar" target="_self" title="Opens in same window.">added sugar</a> and salt.</li> </ul> <h2>Focus on nutrients</h2> <h3>Certain nutrients are important for good health, especially during your pregnancy:</h3> <ul> <li><strong>Protein</strong><br /> Protein is crucial for your baby's growth, especially during the second and third trimesters. <a href="/hometown-health/speaking-of-health/tips-for-eating-more-plant-proteins" target="_self" title="Opens in same window.">Sources of protein</a> include lean cuts of beef, pork, lamb and poultry; fish; eggs; dairy products; beans and peas; whole grains; nuts and nut butter; and peanuts and peanut butter.</li> <li><strong>Calcium and vitamin D</strong><br /> Calcium and vitamin D help with the baby's bone and teeth development. If you do not have enough calcium in your diet, the calcium your baby needs will be taken from your bones. Vitamin D is especially important because it helps your body absorb calcium. Sources of calcium and vitamin D include milk, yogurt, and foods and beverages that are fortified with calcium and vitamin D.</li> <li><strong>B vitamins, including folic acid and choline</strong><br /> B vitamins are needed for the baby's nerve function, growth and cell division. Choline also is an important nutrient for baby's brain development. Folate, or folic acid, helps prevent birth defects, such as neural tube defects, spina bifida and anencephaly during fetal development when taken before and during pregnancy. Sources of B vitamins include whole grains and enriched bread and cereal products; beef, pork, poultry; eggs; dairy products; dark green leafy vegetables; citrus fruits and most berries. Choline is found in eggs, dairy products and soy products.</li> <li><strong>Vitamin C</strong><br /> Vitamin C helps with your baby's bone, teeth and gum development. Sources of vitamin C include <a href="/hometown-health/speaking-of-health/boost-your-senses-with-citrus-fruits" target="_self" title="Opens in same window.">citrus fruits</a>, melons, tomatoes, berries, bell peppers and broccoli.</li> <li><strong>Iron</strong><br /> Iron is needed for the development of blood and muscle cells for you and your baby. Sources of iron include beef, pork and poultry; whole and enriched grains; fortified breakfast cereals; beans and lentils; and dark green leafy vegetables.</li> <li><strong>Fiber</strong><br /> Fiber is important for bowel function to have regular bowel movements and less constipation. Sources of fiber include whole grains, vegetables and fruits.</li> <li><strong>Prenatal vitamins</strong><br /> Many people find it difficult to eat and drink enough during pregnancy to supply them with adequate folic acid, iron and calcium, particularly if they have morning sickness. Vitamins can be used as a supplement. However, the best way to get the vitamins and minerals you need is from well-balanced meals.</li> </ul> <h2>Foods to limit or avoid</h2> <p>Limit or avoid high-calorie, low-nutrient snack foods, such as chips, cookies and candy. This also includes sugar-sweetened beverages, such as fruit juice, lemonade, sweetened tea, sports drinks and soda.</p> <p>It's best to limit caffeine to no more than 200 milligrams a day during pregnancy. This amounts to approximately one to two cups of regular coffee. <a href="/hometown-health/speaking-of-health/what-are-hidden-sources-of-caffeine" target="_self" title="Opens in same window.">Caffeine is not limited to coffee</a>. Tea, carbonated beverages and chocolate also contain caffeine.</p> <p><em><a href="/providers/gabriela-cardenas-palecek-md" target="_self" title="Opens in same window.">Gabriela Palecek, M.D.</a>, is an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> specialist in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><p>Infertility<br /> Women's health</p>M.D.<p>Spanish-speaking</p><p><strong>Medical School</strong> <br />Facultad de Medicine, Universidad, Mexico City, Mexico</p> <p><strong>Residency</strong> <br />OB/GYN, Universidad Nacional Autonoma de Mexico, Mexico City</p> <p><strong>Fellowship</strong> <br />Reproductive Endocrinology & Infertility, Universidad Nacional Autonoma de Mexico, Mexico City</p> <p><strong>Internship & Residency</strong> <br />OB/GYN, Mercy Hospital, Chicago, IL</p>Cardenas Palecek<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/gabriela-cardenas-palecek-md.jpg?h=200&iar=0&w=200&sc_lang=en&hash=221E2E24A7B9DEE0B3229A684E1EF148" alt="Gabriela Cardenas Palecek, M.D." width="200" height="200" DisableNVelocity="true" />{653B65E0-3D6C-43E6-8EAA-3B88F479F022}Gabriela<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15995674Gabriela Palecek, M.D.1{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}<img src="/-/media/national-files/images/hometown-health/2022/toast-with-peanut-butter-and-fruit.jpg?h=370&iar=0&w=660&sc_lang=en&hash=49CCE36A04DF2BC8EFA7E87E97C3A8BB" alt="Toast with peanut butter and fruit" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller5/12/2022People acquire things for multiple reasons, but how do you know if they're a collector or pack rat, or someone who has hoarding behaviors? Gather the warning signs and treatment options.How much stuff is too much stuff?<p>Everyone likes to acquire and hold on to things for a variety of reasons. This item is unique. It reminds me of an important event in my life. It's a great deal. I could have a use for it one day.</p> <p>Most people have a balance among what they obtain, hold on to and let go. However, for some, having too much can lead to significant problems in day-to-day living.</p> <p>Hoarding disorder affects about 3%–6% of the population.</p> <h2>Common characteristics of hoarding include:</h2> <ul> <li>Excessive acquisition of items with limited objective value or immediate use.</li> <li>Difficulties discarding, giving away or recycling accumulated items.</li> <li>Problems with organization, attentiveness, memory and decision-making.</li> <li>Excessive buildup of clutter in living spaces.</li> <li>Avoidance of managing the clutter.</li> </ul> <p>Hoarding disorder isn't the same as being a collector or pack rat. Collectors tend to focus on a specialized area of interest rather than a wide range of different things. They also may collect items that have recognized value. Pack rats may hold on to many sentimental items, but it may not result in problems with their living spaces.</p> <p>With hoarding disorder, living spaces can no longer be used for their intended purpose due to excessive clutter. For example, a person's kitchen counters and stove become so cluttered that meals cannot be prepared. A bathroom is so filled with miscellaneous office supplies that the toilet or shower cannot be used.</p> <p>The most hoarded items are information, including books, magazines, mail and scraps of paper; clothing; household items, including coffee mugs, towels and pens; and crafts. In more serious cases, some people excessively accumulate food or pets, which can result in unsanitary living conditions.</p> <p>People who hoard hold strong beliefs about their possessions, including their uniqueness, future use and not wanting to be wasteful. They also tend to have a strong degree of emotional attachment to their possessions, feel highly responsible for retaining their items, and can become increasingly territorial when there is any threat to discarding or losing their things.</p> <h2>Continued hoarding behavior increases the risk for other health and safety problems, including:</h2> <ul> <li>Narrow pathways between piles of newspapers, books and bags of clothing can be a significant fall risk, especially for the elderly and others with mobility problems.</li> <li>Attempts to conceal hoarding from others can result in isolation and feeling more disconnected from others, and increases the risk of depression.</li> <li>Financial struggles due to spending money on storage facilities for their possessions rather than covering important expenses, such as food and utilities.</li> </ul> <p>Hoarding behaviors can start during the teenage years. However, the problems with clutter in living spaces and other responsibilities in life gradually develop over time, so impairment usually starts to show up in middle-aged and older adults. Hoarding is equally common in men and women, and often is associated with other mental health problems, such as depression.</p> <h4>Researchers have found that hoarding may be related to:</h4> <ul> <li><strong>Family history</strong> <br /> Hoarding tendencies or the full disorder may tend to run in families. This may be due to shared genetics or by learning patterns of acquiring and retaining items.</li> <li><strong>Personality</strong> <br /> Indecisiveness and perfectionism are common traits among those who hoard.</li> <li><strong>Stressful life events</strong> <br /> Sustaining significant losses in life, such as the death of a family member or destruction of possessions in a fire or natural disaster, can increase the risk of developing hoarding disorder.</li> </ul> <h2>Treatment for hoarding disorder</h2> <p>Treatment can be challenging since the problem usually has been going on for several years in private. Plus, the prospect of decluttering can be distressing for some people due to the high degree of emotional attachment to their items, general avoidance tendencies, and strong beliefs about acquiring and retaining. Sometimes treatment is motivated by external factors, such as the threat of eviction, legal action or frustrated family members. Addressing personal motivators for treatment is essential for engagement.</p> <p>Cognitive behavioral therapy is the most evidence-based treatment approach for hoarding. It tends to be more intense and takes longer than other anxiety conditions, such as panic, post-traumatic stress or social-anxiety disorders. No medications are indicated for hoarding, although the use of antidepressants may help when a depressive disorder is present. In some cases, family therapy also may help.</p> <h4>Treatment focuses on:</h4> <ul> <li>Gradually changing patterns and learning new skills.</li> <li>Encouraging participation with others who are healthy and can offer practical assistance.</li> <li>Conducting home visits to apply skills to manage clutter.</li> <li>Providing follow-up to prevent relapse.</li> </ul> <h4>Among the skills that cognitive behavioral therapy teaches are:</h4> <ul> <li>Identifying and challenging beliefs about acquiring and retaining items.</li> <li>Resisting urges to accumulate more items.</li> <li>Organizing and making decisions over where to start in their home, including how to make the best use of storage space.</li> <li>Increasing tolerance for sorting through possessions, including making decisions over keeping, recycling or throwing them away.</li> <li>Preventing clutter from taking over cleaned areas of the home.</li> <li>Increasing involvement with more meaningful activities and social supports.</li> </ul> <p>Hoarding disorder is a treatable but challenging condition. Some communities, counties and social service agencies may have additional resources and specialists available.</p> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/sawchuk-craig-n-ph-d-l-p/bio-20085911" target="_blank" title="Opens in a new window."><em>Craig Sawchuk, Ph.D., L.P.</em></a><em>, is a clinical psychologist in Primary Care in Rochester and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/providers/craig-sawchuk-phdlp/" target="_blank" title="Opens in a new window.">Kasson's Division of Integrated Behavioral Health</a> at Mayo Clinic in Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2022/room-full-of-stuff.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8B8AEA636C6BACC3BE0D4BD095F4E898" alt="Room full of stuff" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller5/10/2022Steam therapy is a minimally invasive treatment for enlarged prostate. It's safe, effective and long-lasting, while preserving sexual function. Learn if it's right for you.Steam therapy to treat enlarged prostate<p>Sterile steam has multiple uses in health care. It can sterilize surgical instruments, clear blocked nasal passages and humidify hospital rooms to limit the spread of pathogens. It also can be used in a minimally invasive therapy to treat an enlarged prostate, also known as benign prostatic hyperplasia, also known as BPH.</p> <p>Benign prostatic hyperplasia is a common condition as men age. By age 60, about 30% of men show moderate to severe symptoms of benign prostatic hyperplasia that require treatment. By age 80, that number grows to 50%.</p> <h2>Benign prostatic hyperplasia can cause uncomfortable symptoms, including:</h2> <ul> <li>A slow or weak urine stream.</li> <li>A feeling of urine still in the bladder.</li> <li>Taking a long time to empty the bladder.</li> <li>Getting up multiple times at night to urinate.</li> </ul> <p>Of those with an enlarged prostate, about half have symptoms of benign prostatic hyperplasia.</p> <p>Steam therapy, also called water vapor thermal therapy, is a minimally invasive treatment option to reduce the size of the prostate and lessen symptoms. It has been shown to effectively eliminate excess prostate tissue and has a low risk of side effects. It is effective for treating small and average-size prostates.</p> <h2>What to expect with steam therapy</h2> <p>Steam therapy is performed under local anesthesia in the clinic. Most patients report mild discomfort during treatment but no pain. No incisions are needed.</p> <p>During the treatment, a physician inserts a small needle into the urethra and positions it within the prostate gland. In nine seconds, the needle produces a 2-centimeter-wide steam ball that shrinks surrounding prostate tissue. It does not carry heat outside the prostate or affect other surrounding tissues. The number of treatments increases with prostate size but can be completely treated during one visit.</p> <p>The needle is removed, and a temporary catheter is placed to drain urine from the bladder. This catheter is usually removed after three to five days.</p> <p>Most patients can return home the same day as steam therapy and resume regular activities within a few days. Initially, benign prostatic hyperplasia symptoms may worsen before they improve. This is because the treatment causes some swelling. Some patients start to experience fewer benign prostatic hyperplasia symptoms within two weeks, and most see improvements by six weeks.</p> <h2>Benefits of steam therapy</h2> <p>Steam therapy for benign prostatic hyperplasia has many benefits. It is a quick outpatient procedure with little downtime required. It's a good option for patients who are not interested or unable to take benign prostatic hyperplasia medications, and it produces long-lasting results and relief from benign prostatic hyperplasia symptoms. Finally, the treatment does not affect erectile function and rarely affects ejaculation.</p> <p>Talk with your health care team about any benign prostatic hyperplasia symptoms you are experiencing. Together, you will consider your symptoms, the size of your prostate, and your goals to determine if treatment is needed and the best option for you.</p> <p><em><a href="/providers/scott-pate-md" target="_self" title="Opens in same window.">Scott Pate, M.D.</a>, is a <a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">urologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/prairie-du-chien" target="_self" title="Opens in same window.">Prairie du Chien</a>, Wisconsin.</em></p><ul> <li>Minimally invasive, office-based procedures for benign prosthetic hyperplasia (BPH)</li> <li>Minimally invasive surgeries for urologic cancer (prostate, kidney, bladder, adrenal, testicular)</li> <li>MRI/ultrasound fusion biopsies for detection of prostate cancer</li> <li>Robotic surgery</li> </ul>M.D.<p>I deliver modern and evidence-based care to men, women and children with urologic concerns. I work to put myself in the patient’s shoes and empower patients to share in decision making by describing the condition in everyday terms and discussing options in depth. I strive to treat patients like family during this decision-making process.</p> <p>You will find me around the community with my family, exercising, biking and enjoying our wonderful outdoors.</p> <p><strong>Education</strong></p> <ul> <li>University of Iowa Carver College of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>University of Kansas Medical Center</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Urology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Urological Association</li> <li>Kansas Urological Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Urology, Mayo Clinic College of Medicine and Science</li> </ul>Pate<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/scott-pate-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=62A8D4B57A98B6C869440327EE4278B9" alt="Scott Pate MD" width="280" height="280" DisableNVelocity="true" />{AA62C0B7-2A25-411B-AEF6-CEEB87C4A150}Scott<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15927202Scott Pate, M.D.1{BFAFB863-D571-4781-ADD9-1398B77B549E}|{83EB2AA2-1436-4DDC-B7BB-51F8E6A87FC9}<img src="/-/media/national-files/images/hometown-health/2022/standing-in-sunny-field.jpg?h=370&iar=0&w=660&sc_lang=en&hash=67D4820C640C224D8D5B7957C0A94A29" alt="Standing in sunny field" width="660" height="370" DisableNVelocity="true" />Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Dawn Haller5/2/2022Regular exercise is important for teens, but it can be a challenge to get them moving. Here's how exercise helps teens, how much they need and tips to get them motivated.Teens and exercise: What parents need to know<p>Teens are busy. Their schedules are filled with school, work, extracurricular activities, homework and social time with friends. They may not have much available leisure time, and what leisure time they have often is spent on screens.</p> <p>On average, teens use screens about nine hours per day. This may have increased during the COVID-19 pandemic, leading to teens being increasingly sedentary.</p> <p>Regular exercise is important for teens, but it can be a challenge to get them moving.</p> <h2>Here's what parents need to know about teens and exercise:</h2> <h3>How does exercise help teens?</h3> <p>There are many benefits of regular exercise that aren't limited just to teens. It improves the physical and mental health of people of all ages and abilities. For teens, exercise builds endurance, bone and muscle strength, and aerobic fitness. It helps maintain a healthy weight and improves sleep. These factors are critical as teens grow and develop during their formative years.</p> <p>Exercise helps teens' mental health, as well. It releases stress-busting endorphins and lowers the body's production of stress hormones. It improves thinking and memory skills, which help in school and social situations. Exercise also reduces the risk of depression, and helps teens feel more energetic and have a positive outlook on life.</p> <p>One of the biggest benefits of regular exercise for teens is that it establishes a healthy habit that sets the foundation for a lifetime of fitness. Research shows that active children and teens become healthy, active adults.</p> <p>My patients motivated me to become more active. I was not a physically active teenager or adult. Watching my inactive patients struggle as they aged convinced me that I needed to do better. While I still don't love exercise, I now regularly run. It would've been so much easier if I had started 30 years ago. And I feel much better.</p> <h3>How much exercise do teens need?</h3> <p>The Department of Health and Human Services recommends that children and teens 6 and older get at least an hour a day of exercise five to six days per week.</p> <p>If your teen participates in a sport, they probably get enough exercise each day. But if they are in the offseason or don't usually participate in sports, you may need to help them find some exercise or activity to do each week.</p> <h3>What types of exercise do teens need?</h3> <h5>As part of their hour per day of exercise, the Department of Health and Human Services recommends that children and teens incorporate these types of activities at least three days per week:</h5> <ul> <li><strong>Aerobic</strong><br /> Examples include running, biking, swimming, dancing, aerobics class, using an elliptical trainer and walking.</li> <li><strong>Muscle-strengthening</strong><br /> Examples include lifting weights; using resistance bands; climbing stairs; dancing; biking; and doing pushups, squats and situps.</li> <li><strong>Bone-strengthening</strong><br /> Examples include jumping rope and running, as well as sports that involve jumping or rapid changes in direction.</li> </ul> <h3>How can I motivate my teen to exercise?</h3> <p>Motivating teens can be a challenge, but it's possible.</p> <h5>Here are some tips if your teen appears to be interested in sitting more and exercising less:</h5> <ul> <li><strong>Model healthy exercise behaviors.</strong> <br /> You are the role model for your teens. They are more likely to be physically active if you make it a family priority. Talk about how great you feel after exercise, plan active vacations, schedule evening walks as a family, or go to the gym or work out together at home.</li> <li><strong>Find the fun.</strong> <br /> Exercise doesn't need to be boring. Work together to find exercises that your teen finds fun and interesting. Try a new sport. Play music and have a dance party in the kitchen. Explore a nature trail or bike to a local park. Try a new exercise video online. Focusing on fun will make exercise something they look forward to instead of dread.</li> <li><strong>Incorporate movement into daily routine.</strong> <br /> Don't forget that every bit counts. Encourage your teen to take a walk with friends during lunch, use the stairs instead of elevator or park the car at the back of the lot. These are ways that you can model healthy habits, as well.</li> <li><strong>Make it social.</strong> <br /> Exercising with others keeps us motivated and inspired and teens are no exception. Encourage them to join a team with friends or schedule a regular pickup basketball game with the neighbors.</li> <li><strong>Cheer them on.</strong> <br /> Notice and compliment teens when they exercise. Everyone likes to hear they are doing a good job, even teens who roll their eyes. Applaud them for their results, and remind them that slow and steady progress is a good way to sustain healthy habits.</li> <li><strong>Tie exercise to other interests.</strong> <br /> Not every teen wants to join a sports team, but movement can be incorporated into other activities. If your teen enjoys photography, explore hiking trails or parks for opportunities. Teens who love to read may be interested in biking to multiple bookstores or animal-loving teens could volunteer as a dog walker at a local humane association.</li> </ul> <p>Remember to check with your teen's primary care provider about any concerns you have before your teen starts a new exercise program, especially if your teen has a chronic health condition, like epilepsy, diabetes or asthma.</p> <p><em><a href="/providers/kimberly-beecher-md" target="_self" title="Opens in same window.">Kimberly Beecher, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/mankato" target="_self" title="Opens in same window">Mankato</a>, Minnesota.</em></p><ul> <li>Children's health</li> <li>Women's health</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Rural Family Medicine, University of Minnesota, Waseca</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Medicine, American Board of Family Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>Minnesota Academy of Family Physicians</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Beecher<img src="/-/media/shared-files/images/medical-professionals/full/mankato/kimberlybeechermd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=F07207855B431B37A5BB156D208C3111" alt="Kimberly Beecher, M.D." width="280" height="280" title="Kimberly Beecher, M.D." DisableNVelocity="true" />{B713AB90-4522-4FC1-BBAB-1649682F881A}Kimberly<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14150999Kimberly Beecher, M.D.1{248CBBB9-E59F-4E83-9DF4-2692D1F58514}<img src="/-/media/national-files/images/hometown-health/2022/teen-tossing-soccer-ball.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BEDDD20FDCB75E6784CB4D4DEE44E102" alt="Teen tossing soccer ball" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller5/31/2022Medications aren't the only way to treat erectile dysfunction. Learn about medical, surgical and psychological treatment options that can lead to satisfying sexual experiences.More than just a pill: Treating erectile dysfunction<p>Some men believe that a small blue pill is the only treatment option for erectile dysfunction. The truth is that medications are not the only tool in the toolbox. Many options relieve symptoms and lead to more satisfying sexual experiences.</p> <p>The first step is to discuss your erectile dysfunction with your health care professional. Erectile dysfunction has many potential causes, so a complete physical examination and medical history can determine the appropriate treatment option for you.</p> <p>Regardless of the cause, erectile dysfunction often can be treated successfully.</p> <h2>Self-care and prevention</h2> <h4>Although most men experience erectile dysfunction from time to time, you can take steps to decrease the likelihood of occurrences by:</h4> <ul> <li><strong>Limiting or avoiding alcohol and drugs.</strong> <br /> Alcohol and drugs can decrease blood flow to the penis and interfere with messengers in the brain during arousal. Over time, alcohol consumption can reduce testosterone levels also.</li> <li><strong>Not smoking or using tobacco products.</strong> <br /> Smoking can cause plaque to build up in arteries throughout the body. This can cause poor blood supply to the penis.</li> <li><strong>Controlling your blood sugar level if you have diabetes.</strong> <br /> Elevated blood sugar levels cause nerve and blood vessel damage, which significantly affects the ability to achieve an erection.</li> <li><strong>Seeking help to cope with anxiety or depression.</strong><br /> Erectile dysfunction can result from depression, stress, anxiety or fatigue, so managing these conditions may reduce your erectile disfunction symptoms.</li> </ul> <h2>Medical treatments</h2> <p>Medical treatments are appropriate treatments for erectile dysfunction caused by a physical condition or medication. Usually, less invasive treatments are tried first.</p> <h4>Medical treatments include:</h4> <ul> <li><strong>Changing usual medication</strong><br /> Some medications can cause erectile dysfunction. A change in medication may help, although finding an alternate medication that works best may take time. Never stop taking a prescribed medication, or change the way you take it, without first talking with your health care professional.</li> <li><strong>Hormone therapy</strong><br /> For men who have testosterone deficiency, testosterone replacement therapy may be an option.</li> <li><strong>Oral medication</strong> <br /> Many men experience improvement in erectile function from phosphodiesterase inhibitors. These medications relax muscles in the penis and increase blood flow in response to sexual stimulation. These medications do not automatically produce an erection but allow an erection to occur as a reaction to physical and psychological stimulation. Examples include sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), and avanafil (Stendra). These medications can interact with other medications and are not recommended if you have certain medical conditions such as a stroke or recent heart attack.</li> <li><strong>Self-administered intraurethral therapy</strong><br /> Medication can be placed into the urethra and absorbed by the erectile bodies. The medication increases blood flow to the penis and produces an erection.</li> <li><strong>Self-injection therapy</strong><br /> Medication can be injected into the erectile bodies to increase blood flow to the penis and produce an erection. You use a fine needle to inject the medication into the base or side of your penis.</li> <li><strong>Vacuum therapy</strong><br /> This treatment uses an external vacuum device that encourages blood to flow into the penis, resulting in an erection. A tube is placed over the penis and a hand-held pump creates a vacuum in the tube. Once you achieve an adequate erection, you slip a rubber ring around the base of your penis to maintain the erection, and then remove the device.</li> </ul> <p>For all medical treatments, discuss the potential benefits and side effects with your health care professional. Do not combine medications or therapies on your own or deviate from prescribed doses.</p> <h2>Surgical treatments</h2> <p>Surgical treatments are appropriate when erectile dysfunction is caused by nerve or blood vessel damage due to pelvic or spinal cord injury, pelvic surgery or radiation in the pelvic area. It's also an option for men who have tried medical treatments without success.</p> <h4>Surgical treatments include:</h4> <ul> <li><strong>Arterial surgery</strong><br /> Arterial bypass surgery is an option if erectile dysfunction results from injured arteries that carry blood to the penis. These procedures are rarely performed, and long-term results are limited.</li> <li><strong>Penile implants</strong><br /> This treatment involves surgically placing a device, or prosthesis, inside the penis to produce an erection when you wish. Everything is concealed in the body. While this device will never replace a natural erection, it provides high patient satisfaction rates when natural erections are not possible.<br /> <br /> Several types of penile implants are available. The most common type is called a three-piece inflatable prosthesis. This has two inflatable cylinders that are placed inside the erectile bodies of the penis and are controlled by a simple pump inside the scrotum. In addition, there is a small fluid filled reservoir inside the abdomen to hold the fluid when not in use.<br /> <br /> The inflatable device allows a man to shift fluid from the reservoir into the penis on demand, making the penis firm for intercourse. When done, a release valve allows the fluid back into the reservoir. This type of device offers the most natural type of on-demand erection.<br /> <br /> A two-piece implant is like the three-piece device, only there is no reservoir in the abdomen. This can be an option for someone who has had multiple previous surgeries. Semirigid devices are available, as well. These devices don't have to be inflated or deflated, and some men may prefer them.</li> </ul> <p>As with any surgery, there is a small risk of complications like an infection. Talk with your health care professional and your surgeon about the risks and benefits of your surgery.</p> <h2>Psychological counseling</h2> <p>Counseling is an appropriate treatment for erectile dysfunction caused by psychological factors. You, or you and your partner, may meet with a psychologist, psychiatrist or other counselor trained to treat sexual problems.</p> <p>Short-term education therapy is often most helpful. In one technique, the couple focuses on physical sensation and pleasure rather than on performance. A goal is to remove self-evaluation and decrease performance anxiety. This technique often has good results, especially if both partners are understanding and cooperative.</p> <p>Work with your health care team to determine the best treatment option for you.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/grey-beard-and-knit-sweater.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8169D8C4D1856752270830C70BD05DC1" alt="Person with grey beard and grey knit sweater with a partner" width="660" height="370" DisableNVelocity="true" />Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Dawn Haller5/20/2022If nonsurgical treatments have failed to improve stress, strain and pain in your back, surgery may be the next option. Learn about the two categories of back surgery and when each is recommended.Decompress and stabilize: Understanding types of back surgery<p>Your back is a complex structure. It has 30 bones, 40 muscles, and many ligaments and tendons that work together to help you move and support your skeleton. Its intricate nature means that your back is susceptible to many types of injuries or degenerative diseases. This has led to about 80% of U.S. adults experiencing back pain at some point.</p> <p>In most cases, the first treatment option is not surgery. People are typically directed to nonsurgical treatments first. This could include physical therapy, steroid injections, medications, chiropractic care, massage, weight loss and rest. These treatment options relieve pain and work well for most people.</p> <p>However, there are situations where surgery is a good option, usually if nonsurgical treatments have failed to improve symptoms over time. Your health care team will discuss with you the options available based on your symptoms, medical history and goals.</p> <p>Overall, back surgery can relieve pain in two ways: by relieving pressure on nerves or stabilizing the structure. Some surgeries address one element, while other procedures incorporate both. The type of surgery, or combination of surgery, will depend on your symptoms and the cause of your pain or numbness.</p> <h2>Decompression surgery</h2> <p>This type of back surgery may benefit people with chronic pain, numbness or weakness that radiates down the arms or legs and is caused by nerve compression. These procedures create space in the spine to relieve pressure on the spinal cord or nerves. Most of the time, they are performed using minimally invasive techniques and last about 30 to 60 minutes. Many patients can go home the same day.</p> <h3>The two most common decompression procedures are:</h3> <ul> <li><strong>Laminectomy</strong><br /> This surgery creates space in the spine by removing a part of the vertebrae bone. It is performed to relieve pressure on the spinal canal that could be caused by bone spurs, arthritis, degenerative disk disease or spinal stenosis.</li> <li><strong>Diskectomy</strong> <br /> This surgery creates space in the spine by removing a damaged part of a disk. The disc is accessed after a laminectomy has been performed. A damaged disk is called a disk protrusion, or herniated, slipped, ruptured or bulging disk. Diskectomy can relieve pain and weakness associated with sciatica, as well.</li> </ul> <h2>Stabilization surgery</h2> <p>This type of surgery is performed to improve stability, correct a deformity or reduce pain. Stabilization surgery often is called a spinal fusion.</p> <p>A spinal fusion permanently connects two or more vertebrae in your spine, eliminating motion between them. Spinal fusion mimics the normal healing process of broken bones.</p> <p>During spinal fusion, your surgeon places bone or a bone-like material within the space between two spinal vertebrae. Metal plates, cages, screws and rods may be used to hold the vertebrae together so they can heal into one solid unit.</p> <p>Spinal fusion may be used to treat spondylolisthesis, degenerative disk disease, scoliosis, spinal fracture or spinal trauma. It may be performed to stabilize the spine after a decompression surgery, such as a laminectomy or diskectomy.</p> <p>The types of spinal fusion surgeries differ depending on vertebrae fused, type of hardware used and if the spine is accessed from the front or the back. For example, an anterior lumbar interbody fusion is a surgery that accesses the spine from the front and is performed between two vertebrae in the lumbar section of the spine.</p> <h2>Surgical complications</h2> <p>Back surgery is safe. In most cases, these surgeries are considered low-risk procedures. Catastrophic complications are extremely uncommon.</p> <p>The most common complication for decompression surgery is disc recurrence. This occurs when a new disc fragment herniates after surgery and causes new pressure on a nerve root. This occurs in 5% to 18% of patients.</p> <p>The most common complication for spinal fusion is adjacent segment disease. This is a condition where degeneration develops in the sections of the spine above and below the treated area. It occurs because spinal fusions immobilize parts of the spine and change the way the spine can move. This places additional stress and strain on the vertebrae above and below the fused portion. Adjacent segment disease occurs in 2% to 14% of patients.</p> <p>Ask your health care team if surgery would help relieve the pain, numbness or weakness you are experiencing.</p> <p><em><a href="/providers/tk-schiefer-md" target="_self" title="Opens in same window.">T.K. Schiefer, M.D.</a>, is a <a href="/services-and-treatments/neurosurgery" target="_self" title="Opens in same window.">neurosurgeon</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/menomonie" target="_self" title="Opens in same window.">Menomonie</a>, Wisconsin.</em></p><ul> <li>Herniated discs</li> <li>Spinal deformity</li> <li>Spinal stenosis, also known as narrowing of the spinal canal</li> <li>Spondylolisthesis, also known as slipped vertebrae</li> <li>Traumatic brain injuries</li> <li>Traumatic spine injuries, such as fractures and spinal cord injury</li> <li>Tumors, spinal and brain</li> </ul>M.D. <p>I view the doctor-patient relationship as a partnership. We will work together to find solutions to treat your condition and improve your quality of life. </p> <p>Since we are working together, it is very important we are on the same page and develop a plan as a team. To help facilitate this, first, I will ask you questions to get details about what is going on. Second, I usually perform a neurological examination pertinent to your problem. Third, we typically review your imaging studies together to better understand the problem. Finally, we have an open and honest discussion about possible solutions and treatments, both surgical and non-surgical. </p> <p>Sometimes non-surgical treatments may be the best option. I only offer and recommend a surgery if I feel it is in your best interest and something I would recommend to one of my own family members. I also try to avoid “doctor jargon” and explain things so they are straight forward and easy to understand. I look forward to partnering together in your neurosurgical care. </p> <p>I am a husband and father of four children. I am very active in my church community and enjoy serving others. I am an Eagle Scout and worked as scoutmaster for my sons' troop for many years. I enjoy traveling, backpacking, being outdoors, staying physically fit and personal finance/investing.</p> <p><strong>Education</strong></p> <ul> <li>Mayo Clinic Alix School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Preliminary Surgery, Mayo Clinic College of Medicine and Science</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Neurologic Surgery, Mayo Clinic College of Medicine and Science</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Neurological Surgery</li> <li>Certificate in Clinical and Translational Science, Mayo Graduate School</li> <li>Silver Level Certification, Mayo Clinic Quality Academy</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Neurological Surgeons</li> <li>Congress of Neurological Surgeons</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Neurosurgery, Mayo Clinic College of Medicine and Science</li> </ul> Schiefer<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/tk-schiefer-md.jpg?h=200&iar=0&w=200&sc_lang=en&hash=5328718020A2786933F34ECF5D6846CB" alt="T.K. Schiefer, M.D." width="200" height="200" DisableNVelocity="true" /> <ul> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/25545552/" target="_blank" title="Opens in new window">In-hospital neurologic deterioration following fractures of the ankylosed spine: a single-institution experience</a>, May 2015.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/24476904/" target="_blank" title="Opens in new window">Significance of cochlear dose in the radiosurgical treatment of vestibular schwannoma: controversies and unanswered questions</a>, May 2014.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/22084629/" target="_blank" title="Opens in new window">Moving forward: advances in the treatment of movement disorders with deep brain stimulation</a>, November 2011.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/19929340/" target="_blank" title="Opens in new window">Importance of the vasculature in cyst formation after spinal cord injury</a>, October 2009.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/18423548/" target="_blank" title="Opens in new window">Epidermoids of the cerebellopontine angle: a 20-year experience</a>, December 2008.</li> </ul> {000BB0CC-A7F9-4570-B165-7B3E176167E9}T.K.<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14270005T.K. Schiefer, M.D. 1{4EA2A40E-3721-48EC-AFC9-E6D0E13BCDEC}|{993AF103-0FE1-4CF2-9F2A-3D064CDA9F32}<img src="/-/media/national-files/images/hometown-health/2022/airpod-in-ear-salt-and-pepper-hair.jpg?h=370&iar=0&w=660&sc_lang=en&hash=58A62A06A8FF5649C0E0490362490C90" alt="Person with Airpod in ear, salt and pepper hair" width="660" height="370" DisableNVelocity="true" />Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.NeurosurgeryNeurosurgery treats disorders that impact any part of the nervous system, which may include the brain, spine or peripheral nerves. Conditions treated range from life-threatening brain tumors, to disorders impacting quality of life, such as back pain and carpel tunnel syndrome.Dawn Haller6/28/2022Urinary tract infections are painful and if left untreated can cause serious outcomes. Follow these tips to reduce your chances of getting a UTI.5 tips to prevent a urinary tract infection<p>A urinary tract infection, also called a UTI, is an infection that occurs in the urinary system. This could include the urethra, bladder, ureters and kidneys. Most infections involve the bladder and urethra, known as the lower urinary tract.</p> <p>The most common symptoms include painful urination, tenderness above the bladder area, urgency and frequency of urination. Cloudy and a strong odor are not signs of infection.</p> <p>Women are at greater risk for a UTI because the urethra is shorter than in men, so it's easier for bacteria to travel to the bladder. UTIs also are more common in postmenopausal women because low estrogen levels change vaginal and urethral tissue to increase the risk of infection.</p> <p>It's always better to prevent an infection rather than simply treat it. UTIs are no different.</p> <h2>Follow these tips to lower your risk of a UTI with little or no potential negative side effects:</h2> <h3>Drink plenty of fluids, especially water. </h3> <p>This helps keep bladder tissue hydrated and healthy. It also dilutes your urine and lowers the concentration of bacteria in the bladder. Some people can clear an infection on their own just by drinking fluids. Try drinking at least 50 ounces, or about 1.5 liters, of fluid daily to prevent infections.</p> <h3>Empty your bladder often. </h3> <p>Regularly emptying your bladder ensures urine is not sitting in your bladder for long periods of time. Since bacteria like warm and wet environments to grow, this takes away good living conditions for the bacteria. It's normal to empty your bladder four to eight times per day.</p> <h3>Urinate soon after sex. </h3> <p>The act of intercourse can cause bacteria to get close to or into the urethra, the small tube that empties your bladder. Voiding after intercourse removes some of the bacteria before it can cause an infection.</p> <h3>Take cranberry supplements. </h3> <p>While cranberry supplements have not been shown in studies to prevent urinary tract infections, there is a reasonable biologic mechanism that using them could be helpful. If you would like to try this option, consider a concentrated over-the-counter cranberry supplement instead of cranberry juice. It likely provides more benefit and reduces extra sugar typically found in juice.</p> <h4>There are many myths about urinary tract infections. In this video, nurse practitioner Breanna Weisbrod clears up any confusion about cranberry juice and birth control:</h4> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/lHNzGFE8HTU" title="Ask Mayo Clinic Health System - UTIs: Fact or Fiction?" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <h3>Wipe front to back. </h3> <p>Doing so after urinating and after a bowel movement helps prevent bacteria in the anal region from spreading to the vagina and urethra.</p> <p>If you have two or more infections in six months, consider talking with your health care team about recurrent UTIs. Your health care team will review your medical history and medications, and complete a thorough physical exam.</p> <h2>Risk factors for recurrent UTIs include:</h2> <ul> <li>Frequent sexual intercourse, which increases the likelihood of bacteria entering the urethra and bladder.</li> <li>Using spermicide with or without a diaphragm, as this can harm protective bacteria in the urinary tract that defend against infection.</li> <li>Urinary retention or incomplete bladder emptying caused by medications; narrowing of the urethra; prolapse of the bladder, uterus or vagina; neurological conditions; or sometimes unknown reasons.</li> <li>Vaginal atrophy, which is a postmenopausal condition caused by decreased estrogen levels.</li> <li>Genetics, especially the inherited genes that regulate the body's immune response to infections.</li> </ul> <p>It's common for some people to have bacteria in their urine but not experience any symptoms. In these cases, no treatment is necessary.</p> <p>Talk with your health care team if you think you have a UTI. You may need an appointment to discuss your symptoms and collect a urine sample.</p> <p>You should seek medical attention if you develop a fever, chills, disorientation, or back or side pain. These could be signs of a kidney infection, which requires treatment, or a systemic infection of the bloodstream that requires hospitalization.</p> <p><em><a href="/providers/sarah-suarez-pac">Sarah Suarez</a> is a physician assistant in <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/prairie-du-chien" target="_self" title="Opens in same window.">Prairie du Chien</a>, Wisconsin.</em></p><ul> <li>Pain with intercourse</li> <li>Pelvic organ prolapse</li> <li>Pelvic pain</li> <li>Pessary care</li> <li>Urinary incontinence</li> </ul>P.A.-C.<p><strong>Education</strong></p> <ul> <li>Master's degree, Physician Assistant Studies, University of Wisconsin-La Crosse</li> </ul> <p><strong>Certification</strong></p> <ul> <li>National Commission on Certification of Physician Assistants</li> </ul>Suarez<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/sarah-suarez-pac.jpg?h=280&iar=0&w=280&sc_lang=en&hash=9CE08A5067CEAD93997FF0CE890FF532" alt="Sarah Suarez, P.A.-C." width="280" height="280" title="Sarah Suarez, P.A.-C." DisableNVelocity="true" />Sarah<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12080993Sarah Suarez PAC1<img src="/-/media/national-files/images/hometown-health/2022/drinking-from-water-bottle.jpg?h=370&iar=0&w=660&sc_lang=en&hash=727280CF3F62D0C22B0EA86D91A67770" alt="Drinking from water bottle" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller6/2/2022Misconceptions about erectile dysfunction may cause some men to skip treatment. We'll debunk myths about this common condition that affects half of men ages 40–70.8 common erectile dysfunction myths<p>Get a group of men together, and the conversation is likely to weave around many topics. Weather, politics, sports, hobbies, work or travel all are likely. But it's unlikely that erectile dysfunction will be freely discussed. That's because most men don't like to talk about it. It may create feelings of embarrassment, shame, guilt and inadequacy.</p> <p>Erectile dysfunction, formerly called impotence, is a term that refers to the continued inability to obtain an acceptable erection for satisfactory sexual activity. More than 150 million men worldwide experience some form of erectile dysfunction.</p> <p>Misconceptions or misunderstandings about erectile dysfunction may cause some men to forgo treatment.</p> <h2>Let's debunk some common myths to help men start talking about this condition:</h2> <h4>Myth: Erectile dysfunction only affects men over age 70.</h4> <p><strong>Fact:</strong> Erectile dysfunction is more common in older men, but it can occur at any age. It affects about half of men ages 40–70.</p> <p>Some erectile function changes with age. Erections may take longer to develop, may not be as rigid or may require more direct stimulation to be achieved. Men may notice that orgasms are less intense, the volume of ejaculate is reduced and recovery time increases between erections. While these changes are expected, the persistent inability to obtain a satisfactory erection is not a normal part of aging.</p> <h4>Myth: Erectile dysfunction is annoying but not dangerous.</h4> <p><strong>Fact:</strong> Erectile dysfunction can be a wake-up call that you're at greater risk for some life-threatening conditions. This includes heart disease, Type 2 diabetes and stroke.</p> <p>The same factors that contribute to heart disease and stroke can cause erectile dysfunction. A man in the early stages of heart disease could develop erectile dysfunction long before he experiences heart symptoms. This is because the arteries supplying the penis are smaller than the heart. If you develop erectile dysfunction, it's recommended that you be screened for heart disease, diabetes, hardening of the arteries and elevated blood pressure.</p> <h4>Myth: Erectile dysfunction is all in your mind.</h4> <p><strong>Fact:</strong> In the past, psychological factors alone were thought to cause erectile dysfunction. Now medical specialists know that physical conditions can cause or contribute to erection problems.</p> <p>Many diseases can cause an inability to achieve or maintain an erection. This includes diabetes; nerve damage; heart disease; and chronic disease of the lungs, liver or kidneys. Also, many medications can interfere with nerve impulses or blood flow to the penis. Some antidepressants, antihistamines and sleeping aids, and certain drugs to treat high blood pressure; pain; prostate cancer; and stomach, bowel or bladder conditions, are known to contribute to erectile dysfunction.</p> <p>Sometimes erectile dysfunction can result from depression, stress, anxiety or fatigue. Personal relationship problems may cause difficulty achieving an erection, as well.</p> <h4>Myth: Erectile dysfunction means there is something wrong with the penis.</h4> <p><strong>Fact:</strong> To produce an erection, a man needs a healthy brain and penis, healthy blood vessels and nerves, and adequate amounts of the male hormone testosterone. If any aspect of this system is affected, erectile dysfunction can result.</p> <p>While a problem with the penis' erectile bodies or blood flow could cause erectile dysfunction, there are many other potential causes, as well. A complete physical examination and medical history with a health care professional can help determine the cause of your erectile dysfunction and appropriate treatment options.</p> <h4>Myth: If you struggle in the bedroom once, you have erectile dysfunction.</h4> <p><strong>Fact:</strong> It's normal to have difficulty maintaining an erection occasionally. It happens to most men and is perfectly normal. Talk with your primary care provider if it becomes a persistent problem and interferes with your self-image or sex life.</p> <h4>Myth: Erectile dysfunction means you're not attracted to your partner.</h4> <p><strong>Fact: </strong>There many possible causes of erectile dysfunction. Personal relationship problems may cause difficulty achieving an erection. However, it's likely caused by a different reason. If you enjoy your partner's company, it's likely that stress, anxiety, fatigue, specific medications or other health conditions are causing your erectile dysfunction.</p> <h4>Myth: Taking testosterone supplements will cure erectile dysfunction.</h4> <p>Fact: Hormonal changes, like low levels of testosterone, can cause erectile dysfunction, but this is not the only cause. Talk with your health care team before beginning testosterone supplements.</p> <h4>Myth: Medications are the only way to treat erectile dysfunction.</h4> <p><strong>Fact:</strong> Many options are available to treat erectile dysfunction. Medications work for some men, but others benefit from simple mechanical devices, surgery or counseling. Learn more about <a href="/hometown-health/speaking-of-health/treating-erectile-dysfunction" target="_self" title="Opens in same window.">erectile dysfunction treatment options</a>.</p> <p>Erectile dysfunction can become a source of stress for a man and his partner. If you experience erectile dysfunction occasionally, try not to assume that you have a permanent problem or expect it to happen again.</p> <p>If you have more frequent difficulties, talk with your primary care provider. Working together, you and your health care team can determine the cause of your symptoms and explore treatment options for a satisfying sexual life.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/couple-smiling-near-waterfront.jpg?h=370&iar=0&w=660&sc_lang=en&hash=13C10E2E7CB0585698A9219B37D72DA9" alt="Couple smiling near waterfront" width="660" height="370" DisableNVelocity="true" />Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Dawn Haller6/8/2022Surgery isn't always needed for back pain. But when it is, it's important to get all your questions answered. Ask your spine surgeon these questions when facing the prospect of back surgery.9 questions to ask your spine surgeon<p>The time has come. You need surgery on your spine. You may feel scared, nervous or excited. It's likely that you have many questions as you weigh your options and make decisions.</p> <p>Talk with your health care team about how you are feeling before you commit to spine surgery. They are available to answer all your questions and provide reassurance.</p> <h2>Here are answers to nine common questions that you may have about spine surgery:</h2> <h3>1. Am I a candidate for surgery?</h3> <p>Not everyone with back, neck, leg or arm pain is a good candidate for surgery. Some back pain is caused by issues that aren't relieved with surgery. In these cases, your surgeon will recommend nonsurgical treatments like activity modification, nonprescription pain medication, physical therapy, rest and time.</p> <p>Other patients may have a surgical problem, but surgery may not be safe for them because they have other uncontrolled chronic health conditions that make surgery risky. Your surgeon may want you to exhaust all nonsurgical measures prior to proceeding with surgery. This could include physical therapy, medications or injections.</p> <p>Your surgeon will outline the benefits, alternatives and risks of surgery. The potential benefits of surgery need to outweigh any personal risks before proceeding.</p> <h3>2. What can I do to improve the likelihood of surgical success?</h3> <p>There are three factors in your control that can improve the chance that you will have a successful surgery.</p> <h4>Many surgeons will not operate on your spine until you safely and successfully modify these factors:</h4> <ul> <li><strong>Get to a healthy body weight.</strong> <br /> Maintaining a healthy weight helps with overall health and wellness, in addition to leading to better surgical outcomes. If you are overweight, your surgeon may direct you to lose weight before the procedure can take place. Obesity can lead to adverse surgical outcomes and complications, some of which can be serious, like blood clots. <br /> It may be difficult to exercise for weight loss if you are suffering from back or leg pain. In this case, your surgeon may recommend that you meet with a nutritionist to create a diet plan and focus on low-impact exercise like swimming.</li> <li><strong>Manage diabetes.</strong> <br /> Any surgery is riskier if you have diabetes. You have a higher risk of cardiovascular complication, infection and issues with wound healing. Ideally, your A1C level should be 7.5 or less before your surgery. Your primary care provider or diabetes educator can help manage your diabetes so surgery is safer.</li> <li><strong>Stop smoking.</strong> <br /> Using tobacco or nicotine products can lead to surgical complications like problems with wounds healing and blood clots. It also changes the way that bones heal or fuse together, which can lead to improper healing and symptom relief. In some severe cases, surgery is pursued despite these risk factors. This could include spinal cord compression, severe symptoms or neurologic impairment. In these circumstances, the risks of doing nothing are higher than the potential surgical risks.</li> </ul> <h3>3. How many of these surgeries have you performed?</h3> <p>Experience and expertise are important when selecting a surgeon. Surgeons may not be able to provide an exact answer over the course of entire careers, but they usually can explain how many similar surgeries they preformed over the last week or month.</p> <p>When considering your options, look for a surgeon who specializes in your condition and routinely performs the procedure. For example, about 90% of my practice is surgeries to correct degenerative spine conditions, and I perform surgeries to address these conditions weekly.</p> <h3>4. Will my surgeon be offended if I seek a second opinion?</h3> <p>No. Never feel badly about seeking a second opinion for any aspect of your health care. It's your body, and a decision to have surgery should not be made lightly.</p> <p>I encourage patients to ask questions, advocate for their health and seek second opinions if that would help them feel more comfortable. Getting a second, or third, opinion can confirm the best course of action as you weigh your decisions. Also, it is helpful to bring a friend or family member to appointments to have another pair of ears to listen and another person to think of questions to ask.</p> <h3>5. What are the goals of my surgery?</h3> <p>An open conversation with your surgeon about what surgery can do and cannot do is critical as you consider surgery. In some cases, the goal of surgery is to prevent additional neurological damage. Other times, it may be to relieve leg pain, but it may not address back pain. This conversation can lower your anxiety about the procedure, establish realistic expectations and help define surgical success.</p> <h3>6. What can I do to shorten my hospital stay after surgery?</h3> <p>The best way to shorten your hospital stay and speed recovery is to thoroughly follow your preoperative and postoperative instructions. This includes losing weight if directed, stopping smoking and taking steps to manage any other chronic health condition.</p> <p>Your care team will encourage you to start moving shortly after surgery. Years ago, recovery after back surgery included days of bed rest. Now we know this caused slower recovery and more complications. It's important that you are up and walking soon to speed your recovery and shorten your hospital stay.</p> <p>As you recover, remember that you are not only recovering from surgery, but also from a lack of mobility. Often, people have had months or even years of compensating for back or leg pain and moving their bodies in unnatural ways to lessen pain. During your recovery, you will need to build back strength and stamina lost during that time.</p> <h3>7. Will I still have pain after surgery?</h3> <p>You will have surgical pain after your procedure. Members of our care team will do their best to manage your pain. Everyone experiences pain differently. Most patients report that surgical pain is significantly less than the nerve pain they were experiencing before surgery.</p> <h3>8. Will I need another back surgery in the future?</h3> <p>It is possible, depending on the reason for your first surgery. Some people have long-lasting pain relief after surgery and don't require additional interventions. However, degenerative disease and arthritis are ongoing processes that cannot be stopped. These conditions could return and require future procedures.</p> <h3>9. How much help will I need after surgery?</h3> <p>Prior to surgery, your health care team will assess your at-home needs. Physical therapists, occupational therapists and social workers will make recommendations to help you have a successful discharge and safe recovery from your surgery.</p> <h2>Learn more about caring for your back:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/preparing-for-surgery-what-you-need-to-know" target="_self" title="Opens in same window.">Preparing for surgery? What you need to know</a></li> <li><a href="/hometown-health/speaking-of-health/understanding-types-of-back-surgery" target="_self" title="Opens in same window.">Decompress and stabilize: Understanding types of back surgery</a></li> <li><a href="/hometown-health/speaking-of-health/what-is-spinal-fusion-and-does-it-work" target="_self" title="Opens in same window.">What is a spinal fusion, and does it work?</a></li> <li><a href="/hometown-health/speaking-of-health/q-and-a-surgery-for-low-back-pain" target="_self" title="Opens in same window.">Q&A: Surgery for low back pain</a></li> </ul> <p><a href="/providers/meghan-murphy-md" target="_self" title="Opens in same window."><em>Meghan E. Murphy, M.D.</em></a><em>, is a neurosurgeon in<a href="/locations/mankato" target="_self" title="Opens in same window."> </a><a href="/services-and-treatments/spine-care" target="_self" title="Opens in same window.">Spine Care</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Degenerative diseases of the spine (stenosis, spondylolisthesis, scoliosis, radiculopathy)</li> <li>Education of medical students and advanced practice providers (physician assistants and nurse practitioners)</li> <li>Mentorship of women pursuing the medical field and surgical specialties</li> <li>Metastatic disease of the brain and spine</li> <li>Spinal tumors</li> <li>Traumatic brain and spine injuries</li> </ul>M.D.<p>Medicine is my vocation. I feel that I have been called to serve others by helping address spinal and brain pathology that is impacting quality of life and potentially quantity of life. It is a joy to play a role in empowering my patients to achieve the quality of life they desire. </p> <p>You can expect my full attention and dedication to your symptoms and concerns at the time of our consultation. I will be honest in discussion of what I can or cannot offer you. If I am unable to recommend surgery that will benefit you — with benefits outweighing the risks — I will help ascertain the best next step and connect you with those resources. </p> <p>I grew up in Colorado and completed my education and subsequent training at Notre Dame, Georgetown, and Mayo Clinic.</p> <p> Family and faith are important to me. I have a wonderful husband with whom I have two young boys — being a boy mom definitely suits me. I also have a goofy golden retriever, and we all love to be outside and active. </p><p><strong>Education</strong></p> <ul> <li>Georgetown University School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Neurologic Surgery, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Neurologic Surgery, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Neurosurgery Spine Enfolded, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Neurological Surgery, American Board of Neurological Surgery</li> </ul> <p><strong>Membership</strong></p> <ul> <li>Alpha Omega Alpha Medical Honor Society</li> <li>Congress of Neurological Surgeons</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Neurosurgery, Mayo Clinic College of Medicine and Science</li> </ul>Murphy<img src="/-/media/shared-files/images/medical-professionals/full/mankato/meghan-murphy-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=488A8D1221A32E0ADEE87A1875CC8219" alt="Meghan Murphy MD" width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=28486638" target="_blank" title="Opens in new window.">Predictors of Discharge to a Nonhome Facility in Patients Undergoing Lumbar Decompression Without Fusion for Degenerative Spine Disease</a>, October 2017.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=27858534" target="_blank" title="Opens in new window.">Lumbar decompression in the elderly: increased age as a risk factor for complications and nonhome discharge</a>, March 2017.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=27908218" target="_blank" title="Opens in new window.">Risk factors for dural tears: a study of elective spine surgery</a>, February 2017.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=27866034" target="_blank" title="Opens in new window.">Micro vs. macrodiscectomy: Does use of the microscope reduce complication rates?</a>, January 2017.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=26838173" target="_blank" title="Opens in new window.">Unique cause of right hemispheric syndrome: Embolism of myocardium after open septal myectomy</a>, April 2016.</li> </ul>{65C398B7-CDF4-4A31-BA46-251A97B286EA}Meghan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15411991Meghan Murphy, M.D.1{4EA2A40E-3721-48EC-AFC9-E6D0E13BCDEC}<img src="/-/media/national-files/images/hometown-health/2022/crouching-while-flower-gardening.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E69E0F8D83592CFA58714AB40945D4A2" alt="Crouching while flower gardening" width="660" height="370" DisableNVelocity="true" />NeurosurgeryNeurosurgery treats disorders that impact any part of the nervous system, which may include the brain, spine or peripheral nerves. Conditions treated range from life-threatening brain tumors, to disorders impacting quality of life, such as back pain and carpel tunnel syndrome.Dawn Haller6/20/2022Heart disease is the leading cause of death for African American women. Learn more about the wide range of contributing factors and first steps toward a healthier heart.African American women need to take their hearts to heart<p>Heart disease is the No. 1 cause of death in women in the U.S. African American women have an even higher risk of dying from heart disease ― and at a younger age ― than white women, according to the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.nhlbi.nih.gov/" target="_blank" title="Opens in a new window.">National Heart, Lung and Blood Institute</a>. Each year, more African American women die from heart disease than breast cancer, lung cancer and strokes — combined.</p> <p>This serious issue is compounded by the fact that less than half of African American women are aware of their risk.</p> <h2>Factors that increase their risk of developing heart disease include:</h2> <ul> <li>Having the highest rates of <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410" target="_blank" title="Opens in a new window.">high blood pressure</a>, or hypertension, among non-Hispanic Black women.</li> <li>Having the highest rates of <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/obesity/symptoms-causes/syc-20375742" target="_blank" title="Opens in a new window.">obesity</a> among non-Hispanic Black and Hispanic women.</li> <li>Being the least physically active group of women in the U.S. </li> <li>Experiencing early onset of menstruation at less than 11 years of age.</li> <li>Experiencing premature menopause at less than 40 years of age.</li> <li>Developing <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439" target="_blank" title="Opens in a new window.">polycystic ovary syndrome</a>. </li> <li>Developing <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy/art-20046098" target="_blank" title="Opens in a new window.">disorders related to high blood pressure</a> during pregnancy.</li> <li>Developing <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339" target="_blank" title="Opens in a new window.">gestational diabetes</a>.</li> <li>Being prone to preterm delivery and having low- or high-birth weight babies. </li> <li>Using oral contraceptives and hormone replacement.</li> </ul> <p>Being aware of and addressing these risk factors is important in preventing heart disease.</p> <h2>Another step toward making a healthy heart a priority is to follow the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.heart.org/en/healthy-living/healthy-lifestyle/lifes-essential-8" style="margin-left:0; font-size:22px;font-family:'HelveticaNeueW02-65Medi', arial, 'sans-serif';" target="_blank" title="Opens in a new window.">American Heart Association's "Life's Essential 8"</a> lifestyle changes:</h2> <ol> <li>Manage blood pressure.</li> <li>Control cholesterol.</li> <li>Reduce blood sugar.</li> <li>Get active.</li> <li>Eat better.</li> <li>Lose weight.</li> <li>Quit tobacco.</li> <li>Get healthy sleep</li> </ol> <p>Campaigns, such as <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.goredforwomen.org/en/" target="_blank" title="Opens in a new window.">Go Red for Women</a>, also help raise awareness about heart disease in women, risks and how-tos for healthy living.</p> <p>If you have concerns about your heart health or would like to start your healthy-heart journey, consult your health care professional.</p> <h2>For more information about heart health and African American women, watch this video created by Mayo Clinic cardiologist <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/brewer-laprincess-c-m-d-m-p-h/bio-20415346" target="_blank" style="margin-left:0; font-size:22px;font-family:'HelveticaNeueW02-65Medi', arial, 'sans-serif';" title="Opens in a new window.">LaPrincess Brewer, M.D., M.P.H.</a>:</h2> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/zvsgsCJq-wQ" title="Mayo Clinic Minute Heart disease in African American women" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p><em><a href="/providers/monique-freund-md" target="_self" title="Opens in same window.">Monique Freund, M.D.</a>, is a <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a> and <a href="/locations/tomah" target="_self" title="Opens in same window.">Tomah</a>, Wisconsin.</em></p><ul> <li>Consultative clinical cardiology</li> <li>Diagnostic angiography</li> <li>Echocardiography</li> <li>Invasive complex hemodynamic assessments</li> </ul>M.B.B.S., M.D.<p><strong>Medical School</strong></p> <ul> <li>University of West Indies</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Mayo Clinic</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Cardiovascular Diseases, Mayo Clinic College of Medicine and Science</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Cardiology, American Board of Internal Medicine </li> <li>National Board of Echocardiography</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Freund<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/monique-freund-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=274F603CEEA3ED0852ADE58852B06872" alt="Monique Freund MD" width="280" height="280" DisableNVelocity="true" />{80DF5FF2-F6FB-49A0-B334-868917B3813F}Monique<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12602531Monique Freund, M.D.1{676428F6-179A-4C9B-9B23-5F1E40032A38}<img src="/-/media/national-files/images/hometown-health/2022/smiling-person-tan-sweater.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3E8474B6859270624CE97BF570E615D7" alt="Smiling person wearing a tan sweater" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller6/10/2022Going to see a health care professional can be especially scary for those in the LGBTQ community. A Mayo Clinic expert shares why it’s crucial to have cancer screenings regardless of gender identity.The importance of cancer screenings for the LGBTQ community<p>The LGBTQ community includes people of all races and ethnicities, religions, and social classes. People who identify as LGBTQ or gender-nonconforming may face specific health concerns related to their gender incongruence, sexual orientation and practices. Many experience stigma around their identity and may fear discrimination when seeking health care.</p> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/erbs-natalie-c-m-d/bio-20344705" target="_blank" title="Opens in a new window.">Natalie Erbs, M.D.</a>, a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">family medicine</a> physician at Mayo Clinic, says one concern is the lack of potentially lifesaving <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/cancer/diagnosis-treatment/drc-20370594" target="_blank" title="Opens in a new window.">cancer screenings</a>.</p> <p>Going to see a health care professional can be scary for anyone, but it's especially scary for some.</p> <p>"One of the things we see is that so many members of our LGBTQ community are just scared to come to the doctor in general," says Dr. Erbs. "They're worried about being judged for life choices or sexual preferences, and they're not comfortable talking about that."</p> <p>And that means missing important health care screenings. This could be due to a lack of gender-related insurance coverage, difficulty finding a health care professional with expertise in transgender care or fear of discrimination in a health care setting.</p> <p>"They're missing their breast cancer screenings. They're missing their colon cancer screenings. They're missing their cervical cancer screenings," says Dr. Erbs.</p> <p>Dr. Erbs says she is concerned that some patients who are <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/transgender-facts/art-20266812" target="_blank" title="Opens in a new window.">transgender</a> may forgo cancer screenings.</p> <p>"For our transgender patients, that can be a much more sensitive topic because the organs that you have, you may no longer identify with," says Dr. Erbs. "And if you don't identify with those organs, you might not want to come in and have them examined."</p> <p>Dr. Erbs says that however you identify, it's crucial to take care of your health.</p> <p>"We want you to be your authentic self," says Dr. Erbs. "And so that you can come in, and we can treat you."</p> <p>The bottom line, says Dr. Erbs, is: "Come in for your preventive screenings. It very well could save your life."</p> <p><strong>Learn more: </strong></p> <ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/adult-health/basics/lgbtq-health/hlv-20049421" target="_blank" title="Opens in a new window.">LGBTQ health</a></li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/transgender-health/art-20154721" target="_blank" title="Opens in a new window.">Health concerns for people who are transgender</a></li> </ul><img src="/-/media/national-files/images/hometown-health/2023/two-people-looking-at-each-other.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CBB0DEFD5B203E611C32CB222D83DA38" alt="Two people looking at each other" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Dawn Haller6/21/2022LGBTQ people may not want to share their sexual identity or orientation with a health care professional if they've experienced stigma in the past. Find out why it’s important to share.Coming out as LGBTQ to your health care professional<p>Pride Month is celebrated each June to commemorate the impact that <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/adult-health/basics/lgbtq-health/hlv-20049421" target="_blank" title="Opens in a new window.">LGBTQ</a>, or gender-nonconforming people have had — and continue to have — on society. While millions may celebrate, many members of the LGBTQ community continue to experience stigma and keep their identity hidden. That may mean not sharing their sexual identity or orientation with their health care professional.</p> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/erbs-natalie-c-m-d/bio-20344705" target="_blank" title="Opens in a new window.">Natalie Erbs, M.D.</a>, a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">family medicine</a> physician at Mayo Clinic, says it's important information to share to ensure everyone gets the best care possible.</p> <p>When filling out forms before seeing your health care professional, you might see a line asking about your sexual orientation or gender identity.</p> <p>"Sometimes it's hard to say the words out loud, but it's much easier to click a button. But again, we want to know that about you to get you the right care and get you to the right place," says Dr. Erbs.</p> <p>But why does it matter?</p> <p>"We want to know that about you so that we can get you the right care and get you to the right place," Dr. Erbs says.</p> <p>Talking about sexual behaviors is essential when it comes to your health.</p> <p>"It affects what type of <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/sexually-transmitted-diseases-stds/diagnosis-treatment/drc-20351246" target="_blank" title="Opens in a new window.">screenings</a> you might need for certain <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/sexually-transmitted-diseases-stds/symptoms-causes/syc-20351240" target="_blank" title="Opens in a new window.">sexually transmitted infections</a>, depending on the type of sex you're having, and what exposures you might have to other things like HIV," says Dr. Erbs. "Some of my patients might qualify to be put on <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/hiv-aids/expert-answers/prep-hiv/faq-20456940" target="_blank" title="Opens in a new window.">HIV prophylaxis</a> to prevent HIV, depending on the type of sex and who they're having sex with."</p> <p>Dr. Erbs says she hopes you choose to come out to your health care professional.</p> <p>"We in Primary Care want to see you, and we want to know about you and get to know you as a person," says Dr. Erbs.</p> <h2>Read more about issues affecting the LGBTQ community:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/trust-primary-care-provider" target="_self" title="Opens in same window.">During uncertain times, trust your primary care provider</a></li> <li><a href="/hometown-health/speaking-of-health/current-sexually-transmitted-infection-trends" target="_self" title="Opens in same window.">Current sexually transmitted infection trends</a></li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/transgender-health/art-20154721" target="_blank" title="Opens in a new window.">Health concerns for transgender people</a></li> </ul> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/artist-with-brush-and-canvas.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4FDCB22599511E012094661313E9D522" alt="Artist with brush and canvas" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller6/30/2022Umbilical cord blood contains cells that carry oxygen, nutrients and stem cells to a baby. Get answers to common questions about delayed cord clamping and cord blood donation.Delayed umbilical cord clamping benefits baby, affects cord blood donation<p>Cord blood is the blood that remains in the umbilical cord after birth. It contains red blood cells that can carry oxygen, nutrients and <a rel="noopener" href="http://www.mayoclinic.org/tests-procedures/stem-cell-transplant/in-depth/stem-cells/art-20048117" target="_blank" title="Opens in a new window.">stem cells</a>. Stem cells replenish cells in blood, skin and organs.</p> <h2>Here are answers to common questions about delayed cord clamping and cord blood donation:</h2> <h3>How can a doctor or nurse midwife maximize the benefit of cord blood for your baby?</h3> <p>When your baby is born, delaying cord clamping for 30–60 seconds benefits your baby. Delaying cord clamping for this time frame allows for higher distribution of blood to your infant rather than leaving this precious blood in the placenta.</p> <p>If cord clamping occurs 10–15 seconds after birth, 67% of the umbilical cord blood goes to the infant. By 1 minute of age, the amount of cord blood in the placenta passed to the infant increases to 80%.</p> <p>Waiting 30–60 seconds after birth is considered the proper cord clamping time frame due to the health benefits for your baby. For babies born prematurely, delaying cord clamping for 30–60 seconds decreases the serious complications of prematurity that can be life-threatening. Full-term babies are less likely to be iron-deficient at 3–6 months of age, which is important for health and development.</p> <h3>When will the doctor or nurse midwife clamp the cord sooner than 30–60 seconds?</h3> <p>In an instance where resuscitation of your baby is necessary, ventilation is most important. If the cord placenta has already separated from the baby — a condition known as abruptio placenta — it may be wiser to clamp the cord immediately for the pediatric care team to perform resuscitation measures.</p> <h3>If blood from your newborn's umbilical cord is important, should it be collected and stored?</h3> <p>Collection and storage of cord blood is known as cord blood banking. You can ask your care team for guidance on cord blood banking for your situation.</p> <p>Delayed cord clamping may lessen the amount of cord blood to be stored or donated. Priority is given to your baby immediately following birth to receive the cord blood through delayed clamping of the umbilical cord.</p> <h3>What options are available for storing cord blood?</h3> <p>Public and private cord blood banks provide options for storing cord blood.</p> <h3>Why is cord blood collected and stored, or donated?</h3> <p>Cord blood is one of the three sources of blood-forming cells used in transplants. Bone marrow and peripheral blood stem cells are the other two sources of cells.</p> <p>Cord blood contains stem cells that can be used to treat certain diseases. Current uses for cord blood transplant include certain genetic and hematologic conditions, and some cancers.</p> <p>If a sibling or family member has one of these conditions, your health care team can provide input on whether a donation to a private cord blood bank could be considered.</p> <h3>How do private cord blood banks operate?</h3> <p>Private cord blood banks store cord blood for a fee. The cord blood is available for potential future use, most commonly in a sibling who has cancer. If you are considering cord blood donation, it will be necessary to choose a private cord blood bank based on your needs.</p> <p>When considering a private cord blood bank, read all contracts thoroughly to understand the cost associated with long-term storage. Ask questions regarding how long the company has been storing cord blood, how many samples they have stored, and the outcomes of transplanted cord blood stored with the company.</p> <p>When a child in the family has a disease where cord blood could be used in treatment, you should speak with your health care team about the potential value of a private cord blood bank to store cord blood.</p> <h3>When would parents want to pay to have cord blood collected and stored in a private cord bank?</h3> <p>The storage of cord blood through a private cord blood bank can be considered if a family member is affected by certain conditions, including <a rel="noopener" href="http://www.mayoclinic.org/diseases-conditions/lymphoma/basics/definition/con-20035937" target="_blank" title="Opens in a new window.">lymphoma</a>, <a rel="noopener" href="http://www.mayoclinic.org/diseases-conditions/leukemia/basics/definition/con-20024914" target="_blank" title="Opens in a new window.">leukemia</a>, <a rel="noopener" href="http://www.mayoclinic.org/diseases-conditions/thalassemia/basics/definition/con-20030316" target="_blank" title="Opens in a new window.">thalassemia</a>, <a rel="noopener" href="http://www.mayoclinic.org/diseases-conditions/sickle-cell-anemia/basics/definition/con-20019348" target="_blank" title="Opens in a new window.">sickle cell anemia</a>, and <a rel="noopener" href="http://www.mayoclinic.org/diseases-conditions/retinoblastoma/basics/definition/con-20026228" target="_blank" title="Opens in a new window.">retinoblastoma</a>. They may need stem cells for a future transplant.</p> <p>Talking with your health care if your family is in this situation is important. Choosing to store umbilical cord blood for use against diseases that may occur in the future is not recommended. This type of action is called biologic insurance.</p> <h3>How do public cord blood banks operate?</h3> <p>Public cord blood banks operate like blood banks. Cord blood is collected for later use by anyone who needs it. The stem cells in the donated cord blood can be used by any person who matches. When cord blood is donated to a public bank, it is not owned by the family who donated the cord blood. If later you would need cord blood, you would not have access to the specific cord blood you donated, but instead you would receive cord blood from another patient. Public banks do not charge for collecting cord blood.</p> <h3>How is cord blood collected?</h3> <p>After you have determined if you will use a private or public donation, your health care team will plan to collect the cord blood at the time of delivery. After your baby is born, the umbilical cord is clamped. The process of collecting the cord blood is painless for the baby because no nerve fibers are in the umbilical cord.</p> <p>Blood is drained from the umbilical cord with a needle, and a special collection bag is attached. After the bag is sealed, the placenta is delivered. The process takes about 10 minutes.</p> <h3>Are there any limitations?</h3> <p>It's important to know insurance does not cover private cord blood banking. It also is unknown how long cord blood can be successfully stored. Although the probability of needing cord blood is remote, research is ongoing to fully understand the potential uses for this resource.</p> <p><em><a href="/providers/dennis-costakos-md" target="_self" title="Opens in same window.">Dennis Costakos, M.D.</a>, is a neonatologist in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Folic acid to prevent neural tube defects in minority populations as part of equity and inclusion</li> <li>Hyperbilirubinemia</li> <li>Newborn screening for biotinidase deficiency</li> <li>Predictive analytics</li> <li>Pulmonary surfactant and inter-hospital transfer</li> <li>Vitamin K and the newborn</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Dartmouth Medical School </li> </ul> <p><strong>Residency</strong></p> <ul> <li>Pediatrics, Mount Sinai Hospital</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Neonatal/Perinatal Medicine, New York Hospital/Cornell University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Neonatology, American Board of Pediatrics</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Pediatrics, Fellow in Neonatal-Perinatal Medicine and Epidemiology</li> <li>American Federation for Medical Research</li> <li>American Medical Association</li> <li>Society of Neuroscience </li> <li>Wisconsin Association for Perinatal care</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Pediatrics, Mayo Clinic College of Medicine and Science</li> </ul>Costakos<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/dennis-costakos-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=0A58CB05C01B2118F3FD82CC17315366" alt="Dennis Costakos MD" width="280" height="280" DisableNVelocity="true" /><p>See my publications at <a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/?term=costakos+dt" target="_blank" title="Opens in a new window">PubMed</a>.</p>Dennis<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12794287Dennis Costakos, M.D.1<img src="/-/media/national-files/images/hometown-health/2022/sleeping-baby-wearing-pink-cap.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2371849A52B1A509D595C7949EF63029" alt="Sleeping baby wearing pink cap" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller6/7/2022If you have back acne, it's hard to ignore when you're shirtless or try on that backless sundress. Here's what you need to know about back acne and how it's treated.Don't turn your back on back acne<p>Your back may be out of sight, but when you have back acne, it's not out of mind. That's especially true when you're shirtless, go for a swim or try on that backless sundress.</p> <p>While back acne can be irritating, painful and embarrassing, various treatments and lifestyle changes relieve this common skin problem.</p> <h2>Here's what you need to know about back acne and how it's treated.</h2> <h3>What is back acne?</h3> <h4>If you have acne on your back, you may experience:</h4> <ul> <li>Red, inflamed bumps</li> <li>Blackheads or whiteheads</li> <li>Back pain or tenderness</li> <li>Acne scars</li> </ul> <p>Like all acne, back acne is caused by overactive sebaceous glands. These glands produce an oily substance called sebum, which helps keep skin healthy. However, too much sebum can lead to bacteria growth and dead skin cells, which can block pores in the skin.</p> <h4>Several factors can trigger overproduction of sebum, including:</h4> <ul> <li>Hormonal changes, such as during puberty or pregnancy</li> <li>Certain medications, such as steroids or testosterone replacement therapy</li> <li>Stress</li> <li>Oily skin or hair products</li> </ul> <h2>How is back acne treated?</h2> <p>If you think you have back acne, you should seek care. Your primary care provider can determine how severe your case is, recommend the best treatment and possibly refer you to a dermatologist.</p> <h4>Typical treatments for back acne include:</h4> <ul> <li>Topical medications, such as benzoyl peroxide, retinoids and antibiotics, that are applied directly to the skin.</li> <li>Oral medications, such as antibiotics or isotretinoin, which is a powerful acne medication.</li> <li>Physical treatments, including laser therapy, light therapy or dermabrasion, which is the removal of surface layers of skin.</li> </ul> <h2>Do lifestyle changes help?</h2> <h4>You can relieve back acne by making dietary and lifestyle changes, such as:</h4> <ul> <li>Avoiding triggers, like oily skin products, stress or certain medications.</li> <li>Eating a healthy diet and exercising regularly.</li> <li>Showering after activities that cause you to sweat.</li> <li>Avoiding tight clothes, clothes that cause friction against the skin, and nonbreathable sports or activewear that traps sweat. Cotton is a good material for workout clothes because it wicks away moisture.</li> <li>Limiting irritating products that may cause acne to flare.</li> <li>Using gentle cleansers, such as Cetaphil and Vanicream, especially if applying prescription retinoids or stronger topicals that can overly dry out and irritate the skin.</li> </ul> <p>If an initial treatment doesn't produce results, your health care professional can help find a solution that works best for you so you can turn your back on back acne.</p> <p><em><a href="/providers/amanda-logan-cnp" target="_self" title="Opens in same window.">Amanda Logan</a> is a nurse practitioner in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><ul> <li>Effective hydration for maturing, dehydrated skin, and collagen building and maintenance</li> <li>Pharmacogenomics</li> <li>Skin care for all ages</li> <li>Using food as medicine for healthy gut, weight loss, and improving fatigue and inflammation</li> </ul>APRN, C.N.P.<p> I like to work with you and want your input. I want to know how we can work together to help you live your best life. Everyone is different and it is in the uniqueness that we can find solutions that are tailored to you. You are the captain of your ship, and I am your navigator. I will help guide and show you your options, but it is you who will ultimately decide your path.</p> <p>I will be open and honest when I see something that may be problematic, need further investigation or could use improvement. I am not opposed to alternative therapies; however, just as with anything you put in the body, even natural therapies have side effects and consequences that should be monitored. I am a big fan of mindfulness, meditating, gratitude, exercise and healthy eating as a basic foundation to good health. </p> <p>I am an avid reader. I read something related to the medical field at least daily, as well as something to stretch the imagination and keep my sense of childlike wonder. I am a huge Harry Potter fan and not ashamed to admit it. Some of my other favorite authors are Jeff Wheeler, Katherine Arden, Kate Quinn and countless others. I'm a huge Simpsons fan, and if I could guess what I was in a past life, it would have to be a dog. I love animals in general, but the best would have to be the dog. How better the world would be if we were all a little more like a dog.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Nursing, Bradley University</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul> <p class="telerik_paste_container" style="border-width: 0px; position: absolute; overflow: hidden; margin: 0px; padding: 0px; left: 3px; top: 66px; width: 1px; height: 1px;"> </p>Logan<img src="/-/media/shared-files/images/medical-professionals/full/mankato/amanda-logan-cnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=855113749ECDCE27DD0FF87769EE15A9" alt="Amanda Logan, C.N.P." width="280" height="280" DisableNVelocity="true" />{3D39AC94-41D4-46AA-9E8E-885783F8246E}Amanda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12858811Amanda Logan, C.N.P.1<img src="/-/media/national-files/images/hometown-health/2022/back-view-of-paddleboarder.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CB5610111890384EE9E3E4FF79301A4F" alt="Back view of paddleboarder" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Dawn Haller6/3/2022Colorful fruits and veggies offer health benefits from a stronger immune system to reduced risk of chronic disease. Here's how to paint your plate.Eat the rainbow for good health<p>Instead of painting a rainbow, how about eating a rainbow of colors? Red, orange, yellow, green, white, blue and purple.</p> <h2>Each of these colors has health benefits, including:</h2> <ul> <li>Improved vision</li> <li>Decreased inflammation</li> <li>Reduced risk of chronic diseases, including cancer, heart disease and diabetes</li> <li>Strengthened immune system</li> </ul> <p>These benefits are due to the phytochemicals that occur naturally within these foods. Phytochemicals also give foods their distinct aroma and taste.</p> <p>While each color provides certain benefits, when paired with other colors, the effects on your health are astonishing. That's why it's important to eat a wide variety of colors.</p> <h2>See what eating a rainbow of colors can do for you:</h2> <ul> <li><strong>Red fruits and vegetables</strong><br /> These contain lycopene, which improves heart health, decreases prostate and breast cancer risk, contributes to stroke prevention and increases brain function. Good sources of lycopene include tomatoes, beets, radish, cherries, strawberries, red onions and red peppers.</li> <li><strong>Orange and yellow fruits and vegetables</strong><br /> These contain carotenoids, which reduce the risk of heart disease and inflammation, strengthen the immune system, build healthy skin and improve vision. Good sources of carotenoids include carrots, winter squash, apricots, yellow peppers, sweet potatoes, bananas, pineapple, mangoes, pumpkins, peaches and oranges.</li> <li><strong>Green fruits and vegetables</strong><br /> These contain indoles and isothiocyanates, which may help prevent cancer. Typically, these foods are high in vitamin K, potassium, fiber and antioxidants. They also contain folic acid, which helps prevent neural tube defects in babies. Good sources include spinach, arugula, broccoli, Brussels sprouts, avocadoes, kiwis, green tea, asparagus, fresh green herbs, kale and artichokes.</li> <li><strong>White and brown fruits and vegetables</strong><br /> These contain flavonoids and allicin, which have anti-tumor properties. They also can reduce cholesterol and blood pressure, improve bone strength and decrease risk of stomach cancer. Good sources include onions, mushrooms, cauliflower, garlic and leeks.</li> <li><strong>Blue and purple fruits and vegetables</strong><br /> These contain anthocyanins and antioxidants, which are associated with improved brain health and memory. They also help lower blood pressure and reduce the risk of stroke and heart disease. Good sources include blueberries, blackberries, eggplant, figs, purple cabbage, concord grapes and plums.</li> </ul> <h2>Eat your way through the rainbow</h2> <p>Trying to eat your way through the scrumptious colors of the rainbow?</p> <h4>Here a few ways to help you include the rainbow at your next snack or meal:</h4> <ul> <li>Change up your usual choices. Rather than purchasing a green pepper, grab a bag of mini multi-colored sweet peppers or try swapping your green pepper for a red, purple or yellow bell pepper.</li> <li>Slice radishes into potato salad for color and extra crunch.</li> <li>Add frozen blackberries to your morning cereal or Greek yogurt.</li> <li>Swap french fries for roasted sweet potatoes fries. Simply cut a whole sweet potato into shoestring pieces, drizzle with extra virgin olive oil, sprinkle with salt and roast at 400 F until tender.</li> <li> Add a half-cup of cauliflower to your smoothie to make it extra creamy</li> <li>Grate purple rather than green cabbage for coleslaw.</li> <li>Spoon chicken curry over cauliflower rice.</li> </ul> <p>Not only will you find eating the rainbow healthy, but it's fun too.</p> <h2>Check out this video with tips for eating a rainbow of produce:</h2> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/V8azUguP1NE" title="Eating a rainbow of produce" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p><em><a href="/providers/caitlin-terpstra-rdld" target="_self" title="Opens in same window.">Caitlin Terpstra</a> is a dietician in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em></p>RDN, LD<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, St. Catherine University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>University of Wisconsin Hospital and Clinics</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Licensed Dietician</li> <li>Registered Dietitian</li> </ul>Terpstra<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/caitlin-terpstra-rd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=D56D6F5A2B6A4866353C6D74A8883157" alt="Caitlin Terpstra RD" width="280" height="280" DisableNVelocity="true" />Caitlin<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>19992149Caitlin Terpstra, RDN, LD1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2022/roasted-vegetables.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EE88F6547ACE669BD1B6EF8C76BA385D" alt="Roasted vegetables" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller6/8/2022Adults outgrow many things, but not the need to keep up on vaccinations. From pneumonia to tetanus, adult vaccines reduce illnesses. Learn which ones adults need and what they do.Even grown-ups need vaccinations<p>You're not a kid anymore, so you don't have to worry about shots, right?</p> <p>Wrong.</p> <p>You never outgrow the need for vaccines to protect you against disease. Vaccines are safe, and the risk of side effects is low. But if you have questions about them or any special health concerns, talk with your health care professional.</p> <p>Recommendations for adult vaccines from the Centers for Disease Control and Prevention (CDC) are based on your age, prior vaccinations, health, lifestyle, occupation, travel destinations and sexual activity.</p> <p>Don't know which one you need? Your electronic health record contains scheduled vaccines, and reminds your health care professional to offer shots that are due when you're in the clinic.</p> <h2>Typically, adults should receive these vaccinations:</h2> <ul> <li><strong>Flu (influenza)</strong><br /> To prevent the <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/flu/symptoms-causes/syc-20351719" target="_blank" title="Opens in a new window.">flu</a>, the CDC recommends annual flu vaccination for everyone ages 6 months or older. Adults 50 and older should not get the nasal spray flu vaccine. The flu can cause serious complications in older adults.</li> <li><strong>Pneumococcal</strong> <br /> The CDC recommends pneumococcal vaccinations — there are two — for adults 65 and older. Younger adults at increased risk for pneumococcal disease also might need a dose of the vaccine. Pneumococcal disease causes infections such as <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/pneumonia/symptoms-causes/syc-20354204" target="_blank" title="Opens in a new window.">pneumonia</a> and <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/meningitis/symptoms-causes/syc-20350508" target="_blank" title="Opens in a new window.">meningitis</a>, as well as bloodstream infections.</li> <li><strong>Tetanus, diphtheria and acellular pertussis (Tdap)</strong><br /> One dose of Tdap is routinely given at ages 11 or 12. If you've never had a Tdap vaccination, the CDC recommends getting this vaccination as soon as possible. One dose of Tdap vaccine also is recommended during each pregnancy, ideally between weeks 27 and 36 of pregnancy. Tdap can protect you from <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/tetanus/symptoms-causes/syc-20351625" target="_blank" title="Opens in a new window.">tetanus (lockjaw)</a>, <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/whooping-cough/symptoms-causes/syc-20378973" target="_blank" title="Opens in a new window.">whooping cough (pertussis)</a> and <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/diphtheria/symptoms-causes/syc-20351897" target="_blank" title="Opens in a new window.">diphtheria</a>, which can lead to breathing problems. A Tdap booster is recommended every 10 years.</li> <li><strong>Shingles</strong><br /> To prevent <a rel="noopener" href="https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/shingles-not-just-a-band-of-blisters" target="_blank" title="Opens in a new window.">shingles</a>, the CDC recommends a Shingrix vaccination for healthy adults 50 and older. It's given in two doses. While not life-threatening, shingles can be painful. This is a newer recommendation, but it is widely covered by insurance.</li> <li><strong>HPV</strong><br /> The CDC recommends the <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/hpv-infection/symptoms-causes/syc-20351596" target="_blank" title="Opens in a new window.">HPV vaccination</a> for boys and girls ages 11 or 12. Teens and young adults who begin the vaccination series later, at ages 15 through 26, should continue to receive three doses of the vaccine. The Food and Drug Administration also has approved the HPV vaccine Gardasil 9 for males and females ages 9 to 45. HPV is a common virus that can lead to several types of cancers, including cervical, vaginal, anal, head and neck, and certain oral cancers.</li> <li><strong>COVID-19</strong><br /> A <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/coronavirus/symptoms-causes/syc-20479963" target="_blank" title="Opens in a new window.">COVID-19</a> vaccination, along with booster vaccinations, might prevent you from getting COVID-19, or from becoming seriously ill or dying due to COVID-19.</li> <li><strong>Measles</strong><br /> As an adult, you may need a <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/measles/symptoms-causes/syc-20374857" target="_blank" title="Opens in a new window.">measles vaccination</a> if you're at increased risk of this contagious virus, such as if you're attending college, traveling internationally or working in a hospital environment, and you don't have presumptive evidence of immunity. This evidence includes written documentation of your vaccinations or lab confirmation of immunity or previous illness. Those born before 1957 typically have presumptive evidence of immunity because they probably have had this virus. Measles can lead to pneumonia, <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/encephalitis/symptoms-causes/syc-20356136" target="_blank" title="Opens in a new window.">encephalitis</a> and pregnancy problems.</li> </ul> <p>If you're not sure which vaccinations you've already had, good sources for that information are your current and former health care professionals, parents, caregivers, schools and employers. Your state health department also may have a registry that tracks adult vaccinations.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/person-with-hooded-jacket-and-ponytail.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9BA1949B452EA679DDCF587B0E3334A2" alt="Person with hooded jacket and ponytail" width="660" height="370" DisableNVelocity="true" />Immunizations<p>Disease prevention is crucial to your health. Getting vaccinated is one of the best ways to maintain good health, and protect you and those you care about against infectious diseases. Vaccinations offer protection against serious diseases by stimulating the immune system to create antibodies against certain bacteria or viruses.</p><br/><p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/vaccine-guidance/art-20536857" target="_blank" title="Opens in a new window.">Get vaccine guidance from Mayo Clinic</a>, including benefits, safety, side effects and what to know about recommended vaccines for babies, children, teens, adults and during pregnancy. For recommended vaccines based on age, refer to the <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/adult" target="_blank" title="Opens in a new window.">adult</a> or <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/child" target="_blank" title="Opens in a new window.">child and adolescent</a> schedules.</p><br/><p>Review the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/coronavirus-covid-19/history-disease-outbreaks-vaccine-timeline" target="_blank" title="Opens in a new window.">history of infectious disease outbreaks and vaccines timeline</a> for information about major disease outbreaks, epidemics and pandemics, and the impact of vaccines and research.</p>Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller6/17/2022One of the latest diet trends is intermittent fasting. But is it healthy? Learn about the different approaches and if it's a safe weight-loss option for you.Intermittent fasting: Fad or valid weight-loss solution?<p>Is skipping meals a bad idea or a secret weight-loss weapon? One diet trend that shows no sign of going away soon is intermittent fasting. That's when you voluntarily abstain from food or beverages other than water for a certain amount of time. Some fasting is for religious reasons, while others fast for weight loss.</p> <p>But is intermittent fasting a healthy way to lose weight?</p> <h2>The three popular approaches to intermittent fasting are:</h2> <ul> <li><strong>Alternate-day fasting</strong><br /> Eat a normal, healthy diet one day and then completely fast or have one small meal the next day. Usually, the small meal is fewer than 500 calories.</li> <li><strong>5-2 fasting</strong><br /> Eat a normal diet five days a week and fast two days per week.</li> <li><strong>Daily time-restricted fasting</strong><br /> Eat normally but only within an eight-hour window each day. For example, skip breakfast, but eat lunch around 11 a.m. and dinner by 7 p.m.</li> </ul> <h2>Benefits of intermittent fasting</h2> <p>Can intermittent fasting improve your health? Recent research has found that using intermittent fasting for weight loss may have some benefits in the short term.</p> <p>It appears that fasting for a short time can produce ketosis, which is a process that occurs when the body doesn't have enough glucose for energy, so it breaks down stored fat instead. This causes an increase in substances called ketones. This, coupled with fewer calories consumed overall, can lead to weight loss. Research suggests that alternate-day fasting is about as effective as a typical low-calorie diet for weight loss.</p> <p>Fasting also affects metabolic processes in the body that may work to decrease inflammation, as well as improve blood sugar regulation and physical stress response. Some research shows this may improve conditions associated with inflammation like arthritis, asthma and multiple sclerosis.</p> <p>Little long-term research has been done on intermittent fasting to examine how it affects people over time. As a result, long-term health benefits or risks are unknown.</p> <h2>Side effects of intermittent fasting</h2> <p>Intermittent fasting can have unpleasant side effects. They could include hunger, fatigue, insomnia, irritability, decreased concentration, nausea, constipation and headaches. Most side effects go away within a month.</p> <p>Sticking with an intermittent fasting routine can be easier for some people rather than trying to watch calories every day. Other people, especially those with busy or variable schedules, have more difficulty maintaining an intermittent fasting routine.</p> <h2>Is intermittent fasting right for you?</h2> <p>Intermittent fasting is safe for many people, but it's not for everyone. Skipping meals is not recommended for people under 18, those with a history of disordered eating, or those who are pregnant or breastfeeding. Athletes may find it difficult to fuel and refuel appropriately for an active lifestyle. If you have diabetes or other medical issues, talk with your health care team before starting intermittent fasting.</p> <p>Also, note that the key to weight loss with intermittent fasting is not to overeat during your eating windows. Eating fewer calories than you expend remains the basis for losing weight.</p> <p>Shortening the eating window may make it difficult to get the vitamins and minerals you need. While on this diet, it is important to eat meals made from quality, healthy ingredients, such as fruits, vegetables, whole grains, low-fat dairy and lean protein.</p> <p>Intermittent fasting can be dangerous if taken too far. A technique called dry fasting restricts food and fluid intake, resulting in severe dehydration and posing serious health concerns. Malnutrition can occur if the caloric restriction is too severe, such as averaging fewer than 1,200 calories a day long term.</p> <p><em><a href="/providers/romi-londre-rdn" target="_self" title="Opens in same window.">Romi Londre</a> is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Eating disorders</li> <li>Enteral nutrition or tube feedings</li> <li>Weight management</li> </ul>RDN, CD<p><strong>Education</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Registered Dietitian Nutritionist</li> <li>Certified Nutrition Support Clinician </li> <li>Certificate of Training in Adult Weight Management</li> </ul> <div> </div>Londre<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/romi-londre-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7919B2F8260054ECC4308684471EEEDB" alt="Romi Londre RDN" width="280" height="280" DisableNVelocity="true" />Romi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15183670Romi Londre, RDN, CD1{2BEE5070-65FF-4406-9E59-103E06C5A535}<img src="/-/media/national-files/images/hometown-health/2022/smiling-in-front-of-brick-wall.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1A5D06A087203DB1D85311FC6AB9E95C" alt="Smiling in front of brick wall" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller6/5/2024People who identify as LGBTQ+ face specific health concerns. Get answers to six common health questions to ease fears of seeking healthcare and learn how to find a trustworthy, affirming team.LGBTQ+ health: Easing fears of seeking care<p>The LGBTQ+ community includes people of all races and ethnicities, religions, and social classes. People who identify as lesbian, gay, bisexual, transgender, asexual or gender-nonconforming may face specific health concerns. Many experience stigma around their identity and may fear discrimination when seeking healthcare.</p> <h2>Here are answers to six common health questions from members of the LGBTQ+ community:</h2> <h3>1. I'm nervous to seek medical care out of fear of being judged and treated differently. How can I find a trustworthy and affirming healthcare team?</h3> <p>Trust is paramount to the patient-healthcare professional connection. At Mayo Clinic Health System, compassion and respect are core values practiced at every location. Discrimination of any type is not tolerated. All healthcare professionals are expected to be open and welcoming to create an inclusive environment where everyone receives the care and support they need.</p> <p>Many healthcare professionals have dedicated services for the LGBTQ+ community. You can <a rel="noopener" href="https://www.mayoclinichealthsystem.org/search-results?term=LGBT" target="_blank" title="Opens in a new window.">search for a healthcare professional</a> who has identified LGBTQ+ health as a priority aspect of their care.</p> <h3>2. Where can I find support and resources?</h3> <p>First, being a member of the LGBTQ+ community is normal. Being gay, bisexual, pansexual or asexual is normal. Being transgender is normal. Being nonbinary, gender-nonconforming or gender-fluid is normal. Your identity is normal.</p> <p>You can ask your healthcare team for resources in your local area. <a rel="noopener" href="https://www.pridecounseling.com/" target="_blank" title="Opens in a new window.">Pride Counseling Services</a> is an available resource in Minnesota that provides counselors specifically for the LGBTQ+ community, along with other resources. Programs such as the <a rel="noopener" href="https://www.glaad.org/" target="_blank" title="Opens in a new window.">Gay and Lesbian Alliance Against Defamation</a> and <a rel="noopener" href="https://www.thetrevorproject.org/" target="_blank" title="Opens in a new window.">The Trevor Project</a> also provide resources.</p> <h3>3. I have a new partner. How can I be proactive regarding sexual health?</h3> <p>If desired, your local healthcare team can screen you and your partner for sexually transmitted infections. You can use barrier contraceptives, such as condoms or dental dams, to provide protection. Other birth control methods, such as pills, injections, patches, or arm implant or intrauterine devices, do not protect against sexually transmitted infections.</p> <p>If you're interested, you also can talk with your healthcare team about a medication to prevent HIV transmission, more commonly known as pre-exposure prophylaxis or PrEP therapy.</p> <h3>4. I know the LGBTQ+ community has a higher likelihood of smoking and vaping, which is having adverse effects on our health. For those interested in quitting, what tools and resources are available to help?</h3> <p>The benefits of quitting smoking are endless. Quitting smoking decreases the risk of 12 types of cancer, heart disease and lung disease, according to the Centers for Disease Control and Prevention.</p> <h4>Here are some tricks to help quit smoking:</h4> <ul> <li><strong>Try to avoid your usual triggers.</strong><br /> If these triggers are unavoidable, have a plan to focus your attention elsewhere. For example, if you tend to smoke during your break at work, plan on going for a walk or calling a friend during that time instead. You also can chew on items like sugarless gum or sugarless candy.</li> <li><strong>Get moving.</strong><br /> Physical activity can curb cravings.</li> <li><strong>Try relaxation techniques.</strong><br /> Try deep breathing or meditation to cope with stress instead of reaching for a cigarette.</li> <li><strong>Find support.</strong><br /> Support can be from family and friends, a local or web-based support group, or a telephone quit line. Call <a href="tel:1-800-355-3569">1-800-QUIT-NOW</a> for free counseling.</li> </ul> <p>Nicotine patches, gum and lozenges have less nicotine than cigarettes. They help address the cravings while reducing the overall risk, and they are available for free through <a rel="noopener" href="https://802quits.org/" target="_blank" title="Opens in a new window.">802quits.org</a>. If you need additional help, you also can talk to your healthcare team about prescriptions like Chantix or bupropion.</p> <h3>5. As I continue exploring and embracing who I am, this journey produces mixed emotions. Although I am excited and relieved, I sometimes feel depressed and anxious. What should I do?</h3> <p>Mental health is just as important as physical health. Diseases like anxiety and depression profoundly affect your well-being. Talk with your healthcare team if you are mentally struggling. There are several avenues of proven treatment options, including medications and counseling. You also could contact your health insurance provider to ask which counselors in your area are covered by your health plan. Many counselors do not require a referral from a healthcare professional to make an appointment. There may be a waitlist for an appointment with a counselor. Ask your healthcare team about temporary, short-term counseling options with immediate availability to provide support.</p> <p>Contact a crisis center if you are contemplating suicide at any point. You can <strong>call or text <a href="tel:988">988</a> to talk with someone at the 988 Suicide and Crisis Lifeline</strong>. This service is available 24/7 for free. Alternatively, you can seek medical care in your local emergency department for emergencies.</p> <h3>6. What routine care is recommended for members of the LGBTQ+ community?</h3> <p>Talk to your healthcare team about how often you should have a physical. At this appointment, your primary care provider will perform a physical exam, discuss any concerns that you have, and review your medical and social history and medications.</p> <p>There are many recommended health screenings at different times in your life. Adults should be screened for colon cancer, starting at age 45. A colonoscopy is the preferred test for this, but you also can consider a Cologuard stool test.</p> <p>All vaccines are strongly recommended. You should be screened for diabetes, depression and high cholesterol. It also is recommended that everyone is screened at least once for hepatitis C and sexually transmitted infections, including HIV. A low-dose CT scan may be recommended for people 55 to 80 depending on their smoking history.</p> <p>Some screening recommendations are based on the reproductive organs present at birth. Your healthcare team can explain these exams and ensure you are comfortable before proceeding. </p> <h4>Additional recommended screenings may include:</h4> <ul> <li><strong>Prostate-specific antigen (PSA) test</strong><br /> This blood test is recommended for between ages 55 and 69 for cisgender men or people assigned male at birth with an average risk of prostate cancer. Those at higher risk may benefit from a PSA test earlier. The prostate typically is not removed as part of gender-affirming surgery, so it should be monitored over time.</li> <li><strong>Abdominal ultrasound</strong><br /> This one-time screening for an aortic aneurysm is recommended for cisgender and transgender men or people assigned male at birth ages 65 to 75 with a history of smoking.</li> <li><strong>Mammogram</strong><br /> A mammogram is recommended annually, beginning at age 40, for cisgender women of average risk for breast cancer. Screening mammograms also are recommended for women or people who have been taking gender-affirming hormones, such as estrogen, for more than five years. For transgender men or people who were assigned female at birth, a chest cancer screening may be recommended in the future. This recommendation is based on the length of time using testosterone therapy and if there has been a gender-affirming surgery. Discuss specific recommendations with your healthcare team.</li> <li><strong>Pap smear</strong><br /> This test screens for signs of HPV, a sexually transmitted infection, and cervical cancers. It's recommended for anyone with a cervix every three years from ages 21 to 29 and every five years from ages 30 to 65. A Pap smear is generally not recommended for transgender women unless they have had bottom surgery. If you have had this surgery, discuss screening recommendations with your healthcare team.</li> <li><strong>Bone density</strong><br /> This screening determines if you have osteoporosis or are at risk for osteoporosis. Bone density scans are recommended for cisgender women and all transgender people ages 65 and older.</li> </ul> <p>Words matter. Your healthcare team should discuss your identified vocabulary to describe your anatomy so you're comfortable with your care. Let your team know if something is said that makes you feel uncomfortable.</p> <p><em><a href="/providers/sara-robinson-md" target="_self" title="Opens in same window.">Sara Robinson, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Behavioral health</li> <li>LGBTQ+ health</li> <li>Preventive health</li> <li>Women's and children's health</li> </ul>M.D.<p>I am a resident in the Mayo Clinic Family Medicine Residency Program and see patients in our clinics in Mankato.</p> <p>My favorite thing in the world is spending time with family and friends. I also love reading, and I have always been a huge fan of musical theater. I enjoy swimming, being outside and Zumba. I am currently learning how to play the banjo.</p><p><strong>Medical School</strong></p> <ul> <li>Central Michigan University College of Medicine</li> </ul>Robinson<img src="/-/media/shared-files/images/medical-professionals/full/mankato/sara-robinson-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=8982B94E8AB7A99FDBD6C494194C6461" alt="Sara Robinson, M.D." width="280" height="280" DisableNVelocity="true" />Sara<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30031049Sara Robinson, M.D.1{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{986C767E-E5DE-43F5-957F-B4212DB8E384}|{61776FD2-05E8-47E9-AB55-EE465BD29A19}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}<img src="/-/media/national-files/images/hometown-health/2022/person-with-glasses-and-nose-ring.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8F100C0256EC8F48970E4012E2FD6056" alt="Person with glasses and nose ring" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller6/27/2022Injuries caused by repetitive motions and overuse can plague team and individual athletes of any age. Learn how to help prevent these injuries and allow your body to recover.Training tips during your sport's offseason<p>When it comes to sports, sometimes too much of a great thing can be, well, too much — too much running, swinging, throwing, jumping. These repetitive motions can lead to overuse injuries, which may prevent you from participating for the rest of the season and limit rehabilitation. And they could even have long-term effects.</p> <p>If you or your child participate in organized sports or focus on a sport individually, you may be at risk for an overuse injury.</p> <h2>Overuse injuries tend to affect muscles and joints and can be caused by:</h2> <ul> <li><strong>Training errors</strong><br /> Training errors can happen when you take on too much physical activity too quickly. Going too fast, exercising for too long or simply doing too much of one type of activity can strain your muscles and lead to an injury.</li> <li><strong>Technique errors</strong><br /> Improper technique also can take its toll. For example, if you use poor form as you perform a set of strength-training exercises, swing a golf club or throw a baseball, you may overload certain muscles.</li> </ul> <h3>Examples of overuse injuries for specific sports include:</h3> <ul> <li><strong>Tennis, swimming, baseball, volleyball</strong><br /> Patellar tendonitis, plantar fasciitis, stress fractures, elbow and shoulder conditions, rotator cuff injuries, and tendonitis.</li> <li><strong>Basketball</strong><br /> Achilles tendonitis, and foot and ankle injuries.</li> <li><strong>Running</strong><br /> Foot and ankle injuries, plantar fasciitis, and stress fractures.</li> </ul> <p>Ideally, at the end of the season, athletes of any age or ability should take a break to give their bodies a chance to rest and heal to prevent overuse injuries. It's also a good time to check with your health care professional to ensure that any aches, pains or reduced range of motion can be addressed.</p> <h3>If you're the parent of a student-athlete, pay attention to signs from your child of a potential overuse injury, including:</h3> <ul> <li>Complaints of pain</li> <li>Drop in performance</li> <li>Reluctance to play</li> </ul> <p>If you notice these signs, make an appointment with your child's health care professional.</p> <h2>3 ways to avoid overuse injury</h2> <h3>Most overuse injuries are avoidable and can be prevented by:</h3> <ol> <li><strong>Using proper form and gear</strong><br /> Whether you're new to an activity or have been doing it for a long time, consider taking lessons. Using the correct technique is crucial to preventing overuse injuries. Also, make sure you wear proper shoes for the activity. Think about replacing your shoes for every 250 to 500 miles you walk or run — or at least twice a year if you exercise regularly.</li> <li><strong style="color: #333333;">Pacing yourself<br /> </strong>Compressing your physical activity for the week into just a couple of days can lead to an overuse injury. Instead, aim for at least 30 minutes of moderate physical activity daily. If you don't have time for a full 30 minutes, you can break it down into smaller blocks throughout the day. Take time to warm up before physical activity and cool down afterward.</li> <li><strong>Gradually increasing your activity level<br /> </strong>If you're changing the intensity or duration of a physical activity, do it gradually. For example, during strength training, increase the weight by no more than 10% a week until you reach your new goal.</li> </ol> <h2>Shake up your training routine</h2> <p>Since overuse injuries typically are due to repetitive motions, it's important to shake up your training routine during your sport's offseason. An offseason training routine should focus on strength and conditioning to prevent injuries and enhance performance. So it may include aspects of speed, strength, agility and mechanics, depending on the sport.</p> <p>Offseason training may be available for student-athletes through their school or private companies.</p> <p>Consider incorporating cross-training into your offseason routine. Instead of focusing on one type of exercise, try a completely different activity.</p> <h3>Elements of cross-training include:</h3> <ul> <li>Building in a variety of low-impact activities, such as walking, biking, swimming, cross-country skiing, and water jogging or water fitness.</li> <li>Seeking out stationary bikes and any type of glider-style machine in the gym, while steering clear of stair machines that are hard on knee and hip joints.</li> <li>Including strength training for the major muscle groups in your arms, legs and core at least twice a week.</li> </ul> <p>These activities can help prevent overuse by allowing your body to use different muscle groups and not overload any one particular group. And because they're low-impact, they're more friendly to your joints.</p> <p>Before the new season for your sport starts, check back with your health care professional to be sure your body's on track for achieving your fitness and performance goals.</p> <p><em><a href="/providers/t-andrew-israel-md" target="_self" title="Opens in same window.">T. Andrew Israel, M.D.</a>, practices <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgery</a> and <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">sports medicine</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Shoulder and knee reconstructive surgery</li> <li>Sports medicine and arthroscopy</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Wisconsin-Madison</li> </ul> <p><strong>Internship</strong></p> <ul> <li>General Surgery, Mayo Clinic</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, Mayo Clinic</li> </ul> <p><strong>Fellowship </strong></p> <ul> <li>Sports Medicine, Lake Tahoe Orthopedic Institute</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Orthopedic Surgery, American Board of Orthopedic Surgery</li> <li>Certificate of Added Qualification, Orthopaedic Sports Medicine</li> </ul> <p><strong>Membership</strong></p> <ul> <li>Fellow, American Academy of Orthopedic Surgeons</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Orthopedics, Mayo Clinic College of Medicine and Science</li> </ul>Israel<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/t-andrew-israel-md.jpg?h=200&iar=0&w=200&sc_lang=en&hash=33D3ECE5FDB664DEF24DFC159C4EAE5F" alt="T. Andrew Israel, M.D." width="200" height="200" DisableNVelocity="true" />T. Andrew<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>11708778T. Andrew Israel, M.D.1{DEF55970-853F-4E96-9A4D-3413874FF059}|{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2022/athlete-using-medicine-ball.jpg?h=370&iar=0&w=660&sc_lang=en&hash=43853D01DDC43B380613A6F1723CCE16" alt="Athlete using medicine ball" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller6/21/2022Fruits and veggies may lower the risk of certain types of cancer. Learn how phytochemicals found in plants protect your body from damage and slow down cancer processes.Plant power: Using diet to lower cancer risk<p>The choices you make at the grocery store have a bigger impact than just your dinner plans. Filling your plate with foods that are grown in the ground may be the best diet for cancer prevention.</p> <p>An estimated 1.9 million cases of cancer will be diagnosed in the U.S. in 2022, according to the American Cancer Society. While some people have a higher genetic risk to develop cancer, research shows that nearly 25% of overall cancer cases could be prevented with diet and nutrition alone. Many cancers can take 10 or more years to develop, so everyday nutrition choices are crucial in cancer prevention.</p> <p>Plant-based diets are full of fruits, vegetables and legumes, with little or no meat or other animal products. In research studies, vegans, people who don't eat any animal products, including fish, dairy or eggs, appeared to have the lowest rates of cancer of any diet. The next lowest rate was for vegetarians, people who avoid meat but may eat fish or foods that come from animals, such as milk or eggs.</p> <p>Plant-based foods do more than taste delicious. They are full of chemicals compounds, called phytochemicals, that protect the body from damage. Phytochemicals also interrupt processes in the body that encourage cancer production. Plant-based diets also are high in fiber, which has been shown to lower the risk for breast and colorectal cancer.</p> <h2>Plant chemicals</h2> <p>Phytochemicals offer many benefits. In addition to protecting from damage, they decrease inflammation and interrupt processes in the body that encourages cancer production.</p> <h3>Two of the most helpful phytochemicals are:</h3> <ul> <li><strong>Antioxidants</strong><br /> This type of phytochemical protects the body from damage. Cancer develops when DNA in cells is damaged. This causes abnormal cells to divide uncontrollably, which can infiltrate and destroy normal body tissue. Cell damage also can be caused by radiation, viruses and exposure to other chemicals. The body's natural metabolism creates oxidants that can cause cell damage, as well. Antioxidants neutralize these damage processes while protecting and restoring cells. Some foods that contain a high level of antioxidants include dark chocolate, apples with the peel, avocados, artichokes, red cabbage, tea, coffee, nuts and grains.</li> <li><strong>Carotenoids</strong><br /> These are fat-soluble compounds, which means they need to be accompanied by a fat source to be absorbed. Carotenoids are naturally present in many fruits, grains, oils and vegetables such as carrots, sweet potatoes, squash, spinach, apricots, green peppers and leafy greens. They are highly pigmented, so look for natural foods that are red, orange, yellow and green. Examples of carotenoids include beta carotene, lycopene, and lutein. They have been linked to reducing the risk of heart disease, cancer, macular degeneration and cataracts.</li> </ul> <p>Many plant-based foods are also high in provitamins called alpha and gamma carotene. When consumed, these vitamins can be converted to vitamin A. This nutrient is important to vision, growth, cell division, reproduction and immunity. Vitamin A also has antioxidant properties.</p> <p>Nutrients and phytochemicals found in plant-based foods seem to work independently and together to decrease cancer and disease risk. This means that plant-based foods work best when eaten in combination with other foods rather than alone. One prostate cancer study showed that a combination of tomato and broccoli diet was more effective at slowing tumor growth than either tomato or broccoli alone. This demonstrates the power that nutrition has when foods are teamed together.</p> <h2>Plant-based fiber</h2> <p>Plant-based diets are high in natural fiber. This has been shown to reduce cancer risk and moderate insulin levels. Young women who ate the most fiber-rich diets were 25% less likely to get breast cancer later in life, a study found. Other research finds that each 10 grams of daily fiber could lower the risk of colorectal cancer by 10%.</p> <p>Healthy bacteria in the digestive track can ferment fiber and other starches to produce compounds known to help promote normal colon development and reduce inflammation. These bacteria convert some phytochemicals to more useable or active forms.</p> <h2>Eat for color, variety</h2> <p>There are many delicious options in a plant-based diet. Experiment with new fruits or vegetables, or new ways to incorporate staples.</p> <p>Cost can be a factor in selecting a plant-based diet menu, as fresh fruits and vegetables may be more expensive. Good alternatives are frozen fruits and vegetables. They are flash-frozen to preserve nutrients and are less expensive. Canned options are available, as well, for people with a stricter budget. Be sure to look for options without added sugar or salt.</p> <h3>Aim to eat at least these amounts in your diet to feel full and get the necessary phytochemicals and fiber:</h3> <ul> <li>Fruits, 1.5 to 2.5 cups per day</li> <li>Vegetables, 2.5 to 4 cups per day</li> <li>Whole grains, 3 to 5 ounces per day</li> <li>Legumes, 1.5 cups per week</li> <li>Protein, 5 to 7 ounces per day. Legumes, dairy, tofu and eggs are excellent sources of protein. Or select lean cuts of meats and avoid processed meats</li> <li>Fats, 3 to 5 servings per day. One serving equals one teaspoon of oil, four walnut halves or one-sixth of an avocado</li> </ul> <h2>Shifting to a plant-based diet</h2> <h3>Eating a plant-based diet doesn't need to be all or nothing. Making gradual changes is more sustainable and realistic for most people. Some ways to do this include:</h3> <ul> <li><strong>Start your day off right.</strong><br /> Enjoy a delicious and healthy breakfast with whole-grain oatmeal, buckwheat or quinoa, along with fruit, to give you the energy to tackle your day.</li> <li><strong>Experiment with meatless meals.</strong><br /> Embrace "meatless Mondays" and try one new meatless recipe per week.</li> <li><strong>Treat meat like a condiment.</strong><br /> Instead of using meat as a main dish, use just a little for flavor.</li> <li><strong>Use legumes for bulk.</strong><br /> Decrease the amount of meat in some recipes by increasing the amount of beans, lentils or vegetables. These foods fill more space on your plate so you won't feel deprived.</li> <li><strong>Fill your plate with fruits and vegetables first.</strong><br /> Cover about half of your plate with fruits and vegetables for lunch and dinner.</li> </ul> <p>More investigation of foods and their functional components is bound to reveal all that a plant-based diet has to offer. Until then, eating a variety of fruits and veggies prepared in numerous ways will improve your odds for preventing cancer. And don't forget to pair proper nutrition with plenty of exercise.</p> <p><span style="font-size: 22px; color: #000033;">Learn more about disease-fighting foods in this webinar:</span></p> <p class="video-container"><iframe width="560" height="315" src="https://www.youtube.com/embed/jt0urSYKvs8" title="disease fighting foods" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture"></iframe></p> <p><em><a href="/providers/grace-fjeldberg-rd" target="_self" title="Opens in same window.">Grace Fjeldberg</a> is dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Bariatric surgery</li> <li>General nutrition</li> <li>Oncology</li> <li>Pediatric nutrition</li> </ul>RDN, LD <p><strong>Education</strong></p> <ul> <li>Minnesota State University, Mankato</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Mayo Clinic College of Medicine, Minnesota</li> </ul> <p><strong>Certifications</strong> </p> <ul> <li>Commission on Dietetic Registration</li> <li>Minnesota Board of Dietetics and Nutrition Practice</li> </ul> Fjeldberg<img src="/-/media/shared-files/images/medical-professionals/full/mankato/grace-fjeldberg-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=FB99EC499314FA86AE8202C30AB740A2" alt="Grace Fjeldberg RDN" width="280" height="280" DisableNVelocity="true" /> Grace<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15268781Grace Fjeldberg R.D.N. 1<img src="/-/media/national-files/images/hometown-health/2022/roasted-sweet-potatoes-with-herbs.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1D0A050B154356E4EE0A397DCB1AB1F2" alt="Roasted sweet potatoes with herbs" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Dawn Haller7/10/2023A sprained ankle is one of the most common injuries and can range from minor to severe. Learn why prompt evaluation and treatment are key to recovery.Sprained your ankle — now what?<p>You step off a sidewalk curb, land wrong after shooting a basketball or stumble on uneven ground. Your ankle pops, twists or crunches, and now you're limping and sore. You may just have sprained your ankle.</p> <p>An ankle sprain typically happens when you roll your ankle inward, which stretches or tears the ligaments supporting the outer part of the joint. An ankle sprain is the most common injury among athletes and active adults, but it can happen to anyone.</p> <h2>What to do immediately following a sprain</h2> <p>While common, if an ankle sprain isn't treated properly, it can lead to chronic issues, such as <a href="/hometown-health/speaking-of-health/ankle-instability-causes-and-fixes" target="_self" title="Opens in same window.">ankle instability</a> or pain, limited ability to return to sports and degenerative arthritis. Also, significant tendon or ligament injuries, cartilage damage or even fractures may be missed if a severe sprain isn't properly evaluated.</p> <h4>If you've sprained your ankle, promptly begin following the "RICE" treatment to improve comfort, and minimize the risk of complications and long-term issues:</h4> <ul> <li><strong>Rest</strong><br /> Avoid any activity that causes pain in the ankle. Rest your ankle, and minimize walking for the rest of the day.</li> <li><strong>Ice</strong><br /> Apply ice to the sore part of your ankle, typically for 15 minutes on and then 15 minutes off, as much as possible for the rest of the day. Continue with 15 minutes of icing three times a day until the pain and swelling subside. Don't apply ice directly to your skin, and use a towel or cloth for protection.</li> <li><strong>Compression</strong><br /> Using a compression sleeve, elastic bandage wrap or brace on the affected ankle can prevent excessive swelling, protect the area from repeated injuries and provide support. Some inflammation is needed for healing, but too much can be harmful.</li> <li><strong>Elevation</strong><br /> Elevate your foot and ankle at or above the level of your heart as often as possible for the rest of the day. This will help control pain and decrease swelling.</li> </ul> <h4>Depending on the severity of your symptoms, for the first one to two weeks:</h4> <ul> <li>Continue with RICE, gradually reducing the steps as pain and swelling decrease.</li> <li>Take over-the-counter medications, such as acetaminophen, ibuprofen, naproxen or aspirin, if you can safely take them. To manage pain, consider applying topical medications or patches.</li> <li>Start resistance-free, nonweight-bearing, range-of-motion exercises, such as drawing each letter of the alphabet with your foot. Or move your ankle to the compass points: north to south and east to west. Maintaining this range of motion can help prevent long-term stiffness, reduce swelling and help the stretched ligaments heal. Keep motion within your pain-free zone to avoid making the injury worse.</li> <li>Gradually return to your normal activities as long as your pain doesn't increase. At first, this includes walking short distances, such as to the bathroom, then progressing to your normal level of walking.</li> </ul> <p>If there's little or no improvement after the first week, consider consulting with a health care professional, such as a <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">sports medicine specialist</a>, your <a href="/services-and-treatments/primary-care" target="_self" title="Opens in same window.">primary care provider</a> or a <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapist</a>.</p> <h2>What to expect for recovery, additional treatment</h2> <p>Once you've passed the initial recovery period, further treatment depends on the extent of the injury. If it was a straightforward injury, didn't require an evaluation and you did not have any setbacks, you can expect symptoms to last for 10 to 12 weeks as the ligament heals.</p> <p>Once you've sprained your ankle, it's more susceptible to future injury. An ankle sleeve or lace-up brace can provide added support and stability.</p> <h4>If your sprain was significant, especially if it prompted you to see a health care professional, you may experience a slower, longer recovery that could include:</h4> <ul> <li>A brief period of immobilization and nonweight-bearing with crutches or a knee scooter</li> <li>One to two weeks of protected weight-bearing in a tall walking boot</li> <li>Physical therapy to help increase stability, strength and balance</li> <li>Possible ankle surgery</li> </ul> <p>If your health care professional suspects the injury requires surgery, you'll undergo X-rays and possibly an MRI to determine the extent of the damage. Then you'll be evaluated by a surgical podiatrist or orthopedic surgeon to discuss your injury and surgical options.</p> <h4>You may need surgery if there is:</h4> <ul> <li>Evidence of a complete rupture of one or more of the lateral ankle ligaments requiring repair</li> <li>History of repeated sprains and a determination that ligament reconstruction is needed</li> <li>An associated injury, such as a partially or completely torn tendon, a fracture, or damage to cartilage in the ankle joint</li> </ul> <p>While an ankle sprain is relatively common, most of the time it heals, and patients and athletes recover with little intervention. Thoroughly addressing any issues early can help you return to your best activity level.</p> <h2>Next steps:</h2> <ul> <li>Learn about <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">Sports Medicine services and treatments, and find a specialist near you</a>.</li> <li>See an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgeon</a> to discuss options for more serious ankle injuries or long-term effects from an ankle sprain.</li> <li>Find out if you should <a href="/hometown-health/speaking-of-health/to-brace-or-not-to-brace" target="_self" title="Opens in same window.">wear an ankle brace</a> to support your injured joint.</li> </ul> <p><a href="/providers/alecia-gende-do" target="_self" title="Opens in same window."><em>Alecia Gende, D.O.</em></a><em>, is a <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">sports medicine</a> specialist in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Exercise and movement</li> <li>Female athletes</li> <li>Sports injuries</li> <li>Teaching</li> <li>Ultrasound-guided procedures</li> <li>Women's musculoskeletal health</li> </ul>D.O.<p>I practice collaboratively with my patients, offering an explanation of their situation and a few options for workup and management. I try to empower my patients to make informed decisions regarding their care. </p> <p>My goals are to optimize overall well-being and to see more than just a sports injury or musculoskeletal complaint. I will treat the whole person, working to get them back to their goals, whether that is playing organized sports, golfing, recreational running, weightlifting or being able to play with their kids or grandkids.</p> <p>I enjoy time outdoors, working on our farm and with my family. For my own fun and fitness, I enjoy CrossFit, running, weightlifting, walking, hiking, hunting and anything outdoors.</p><p><strong>Education</strong></p> <ul> <li>Midwestern University Chicago College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Emergency Medicine, University of Iowa Hospitals & Clinics</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Primary Care Sports Medicine, University of Iowa Hospitals & Clinics</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Emergency Medicine</li> <li>American Association Women Emergency Physicians</li> <li>American College of Emergency Physicians</li> <li>American College of Sports Medicine</li> <li>American Institute of Ultrasound in Medicine</li> <li>American Medical Society for Sports Medicine</li> <li>Emergency Medicine Residents Association (EMRA)</li> <li>Veterans of Foreign Wars</li> </ul> <p><strong>Academic Appointments</strong></p> <ul> <li>Assistant Professor of Emergency Medicine, Mayo Clinic College of Medicine and Science</li> <li>Assistant Professor of Orthopedics (Orthopedic Surgery), Mayo Clinic College of Medicine and Science</li> </ul>Gende<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/alecia-gende-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=5BCB6FFA652C592FF31686030603223C" alt="Alecia Gende DO" width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/37208055/" target="_blank" title="Opens in a new window.">Acute hemorrhage on the playing field</a>, July 2023.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/33585801/#:~:text=Conclusion%3A%20Preliminary%20findings%20indicate%20a,requiring%20referral%20to%20a%20cardiologist." target="_blank" title="Opens in a new window.">Use of electrocardiographic screening to clear athletes for return to sports following COVID-19 infection</a>, April 2021.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/33306518/" target="_blank" title="Opens in new window. ">Ultrasound in trauma and other acute conditions in sports, Part II</a>, December 2020.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/30908326/" target="_blank" title="Opens in a new window.">Delayed-union of acetabular stress fracture in female gymnast: Use of teriparatide to augment healing</a>, September 2020.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/29560061/" target="_blank" title="Opens in a new window.">Educator toolkits on Second Victim Syndrome, mindfulness and meditation, and positive psychology: The 2017 Resident Wellness Consensus Summit</a>, March 2018.</li> </ul>{D57FF1AB-3266-4374-BBD1-D222CFB57AA6}Alecia<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21428671Alecia Gende, D.O.1{7746ADF8-715B-4593-8AAB-55D7F0467848}|{FB3BB67A-14FA-4DDE-B183-F85C42E0B255}<img src="/-/media/national-files/images/hometown-health/2022/hiking-boots-on-log.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A51CC45DABEC72EB5B37489DC29F091B" alt="Hiking boots on log" width="660" height="370" DisableNVelocity="true" />Foot HealthPodiatry is a branch of medicine devoted to the study of diagnosis, medical and surgical treatment of disorders of the foot, ankle and lower extremity.Dawn Haller6/24/2022The teen years are challenging, but for LGBTQ youth, statistics for mental health issues and suicide risk are alarming. Supporting LGBTQ youth who are struggling starts with lending a listening ear.Why it's important to support kids who identify as LGBTQ and may be struggling<p>It's not uncommon for teens to experience <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/teen-depression/symptoms-causes/syc-20350985" target="_blank" title="Opens in a new window.">mental health</a> issues like anxiety. It's believed that 1 in 5 young people experiences some type of mental health issue during the teen years. For LGBTQ youth, the statistics are alarming. A recent <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.thetrevorproject.org/survey-2023/#intro" target="_blank" title="Opens in a new window.">national survey</a> showed 41% expressed serious <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/tween-and-teen-health/in-depth/teen-suicide/art-20044308" target="_blank" title="Opens in a new window.">suicidal ideation</a>.</p> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/billings-marcie-l-m-d/bio-20054087?mc_id=us&utm_source=newsnetwork&utm_medium=l&utm_content=content&utm_campaign=mayoclinic&geo=national&placementsite=enterprise&invsrc=other&cauid=100721" target="_blank" title="Opens in a new window.">Marcie Billings, M.D.</a>, a Mayo Clinic pediatrician, says these kids need support. It can be as simple as listening.</p> <p>If the teen in your life identifies as LGBTQ and decides to share that information, Dr. Billings asks parents to lend an ear as an important first step.</p> <p>She says supporting children is critical.</p> <p>LGBTQ youth with high levels of support from family had less than half the rate of <a href="/hometown-health/speaking-of-health/suicide-isnt-about-dying-its-about-perceived-relief" target="_self" title="Opens in same window.">suicide</a> attempts, compared to youth who felt low to moderate support, according to the survey.</p> <p>"Even if it's something that you're not sure of what to do, just be that listening ear, extending your love and support," says Dr. Billings.</p> <p>Don't worry about getting it perfect. And you don't have to do it alone.</p> <p>"We have a lot of avenues into different resources, whether that be mental health care providers, medical providers — in terms of whatever the needs are for that population of kids," says Dr. Billings.</p> <h2>Read more about how to help children:</h2> <ul style="list-style-type: disc;"> <li><a href="/hometown-health/speaking-of-health/5-ways-to-help-teens-overcome-suicidal-thoughts" target="_self" title="Opens in same window.">5 ways to help teens overcome suicidal thoughts</a></li> <li><a href="/hometown-health/speaking-of-health/social-media-risks-tips-to-keep-your-children-safe" target="_self" title="Opens in same window.">Social media risks: Tip to keep your children safe</a></li> <li><a href="/hometown-health/speaking-of-health/5-things-you-need-to-know-about-mental-health-and-girls" target="_self" title="Opens in same window.">5 things you need to know about mental health and girls</a></li> </ul> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/teenager-wearing-blue-hoodie.jpg?h=370&iar=0&w=660&sc_lang=en&hash=50AD1309C445DB58CE15731BD023DC6F" alt="Teenager wearing blue hoodie" width="660" height="370" DisableNVelocity="true" />Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Suicide PreventionSuicide is a major concern in the U.S. According to the Centers for Disease Control and Prevention, suicide was among the top nine leading causes of death for people ages 10–64 and the second leading cause of death for people ages 10–14 and 25–34. The positive news is that with the right information and willingness to reach out to someone in need, we all can help prevent suicide.<br /><br /><strong>If you are having suicidal thoughts, call the 988 Suicide and Crisis Lifeline at <a href="tel:988">988</a>, or chat at <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://988lifeline.org/" target="_blank" title="Opens in a new window.">988lifeline.org</a>.</strong>Dawn Haller6/13/2022Ear wax has many important jobs, including protecting and lubricating your ears. Discover the simple, safe way to keep your ears clean and why you shouldn't put a small object into your ear canal.The scoop on earwax<p>Wax has many uses, ranging from crayons and adhesives to polishes and candles. It also helps to protect and lubricate your ears.</p> <p>Cerumen, commonly called earwax, is found in the ear canal. It's made up of several components.</p> <p>The ear canal is lined with small hairs and glands. Earwax is made up of secretions from these glands, skin cells that have sloughed off, hairs that have shed and usual bacteria that lives on the skin's surface.</p> <p>Earwax has many jobs. It moisturizes the fragile ear canal skin, and prevents dry and itchy ears. It also protects the ear canal skin from infection, and traps dust and other foreign particles. It has antibacterial properties to protect your ears from unhealthy bacteria. Finally, its water-repelling features prevent water damage to the ear canal and eardrum.</p> <h2>How to clean your ears</h2> <p>The ears are self-cleaning for most people. Earwax migrates from deeper in the ear canal to the ear canal opening via different mechanisms, including normal skin migration pattern and movement of the jaw joint. These mechanism help push earwax outward toward the ear canal opening. Once it arrives, it falls out or is washed away.</p> <p>You don't need to take extra steps to keep your ears clean. Just wash your hair regularly and gently dry your ear canal opening with a towel.</p> <h2>Clinical removal of earwax</h2> <p>Some people produce an excessive amount of earwax. This can be due to various causes. Other people have issues with wax blockage because they put items into their ears, thus embedding the wax deeper into the ear canal.</p> <p>Talk with your health care team if you have concerns about your earwax or concerns that you may have a wax blockage. They can remove excess wax in the clinic using a small instrument called a curette, or suction or other specialized methods.</p> <h2>Hydrogen peroxide drops</h2> <p>Your health care team may recommend that you use hydrogen peroxide drops in your ears. Hydrogen peroxide is a cerumenolytic. This means that it softens, loosens, dissolves and breaks down earwax.</p> <p>This treatment should only be completed under the guidance or at the direction of a health care professional who will direct you on proper use, including the number of drops and length of time. It is likely your health care team will want you to return to the clinic after completing the treatment course to make sure that any remaining earwax is cleared and perform an ear exam.</p> <p>Hydrogen peroxide drops should not be attempted in people who have a history of recurrent ear infections, holes in eardrums or prior ear surgeries. It can cause harm and pain in these cases.</p> <h2>Keep items out of the ears</h2> <p>Never attempt to dig out excess or hard earwax using a paper clip, Q-tip or another small object. These instruments can push the earwax deeper into the ear canal, which can cause an earwax impaction.</p> <p>Q-tips and other small objects can traumatize the fragile ear canal skin and lead to infection and bleeding. They also can disrupt the tiny hairs that protect your ear canal skin. Finally, Q-tips contribute to single-use plastic waste, which is yet another great reason to avoid them.</p> <p><em><a href="/providers/fareeda-hussain-md" target="_self" title="Opens in same window.">Fareeda Hussain, M.D.</a>, is an <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">otolaryngologist</a> and head and neck surgeon in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a> and <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</em></p><ul> <li>Ear and hearing-related conditions, including chronic ear disease and cochlear implantation</li> <li>Head and neck endocrine surgeries, including thyroid and parathyroid issues</li> <li>Nonsurgical ear molding</li> <li>Outer ear deformities</li> <li>Pediatric ENT conditions</li> <li>Salivary gland disorders, including parotid masses</li> <li>Sinus and nasal disorders</li> </ul>M.D.<p>I enjoy practicing collaborative, individualized medicine, and including my patients in shared decision-making. I greatly value team care — when the patient, nurses and schedulers all are intimately involved in ensuring we work as a well-functioning team to deliver high-quality care.</p> <p>I grew up in Sri Lanka and moved to Minnesota for college. I did my undergraduate training at Winona State University, then several years of research at Mayo Clinic prior to completing medical school.</p> <p>In my free time, I enjoy being with my family, traveling and staying active.</p><p><strong>Education</strong></p> <ul> <li>Mayo Clinic Alix School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Otolaryngology and Head and Neck Surgery, University of Minnesota</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Head and Neck Surgery, American Academy of Otolaryngology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Otolaryngology-Head and Neck Surgery</li> <li>American Academy of Otolaryngology-Head and Neck Surgery, Women in Otolaryngology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Otolaryngology, Mayo Clinic College of Medicine and Science</li> </ul>Hussain<img src="/-/media/shared-files/images/medical-professionals/full/mankato/fareeda-hussain-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7E1879B82EFF6247427737390FB8C652" alt="Fareeda Hussain MD" width="280" height="280" DisableNVelocity="true" /><ul> <li><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Detection+of+colorectal+serrated+polyps+by+stool+DNA+testing%3A+comparison+with+fecal+immunochemicaltesting+for+occult+blood+(FIT)" target="_blank" title="Opens in new window.">Detection of colorectal serrated polyps by stool DNA testing: comparison with fecal immunochemical testing for occult blood (FIT)</a>, January 2014</li> <li><a href="https://www.ncbi.nlm.nih.gov/pubmed/23347191" target="_blank" title="Opens in new window.">Stool DNA testing for the detection of colorectal neoplasia in patients with inflammatory bowel disease</a>, March 2013</li> <li><a href="https://www.ncbi.nlm.nih.gov/pubmed/23804918" target="_blank" title="Opens in new window.">Surgical Repair of Tetralogy of Fallot at Age 83</a>, October 2012</li> <li><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Sole+abnormalities+of+chromosome+7+in+myeloid+malignancies%3A+Spectrum%2C+histopathologic+correlates%2C+and+prognostic+implications" target="_blank" title="Opens in new window.">Sole abnormalities of chromosome 7 in myeloid malignancies: Spectrum, histopathologic correlates, and prognostic implications</a>, July 2012</li> </ul>{1026DEB5-A821-4F7A-8AA8-A61170A07A2C}Fareeda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14791757Fareeda Hussain, M.D.1{E9B8BDBE-375B-4E7D-A1D2-2B64B5513AF7}|{18E5E65E-45C8-4C48-BD32-A914794E2AA4}<img src="/-/media/national-files/images/hometown-health/2022/wearing-baseball-style-cap-ponytail.jpg?h=370&iar=0&w=660&sc_lang=en&hash=664EA981D5A4E36C2781BF70A65888C1" alt="Person with ponytail wearing baseball style-cap" width="660" height="370" DisableNVelocity="true" />Ear HealthAn audiologist specializes in evaluating and treating people of all ages with hearing loss, dizziness and balance disorders. Specialty audiology consultation is available for assessment and treatment of hearing loss, tinnitus, dizziness and balance disorders.Ear, Nose and Throat (ENT)Get information about symptoms, disorders and diseases affecting the ear, nose and throat, and related head and neck structures.Dawn Haller7/5/2022Blue light-blocking glasses can be found everywhere. But should you buy a pair to protect your eyes from strain? Find out what research says.Are blue light-blocking glasses a must-have?<p>Blue light is one of the colors in the visible light spectrum. The others are red, orange, yellow, green, indigo and violet. When combined, they create white light. When the sun is shining, this is natural white light.</p> <p>Blue light has a shorter wavelength with higher energy: 400–500 nanometers. Blue-light exposure can affect the retina — the layer of cells lining the back wall inside the eye that sense light and send signals to the brain so you can see.</p> <p>Exposing the retina to shorter light wavelengths is the basis of "blue-light hazard" and contributes to phototoxicity or sensitivity to light. In animal studies, prolonged exposure to natural blue light has been shown to damage the retina.</p> <p>LED and compact fluorescent lamps also give off blue light. LEDs are used for the backlighting of computer screens, laptops, TVs and smartphones. Fortunately, the level of blue light from these devices is significantly less than the levels of blue light in natural daylight.</p> <p>However, at night, blue light exposure can potentially cause sleep issues by shifting your circadian rhythm, which is the body's internal clock. Research has suggested that excessive exposure to visible blue light also can cause eyestrain. Up to 69% of computer users report eyestrain, also known as computer vision syndrome.</p> <p>Since 2008, research into blue-blocking or filtering products, such as blue-blocking glasses, has increased. These products decrease the transmission of ultraviolet light involving wavelengths between 440 and 500 nanometers. Some digital devices now offer blue light-filtering settings that reduce the transmission of short wavelengths of light.</p> <p>Studies have been conducted on the benefits of blue-blocking lenses — whether these lenses alleviated eyestrain and discomfort when using digital devices and if sleep quality improved when the lenses were used in the evening. However, no significant improvement in vision performance or sleep quality has been found from using blue-blocking lenses.</p> <p>Since the amount of blue light from the devices used at work, school and home is less than that of natural sunlight, and eyestrain hasn't been found to be related to blue light, what can be done to prevent it?</p> <p>Prolonged screen time decreases your natural blink rate, which reduces the film of tears covering your eyes, making them dry. You can prevent this by:</p> <ul> <li>Taking frequent breaks during screen time. Try following the "20-20-20 rule." Every 20 minutes, look at an object 20 feet away for at least 20 seconds.</li> <li>Using artificial tears to refresh your eyes when they feel dry.</li> <li>Getting a vision exam to evaluate an uncorrected eyeglasses prescription or refractive error. This helps identify focusing issues and if your eyes are working well together, both of which could cause eyestrain.</li> </ul> <p>So rather than investing in blue-blocking glasses, you should:</p> <ul> <li>Monitor the length of screen time.</li> <li>Reduce the duration of your screen time.</li> <li>Take frequent breaks.</li> </ul> <p>If you're still experiencing eyestrain or other eye issues, make an appointment for a thorough eye examination to ensure your eyes stay healthy and any problems are caught early.</p> <p><em><a href="/providers/gretchen-kelly-od" target="_self" title="Opens in same window.">Gretchen Kelly, O.D.</a>, is an <a href="/services-and-treatments/ophthalmology" target="_self" title="Opens in same window.">optometrist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p> <ul> <li>Contact lenses</li> <li>General vision exams for all ages</li> </ul> O.D. <p><strong>Education</strong></p> <ul> <li>Pacific University College of Optometry</li> </ul> <p><strong>Internship</strong></p> <ul> <li>State University of New York</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Ophthalmology, Mayo Clinic College of Medicine and Science</li> </ul> Kelly<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/gretchen-kelly-od.jpg?h=280&iar=0&w=280&sc_lang=en&hash=9160614AE3B4312F63136B398970EFF4" alt="Gretchen Kelly OD" width="280" height="280" DisableNVelocity="true" /> Gretchen<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12739111Gretchen Kelly, O.D. 1<img src="/-/media/national-files/images/hometown-health/2022/wearing-blue-light-blocking-glasses.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B77CF7FE1A704F67B446EF2CAE8D7583" alt="Wearing blue light blocking glasses" width="660" height="370" DisableNVelocity="true" />Dawn Haller7/6/2022Misinterpreting a diagnosis can have a radically different meaning between similar-sounding conditions. This is true for inflammatory bowel disease, or IBD, and irritable bowel syndrome, or IBS.What’s the difference between inflammatory bowel disease and irritable bowel syndrome?<p>Receiving a diagnosis from your health care team can be difficult. You may only hear parts of the conversation as your mind starts to think about what treatment will be necessary or how this will affect your daily life. </p> <p>When receiving a diagnosis related to gastroenterological conditions, misinterpreting the diagnosis can have a radically different meaning between similar-sounding conditions. This is true for inflammatory bowel disease, or IBD, and irritable bowel syndrome, or IBS. </p> <h2>What is inflammatory bowel disease?</h2> <p><a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/symptoms-causes/syc-20353315" target="_blank" title="Opens in a new window.">Inflammatory bowel disease</a> is a group of autoimmune diseases that run the spectrum from ulcerative colitis to Crohn's disease. Inflammatory bowel disease is a dysregulation in the body where the immune system attacks the bowel and causes inflammation. </p> <p>The onset of inflammatory bowel disease may be triggered by a combination of a genetic predisposition and an illness or exposure to something in your environment that causes the immune system to attack the bowel and create inflammation.</p> <p>Inflammatory bowel disease has two peak times for diagnosis in adults: people in their early 20s to 30s and people in their 50s and 60s. </p> <h3>Common symptoms you may experience with inflammatory bowel disease are:</h3> <ul style="list-style-type: disc;"> <li>Diarrhea</li> <li>Rectal bleeding</li> <li>Bloating</li> <li>Occasional constipation</li> <li>Gas</li> <li>Urgent bowel movements</li> <li>Cramping abdominal pain</li> </ul> <p>Symptoms of inflammatory bowel disease may be experienced regularly and can significantly affect your quality of life. The treatment for inflammatory bowel disease is multifactorial. Treatment typically involves using immunosuppressive drugs to help the immune system avoid attacking the bowel. <a href="/hometown-health/speaking-of-health/lifestyle-and-diet-in-inflammatory-bowel-disease" target="_self" title="Opens in same window.">Dietary modifications</a> can decrease inflammation. </p> <h2>It's OK to talk about irritable bowel syndrome</h2> <p>You should not feel embarrassed discussing the symptoms of irritable bowel syndrome with your health care team. As many as 1 in 5 adults in the U.S. have signs and symptoms of irritable bowel syndrome; yet, fewer than 1 in 5 who have these symptoms seeks medical help. </p> <p><a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/symptoms-causes/syc-20360016" target="_blank" title="Opens in a new window.">Irritable bowel syndrome</a> is a functional bowel disorder that causes your digestive organs to look normal but not function normally. For most people, irritable bowel syndrome is a chronic condition that can fluctuate from producing mild to severe symptoms. Sometimes symptoms disappear entirely.</p> <h3>While irritable bowel syndrome can affect almost anyone, certain risk factors exist, including people who are:</h3> <ul style="list-style-type: disc;"> <li>Young</li> <li>Female</li> <li>Have a family history of irritable bowel syndrome</li> <li>Have a history of anxiety or depression</li> </ul> <h2>Living with irritable bowel syndrome</h2> <p>While irritable bowel syndrome cannot be cured, it doesn't permanently harm the intestines and doesn't cause cancer. Irritable bowel syndrome may affect your quality of life, so it's important to learn about your symptoms and what you can do to control them. </p> <p>The current understanding of irritable bowel syndrome indicates hypersensitivity in the gut causes the symptoms. This affects how your body perceives stimuli related to bowel function. Treatment focuses on relieving symptoms so you can live as normally as possible. </p> <p>In most cases, you can successfully control mild symptoms of irritable bowel syndrome by learning to manage stress and making healthy changes to your diet and lifestyle. This includes exercising regularly, <a href="/-/media/national-files/images/hometown-health/2018/tips-for-drinking-more-water.jpg" target="_self" title="Opens in same window.">drinking plenty of fluids</a> and getting enough sleep. Your health care team may prescribe other specific dietary changes, medications and supplementary treatments.</p> <p>While living with irritable bowel syndrome can present daily challenges, your health care team is available to help. They can guide you through an appropriate evaluation of your symptoms and provide treatments to help you optimize your quality of life. </p> <em><a href="/providers/daisy-batista-md" target="_self" title="Opens in same window.">Daisy Batista, M.D.</a>, is a <a href="/services-and-treatments/gastroenterology-and-hepatology" target="_self" title="Opens in same window.">gastroenterologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em><ul> <li>Diagnostic and therapeutic endoscopy</li> <li>Management of advanced inflammatory bowel disease and Crohn's disease</li> </ul>M.D.<p>My area of expertise is in the care of patients with inflammatory bowel disease, such as ulcerative colitis and Crohn's disease. I also see patients with a variety of general gastrointestinal (GI) complaints, such as diarrhea, constipation and reflux.</p> <p>I enjoy teaching patients about their disease as a tool to empower them to make decisions that would help them get relief of their symptoms and achieve the highest quality of life possible.</p><p><strong>Education</strong></p> <ul> <li>University of Chicago, Pritzker School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Massachusetts General Hospital</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Massachusetts General Hospital</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Gastroenterology, University of Florida, Shands University Hospital</li> <li>Advanced Inflammatory Bowel Disease, Mayo Clinic</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Gastroenterology, American Board of Gastroenterology</li> <li>Hepatology, American Board of Internal Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Gastroenterology</li> <li>American Gastroenterology Association</li> <li>American Society of Gastrointestinal Endoscopy</li> <li>Crohn's and Colitis Foundation of America</li> </ul>Batista<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/daisy-batista-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4A32C6488B16AA601137C0EACEFA17E6" alt="Daisy Batista, M.D." width="280" height="280" DisableNVelocity="true" />Daisy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15833224Daisy Batista, M.D.1{CDA27FD1-23E5-4D31-BD85-567A48B862F7}|{63CBB755-37F9-4058-9120-6CD50C94BD16}|{164A5F93-090D-40B1-B93B-7C91986AE546}<img src="/-/media/national-files/images/hometown-health/2022/sitting-holding-arms-around-stomach.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3068A687CE728742BAA7D9A75C98AFDD" alt="Sitting holding arms around stomach" width="660" height="370" DisableNVelocity="true" />Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Dawn Haller7/12/2022Vegetable gardens are gaining popularity. Digging in the dirt and growing your own food can improve your physical and mental health. Get the scoop and gather tips before starting a garden.Dig into the benefits of gardening<p>Growing your own food in a garden isn't a new idea. It was a critical way for ancient people to have access to reliable, nutritious foods.</p> <p>The necessity of vegetable gardens has varied through time. Gardening has gained popularity recently, even with easy and inexpensive access to food at grocery stores. </p> <p>A study found that interest in gardening increased during the COVID-19 pandemic. People spent more time at home and turned to their gardens for a connection to nature, stress relief and food provisions.</p> <p>For 10 years, I've tended large vegetable and flower gardens at my home. I find it to be challenging and gratifying to watch the gardens grow and develop.</p> <h2>Here are a few of the many benefits I've found from digging in the dirt:  </h2> <h3>Increased exercise</h3> <p>A busy day in the garden can be a good form of exercise. While tending a garden, you perform functional movement that mimics whole body exercise. You perform squats and lunges while weeding. Carrying bags of mulch and other supplies works large muscle groups. Digging, raking and using a push mower can be physically intense activities.</p> <p>You may burn as many calories as a workout in the gym. If you aren't used to these types of activities, it is likely that you will feel a bit sore after a busy day gardening. Gardening also can improve your balance, strength and flexibility.</p> <p>Gardening activities can be modified if movement is a challenge. There are different ways to participate if you think outside of the box. Use a small stool or raised garden beds if you suffer from back pain. A shovel or rake can be used to support your knees when squatting. Smaller pots are lighter and easier to move than large ones. Buy smaller bags of mulch or soil that are easier to carry.</p> <h3>Improved diet</h3> <p>Growing and eating your own fruits and vegetables can have a positive impact on your diet. Gardeners are more likely to include vegetables as part of healthy, well-balanced diets. My family eats corn, potatoes and salsa made from ingredients grown in our garden year-round.</p> <p>Different vegetables have a variety of unique health benefits. Peppers contain capsaicin, which has anti-inflammatory properties and can reduce heart disease. Tomatoes are high in vitamin C and potassium. They also contain lycopene, an antioxidant that may reduce prostate cancer risk. Sweet potatoes are high in beta carotene, an antioxidant that may help slow the aging process and reduce the risk of some cancers. Spinach may boost your immune system and broccoli protects your body's cells from damage.</p> <h3>Time in nature</h3> <p><strong> </strong></p> <p>Getting outdoors is good for your physical and mental health. People tend to breathe deeper when outside. This helps to clear out the lungs, improves digestion, improves immune response and increases oxygen levels in the blood.</p> <p>Spending time outdoors has been shown to reduce heart rate and muscle tension. Sunlight lowers blood pressure and increases vitamin D levels.</p> <h3>Reduced stress levels</h3> <p>Nearly all forms of exercise can reduce stress including gardening. It's been shown to lighten mood and lower levels of stress and anxiety. It's very gratifying to plant, tend, harvest and share your own food.</p> <p>Routines provide structure to our day and are linked to improved mental health. Gardening routines, like watering and weeding, can create a soothing rhythm to ease stress.</p> <p>After a day in the clinic, my routine is to check in with my family and then spend an hour or so in my garden. I find that pulling weeds can be therapeutic and calming after a long day. It provides the opportunity to slow down, plan or mentally work out a problem.</p> <h3>Social connection</h3> <p>Gardening brings people together and strengthens social connections. The gardening community is rich with people willing to share their expertise, time and occasionally plants with new gardeners. Master gardeners are local volunteers dedicated to educating and empowering fellow gardeners. Community garden plots bring together people with diverse backgrounds to work on a common goal. Many gardening friendships begin over celebrating a success or bemoaning a gardening misstep.</p> <p>Social connections are important because they help lower stress, improve resilience and provide support during difficult times in life. A strong sense of belonging lowers your risk of depression, anxiety and suicide.     </p> <p>The friendships that I've made have been the biggest benefit of gardening for me. During the spring, my friends and neighbors plan our vegetable gardens together. We discuss what worked well or needs to be improved from the previous year. In summer, we share extra produce with each other. In the fall, we host a big salsa making party to enjoy the harvest together. These activities improve the joy we get out of the garden and strengthen our connections.</p> <h2>Starting a garden</h2> <h3>Here are three tips if you are considering starting a garden at your home:</h3> <ul> <li><strong>Start small.</strong> <br /> It's easy to get excited and want a large plot with many plants. Don't take on more than you can handle because that could cause more stress. The larger the garden, the more work it is. It can quickly overwhelm you if you don't have enough resources or time to care for it. You can always increase the size of your garden in the future. </li> <li><strong>Build a network.</strong> <br /> Find other people who are interested in gardening. Learn from each other's successes and failures. </li> <li><strong>Research appropriate plants.</strong> <br /> Find plants that grow well in your climate or hardiness zone. Talk with local master gardeners or county agricultural resource office to get tips on what plants thrive in your area. This improves your chances of success and lowers the stress and potential disappointment.</li> </ul> <em><a href="/providers/lisa-wimmer-dnp" target="_self" title="Opens in same window.">Lisa Wimmer</a></em><em> is a nurse practitioner in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> and avid gardener in </em><em><a href="/locations/lake-city" target="_self" title="Opens in same window.">Lake City</a></em><em>, Minnesota.</em><ul> <li>Acute and chronic disease management</li> <li>Mental health and addiction</li> <li>Palliative medicine</li> <li>Preventive medicine</li> <li>Women’s health</li> </ul>APRN, C.N.P., D.N.P.<p>I enjoy getting to know my patients, establishing a relationship, and working together to optimize their health goals.</p> <p>In my spare time, I enjoy spending time with family and friends, four-wheeling, tending to my chickens and three Golden Retrievers, gardening and bowling.</p><p><strong>Education</strong></p> <ul> <li>Bachelor’s Degree in Nursing, Chamberlain University</li> <li>Doctor of Nursing Practice (DNP), Family/Primary Care Focus, Viterbo University</li> </ul> <p><strong>Residency </strong></p> <ul> <li>Mayo Clinic College of Medicine and Science & Mayo Clinic School of Health Sciences, Nurse Practitioner Program</li> </ul> <p><strong>Certification </strong></p> <ul> <li>Family Nurse Practitioner Certification, American Academy of Nurse Practitioners</li> </ul>Wimmer<img src="/-/media/shared-files/images/medical-professionals/full/lake-city/lisa-wimmer-np.JPG?h=280&iar=0&w=280&sc_lang=en&hash=AF228AC35C9A5C287EF231EEFED4FA90" alt="Lisa Wimmer NP" width="280" height="280" DisableNVelocity="true" />Lisa<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13620916Lisa Wimmer, APRN, C.N.P., D.N.P.1<img src="/-/media/national-files/images/hometown-health/2022/gardening-in-raised-bed.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1FB6FB346009267AB4714442ED73E81B" alt="Gardening in raised bed" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller7/25/2022Genes act like an instruction manual for your body. Genetic testing can tell if you have an increased risk for developing certain conditions like cancer. Get answers to common testing questions.9 common questions about genetic testing for cancer<p>Your genes play a role in nearly all areas of your health. A gene is like an instruction manual for your body that tells your body how to function, develop and stay healthy. People have about 20,000 genes in their bodies.</p> <p>Many health conditions have a genetic link. Genetic testing can help you and your health care team understand if you have an increased risk for developing certain conditions that are present in your family. If you're at risk, you may be able to take preventive measures to decrease your risk or undergo genetic testing to clarify your risk.</p> <h2>Here are nine common questions about genetic testing:</h2> <h3>Do all types of cancers have a genetic component?</h3> <p><strong> </strong></p> <p>Most cancers are considered sporadic, meaning the cancer happens randomly or has environmental influences, such as smoking and lung cancer. About 25% of cancers are considered familial. This is when multiple members of a family are affected by cancer. These family members have some shared genetic factors in combination with shared environmental factors that lead to the development of these cancers.</p> <p>About 10% of cancers are considered hereditary or have a single specific genetic component that can be tested and increase a person's risk for developing cancer. Genetic counseling and genetic testing can help determine which category a person's individual or family cancer falls into. It also can help estimate your risk for developing cancer.</p> <h3>What types of genes are examined during genetic testing?</h3> <p><strong> </strong></p> <p>You may have an increased risk for some health conditions, including some types of cancer, based on your genes. A genetic test looks for specific harmful gene changes, called mutations or pathogenic variants, that can cause you to develop a genetic condition. Gene changes are like spelling errors within your body's instruction manual.</p> <p>Most genetic tests look for changes in group of genes called a panel. However, testing may look for changes in a single gene when there is a known genetic mutation in your family. The most common genes typical thought of related to cancer risk are BRCA1 and BRAC2. These genes are associated with breast and ovarian cancer. It's known that changes in other genes can increase risk for these cancers, as well.</p> <p>There also are gene panels that assess risk for other cancers, such as colorectal, pancreatic, prostate, liver, uterine and endometrial cancers.</p> <h3>Am I guaranteed to get cancer if I have a known gene?</h3> <p><strong> </strong></p> <p>No. Inheriting a harmful gene change means that you have an increased risk for cancer, but it does not guarantee that you will develop a cancer in your lifetime.</p> <p>If testing shows that you have an increased risk for cancer, you may need to be screened earlier or more often. For example, if you have a change in the BRCA gene that increases your risk for breast cancer, your care team will recommend that you have mammogram or MRI breast screenings beginning at a younger age or more frequently. The genetic counselor will explain your associated cancer risks and screening recommendations based on your genetic test results.</p> <h3>What criteria do I need to meet to have genetic testing completed?</h3> <p><strong> </strong></p> <p>Your health care team may recommend genetic testing based on guidelines established by the National Comprehensive Cancer Network (NCCN). These guidelines use factors such as your personal cancer history, family cancer history, ancestry or the presence of abnormal cells to determine if you qualify for genetic testing.</p> <p>If you do not meet the NCCN guidelines, you can still pursue testing. Your health insurance may not cover any or all of the testing costs, so more out-of-pocket expenses to be tested are possible.</p> <h3>Can genetic testing help during cancer treatment?</h3> <p><strong> </strong></p> <p>If you are battling cancer, genetic testing can help your care team make recommendations for treatments and surgical procedures. For example, some cancers associated with genetic mutations respond better to certain types of chemotherapy treatments. Similarly, genetic testing can help you determine between a lumpectomy or a mastectomy when making surgical decisions about breast cancer. It also can affect the management of cancer risk over time.</p> <p>The results also can help other family members. Potentially, your children, siblings, nieces and nephews could have inherited the same gene mutation. Knowing this information can help them establish early screening schedules and make healthy decisions about their lives.</p> <h3>How can I prepare for a genetic testing consultation?</h3> <p><strong> </strong></p> <p>Gathering a detailed family health history is the most important thing to prepare for a genetic counseling appointment. Try to gather information about relatives, including types of cancer diagnosed, age of diagnosis, current age or age at death. Also find out if any relatives have previously had genetic testing completed.</p> <p>If no previous genetic testing has been performed, often the best person to be tested is the family member with cancer. That person is most likely to have a genetic change, if there is one. If an affected family member is unavailable for testing due to death or lack of interest, an unaffected person can still be tested.</p> <p>Something else to think about before your consultation is the purpose of your test. Younger patients usually want to know their personal risk so they can do extra screening. Older patients who are cancer survivors may wish to gather information and share it with downstream family members so they are aware of harmful genetic changes they could have potentially inherited.</p> <h3>Am I only able to get cancer if I have the BRCA gene or one of these other genes?</h3> <p>A common misconception is that you have one of these genes or you don't. Everyone has the BRCA genes and these other genes associated with cancer risk. The role these genes play in the body is to prevent cancer from occurring.</p> <p>It's when a harmful change occurs in one of these genes that causes it not to work like it should. This leads to the increased risk for cancer to develop.</p> <p>People without these harmful changes can still develop cancer, but the risk is not as high as someone who has a hereditary predisposition.</p> <h3>Am I more likely to inherit something from a parent of the same sex as me? Or the parent that I most resemble?</h3> <p><strong> </strong></p> <p>No. Every person has two copies of every gene — one copy inherited from each parent. If a parent has a harmful genetic change in one copy of a gene, it is random which copy they will pass on to children.</p> <p>Every child has a 50-50 chance of inheriting the typical copy or the changed copy, regardless of you or your parent's biological sex, or whether you more closely resemble one side of the family.</p> <h3>There is breast cancer on my dad's side of the family, I'm not at risk because my dad can't pass that on, right?</h3> <p>People often think that a heritable risk for some cancers, such as breast and ovarian cancer, can't be passed on from males. This is not true.</p> <p>All people, regardless of biological sex, can carry a heritable risk factor for any type of cancer and can pass it on to any of their children.</p> <p>While you can't change your genes, you can control some aspects of your environment, such as diet and physical activity level, as well as alcohol and tobacco use. That's why it's still so important to live a healthy life, regardless of your personal and family genetic history.</p> <p><em><a href="/providers/breanna-mitchell-ms" target="_self" title="Opens in same window.">Breanna Mitchell</a> is a <a href="/services-and-treatments/medical-genetics" target="_self" title="Opens in same window.">genetic counselor</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin. She also is available to consult with patients at any location through virtual visits.</em></p> <ul> <li>Genetic counseling for family planning, prenatal and hereditary cancer syndromes</li> </ul> CGC <p>I'm am excited to be a part of the Mayo Clinic Health System team and have the opportunity to share the benefits of genetic counseling and demonstrate the utility of our practice.</p> <p><strong>I see patients in person in Eau Claire and La Crosse, Wisconsin, and offer video visits for patients referred for genetic counseling at other Mayo Clinic Health System locations.</strong></p> <p>In my free time, I enjoy exploring the local Eau Claire cuisine and spending time at the dog parks.</p> <p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Genetics, Cell Biology & Development, University of Minnesota</li> <li>Master's degree, Genetic Counseling, University of Wisconsin</li> </ul> <p><strong>Membership</strong></p> <ul> <li>National Society of Genetic Counselors</li> </ul> Mitchell<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/breanna-mitchell-ms.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7ACD6FDE328C9FCAF3130DCE6A741563" alt="Breanna Mitchell, M.S." width="280" height="280" DisableNVelocity="true" /> {5E30DC78-E3D7-40B9-B466-03FB9EDFDCBF}Breanna<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30175421Breanna Mitchell, CGC 1{546684F5-41C6-4BEA-AD6B-DE3D7D6451C1}<img src="/-/media/national-files/images/hometown-health/2022/person-leaning-on-shoulder-of-another.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6727B12D042A86ECA5601FAC040A888B" alt="Person leaning on shoulder of another" width="660" height="370" DisableNVelocity="true" />Genetic TestingGenetic testing examines your DNA — the chemical database that carries instructions for your body's functions — to reveal changes or alterations in your genes that may cause illness or disease. <br/><br/>CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Dawn Haller7/14/2022Feeling tired during the day may seem like a minor annoyance. But not getting enough sleep is linked to poor health. New research from Mayo Clinic is a wake-up call on why a healthy sleep schedule matters.Give your heart some love with sleep<p>Over the past 50 years, sleep habits of people in the U.S. have changed dramatically. Increased exposure to artificial light, shift work and 24-hour services have become common. With these changes, sleep duration has decreased.</p> <p>Thirty-five percent of U.S. adults report sleeping six hours or fewer per night. Beyond feeling tired, <a href="/hometown-health/speaking-of-health/8-common-sleep-study-questions" target="_self" title="Opens in same window.">lack of sleep</a> has been identified to be an influence for many diseases. For example, shorter sleep duration is recognized as a cardiometabolic risk factor linked to poor health. Why that is remains unclear, but new research from Mayo Clinic is starting to shed light on this mystery.</p> <h2>Sleep and fat</h2> <p>You may feel more hungry when you don't get enough sleep. While you may think this is justified by burning more calories when not sleeping, unfortunately, this isn't true.</p> <p>In a recent study, normal, healthy volunteers were allowed only to sleep two-thirds of their average sleep time. During the period of reduced sleep, the volunteers ate an additional 559 calories per day but did not change <a href="/hometown-health/speaking-of-health/getting-your-weight-loss-back-on-track" target="_self" title="Opens in same window.">physical activity to burn off those calories</a>.</p> <p>In a follow-up study, the same volunteers spent nine hours per night in bed for two weeks followed by two weeks with only four hours per night in bed. During the period of the shorter time in bed, the volunteers consumed an additional 308 calories per day and did not change physical activity to burn off those calories.</p> <p>The additional food consumption translated into 1.1 pounds of weight gain. Notably, the extra 1.1 pounds was fat deposited in the visceral fat of the abdomen, which seems to be a particularly dangerous place for the body to store fat.</p> <p>Extra fat tissue around the organs in the abdomen is less sensitive to insulin, more metabolically active, and produces more proinflammatory effects. These factors may explain why visceral fat is linked to cardiovascular disease. /p> </p> <p>It is unclear if efforts to enhance sleep can help a person lose weight. If you experience a lack of sleep, try to resist the munchies and make healthy food choices.</p> <h2>Sleep and blood pressure</h2> <p>Beyond the visible effects of weight gain related to lack of sleep, perhaps even more concerning are the effects that aren't as detectable.</p> <p>In another study on sleep, it was found when people were not allowed to sleep their normal time, their blood vessels did not function properly. Healthy blood vessels expand and contract to meet the body's needs through a process regulated by the hormone nitric oxide. </p> <p>When this process doesn't work correctly, you are more likely to develop <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/arteriosclerosis-atherosclerosis/symptoms-causes/syc-20350569" target="_blank" title="Opens in a new window.">atherosclerosis</a>, or hardening of the arteries.</p> <p>During sleep deprivation, a specific type of blood vessel function — flow-mediated dilatation — doesn't work correctly. This is due to the inability of the body to produce nitric oxide, but not the ability of the body to respond appropriately to nitric oxide. /p> </p> <p>In a follow-up study that was more extensive, people were allowed to sleep only four hours per night for 16 days. Again, the results showed impaired blood vessel function and increased blood pressure while awake and asleep.</p> <p>Effects on <a href="/hometown-health/speaking-of-health/know-your-numbers-blood-pressure">blood pressure</a> were primarily seen in women, although the reason is unknown at this point.</p> <p>Whether improving sleep can improve control of blood pressure is unclear. For now, it seems logical that following a healthy sleep schedule is wise if you're trying to maintain healthy blood pressure or reduce high blood pressure.</p> <em><a href="/providers/andrew-calvin-md" target="_self" title="Opens in same window.">Andrew Calvin, M.D.</a>, is a <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em><ul> <li><a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/echocardiogram/basics/what-you-can-expect/prc-20013918" target="_blank" title="Opens in a new window.">Echocardiography</a></li> <li><a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/echocardiogram/basics/what-you-can-expect/prc-20013918" target="_blank" title="Opens in a new window."> </a><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/definition/con-20019580" target="_blank" title="Opens in a new window.">Hypertension</a></li> <li><a rel="noopener" href="http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/definition/con-20019580" target="_blank" title="Opens in a new window."> </a><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/basics/definition/con-20020865" target="_blank" title="Opens in a new window.">Lipid disorders</a></li> <li>Medical education</li> <li> Preventive cardiology</li> <li> <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/stress-test/about/pac-20385234" target="_blank" title="Opens in a new window.">Stress testing</a></li> <li>Valve disorders</li> </ul>M.D., M.P.H.<p>I'm a specialist in cardiovascular medicine with a passion for prevention of cardiovascular disease, cardiovascular physiology and noninvasive testing. I seek to match the best available treatments to my patients’ preferences and values through shared decision-making.</p> <p>In addition to practicing clinical cardiology, I have the privilege of serving as Chair of Education for Mayo Clinic Health System. I love working with medical students, residents, and trainees, as it helps improve our practice. I am also passionate about ongoing professional education, with leadership roles as an Associate Dean in the Mayo Clinic School of Continuous Professional Development, a member of the Cardiovascular Disease Approval Committee of the American Board of Internal Medicine, and a member of the board of directors of the Wisconsin Medical Society.</p><p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> <li>Master of Public Health, University of Minnesota School of Public Health</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Internal Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Cardiovascular Disease, Mayo Clinic School of Graduate Medical Education</li> <li>Echocardiography, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Cardiovascular Disease, American Board of Internal Medicine</li> <li>Internal Medicine, American Board of Internal Medicine</li> <li>Adult Comprehensive Echocardiography, National Board of Echocardiography</li> <li>Special Qualification in Preventive Cardiology, Mayo Clinic </li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Cardiology</li> <li>American College of Physicians</li> <li>American Heart Association</li> <li>American Medical Association</li> <li>American Society of Echocardiography</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Associate Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Calvin<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/andrew-calvin-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=950E112EFF943E2362105E122B66405C" alt="Andrew Calvin, M.D." width="280" height="280" DisableNVelocity="true" />{9552C266-D741-4612-8CB3-21B67C81B413}Andrew<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14765101Andrew Calvin, M.D.1{676428F6-179A-4C9B-9B23-5F1E40032A38}<img src="/-/media/national-files/images/hometown-health/2022/sleeping-head-on-pillow.jpg?h=370&iar=0&w=660&sc_lang=en&hash=05FB3CC0AC54AF6E8367D265D44E7A7B" alt="Sleeping with head on pillow" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.SleepSleep is essential to good health. It's one of the body's basic needs. But, what do you do when you have troubles sleeping, or getting enough hours of sleep? Dawn Haller12/16/2022When a friend or family member experiences depression, it's difficult to know what to do or say. Here's how to offer support and understanding, and help your loved one get the resources they need.Supporting a loved one experiencing depression<p>When a loved one is affected by depression, it can be difficult to understand or know how to help</p> <p>Depression is an incredibly complex and individualized experience. There isn't one truth or simple solution that works for every person.</p> <h2>Downward-spiraling staircase of depression</h2> <img alt="Depression spiral" src="/-/media/national-files/images/hometown-health/2022/depression-spiral.png?h=332&w=200&sc_lang=en&hash=A601C513D0DB4C677AB155F1B150E420" style="width: 200px; height: 332px; float: right; margin-bottom: 5px; margin-left: 5px;" /> <p>Gaining perspective on what your loved one is experiencing is a crucial part of the process. Visualizing depression as a downward spiral is one way to simplify and understand clinical depression.</p> <p>One way to develop perspective is by visualizing depression as a steep, downward-spiraling staircase. Your loved one may be having difficulty finding an open door along that staircase or may not be able to turn around without your support and guidance.</p> <p>The downward-spiraling staircase may start with the person feeling worse than usual from a physical, social or psychological stressor. A worsened mood may lead to taking part in fewer meaningful or enjoyable day-to-day activities. Self-criticism and stress increase due to mounting responsibilities or missed opportunities. Depressive thinking may encompass guilty thoughts, pessimism, putting themselves down and irritable behavior.</p> <p>As the spiral develops, a complex dynamic emerges. Your loved one may become increasingly stressed while simultaneously less able to cope with stress. The response of the brain is to slow, stop and depress. A person can get stuck in the spiral for weeks, months or years.</p> <p>The silver lining is that if people can spiral down, they can spiral back up. However, depression affects the motivation, energy and curiosity needed to spiral up.</p> <p>It can be disheartening and stressful that you can't fix a loved one's depression. But you can help them start and continue moving on an upward path.</p> <h2>Symptoms of depression</h2> <h3>Depression symptoms vary from person to person, including:</h3> <ul> <li>Feelings of sadness, tearfulness, emptiness or hopelessness</li> <li>Angry outbursts, irritability or frustration, even over small matters</li> <li>Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports</li> <li>Insomnia or sleeping too much</li> <li>Tiredness and lack of energy, so even small tasks take extra effort</li> <li>Changes in appetite — reduced appetite and weight loss, or increased cravings for food and weight gain</li> <li>Anxiety, agitation or restlessness</li> <li>Slowed thinking, speaking or body movements</li> <li>Feelings of worthlessness or guilt, fixating on past failures or taking unnecessary blame for things</li> <li>Trouble thinking, concentrating, making decisions and remembering things</li> <li>Frequent or recurrent mention of death, suicidal thoughts, suicide attempts or death from suicide</li> </ul> <p>For many with depression, symptoms can be severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities or relationships with others. Others may generally feel miserable or unhappy without knowing why.</p> <p>Children and teens may show depression by being irritable or cranky rather than sad. Clinical depression doesn't require profound sadness. Rather it can be lack of positive emotion instead of intensely negative feelings.</p> <h2>Encourage treatment for symptoms</h2> <p>People with depression may not recognize or acknowledge their symptoms. They also may have difficulty asking for help or recognizing how treatment can help.</p> <h3>Here's what you can do to help:</h3> <ul> <li>Talk to the person about what you've noticed and why you're concerned.</li> <li>Explain that depression is a complex condition, not a personal flaw or weakness</li> <li>Remind them there are people who want to help them.</li> <li>Suggest seeking help from a health care or a mental health professional</li> <li>Consulting with a primary care professional can be the best place to start since a trusting relationship already has been established.</li> <li>Express your willingness to help by setting up appointments, accompanying your loved one and attending family therapy sessions.</li> <li>Offer to help prepare a list of questions and notable changes to discuss at an initial consultation.</li> </ul> <h2>Provide support</h2> <p>Your support and understanding can kick-start or reinforce the healing process.</p> <h3>Here are some ideas for helping your loved one:</h3> <ul> <li><strong>Encourage sticking with treatment.</strong><br /> Help your friend or loved one remember to take prescribed medications and keep appointments.</li> <li><strong>Be willing to listen without judgment — when desired.</strong><br /> When your loved one wants to talk, listen carefully and intently. Avoid giving too much practical advice or opinions, or making judgments. Just listening and being understanding can be a powerful healing tool.</li> <li><strong>Give positive reinforcement.</strong><br /> Remind your loved one about his or her positive qualities and how much the person means to you and others.</li> <li><strong>Offer assistance.</strong><br /> Certain tasks for your loved one may be hard to do. Suggest specific tasks you're able to help with or take on.</li> <li><strong>Help establish a routine.</strong><br /> Depression may make it hard for your loved one to make spontaneous healthy choices. Developing routines and scheduling everyday activities becomes crucial. Offer to make a schedule for meals, medication, physical activity and sleep, outside time or time in nature, and help organize household chores.</li> <li><strong>Make plans together.</strong><br /> Ask your loved one to join you on a walk, see a movie or work together on a hobby or other activity. Don't try to force the person into doing something.</li> <li><strong>Be patient.</strong><br /> For some people, symptoms can quickly improve after starting treatment. For others, it will take much longer.</li> </ul> <h2>Be aware of suicide risk</h2> <p>People experiencing depression are at an increased risk of death from suicide.</p> <h3>If you believe a loved one's illness is severe or life-threatening emergency, please reach out to these resources for help:</h3> <ul> <li>Call the 988 Suicide and Crisis Lifeline at <a href="tel:988">988</a>. To reach the Veterans Crisis Line, use the same number and press "1."</li> <li>Call <a href="tel:911">911</a>.</li> <li>Contact a health care professional or hospital.</li> </ul> <h2>Remember to take care of yourself</h2> <p>Witnessing a loved one's struggle with depression and knowing you can't fix it is challenging. Understand that emotions you experience, such as frustration, helplessness, fear, guilt or anger, are all natural responses. It's important to take care of yourself, too. Validate your feelings and prioritize your own mental health by devoting time to hobbies, meaningful experiences, physical activity and other valued, meaningful relationships.</p> <p><a href="/providers/jessie-wolf-licsw" target="_self" title="Opens in same window."><em>Jessie Wolf</em></a><em> is a clinical social worker in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Adjustment disorders</li> <li>Adolescent and children’s behavioral health (ages 6-17)</li> <li>Anxiety disorders</li> <li>Attention-deficit/hyperactivity disorder (ADHD) assessment and treatment with adults and children (ages 6-17)</li> <li>Depressive disorders</li> <li>Grief and loss</li> </ul>L.I.C.S.W.<p>I see children six years of age through adulthood.</p><p><strong>Education </strong></p> <ul> <li>Master's degree, Social Work, Minnesota State University-Mankato</li> </ul> <p><strong>Internships</strong></p> <ul> <li>Hospice and Palliative Care, Mayo Clinic Health System-Mankato</li> <li>Nursing Home and Rehab Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>ADHD, Certified Clinical Services Provider </li> <li>Art of Traumatic Grief Counseling, Compassionate Bereavement Care</li> <li>Licensed Independent Clinical Social Worker</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Professional Society of ADHD and Related Disorders</li> <li>National Social Work Association</li> </ul> <p><strong>Academic Rank</strong></p> <ul> <li>Instructor in Social Work, Mayo Clinic College of Medicine and Science</li> </ul>Wolf<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jessie-wolf-licsw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B680201D1A0D763676AD889806D46E00" alt="Jessie Wolf LICSW" width="280" height="280" DisableNVelocity="true" />Jessie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14640821Jessie Wolf LICSW1{2B88C934-922C-4130-B661-197B59D83899}|{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2022/two-people-hugging.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6271A808AE2A31705A847BA1D610765C" alt="Two people hugging, resting head on shoulder, arm around neck" width="660" height="370" DisableNVelocity="true" />Suicide PreventionSuicide is a major concern in the U.S. According to the Centers for Disease Control and Prevention, suicide was among the top nine leading causes of death for people ages 10–64 and the second leading cause of death for people ages 10–14 and 25–34. The positive news is that with the right information and willingness to reach out to someone in need, we all can help prevent suicide.<br /><br /><strong>If you are having suicidal thoughts, call the 988 Suicide and Crisis Lifeline at <a href="tel:988">988</a>, or chat at <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://988lifeline.org/" target="_blank" title="Opens in a new window.">988lifeline.org</a>.</strong>DepressionDepression is a medical illness that causes a persistent feeling of sadness, loss of interest and, sometimes, physical symptoms. It's also called major depression, major depressive disorder and clinical depression.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller7/20/2022It's impossible to avoid stress. Find out why massage therapy isn't just for pampering and can help your body and mind find relief.Can massage relieve symptoms of depression, anxiety and stress?<p>Stress is an inevitable part of life. It is nearly impossible to remove all stress from day-to-day life. Stress is physiological and psychological responses to situations the body and mind find to be overwhelming.</p> <p>Even situations perceived as good, like getting married, starting a new job or becoming a parent, can produce significant stress. When people struggle to cope with stressful situations, depression and anxiety symptoms can become more noticeable.</p> <p>Massage therapy is one of many ways to cope with stress, and treat anxiety and depression.</p> <p>Some people mistakenly believe that massage therapy is only for pampering yourself. While this is true for some people, it also helps manage anxiety, depression and insomnia.</p> <h2>Physical benefits of massage</h2> <p>A massage does more than just feel good. It can lower the amount of cortisol in your body. This hormone is produced when your body is stressed. It increases glucose in your bloodstream, enhances your brain's use of glucose and curbs functions that are nonessential in a fight-or-flight situation.</p> <p>A one-hour massage lowers cortisol in your body while also releasing serotonin. This hormone neurotransmitter is sometimes called the "happy chemical" because it reduces feelings of depression and carries signals between nerves and your body. By lowering cortisol and increasing serotonin, you're boosting your body's ability to fight off pain, anxiety and feelings of sadness.</p> <p>Also, massage could be considered an hourlong hug, as it can fulfill the need for human contact and comforting touch. A session provides you with a nurturing safe place to physically rest.</p> <h2>Emotional benefits of massage</h2> <p>Massage provides many emotional benefits, which can be just as important as the physical benefits. Many people say that after a massage they feel more relaxed and calmer. It a safe and nurturing place for people to refocus and find clarity.</p> <p>Massage can lower stress levels and feelings of anxiety. It can improve mood and relaxation while increasing confidence and self-image.</p> <p>If you experience depression or anxiety, or are just overloaded with extra stress, massage can be an effective part of treatment. It can create a sense of relief and empowerment, and allow you to focus on your mind-body connection.</p> <p>Massage therapists listen to your needs and concerns. They can develop a treatment plan to decrease stress and symptoms of anxiety and depression. Sessions range from 15 to 90 minutes in length. Therapeutic massage may help support you on your mental health journey.</p> <em><a href="/providers/amy-marsolek-lmt" target="_self" title="Opens in same window."><em>Amy Mar</em><em>solek</em></a> is a <a href="/services-and-treatments/massage-therapy" target="_self" title="Opens in same window.">massage therapist</a> in </em><em><a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a></em><em>, Wisconsin.</em><ul> <li>Infant massage</li> <li>Massage for cancer patients</li> <li>Medical massage for injuries and headaches</li> <li>Pregnancy massage</li> <li>Sports medicine massage</li> </ul>MSSG-C<p>I offer Swedish, hot stone, deep tissue and chair massages.</p><p><strong>Education</strong></p> <ul> <li>Massage Therapy, Capri College</li> <li>Occupational Therapy Assistant, Western Wisconsin Technical College</li> </ul>Marsolek<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/amy-marsolek.jpg?h=280&iar=0&w=280&sc_lang=en&hash=66DBCA016645D8C1258AACFFD2ABE880" alt="Amy Marsolek" width="280" height="280" DisableNVelocity="true" />Amy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12739201Amy Marsolek, MSSG-C1<img src="/-/media/national-files/images/hometown-health/2022/massage-on-back-of-neck.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2E470AA8C40466B333C6E4501FA6EF18" alt="Massage on back of neck" width="660" height="370" DisableNVelocity="true" />AnxietyFeelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. Symptoms may start during childhood or the teen years and continue into adulthood. We have the experts who can help diagnose and treat anxiety concerns.DepressionDepression is a medical illness that causes a persistent feeling of sadness, loss of interest and, sometimes, physical symptoms. It's also called major depression, major depressive disorder and clinical depression.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller7/18/2022Ears are amazing organs. They help us hear and experience the world. Yet some people are prone to painful ear infections. Get answers to questions about this common condition.6 common questions about earaches and ear infections<p>The ears — home to the smallest bones in the body — are amazing organs. They help you hear and experience the world and help maintain balance. They are self-cleaning, and the outer part of the ear never stops growing. </p> <p>Infections can occur in the middle ear, in the air-filled space behind the eardrum that contains the tiny vibrating bones of the ear. This can cause pain that could be mild or severe. </p> <h2>Here are answers to questions about this common condition:</h2> <h3>What causes ear infections?</h3> <p>Middle ear infections, which are the most common ear infections, are caused by a bacterium or virus that infects fluid that builds up in the middle ear. Ear infections are often a direct result of a common cold, allergy or other upper respiratory illness.</p> <h3>Why do children have more ear infections than adults?</h3> <p>Eustachian tubes are narrow channels inside your ears that allow drainage to the back of the nose and prevent fluid in the middle ear from building up. Children have eustachian tubes that are shorter, narrower and straighter than those of adults. These tubes can become inflamed or irritated, and then they don't drain appropriately. This results in middle ear fluid and potential ear infections.</p> <h3>How do I know if my child has an ear infection?</h3> <h4>Some of the common signs of an ear infection in children are:</h4> <ul style="list-style-type: disc;"> <li>Ear pain, especially when lying down</li> <li>Tugging or pulling on the ear</li> <li>Trouble sleeping</li> <li>Hearing difficulty</li> <li>Headache or fever</li> <li>Fluid drainage from the ear</li> </ul> <h3>How do you treat an ear infection?</h3> <p>The best treatment for an ear infection depends on many factors, including the age of the child and the severity of the symptoms. Most ear infections clear up on their own within a week without medical treatment such as antibiotics. </p> <p>You can lessen the pain associated with ear infections by using a warm compress, pain medications and topical numbing eardrops. Children with chronic ear infection issues may need ear tubes surgically placed to drain the fluid and prevent future infections.</p> <h3>What is swimmer's ear?</h3> <p>Swimmer's ear is an infection of the outer ear canal. It's most often caused when moisture that collects in the ear and aids bacterial growth. It's more common in people who spend a lot of time in the water — hence the name "swimmer's ear."</p> <p>Medicated antibiotic eardrops are the most common treatment of swimmer's ear.</p> <h3>How do you prevent ear infections?</h3> <h4>Ear infections are sometimes unavoidable, especially with small children. However, you can reduce your risk by:</h4> <ul> <li>Using a hair dryer to dry out your ears after swimming or bathing</li> <li>Not using any objects to clean out your ears</li> <li>Practicing good hand hygiene</li> <li>Avoiding secondhand smoke</li> <li>Not bottle-feeding your infant in the lying position</li> <li>Protecting your ears from excessive noise by using earplugs</li> </ul> <p><em><a href="/providers/luke-andera-md" target="_self" title="Opens in same window.">Luke Andera, M.D.</a>, is an <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">otolaryngologist</a> and head and neck surgeon in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a> and <a href="/locations/prairie-du-chien" target="_self" title="Opens in same window.">Prairie du Chien</a>, Wisconsin.</em></p><ul> <li>Chronic ear disease</li> <li>Chronic sinusitis</li> <li>Ear tubes/tympanostomy tubes</li> <li>Endoscopic dacryocystorhinostomy (tear duct surgery)</li> <li>Head and neck cancer (lip, mouth, tonsil, throat, voice)</li> <li>Hearing loss</li> <li>Nasal polyps</li> <li>Nose and sinus disease</li> <li>Parotid disease</li> <li>Salivary gland/parotid</li> <li>Thyroid nodules</li> <li>Thyroid/parathyroid disease</li> <li>Tonsillectomy and adenoidectomy</li> </ul>M.D.<p>I am a native of Cresco, Iowa.</p><p><strong>Education</strong></p> <ul> <li>Wright State University Boonshoft School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Otolaryngology – Head and Neck surgery, Geisinger Medical Center</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Academy of Otolaryngology – Head and Neck Surgery</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Otolaryngology, Mayo Clinic College of Medicine and Science</li> </ul>Andera<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/luke-andera-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7E709A42F6E193B329E44B5FF5737641" alt="Luke Andera MD" width="280" height="280" DisableNVelocity="true" />{CCECDF11-8962-4146-A324-CAFE735B0C95}Luke<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20991193Luke Andera, M.D.1{18E5E65E-45C8-4C48-BD32-A914794E2AA4}<img src="/-/media/national-files/images/hometown-health/2022/child-lying-on-bed-head-on-hand.jpg?h=370&iar=0&w=660&sc_lang=en&hash=63B60E51F136CE24DC8ABBC10B8B492E" alt="Red-headed child lying on bed resting head on hand" width="660" height="370" DisableNVelocity="true" />Ear HealthAn audiologist specializes in evaluating and treating people of all ages with hearing loss, dizziness and balance disorders. Specialty audiology consultation is available for assessment and treatment of hearing loss, tinnitus, dizziness and balance disorders.Ear, Nose and Throat (ENT)Get information about symptoms, disorders and diseases affecting the ear, nose and throat, and related head and neck structures.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller7/21/2022Continuous positive airway pressure therapy is a proven treatment for sleep apnea. Take a quiz to get answers to learn more about this therapy, including if it can improve golf scores.Test your CPAP IQ<p>Will I look and sound like Darth Vader? Is it possible to suffocate if the power goes off? Isn't it just a gimmick? Will I get cancer from using it?</p> <p>These are just a few of the questions pulmonologists have been asked when prescribing a continuous positive airway pressure (CPAP) machine to relieve their patients' <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631" target="_blank" title="Opens in a new window.">sleep apnea</a> symptoms.</p> <h2>Whether you've recently been prescribed a CPAP machine or have been using one for a while, take this true or false quiz to learn more about this therapy:</h2> <h3>CPAP therapy is a gimmick.</h3> <p>False. CPAP therapy was introduced in the early 1980s, and it has become a proven treatment for sleep apnea. Study results and data back up its effectiveness. Although other options for treating sleep apnea are being developed, CPAP is considered the gold standard.</p> <h3>A CPAP machine isn't a ventilator.</h3> <p>True. The machine uses a continuous stream of air into the upper airway to prop up the upper airway collapse to keep the airway open. It's this collapse that causes sleep apnea symptoms. In other words, it acts like an air splint. CPAP doesn't help you breathe or provide oxygen.</p> <h3>Using CPAP can cure sleep apnea.</h3> <p>False. CPAP relieves the symptoms of sleep apnea: snoring, airway blockage, gasping and awakening from sleep. Because of this therapy, patients may feel they are cured. But if they stop using CPAP, the symptoms will return. If obese patients lose weight, the severity of their sleep apnea may decrease.</p> <p>A new sleep study and consultation with a sleep medicine professional will be needed to determine if CPAP use can be discontinued.</p> <h3>I've heard CPAP machines can cause lung cancer.</h3> <p>False. In general, CPAP use has not been associated with cancer. However, in recent years, one manufacturer recalled its CPAP machines because sound abatement foam inside the device could degrade, and the particles were inhaled by the users.</p> <p>If your machine was part of this recall, you should see your sleep specialist or pulmonologist for follow-up.</p> <h3>CPAP causes red, swollen eyes and sinus infections.</h3> <p>Maybe. If your mask is leaking or the pressure is too high, air can escape up toward your eyes and irritate them. This issue can be fixed by checking the fit and style of your mask. Some limited studies suggest that if a patient has glaucoma, the air pressure can increase pressure in the eyes. But more evidence is needed.</p> <p>If you have sinus or other nasal issues, wearing the mask can worsen them. Consult with your health care professional to address these underlying issues, as well as your sleep specialist to find a mask that doesn't increase your discomfort.</p> <h3>CPAP machines can be as small as a cellphone.</h3> <p>True. The design of CPAP machines has come a long way since their development 40 years ago. The first CPAP machine was powered by a vacuum cleaner motor, the hoses were swimming pool tubing, and the mask was a plaster cast glued to the patient's face.</p> <p>Today, manufacturers offer CPAP machines in various sizes that are easy to transport and set up. Battery-operated CPAP machines are perfect for those who travel — and even go camping.</p> <h3>I'll have to buy a special cleaning machine.</h3> <p>False. Regular cleaning with soap and water, according to the manufacturer's instructions, are all that's needed.</p> <h3>If the power goes out, I'll suffocate.</h3> <p>False. Since the CPAP machine doesn't help you breathe or provide oxygen, you won't suffocate, even if the power goes off. However, without the stream of air propping up your airway, it may feel like you can't breathe, as well. That's why some patients like to keep backup battery packs on hand. And you can always remove the mask.</p> <h3>A CPAP machine is addictive.</h3> <p>False. While the machine itself is not addictive, patients become addicted to the results of regular CPAP use. These results include getting better sleep and feeling more energize and focused. If they stop using CPAP, their sleep apnea symptoms will return, along with drowsiness and lack of concentration.</p> <h3>You'll look and sound like Darth Vader.</h3> <p>False. Vader would gladly have traded for today's quiet, comfortable CPAP machines and masks. Your sleep specialist will help you find the style of mask that's the most comfortable and suited to your needs.</p> <h3>Using a CPAP machine can improve your golf score.</h3> <p>True. A small study of golfers showed that the group taking part in CPAP therapy for six months reported improved quality of life, concentration, endurance and decision-making. And their golf handicap score dropped by 11%. Those golfers with handicap scores of 12 or fewer showed a 31% improvement.</p> <a href="/providers/christopher-williams-md" target="_self" title="Opens in same window."><em>Christopher Williams, M.D.</em></a><em>, is a <a href="/services-and-treatments/pulmonology" target="_self" title="Opens in same window.">pulmonologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin</em><ul> <li>Acute respiratory distress syndrome</li> <li><a href="/locations/eau-claire/services-and-treatments/pulmonology/alternative-cpap-therapy" target="_self" title="Opens in same window.">Alternative CPAP therapy</a></li> <li>Chronic obstructive pulmonary disease (COPD)</li> <li>Chronic respiratory failure</li> <li>Intensive care</li> <li>Narcolepsy</li> <li>Obstructive sleep apnea</li> <li>Pulmonary embolism</li> <li>Sleep medicine</li> </ul>M.D.<p>I believe in treating the patient as a whole and not just a specific disease. I like spending quality time with my patients and helping them understand their disease process. I want to walk with them through their journey of recovery. I am honored and excited to be a part of Mayo Clinic Health System.</p> <p>In my free time, I enjoy fountain pen collecting, reading and working out.</p><p><strong>Medical School</strong></p> <ul> <li>Vinayaka Mission's Medical College</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, St. Barnabas Hospital</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Pulmonary/Critical Care, University of South Alabama Medical Center</li> <li>Sleep Medicine, Yale University School of Medicine</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Critical Care Medicine, American Board of Internal Medicine</li> <li>Internal Medicine, American Board of Internal Medicine</li> <li>Pulmonary Disease, American Board of Internal Medicine</li> <li>Sleep Medicine, American Board of Sleep Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Chest Physicians</li> <li>American Society of Sleep Medicine</li> <li>American Thoracic Society</li> <li>Wisconsin Medical Society</li> </ul>Williams<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/christopher-williams-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=40FC28730938B55F51EAB0AD4C2F2B3F" alt="Christopher Williams, M.D." width="280" height="280" DisableNVelocity="true" />{4A1FA153-D77E-46DD-9393-052D7317398E}Christopher<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20893931Christopher Williams, M.D.1{1D6651B0-86E1-4FF6-9A93-07B8EE2D26EE}|{1A90F4B2-3C68-421C-89C5-AC045A6F8F56}|{B98A8ABA-9382-4804-A585-EA5B53B1D179}<img src="/-/media/national-files/images/hometown-health/2022/wearing-a-cpap.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B8AD9217DFB0AC1D9725722B80D26361" alt="Wearing a CPAP" width="660" height="370" DisableNVelocity="true" />PulmonologyTreatment for diseases and conditions affecting lung and airway function.SleepSleep is essential to good health. It's one of the body's basic needs. But, what do you do when you have troubles sleeping, or getting enough hours of sleep? Dawn Haller8/9/2023In addition to buying school supplies and signing up for activities, be sure to schedule your child for a well-teen visit. This checkup helps ensure your child is ready for the year ahead.Add health checkup to teens' back-to-school list<p>Your teen probably has a back-to-school to-do list that's a mile long. But be sure one item moves to the top: a health checkup or well-teen visit. Similar to the well-child visits that parents regularly schedule beginning when their children are born, well-teen visits are tailored especially for the ages when tweens and teens are undergoing significant physical and mental changes and challenges.</p> <p>Well-teen visits typically start at age 11 and older. That's when most major health and social changes begin such as puberty, changing schools, forming new relationships and becoming more independent.</p> <h2>A 'temperature check' for overall health</h2> <p>Just as important as when children are younger, well-teen visits assess overall health and developmental benchmarks and ensure vaccinations are up to date.</p> <p>By the time they are 11, children should have all childhood vaccinations and also receive shots for meningitis, HPV and a tetanus booster.</p> <p>Typically, during the first part of the visit, the healthcare professional will talk with the parents or guardians and the child together. Then the healthcare professional will spend one-on-one time with the teen.</p> <h2>Beyond vaccinations</h2> <p>The second part of the visit focuses on health and wellness issues facing tweens and teens. These issues include nutrition, exercise, school performance, screen time, social media, safety at home and school, puberty, safe sex practices, relationships and mental health.</p> <p>A mental health assessment is a crucial part of the visit. When a parent or guardian is in the room, the healthcare professional is observing how caregivers and children communicate, how children respond to questions — whether they turn to the adult to answer, engage in their own healthcare or if they're shy about talking in front of the adult.</p> <p>To put children at ease, the healthcare professional often starts with questions about what makes them happy, what gives them confidence, what their strengths are, who their friends are and what they like to do. Then the conversation may turn to what bothers them, makes them sad or gives them stress.</p> <p>The healthcare professional also will ask if teens have been or are in a relationship and if they feel safe in that relationship — whether the relationship is with a male, female or either sex. As most parents know, teens are pretty savvy about what makes them feel safe or unsafe when online. However, the healthcare professional will review cyberbullying, what to do if someone talks to the teen inappropriately and who to reach out to for help or support.</p> <p>No matter a child's sexual identification, gender identity or orientation, the healthcare professional aims to express support and encourage them to seek support in their community — starting with their parents. The goal is to give them healthy avenues to cope with stress or anxiety due to relationships.</p> <h2>Coming together</h2> <p>Before the healthcare professional invites the parents or guardians to rejoin the conversation, the provider will verify that it's OK with the teen to share information with the adults. While respecting the teen's privacy, the healthcare professional's role also can be one of facilitator to promote open communication between teens and their parents or guardians. Laws protect information about teen health, pregnancy, sexually transmitted diseases and gender. Unless shared information poses direct, immediate harm to the child, it can remain confidential between the healthcare professional and the teen.</p> <p>A well-teen visit can have a major effect on a child's health and well-being. Recommended annually, it's a time to identify any issues or concerns early and then follow up to monitor improvement or additional problems. The visit also begins laying the groundwork for teens to take charge of their healthcare as they move into adulthood.</p> <p><a href="/providers/mohammed-solaiman-md" target="_self" title="Opens in same window."><em>Mohammed Solaiman, M.D.</em></a><em>, is a physician in <a href="/services-and-treatments/family-medicine">Family Medicine</a> in <a href="/locations/mankato" target="_self" title="Opens in same window">Mankato</a>, Minnesota.</em></p> <ul> <li>Adolescent medicine </li> <li>Cardiovascular disease </li> <li>Diabetes</li> </ul> M.D. <p><strong>Education</strong></p> <ul> <li>Dhaka Medical College</li> </ul> <p><strong>Residency </strong></p> <ul> <li>University of Manitoba</li> </ul> <p><strong>Certifications </strong></p> <ul> <li>American Board of Family Medicine</li> <li>Canadian Board of Family Medicine</li> <li>Certified medical examiner, Department of Transportation</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Solaiman<img src="/-/media/shared-files/images/medical-professionals/full/mankato/mohammed-solaiman-md.jpg?h=280&iar=0&w=280&hash=8ABED7E7C3E8AE044A855135CC2DEEE9" alt="Mohammed Solaiman MD" width="280" height="280" DisableNVelocity="true" /> {7AC41804-CA09-4C5A-AA32-063465438817}Mohammed <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14150981Mohammed Solaiman, M.D. 1{B3F96F77-F93E-41A4-AE4E-603045CDB443}<img src="/-/media/national-files/images/hometown-health/2022/parent-side-hugging-teen.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E33EA83F4112966F52ED0E0021BA5027" alt="Parent side hugging teen" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller8/11/2022Colorectal surgery is a wide range of procedures that treat conditions of the lower digestive tract, ranging from hemorrhoids to cancer. Here's what you need to know if you need surgery.Breaking down the details of colorectal surgery<p>Most people aren't excited about the possibility of surgery, but it is sometimes necessary. Educating yourself about your procedure can make the process less stressful for you and your family.</p> <h4>Considering surgery on the colon, rectum or other parts of the lower intestinal track can raise additional questions:</h4> <ul> <li>Will organs need to be removed? </li> <li>How long will recovery take? </li> <li>Will I be able to eat and use the bathroom normally after surgery?</li> </ul> <h2>Here's what you need to know if your health care team recommends colorectal surgery:</h2> <h3>Colorectal surgery basics</h3> <p>The term "colorectal" is a combination of two words: colon and rectum. This term often refers to all organs of the lower digestive tract, including the colon, rectum, anus, pelvic floor and small intestine.</p> <p style="background: white;">Colorectal surgery includes a wide range of surgical procedures that can treat conditions affecting the lower digestive tract, ranging from hemorrhoids to diverticulitis to cancer. Many procedures can be performed using minimally invasive, or laparoscopic or robotic, techniques.</p> <p>Colorectal surgeons have completed specialized training on the surgical care of conditions affecting the small bowel, colon, rectum and anus. The two primary categories of colorectal surgeries are abdominal surgery and anorectal surgery.</p> <h3>Abdominal surgeries</h3> <p>These surgical procedures are performed on the digestive organs in the abdomen, primarily the small intestine and colon.</p> <h4>The most common surgical procedures treat:</h4> <ul> <li><strong>Colon cancer<br /> </strong>Colon cancer surgery can be performed using an open (traditional) or minimally invasive (small incision) technique. The use of laparoscopic or robotic surgery can minimize the size of incisions and speed your recovery. During laparoscopic or robotic surgery, your surgeon performs the operation through several small incisions in your abdominal wall, inserting a camera and small instruments. Colon cancer operation involves removing a portion of your colon that contains the cancer along with nearby lymph nodes. In most cases, the bowel is then reattached internally to allow for normal passage of stool. It is rare that a colostomy is needed.</li> <li><strong>Rectal cancer<br /> </strong>While rectal and colon cancers are similar in many ways, treatments can differ. This is mainly because the rectum sits in a tight space, barely separated from other organs and structures. Because of this, surgery is often combined with radiation and chemotherapy. And in specialized cases, surgery can be avoided entirely. When a rectal cancer requires surgery, attempts are made to preserve the normal function and allow for normal bowel movements. In certain instances, a temporary or permanent colostomy bag may be needed.</li> <li><strong>Diverticulitis<br /> </strong>Diverticulosis occurs when small, bulging pouches called diverticula develop in your digestive tract. When one or more of these pouches become inflamed or infected, the condition is called diverticulitis. Your health care team may recommend surgery if you have had multiple episodes of diverticulitis, infectious complications or persistent symptoms. During surgery, the diseased part of your intestine is removed and the healthy segments are reconnected. Generally, you will be able to have normal bowel movements after surgery. When there is a need for emergency surgery, your surgeon may perform a colostomy to allow your bowel to heal. The colostomy may be reversed later and the bowel reconnected.</li> </ul> <h3>Ostomy creation</h3> <p>In some cases, it may not be safe to internally reconnect the intestine. Then it may be necessary to attach the colon to the outside of the body. This procedure is called a colostomy.</p> <p>During this procedure, your surgeon will create a hole in your abdominal wall and pull the intestine out and secure it to the skin. This is called a stoma or ostomy. It allows stool to leave your body. A colostomy bag attaches to the stoma to collect the waste.</p> <p>Sometimes the ostomy is only temporary, allowing your colon or rectum time to heal after surgery. In rare cases, however, the colostomy may be permanent. Ostomies may be indicated for a variety of colon-related conditions, including colon cancer, diverticulitis, Crohn's disease or ulcerative colitis.</p> <h3>J-pouch surgery</h3> <p>In cases of severe ulcerative colitis or hereditary cancer syndromes, ileoanal anastomosis surgery is an alternative to a permanent ostomy. It's commonly called J-pouch surgery.</p> <p>During J-pouch surgery, your surgeon removes the entire colon and constructs a pouch, shaped like the letter J, from the end of the small intestine and attached to the end of the rectum. A temporary ostomy is usually created to allow the J pouch to heal for about two to three months. A second surgery closes the ileostomy, allowing you to pass stool normally.</p> <h3>Anorectal surgeries</h3> <p>Anorectal disorders are a group of medical disorders that occur within the anal canal and rectum. Often these conditions are a source of discomfort, pain, embarrassment and worry.</p> <h4>The most common anal and rectal procedures are treatments for:</h4> <ul> <li><strong>Hemorrhoids</strong><br /> Hemorrhoids are swollen veins in the anus or lower rectum. This is a common condition, with nearly 75% of adults having the condition at some point. Many people get relief from home treatments and lifestyle changes. However, surgery may be necessary for painful or persistent bleeding hemorrhoids. Hemorrhoidectomy, the surgical removal of hemorrhoids, is the most effective and complete way to treat severe or recurring hemorrhoids. Other office-based procedures may be available for more minor symptoms.</li> <li><strong>Anal fissures</strong><br /> Anal fissures are small tears in the thin tissue that lines the anus. An anal fissure may occur when you pass hard or large stools during a bowel movement. Anal fissures typically cause pain and bleeding with bowel movements. Most anal fissures get better with simple treatments, such as increased fiber intake, sitz baths or topical ointments. Your health care team may recommend surgery if you have a chronic anal fissure that resists other treatments or if your symptoms are severe. Surgeons usually perform a procedure called lateral internal sphincterotomy, which involves cutting a small portion of the anal sphincter muscle to reduce spasms and pain and promote healing. There also are treatments using Botox that may be able to preserve the muscle while still allowing healing.</li> <li><strong>Anal fistulas</strong> <br /> Fistulas are small tunnels that develop between the skin and the anus or rectum. Fistulas can become infected and may ooze blood or pus. Surgery can repair the tunnel, prevent recurrence and protect the sphincter muscles. The surgeon takes care to avoid damaging these muscles, thereby avoiding the potential for fecal incontinence. </li> <li><strong>Prolapse</strong><br /> Rectum prolapse occurs when a part of the rectum slips outside the anus. Sometimes this is mistaken for hemorrhoids. There are multiple approaches to repair rectal prolapse. A minimally invasive, robotic procedure can correct the condition, and most patients are satisfied with the results.</li> </ul> <p>These conditions can be treated in the office or the operating room, depending on their severity.</p> <h3>Recovery after colorectal surgery</h3> <p>Recovery time after colorectal surgery varies depending on the type of surgical procedure performed. Typically, abdominal surgeries require a hospital stay and have a longer recovery time. You can expect activity and lifting restrictions for a few weeks while you recover. Anal and rectal surgeries have a shorter recovery time. These operations are usually performed as an outpatient with no overnight hospital stay necessary. Most patients see improvement in their symptoms within a few days to a week.</p> <p>A common question people have before surgery is if they will be able to eat, drink and use the bathroom normally. In most cases, the answer is yes. While healing, it may be normal to have some discomfort when passing stool. Your bowel habits may become irregular for a few weeks after surgery as your body heals and adjusts.</p> <p>Managing pain is critical after all surgeries, including colorectal surgeries. Your health care team will work with you to address your pain.</p> <p>Pain management techniques have improved, and surgeons can treat most surgical pain with minimal use of narcotics. The goal is to control pain enough to allow patients to recover and return to normal function as soon as possible.</p> <p>It's common to feel nervous about the prospect of surgery. That's why it's important to talk with the surgeon to learn more about the procedure and get answers to your questions.</p> <em><a href="/providers/andrew-morris-md" target="_self" title="Opens in same window.">Andrew Morris, M.D.</a></em><em>, is a </em><em><a href="/services-and-treatments/surgery" target="_self" title="Opens in same window.">colorectal surgeon</a></em><em> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em><ul> <li>Anorectal pathology (hemorrhoids, fissures, fistulas)</li> <li>Colorectal surgery</li> <li>Colon cancer</li> <li>Crohn's disease</li> <li>Diverticulitis</li> <li>Enhanced recovery after surgery</li> <li>General/acute care surgery</li> <li>Minimally invasive surgical techniques</li> <li>Ulcerative colitis</li> <li>Rectal cancer</li> <li>Robotic-assisted surgery</li> </ul>M.D.<p>I am a board-certified general surgeon with specialized training in colon and rectal surgery. I have specific interests in treating colorectal cancer, inflammatory bowel disease and benign anorectal disorders. My goal is to provide the highest quality care with compassionate patient interactions. I understand that anorectal disorders are a sensitive topic and try to approach these with respect. By incorporating advanced surgical techniques, up-to-date research and open patient communication, we can develop patient-centered care plans that fit your treatment goals.</p> <p>I was born and raised in the Midwest, and lived for a few years in the Coulee Region during my childhood. I completed my surgical training in southeastern U.S. before deciding to return to the Midwest. My extended family has lived in the Coulee Region for over 100 years. I feel privileged to return to this community that has been home to raise my own family. In my leisure time, I enjoy spending time with my wife and son, exploring the surrounding area, attending local festivals and playing golf.</p><p><strong>Education</strong></p> <ul> <li>Northwestern University – Feinberg School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>General Surgery, Emory University</li> </ul> <p><strong>Residency</strong></p> <ul> <li>General Surgery, Emory University</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Colon and Rectal Surgery, Prisma Health</li> </ul> <p><strong>Certification</strong></p> <ul> <li>General Surgery, American Board of Surgery</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Surgeons</li> <li>American Society of Colon and Rectal Surgeon</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Surgery, Mayo Clinic College of Medicine and Science</li> </ul>Morris<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/andrew-morris-md.jpg?h=210&iar=0&w=210&sc_lang=en&hash=E6043BC275CE0C2291AF4DDBE1F5602C" alt="Andrew Morris, M.D." width="210" height="210" DisableNVelocity="true" />{65D25FD6-A7BD-4271-88ED-2162C7A6D4B8}Andrew<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30069560Andrew Morris, M.D.1{DC3A2E5F-C54B-4BFA-AE04-95AE79DD4488}|{CE631A85-B409-4C11-907C-39868E49E636}<img src="/-/media/national-files/images/hometown-health/2022/surgeon-masked-wearing-surgical-glasses.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D6767CD3703BABAA14DEE484FA1E668F" alt="Surgeon masked and wearing surgical glasses" width="660" height="370" DisableNVelocity="true" />SurgeryHaving surgery is a major event in your life. We know this and make every effort to keep you as comfortable as possible, focusing on you as an individual. Our surgeons and staff work as a coordinated team treating a wide variety of illnesses ranging from simple to complex. We offer comprehensive, advanced care and service to every patient.Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Dawn Haller8/18/2022While more people experience a mild form of pancreatitis, which appears suddenly, some experience a severe case that can cause life-threatening conditions. Learn about the symptoms and treatment for each form of pancreatitis.Breaking down acute and chronic pancreatitis<p>Simply put, pancreatitis is inflammation of the pancreas. Located behind the stomach in the upper abdomen, your pancreas produces digestive enzymes and hormones that regulate how your body produces sugar. </p> <p><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/pancreatitis/symptoms-causes/syc-20360227" target="_blank" title="Opens in a new window.">Pancreatitis</a> is caused by the irritation and inflammation of the cells of your pancreas. This occurs when digestive enzymes released by the pancreas become active while still in the pancreas. </p> <p>Pancreatitis can occur in two forms — acute and chronic.</p> <h2>Acute pancreatitis</h2> <p>More people experience an acute form of pancreatitis, which appears suddenly. Mild cases of pancreatitis can typically be resolved in days with treatment. Severe cases of acute pancreatitis can cause life-threatening conditions, such as kidney and lung failure. </p> <h3>Acute pancreatitis symptoms include:</h3> <ul style="list-style-type: disc;"> <li>Severe upper abdominal pain</li> <li>Abdominal pain that extends to your back and shoulders</li> <li>Yellowing of the skin</li> <li>Tender abdomen</li> <li>Nausea and vomiting </li> <li>Fever</li> </ul> <p>Treatment for acute pancreatitis consists of IV fluids and medication to manage pain. You can eat if tolerated, or tube feeding may be necessary. After getting your symptoms under control, identifying and treating the cause of your pancreatitis is the next step for your health care team. </p> <h3>Treating the cause</h3> <p>Once your pancreatitis is under control, your health care team will determine what caused the pancreatitis attack. Treatment depends on the cause.</p> <h4>Examples of treatment include:</h4> <ul> <li><strong>Removing bile duct stones<br /> </strong>A procedure called endoscopic retrograde cholangiopancreatography, or ERCP, uses a long tube with a camera on the end to take pictures of your pancreas and bile ducts. This helps your health care team see if stones are blocking the bile duct. If so, the stones can be removed using tools passed through the endoscope. The bile duct and pancreatic duct enter the bowels in the same area. This is why a blockage of the bile ducts can cause pancreatitis. </li> <li><strong>Gallbladder surgery</strong><br /> If <a href="/hometown-health/speaking-of-health/common-questions-about-gallstones" target="_self" title="Opens in same window.">gallstones</a> caused your pancreatitis — with or without bile duct blockage — your health care team may recommend surgery to remove your gallbladder. This procedure is a cholecystectomy. Surgery may be done before you go home if your attack is mild. In severe cases, surgery may be done later to let the inflammation go down.</li> <li><strong>Treatment for excessive alcohol use</strong><br /> <a href="/hometown-health/speaking-of-health/effects-of-alcohol-on-your-health-and-liver" target="_self" title="Opens in same window.">Consuming several alcoholic drinks</a> a day over many years can cause pancreatitis. If this is the cause of your pancreatitis, your health care team may recommend you enter a treatment program to help you stop. Continuing to drink alcohol may worsen your pancreatitis and lead to serious complications including chronic pancreatitis.</li> </ul> <h2>Chronic pancreatitis</h2> <p>Pancreatitis that occurs over many years can damage your pancreas and lead to chronic pancreatitis. It causes permanent damage and scarring of the pancreas. Chronic pancreatitis can lead to weight loss, pain, diabetes and pancreatic cancer.</p> <h3>Chronic pancreatitis symptoms include:</h3> <ul> <li>Upper abdominal pain</li> <li>Indigestion</li> <li>Abdominal pain that worsens after eating</li> <li>Unexpected weight loss</li> <li>Oily, smelly stools called steatorrhea</li> <li>Jaundice, which is yellowing of the eyes and skin</li> <li>Development of diabetes</li> </ul> <p>Treating chronic pancreatitis may involve changes to your diet, pain management, and taking enzymes to improve digestion. </p> <h2>Reducing the risk of pancreatitis</h2> <h3>Some factors increase your risk of developing pancreatitis:</h3> <ul> <li>Excessive alcohol use</li> <li>Cigarette smoking</li> <li>Obesity</li> <li><a href="/hometown-health/speaking-of-health/how-to-live-well-with-diabetes" target="_self" title="Opens in same window.">Diabetes</a></li> <li>Family history of pancreatitis</li> </ul> <p>Talk with your health care team about sudden or persistent symptoms related to pancreatitis.</p> <em>By Mayo Clinic Health System staff.</em><img src="/-/media/national-files/images/hometown-health/2022/person-with-airpod-in-ear.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3996CB0728D42FF80E9C1A7B5B5A7F8B" alt="Person with Airpod in ear" width="660" height="370" DisableNVelocity="true" />Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Dawn Haller8/16/2022Experiencing throbbing pain down the front of your lower legs when you work out? You may have shin splints. Learn how to speed your recovery.Don’t let shin splints halt your workout<p>At first, you may brush it off as fatigue or pushing your run or walk too far. But eventually, the recurring, throbbing pain in your shins gets your full attention. By then, you may have a full-blown case of shin splints, also known as medial tibial stress syndrome.</p> <h2>Here's what you need to know about this condition:</h2> <h3>What are shin splints and their symptoms?</h3> <p>Stress on the shinbone and the connective tissues that attach the muscles to the bones inflames the tissues, causing pain. The front of the shin aches or throbs, especially after exercise. These symptoms are common in runners, hikers, dancers and military recruits.</p> <h3><strong>What causes this condition?</strong></h3> <h4>The risk of developing this syndrome increases for a variety of reasons, including:</h4> <ul style="list-style-type: disc;"> <li>Repetitive stress to the lower leg from running or walking, or an increase in overall activity, intensity or mileage</li> <li>Flat feet or a collapsed arch, also known as pronation or a high arch</li> <li>Poorly fitting shoes without good support</li> <li>Weak ankles, hips or core muscles</li> <li>Poor warmup before exercise or insufficient cooldown with stretching after exercise</li> </ul> <h3>How are shin splints diagnosed?</h3> <p>Shin splints or possibly stress fractures may cause pain in the front of the lower leg. These fractures need to be ruled out with X-rays or bone scans.</p> <h3>What's the treatment for medial tibial stress syndrome?</h3> <p>Most cases of shin splints can be treated with rest, ice and proper footwear.</p> <p>Take a break from your walking or running workout to give your shins time to heal. You can remain active by exercising with non-weight-bearing exercise, like swimming or biking, if it doesn't cause pain.</p> <p>Icing the shins can decrease pain. This is typically done for 20 minutes four times a day for three days, or until the pain is gone. Nonsteroidal anti-inflammatory drugs, or NSAIDS, including ibuprofen (Advil) and naproxen (Aleve), will ease pain and decrease inflammation. If you have high blood pressure or kidney disease, consult your health care professional before taking these medications.</p> <p>Be sure your footwear fits properly, provides adequate support and is appropriate for your activity. For example, running shoes typically have a more cushioned heel than walking shoes. Runners should replace their shoes after 350–400 miles.</p> <h3>When can you return to your normal activities?</h3> <p>When your shins are pain-free, you can return to your regular activities. But start slowly. Gradually increase the intensity or distance to avoid reinjuring your shins.</p> <h3>How can you prevent shin splints?</h3> <h4>Repetitive stress and overdoing an activity primarily cause shin splints. They can be prevented by:</h4> <ul style="list-style-type: disc;"> <li>Progressively working your way into a new workout or routine</li> <li>Gradually increasing physical activity, intensity and mileage</li> <li>Wearing proper footwear</li> <li>Adding arch supports or insoles designed to absorb more shock or impact</li> <li>Bringing cross-training and strength workouts to a training regimen</li> </ul> <p>If your issues with shin splints continue or recur repeatedly, consult with an orthopedic or sports training specialist.</p> <em><a href="/providers/amy-rantala-md" target="_self" title="Opens in same window.">Amy Rantala, M.D.</a></em><em>, practices primary care <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">sports medicine</a> in </em><em><a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin</em><ul> <li>Musculoskeletal care</li> <li>Nonsurgical orthopedic care</li> <li>Sports medicine</li> <li>Sports-related concussion management</li> </ul>M.D.<p>I believe in working together with my patients to maximize their health and physical abilities. Actively listening to patients to hear their story and assist them in meeting their health goals is exceptionally important to me. I have been a family medicine physician for 20+ years. It is an honor to serve the Chippewa Valley.</p> <p>My sports medicine practice is inclusive of uniformed athletes; athletes just starting their exercise program and trying to make it to the finish line; athletes trying to set a personal record; and active patients pursuing their passions. We all have an athlete in us and exercise is the best medicine.</p> <p>I am fortunate to be married to my wonderful, supportive husband and have three sons and two dogs. I like to do anything active outside. My personal passions are cross-country and downhill skiing, as well as biking and running. I am an avid reader and really like to travel and eat good food.</p><p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Sports Medicine, University of Chicago</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Family Medicine, American Board of Family Medicine</li> <li>Certificate of Added Qualification in Sports Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Practice</li> <li>American College of Sports Medicine</li> <li>American Medical Society for Sports Medicine</li> <li>Tri-County Medical Society</li> <li>Wisconsin Academy of Family Physicians</li> <li>Wisconsin Medical Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Rantala<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/amy-rantala-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B7A534FAE36A7D091C9F77015DD8E152" alt="Amy Rantala, M.D." width="280" height="280" DisableNVelocity="true" />{4F47E9FB-6E1F-41F8-9D4C-335E9C8FAFB8}Amy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13342967Amy Rantala, M.D.1{7746ADF8-715B-4593-8AAB-55D7F0467848}|{DEF55970-853F-4E96-9A4D-3413874FF059}|{2951D78A-CC76-4C49-B556-549282DF4345}<img src="/-/media/national-files/images/hometown-health/2022/runner-legs.jpg?h=370&iar=0&w=660&sc_lang=en&hash=FF2FF307BD09698495E757C48F1C4AAE" alt="Runner legs" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller8/30/2022The shoulder is an amazing joint, but it can become dislocated, especially during sports that involve contact, falls and reaching overhead. Here's what you can expect if it happens.Helping athletes come back after a dislocated shoulder<p>The shoulder is an amazingly mobile joint, allowing you to reach and rotate in a number of directions. Picture it like a golf ball on tee. Unfortunately, this design makes it easy to slip out of place with just the right amount of force.</p> <p>It's the kind of force that's common for athletes who play:</p> <ul> <li>Overhead sports, like volleyball, tennis and swimming</li> <li>Contact sports, like football, hockey and wrestling</li> <li>Sports that involve falling, such as downhill skiing and gymnastics</li> </ul> <p>People in their teens and 20s, because they tend to be physically active, are at highest risk for shoulder dislocation. Also, people with looser joints can be prone to dislocation from smaller amounts of force.</p> <p>However a shoulder becomes dislocated, it needs to be treated immediately.</p> <h2>Here are answers to questions frequently asked by patients a dislocated shoulder:</h2> <h3>How would I know if my shoulder is dislocated?</h3> <p>You'll know your shoulder is dislocated because it will look deformed or out of place. Also, you won't be able to move it, and you'll probably experience intense pain.</p> <h3>Do I need to seek medical care?</h3> <p>You should seek prompt attention for your injury. While you're waiting for treatment:</p> <ul> <li>Don't move the joint or try to put it back in place. Use a sling or splint to hold it in its current position.</li> <li>Ice the joint to reduce pain and swelling.</li> </ul> <h3>What is the treatment?</h3> <p>Typically, you'll undergo X-rays and possibly an MRI to assess the damage. The results will help the health care professional determine the appropriate treatment, which can include:</p> <ul> <li><strong>Putting the joint back in the correct position.</strong><br /> This can be done with a simple maneuver, but if the joint is badly damaged, it may require surgery.</li> <li><strong>Placing the shoulder in a sling to allow the muscles to rest.</strong><br /> Icing and anti-inflammatory medications will relieve pain and swelling. Physical therapy will be prescribed to help you regain range of motion and strength — or prepare the shoulder for surgery.</li> <li><strong>Performing surgery.</strong><br /> Arthroscopic surgery, which involves making small incisions to allow the surgeon to repair the damage, is the most common. Typically, this is an outpatient procedure, and you'll go home the same day. Surgery also will be followed by icing, anti-inflammatory medications and physical therapy.</li> </ul> <h3><strong>What's the recovery time?</strong></h3> <p>How long it takes to recover depends on the extent of the injury, and whether you undergo surgery. If your dislocation is fairly simple, your shoulder joint will improve over a few weeks.</p> <p>After surgery, you'll wear a sling for about six weeks, gradually working on range of motion and strength. Full recovery may take five to six months.</p> <p>The greatest risk during healing for any shoulder dislocation is returning to activities before the shoulder is stable, even though you may be feeling pretty good. Resuming activities too quickly can lead to injury or possible repeat dislocation.</p> <h3>Can I prevent a shoulder dislocation?</h3> <p>The best way to prevent a shoulder dislocation is to concentrate on good mechanics and strength conditioning. However, competitive and casual athletes can experience this injury despite the best preparation because so many are caused by contact or falls.</p> <h3>Will I have issues in the future?</h3> <p>Those who have dislocated a shoulder once are prone to have it happen again. That's because the ligaments have stretched.</p> <p>If you experience a shoulder dislocation, health care professionals, including sports medicine and orthopedics specialists, orthopedic surgeons, physical therapists and athletic trainers, will help you get back into the game and regain your levels of performance and strength.</p> <a href="/providers/scott-kuzma-md" target="_self" title="Opens in same window."><em>Scott Kuzma, M.D.</em></a><em>, practices <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedics</a> and <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">sports medicine</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em><ul> <li>Ankle injuries</li> <li>Athletic injuries</li> <li>Complex knee injuries</li> <li>Meniscus and cartilage preservation and restoration</li> <li>Shoulder injuries and instability</li> <li>Sports medicine</li> </ul>M.D.<p><strong>Medical School</strong></p> <ul> <li>Medical College of Wisconsin, Milwaukee</li> </ul> <p><strong>Residency</strong></p> <ul> <li style="margin-bottom: 12px;">Medical College of Wisconsin, Milwaukee</li> </ul> <p style="margin-bottom: 12px;"><strong>Fellowship</strong></p> <ul> <li style="margin-bottom: 12px;">Orthopedic Surgery Sports Medicine, The Ohio State University, Columbus</li> </ul> <p style="margin-bottom: 12px;"><strong>Certification</strong></p> <ul> <li style="margin-bottom: 12px;">American Board of Orthopaedic Surgery</li> </ul> <p style="margin-bottom: 12px;"><strong>Memberships</strong></p> <ul> <li>American Academy of Orthopedic Surgery</li> <li>American Medical Association</li> <li>American Orthopaedic Society for Sports Medicine</li> <li>American Orthopaedic Association Emerging Leaders Program</li> <li>Arthroscopy Association of North America</li> <li>Mid-America Orthopedic Association</li> <li>Wisconsin Orthopedic Society</li> <li>Milwaukee Orthopedic Society</li> </ul>Kuzma<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/scott-kuzma-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B12F250B520326B80D27587E72FD92F7" alt="Scott Kuzma MD" width="280" height="280" DisableNVelocity="true" />{BD124C33-28FB-40BE-BAB7-DD857E212A20}Scott<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15748189Scott Kuzma, M.D.1<img src="/-/media/national-files/images/hometown-health/2022/baseball-pitcher.jpg?h=370&iar=0&w=660&sc_lang=en&hash=742977974E0B8BB8594BB2B015E18804" alt="Baseball pitcher" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller8/2/2022A three-digit number — 988 — provides immediate help during a mental health crisis. While the hotline helps those in crisis get support, a crisis safety plan can help identify the warning signs.Suicide crisis: How to develop your safety plan<p>It can be difficult to ask for help, particularly when in distress. It is hard to think clearly or rationally when your life seems overwhelming or hopeless. You may feel alone, like there is no way out, or things will never get better. For some people, these feelings may lead to suicidal thoughts.</p> <p>Suicide is a serious problem affecting people in the U.S. Suicide rates have increased by 30% between 2000 and 2018, according to the Centers for Disease Control. In 2020, an estimated 12.2 million American adults seriously thought about suicide, 3.2 million planned a suicide attempt, and 1.2 million attempted <a href="/hometown-health/speaking-of-health/suicide-isnt-about-dying-its-about-perceived-relief" target="_self" title="Opens in same window.">suicide</a>.</p> <p>In recognizing the growing mental health crisis, Congress recently passed the National Suicide Hotline Act designating a new three-digit number — <a href="tel:988">988</a> — as the Suicide and Crisis Lifeline number. Effective Saturday, July 16, people in distress can dial 988 rather than the previous 10-digit number. The change is modeled after the 911 emergency assistance program allowing those in crisis to seek support.</p> <p>Being in crisis or having <a href="/hometown-health/speaking-of-health/5-ways-to-help-teens-overcome-suicidal-thoughts" target="_self" title="Opens in same window.">suicidal thoughts</a> may be intermittent or persistent. If the underlying cause isn't treated, your suicidal thoughts will likely return. You may feel embarrassed to seek treatment for mental health issues. But getting the right treatment for depression, substance misuse or another underlying problem will help you feel better about life — and keep you safe.</p> <p>While the 988 hotline will improve access for people needing immediate help from trained counselors, it is important to identify warning signs of a looming crisis. Learn how to access emergency services in your community before you're in a moment of crisis.</p> <p>A crisis safety plan is a set of written instructions, such as notes saved on your phone, to act as your guide when psychiatric distress emerges. Creating this plan when you are in a good frame of mind will help you when things seem hopeless or overwhelming, and you may be unable to think so clearly or rationally.</p> <h2>Warning signs for help</h2> <p>First, identify early warning signs you aren't feeling well.</p> <h3>Identify changes in thoughts, behaviors, emotions that aren't characteristic of your typical self:</h3> <ul> <li>Are you isolating more?</li> <li>Have you started losing interest in things you enjoy?</li> <li>Are you ruminating more or being more irritable with those around you?</li> </ul> <p>Knowing your warning signs will allow you to be proactive in reducing psychiatric distress rather than waiting until you are in crisis.</p> <h2>Find coping strategies</h2> <p>Next, identify coping strategies that you can use to take your mind off what is going on. This could be taking extra time for yourself to do something special that you enjoy or to <a href="/hometown-health/speaking-of-health/discovering-calm-in-the-chaos" target="_self" title="Opens in same window.">practice self-care</a>. Use relaxation techniques, such as deep breathing, or practice structured mindfulness exercises. Sometimes a distraction, such as music or making art, can reduce stress and allow you to reset.</p> <h2>Identify your support system</h2> <p>If <a href="/hometown-health/speaking-of-health/5-tips-to-manage-stress" target="_self" title="Opens in same window.">coping strategies</a> don't work, reach out to people you are close with. It may be hard to talk about suicidal feelings. Your friends and family may not understand why you feel like you do. Reach out anyway.</p> <p>Make sure the people who care about you know what's going on. Knowing that somebody is there when you need them can be comforting.</p> <p>You also may get encouragement from your place of worship, support groups or other community resources. Feeling connected and supported can reduce psychiatric distress.</p> <h2>Professional and emergency services</h2> <p>When symptoms seem too overwhelming, it is important to know the professionals or agencies you can contact during a crisis. This may be your health care team or therapist during business hours. Also, explore online resources such as the National Alliance on Mental Illness or the National Institute of Mental Health.</p> <p>Because crises are unpredictable, emergency or crisis services are available 24/7, including the crisis center, mobile crisis services and the 988 hotline. If you or someone you know is at imminent risk of harm, call 911 or your local emergency number immediately.</p> <p>Remember, suicidal feelings are temporary. If you feel hopeless or that life's not worth living anymore, know treatment can help you regain your perspective and life will get better. It is important to recognize that in moments of crisis it may be challenging to think clearly or rationally.</p> <p>A crisis <a rel="noopener" href="https://www.bethe1to.com/safety-plan/" target="_blank" title="Opens in a new window.">safety plan</a> provides a good visual reminder of your warning signs, coping strategies, support system, professional agencies and emergency services. An established written safety or crisis plan, like a weather or disaster emergency plan, can prevent or manage a crisis and help save a life.</p> <h3>Local services to Minnesota include: </h3> <ul> <li><strong>988 hotline</strong><br /> This hotline connects you with a crisis center in the Lifeline network closest to your location. Your call will be answered by a trained crisis worker who will listen empathetically and without judgment. The crisis worker will work to ensure that you feel safe and identify options and information about mental health services in your area. The call is confidential and free.</li> <li><strong>Horizon Homes Mobile Crisis Team 24-Hour Crisis Line</strong><br /> This crisis line serves Blue Earth, Brown, Faribault, Freeborn, Le Sueur, Martin, Nicollet, Rice, Sibley and Watonwan counties. It's available 25/7 for mental health crisis support and resources by calling <a href="tel:1-877-399-3040">1-877-399-3040</a>.</li> <li><strong>South Central Crisis Center</strong><br /> This center serves Blue Earth, Brown, Faribault, Freeborn, Le Sueur, Martin, Nicollet, Rice, Sibley and Watonwan counties. It's available at <a href="tel:507-344-0621">507-344-0621</a> for crisis residence stabilization and mobile crisis supports. </li> <li><strong>Crisis Response for Southeast Minnesota</strong><br /> This service is available in Dodge, Fillmore, Goodhue, Houston, Mower, Olmsted, Steele, Wabasha, Waseca, and Winona counties by calling <a href="tel:1-844-274-7472">1-844-274-7472</a>. This line is available 24/7 for mental health crisis support and resources.</li> <li><strong>Online Resources</strong><br /> Explore the resources available from <a rel="noopener" href="https://nami.org/Home" target="_blank" title="Opens in a new window.">National Alliance on Mental Illness</a>, <a rel="noopener" href="https://www.nimh.nih.gov/" target="_blank" title="Opens in a new window.">National Institute of Mental Health</a> and <a rel="noopener" href="https://mentalhealthmn.org/" target="_blank" title="Opens in a new window.">Mental Health Minnesota</a>.</li> </ul> <p><a href="/providers/patrick-bigaouette-md" target="_self" title="Opens in same window."><em>Patrick Bigaouette, M.D.</em></a><em>, is a psychiatrist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Anxiety disorders</li> <li>LGBTQIA+ populations</li> <li>Medical education</li> <li>Mood disorders</li> <li>Peripartum psychiatry</li> <li>Psychopharmacology</li> <li>Trauma- and stressor-related disorders</li> <li>Women's health</li> </ul>M.D.<p>I enjoy working with patients in managing a wide spectrum of psychiatric disorders across psychosocial stages of life. I work in a collaborative, shared decision-making approach based on biologic, psychologic and social factors. My goal is to provide high-quality, evidence-based, patient-centered care to achieve the best possible outcomes in managing psychiatric distress.</p> <p>Outside of my clinical work, I am passionate about medical education and enjoy working with resident physicians and students.</p> <p>In moving back to Minnesota from the East Coast, I enjoy staying active outdoors, going to local theater, and I am always open to book recommendations.</p><p><strong>Education</strong></p> <ul> <li>Georgetown University School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Psychiatry, Mount Sinai-Beth Israel, Icahn School of Medicine at Mount Sinai</li> </ul> <p> <strong>Residency</strong> </p> <ul> <li>Psychiatry, Mount Sinai-Beth Israel, Icahn School of Medicine at Mount Sinai, New York</li> </ul> <p><strong>Certification</strong> </p> <ul> <li>Psychiatry, American Board of Psychiatry and Neurology </li> </ul> <p><strong>Membership</strong> </p> <ul> <li>American Psychiatric Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Psychiatry, Mayo Clinic College of Medicine and Science</li> </ul>Bigaouette<img src="/-/media/shared-files/images/medical-professionals/full/mankato/patrick-bigaouette-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4A09A81BD845D197A88A6FB7DC116F24" alt="Patrick Bigaouette MD" width="280" height="280" DisableNVelocity="true" />Patrick<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30014612Patrick Bigaouette, M.D.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2022/hands-holding-cellphone.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2A471027BE526D28A90084C8E1D3DBFF" alt="Hands holding cellphone" width="660" height="370" DisableNVelocity="true" />Suicide PreventionSuicide is a major concern in the U.S. According to the Centers for Disease Control and Prevention, suicide was among the top nine leading causes of death for people ages 10–64 and the second leading cause of death for people ages 10–14 and 25–34. The positive news is that with the right information and willingness to reach out to someone in need, we all can help prevent suicide.<br /><br /><strong>If you are having suicidal thoughts, call the 988 Suicide and Crisis Lifeline at <a href="tel:988">988</a>, or chat at <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://988lifeline.org/" target="_blank" title="Opens in a new window.">988lifeline.org</a>.</strong>Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller8/3/2022The endocrine system regulates hormone levels in your body. But sometimes it doesn't work properly. Learn when you may need surgery and about the safer, more effective surgical advancements.Surgical options when a gland goes awry<p>The body's endocrine system includes the pituitary gland, thyroid gland, parathyroid glands and the adrenal glands.</p> <p>The pituitary gland is a kidney-bean-sized gland situated at the base of your brain. The thyroid gland is a small, butterfly-shaped gland in the lower front of your neck. Also in the neck are four oval-shaped glands called the parathyroid glands. Two adrenal glands are just above each kidney in the back of the upper abdomen. Finally, the pancreas, ovaries and testicles also are part of the endocrine system.</p> <p>The endocrine system regulates hormone levels in your body. Hormones act like messengers. They are released into your bloodstream to give instructions to another organ. Hormones control many biological processes, like your blood sugar, energy, body growth, metabolism, body temperature, heart rate and protein production.</p> <p>Two branches of medicine treat conditions of the endocrine system: endocrinologists and endocrine surgeons.</p> <p>Physicians who specialize in endocrinology, called endocrinologists, can evaluate and treat endocrine disorders using treatments like medications, hormone replacement therapies or nutrition therapies. Endocrine surgeons have completed specialized training in the surgical care of conditions affecting the endocrine system. They work closely with endocrinologists and can perform surgery if medical treatments are not effective.</p> <h2>Conditions treated</h2> <p>Endocrine surgery is used to treat benign and malignant diseases of the endocrine system. Benign conditions are not cancerous and don't spread to other parts of the body. However, they can cause damage due to excessive hormone production or due to local compression.</p> <h4>Some benign conditions include:</h4> <ul> <li><strong>Hyperparathyroidism</strong><br> There are four parathyroid glands in the neck, and they are responsible for regulating calcium levels in your blood. This condition occurs when one or more of the parathyroid glands secretes hormones in an uncontrolled manner. Over time, this can damage your kidneys, bones, gastrointestinal system and central nervous system. In many cases, the best solution is surgical resection of the affected gland or glands.</li> <li><strong>Hyperthyroidism and Graves' disease</strong><br> If your thyroid releases too many hormones, you have an overactive thyroid. This is also called hyperthyroidism. It can cause sudden weight loss, fast or irregular heart rate, sweating and irritability. Graves' disease is an immune system disorder that leads to hyperthyroidism. Graves' disease can cause weight loss, heat sensitivity, irritability, changes in sexual health, bulging eyes, fatigue, red skin, rapid heart rate and sleep disturbances. In selected cases, surgery could be the best cure.</li> <li><strong>Goiter</strong><br> A goiter is an enlargement or irregular growth of the thyroid gland. Usually, a goiter doesn't change thyroid function or hormone levels. However, such an enlargement might cause local compression symptoms that might result in breathing difficulties or become cosmetically bothersome and require surgical resection.</li> <li><strong>Thyroid nodules</strong><br> This common condition is a growth in the thyroid gland. Although most of the time, nodules are benign and do not warrant a surgical intervention, a diligent evaluation should be conducted to identify and treat those nodules that appear more suspicious</li> <li><strong>Adrenal nodule</strong><br> Another common condition is a lump on the adrenal gland. It is often discovered during a cross-section CT or MRI. Adrenal nodules are usually benign and rarely malignant. However, in many cases, they require a surgical resection due to excess hormone production. Thyroid nodules may be evaluated by ultrasound to determine if they are suspicious for malignancy. In some cases, a fine needle aspiration biopsy will be necessary. In this procedure, cells from the lump are collected using a thin needle and analyzed under a microscope. About 80% of thyroid nodules are benign, about 10% are cancerous, and about 10% are indeterminate. This means that a repeat biopsy or surgery may be needed to confirm the diagnosis.</li> </ul> <p>Malignant tumors are tumors that grow in an uncontrolled manner and have the potential to invade surrounding tissues and spread, or metastasize, to other parts of the body.</p> <h4>Most people with cancer in the endocrine system will undergo surgery to remove all or part of the gland. This includes:</h4> <ul> <li>Thyroid cancer</li> <li>Parathyroid cancer</li> <li>Adrenal cancer</li> </ul> <p>Which operation your health care team recommends will depend on your type of cancer, the size of the cancer and other characteristics, and whether the cancer has spread to adjacent tissues or nearby lymph nodes.</p> <h2>Endocrine surgery</h2> <p>Surgery is not always necessary to treat benign endocrine conditions. Medications and other nonsurgical treatments are effective for many people. Surgery may be necessary if these other treatments are ineffective.</p> <p>The kind of surgery you have will depend on your issue and the affected gland. For example, thyroid surgery could remove half of the gland, called a lobectomy, or all of the gland, called a thyroidectomy. A near-total thyroidectomy also could be performed, where almost all the gland is removed. Your surgeon may not know how much thyroid gland must be removed until the surgery.</p> <p>Often, parathyroid conditions are caused by one or more parathyroid glands. In this case, usually only the affected glands will be surgically removed. Then the normally functioning glands will remain in place.</p> <p>If a gland is removed completely, you'll need to take hormones for the rest of your life to replace your natural hormones. This lessens side effects once your health care team finds the right dose for you.</p> <h2>Surgical advancements</h2> <p>Endocrine surgery is safe. Two significant surgical advancements for thyroid and parathyroid surgery have improve surgical effectiveness. The first is continuous interoperative nerve monitoring to protect the recurrent laryngeal nerve. This nerve is adjacent to the delicate structures of these glands. It controls a person's vocal cords. Damage during surgery can cause long-lasting side effects ranging from voice hoarseness to an obstruction of the airway. With continuous interoperative nerve monitoring, the nerve's function is checked during surgery so your surgeon can modify techniques or strategy to avoid nerve damage.</p> <p>Another advancement is called rapid intraoperative parathyroid assay. One of the properties of the parathyroid hormone is that it lasts in the bloodstream for a short time, often only about four and a half minutes. During surgery, the team checks this hormone level in the operating room. A decline in levels of that hormone can indicate if the team has the correct gland to remove or if further exploration is necessary.</p> <p>Sometimes, people are confused if they should seek care from an endocrine surgeon; an otorhinolaryngologist, also called an ear, nose and throat specialist; or a urologist. The areas of the body cared for by these professionals overlap, as the thyroid and parathyroid glands are in the neck and the adrenal glands are adjacent to the kidneys. The main advantage of an endocrine surgeon is specialized training in the comprehensive treatment of disorders of the endocrine system.</p> <p>Your primary care provider can help refer you to the appropriate specialist to meet your needs.</p> <h3>In this video, learn everything you need to know about thyroid and parathyroid surgical treatment:</h3> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/USGwFHCibTs" title="Ask Mayo Clinic Health System: Thyroid & Parathyroid Surgery" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <p><em>Tal Yalon, M.D., is a <a href="/services-and-treatments/surgery" target="_self" title="Opens in same window.">general and endocrine surgeon</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2022/stubbled-chin-and-neck-closeup.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0CB6DA466CBCE9343342C1C5D7E724D6" alt="Stubbled chin and neck closeup" width="660" height="370" DisableNVelocity="true" />SurgeryHaving surgery is a major event in your life. We know this and make every effort to keep you as comfortable as possible, focusing on you as an individual. Our surgeons and staff work as a coordinated team treating a wide variety of illnesses ranging from simple to complex. We offer comprehensive, advanced care and service to every patient.Dawn Haller9/18/2025When you feel like a lift, a caffeinated beverage, from coffee to an energy shot, may be your top choice. What's the latest on the health benefits and risks of these buzzy drinks?What's the latest buzz on energy drinks?<p>About 90% of adults consume caffeine every day, making it the most common stimulant in the world. <a href="/hometown-health/speaking-of-health/what-are-hidden-sources-of-caffeine" target="_self" title="Opens in same window">Widely available sources of caffeine</a> include coffee, green and black tea, soft drinks, "energy shots," over-the-counter supplements, energy or protein bars, sports and energy drinks, chocolate, chewing gum and even ice cream.</p> <p>Total sport and energy drink sales globally reached $193 billion in 2023. The U.S. is the No. 1 market, with people consuming nearly eight gallons of sports and energy drinks a year. These beverages are the second most popular dietary supplement among U.S. teens and young adults, behind multivitamins.</p> <h2>Caffeine guidelines</h2> <p>To give you an idea of how much daily caffeine consumption is safe, the <a rel="noopener" href="https://www.fda.gov/consumers/consumer-updates/spilling-beans-how-much-caffeine-too-much#:~:text=For%20most%20adults%2C%20the%20FDA,eliminate%20it%20from%20the%20body." target="_blank" title="Opens in a new window.">Food and Drug Administration</a> (FDA) made these recommendations:</p> <ul> <li>Adults: up to 400 milligrams of caffeine, the equivalent of two to three 12-ounce cups of coffee </li> <li>Pregnant or breastfeeding people: up to 200 milligrams </li> <li>Children: no safe limits set</li> </ul> <p>The <a rel="noopener" href="https://publications.aap.org/aapnews/news/27276/Children-should-avoid-drinks-with-sugar-caffeine?searchresult=1" target="_blank" title="Opens in a new window.">American Academy of Pediatrics</a> discourages the consumption of caffeine and other stimulants by children and adolescents. In recent years, emergency departments have seen a rising trend of children being admitted due to overconsumption of caffeine, also known as <a rel="noopener" href="https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Caffeine_and_Children-131.aspx" target="_blank" title="Opens in a new window.">caffeine toxicity</a>. Symptoms include vomiting, high blood pressure, racing heart, heart rhythm problems, and, less commonly, disorientation and hallucinations.</p> <p>So how do these recommended levels compare with typical energy drinks? Most energy drinks contain 100-300 milligrams of caffeine per serving, although amounts can vary.</p> <h2>Caffeine health effects</h2> <p>The positive health effects of caffeine vary from person to person, depending on the dose. These effects include:</p> <ul> <li>Improved reaction time, alertness and ability to concentrate.</li> <li>Lessened adverse effects of sleep deprivation.</li> <li>Protection against <a rel="noopener" href="https://newsnetwork.mayoclinic.org/discussion/3-21-mayo-clinic-q-and-a-caffeines-effects-on-blood-sugar-and-blood-pressure/?mc_id=us&utm_source=newsnetwork&utm_medium=l&utm_content=content&utm_campaign=mayoclinic&geo=national&placementsite=enterprise&invsrc=other&cauid=100721" target="_blank" title="Opens in a new window.">type 2 diabetes</a>, heart attack and stroke.</li> <li>Reduced risk of Parkinson's disease; Alzheimer's disease; liver disease, including liver cancer; alcoholic cirrhosis and gout.</li> </ul> <p>But caffeine also can have negative effects such as nervousness, insomnia, irritability and panic attacks. Those with preexisting anxiety disorders may be more susceptible to these effects.  </p> <p><a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/caffeine/art-20045678" target="_blank" title="Opens in a new window.">Heavy caffeine use</a> — more than 400 milligrams per day — can cause:</p> <ul> <li>Headache, insomnia, nervousness, irritability, fast heartbeat, palpitations, tremors, agitation and gastrointestinal upset.</li> <li>Increased risk of other addictive behaviors, like smoking and alcohol abuse.</li> <li>Physical and psychological dependence and withdrawal symptoms if intake is abruptly stopped.</li> </ul> <p>The FDA notes that toxic effects, including seizures, can occur with rapid consumption of 1,200 milligrams of caffeine. </p> <h2>Not just caffeine</h2> <p>Many energy drinks contain other ingredients that can affect your health as well.</p> <h3>Sugar</h3> <p>Energy drinks can contain significant amounts of <a href="/hometown-health/speaking-of-health/rethink-your-drink-beware-of-hidden-sugar" target="_self" title="Opens in same window">added sugar</a> or other sweeteners. Because high intake of added sugar can contribute to health problems, the Dietary Guidelines for Americans recommends limiting it to no more than 10% of total daily calories. </p> <p>For example, in a 2,000-calorie diet, no more than 200 calories — about 12 teaspoons — should come from added sugars. One 16-ounce can of Monster Energy Juice Pacific Punch supplies 210 calories and 47 grams of added sugar, which is equal to roughly 12 teaspoons. That's an entire day's worth of added sugar.  </p> <h3>Other substances</h3> <p>Energy drinks may contain vitamins, minerals and amino acids. </p> <p>Many also use <a href="/hometown-health/speaking-of-health/supplements-what-you-need-to-know" target="_self" title="Opens in same window">herbal supplements</a>, such as ginseng and guarana, which may be used to increase energy and mental alertness. Use caution with these substances since research on their safety and effectiveness is limited. Also, some herbal supplements can interact with prescriptions, so consult your healthcare professional before consuming them.</p> <p>Keep in mind that even if a beverage is labeled "natural," that doesn't mean it's healthy. Adding vitamins, minerals and other substances doesn't make energy drinks healthier.</p> <h2>Safety of energy drinks</h2> <p>The FDA classifies energy drinks as dietary supplements and doesn't approve them before they're marketed. That means they aren't subjected to the same rigorous review process as prescription medications.</p> <p>Manufacturers are responsible for safety, good manufacturing processes and truth in labeling.</p> <p>Energy drink alternatives</p> <p>If you've got the afternoon slumps, that doesn't necessarily mean you need a caffeine boost. You may be dehydrated. Dehydration can cause fatigue, dry mouth and skin, and nausea. It also can take a toll on your attention and short-term memory.</p> <p>To hydrate, skip energy or sugary drinks or a cup of coffee or tea. Instead, try <a href="/hometown-health/speaking-of-health/tips-for-drinking-more-water" target="_self" title="Opens in same window">drinking plain water</a> and eating hydrating foods like apples, berries, melons, celery and lettuce.</p> <h3>Brew a decaf iced latte at home</h3> <p>This coffee-shop-style decaf coffee drink is sweetened with brown sugar and almond syrup. You can use any other flavored syrup, such as hazelnut, or skip it. To make your latte plant-based, leave off whipped topping or use a whipped topping substitute. If you need to follow a gluten-free diet, check the syrup and whipped topping labels.</p> <h3>Iced latte</h3> <p>By Mayo Clinic Staff<br /> Makes 4 servings</p> <p>2 cups brewed decaffeinated espresso coffee, cooled<br /> 2 tablespoons light brown sugar<br /> 1 1/2 cups fat-free milk<br /> 2 tablespoons sugar-free almond syrup*<br /> Ice cubes<br /> 1 cup fat-free whipped topping<br /> 1 teaspoon ground espresso beans</p> <p>In a pitcher, combine the espresso, brown sugar, milk and syrup. Stir to mix evenly. Refrigerate until cold. Fill 4 glasses with ice cubes. Pour coffee over ice. Add 1/4 cup whipped topping to each drink and sprinkle with ground espresso beans.</p> <p>Nutritional per serving (1 8-oz. glass): 84 calories, trace total fat, 11 grams sugar, 82 milligrams sodium, 18 grams carbohydrates, 3 grams protein, 0 grams fiber.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2022/drinking-an-energy-drink.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D926AF6696541632142FAA4A939ABA3F" alt="Drinking an energy drink" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller8/26/2022ADHD affects roughly 5.7 million children ages 6–17 and may lead to struggles with anxiety or depression and behavior problems. Learn the different types of ADHD and when to consider evaluation.What is attention-deficit/hyperactivity disorder?<p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/adhd/symptoms-causes/syc-20350889" target="_blank" title="Opens in a new window.">Attention-deficit/hyperactivity disorder</a> (ADHD) is a neurodevelopmental disorder of childhood. Symptoms begin before age 12 and persist into adulthood for some children. ADHD affects roughly 2.4 million children ages 6–11 and 3.3 million children ages 12–17.</p> <p>Six of 10 children who experience symptoms of ADHD also may struggle with other emotional problems, such as anxiety or depression, and behavior problems.</p> <p>Consider evaluation and treatment when ADHD causes symptoms that affect a person's ability to <a href="/hometown-health/speaking-of-health/helping-your-childs-education-through-an-iep-or-504-plan" target="_self" title="Opens in same window.">do well in school</a>, at work, at home or in their relationships.</p> <h2>The three types of ADHD are:</h2> <h3>1. Inattention ADHD</h3> <h4>Symptoms can present themselves as:</h4> <ul> <li>Easily distracted</li> <li>Poor attention to detail</li> <li>Putting off or avoiding tasks or projects that the person perceives or anticipates will take time or mental effort</li> <li>Difficulty organizing or prioritizing tasks</li> <li>Poor time management, such as consistently missing work deadlines, attending family functions or appointments late, not turning in or completing schoolwork, or underestimating how long something will take</li> <li>Forgetting or misplacing items frequently</li> <li>Difficulty following multiple-step instructions</li> <li>Forgetting to perform daily activities, such as completing chores or homework</li> <li>Not fully listening even though the person may be looking right at you</li> </ul> <h3>2. Hyperactivity or impulsivity ADHD</h3> <h4>Symptoms can present themselves as:</h4> <ul> <li>Having a hard time sitting still and a constant need to be on the go or moving around</li> <li>Frequently shifting from task to task without fully completing what has been started</li> <li>Difficulty standing in line or waiting. This may present as a child touching everything while waiting or a person bouncing from line to line to find the shortest line</li> <li>Tendency to talk too much, blurt or interrupt</li> <li>Impulsive behaviors — acting without thinking</li> </ul> <p>In children, symptoms also can include running or climbing in inappropriate situations. In adults and adolescents, symptoms can include restlessness and fidgeting.</p> <h3>3. Combined ADHD</h3> <p>This type of ADHD is seen in a person who experiences a combination of inattention and hyperactivity or impulsivity symptoms.</p> <h2>What ADHD is not</h2> <p>ADHD is unrelated to intelligence. Many notable people have had ADHD, including Benjamin Franklin and President John F. Kennedy.</p> <p>Also, ADHD has nothing to do with being lazy, lacking self-control or not trying hard enough. The brains in people with ADHD work differently than those without ADHD.</p> <h2>Treatment for ADHD</h2> <p>Standards of treating ADHD include learning techniques and skills to improve organization, completion of tasks, time management, and strategies to improve impulse control. Medications also can reduce symptoms so a person can learn the <a href="/hometown-health/speaking-of-health/5-tips-to-manage-adhd-in-children" target="_self" title="Opens in same window.">skills and techniques to improve symptoms</a>.</p> <p>If you are concerned that you or someone you care about may have ADHD, contact your health care team to discuss assessment and treatment options.</p> <p><em><a href="/providers/jessie-wolf-licsw" target="_self" title="Opens in same window.">Jessie Wolf</a> is a clinical social worker in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Adjustment disorders</li> <li>Adolescent and children’s behavioral health (ages 6-17)</li> <li>Anxiety disorders</li> <li>Attention-deficit/hyperactivity disorder (ADHD) assessment and treatment with adults and children (ages 6-17)</li> <li>Depressive disorders</li> <li>Grief and loss</li> </ul>L.I.C.S.W.<p>I see children six years of age through adulthood.</p><p><strong>Education </strong></p> <ul> <li>Master's degree, Social Work, Minnesota State University-Mankato</li> </ul> <p><strong>Internships</strong></p> <ul> <li>Hospice and Palliative Care, Mayo Clinic Health System-Mankato</li> <li>Nursing Home and Rehab Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>ADHD, Certified Clinical Services Provider </li> <li>Art of Traumatic Grief Counseling, Compassionate Bereavement Care</li> <li>Licensed Independent Clinical Social Worker</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Professional Society of ADHD and Related Disorders</li> <li>National Social Work Association</li> </ul> <p><strong>Academic Rank</strong></p> <ul> <li>Instructor in Social Work, Mayo Clinic College of Medicine and Science</li> </ul>Wolf<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jessie-wolf-licsw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B680201D1A0D763676AD889806D46E00" alt="Jessie Wolf LICSW" width="280" height="280" DisableNVelocity="true" />Jessie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14640821Jessie Wolf LICSW1{2B88C934-922C-4130-B661-197B59D83899}|{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2022/child-on-green-ropes-course.jpg?h=370&iar=0&w=660&sc_lang=en&hash=DFA7D8AC04944FBE27EE903D71DB8FC3" alt="Child on green ropes course" width="660" height="370" DisableNVelocity="true" />Child DevelopmentWe all want our children to grow up happy and healthy. The reality is most all of them do — but at vastly different rates. Experts across Mayo Clinic Health System see thousands of children each year, and have the experience and resources to know what is normal and what may be cause for closer observation. This includes not only physical and motor skills development, but psychological and social skill advancement.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller9/12/2022Pharmacies and other retailers soon will offer over-the-counter hearing devices for people with moderate hearing loss. Here's what you should know before you buy.Are OTC hearing devices a good fit for you?<p>People with mild to moderate hearing loss soon will be able to buy hearing aids over the counter without medical exams or professional fittings. But will an over-the-counter (OTC) hearing device be a good fit for you?</p> <h2>Here are some things to consider before you buy:</h2> <h3>More convenient and accessible</h3> <p>An OTC option will be more convenient and accessible, especially for those who live in rural areas, where making an appointment with a hearing specialist and getting to that appointment can be a barrier to care. These devices will be available at pharmacies, drug stores, other major retailers and online.</p> <h3>Less expensive</h3> <p>Hearing aids typically are expensive, with prices averaging $1,000 to more than $3,000 per ear, depending on the level of technology and included services. Insurance coverage for adults can be limited, expensive or nonexistent. The OTC option could save many people money.</p> <h3>Quality devices</h3> <p>Some of the developers behind OTC hearing devices are traditional hearing aid manufacturers, in some cases, they're working in partnership with companies known for products with high sound quality, such as wireless headsets. These devices will go beyond just noise reduction and sound amplification and include a level of sound shaping you'd experience with a hearing aid.</p> <h3>Entry-level option</h3> <p>Over-the-counter hearing aids promise to be a good first step for people who are just beginning to notice hearing loss. People in the target market tend to be younger — 40 to 65 — fairly tech savvy and able to navigate the home fitting process.</p> <h3>Self-diagnosis</h3> <p>Under the new Food and Drug Administration ruling, people will need to determine their level of hearing loss. But patients may not be the most accurate judge of their condition. Since hearing loss varies from person to person, hearing aids are customized — not one-size-fits-all.</p> <h3>How-to instructions</h3> <p>The OTC devices will include step-by-step instructions for fitting and use, whether through an app or an online portal. Companies offering OTC devices also will be required to make the same software available to hearing professionals and audiologists, so many will be able to troubleshoot, and provide counseling and programming services.</p> <h3>Hearing test</h3> <p>Before you dash off to buy an OTC hearing device, you should have an audiologist or hearing professional check your hearing. By knowing where you stand, you'll eliminate some of the guesswork determining which OTC device will be the best fit for you.</p> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/_QfJpMG-YuE" title="Over-the-counter hearing aids" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <p><a href="/providers/katie-dease-aud" target="_self" title="Opens in same window."><em>Katie Kendhammer, Au.D.</em></a><em>, is an <a href="/services-and-treatments/audiology" target="_self" title="Opens in same window.">audiologist</a> in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em></p><ul> <li>Amplification/hearing aids</li> <li>Audiometry</li> <li>Pediatrics</li> <li>Tinnitus</li> </ul>Au.D.<p><strong>Education</strong></p> <ul> <li>Doctor of Audiology, University of Wisconsin-Stevens Point</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Audiology</li> <li>Certificate of Clinical Competence, American Speech-Language-Hearing Association</li> <li>Hearing Instrument Dispenser</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Speech-Language-Hearing Association</li> </ul>Dease<img src="/-/media/shared-files/images/medical-professionals/full/mankato/katie-dease-aud.jpg?h=280&iar=0&w=280&hash=2A9E758AE48ADAA463D9362B7EE868C8" alt="Katie Dease, Au.D." width="280" height="280" DisableNVelocity="true" />{A4D89010-062B-42B7-830A-2F6D0A2BD079}Katie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15263924Katie Dease, Au.D.1{18E5E65E-45C8-4C48-BD32-A914794E2AA4}<img src="/-/media/national-files/images/hometown-health/2022/using-cellphone-with-hearing-aid.jpg?h=370&iar=0&w=660&sc_lang=en&hash=12BC54F2C7EC163049A70B1ECC6E75A8" alt="Using cellphone with hearing aid" width="660" height="370" DisableNVelocity="true" />Ear HealthAn audiologist specializes in evaluating and treating people of all ages with hearing loss, dizziness and balance disorders. Specialty audiology consultation is available for assessment and treatment of hearing loss, tinnitus, dizziness and balance disorders.Dawn Haller9/14/2022A little boredom can be a good thing. It can simulate creativity and problem-solving, while recharging the brain. Get tips to give your brain a boost and overcome feeling uncomfortable being bored.Boost your brain with boredom<p>"Mom, Dad, I'm bored."</p> <p>How many parents have heard this from children? It may make parents feel like they're failing, need to find something for the child to do or simply annoyed that children seem incapable of entertaining themselves.</p> <p>Yet a little boredom for children and adults can be a good thing. It can simulate creativity and problem-solving, while giving the brain time to recharge.</p> <h2>Boredom basics</h2> <p>Why do people get bored? The feeling of boredom is when brains struggle to fill time. People may feel restless or have a lack of interest in their surroundings. Boredom is common, with over 60% of U.S. adults reporting that they feel bored at least once a week.</p> <p>People's brains rarely are bored while focused on taking part in demanding tasks like work or school, or while taking part in a good conversation. When these activities are done, people experience fatigue and seek ways to entertain themselves and their brains.</p> <p>Play and entertainment have been ways humans have figured out to overcome boredom. Adults read, spend time with hobbies or tell stories to avoid boredom. Before the advent of TV and mobile devices, children overcame boredom by going outside or playing with a friend or sibling.</p> <p>Today, electronics capture a significant amount of people's attention. But this readily accessible medium may have swung too far in capturing people's attention. Instead of short-term relief from boredom, many people spend hours on electronics.</p> <p>It's easy not to feel the passage of time while scrolling TikTok or watching YouTube videos. Quickly, an hour or two can pass without a person realizing it. For all that time spent, people don't necessarily feel refreshed. Rather, most people experience greater fatigue.</p> <p>Consuming so much time on electronics lessens the amount of bored time, but also it causes a different problem. The less people experience boredom, the less equipped the brain is to deal with it.</p> <h2>Restoring the brain</h2> <p>When your brain is focused on an intense activity, it exerts a lot of energy. When you finish the activity, it returns to a default state. This is normal and the way that brains restore. The default state can be thought of as a resting state. Several interconnected brain regions are active during this time. These regions seem to act in unison as a connected network. This is referred to as the default mode network.</p> <p>When people are in this state, many important things are happening in the brain. It's consolidating memories and reflecting on lessons learned. The brain plays through scenarios and applies what was learned and how it could be used in the future. People spend time thinking about themselves and others. They reminisce about the past and daydream about the future.</p> <h2>Developing creative solutions</h2> <p>The resting state also can be a creative time, and it can lead to finding creative solutions to problems that are bothering people. For example, many people claim to come up with great solutions to problems they are grappling with while in the shower. This is because their mind is free to wander while their body is engaged in a mindless task and captive to the task.</p> <p>While in the shower, the person can't escape or play a game on a phone. The brain is thinking through something almost effortlessly and often coming up with solutions to problems that have been in the back of the mind.</p> <p>Another example is when a person takes a nature walk. During this time, it's a safe and calming environment. Within the first five minutes, the person gradually gets used to the environment, reducing anxiety. The rest of the walk, the brain starts to rest and wander. When a new stimulus comes in, the mind identifies it but returns to a restful state. During this time, the brain is involved in creative thinking and finding interesting solutions.</p> <h2>Embracing boredom</h2> <h3>Follow these tips to overcome the uncomfortable feelings of boredom:</h3> <ul> <li><strong>Balance activities with rest.</strong><br /> It's good to have a variety of activities that you enjoy, include socializing with others and are mentally stimulating. Yet rest time is important to recharge your brain. Seek a balance between structured activities and intermittent rest time to increase your creative thinking.</li> <li><strong>Try something new.</strong><br /> Join a club, try a new hobby, play a game, read a book or cook a new recipe to ignite your creativity and provide a distraction from boredom.</li> <li><strong>Get outdoors.</strong><br /> Spending time with nature is one of the best therapeutic ways to ward off boredom. It also promotes creative thinking.</li> <li><strong>Embrace curiosity and kindness.</strong><br /> This will get you more involved with the people and the world around you.</li> <li><strong>Embrace reminiscing.<br /> </strong>Reminiscing is a big part of time spent as people age. It's normal and expected. If excessive reminiscing becomes a problem, try to channel focus on current or future goals and wishes for a few minutes.</li> </ul> <h2>Helping kids accept boredom</h2> <p>It's not parents' responsibility to entertain their children every moment of the day. Kids are naturally curious and creative. Being bored helps them strengthen their creative muscles and learn to cope with feelings of boredom as they get older.</p> <p>If they protest boredom, acknowledge their feelings and ask them to come up with a solution. If they struggle, offer ideas that don't include an electronic device.</p> <p>Boredom can be more uncomfortable or distressing for people feeling fearful, anxious or depressed. If this is the case, they should seek professional help to work through their feelings and develop healthy coping skills.</p> <p>Don't be afraid of boredom. It's a normal part of life. Try not to dismiss or dislike it. Instead, try to view is as an opportunity to restore your brain and develop create solutions to problems.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2022/fist-in-hand-against-cheek.jpg?h=370&iar=0&w=660&sc_lang=en&hash=75B5CC9405234C22AE2989F112BAC4A2" alt="Fist in hand against cheek" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller9/7/2022Peyronie's disease occurs when scar tissue develops on the penis. It can cause pain, deformity, shortening and anxiety. Learn how early treatment can improve symptoms or stop it from getting worse.Early treatment critical for Peyronie's disease<p>Peyronie's disease is a common yet poorly understood condition. Between 8% and 10% of men in their mid-teens to their 80s have signs or symptoms of Peyronie's disease.</p> <p>It is a noncancerous condition that is a result of scar tissue developing on the penis. This causes curved and painful erections. It can prevent sexual intercourse, lead to penile shortening, and could make it difficult to get or maintain an erection. Peyronie's disease can cause significant stress and anxiety.</p> <p>Early evaluation and treatment is important, as Peyronie's disease rarely goes away on its own. Without treatment, only about 10% to 15% of men experience symptom relief in one year, while symptoms worsen for about 45% of men.</p> <h2>Causes</h2> <p>In some cases, Peyronie's disease is caused by an injury to the penis during sex, athletic activity or an accident. During the healing process, scar tissue forms in a disorganized way. When the penis becomes erect, the scar tissue doesn't stretch, and the penis curves, bends or becomes disfigured. This can cause pain, as well.</p> <p>Often, men cannot recall a specific episode of trauma. In those cases, it could be a result of excessive pressure creating microtrauma or a genetic predisposition to abnormal scar tissue formation or connective tissue disorders.</p> <h2>Early treatment</h2> <p>Peyronie's disease begins in the acute phase, which can last three months to one year. This is often associated with pain with erections and the initial development of curvature. Early diagnosis and treatment may be able to halt or treat the curvature with nonsurgical means. This is why it's important to seek treatment early.</p> <h3>Most often, treatment in the acute phase may include:</h3> <ul> <li><strong>Penile traction therapy</strong><br /> This involves stretching the penis with a self-applied device to improve penile length and curve while correcting any deformity. It is worn for as little as 30 minutes to as much as eight hours a day. It's the only treatment shown to improve penile length. </li> <li><strong>Injection therapy</strong><br /> Some medications can be injected directly in the penile scar tissue. One example is collagenase, the only medication that the Food and Drug Administration has approved for the disease. This medication breaks down the buildup of collagen. Verapamil and interferon are other injection options. They disrupt the production of fibrous tissues and are shown to reduce pain.</li> </ul> <p>Oral medications aren't recommended during the acute phase, as they haven't been shown to be effective.</p> <h2>Treatment for chronic symptoms</h2> <p>The chronic phase happens later in the disease and generally occurs around three months to one year after symptoms begin. It is when the curvature stabilizes, and pain typically resolves.</p> <p>While penile traction and injection therapy are a part of the treatment plan during the chronic phase, surgery is another option and is the most definitive treatment. Surgery, however, is not recommended until symptoms have stabilized for at least three months.</p> <h3>Some common surgical options include:</h3> <ul> <li><strong>Suturing the unaffected side (penile plication)</strong><br /> A surgical procedure can be performed on the side of the penis with no scar tissue. The surgeon cinches together the excess tissue on what had been the outer side of the curve by placing a series of stitches or "tucks." The final penile length will depend on the length of the shorter side — the side with the scarring from Peyronie's disease. It's usually for men with less severe curvatures.</li> <li><strong>Grafting (plaque incision and grafting)</strong><br /> During this procedure, the scar tissue is cut, and a piece of tissue called a graft is sewn into place to cover the gaps. This procedure is generally for men with more severe curvature or deformities and excellent erectile function.</li> <li><strong>Penile implants</strong><br /> Often, men with Peyronie's disease also are affected by erectile dysfunction. The best treatment to correct both conditions is placement of an inflatable penile prosthesis. This device is implanted within the erectile bodies of the penis with a small pump in the scrotum. With inflation of the device, the man can have a firm, long-lasting erection, with minimal to no curve, hinge or indentation deformity.</li> </ul> <p>A urologist can explain the benefits and risks of all treatment options and recommend a treatment plan based on your current erectile function, duration of symptoms and personal preferences.</p> <p><em><a href="/providers/david-yang-md" target="_self" title="Opens in same window.">David Yang, M.D.</a>,</em><em> is a <a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">urologist</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Male infertility (microscopic variocelectomy)</li> <li>Male stress incontinence (male sling, artificial urethral sphincter)</li> <li>Male urethral stricture disease (urethroplasty)</li> <li>Men’s health</li> <li>Men’s sexual medicine (erectile dysfunction, penile prosthesis/prosthetic surgery)</li> <li>Peyronie's disease (penile plication, penile incision and grafting)</li> <li>Robotic surgery</li> <li>Urethral stricture disease</li> </ul>M.D.<p>My goal is for every patient to leave our visit with a newfound understanding of their condition and options for management, and they feel comfortable with the future plan. I try to treat every patient as family, and will deliver information and guidance as such. My clinical interests include urologic oncology and men's sexual health, including erectile dysfunction, Peyronie's disease and male infertility.</p> <p>I grew up in Indianapolis but have lived in Minnesota for the last seven years. In my free time, I like to golf, hike, and spend time with my wife and two Newfoundland dogs.</p><p><strong>Education</strong></p> <ul> <li>Indiana University School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Urology, Mayo Clinic</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Urology, Mayo Clinic School of Graduate Medical Education </li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Andrology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Urology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Urologic Association</li> <li>Sexual Medicine Society of North America</li> <li>Society for the Study of Male Reproduction</li> <li>Society of Genitourinary Reconstructive Surgeons</li> <li>Society of Urologic Prosthetic Surgeons, Inc.</li> </ul>Yang<img src="/-/media/shared-files/images/medical-professionals/full/mankato/david-yang-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=3161395B079F288AA0229E441F6302D1" alt="David Yang, M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/33223428/" target="_blank" title="Opens in new window">The Tubing, Hitch and Lasso, Intussusception Anchor (THALIA) Technique: A novel approach to fixate the penile implant reservoir</a>, January 2021.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/32198103/" target="_blank" title="Opens in new window">Multicenter experience using collagen fleece for plaque incision with grafting to correct residual curvature at time of inflatable penile prosthesis placement in patient’s with Peyronie’s disease</a>, June 2020.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/33676956/" target="_blank" title="Opens in new window">Patient attitudes towards surgical management of Peyronie’s Disease prior to men’s health consultation</a>, June 2020.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/30701330/" target="_blank" title="Opens in new window">Damage control considerations during IPP surgery</a>, January 2020.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/25240762/" target="_blank" title="Opens in new window">Oncologic and quality-of-life outcomes with wide resection in robot-assisted laparoscopic radical prostatectomy</a>, February 2015.</li> </ul>David<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16240391David Yang, M.D.1<img src="/-/media/national-files/images/hometown-health/2022/back-of-couple-looking-to-right.jpg?h=370&iar=0&w=660&sc_lang=en&hash=16FD9285E6002A31607C3C62463B5102" alt="Back of couple looking to right" width="660" height="370" DisableNVelocity="true" />Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Dawn Haller9/8/2022This year's flu season could be different than the last two years. A Mayo Clinic expert explains why vaccination for flu will be important this year.Expect a different flu season: Why you'll want to be vaccinated for the flu<p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/coronavirus-covid-19" target="_blank" title="Opens in a new window.">COVID-19</a> may be the most prominent virus of concern in the U.S. now, but public health officials also are preparing for seasonal <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/flu/symptoms-causes/syc-20351719" target="_blank" title="Opens in a new window.">influenza</a>. And indications are that it could be a different season than the U.S. experienced the past two years.</p> <p>The Australian flu season, which typically runs May through September, already has exceeded its five-year average, particularly affecting children under age 5, according to a recent <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www1.health.gov.au/internet/main/publishing.nsf/Content/cda-surveil-ozflu-flucurr.htm" target="_blank" title="Opens in a new window.">report</a>.</p> <p>During the height of the COVID-19 pandemic, the U.S. experienced a steep drop in influenza rates due to masking and social distancing measures. However, those practices have changed.</p> <p>"Many have stopped masking," says <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/virk-abinash-m-d/bio-20054178" target="_blank" title="Opens in a new window.">Abinash Virk, M.D.</a>, an infectious diseases specialist at Mayo Clinic. "For the large part, we will see influenza reemergence in the winter. In comparison, in 2020 winter, when we were all masking and social distancing, there was literally no influenza. But now that has all changed."</p> <p>Dr. Virk says that cases of influenza began to return as the masks came off. "We're going to get influenza this winter again, and people should seek out influenza vaccination when it becomes available in their local community," she says.</p> <h2>In this video, Dr. Virk talks about the 2022–2023 flu season:</h2> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/cpjTMUOS8Jc" title="Expect a different flu season" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <p>Seasonal influenza, like COVID-19, is a contagious respiratory illness that disproportionately affects adults ages 65 and older. However, they are not the same viruses. The <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-vs-flu/art-20490339" target="_blank" title="Opens in a new window.">similarity and differences between the two viruses</a> also mean it can be difficult to discern between them when symptoms overlap.</p> <p>Testing helps limit the spread, but it is particularly important for people at risk of severe influenza or COVID-19 so that they can be treated with specific antiviral treatments for these viruses.</p> <p>The <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.cdc.gov/flu/highrisk/65over.htm" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention (CDC) recommends</a> that those 65 and older receive higher-dose, including high-dose and recombinant vaccinations, or adjuvanted flu vaccinations over standard-dose flu vaccinations.</p> <p>All people over 6 months are encouraged to get vaccinated for the flu when available in their local community. The CDC recommends that people are vaccinated for flu by the end of October to ensure they are fully vaccinated for the influenza season.</p> <h2>Along with vaccination, you can take these steps to protect yourself from influenza and other contagious viruses:</h2> <ul> <li>Wash your hands often and thoroughly with soap and water for at least 20 seconds.</li> <li>Use an alcohol-based sanitizer on your hands if soap and water aren't available.</li> <li>Avoid touching your eyes, nose or mouth.</li> <li>Avoid crowds when flu is spreading in your area.</li> <li>Avoid being in close contact with others who are sick.</li> <li>Cover your mouth with a tissue or elbow when coughing or sneezing, and then wash your hands.</li> <li>Regularly clean and disinfect commonly touched surfaces, such as counters, light switches or doorknobs. This can prevent the spread of infection from touching a surface with the virus on it and then your face.</li> <li>Practice good health habits. Get regular exercise, get enough sleep, drink plenty of fluids, eat a healthy diet and manage stress.</li> <li>Consider masking in crowded indoor locations, especially if you have risk factors for severe influenza or COVID-19.</li> </ul> <p>If you become sick with the flu, you also can help prevent the spread of the flu by staying home and away from others. Stay home until your fever has been gone for at least 24 hours.</p> <p>A flu shot doesn't protect people against getting infected with COVID-19. And getting vaccinated for COVID-19 doesn't protect people against getting the flu.</p> <p>Currently, a combination vaccine against influenza and COVID-19 is not available, so it's best to have both vaccines to have protection against both diseases.</p> <h2>Learn more about the flu:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/what-should-you-do-if-you-have-covid-19-or-the-flu" target="_self" title="Opens in same window.">What should you do if you have COVID-19 or flu?</a></li> <li><a href="/hometown-health/speaking-of-health/facts-about-flu" target="_self" title="Opens in same window.">Facts about flu</a></li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/when-to-test-for-flu-covid-19/" target="_blank" title="Opens in a new window.">When to test for flu, COVID-19</a></li> </ul><img src="/-/media/national-files/images/hometown-health/2022/holding-tissue-against-nose.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E401AD4DFB1C4518A75CEF7C88851E38" alt="Holding tissue against nose" width="660" height="370" DisableNVelocity="true" />InfluenzaInfluenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza, commonly called the flu, is not the same as the stomach "flu" viruses that cause diarrhea and vomiting.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller4/8/2025Noise over 140 decibels can permanently damage hearing, and almost all firearms are in that range or higher, putting hunters at risk for hearing loss. Learn how protective devices can reduce that risk.Hunting? Be sure to protect your hearing<p>I'm a hunter, and I come from a family of hunters, so I know how important it is to be able to hear when you're in the field. But as an audiologist, I also know how important it is to protect your hearing when using firearms. That's true whether you're hunting, shooting targets or sighting a firearm.</p> <p>Noise over 140 decibels can permanently damage hearing, and almost all firearms are in that range or higher. In comparison, normal conversation falls in the 55–60 decibel range. As we lose hearing due to noise exposure, high-pitched sounds like "s," "th" and "f" tend to be the first affected.</p> <p>People who lose ability to hear these sounds complain that others are mumbling or that sounds feel muffled. They also may develop ringing in the ears, or what's known as <a href="/hometown-health/speaking-of-health/are-you-hearing-crickets" target="_self" title="Opens in same window.">tinnitus</a>.</p> <p>Unfortunately, many hunters don't use hearing protection while in the field. The most common complaints about hearing protection devices are that they don't allow hunters to hear game, and the devices are uncomfortable.</p> <h2>Find a hearing protection option that fits</h2> <p>For hearing protection to be accepted, it has to fit well, be easy for the user to insert or wear, and be simple to clean and maintain.</p> <p>Earplugs are one of the most common HPDs. They can be as basic as disposable foam plugs or more advanced custom-made ear molds. They can be designed with filters to let soft and moderate sounds pass through, while reducing loud noises. Consider wearing them on a cord around your neck so they're always at hand.</p> <p>Electronic HPD options can make softer sounds louder, but shut off when there is a loud noise, like gunfire. They include earmuffs — instant fit and custom in-ear versions. These HPDs allow hunters to talk and hear animals without removing the devices.</p> <p>Some higher-end hearing protection devices can provide minimal amplification and protection. For example, if someone is going on an elk hunt, the device can be programmed to pick up the high-pitched elk bugling, while also protecting from loud noises.</p> <p>An audiologist can test your hearing and help you find higher-quality options that may not be available from retail stores.</p> <h2>Protection practice makes perfect</h2> <h3>Once you select a hearing protection option:</h3> <ul> <li>Practice wearing your new hearing protection, just as you practice your aim. Make it part of your routine. A good time to start is during target practice or sighting.</li> <li>Always have disposable hearing protection like foam earplugs handy.</li> <li>Consider double-protecting your ears by wearing muffs over plugs.</li> <li>Avoid shooting in locations where noise reverberates in the space.</li> </ul> <p>HPDs range in price from $10 to more than $1,000. But just as you invest in clothing, equipment, ammunition and firearms, consider the cost of high-quality hearing protection as part of your sport.</p> <p><a href="/providers/katie-dease-aud" target="_self" title="Opens in same window."><em>Katie Dease, Au.D</em></a><em><a href="/providers/katie-dease-aud" target="_self" title="Opens in same window.">.</a>, is an <a href="/services-and-treatments/audiology" target="_self" title="Opens in same window.">audiologist</a> in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em></p><ul> <li>Amplification/hearing aids</li> <li>Audiometry</li> <li>Pediatrics</li> <li>Tinnitus</li> </ul>Au.D.<p><strong>Education</strong></p> <ul> <li>Doctor of Audiology, University of Wisconsin-Stevens Point</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Audiology</li> <li>Certificate of Clinical Competence, American Speech-Language-Hearing Association</li> <li>Hearing Instrument Dispenser</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Speech-Language-Hearing Association</li> </ul>Dease<img src="/-/media/shared-files/images/medical-professionals/full/mankato/katie-dease-aud.jpg?h=280&iar=0&w=280&hash=2A9E758AE48ADAA463D9362B7EE868C8" alt="Katie Dease, Au.D." width="280" height="280" DisableNVelocity="true" />{A4D89010-062B-42B7-830A-2F6D0A2BD079}Katie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15263924Katie Dease, Au.D.1{18E5E65E-45C8-4C48-BD32-A914794E2AA4}<img src="/-/media/national-files/images/hometown-health/2022/hunters-in-orange-vests.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D93367DE08614DEFCADB540CD41B77DE" alt="Hunters in orange vests" width="660" height="370" DisableNVelocity="true" />Ear HealthAn audiologist specializes in evaluating and treating people of all ages with hearing loss, dizziness and balance disorders. Specialty audiology consultation is available for assessment and treatment of hearing loss, tinnitus, dizziness and balance disorders.Dawn Haller9/30/2022Flu season usually starts in the fall. Learn how the influenza vaccine reduces hospitalization during pregnancy and can protect the baby from the flu after birth.Pregnancy and respiratory illnesses: Tips to reduce your flu risks<p>Flu season usually starts in the fall, peaks during the height of winter and tapers around spring. Other respiratory illnesses, including respiratory syncytial virus, enterovirus, the common cold and COVID-19, also can spread during flu season and cause flu-like symptoms.</p> <p>One of the best ways to protect yourself from illness is to get a seasonal flu shot. Vaccination is vital for those at higher risk of complications, including people who are pregnant.</p> <p>A person's risk of getting sicker from influenza, from COVID-19, from any kind of pulmonary respiratory disease increases during pregnancy.</p> <p>Pregnancy tends to be an immunocompromised health status. You have another human growing inside you that your body needs not to reject. Your body puts your immunity down a little bit. Another reason is that pregnancy makes people breath faster due to chemicals in the blood and anatomic changes as the baby grows.</p> <p>The benefits of vaccination can protect both adult and baby. A study published in Clinical Infectious Diseases found that flu vaccination reduced hospitalization during pregnancy by up to 40%. Antibodies developed from a flu shot during pregnancy pass through the placenta (and through breast milk if breastfed). Those antibodies protect the baby from the flu after birth.</p> <p>The Centers for Disease Control and Prevention (CDC) recommends annual flu vaccination for everyone 6 months or older. Vaccination can reduce your risk of the flu and its severity, lowering the risk of having severe illness from the flu and needing hospitalization.</p> <p>People who are pregnant should get the flu shot made from an inactivated virus and not the flu nasal spray vaccine, which is a live vaccine. It's not a virus that the baby can get infected by, it doesn't give you the flu, and it doesn't make you sick, although occasionally you can have some mild aches or arm soreness.</p> <h2>Tips to stay healthy during flu season</h2> <h3>Along with vaccination, follow these tips to stay healthy during flu season:</h3> <ul> <li>Get adequate rest.</li> <li>Eat a healthy diet, especially fruits and vegetables.</li> <li>Get regular exercise.</li> <li>Stay home when sick.</li> <li>Keep your children home when they are sick.</li> <li>Avoid others if they are sick.</li> <li>Follow your pregnancy plan.</li> </ul> <h2>Know your immunization status</h2> <p>It's worth knowing your immunization status for measles, mumps, rubella and chickenpox during pregnancy because we are starting to see a rise again in those diseases due to a lack of immunization in the last few years. If you're not immune or have not had chickenpox, you should stay away from people that have active shingles because they're possibly shedding chickenpox virus.</p> <p>The CDC recommends everyone get their flu shot by the end of October. People who are pregnant also are encouraged to get their COVID-19 vaccination and booster when eligible.</p> <p>The COVID-19 vaccine also has offered some protection to the baby after birth. Infants are vulnerable, particularly to respiratory disease. And so, getting vaccinated during pregnancy not only helps you not get sick, but also helps your baby not get sick.</p> <p>Thomas Howell Jr., M.D., in an <a href="/services-and-treatments/obstetrics-and-gynecology">OB-GYN</a> in <a href="/locations/faribault" target="_self" title="Opens in same window.">Faribault</a>, Minnesota.</p><img src="/-/media/national-files/images/hometown-health/2022/close-up-of-pregnant-belly.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8F41F3FD3670FB9B139EBC1FD859FD4F" alt="Close up of pregnant belly" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Prenatal CareOB-GYN and Family Medicine providers offer exactly the care you need for starting or growing your family, including pregnancy planning and prenatal care.InfluenzaInfluenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza, commonly called the flu, is not the same as the stomach "flu" viruses that cause diarrhea and vomiting.Dawn Haller9/27/2022Pregnancy and childbirth are life-changing events. Having both partners involved and connected during this time is important. Find out how to prepare for the unexpected when welcoming a new baby.Partners in pregnancy: Preparing for a baby together<p>Pregnancy and childbirth are life-changing events.</p> <p>During pregnancy, much of the attention is on the person who is pregnant and experiencing physical and emotional changes associated with <a href="/hometown-health/speaking-of-health/are-you-ready-to-have-a-baby" target="_self" title="Opens in same window.">pregnancy</a>. But there are ways for the partner to get involved and feel connected during the pregnancy and childbirth.</p> <p>Planning for a baby takes place months leading up to your baby's birth. Having both partners involved in the planning is important.</p> <h2>Activities partners can do together include:</h2> <ul> <li>Attend <a href="/hometown-health/speaking-of-health/is-virtual-prenatal-care-right-for-you" target="_self" title="Opens in same window.">prenatal visits</a>, particularly the ultrasound, when seeing the baby.</li> <li>Create a list and discuss potential name ideas for the new baby.</li> <li>Take a tour of the hospital's obstetrics unit and nursery.</li> <li>Prepare your baby's nursery space at home.</li> </ul> <p>Also, some couples have maternity photos taken together to remember this special time in their lives.</p> <p>Open communication and active attempts for both partners to communicate and share their feelings and concerns go a long way in helping a couple feel closer during pregnancy.</p> <h2>Welcoming a new baby is a life transition</h2> <p>For people having their first child, many changes occur in lifestyle, relationship and finances after birth. Couples can plan for the financial responsibilities of pregnancy and caring for a newborn. While this is a good idea, it's not always a realistic option.</p> <p>Reviewing your finances and debts can make planning for a new baby much easier. Meeting with a financial planner can help you figure out future decisions and possible roadblocks in the future.</p> <p>Your obstetrician also should be able to help find you community or social work support if you have any concerns about making sure you have everything ready for when your baby arrives. Spending as much time together as a couple is an excellent way to bond and can help prepare you for the new infant.</p> <p>Many couples plan and set up as much as possible before delivery. This minimizes the time spent on regular chores during the first few weeks caring for a new baby. A newborn will bring new stresses to a couple and many great new joys.</p> <p>If a new mother is experiencing struggles with anything after delivery, she should always talk to her health care team. They are there to help.</p> <p>Many of the struggles or concerns you may have are common for new moms. Your health care team can reassure you about normal things and assist with anything out of the ordinary or more complicated to ensure your family is happy and healthy.</p> <h2>Gather as much information as possible before delivery</h2> <p>The more information new parents can get, the more likely they will be prepared. <a href="/classes-and-events" target="_self" title="Opens in same window.">Birth classes</a> are typically taught by nurses who have helped many new parents through labor and delivery. They are ready to walk you through the process and what to expect. These classes are great for both parents and will help you feel more comfortable about what is to come.</p> <p>It's becoming more common for companies to offer parental leave and other parental support benefits. The more time you and your partner can spend together during the first weeks and months after leaving the hospital, the better. Having a newborn is an adjustment for everyone in the family. Being together and bonding with the baby will be an experience you will never forget. </p> <p>Families may have limitations with the amount of leave they can take due to financial reasons. Consider what is reasonable for your situation and use the available time to bond with each other and the new infant.</p> <h2>Be prepared for the unexpected</h2> <p>Prenatal and postpartum depression can present with a variety of symptoms. <a href="/hometown-health/speaking-of-health/too-embarrassed-to-ask-i-just-had-a-baby-whats-wrong-with-my-moods" target="_self" title="Opens in same window.">Mood changes</a> are common during pregnancy, as pregnancy causes physical and emotional changes. Discuss your feelings and concerns with your health care team. Let your health care team know if you have a history of depression or mood changes.</p> <p>If you're doing well with your depression management, keep your health care team updated on how you feel. Because partners usually spend more time together, let your health care team know if your partner has any concerns. Discussing concerns together as a group is helpful.</p> <p>Concerning symptoms to discuss with your health care team include self-harm thoughts; feeling guilty, worthless or hopeless; or losing interest in everyday activities. Typically, during pregnancy, moms are screened for signs of mood disorders at their first visit, during pregnancy and after delivery.</p> <p>Partners should talk to each other first. Let your partner know your concerns and questions. You also can bring up your concerns at a prenatal visit so your health care team can answer any questions and ease your apprehension. Partners often are concerned about speaking up. Expressing your <a href="/hometown-health/speaking-of-health/the-importance-of-a-birth-plan" target="_self" title="Opens in same window.">concerns and thoughts</a> will benefit both of you, and your partner will appreciate your involvement in the pregnancy.</p> <p><em><a href="/providers/okechukwu-osuebi-md" target="_self" title="Opens in same window.">Okechukwu Osuebi, M.D.</a>, is an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a>, Minnesota.</em></p><ul> <li>Fertility</li> <li>Hysterectomy</li> <li>Hysteroscopy</li> <li>Minimally invasive surgery</li> <li>Obstetrical care</li> <li>Preconception counseling</li> <li>Vulvar diseases</li> <li>Women's health</li> </ul>M.D.<p>My guiding philosophy is the need of the patient comes first. I strongly believe in patient-centered care that aims to provide the best care through collaborative efforts with the patient being an integral part of the decision making process. Patient education is an integral part of my practice.</p> <p>I enjoy travelling, discovering and learning about new places and cultures, being outdoors and reading.</p><p><strong>Education</strong></p> <ul> <li>University of Nigeria College of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Obstetrics-Gynecology, Howard University Hospital</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Obstetrics and Gynecology, American Board of Obstetrics and Gynecology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Obstetricians and Gynecologists</li> <li>Fellow, American Board of Obstetrics and Gynecology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Obstetrics and Gynecology, Mayo Clinic School of Medicine and Science</li> </ul>Osuebi<img src="/-/media/shared-files/images/medical-professionals/full/fairmont/okechukwu-osuebi-md.jpg?h=280&iar=0&w=280&hash=4F2C4FB876EE0180B8F0A9CDABEE140A" alt="Okechukwu Oseubi M.D." width="280" height="280" DisableNVelocity="true" />{565FE410-796E-4B7A-A005-C8951C6BAF2A}Okechukwu<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15593614Okechukwu Osuebi, M.D.1{54693F31-87AF-4B21-91DB-1DEC1E21F878}|{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}<img src="/-/media/national-files/images/hometown-health/2022/pregnant-with-partners-hand-on-belly.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C055B807C551B18AA40012FEDC278EAA" alt="Pregnant woman with partner's hand on belly" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Prenatal CareOB-GYN and Family Medicine providers offer exactly the care you need for starting or growing your family, including pregnancy planning and prenatal care.Dawn Haller9/26/2022Urinary incontinence is a common condition. Learn why it can be particularly troublesome for men, and about treatment options to improve symptoms and bring comfort.Treatment options for men with urinary leakage<p>Urinary incontinence is a common and often embarrassing condition that results in the unintentional loss of urine. While women are more likely than men to experience symptoms of urinary incontinence, it can be particularly troublesome for men.</p> <p>About 3% to 10% of men will experience symptoms in their lifetimes and report a high level of associated stress due to the condition. Some men say they would rather be impotent than incontinent.</p> <h2>Gender differences</h2> <p>Both genders can have urinary incontinence, but their experiences may differ. Often, people have similar symptoms, such as increased frequency and urgency. However, waking up in the night to urinate — called nocturia — is more common in men.</p> <p>Men are more likely to have urge incontinence than stress incontinence. This occurs when there is a compelling and sudden urge to void that cannot be delayed or postponed and results in urine leakage. About 80% of men with urinary incontinence experience urge incontinence, compared to 31% of women.</p> <p>Stress incontinence is more common in women, with about 48% of all instances. It accounts for only about 10% of instances in men. It is possible to have urge and stress incontinence simultaneously.</p> <p>Urge incontinence imposes restrictions on a person's lifestyle, with many people practicing toilet mapping strategies and limiting social gatherings because they are afraid of being embarrassed in public.</p> <p>Structural changes in the pelvic floor area can cause urinary incontinence. For men, the most common change is an enlarged prostate — called benign prostatic hyperplasia. As the prostate grows, it can cause frequent or urgent need to urinate, nocturia and many other symptoms. Furthermore, surgery on the prostate can lead to damage of the sphincter muscle, which can lead to stress urinary incontinence. In women, pregnancy and vaginal delivery can damage or weaken pelvic floor muscles.</p> <p>Finally, urinary incontinence symptoms are more likely to be overlooked in men. This could because it's less common because of embarrassment to discuss it or other factors.</p> <h2>Treatment options for men</h2> <p>The good news is that urge and stress urinary incontinence can be treated. A combination of treatments may be needed. Usually, the health care team recommends less-invasive treatments to start with and move on to other options if these techniques fail to help the person.</p> <h3>Treatment options include:</h3> <ul> <li><strong>Behavioral techniques</strong><br /> Lifestyle changes can improve in urinary incontinence symptoms in some people. This could include bladder training, double voiding and scheduled toilet trips. The health care team may recommend reducing or avoiding alcohol, caffeine or acidic foods that stimulate the bladder. </li> <li><strong>Pelvic floor muscle exercises</strong><br /> These exercises are not just for women. These exercises strengthen the muscles that control urination and support the bladder and penis.</li> <li><strong>Medications</strong><br /> Alpha blocker medications can relax bladder neck muscles and muscle fibers in the prostate and make it easier to empty the bladder. Mirabegron is another medication used to relax the bladder muscle and increase the amount of urine the bladder can hold.</li> <li><strong>Benign prostatic hyperplasia treatments</strong><br /> Several effective treatments for prostate gland enlargement are available, including medications, minimally invasive therapies and surgery. The health care team will recommend the best approach based on a person's symptoms, size of the prostate, preferences and other health conditions. </li> <li><strong>Slings or artificial urinary sphincter </strong><br /> Men with stress urinary incontinence may benefit from a surgery to prevent unintentional urinary leakage. Your health care team will determine if you are a good candidate for this type of surgery based on history and physical exam.</li> </ul> <p>Some men feel embarrassed about their bladder control problems. They may try to cope on their own by wearing absorbent pads, carrying extra clothes or not going out. But effective treatments are available for urinary incontinence. It's important to talk with your health care team about treatment to regain an active and confident life.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/driver-in-car-coffee-cup-in-hand.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E92C01D7F0ED3643558046F997EE18E3" alt="Car driver with cup in hand" width="660" height="370" DisableNVelocity="true" />Urinary IncontinenceThe loss of bladder control is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that's so sudden and strong you don't get to a toilet in time. For most people, simple lifestyle changes or medical treatment can ease discomfort or stop urinary incontinence.Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Michele Halterman9/9/2022A hospital stay can cause feelings of worry and stress. Hospitalists care only for hospitalized patients, providing consistency and communication with their primary care provider.What is a hospitalist?<p>Finding yourself or a loved one hospitalized can be worrisome and stressful. You may be in pain, your family member might be confused and you feel vulnerable. A hospitalist can help you or your loved one during this time. A hospitalist, entrusted with your care, seeks to replace fear with hope.</p> <p>Hospitalists are ready to care for patients who find themselves hospitalized. The focus is solely on caring for hospitalized patients and coordinating their care during their hospital stay.</p> <p>The use of hospitalists has been implemented nationwide, enhancing a <a href="/hometown-health/our-thoughts/wading-through-hospital-quality-rankings" target="_self" title="Opens in same window.">patient's hospital experience</a>.</p> <p>Hospitalists provide continuity of care for patients by working only in the hospital setting. A hospitalist typically works in seven-day shifts. This allows patients to likely have a consistent health care professional taking care of them during their stay. The hospitalist will know these patients and their conditions, giving them complete attention.</p> <p>Hospitalists work in the hospital to be available for follow-up on tests, procedures and treatments throughout a patient's stay. As a result, problems are detected earlier, and complex medical issues are better managed.</p> <p>Hospitalists work with a great team of other health care professionals, including nurses, therapists, social workers and pharmacists. The <a href="/hometown-health/speaking-of-health/faq-your-care-team" target="_self" title="Opens in same window.">health care team's</a> goal is to coordinate care with thoughtful consideration to promote wellness and healing.</p> <p>When a patient is admitted to the hospital, the patient's <a href="/hometown-health/speaking-of-health/trust-primary-care-provider" target="_self" title="Opens in same window.">primary care provider</a> will transfer the management of care to a hospitalist. The hospitalist communicates with the primary care provider as needed throughout the patient's stay. When a patient leaves the hospital, the primary care provider receives a summary of the hospital stay and resumes care at that point.</p> <p>No one wants to be sick enough to go to the hospital. But if you need a hospital stay, know you are in good hands. Hospitalists focus on caring for hospitalized patients, and they are highly trained to treat patients with multiple complex medical issues. Hospitalists provide high-quality, efficient patient and family-centered care, which is what you need and deserve.</p> <p><a href="/providers/anne-liwonjo-md" target="_self" title="Opens in same window."><em>Anne Liwonjo, M.D.</em></a><em>, is a hospitalist in <a href="/locations/lake-city" target="_self" title="Opens in same window.">Lake City, Minnesota</a>.</em></p><ul> <li>Hospital medicine</li> <li>Preventive care</li> <li>Women's health</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>St. Matthew’s University School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Ascension Health Saints Mary and Elizabeth Medical Center</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Practice, American Board of Family Medicine</li> </ul> <p><strong>Academic Appointment </strong></p> <ul> <li>Instructor in Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Liwonjo<img src="/-/media/shared-files/images/medical-professionals/full/lake-city/anne-liwonjo-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=11EB6C70360D35678C2159CB7A3C133A" alt="Anne Liwonjo MD" width="280" height="280" DisableNVelocity="true" />Anne<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16384253Anne Liwonjo, M.D.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{FB3BB67A-14FA-4DDE-B183-F85C42E0B255}<img src="/-/media/national-files/images/hometown-health/2022/two-masked-medical-professionals.jpg?h=370&iar=0&w=660&sc_lang=en&hash=FAC6D9782A69910194AC8E628692F0B4" alt="Two masked medical professionals" width="660" height="370" DisableNVelocity="true" />Dawn Haller10/10/2022Trips — long or short — can induce carsickness at any age. These simple tips can help prevent or relieve feeling dizzy or nauseous.4 words drivers dread: 'Ugh, I feel sick'<p>Whether your trip is around town or across the country, four words most drivers dread hearing moaned from the backseat are, "Ugh, I feel sick."</p> <p>Carsickness, also known as motion sickness, isn't associated with just cars. It also strikes on buses, boats, trains, airplanes and amusement park rides. Anyone who's ever been plagued with motion sickness recognizes the queasy dizziness that can make travel miserable.</p> <h2>Causes of motion sickness</h2> <p>Motion sickness starts deep in the inner ear with the vestibular system, which is responsible for coordinating balance and telling the body its position in space. Basically, it's a mismatch between what visual and sensory signals are being received and how the brain is interpreting them. For instance, when in a car, your eyes tell you you're standing still. But your body is feeling motion and your brain interprets it as being off-balance or dizzy.</p> <p>Fixating on something inside the vehicle, such as book, tablet, movie screen, can trigger motion sickness.</p> <h2>Preventing motion sickness</h2> <h3>To keep motion sickness at bay, try these tips:</h3> <ul> <li>If riding in a car, people over 12 can sit in the front seat. Look forward rather than out the side window.</li> <li>If in the back seat, sit in the middle so you can look out the front window.</li> <li>If riding on a bus, sit close to the front and look in the direction you're going.</li> <li>If on a plane, choose a seat over the front edge of the wing. Once seated, direct the air vent toward your face.</li> <li>If on a boat, sit near the middle and keep your eyes on the horizon, which will help your brain match the movement your body is feeling.</li> <li>Avoid reading, watching a movie or being on a screen, such as a phone or tablet.</li> <li>In a car, crack the window to let a little fresh air in.</li> <li>Keep your head still while resting against a seat back.</li> <li>Don't sit near smokers, and don't smoke.</li> <li>Avoid strong odors, spicy and greasy foods. Adults should avoid alcohol.</li> </ul> <h2>Try these treatments</h2> <h3>Home remedies and over-the-counter medications also can help, including:</h3> <ul> <li>Trying ginger, which can soothe nausea. Gingersnap cookies, ginger ale and ginger hard candies or chews are options. Be sure the candy isn't a choking hazard for your child.</li> <li>Sipping on cold water or caffeine-free carbonated beverage.</li> <li>Nibbling on plain crackers.</li> <li>Wearing an acupressure band around the wrist.</li> <li>Taking Dramamine, which is approved for anyone 2 years old and up. If you or your child has a history of motion sickness, take it an hour ahead of travel as a preventive medication. Drowsiness is a side effect. Benadryl is another option, but not the preferred choice because it can make children more active rather than sleepy.</li> <li>Lying down flat once you've reached your destination can ease symptoms.</li> </ul> <h2>Tips for trips</h2> <h3>When kids can't look out the windows, read or be on screens, here are some ways to amuse them during a trip:</h3> <ul> <li>Bring along a selection of favorite singalong music.</li> <li>Play games that don't involve looking out the window such as: <ul> <li>20 Questions, where players have 20 questions to solve "Who am I?" or "What am I?"</li> <li>I Went to the Zoo, where players complete the sentence by naming an animal starting with "a" and working through the alphabet.</li> <li>Hink Pink, where a player thinks of two words that rhyme, such as big rig, and then gives other players clues like "large truck" to help them solve the rhyme.</li> </ul> </li> <li>Listen to audiobooks or podcasts.</li> </ul> <h2>Learning to live with it</h2> <p>Unfortunately, if people suffer motion sickness as a child, they also tend to be affected as an adult.</p> <p><em><a href="/providers/emily-majerus-pa" target="_self" title="Opens in same window.">Emily Majerus</a> is a physician assistant in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</em></p>P.A.-C.<p><strong>Education</strong></p> <ul> <li>Masters in Physician Assistant Studies, St. Catherine University, St. Paul, Minnesota</li> </ul>Majerus<img src="/-/media/shared-files/images/medical-professionals/full/austin/emily-majerus-pa.jpg?h=280&iar=0&w=280&sc_lang=en&hash=2D24DFFF39D2F2CE97D2C7C1EAC9BCCE" alt="Emily Majerus PA" width="280" height="280" DisableNVelocity="true" />{3F204655-2BBA-443A-936F-59ECF40C390B}Emily<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16049314Emily Majerus, P.A.-C.1<img src="/-/media/national-files/images/hometown-health/2022/kids-seat-belted-back-seat-of-vehicle.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1864961771B123E9EEDA953B1E5DC7DD" alt="Kids seat-belted in the back seat of a vehicle" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller10/13/2022RFID isn’t just for inventory tracking anymore. Learn how It’s now used in the operating room to guide breast biopsies, and benefits the surgeon and patient.Chip technology marks the spot for breast biopsies<p>Radio frequency identification, also called RFID, is a technology that uses wireless radio waves to transfer data and identify objects. It’s used in many ways, from inventory tracking and race timing to dairy herd management and car rental returns. Now this technology is used to guide surgeons during breast biopsies.</p> <p>A biopsy is a procedure to remove a small sample of tissue for laboratory testing. A breast biopsy may be needed to evaluate a suspicious area in the breast.</p> <p>For years, radiologists used wire guide localization to mark the exact spot or spots for the biopsy. They used ultrasound or other images to identify a breast lesion and placed a thin wire into the breast tissue to mark the location. The wire would remain in place and stick out of the breast until the surgeon removed it during the biopsy.</p> <p>Thanks to RFID technology, breast lesions now can be marked for surgical removal without using traditional surgical wires.</p> <p>The technology is advanced, but the process is simple. First, the biopsy site is numbed using a local anesthetic. Then, a radiologist uses ultrasound or other imaging to identify the breast lesions that need to be removed. Next, the small RFID tag is placed on the lesion using a needle. Each tag is about 2 millimeters by 1 centimeter in size — about the size of a staple. Multiple lesions can be identified as needed using multiple tags with unique codes. During the biopsy, the surgeon uses a handheld device to identify the exact location of each unique RFID tag.</p> <h4>Benefits of the wire-free guidance system include:</h4> <ul> <li><strong>More comfortable experience for patients</strong><br /> Previously, patients needed to be careful not to bump or move the wire prior to their biopsies. In addition to being uncomfortable, the view of wires hanging out of the breast was distressing for some patients. With the new process, the patient cannot see or feel the tags after placement. and they can move freely without fear of shifting the tags.</li> <li><strong>Easier scheduling</strong><br /> RFID tags can be placed up to one week prior to surgery. This gives patients and their health care teams more flexibility with scheduling. Previously, wire placement and surgery were required to be scheduled on the same day.</li> <li><strong>Greater surgical precision</strong><br /> Surgeons no longer need to work around wires while performing a biopsy. This means the area sampled is more accurate and, occasionally, accessed with less trauma to adjacent tissues. This results in less pain, lower rate of infection and a quicker recovery.</li> </ul> <p>Talk with your health care team to find out if wire-free guidance is right for your breast biopsy. Their goal is to answer your questions and ease any anxiety during this stressful time.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2022/laughing-with-hands-together.jpg?h=370&iar=0&w=660&sc_lang=en&hash=FD0B384C9F0ADCDCDCF12D6747DD1680" alt="Laughing with hands together" width="660" height="370" DisableNVelocity="true" />Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.Dawn Haller10/20/2022Urinary tract infections are among the most common infections in the U.S., causing significant pain and discomfort. It's time to clear up the infection and its misconceptions.Debunking 6 urinary tract infection myths<p>A urinary tract infection, also called a UTI, is an infection that occurs in the urinary system. This includes the bladder, ureters and kidneys. Most infections involve the bladder, which is known as the lower urinary tract.</p> <p>UTI is the most common infection in the U.S. for women. About 40% of women will have at least one UTI in their lifetimes, and 1 in 10 postmenopausal women had a UTI in the last year. It’s also common to have multiple infections, with about half getting a second infection within a year.</p> <p>UTIs don’t always cause symptoms, but when they do, they may include a strong urge to urinate; burning feeling while urinating; urinating more often; red or bright pink urine; or pelvic pain.</p> <p>Patients also may experience chills, marked fatigue, fever or flank pain along the side of the torso below the ribs. These symptoms indicate that the infection has extended beyond the bladder, possibly to the kidney or into the blood stream.</p> <h2>Get the facts about this common infection by reviewing these debunked myths:</h2> <h3>Myth: Only women can get a urinary tract infection.</h3> <p><strong>Truth</strong>: UTIs can affect both men and women. Women are at greater risk for a UTI because the urethra is shorter than in men, so it's easier for bacteria to travel to the bladder. UTIs also are more common in postmenopausal women because low estrogen levels change vaginal and urethral tissue to increase the risk of infection.</p> <h3>Myth: All UTIs cause symptoms.</h3> <p><strong>Truth: </strong>Most UTIs cause symptoms, like pain or burning when urinating; feeling like you need to urinate often; or a burning sensation while urinating. However, it is possible to have bacteria in the urinary tract but not have any UTI symptoms. This is called asymptomatic bacteriuria, and it is more common in older adults or people who use a catheter to empty their bladders.</p> <h3>Myth: All UTIs must be treated with antibiotics.</h3> <p><strong>Truth: </strong>Not all UTIs require antibiotics.<strong> </strong>Some people can have bacteria in their bladders but not experience any symptoms. This is called asymptomatic bacteriuria. In most cases, no treatment is necessary as the bacteria is not causing issues.</p> <p>But there are a few groups of people that may require treatment, including people who are pregnant, people with planned urologic surgery and people with weakened immune systems.</p> <p>Antibiotics are used to treat UTIs when the person is experiencing painful or bothersome symptoms and bacteria present in the urine.</p> <h3>Myth: A UTI will go away on its own.</h3> <p><strong>Fact: </strong>Asymptomatic bacteriuria, which is a UTI without symptoms, could go away without treatment. However, UTIs with symptoms rarely resolve on their own.</p> <p>If you are experiencing UTI symptoms, like burning, pain or frequency, talk with your health care team about obtaining a urine culture and the right treatment for you.</p> <h3>Myth: UTIs can be passed to your partner.</h3> <p><strong>Truth: </strong>UTIs are not contagious or passed between partners by sexual or casual physical contact.</p> <h3>Myth: UTIs are sexually transmitted infections.</h3> <p><strong>Fact: </strong>Sexual activity can increase the risk for, but it does not cause a UTI. Therefore, UTIs are not classified as sexually transmitted infections.</p> <p>The act of intercourse can cause bacteria to get close to or into the urethra, the small tube that empties your bladder. Lower your risk by urinating after intercourse to remove some of the bacteria before it can cause an infection.</p> <p>Talk with your health care team if you think you have a UTI. Seek medical attention if you believe you have a UTI and are experiencing a fever, chills, disorientation, or back or side pain.</p> <p><a href="/providers/ross-avant-md" target="_self" title="Opens in same window."><em>Ross Avant, M.D.</em></a><em>, is a <a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">urologist</a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a> and <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota, and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/patient-visitor-guide/minnesota" target="_blank" title="Opens in a new window.">Mayo Clinic</a> in Rochester, Minnesota.</em></p><ul> <li>Benign and malignant scrotal conditions</li> <li>Benign prostatic hyperplasia/enlarged prostate</li> <li>Bladder cancer</li> <li>Erectile dysfunction</li> <li>Gross and microscopic hematuria</li> <li>Management of kidney stones</li> <li>Minimally invasive/robotic surgery for treatment of prostate cancer and kidney cancer</li> <li>Vasectomy</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Louisiana State University Health Sciences Center, School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>General Surgery, Mayo School of Graduate Medical Education, Mayo Clinic College of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Urology, Mayo School of Graduate Medical Education, Mayo Clinic College of Medicine</li> <li>Chief resident, Urology, Mayo School of Graduate Medical Education, Mayo Clinic College of Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Medical Association</li> <li>American Urology Association</li> </ul>Avant<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/ross-avant-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=54DB2876B3B708B3760C7C9DE50B9406" alt="Ross Avant MD" width="280" height="280" DisableNVelocity="true" />Ross<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16235801Ross Avant, M.D.1<img src="/-/media/national-files/images/hometown-health/2022/backpacking-couple.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A8887500A73ADAA15BE05F212C7B913A" alt="Backpacking couple" width="660" height="370" DisableNVelocity="true" />Dawn Haller8/12/2025 Mammograms play a key role in early breast cancer detection. Don't let these seven common excuses make you miss this important screening. Excuses for not getting a mammogram <p>A mammogram is an X-ray image of your breasts that is used to screen for breast cancer. Mammograms play a key role in early <a href="/topics/breast-cancer" target="_self" title="Opens in same window.">breast cancer</a> detection and help decrease breast cancer deaths. Unfortunately, not everyone who should get a mammogram does.</p> <h2>Here are seven common excuses for skipping this important screening and why these should not be a barrier:</h2> <h3>Excuse: If I'm going to get cancer, I'm going to get cancer.</h3> <p><strong>Response:</strong> If breast cancer is diagnosed at an early stage, the chance of survival is higher and is less likely to require aggressive treatment.</p> <h3>Excuse: I don't have a family history or other risk factors of breast cancer.</h3> <p><strong>Response:</strong> Approximately 10% of individuals diagnosed with breast cancer are thought to have a hereditary component, which makes annual screening mammograms even more important.</p> <h3>Excuse: I don't want to be exposed to radiation.</h3> <p><strong>Response:</strong> Radiation often is used by health care professionals to diagnose health conditions. Your care team will use the lowest possible radiation dose to get the images needed to accurately make a diagnosis. The health risks from radiation used during a mammogram are very small, and the benefits far outweigh any potential risks. </p> <h3> Excuse: I can't afford a mammogram.</h3> <p><strong>Response:</strong> Most health insurance policies cover the cost of a screening mammogram. If you are concerned about the cost of a mammogram, contact your state health department. There are many programs available to help with the cost, including the <a rel="noopener" href="https://www.dhs.wisconsin.gov/wwwp/index.htm" target="_blank" title="Opens in a new window.">Wisconsin Well Woman Program</a>, <a rel="noopener" href="https://www.health.state.mn.us/diseases/cancer/sage/screening/index.html" target="_blank" title="Opens in a new window.">Sage Cancer Screenings</a> in Minnesota and <a rel="noopener" href="https://hhs.iowa.gov/public-health/cancer/cfy" target="_blank" title="Opens in a new window.">Care for Yourself</a> Program in Iowa. </p> <h3> Excuse: It's going to hurt.</h3> <p><strong>Response:</strong> Compression can be uncomfortable, and you are encouraged to notify the mammography technician if you are experiencing pain. With advanced 3D technology at Mayo Clinic Health System, digital mammography screening produces 300 images to evaluate your breast tissue in greater detail.</p> <h3> Excuse: I don't want to take my shirt off in front of a stranger.</h3> <p><strong>Response:</strong> Mammography technologists are specially trained health care professionals. They do everything they can to make you feel comfortable and respect your privacy. </p> <h3> Excuse: I can't get a mammogram because I have a disability.</h3> <p><strong>Response:</strong> You can get a mammogram no matter your height, abilities or physical needs. Mammography machines raise or lower to match your height, and mammography technologists are trained to help people with different body types, sizes and abilities.</p> <p><em><a href="/providers/mariah-koenen-pac" target="_self" title="Opens in same window.">Mariah Koenen</a> is a physician assistant in <a href="/locations/la-crosse/services-and-treatments/radiology-and-imaging" target="_self" title="Opens in same window">Interventional Radiology</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p> <ul> <li>Benign breast disease</li> <li>Breast cancer survivorship</li> <li>Dense breast tissue and supplemental screening</li> <li>Elevated breast cancer risk and breast cancer-related genetic mutations</li> <li>High-risk breast lesions, including atypical hyperplasia and lobular carcinoma in situ</li> <li>Outpatient breast surgery</li> </ul>P.A.-C., P.A.<p>I care for patients with complex medical and surgical needs. I closely support the surgical breast practice. My practice philosophy focuses on providing high-quality medical care and meeting the needs of the patient.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Biochemistry, University of Wisconsin-La Crosse</li> <li>Master's degree, Physician Assistant Studies, Northern Arizona University</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Academy of Physician Assistants</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Surgery, Mayo Clinic College of Medicine and Science </li> </ul>Koenen<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/mariah-koenen-pa.jpg?h=280&iar=0&w=280&sc_lang=en&hash=231E7AB1D03357CD766A8518E754D539" alt="Mariah Koenen PA" width="280" height="280" DisableNVelocity="true" />Mariah<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15428257Mariah Koenen, P.A.-C.1<img src="/-/media/national-files/images/hometown-health/2022/looking-at-cellphone.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E2F32F67ECE2E1716C359BFB2ECD1A61" alt="Looking at cellphone" width="660" height="370" DisableNVelocity="true" />Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller6/26/2024Back pain is common. Yours could be caused when the fluid-filled, shock-absorbing cushions in your spine wear out. Learn about why this happens and the nonsurgical to surgical treatment options.Pain relief for worn spinal disks<p>The fluid-filled cushions between the bones in your spine are called disks. They provide flexibility, allow for spine movement like flexion and extension, and act as shock absorbers.</p> <p>Most young people have healthy disks. Each disk is flexible, with fluid-filled collagen fibers that fill the space between the vertebrae and provide the necessary cushion to allow their spines to bend and flex fully without pain.</p> <p>Disks can wear out with age and use, however, which causes the degeneration and dehydration of the collagen fibers. This is called degenerative disk disease, which usually is a slow degradation of disks over time. Here's what you need to know about this common condition.</p> <h2>Disk anatomy</h2> <p>Understanding the structure or anatomy of disks is essential. There are 23 disks in the spinal column, running from the base of the skull to the tailbone.</p> <h3>Each disk is made up of two parts that work together to absorb and cushion the spine:</h3> <ul style="list-style-type: disc;"> <li><strong>Annulus fibrosus</strong><br /> This is the sturdy yet flexible outer layer of the disk. It forms a ring or circle around the inner core of the disk.</li> <li><strong>Nucleus pulposus</strong><br /> The center area of each disk is filled with a soft, gel-like substance that acts as the spine's shock absorber.</li> </ul> <h2>Degenerative disk disease causes</h2> <p>Multiple factors cause degenerative disk disease, some of which can be controlled and others that cannot.</p> <p>Age and time increase the odds of developing degenerative disk disease. About 20% of all U.S. adults have some amount of degeneration by age 65. This increases to about 35% by age 80. Sex plays a factor, as females are more likely than males to develop degenerative disk disease.    </p> <p>Contributing factors you can control include excess body weight and spine strain due to manual labor, poor posture and heavy lifting.</p> <h2>Degeneration progression</h2> <p>Everyone has a degree of degeneration with time. It may or may not worsen or cause symptoms. Progression can be slow or fast, or the condition can remain stagnant.</p> <p>As degenerative disk disease begins, the spinal disks start to lose fluidity. They become dehydrated and are less rubbery or soft. This leads to disk shrinking and a loss of disk height. Often, the disks that are low in the spine degenerate first.</p> <p>As degeneration progresses further, the disks dry out even more or change shape, known as herniation. When this happens, they may begin pushing on nerves. A person may develop a ruptured or bulging disk. </p> <p>A bulging disk happens when the outer layer of the disk, the annulus fibrosus, bulges into the spinal canal. A ruptured disk, sometimes called a herniated or slipped disk, happens when the inner part of the disk, the nucleus pulposus, leaks out of the disk through a crack in the annulus fibrosus.</p> <p>Often, people have a bulging or ruptured disk with no symptoms, but sometimes, this can cause symptoms in one or both legs. </p> <p>If a disk continues to degrade, it can result in a complete loss of the disk. Then, the person only has an air-filled space between the vertebrae or the bones of two vertebral bodies directly contact each other. A person with this level of progression can experience severe pain, stiffness and possibly nerve compression.</p> <h2>Degenerative disk disease treatment</h2> <p>There are many treatment options for degenerative disk disease. Nonsurgical treatments are crucial throughout the continuum. Weight loss can be highly beneficial, along with decreasing manual labor to reduce stress on the spine. Injections, medications, physical therapy and strengthening your core can ease symptoms. </p> <p>The majority of degenerative disc disease cases can successfully be treated with conservative treatment, including about 80% of acute radiculopathy, known as <a href="/hometown-health/speaking-of-health/sciatica-and-radiculopathy-peculiar-names" target="_self" title="Opens in same window.">sciatica</a>.</p> <p>Surgical intervention might be an option after nonsurgical treatments are exhausted first. A healthcare professional may recommend surgery if your condition is causing symptoms of nerve compression and these symptoms are progressing despite physical therapy, medications and injections. Symptoms from nerve compression may include pain, numbness or weakness that radiates into a limb. Surgery usually is not a good option for treating solely back pain from <a href="/hometown-health/speaking-of-health/pain-in-the-back-spinal-arthritis" target="_self" title="Opens in same window.">osteoarthritis in the spine</a>.</p> <p> Your healthcare team will explain other circumstances that might warrant surgery, such as when a disc herniation impinges the spinal cord or if there is severe weakness in an extremity, like foot drop.</p> <h3>Surgical options for degenerative disk disease include:</h3> <ul> <li><a href="/hometown-health/speaking-of-health/understanding-types-of-back-surgery" target="_self" title="Opens in same window.">Decompression surgery</a>, such as a laminectomy or diskectomy, relieves compression of the nerve root for the spinal cord. </li> <li><a href="/hometown-health/speaking-of-health/understanding-types-of-back-surgery" target="_self" title="Opens in same window.">Stabilization surgery</a>, such as a spinal fusion, improves stability by permanently connecting two or more vertebrae in the spine. It may be performed after a decompression surgery in certain cases. </li> <li>Disk replacement surgery replaces a worn out disk with an artificial disk. Replacing a disk may help relieve pain in your arms or legs while maintaining motion and flexibility.</li> </ul> <p>Your healthcare team, including experts in pain management, physical medicine and rehabilitation, physical therapy and neurosurgery, will work together to tailor a treatment plan for you.</p> <h2>Next steps:</h2> <ul> <li><a href="https://www.mayoclinichealthsystem.org/providers?service=Neurosurgery&populateTracking=True" target="_self" title="Opens in same window.">Find a neurosurgeon</a> near you.</li> <li>Get <a href="/hometown-health/speaking-of-health/9-questions-to-ask-your-spine-surgeon" target="_self" title="Opens in same window.">nine questions to ask your spine surgeon</a>.</li> <li>Learn about <a href="/hometown-health/speaking-of-health/back-pain-self-care-tips" target="_self" title="Opens in same window.">back pain self-care</a>.</li> <li>Read about the <a href="/hometown-health/speaking-of-health/not-all-low-back-pain-is-the-same" target="_self" title="Opens in same window.">common causes of back pain</a>.</li> </ul> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/farmer-bending-in-crop-field.jpg?h=370&iar=0&w=660&sc_lang=en&hash=364DFFE374AB7C8DE76ACE58B5704D05" alt="Farmer bending in crop field" width="660" height="370" DisableNVelocity="true" />NeurosurgeryNeurosurgery treats disorders that impact any part of the nervous system, which may include the brain, spine or peripheral nerves. Conditions treated range from life-threatening brain tumors, to disorders impacting quality of life, such as back pain and carpel tunnel syndrome.Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.Dawn Haller10/17/2022This congenital condition causes a chest wall depression and has significant impact on a child's daily functioning. Learn how it's evaluated and why it's important to get treatment.Pectus excavatum: Treatment for hollow chest is more than cosmetic<p>In Latin, pectus excavatum translates to "chest hollow." This term describes a condition in which the chest is sunken in the center or to one side. Depending on the severity, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/pectus-excavatum/symptoms-causes/syc-20355483" target="_blank" title="Opens in a new window.">pectus excavatum</a> can be a noticeable disfigurement, but the effects are more than cosmetic. The condition can have a significant impact on daily life and physical activities.</p> <img height="333" alt="Pectus excavatus illustration" width="400" src="/-/media/national-files/images/hometown-health/2022/pectus-excavatus-illustration.jpg?h=333&w=400&sc_lang=en&hash=3194D100FCBD72A02A60460A36FC0331" />  <h2>Who is most affected by pectus excavatum?</h2> <p>The congenital chest wall anomaly is seen most in children and tends to affect boys more than girls. It can develop when children go through a growth spurt, around 8 to 10.</p> <p>With pectus excavatum, the cartilages grow abnormally, which pushes the bony sternum in so it only changes when a child grows. Parents may notice this depression after the child experiences a significant growth spurt as the chest becomes more sunken.</p> <h2>How is pectus excavatum evaluated?</h2> <p>Evaluation is important to determine whether the appearance of the chest results from a weakness of the chest wall or a deformity, such as pectus excavatum. As a young child grows and becomes stronger, weakness in the chest may disappear and not develop into pectus excavatum.</p> <p>The severity of the condition can range from mild to severe. A measurement called the Haller index is used to grade the severity.</p> <p>Typically, a chest X-ray measures the width of the chest inside the rib cage and the depth of the chest from the back of the sternum to the vertebrae of the spine. The width calculation divided by the depth shows how much space is in the chest for the heart and lungs.</p> <p>On occasion, additional imaging, such as a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/ct-scan/about/pac-20393675" target="_blank" title="Opens in a new window.">CT scan</a> is required to measure for Haller index accurately.</p> <p>For a person who does not have pectus excavatum, the Haller index number is around 2.5 cm. A moderate condition level would have an index of 3.25 cm or higher.</p> <p>The higher the index number, the more severe the condition. The heart and lungs may not work properly with less space in the chest. This can lead to shortness of breath with exercise or other physical activity.</p> <h2>What is the treatment for pectus excavatum?</h2> <p>For mild cases, there are some nonoperative options to improve pectus excavatum. When the condition is mild, many people can live with it normally.</p> <p>Surgery becomes an important treatment option for a Haller Index greater than 3.25 cm.</p> <p>During a Nuss procedure, a curved metal bar made of nickel or titanium is inserted through small incisions on each side of the chest. The bar is flipped over to push the breastbone up using the bar's arch. More than one bar may be used in some cases. The bar is removed after two to three years.</p> <p>Surgery stops the sternum from pushing on the heart and lungs, allowing for better breathing. Children may be able to perform better athletically or be able to keep up with their peers in common activities, like walking, climbing stairs or riding a bike.</p> <h2>Pectus excavatum myths</h2> <p><strong>Myth:</strong> Treatment for pectus excavatum is cosmetic.<br /> <strong>Fact:</strong> While children can be self-conscious about the shape of the chest, most patients are healthier after surgery to correct pectus excavatum. After the sternum is put in the correct position using a metal bar, children may have improved breathing and increased endurance with exercise.</p> <p><strong>Myth:</strong> Recovery from the surgery is painful.<br /> <strong>Fact:</strong> Prior to surgical advancements, recovery used to include being in bed for five days after the surgery in the hospital. Now, most patients leave the next day after surgery. This is due to cryotherapy, which treats the nerves on each side of the body and decreases the use of narcotic pain medicine after leaving the hospital.</p> <p><strong>Myth:</strong> After surgery, a magnet will stick to the bar in a child's chest.<br /> <strong>Fact:</strong> A normal magnet will not stick to the chest. Children can still have an <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/mri/about/pac-20384768" target="_blank" title="Opens in a new window.">MRI scan</a> with the bar in place by disclosing the medical equipment before the MRI.</p> <p><strong>Myth:</strong> A child can't travel by airplane after having pectus excavatum surgery.<br /> <strong>Fact:</strong> The bar inserted during surgery will not limit travel in the U.S. A letter of disclosure for the medical device can be used when going through a metal detector.</p> <h2>Learn more about pectus excavatum:</h2> <ul> <li><a rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/indiana-boy-standing-tall-and-hitting-the-beach-after-surgery-to-correct-pectus-excavatum/" target="_blank" title="Opens in a new window.">Indiana boy standing tall and hitting the beach after surgery to correct pectus excavatum</a> </li> <li><a rel="noopener noreferrer" href="https://www.youtube.com/watch?v=09v-WOT2jG8" target="_blank" title="Opens in a new window.">Pectus excavatum treatment at Mayo Clinic Children's Center</a> (video)</li> <li><a rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/sharing-mayo-clinic-scarlett-is-running-and-smiling-after-surgery-to-correct-pectus-excavatum/" target="_blank" title="Opens in a new window.">Sharing Mayo Clinic: Scarlett is running and smiling after surgery to correct pectus excavatum</a></li> <li><a rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/ask-the-mayo-mom-surgical-options-to-repair-pectus-excavatum/" target="_blank" title="Opens in a new window.">Ask the Mayo Mom: Surgical options to repair pectus excavatum</a></li> <li><a rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-understanding-and-treating-pectus-excavatum/" target="_blank" title="Opens in a new window.">Mayo Clinic Q and A: Understanding and treating pectus excavatum</a></li> <li><a rel="noopener noreferrer" href="https://www.youtube.com/watch?v=HPXxLB3z4Ec" target="_blank" title="Opens in a new window.">Why choose Mayo Clinic for pediatric surgery</a> (video)</li> </ul> <p><a rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/potter-d-dean-jr-m-d/bio-20154706" target="_blank" title="Opens in a new window."><em>D. Dean Potter Jr., M.D.</em></a><em> is a <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">pediatric</a> surgeon, and consults with patients in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin. </em></p><img src="/-/media/national-files/images/hometown-health/2022/children-running-in-wooded-area.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3D2EDA5F6B4EA0941481789A778695DB" alt="Children running in wooded area" width="660" height="370" DisableNVelocity="true" />Dawn Haller10/4/2022A mental health day isn't just a nap and a latte. It's intentional time away from stress and responsibilities to improve health and boost mood. Create a plan so you can get all the benefits.Recharge with a planned mental health day<p>Surveys show a significant increase in the number of adults in the U.S. who reported symptoms of stress, anxiety, depression and insomnia occurred during the COVID-19 pandemic, compared with surveys before the pandemic. One way to manage stress or mental health symptoms is by taking a mental health day.</p> <p>You may have heard this phrase before. Maybe a friend or colleague talked about needing a mental health day, but what does it mean?</p> <p>A mental health day is a limited time away from your usual responsibilities with the intention of recharging and rejuvenating your mental health. It is an intentional act to alleviate distress and poor mood and motivation, while improving attitude, morale, functioning, efficiency and overall well-being.</p> <p>The phrase "mental health day" is a bit of a misnomer because it may not be a single day. It could be used to describe an hour, half-day or even a month away from stressful situations. There is no perfect length of time either. A mental health day should be long enough to experience the benefits but not too long as to create more problems in the long term.</p> <h2>Mental health day benefits</h2> <p>Stepping away from responsibilities and stress for a short time can help refocus and recharge the brain and body.</p> <h3>A few of the benefits include:</h3> <ul> <li><strong>Reduced feelings of burnout</strong><br /> Many people feel burned out at some point in life, whether it is from caregiving for children or aging parents, work or other commitments. Dedicating time and focusing on yourself or other things can help lessen feelings of burnout.</li> <li><strong>Improved morale and attitude</strong><br /> Mental health day can help the person get recentered, experience gratitude and improve mood and attitude by focusing on things that bring joy.</li> <li><strong>Improved resiliency</strong><br /> Resiliency is the ability to recover quickly from stress or changes without being overwhelmed or acting in harmful ways. Mental health days can help establish boundaries and develop coping skills to help with future stress.</li> <li><strong>Reduced isolation and loneliness</strong><br /> Often, people who feel burned out report feeling more isolated and lonelier. Planning to meet a friend for lunch or spending quality time with family during a mental health day can improve the sense of connection with others.</li> <li><strong>Prevention of mental health crisis</strong><br /> For people with a mental health diagnosis, like anxiety or depression, a mental health day can prevent crisis situations, like a major depressive episode or panic attack. It allows people to set healthy boundaries and enables them to communicate how they are feeling and what they need from friends, family and colleagues. </li> <li><strong>Increased productivity</strong><br /> Stepping away from responsibilities for a short period of time can make a person more productive and efficient upon returning. </li> <li><strong>Reduced presenteeism and long-term absenteeism</strong><br /> A person can be present at work or tend to their daily responsibilities but not be engaged. This disconnection is sometimes called presenteeism, which is physically showing up to do the work but not fully functioning. Long-term burnout and stress can lead to lengthy absences or even people quitting their jobs. Mental health days increases engagement and diligence with responsibilities. </li> <li><strong>Improved physical health </strong><br /> Chronic stress can lead to issues with sleep, digestive health, heart health, weight, inflammation and pain. It also negatively affects chronic conditions, like diabetes and cancer. Taking a mental health day to manage stress can lessen symptoms and increase focus and goal direction for other chronic health conditions.</li> </ul> <p>Mental health days aren't just for adults. They can be useful tools in protecting the mental health of children and teens, as well.</p> <h3>In addition to the benefits listed above, children may experience:</h3> <ul> <li><strong>Better self-management of emotions</strong><br /> Give children permission to ask for a break if they feel overwhelmed. Recognize that kids have emotions just like adults and sometimes struggle to handle or balance everything going on in their lives. Allowing a mental health day teaches children self-control and the importance of being autonomous to make decisions for their health. </li> <li><strong>Develop boundaries</strong><br /> Allowing an occasional mental health day helps children develop their own parameters and balance their needs versus the needs of others. It also helps children socially engage with people in more appropriate ways and identify when they need to take care of themselves and their mental health.</li> <li><strong>Reduce stigma</strong><br /> Often, children mirror the behaviors of the adults in their lives. By seeing parents take days to themselves, kids understand the importance of mental health and feel less shame or embarrassment if they need to take mental health days.</li> </ul> <h2>Plan the day</h2> <p>A mental health day is much more than just getting a latte and taking a nap. Or sleeping until noon and then mindlessly scrolling through social media all afternoon. These are easy ways to waste away a day but not improve your mental health.</p> <p>Be intentional about the activities you do during a mental health day to get the full benefits and improve your health. Create a plan for the day so you will stay on track. If the thought of planning feels overwhelming, identify activities that will stimulate the five senses: sight, smell, taste, touch and hearing.</p> <h3>Here are a few things that could be incorporated into a healthy and intentional mental health day:</h3> <ul> <li><strong>Unplug from social media.</strong><br /> This frees up time to do things that had been neglected and allows for self-reflection. Connect with family and friends and be fully present in the moment so you can experience the world's beauty. </li> <li><strong>Review goals.</strong><br /> Reflect on the changes you have made or plan to make. Spend time setting achievable goals to position yourself for long-term success, like clearing clutter from a room in your home. This can increase your sense of mastery and accomplishment.</li> <li><strong>Be creative.</strong><br /> Use the creative side of your brain by doing something inventive that brings you joy. It could be painting, playing music, working in the garden, baking or putting together a puzzle. </li> <li><strong>Get physical.</strong><br /> Move to awaken your body and mind. Aerobic exercise can ease the gloominess of depression, reduce anxiety tension and promote relaxation. Or turn up the music and dance in the kitchen. Moving and increasing your heart rate is good for your physical health and will improve the quality of your sleep. </li> <li><strong>Spend time outdoors.</strong><br /> Get outside and feel the elements. Take your shoes off in the grass, sit by or wade in water, watch cloud formations or listen to the wind in the trees. Natural elements are rejuvenating to the body and mind. </li> </ul> <p>Taking a mental health day is easier said than done. Some people have concerns about what their employers or families will think. Will they be supportive or judgmental? With most things, communication is key. Talk about the importance of mental health in your roles and how some time away can make you more productive, present and healthier.</p> <p>Mental health days are one way to manage your mental health. There are many other resources and tools available to work through feelings of anxiety, depression and stress. Talk to your health care team if you have concerns about your mental health.</p> <p><em><a href="/providers/angela-theisen-lcsw" target="_self" title="Opens in same window.">Angela Theisen</a> is a psychotherapist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Behavioral therapy</li> <li>Chronic mental illness</li> <li>Depression and anxiety</li> <li>Individual, couple and family therapy</li> <li>Personality disorders</li> </ul>L.C.S.W.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Psychology, College of St. Catherine</li> <li>Master's degree, Social Work, University of Illinois-Champaign</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Licensed Clinical Social Worker</li> </ul>Theisen<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/angela-theisen-lcsw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=5D9B806BD75FE7B8FC04136702B9A77A" alt="Angela Theisen, L.C.S.W." width="280" height="280" DisableNVelocity="true" />{FF9B919D-292C-4F0E-A169-713C11DD7B2A}Angela<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14802660Angela Theisen, L.C.S.W.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}|{C4130004-0F31-48C4-AC9F-A4350A75AB24}|{2B88C934-922C-4130-B661-197B59D83899}<img src="/-/media/national-files/images/hometown-health/2022/cooking-together-and-laughing.jpg?h=370&iar=0&w=660&sc_lang=en&hash=73799DE9A29483CA63BEC94E4EB3BFA2" alt="Cooking together and laughing" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Stress ManagementGuidance to help you reduce and manage daily stress.ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Dawn Haller10/28/2022Family support and connection are important for helping children manage depression or anxiety. Learn how youth-focused treatment and techniques can help families find the right recipe for care.Empowering families to strengthen youth mental health<p>Rates of behavioral health conditions were rising before the COVID-19 pandemic and have been escalating since the pandemic. Healthcare professionals are seeing clinically elevated rates of depression, anxiety, substance abuse disorders and suicidal ideation symptoms at a rate double pre-pandemic levels.</p> <p>While <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007" target="_blank" title="Opens in a new window.">depression</a> may partially be a result of a chemical imbalance in the brain, depression also can be a result of an imbalance in life.</p> <h4>You may be more likely to struggle with depression if you are:</h4> <ul> <li>Lonely</li> <li>Sleep-deprived</li> <li>Unable to identify areas of meaning in life</li> <li>Feeling like you have no control over your health, life situation, <a href="/hometown-health/speaking-of-health/college-students-and-depression" target="_self" title="Opens in same window.">school</a> or work</li> <li>In a habit of avoiding dealing with problems</li> <li>Experiencing strained relationships with family members</li> <li>Disengaging from physical activities</li> </ul> <h2>Interconnection of mental and physical health</h2> <p>Mental health and physical health are intertwined. You can't have one without the other. When one condition is treated successfully, the other condition also is improved.</p> <p>Treating mental health improves physical health. Likewise, when physical health is improved, mental health also improves.</p> <p>Often, when mental health is treated successfully, physical symptoms, such as headaches, pain and stomach aches, improve. Physical and mental health should be treated equivalently. This increases the expectation of quality care and reduces the stigma of receiving care for mental health conditions.</p> <h2>Good sleep hygiene</h2> <p>Sleep and mental health are inextricably linked. Ninety percent of children with depression have sleep problems. If you are concerned about your children's mental health, consider the amount of sleep they get each night. The adequate amount of sleep for most children is eight to nine hours. When children miss two hours of sleep each night, the risk of depression doubles.</p> <h3>Adequate sleep can have many benefits including:</h3> <ul> <li>Boosting mental health in children threefold</li> <li>Improving grades and enjoyment of school</li> <li>Dramatically reduce <a href="/hometown-health/speaking-of-health/stressed-out-kids" target="_self" title="Opens in same window.">anxiety and stress</a></li> <li>Decreasing the risk of having a car accident by half</li> <li>Lowering the risk of chronic health conditions, such as Type 2 diabetes and obesity</li> </ul> <p>Elementary-age children are more likely to get an adequate amount of sleep. By middle school, the rate of children getting enough sleep drops to 30%. By senior year of high school, the rate is only 5% of youth getting optimal sleep. </p> <p>A significant percentage of youth are sleep deprived. Sleep deprivation causes wear and tear on the brain. Sleep loss raises stress levels and decreases the brain's emotional regulation pathways. Sleep releases neurochemicals in the brain, such as serotonin and dopamine.</p> <h3>How does the amount of sleep affect behavior?</h3> <h4>Too little sleep:</h4> <ul> <li>Short temper</li> <li>Difficulty concentrating</li> <li>Low immune strength</li> <li>Lack of motivation</li> <li>ADHD-like symptoms</li> <li>Lower testosterone</li> <li>Depression</li> </ul> <h3>Healthy amount of sleep:</h3> <ul> <li>Better regulation of emotions</li> <li>Higher energy</li> <li>Improved focus</li> <li>Muscle repair</li> <li>Lower stress</li> <li>Improved immunity</li> <li>Higher levels of optimism</li> </ul> <h2>What is keeping children awake at night? </h2> <p>Increased use of electronic devices and decreased sleep go hand in hand. Engaging with electronics before bed activates the brain, making it more challenging to relax and fall asleep. Consider having a sleep routine that includes moving electronics out of your children's bedrooms or using apps to minimize use after certain hours. <a href="/hometown-health/speaking-of-health/children-and-screen-time" target="_self" title="Opens in same window.">Decreasing electronic use</a> before bed and increasing optimal sleep is one tool for improving mood in youth.</p> <h2>Dealing with problems head on</h2> <p>For children, fears not dealt with at an early age may limit them as they enter adulthood. For example, if children are dealing with bullying in school and fail to address it during childhood, they can experience issues with social anxiety and mood issues in adulthood.</p> <p>Depression needs to be dealt with head-on, with the <a href="/hometown-health/speaking-of-health/how-to-support-a-loved-one-with-depression" target="_self" title="Opens in same window.">support of loved ones</a>. Children cannot deal with depression by themselves. It is the role of parents and other adults to encourage children to address thoughts and feelings head-on, so they can be managed.</p> <h2>Social supports</h2> <p>At worst, depression is a disease of isolation. People tend to be social creatures and feel best when connected to others in a community, school or social setting. People strive to feel like they belong and are needed and valued. Half of the people in the U.S. have reported feeling lonely since the pandemic.</p> <p>This is most significant for youth. Loneliness has been associated with poor mental health as well as poor physical health.</p> <h3>Increasing your children's social support network can improve depression symptoms through:</h3> <ul> <li>Improving the ability to cope with stressful situations</li> <li>Alleviating the effects of emotional distress</li> <li>Promoting lifelong good mental health</li> <li>Enhancing self-esteem</li> <li>Lowering cardiovascular risks, such as lowering blood pressure</li> <li>Promoting healthy lifestyle behaviors</li> </ul> <h2>Strong family connections</h2> <p>Families are essential for helping children manage depression or anxiety. Family strength is built through strong connections, spending time together and having mutual interests.</p> <p>Family dynamics that cause disconnection are highly correlated with the onset and severity of a child's mental health. So the more poorly the family functions, the more at risk children are for serious mental health conditions.</p> <h3>The components of a well-functioning family include:</h3> <ul> <li>Low reactivity to stressors</li> <li>Warm and affectionate feelings toward each other</li> <li>Spending time together in age-appropriate activities </li> <li>Good communication skills</li> <li>Collaborative problem-solving</li> </ul> <p>Working with <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">healthcare professionals specializing in treating mental health conditions in youth</a> can help families find the right recipe for treatments and techniques to develop a care plan specifically tailored to your child and family.</p> <h4>Watch the "Empowering Families to Strengthen Youth Mental Health" presentation to learn more:</h4> <p><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/S7F53ehZDeU" title="Empowering families to strengthen youth mental health" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <p><a href="/providers/janice-schreier-lcsw" target="_self" title="Opens in same window."><em>Janice Schreier</em></a><em> is a child and adolescent clinical therapist in <a href="/services-and-treatments/psychiatry-and-psychology">Psychiatry & Psychology</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Anxiety</li> <li>Attention deficit hyperactivity disorder</li> <li>Bipolar disorders</li> <li>Chemical dependency</li> <li>Depression</li> <li>Eating disorders</li> <li>Facilitates social skills groups for adolescents with autism spectrum disorders</li> <li>Individual, family and group therapy</li> <li>Obsessive-compulsive disorders</li> <li>Post-traumatic stress disorder</li> <li>Reactive attachment disorder</li> <li>Trauma</li> <li>Treatment for children 7–17 and young adults</li> </ul>L.C.S.W.<p><strong>Education</strong></p> <ul> <li>Addiction Counseling, Viterbo University</li> <li>Bachelor's degree, Social Work, University of Wisconsin-La Crosse</li> <li>Master's degree, Social Work, University of Wisconsin-Milwaukee</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Autism Spectrum Disorders</li> <li>Licensed Clinical Social Worker, Substance Abuse Specialty</li> </ul>Schreier<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/janice-schreier-msw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=42215A8A31EDEE2903AC5F89E6D23B11" alt="Janice Schreier MSW" width="280" height="280" DisableNVelocity="true" />Janice<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15449963Janice Schreier, L.C.S.W.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2022/parent-and-child-touching-foreheads.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0EAE4937B5410C0A8E68B44846181EFC" alt="Parent and child laughing and touching foreheads" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Dawn Haller10/25/2022Puberty is natural, and parents have no reason to fear it for their children. Get practical tips for discussing this exciting phase with kids and preparing them for the changes ahead.Changes ahead: Talking with children about puberty<p>There are many milestones in children's lives to look forward to. First steps, words and day of school are celebrated.</p> <p>Puberty is a phase of children's lives that should be celebrated as well. It's an exciting time of growth for kids' bodies and minds.</p> <p>Puberty is natural and expected. It happens so children can grow and become adults. It's triggered by chemicals called hormones, and these cause physical changes in children's bodies.</p> <p>When puberty begins, the brain starts producing a hormone called gonadotropin-releasing hormone (GnRH). When this hormone reaches the pituitary gland — a small bean-shaped gland at the base of the brain — it leads to the production of more hormones in the ovaries for females (estrogen) and the testicles for males (testosterone).</p> <h2>Common changes between sexes</h2> <h3>All children, regardless of sex, will experience a few similar changes during puberty, such as:</h3> <ul> <li><strong>Height</strong><br /> Most children get taller during puberty. It can happen quickly or at a slower pace.</li> <li><strong>Weight</strong><br /> Most people gain weight during puberty. For boys, it's often because their shoulders get broader, and they develop more muscles. For girls, their bodies start to build up more fat and their hips widen during this time.</li> <li><strong>Mood changes</strong><br /> Hormones can cause moods to change or switch quickly. Children may get mad, sad or lonely more often. They may feel confused or scared. It can be difficult to deal with mood swings, but remember that this is normal. Their moods should stabilize over time.</li> <li><strong>Hair growth</strong><br /> During puberty, children start growing hair where there wasn't much before. The hair on their legs usually gets thicker. They start growing hair in their armpits and pubic areas. Some boys start to grow hair on their face and chest as well.</li> <li><strong>Acne <br /> </strong>Acne is a common condition and often begins during puberty. Often, it affects the face, back and chest. Although most people will have acne at some point, children still may be embarrassed by it.</li> </ul> <h2>Physical changes for girls</h2> <p>Girls usually start puberty earlier than boys. Typically, it starts between 8 and 13 years old, but it doesn't mean anything is wrong if your children don't start puberty until later. Girls' bodies begin to produce the hormone estrogen, which participates in the growth and development of female sexual characteristics.</p> <h3>Girls will start to experience:</h3> <ul> <li><strong>Breast development</strong><br /> During puberty, girls begin to develop breasts. It's common for one breast to develop more quickly than the other. Most girls begin wearing a bra or tank under shirts during puberty.</li> <li><strong>Maturing of ovaries</strong><br /> In this time, girls' ovaries begin releasing eggs. </li> <li><strong>Menstruation</strong><br /> Menarche is the name of the first menstrual period for girls. This happens by 13 or 14 for most. It's common for the first few periods to be irregular and unpredictable for the first two years. Talk with your child's primary care provider if she is concerned about her period or struggles with pain, cramping or discomfort.</li> </ul> <h2>Physical changes for boys</h2> <p>For boys, puberty usually starts between 9 and 14, but it can occur earlier or later. Their bodies begin to produce the hormone testosterone. It's responsible for the growth and development of male sexual characteristics.</p> <h3>Boys will start to experience: </h3> <ul> <li><strong>Voice changes</strong><br /> During puberty, boys' voices get lower. They may "crack" occasionally while this transition is happening.</li> <li><strong>Genital growth</strong><br /> Boys' penises and testes get larger. They may notice they develop erections or begin to ejaculate while sleeping. These are normal changes.</li> <li><strong>Chest tenderness</strong><br /> Some boys have swelling or tenderness in their chests. This usually doesn't last, but talk with your child's primary care provider if you're concerned.</li> </ul> <h2>Tips for parents</h2> <p>Not every day during puberty is fun, but there's no reason to fear it. Parents play an important role in preparing children for the transition, providing education and encouraging independence. Talking to children about puberty should be an ongoing conversation, not a one-time event.</p> <h3>Here are some tips to help you navigate this phase in children's lives:</h3> <ul> <li><strong>Use proper names for body parts.<br /> </strong>At a young age, begin using the correct terms when discussing body parts, such as breasts, penis and vagina. This helps children become more comfortable talking about their bodies as they grow, and gives children the language to ask questions and express concerns. It also reinforces that they don't have to be embarrassed about their bodies changing.</li> <li><strong>Explain differences in timing.</strong><br /> Many kids compare themselves to others, especially during puberty. There's no "right time" or "right way" to go through puberty. Every child is different, and that's normal. Most kids start puberty by 14, but it doesn't mean something's wrong if your children starts later. Lots of kids fall outside of the typical age ranges.</li> <li><strong>Encourage new hygiene habits.</strong><br /> Most children need to modify their hygiene habits at the start of puberty. Hormonal changes cause children to sweat more, and this can lead to body odor. A big change for many kids is that they need to shower more often to prevent order. Supply your children with deodorant and face wash to prevent acne. Remind them to wear clean clothes every day as well.</li> <li><strong>Don't forget other healthy routines.</strong><br /> Eating healthy foods and getting regular exercise and enough sleep helps children adjust to hormonal changes and regulates mood, too. Plus, if they get into the habit of doing things that are good for them now, and it will be easier for them to stay healthy as they get older.</li> <li><strong>Discuss physical changes openly.</strong><br /> Often, physical changes are the first signs of puberty. As they experience changes, they may feel self-conscious or embarrassed. Explain that your children's bodies are growing from a being kids to becoming adults. Start by having small conversations early and explain what changes to expect. It may be helpful to share how you felt or noticed when you went through puberty, like when your voice deepened or you developed acne.</li> <li><strong>Navigate mood swings carefully.</strong><br /> Dealing with significant mood swings isn't easy. You may go from being a favorite companion to the target of their anger. Don't take it personally or match their intensity or mood. It is easier for parents to focus on remaining neutral and consistent while children ride a rollercoaster of emotions.</li> <li><strong>Plan for peer pressure.</strong> <p>During this age, kids often form tight-knit groups of friends. It can feel great to be a part of a group, but this can lead to peer pressure to do things that are wrong. The best way to avoid negative peer pressure is to plan ahead. Role play situations and practice phrases they can use when standing up for themselves.</p> </li> <li><strong>Practice kindness.</strong><br /> Routines and behavior expectations are important for kids, but it's just as critical that you give your children some grace during puberty. If they blows up at you or does something challenging, take a step back before responding. Remember, children may feel confused or scared. Or are figuring out a complicated social situation at school. Give children your time, kindness and unconditional love.</li> </ul> <p>Try to enjoy this time. Puberty should be embraced and celebrated. Your children are maturing and growing into adults.</p> <p>Talk with your child's primary care provider if you or your child has questions or concerns regarding puberty or development. Together, you will help your child thrive and be healthy.</p> <p><em><a href="/providers/sarah-sistek-np" target="_self" title="Opens in same window.">Sarah Sistek</a></em><em> is a nurse practitioner in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota. </em></p><ul> <li>Caring for patients of all ages in an acute care setting</li> </ul>APRN, C.N.P., D.N.P.<p><strong>Education</strong></p> <ul> <li>Master's degree, Nursing, Minnesota State University</li> <li>Doctorate of Nursing, University of Minnesota</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Sistek<img src="/-/media/shared-files/images/medical-professionals/full/austin/sarah-sistek-aprn-cnp-dnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=76670AD1EC4FF430FA17846F6FEA3338" alt="Sarah Sistek, APRN, C.N.P., D.N.P." width="280" height="280" title="Sarah Sistek, APRN, C.N.P., D.N.P." DisableNVelocity="true" />Sarah<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14071380Sarah Sistek APRN, C.N.P., D.N.P.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}<img src="/-/media/national-files/images/hometown-health/2022/parent-talking-with-child.jpg?h=370&iar=0&w=660&sc_lang=en&hash=283F9E9F5FCBC209E8FA6F7C5F576705" alt="Parent talking with child" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Dawn Haller10/24/2022Healthy habits sometimes need a refresh, especially as families settle into the routine of school, work and activities. Learn how to use "95210 Let's Go!" to get your family back on track.Use '9-5-2-1-0' to refresh your family's healthy habits<p>Sometimes healthy eating and living habits need a refresh, especially as families settle into the routine of school, work and activities. The Safe and Healthy Children's Coalition created the "9-5-2-1-0 Let's Go!" campaign to educate children and families about healthy habits and help reduce childhood obesity.</p> <h2>Using "9-5-2-1-0" can help you and your family get back on track:</h2> <h3>9 — This is the number of hours of sleep children and teens should get each day.</h3> <p> It's recommended adults get seven to nine hours. Sleep loss can lead to fatigue, difficulty concentrating at school and work, and lead to increased snacking as your body tries to get energy from other sources.</p> <h3>5 — Aim to eat five servings of fruits and vegetables a day.</h3> <p>A diet rich in fruits and vegetables is associated with lower rates of obesity and chronic diseases, such as diabetes and heart disease. This may sound like a lot, but if you plan ahead to have a fruit and/or vegetable at each meal and snack, the servings add up.</p> <p>A serving of fruit is ½ cup, or 1 medium piece, such as an apple, or ¼ cup of dried fruit. A serving of vegetables is 1 cup raw or ½ cup cooked. If you eat a larger portion, you may be getting more than one serving.</p> <h3>2 — Limit screen time to two or less hours per day.</h3> <p>This includes TV, phones, computers and video games.</p> <h4>Children who spend more time on screens:</h4> <ul> <li>Have a higher risk for obesity because they're sitting more — and may be snacking or eating while they're on those screen</li> <li>Have trouble falling asleep or have an irregular sleep schedule</li> <li>Tend to be less active and spend less time in active, creative play</li> </ul> <p>To slim screen time, turn off background TV, keep TVs, smartphones and computers out of bedrooms, and <a href="/hometown-health/speaking-of-health/6-tips-to-reduce-childrens-screen-time" target="_self" title="Opens in same window.">set boundaries for screen time</a>.</p> <h3>1 — Set aside at least one hour a day for physical activity each day.</h3> <p>Not only does physical activity benefit children now, it sets the foundation for a lifetime of fitness and good health. According to the podcast, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/ask-the-mayo-mom-how-exercise-benefits-the-body-and-mind/" target="_blank" title="Opens in a new window.">"Ask the Mayo Mom: How exercise benefits the body and mind,"</a> children who get regular exercise have lower levels of depression and stress, and higher levels of positive self-image.</p> <p>Exercise also is linked to better thinking skills, which leads to improved behavior, attention and academic performance. Kids who have recess and physical education class will reach at least part of their one-hour goal for the day. Make a routine of doing something active as a family, such as taking a walk after supper, dancing during commercial breaks or shooting baskets after school.</p> <h3>0 — It's recommended that kids consume no sugary beverages in a day.</h3> <p>This includes soda, fruit drinks, sports and energy, which should be an occasional treat, not a daily part of their diet. Increased intake of sugar-sweetened beverages is associated with cavities and excessive weight gain. Instead, drink water, sugar-free flavored water and skim milk.</p> <h2>Not just for kids</h2> <p>Even though these recommendations are geared toward children, adults also can benefit from them.</p> <h2>Here are some recipes to help you meet your five servings of fruits and vegetables a day:</h2> <h4>Fruit wrap bites</h4> <p>Serves 8</p> <p>6 tablespoons cream cheese<br /> 1/4–1/2 teaspoon vanilla extract, to taste<br /> Three 9-inch whole-wheat tortillas<br /> 10–12 strawberries, thinly sliced<br /> 2 kiwis, peeled and thinly sliced<br /> 1 banana, thinly sliced</p> <p>Mix vanilla into the cream cheese. Spread each tortilla with 2 tablespoons of cream cheese, spreading all the way to edges. To define the filling area, draw a square in the cream cheese with a butter knife or spatula, making the biggest square possible. Arrange strawberries and kiwi in a single layer in the top 2/3 of the square. Top with banana slices. Fold up bottom of tortilla along scratched line, and fold in sides along lines. Tightly roll up tortilla, pushing in any filling that slides out. Set seam-side down on a plate, and freeze for 20–30 minutes. Cut into 1-inch pieces. Use toothpicks to keep them from unrolling.</p> <p>Nutrition information per serving (3 pieces): 120 calories, 5 grams fat, 3 grams saturated fat, 10 milligrams cholesterol, 120 milligrams sodium, 16 grams carbohydrates, 3 grams fiber, 3 grams protein</p> <p>Note: Mix and match your favorite fruit, use 1 tablespoon peanut butter instead of cream cheese or make veggie wrap bites with light ranch dressing and shredded veggies.</p> <h4>Vanilla yogurt fruit dip</h4> <p><strong> </strong></p> <p>Serves 8</p> <p>1 cup plain, nonfat Greek yogurt<br /> 2 tablespoons cream cheese, softened<br /> 2 tablespoons honey<br /> 1½ teaspoon vanilla extract<br /> Fresh fruit</p> <p>Mix all ingredients in a bowl until smooth. Serve with your choice of fresh fruit for dipping.</p> <p>Nutrition information per serving (2 tablespoons): 48 calories, 1 gram fat, 1 gram saturated fat, 5 milligrams cholesterol, 22 milligrams sodium, 6 grams carbohydrates</p> <p><em><a href="/providers/romi-londre-rdn" target="_self" title="Opens in same window.">Romi Londre</a> is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Eating disorders</li> <li>Enteral nutrition or tube feedings</li> <li>Weight management</li> </ul>RDN, CD<p><strong>Education</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Registered Dietitian Nutritionist</li> <li>Certified Nutrition Support Clinician </li> <li>Certificate of Training in Adult Weight Management</li> </ul> <div> </div>Londre<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/romi-londre-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7919B2F8260054ECC4308684471EEEDB" alt="Romi Londre RDN" width="280" height="280" DisableNVelocity="true" />Romi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15183670Romi Londre, RDN, CD1{2BEE5070-65FF-4406-9E59-103E06C5A535}<img src="/-/media/national-files/images/hometown-health/2022/veggies-cooking-in-pan.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C044DDCE37BB862C5A49526D3497876B" alt="Veggies cooking in pan" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller11/10/2022If you're a smoker, you may be ready to quit but need a guide for how to get from the "here" of smoking to the "there" of not smoking. Here's how to get started on your smoke-free journey.You are 'here': A smoker's guide to quitting<p>When you're at the mall or on a hike, there's usually a map somewhere with an "X" that says, "You are here." If you're a smoker, you may be at the point where you want to stop, but need a guide for how to get from the "here" of smoking to the "there" of not smoking.</p> <h2>Here's how to get started on your smoke-free journey:</h2> <h3>Add up the costs of smoking.</h3> <h4>Smoking takes a toll on your body, the people around you and your wallet:</h4> <ul> <li>Smoking puts you at higher risk for many health conditions, including cancer, cardiovascular disease and chronic obstructive pulmonary disease. It also can lower your life expectancy.</li> <li>People around you — loved ones, friends, co-workers — can be affected by secondhand smoke.</li> <li>Do the math. A pack of cigarettes costs about $12. One pack a day times 30 is $360/month. Smoking also costs you time — time away from your work, family and activities while you take a smoke break.</li> <li>E-cigarettes have similar physical and financial costs, although the health risks aren't fully understood since they're relatively new. Plus, these products aren't FDA-approved, so there's no regulation of what's in them.</li> </ul> <h3>Know when you're ready to quit.</h3> <p>Why is it so hard to quit? <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/nicotine-dependence/symptoms-causes/syc-20351584" target="_blank" title="Opens in a new window.">Nicotine</a> stimulates the reward pathway in the brain, releasing dopamine, which feels good. Over time, you begin to crave the feelings you get from nicotine, and it begins to feel normal. When your body doesn't have nicotine, it goes into withdrawal.</p> <p>When you reach the point when the harmful effects outweigh what you gain from smoking and recognize nicotine's control over your day-to-day life, you're ready. But the decision has to be yours. It's a commitment you're making to yourself. You may have tried to quit before and failed, but you may have made the effort for others, not yourself.</p> <h3>Get from 'here' of smoking to 'there' of not smoking.</h3> <p>Becoming smoke-free is a process. Developing a quit plan can help you prepare and follow through with your decision to quit.</p> <h4>Here are some elements of a successful quit plan:</h4> <ul> <li><strong>Commit to quitting.</strong><br /> Tell your family, friends, loved ones and those who will be part of your support system.</li> <li><strong>Choose a date.</strong><br /> The <a rel="noopener noreferrer" href="https://www.cancer.org/healthy/stay-away-from-tobacco/great-american-smokeout.html" target="_blank" title="Opens in a new window.">Great American Smokeout</a> — an annual event on the third Thursday of November — might be a good option. Be realistic and give yourself some time to get your quit plan in place.</li> <li><strong>Form a support system.<br /> </strong>You might want to find someone to quit with you, join a social media or online support group, or seek counseling to help you cope with triggers, withdrawal and emotional challenges.</li> <li><strong>Know your triggers.</strong><br /> Maybe it's driving in the car, doing a particular activity or when you're stressed. Think about how you'll manage your triggers or avoid them entirely.</li> <li><strong>Consider cravings.</strong><br /> Brainstorm how you'll manage <a rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/quit-smoking/in-depth/nicotine-craving/art-20045454" target="_blank" title="Opens in a new window.">cravings</a> and address withdrawal symptoms. Have healthy snacks on hand, practice mindfulness, go for a walk or text a support person.</li> <li><strong>Think about </strong><a rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/quit-smoking/in-depth/quit-smoking-products/art-20045599" target="_blank" title="Opens in a new window."><strong>helpful aids</strong></a>.<br /> These could be nicotine replacement therapy, such as patches, gum, lozenges or an inhaler, or medication assistance with <a rel="noopener noreferrer" href="https://www.mayoclinic.org/drugs-supplements/bupropion-oral-route/description/drg-20062478" target="_blank" title="Opens in a new window.">bupropion</a> or <a rel="noopener noreferrer" href="https://www.mayoclinic.org/drugs-supplements/varenicline-oral-route/description/drg-20068324" target="_blank" title="Opens in a new window.">varenicline</a>.</li> </ul> <h3>Work through discouragement.</h3> <p>When people are trying to quit smoking, if they slip up, they tend to think the worst: "I'm a failure. I've blown it." Those thoughts can drive anxiety, which may cause you to revert to your go-to coping technique: smoking.</p> <h4>But if you have a cigarette or vape, all is not lost:</h4> <ul> <li><strong>Be kind to yourself.</strong><br /> This is hard. Fewer than 1 in 10 adults successfully quit smoking each year. However, over time, 60% of those who try to quit — usually more than once — are successful.</li> <li><strong>Reset and restart.</strong><br /> Tomorrow really is another day.</li> <li><strong>Review your quit plan.</strong><br /> You may need to adjust it and consider what other tools you need in your toolbox.</li> <li><strong>Check in with your support system.</strong></li> </ul> <p>Congratulations on your decision to stop smoking. Remember, there isn't just one path to your goal, and you have lots of options to help you succeed. Good luck.</p> <h3>Check out these additional resources to help you quit smoking:</h3> <ul> <li><a href="/services-and-treatments/primary-care" target="_self" title="Opens in same window.">Your primary care clinician</a></li> <li><a rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/quit-smoking/basics/quitsmoking-basics/hlv-20049487" target="_blank" title="Opens in a new window.">Mayo Clinic</a></li> <li><a rel="noopener noreferrer" href="https://www.cancer.org/healthy/stay-away-from-tobacco/great-american-smokeout.html" target="_blank" title="Opens in a new window.">American Cancer Society</a></li> <li><a rel="noopener noreferrer" href="https://smokefree.gov/" target="_blank" title="Opens in a new window.">Smokefree.gov</a></li> <li><a rel="noopener noreferrer" href="https://www.cdc.gov/tobacco/campaign/tips/quit-smoking/" target="_blank" title="Opens in a new window.">Centers for Disease Control & Prevention</a></li> </ul> <p><em><a href="/providers/patrick-bigaouette-md" target="_self" title="Opens in same window.">Patrick Bigaouette, M.D.</a>, is a psychiatrist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Anxiety disorders</li> <li>LGBTQIA+ populations</li> <li>Medical education</li> <li>Mood disorders</li> <li>Peripartum psychiatry</li> <li>Psychopharmacology</li> <li>Trauma- and stressor-related disorders</li> <li>Women's health</li> </ul>M.D.<p>I enjoy working with patients in managing a wide spectrum of psychiatric disorders across psychosocial stages of life. I work in a collaborative, shared decision-making approach based on biologic, psychologic and social factors. My goal is to provide high-quality, evidence-based, patient-centered care to achieve the best possible outcomes in managing psychiatric distress.</p> <p>Outside of my clinical work, I am passionate about medical education and enjoy working with resident physicians and students.</p> <p>In moving back to Minnesota from the East Coast, I enjoy staying active outdoors, going to local theater, and I am always open to book recommendations.</p><p><strong>Education</strong></p> <ul> <li>Georgetown University School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Psychiatry, Mount Sinai-Beth Israel, Icahn School of Medicine at Mount Sinai</li> </ul> <p> <strong>Residency</strong> </p> <ul> <li>Psychiatry, Mount Sinai-Beth Israel, Icahn School of Medicine at Mount Sinai, New York</li> </ul> <p><strong>Certification</strong> </p> <ul> <li>Psychiatry, American Board of Psychiatry and Neurology </li> </ul> <p><strong>Membership</strong> </p> <ul> <li>American Psychiatric Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Psychiatry, Mayo Clinic College of Medicine and Science</li> </ul>Bigaouette<img src="/-/media/shared-files/images/medical-professionals/full/mankato/patrick-bigaouette-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4A09A81BD845D197A88A6FB7DC116F24" alt="Patrick Bigaouette MD" width="280" height="280" DisableNVelocity="true" />Patrick<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30014612Patrick Bigaouette, M.D.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2022/couple-hiking-in-woods.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EE36A9EF6DB2550457567F1C9127ADE1" alt="Couple hiking in woods" width="660" height="370" DisableNVelocity="true" />Lung CancerLung cancer is a type of cancer that begins in the lungs. It is the leading cause of cancer deaths in the U.S., among both men and women. Lung cancer claims more lives each year than do colon, prostate, ovarian and breast cancers combined. <br/><br/>PulmonologyTreatment for diseases and conditions affecting lung and airway function.BreathingMost cases of shortness of breath are due to heart or lung conditions. Your heart and lungs are involved in transporting oxygen to your tissues and removing carbon dioxide, and problems with either of these processes affect your breathing.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller11/15/2022Chronic hepatitis B infection can go undiagnosed until serious liver disease symptoms arise. Learn why vaccination is the best way to prevent infection, and g<span>et additional tips to avoid getting the virus. </span>Hepatitis B vaccine: What to know to protect yourself<p>Hepatitis is inflammation in the liver caused by specific viruses. The hepatitis viruses are referred to as types A, B, C, D and E. All types affect the liver, but they differ in illness severity and prevention options.</p> <p>In the U.S., the most common forms are hepatitis A, hepatitis B and <a href="/hometown-health/speaking-of-health/hepatitis-c-testing-could-save-your-life" target="_self" title="Opens in same window.">hepatitis C</a>.</p> <h2>Acute or chronic hepatitis B</h2> <p><strong> </strong></p> <p><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/hepatitis-b/symptoms-causes/syc-20366802" target="_blank" title="Opens in a new window.">Hepatitis B</a> is a serious disease caused by a virus that attacks the liver. It's one of the more common reasons for liver transplants in the U.S. Hepatitis B can be passed through blood, semen and other bodily fluids. Sneezing and coughing do not spread the virus.</p> <p>For many people, hepatitis B is acute, or lasts less than six months. Acute infection may not need treatment and can be managed with rest, drinking plenty of fluids and monitoring of the infection.</p> <p>For some people, however, hepatitis B can become chronic if it lasts more than six months. Chronic infection can go undiagnosed until symptoms of serious liver disease arise. Treatment for may include antiviral medications or a liver transplant if the liver is severely damaged.</p> <h3>When the hepatitis B virus becomes chronic, it can increase the risk of developing:</h3> <ul> <li>Lifelong infection</li> <li>Cirrhosis, or scarring, of the liver</li> <li>Liver cancer</li> <li>Liver failure</li> </ul> <p>The risk of the infection becoming chronic increases the younger people are when they are infected with hepatitis B, particularly newborns or children under 5.</p> <p>Although there is no cure for hepatitis B, getting vaccinated is the best way to prevent it.</p> <h2>Hepatitis B vaccine</h2> <p>The hepatitis B vaccine usually is given as either a two-dose series spread out over one month or a three-dose series spread out over six months, depending on the vaccine used. Similar to the influenza vaccine, hepatitis B cannot be acquired from getting the vaccine.</p> <p>The Advisory Committee on Immunization Practices (ACIP) updated the <a rel="noopener" href="https://www.cdc.gov/acip-recs/hcp/vaccine-specific/hepatitis-b.html" target="_blank" title="Opens in a new window.">vaccine guidelines for hepatitis B</a>.</p> <h3>The hepatitis B vaccine is recommended for:</h3> <ul> <li>Newborns</li> <li><a href="/hometown-health/speaking-of-health/the-facts-about-vaccinations" target="_self" title="Opens in same window.">Children and adolescents not vaccinated</a> at birth</li> <li>People who live with someone who has hepatitis B</li> <li>People with chronic liver disease or end-stage kidney disease</li> <li>Adults ages 19–59</li> <li>Adults, 60 and older, with or without known risk factors for hepatitis B infection</li> </ul> <p>People who have not completed the vaccine series should contact their primary care provider to discuss the vaccine.</p> <h2>Avoid hepatitis B infection</h2> <h3>The hepatitis B vaccine is the best way to prevent getting the virus. Other ways to reduce infection risk include:</h3> <ul> <li><strong>Ask about the hepatitis B status of any sexual partner.</strong><br /> Use a new latex or polyurethane condom if the partner's health status is unknown. Condoms reduce the risk of contracting hepatitis B, but don't eliminate the risk.</li> <li><strong>Don't use illegal drugs and never share needles.</strong></li> <li><strong>Be cautious about body piercing and tattooing.</strong><br /> Ask how the equipment is cleaned, and ensure sterile needles are used.</li> <li><strong>Ask about the hepatitis B vaccine before traveling.</strong><br /> When visiting a region with high rates of hepatitis B, <a href="/hometown-health/speaking-of-health/9-reasons-to-see-a-travel-medicine-specialist" target="_self" title="Opens in same window.">talk to a travel medicine specialist</a> about the vaccine at least six months before traveling.</li> </ul> <p><a href="/providers/victoria-louwagie-pac" target="_self" title="Opens in same window."><em>Victoria Louwagie</em></a><em> is a physician assistant in <a href="/services-and-treatments/gastroenterology-and-hepatology" target="_self" title="Opens in same window.">Gastroenterology</a>, and <a href="/providers/jessica-sheehy-pac" target="_self" title="Opens in same window.">Jessica Sheehy</a> is a physician assistant in <a href="/services-and-treatments/infectious-diseases" target="_self" title="Opens in same window.">Infectious Diseases</a>, both in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Celiac disease</li> <li>Cirrhosis</li> <li>Eosinophilic esophagitis, also called chronic immune system disease</li> <li>Liver disease</li> </ul>P.A.-C., M.S.<p>I have been a practicing physician assistant in the Mankato area for nearly 10 years. I am a grateful clinician, assistant professor and researcher. It brings me joy to care for my patients and provide disease-oriented, evidence-based medical care. I practice shared decision-making with each of my patients and their loved ones. </p> <p>I am an avid reader, and enjoy spending time with my family, camping and being on the water. </p><p><strong>Education</strong></p> <ul> <li>Master's degree, Physician Assistant Studies, Le Moyne College</li> <li>Certificate, Healthcare Administration and Management, University of Lynchburg</li> <li>Advanced Professional Practice degree, University of Lynchburg</li> </ul> <p><strong>Certification</strong></p> <ul> <li>National Commission on Certification of Physician Assistants (NCCPA)</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Academy of Doctoral Physician Assistants</li> <li>American Academy of Physician Assistants</li> <li>American College of Gastroenterology</li> <li>American Gastroenterological Association</li> <li>Minnesota Academy of Physician Assistants</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li><strong></strong>Assistant Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul> <br /> <br />Louwagie<img src="/-/media/shared-files/images/medical-professionals/full/mankato/victoria-louwagie-pac.jpg?h=280&iar=0&w=280&sc_lang=en&hash=79728B1A24856BB2CA6CA11472FCFFCE" alt="Victoria Louwagie PAC" width="280" height="280" DisableNVelocity="true" />{0EA59485-82F3-48D7-8DCC-7F3F87220D3F}Victoria<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15653421Victoria Louwagie, P.A.-C., M.S.1{DC3A2E5F-C54B-4BFA-AE04-95AE79DD4488}|{CDA27FD1-23E5-4D31-BD85-567A48B862F7}<ul> <li>Antimicrobial stewardship</li> <li>Infectious disease</li> <li>Travel medicine</li> </ul>P.A.-C.<p>My goal is to help my patients understand what is happening in regard to their infection, and how it impacts them. When my patients are informed, they can fully participate in the development of a plan that will treat their infection.</p> <p>I have always had an interest in microbiology, and have a college minor in microbiology. Therefore, infectious diseases was a natural fit for my professional career. </p> <p>I love to travel and visit my friends and family in Montana as often as I can.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Physician Assistant Studies, Arcadia University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>National Commission on Certification of Physician Assistants</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Sheehy<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jessica-sheehy-pac.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4E5429A03BCFC322B550B0EC92C132BF" alt="Jessica Sheehy, P.A.-C., P.A." width="280" height="280" DisableNVelocity="true" />{645A5342-C9AE-4AD4-9114-2A0634580FC2}Jessica<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15739287Jessica Sheehy PAC1{C8A905E8-82D3-45FC-9669-A5F09F2EF6CA}<img src="/-/media/national-files/images/hometown-health/2022/tourist-reading-map.jpg?h=370&iar=0&w=660&sc_lang=en&hash=60B143EC3F95A56C6EC44980A8128B4F" alt="Tourist reading map" width="660" height="370" DisableNVelocity="true" />Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Dawn Haller6/10/2025Potatoes have gotten a bad rap for their carb content. Learn why they're good for you, and get recipes to bring the comfort of potatoes to a healthy diet.It's OK to say 'yes' to potatoes<p>Native to South America, potatoes are root vegetables and a dietary staple in many parts of the world. In recent years, low- or no-carb diets have become increasingly popular, leading people to avoid eating potatoes. However, potatoes can have a place in your meals, especially when prepared in a health-conscious way.</p> <h2>A tasty gift</h2> <p>The ancient Incas were cultivating this versatile tuber thousands of years ago. Potatoes made their way to North America in the early 1600s when the governor of the Bahamas sent a potato as a gift to the governor of Virginia. But it wasn't until Thomas Jefferson served potatoes at the White House that they gained popularity.</p> <h2>The concern</h2> <p>And the rest, as they say, is history. By 2023, potatoes — in all their forms — were the most-consumed vegetable in the U.S. According to the Department of Agriculture, potatoes are most commonly eaten as potato chips at home and as french fries when eaten at restaurants.</p> <p>How potatoes are prepared and what they're eaten with may be the real culprits in potatoes getting a bad reputation. It may seem like common sense, but eating a lot of fried foods like chips and french fries can lead to added calories and unhealthy weight gain. Also, people who eat large amounts of potatoes tend to consume more butter, red meat and sodas.</p> <p>It's true that potatoes are high in starch or carbohydrates, the nutrients that cause spikes in blood sugar. But pairing them with foods high in protein, fiber and unsaturated fats can slow digestion and lead to a steadier release of glucose into the bloodstream.</p> <h2>Wealth of micronutrients</h2> <p>In addition to carbohydrates — a needed energy source for your body and brain — potatoes contain a wealth of micronutrients. They're a good source of vitamins, minerals and fiber. As a bonus, potatoes are low in calories, contain no fat or cholesterol, and are sodium-free. They're high in vitamin C and potassium and are a good source of vitamin B6. A medium potato, about 5.5 ounces, contains only 145 calories.</p> <h2>Saying "yes" to potatoes</h2> <p>Energy, micronutrients, versatility and just plain deliciousness make the case for potatoes to become part of a healthy diet. That's especially true when they're paired with foods high in protein and fiber and prepared in ways that capitalize on their zero-fat content.</p> <h3>These two recipes are a tasty place to start:</h3> <h4>Low-calorie potato salad</h4> <p>1 pound potatoes, diced, boiled or steamed<br> 1 large onion, chopped (1 cup)<br> 1 large carrot, diced (1/2 cup)<br> 2 ribs celery, diced (1/2 cup)<br> 2 tablespoons minced fresh dill or 1/2 tablespoon dried dill<br> 1 teaspoon ground black pepper|<br> 1/4 cup low-calorie mayonnaise<br> 1 tablespoon Dijon mustard<br> 2 tablespoons red wine vinegar</p> <p>Combine dill, pepper, mayonnaise, mustard and vinegar in a small bowl, set aside. Combine potatoes, onions, carrots and celery in a large bowl. Spoon the dressing over the vegetables and toss until well coated. Refrigerate before serving.</p> <p>Nutrition for 1 serving (3/4 cup): 77 calories, 14 grams carbohydrates, 2 grams fiber, 127 milligrams sodium, 1 grams total fat, 2 milligrams cholesterol, 1 grams protein, 2 grams total sugars</p> <h4>Roasted potatoes with garlic and herbs</h4> <p>3/4 pound small (2-inch) white or red potatoes<br> 4 cloves garlic<br> 2 teaspoons olive oil<br> 2 teaspoons chopped fresh rosemary<br> 1/8 teaspoon salt<br> 1/4 teaspoon ground black pepper<br> 2 teaspoons butter<br> 2 tablespoons chopped fresh parsley</p> <p>Heat oven to 400 F. Lightly coat a large baking dish with cooking spray. In a large bowl, combine the potatoes, garlic, olive oil, rosemary, salt and pepper. Toss until the potatoes are well coated with oil and spices. Arrange the potatoes in a single layer in the baking dish. Cover with a lid or aluminum foil, and bake for 25 minutes.</p> <p>Remove the covering. Turn potatoes and bake, uncovered, until they're soft and slightly browned, about 25 minutes. Transfer to a serving bowl, mix with butter and sprinkle with parsley before serving.</p> <p>Nutrition for 1 serving (about 2/3 cup): 104 calories, 15 grams carbohydrates, 2 grams fiber, 103 milligrams sodium, 2 grams saturated fat, 4 grams total fat, 5 milligrams cholesterol, 2 grams protein, 1 gram total sugars</p> <p>Recipes by Mayo Clinic staff.</p> <p><em>Lizzie Bertrand is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in </em><em><a href="/locations/st-james">St. James</a></em><em>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2022/spoon-in-mashed-potatoes.jpg?h=370&iar=0&w=660&sc_lang=en&hash=17AEA9ED99327827111E85510AF8E366" alt="Spoon in mashed potatoes" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller11/29/2022Protect yourself and others by properly disposing of sharps in and away from home. It's easy to do with some planning. Here are tips to get you on the right path.Get to the point: Proper disposal of sharps<p>"Sharps" is the term used to describe any device with a sharp point or edge that could cut your skin. This includes needles, syringes, infusion sets, lancets (sometimes called "fingersticks") and auto-injectors, like EpiPens.</p> <p>There are many reasons why you may have sharps in your home. They are used to manage multiple health conditions, including allergies, arthritis, cancer, diabetes, HIV/AIDS, infertility, blood clotting disorders and psoriasis.</p> <p>It's important to correctly dispose of sharps to protect yourself and others. Sharps thrown into the trash, recycling bin or flushed down the toilet can lead to accidental needlesticks or injure sanitation workers and the community.</p> <h2>The good news is that it is easy to correctly dispose of sharps with some planning. Follow these tips:</h2> <ul> <li>Don't throw loose needles, syringes, lancets or any sharps in the trash or recycling.</li> <li>Purchase a designated medical sharps container from a pharmacy or home health provider. It should be heavy plastic or metal with a puncture-proof, tight-fitting lid.</li> <li>If needed, a heavy plastic jug with a screw top, such as a laundry detergent bottle, can be used. Write "Do not recycle" and "Sharps" on the container with a black permanent marker. Do not use clear or plastic containers, coffee cans, milk jugs, aluminum cans or soda cans.</li> <li>Place the container near where you use medical sharps, so you don't need to carry a used sharp across your home for disposal.</li> <li>Keep the container out of reach of children and pets.</li> <li>Always wash hands after touching or handling medical sharps.</li> <li>Do not overfill the container. This can increase pressure and cause the lid to pop off.</li> <li>When filled, seal the lid with heavy-duty tape, such as electrical or duct tape.</li> </ul> <p>When away from home, look for sharps containers in public restrooms at restaurants, airports, highway rest areas and clinics.</p> <p>You should drop off full sharps containers at <a rel="noopener" href="https://safeneedledisposal.org/" target="_blank" title="Opens in a new window.">local sharps collection stations</a>. Some are free, while others may charge a small fee.</p> <p>There also are sharps mailing services available. Companies provide a sharps container and a return shipping label for a fee. You ship back the container when full. This service could be a good option if there aren't collection stations near your home or you have mobility concerns and unreliable transportation.</p> <p>Talk with your health care team if you have questions about the best way to safely dispose of sharps in your home.</p> <p><em><a href="/providers/jill-christensen-cnp" target="_self" title="Opens in same window.">Jill Christensen</a> is a nurse practitioner in <a href="/services-and-treatments/family-medicine">Family Medicine</a> in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><ul> <li>Adoption</li> <li>Behavioral and developmental pediatrics</li> <li>Chronic disease management </li> <li> Department of transportation (DOT) exams</li> <li>Diabetes mellitus</li> <li>Mental health – attention-deficit/hyperactivity disorder (ADHD)</li> <li>Newborn and infant care</li> <li>Preventive care and motivational interviewing</li> <li>Sports</li> <li>Telemedicine, care everywhere</li> </ul>APRN, C.N.P.<p>As a Mayo Clinic Health System family medicine provider, I have an established and coveted relationship with the rural and farming community, and I think of families as a bionet of person’s that take care of each other. I enjoy community health education and have done multiple presentations for different communities on sun protection, skin cancer, pediatric health and wellness, and diet education. </p> <p>I enjoy blogging about mental health, diabetes care and how people can navigate through tough times in life, such as the COVID-19 pandemic. I am largely reachable and communicate by phone, email, telemedicine and in-office visits. I enjoy meeting new faces, and connecting with families. </p> <p>My special interests lie in meeting the patient where they are in their health needs, working with their health priorities and guiding them through their care. I want my patients to understand to the best of their ability, their own personal health goals and diagnoses, and who they may seek for questions, care, referrals and follow-up. </p> <p>My personal interests include hobby farming, taking care of my loved ones, gardening, hunting, fishing and meeting new people.</p><p><strong>Education</strong></p> <ul> <li>Master's degree, Nursing, Family Nurse Practitioner Program, Minnesota State University-Mankato</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>Nurse Practitioner Residency Program, Mayo Clinic School of Graduate Medical Education</li> <li>Women's Health Rotation, Mayo Clinic Health System-Mankato</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Family Nurse Practitioner, American Academy of Nurse Practitioners</li> <li>Certified medical examiner, Department of Transportation (DOT) </li> <li>Nexplanon implant trained, Merck</li> <li>Preceptor for Nurse Practitioner students, Minnesota State University, Mankato</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Nurse Practitioners</li> <li>Golden Key Honor Society</li> <li>Minnesota Board of Nursing</li> <li>Mortar Board Honor Society</li> <li>Sigma Theta Tau, Nursing Affiliate Honor Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Christensen<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/jill-christensen-np.jpg?h=280&iar=0&w=280&sc_lang=en&hash=E486ED336C7F30C86357408497A2575E" alt="Jill Christensen NP" width="280" height="280" DisableNVelocity="true" />{F972C1E4-A740-4E1A-9126-21A8DA2A563E}Jill<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15458067Jill Christensen, C.N.P.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}<img src="/-/media/national-files/images/hometown-health/2022/disposing-syringe-in-sharps-container.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D766DD3909B6876857386F969FC1C13E" alt="Dsiposing syringe in sharps container" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller11/18/2022When tendons become irritated, your finger or thumb can get stuck in a bent or straight position. Find out who typically is affected by trigger finger and how to treat this common condition.What triggers trigger finger?<p>Your hands are mechanical marvels, with pulleys — in the form of tendons — flexing and extending to open and close your fist, and straighten and bend your fingers. Each tendon is wrapped in a sheath that holds it in place.</p> <p>The tendon sometimes can become irritated and swell, preventing it from sliding smoothly under the sheath. When that happens, your finger or thumb can get stuck in a bent or straight position in a condition called trigger finger.</p> <h2>Who can get trigger finger?</h2> <p>Typically, people 45 and older and those with diabetes or rheumatoid arthritis may be predisposed to trigger finger. It's rare in children. Usually, the tendon sheath becomes irritated due to overwork or injury, so people who do repetitive movements, heavy squeezing or lifting in their work can be prone to the condition. It can happen at any time and is more common than people realize.</p> <h2>How is it treated?</h2> <p>If you're experiencing mild symptoms, such as a small, tender lump at the base of a finger or your thumb on the palm side of your hand but can straighten or bend your finger without it locking, take an over-the-counter anti-inflammatory medication, such as ibuprofen, every day for two weeks. If your finger or thumb is locked, you may be able to use gentle pressure to force it straight or bent.</p> <p>If your finger or thumb is locked, you're not able to force it straight or bent, and you're feeling catching or popping, the next level of treatment is a steroid injection to calm the irritation and swelling. Performed in the clinic, the injection is done in the palm of your hand. A cold spray is used to numb the area.</p> <p>One injection may alleviate the problem, but it may recur. If so, another injection may be done after three months.</p> <p>A less common, nonsurgical treatment is splinting. At night, you wear a splint to keep your affected finger or thumb straight.</p> <h2>Is surgery an option?</h2> <p>When over-the-counter medications and steroid injections aren't effective, you may need surgery, which is a quick, same-day procedure. A small incision is made in your palm, usually along the crease so a scar will be less noticeable. The surgeon probes under the skin to loosen the adhesion.</p> <p>You can go home the same day, although for 10–14 days, you'll have limited use of your surgical hand while it heals. You'll be able to dress, drive, eat and do other light activities, making sure you don't lift anything heavier than 15 pounds.</p> <p>After about 10 days to two weeks, you'll return to the clinic where the dressing and stitches will be removed. Most people can go back to work without any restrictions and seldom need follow-up physical therapy.</p> <h2>Can trigger finger be prevented?</h2> <p>Awareness is the first line of prevention. If you notice a small, tender lump at the base of your thumb or finger or experience catching or popping, you may want to consult with an orthopedic health care professional.</p> <p><a href="/providers/sara-snyder-cnp" target="_self" title="Opens in same window."><em>Sara Snyder</em></a><em> is a nurse practitioner in <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">Orthopedics</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a>, Minnesota.</em></p><ul> <li>General Orthopedics</li> <li>Arthritis</li> <li>Joint Injections</li> <li>Sports Injuries</li> <li>Total Joints</li> <li>Carpal Tunnel</li> <li>Trigger Finger</li> <li>Hand/wrist injuries</li> <li>Fractures</li> </ul>C.N.P.I deliver up to date, individualized and quality care to my patients in a compassionate and healing environment.<br /> <br /> In my spare time, I enjoy spending time with my family and staying active.<p><strong>Education</strong></p> <ul> <li>Master's degree, nursing, Briar Cliff University, Iowa</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Academy of Nurse Practitioners (AANP)</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Association of Nurse Practitioners</li> </ul>Snyder<img src="/-/media/shared-files/images/medical-professionals/full/fairmont/sara-snyder-np.jpg?h=280&iar=0&w=280&sc_lang=en&hash=D2C2F39100010D5560FB4CF0C581959E" alt="Sara Snyder NP" width="280" height="280" DisableNVelocity="true" />{A2EDFABA-BC3D-437F-9E9F-5D6800B85204}Sara<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15636798Sara Snyder, C.N.P.1<img src="/-/media/national-files/images/hometown-health/2022/fingers-on-piano-keys.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CF7D9736E215AC6D6683412A182358EC" alt="Fingers on piano keys" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller11/11/2022Pain on the outside of your knee may be a warning sign of an iliotibial, or IT, band issue. Learn why rest and early treatment is best instead of pushing past the pain, and how to avoid future injury.Why your IT band can be a pain in the leg<p>The iliotibial, or IT, band is a long fibrous band of fascia tissue that runs from the outside of your hip down to the outside of your knee. It has a complex job description: it helps lift your leg to the front and to the side of your body, and it supports your knee during flexion and extension. So when this hardworking tissue is injured or overworked, it can be a real pain in the leg.</p> <p>Repetitive motion, like running, rowing or cycling, typically is the culprit in IT band issues. The IT band also is irritated when exercising on uneven surfaces, like trails or hiking downhill. The first warning sign of injury usually is pain on the outside of your knee, at the hip or down the side of your leg. You may notice the pain right after an exercise class or run. IT band problems can be experienced by active adults, children, and student and adult competitive athletes.</p> <h2>Take it easy</h2> <p>The key is to keep a small problem small. Don't ignore the pain and try to push through it. Instead, take a rest from the activity you were doing for a few days. If the pain persists, see a sports medicine specialist or athletic trainer, who often will prescribe physical therapy.</p> <h2>Do physical therapy</h2> <p>The physical therapist will develop a series of exercises for you that will treat your whole leg, including targeting and strengthening your core and larger gluteal muscles to relieve some of the IT band's workload. The therapist also may do some soft-tissue work or <a href="/hometown-health/speaking-of-health/on-pins-and-needles-just-what-is-dry-needling" target="_self" title="Opens in same window.">dry needling</a>.</p> <p>Other treatments may include steroid injections or, in rare cases, surgery.</p> <h2>Avoid injury</h2> <p>People whose leg and core muscles are weaker may be predisposed to IT band injuries.</p> <h3>Weakness can be diagnosed with a simple test:</h3> <ul> <li>Do a single-leg squat.</li> <li>If your knee tips in as you bend down, rather than pointing forward, be proactive and consider leg-strengthening exercises.</li> </ul> <p>Students involved with youth sports typically are screened, and any concerns are identified before they begin the activity. Not catching issues before the activity may result in injury midseason with athletes having to take time away from their sport while they go through rehabilitation.</p> <p>In general, the best way to avoid having your IT band become a pain the leg, is to maintain your core, leg and gluteal muscle strength.</p> <p><em><a href="/providers/jacob-erickson-do" target="_self" title="Opens in same window.">Jacob Erickson, D.O.</a> is a physician in <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">Sports Medicine</a> in <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Minor trauma</li> <li>Musculoskeletal/sports ultrasound</li> <li>Office procedures</li> <li>Preventive medicine</li> <li>Sports/musculoskeletal medicine</li> </ul>D.O.<p><strong>Medical Degree</strong></p> <ul> <li>Kirksville College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo College of Medicine and Science</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Sports Medicine, University of Iowa</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Medical Association</li> <li>American Osteopathic Association</li> <li>American Society of Sports Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor, Family Medicine, Mayo Clinic Alix School of Medicine</li> </ul>Erickson<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/jacob-erickson-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=E94E476103713CA50775C5FD045B05EB" alt="Jacob Erickson DO" width="280" height="280" DisableNVelocity="true" />{C6B5FA43-E21E-423A-A349-342C8DCCBC31}Jacob<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15534570Sports Medicine - Jacob Erickson DO1{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2022/two-people-running-on-wooded-trail.jpg?h=370&iar=0&w=660&sc_lang=en&hash=AF8553B6070D44B68565FF762D16056E" alt="Two people running on wooded trail" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller12/13/2022Multiple sprains, an old break, rolling, inflammatory disease or age can lead to activity-limiting ankle instability, stiffness and pain. Learn about treatments to keep you moving with confidence.Ankle instability causes and fixes<p>Maybe you sprained your ankle one too many times. Maybe age or a previous injury is taking its toll on this hardworking, supportive joint. Or maybe an inflammatory condition, like lupus or rheumatoid arthritis, has damaged your ankle.</p> <p>Whatever the cause, ankle arthritis could be contributing to symptoms, including catching or locking, instability, stiffness, and activity-related pain. Ankle arthritis tends to affect people older than 40 due to cumulative wear and tear or inflammation. Sometimes younger patients develop ankle arthritis if they've had a bad injury, such as a broken ankle, early in life.</p> <p>Ankle arthritis can be painful and limit daily living as much as hip or knee arthritis. While younger people rarely have arthritis, they may still have ankle instability or cartilage problems due to athletic injuries or ankle sprains.</p> <p>But there are fixes — both nonsurgical and surgical — that can reduce pain, strengthen your ankle and improve your mobility.</p> <h2>Start with nonsurgical options</h2> <h4>Three main bones make up the ankle joint:</h4> <ul> <li>Tibia, which is the long shin bone in your lower leg and provides the main weight-bearing surface at the roof of the ankle joint.</li> <li>Fibula, which is on the outside of the ankle and provides lateral and rotational stability.</li> <li>Talus, which provides the lower cartilage in the ankle, connects the ankle to the foot and functions like a hinge to flex your foot.</li> </ul> <p>A network of ligaments and tendons stabilizes the ankle joint.</p> <h4>When treating ankle arthritis, your health care professional typically begins with the least-invasive, nonsurgical options, including:</h4> <ul> <li><a href="/hometown-health/speaking-of-health/to-brace-or-not-to-brace" target="_self" title="Opens in same window.">Bracing</a> — either over-the-counter or custom — can reduce pain and provide support, without interfering with day-to-day activities, exercise or sports. Braces are a particularly good choice for first-line treatment, for patients who are too young or aren't good candidates for surgery.</li> <li>Injections of steroids, such as <a rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/cortisone-shots/about/pac-20384794" target="_blank" title="Opens in a new window.">cortisone</a> or <a rel="noopener noreferrer" href="https://www.mayoclinic.org/drugs-supplements/hyaluronic-acid-injection-route/description/drg-20074557" target="_blank" title="Opens in a new window.">hyaluronic acid</a>, can reduce pain and swelling. While injections don't cure the problem, they can provide long-term pain relief for mild to moderate arthritis in your ankle.</li> <li>Physical therapy, customized to your needs, will strengthen all muscle groups in your lower body. This strengthening can improve support and mobility, and reduce pain in your ankle.</li> </ul> <h2>Consider surgery</h2> <p>Ankle arthritis or instability may be severe enough or progress to the point where nonsurgical options no longer work. Then it's time to consider surgery.</p> <h4>There are several surgical procedures for ankle issues, including:</h4> <ul> <li><strong>Arthroscopic surgery</strong><br /> This is the least invasive type of surgery, and typically is used to repair cartilage, remove bone spurs — especially if they're causing impingement when moving your ankle — and tighten ligaments to stabilize the ankle. In general, this is reserved for smaller cartilage problems and mild arthritis conditions.</li> <li><strong>Ankle replacement</strong><br /> If your ankle joint is damaged with extensive arthritis, total ankle replacement may be an option. As with knee or hip replacement, the surgeon removes the arthritic bone surfaces and replaces them with metal components and a plastic articulating surface. This can be a long-term solution for pain relief and has the benefit of preserving motion in the joint. After surgery, patients usually need to stay off the foot for about a month to allow for healing. Following physical therapy, patients can expect to lead an active life.</li> <li><strong>Ankle fusion</strong><br /> Another option for ankle arthritis that no longer responds to nonsurgical treatment is <a rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/ankle-surgery/about/pac-20385132" target="_blank" title="Opens in a new window.">ankle fusion</a>. Like ankle replacement, patients who undergo ankle fusion can achieve excellent pain relief and lead an active life. Fusion is a good option for patients who aren't good candidates for replacement, including those who are too young for ankle replacement, obese, or have diabetes or diabetes-related neuropathy. Ankle fusion is a more durable, long-term solution compared to ankle replacement. However, patients may experience more stiffness, although not to the point where it affects walking. Healing following ankle fusion surgery may take a couple of months.</li> <li><strong>Combination treatment</strong><br /> Orthopedic health care professionals may take a combination approach in young, athletic patients who experience ankle injuries that affect their ability to participate in their sport. Treatment, which is geared to save the ankle joint, may include bracing, injections, physical therapy and surgery to repair cartilage damage or improve ankle instability.</li> </ul> <p>No matter your age or activity level, if you're experiencing ankle stiffness or instability, consult with an orthopedic health care professional to find a solution that will work best for you.</p> <p><a href="/providers/taylor-beahrs-md" target="_self" title="Opens in same window.">Taylor Beahrs, M.D.</a>, specializes in <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgery</a>, including foot and ankle surgery, and <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">sports medicine</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota. </p><ul> <li>Ankle and hindfoot reconstructive surgery</li> <li>Ankle arthroscopy (minimally invasive surgery)</li> <li>Ankle joint replacement</li> <li>Lower extremity fracture care</li> <li>Minimally invasive foot and ankle surgery</li> <li>Robotic assisted hip and knee arthroplasty</li> <li>Sports injuries of the foot and ankle</li> </ul>M.D.<p>Orthopedic surgery is about relieving pain, restoring function and treating the whole patient. It is a great privilege to help patients with difficulties related to lower extremity arthritis, other bone and tendon degenerative conditions, trauma, deformity and more. In my clinic, you will learn about your orthopedic diagnosis and treatment options. Whenever possible, we start with safe nonoperative treatment plans, and we will discuss if or when surgery is an option.</p> <p>In addition to practicing orthopedic surgery, I serve as Chair of Quality and Value for Mayo Clinic Health System in Minnesota. In this role, I work with multidisciplinary teams to improve patient experience, patient safety and overall quality of care for Mayo Clinic Health System patients.</p> <p>Outside of work, I enjoy spending time with my wife and three children. I enjoy outdoor activities on the lakes, rivers and beautiful farmlands in southern Minnesota. My personal interests and hobbies include walleye fishing, canoeing, golfing and downhill skiing.</p><p><strong>Education</strong></p> <ul> <li>University of Illinois at Chicago College of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Foot and Ankle Surgery, University of Tennessee Campbell Clinic</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Orthopaedic Surgery, American Board of Orthopaedic Surgery</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Orthopaedic Surgeons</li> <li>American Orthopaedic Foot and Ankle Society</li> <li>Mid-America Orthopaedic Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Orthopedics, Mayo Clinic College of Medicine and Science</li> </ul>Beahrs<img src="/-/media/shared-files/images/medical-professionals/full/mankato/taylor-beahrs-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=C2623E1C3B3AA3CCC3069D68C37B8740" alt="Taylor Beahrs, M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/31423824/" target="_blank" title="Opens in new window. ">Smoking Effects in Foot and Ankle Surgery: An Evidence-Based Review</a>, August 2019</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=What+Factors+Are+Predictive+of+Outcome+in+the+Treatment+of+Soft+Tissue+Sarcomas+of+the+Foot+and+Ankle" target="_blank" title="Opens in new window.">What Factors Are Predictive of Outcome in the Treatment of Soft Tissue Sarcomas of the Foot and Ankle</a>, February 2017</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/27605690" target="_blank" title="Opens in new window.">Complex Primary Total Knee Arthroplasty: Long-Term Outcomes</a>, September 2016</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/27815014" target="_blank" title="Opens in new window.">Rotating platform versus fixed bearing total knee arthroplasty at mid-term follow-up</a>, December 2016</li> </ul>{3B7AEE26-7FB1-48F3-A835-0A05DDDD39A7}Taylor<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15701328Taylor Beahrs, M.D.{DEF55970-853F-4E96-9A4D-3413874FF059}|{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2022/showshoeing.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2E15B859EEF6961B1BC048602B2CEABD" alt="Showshoeing" width="660" height="370" DisableNVelocity="true" />Foot HealthPodiatry is a branch of medicine devoted to the study of diagnosis, medical and surgical treatment of disorders of the foot, ankle and lower extremity.Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller12/19/2022A vasectomy is considered a permanent form of birth control. But plans sometimes change and a reversal is wanted. Learn about factors that affect success and the surgical options available.Can a vasectomy be reversed?<p>A vasectomy is a form of male birth control that cuts and seals the tubes that carry sperm, called the vas deferens. It's a common procedure, and about half a million are performed each year. It's considered permanent.</p> <p>A vasectomy reversal is a surgery that can undo the effect of a vasectomy. This is done by reconnecting the vas deferens, which allows sperm to travel from the testicles into the semen.</p> <p>Vasectomy reversal success rates range from 60% to 95%. Success depends on several factors, including how long ago the vasectomy was done, the amount of scar tissue present, hormone levels at the time of reversal and if you had fertility issues before the vasectomy.</p> <p>I recommend that people consider different forms of birth control if they know they want future children. They should not rely on the success of a vasectomy reversal surgery in family planning.</p> <h2>There are two surgical approaches for a vasectomy reversal that are determined at the time of surgery:</h2> <ul> <li><strong>Vasovasostomy</strong><br /> During this surgery, the surgeon sews back together the cut ends of the vas deferens. This procedure occurs more often when the initial vasectomy was performed within a few years. Over time, scar tissue can develop in the vas deferens that can prevent successful vasovasostomy.</li> <li><strong>Vasoepididymostomy<br /> </strong>This procedure is performed when there is too much scar tissue to allow vasovasostomy or in cases of prior failed vasectomy reversal. The option is more complex as the surgeon attaches the cut vas deferens to the small organ at the back of each testicle that holds sperm, called the epididymis.</li> </ul> <p>While vasectomies usually are performed in the clinic with local anesthesia, a vasectomy reversal typically is done in an operating room under general anesthesia. The procedure can take two to four hours to complete. Most patients go home the same day.</p> <p>There is a significant recovery time from a vasectomy reversal, with lifting and pushing restrictions for six to eight weeks. This is because the sutures used in the procedure are finer than a strand of hair and can easily be dislodged.</p> <p>Patients who have had their prostate removed cannot have a vasectomy reversal, but there are other means of treating fertility concerns.</p> <p>Check your insurance coverage if you are considering a vasectomy reversal.</p> <p><em><a href="/providers/david-yang-md" target="_self" title="Opens in same window.">David Yang, M.D.</a>, is a <a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">urologist</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Male infertility (microscopic variocelectomy)</li> <li>Male stress incontinence (male sling, artificial urethral sphincter)</li> <li>Male urethral stricture disease (urethroplasty)</li> <li>Men’s health</li> <li>Men’s sexual medicine (erectile dysfunction, penile prosthesis/prosthetic surgery)</li> <li>Peyronie's disease (penile plication, penile incision and grafting)</li> <li>Robotic surgery</li> <li>Urethral stricture disease</li> </ul>M.D.<p>My goal is for every patient to leave our visit with a newfound understanding of their condition and options for management, and they feel comfortable with the future plan. I try to treat every patient as family, and will deliver information and guidance as such. My clinical interests include urologic oncology and men's sexual health, including erectile dysfunction, Peyronie's disease and male infertility.</p> <p>I grew up in Indianapolis but have lived in Minnesota for the last seven years. In my free time, I like to golf, hike, and spend time with my wife and two Newfoundland dogs.</p><p><strong>Education</strong></p> <ul> <li>Indiana University School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Urology, Mayo Clinic</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Urology, Mayo Clinic School of Graduate Medical Education </li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Andrology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Urology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Urologic Association</li> <li>Sexual Medicine Society of North America</li> <li>Society for the Study of Male Reproduction</li> <li>Society of Genitourinary Reconstructive Surgeons</li> <li>Society of Urologic Prosthetic Surgeons, Inc.</li> </ul>Yang<img src="/-/media/shared-files/images/medical-professionals/full/mankato/david-yang-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=3161395B079F288AA0229E441F6302D1" alt="David Yang, M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/33223428/" target="_blank" title="Opens in new window">The Tubing, Hitch and Lasso, Intussusception Anchor (THALIA) Technique: A novel approach to fixate the penile implant reservoir</a>, January 2021.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/32198103/" target="_blank" title="Opens in new window">Multicenter experience using collagen fleece for plaque incision with grafting to correct residual curvature at time of inflatable penile prosthesis placement in patient’s with Peyronie’s disease</a>, June 2020.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/33676956/" target="_blank" title="Opens in new window">Patient attitudes towards surgical management of Peyronie’s Disease prior to men’s health consultation</a>, June 2020.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/30701330/" target="_blank" title="Opens in new window">Damage control considerations during IPP surgery</a>, January 2020.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/25240762/" target="_blank" title="Opens in new window">Oncologic and quality-of-life outcomes with wide resection in robot-assisted laparoscopic radical prostatectomy</a>, February 2015.</li> </ul>David<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16240391David Yang, M.D.1<img src="/-/media/national-files/images/hometown-health/2022/couple-leaning-on-shoulder.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C94FE9A4BADEBB33E91B4417DF85A5DE" alt="Couple, one leaning on shoulder of the other" width="660" height="370" DisableNVelocity="true" />Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.FertilityFertility issues may be due to a single cause with you or your partner or a combination of factors that may prevent a pregnancy from occurring or continuing. There are multiple safe, effective fertility therapies available.Dawn Haller12/23/2022Popcorn is more than fluffy fun. There's plenty of fiber. Learn how to pop and top this much-loved treat to keep it healthy.Discover popcorn's healthy side<p>When you think of popcorn, you may associate this much-loved comfort food with going to the movies or curling up on the couch for a cozy evening. But we're not the first people to enjoy snacking on these fluffy, crunchy kernels. There's evidence that Native Americans in the Southwestern U.S., and Central and South America ate popcorn more than 2,500 years ago.</p> <h2>More than a fun treat</h2> <p>Yes, popcorn is fun, but it's also healthy. Popcorn is a whole grain and a good source of fiber. And 3 cups of plain, air-popped popcorn weighs in at only about 95 calories. For the healthiest results, pop your corn in an air popper or in the microwave. If using the microwave, put 1/4 cup of kernels in a paper bag, fold the top over twice, and microwave on high for about two minutes, or until the popping slows to about two seconds between pops. </p> <h2>Up your popcorn game</h2> <p>Forget boring old butter and salt, and spice up your popcorn with some new flavorings. Although some include a little oil to help the seasonings stick to the popcorn, go easy on the oil and any sugar because they add calories. Use a sprayer or spritzer to minimize the amount of oil while ensuring an even application. If you're feeling adventurous, try a spritz of citrus juice.</p> <h3>Let these ideas spark your own variations:</h3> <ul> <li>Buffalo sauce or sriracha mixed with a little oil </li> <li>Chili powder and lime zest</li> <li>Cinnamon and a sprinkle of brown sugar</li> <li>Cocoa powder, cayenne pepper, a dusting of powdered sugar and canola oil</li> <li>Curry powder and canola oil</li> <li>Vinegar, garlic powder, onion powder and dill</li> <li>Maple syrup and a handful of chopped pecans</li> <li>Parmesan cheese, garlic powder and pepper </li> <li>Nutritional yeast gives a cheese flavor suitable for vegan diets</li> </ul> <h3>Enjoy this savory popcorn by itself or with tomato or vegetable soup:</h3> <h4>Garlic parmesan popcorn</h4> <p>Serves 1</p> <p>3 cups popped popcorn<br /> 2 tablespoons grated parmesan<br /> 1/4 teaspoon garlic powder (or to taste)</p> <p>Mix garlic powder and parmesan together. When the popcorn is still warm, sprinkle the cheese and garlic mixture over the popcorn, and allow the mixture to melt for a minute or two. Then toss and serve. Try this version with a dash of Italian seasoning or ground pepper.</p> <p>Nutrition for 1 serving (3 cups): 140 calories, 4 grams total fat, 2 grams saturated fat, 21 grams carbohydrates, 180 milligrams sodium, 4 grams fiber, 6 grams protein</p> <h3>Serve this sweet treat after a day of playing outside:</h3> <h4>Cranberry chocolate popcorn</h4> <p>Serves 2</p> <p>6 cups popped popcorn<br /> 2 tablespoons dark chocolate chips<br /> 4 tablespoons dried cranberries<br /> Pinch of salt (optional)</p> <p>In a small glass bowl, microwave the dark chocolate chips until just beginning to melt. Mix well with a rubber spatula until chocolate is about three-quarters melted; some lumps should remain. Place popped popcorn in a medium bowl and top with melted chocolate. Sprinkle with 2 tablespoons dried cranberries and salt (if using), then mix thoroughly. Place the bowl in the refrigerator for 10 minutes to harden the chocolate.</p> <p>Nutrition for 1 serving (3 cups): 215 calories, 6 grams total fat, 3 grams saturated fat, 38 grams carbohydrates, 6 milligrams sodium, 5 grams fiber, 4 grams protein</p> <p>Note: Adding salt will increase the sodium. Using unsweetened or low-sugar dried cranberries will reduce the carbohydrates. White chocolate also pairs well with cranberries.</p> <p><em><a href="/providers/romi-londre-rdn" target="_self" title="Opens in same window.">Romi Londre</a> is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Eating disorders</li> <li>Enteral nutrition or tube feedings</li> <li>Weight management</li> </ul>RDN, CD<p><strong>Education</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Registered Dietitian Nutritionist</li> <li>Certified Nutrition Support Clinician </li> <li>Certificate of Training in Adult Weight Management</li> </ul> <div> </div>Londre<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/romi-londre-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7919B2F8260054ECC4308684471EEEDB" alt="Romi Londre RDN" width="280" height="280" DisableNVelocity="true" />Romi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15183670Romi Londre, RDN, CD1{2BEE5070-65FF-4406-9E59-103E06C5A535}<img src="/-/media/national-files/images/hometown-health/2022/microwave-popcorn-in-bowl.jpg?h=370&iar=0&w=660&sc_lang=en&hash=533B105AAFA2DEA02A5447F7584B2E7F" alt="Microwave popcorn in bowl" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller12/5/2022Any vein can become varicose, including those in the scrotum. Learn how these enlarged, twisted veins can cause pain, uneven development or fertility challenges and how microscopic surgery can help.Enlarged veins can cause pain, infertility<p>Many people have heard of varicose veins before. But it's not just the leg veins that can become twisted, enlarged, and feel achy or itchy. Any vein can become varicose, including veins in the scrotum.</p> <p>About 30% of men have enlarged and twisted veins in their scrotums. These are called varicoceles. They develop when blood pools in the veins instead of circulating out of the scrotum.</p> <img height="208" alt="Scrotal varicocele illustration" width="325" src="/-/media/national-files/images/hometown-health/2022/scrotal-varicocele-illustration.jpg?h=208&w=325&sc_lang=en&hash=02BFF44B666BCEE5BA289AD99D77737E" /> <p>Varicoceles usually develop over time, beginning in puberty, but can occur at any age. It's more common to have a varicocele on the left side of the scrotum because of differences in the vein anatomy. In some patients, they can lead to impaired fertility.</p> <h2>Varicoceles symptoms</h2> <p>For many men, varicoceles cause no symptoms or discomfort. They may not even know they have the condition.</p> <h3>Some signs of varicoceles may include:</h3> <ul> <li><strong>Dull or aching testicle pain</strong><br /> It's more pronounced when you're standing and less when lying down. </li> <li><strong>A mass in the scrotum</strong><br /> It could look like a "bag of worms" if large enough, or only noticeable by touch. </li> <li><strong>Differently sized testicles</strong><br /> Occasionally, the testicle with varicocele can be smaller than the unaffected testicle. </li> <li><strong>Infertility</strong><br /> Challenges conceiving a child can occur due to varicocele's effect on sperm production. </li> </ul> <h2>Difficulties with infertility</h2> <p>Not all varicoceles cause infertility. It's estimated that 10% to 20% of men diagnosed with varicoceles have difficulties fathering a child. About 40% of men with fertility problems have a varicocele.</p> <p>Varicoceles can affect fertility because they can affect the temperature of the testicle. Sperm production is most efficient at a lower temperature, about 4 degrees lower than the average body temperature. This is why the scrotum and testicles are outside the body cavity. Pooling blood in a varicocele can heat the testicles above the optimal temperature, leading to lower sperm counts. Similarly, men with fertility challenges are told to avoid hot tubs and saunas. The cooler testicle temperatures are more conducive to a high sperm count.</p> <h2>Microscopic surgery</h2> <p>Varicoceles that aren't causing pain, discomfort or other symptoms don't need to be treated. However, surgery may be necessary for men with significant testicular pain or low sperm counts affecting fertility; or young boys with delays in testicle growth.</p> <p>Surgery aims to ligate the troublesome veins while preserving adequate blood flow through the arteries feeding the testicle. While the aim is to improve pain or fertility, the appearance of the varicocele may not change after surgery.</p> <p>One type of surgery to treat varicoceles is called microsurgical subinguinal varicocelectomy. During this procedure, the surgeon uses an operative microscope and a doppler probe to assess blood flow through the testicle. The enlarged veins are closed off while the arteries are protected. The procedure usually takes two hours in an operating room.</p> <p>A different procedure option is called embolization. A radiologist injects a coil or solution that scars and closes the troublesome veins, like leg varicose vein treatment.</p> <p>Most varicoceles develop slowly over time. Talk with your health care team if you have concerns about testicular pain or fertility, or if you have a sudden onset varicocele, as it could be a sign of other health conditions.</p> <p><a href="/providers/david-yang-md" target="_self" title="Opens in same window."><em>David Yang, M.D.</em></a><em>, is a <a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">urologist</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Male infertility (microscopic variocelectomy)</li> <li>Male stress incontinence (male sling, artificial urethral sphincter)</li> <li>Male urethral stricture disease (urethroplasty)</li> <li>Men’s health</li> <li>Men’s sexual medicine (erectile dysfunction, penile prosthesis/prosthetic surgery)</li> <li>Peyronie's disease (penile plication, penile incision and grafting)</li> <li>Robotic surgery</li> <li>Urethral stricture disease</li> </ul>M.D.<p>My goal is for every patient to leave our visit with a newfound understanding of their condition and options for management, and they feel comfortable with the future plan. I try to treat every patient as family, and will deliver information and guidance as such. My clinical interests include urologic oncology and men's sexual health, including erectile dysfunction, Peyronie's disease and male infertility.</p> <p>I grew up in Indianapolis but have lived in Minnesota for the last seven years. In my free time, I like to golf, hike, and spend time with my wife and two Newfoundland dogs.</p><p><strong>Education</strong></p> <ul> <li>Indiana University School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Urology, Mayo Clinic</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Urology, Mayo Clinic School of Graduate Medical Education </li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Andrology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Urology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Urologic Association</li> <li>Sexual Medicine Society of North America</li> <li>Society for the Study of Male Reproduction</li> <li>Society of Genitourinary Reconstructive Surgeons</li> <li>Society of Urologic Prosthetic Surgeons, Inc.</li> </ul>Yang<img src="/-/media/shared-files/images/medical-professionals/full/mankato/david-yang-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=3161395B079F288AA0229E441F6302D1" alt="David Yang, M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/33223428/" target="_blank" title="Opens in new window">The Tubing, Hitch and Lasso, Intussusception Anchor (THALIA) Technique: A novel approach to fixate the penile implant reservoir</a>, January 2021.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/32198103/" target="_blank" title="Opens in new window">Multicenter experience using collagen fleece for plaque incision with grafting to correct residual curvature at time of inflatable penile prosthesis placement in patient’s with Peyronie’s disease</a>, June 2020.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/33676956/" target="_blank" title="Opens in new window">Patient attitudes towards surgical management of Peyronie’s Disease prior to men’s health consultation</a>, June 2020.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/30701330/" target="_blank" title="Opens in new window">Damage control considerations during IPP surgery</a>, January 2020.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/25240762/" target="_blank" title="Opens in new window">Oncologic and quality-of-life outcomes with wide resection in robot-assisted laparoscopic radical prostatectomy</a>, February 2015.</li> </ul>David<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16240391David Yang, M.D.1<img src="/-/media/national-files/images/hometown-health/2022/bearded-person-wearing-stocking-cap.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3DBBE0FAA875E48753FE0525C315205F" alt="Bearded person wearing stocking cap" width="660" height="370" DisableNVelocity="true" />Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Dawn Haller12/15/2022Every year, millions of teens in the U.S. experience dating violence, which can lead to lifelong effects on health and well-being. As a parent or caregiver, here's what you need to know.What to know, do if your teen experiences dating violence<p>Dating is a young person's first foray into the world of intimate relationships. But every year, millions of teens in the U.S. experience dating violence, which can lead to lifelong effects on health and well-being.</p> <p>Intimate partner violence in teens, which can include physical, emotional and sexual abuse, is a common adolescent health problem. According to a 2019 survey by the <a rel="noopener" href="https://www.cdc.gov/intimate-partner-violence/about/about-teen-dating-violence.html" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention</a>, 1 in 12 high school students experienced physical dating violence, and 1 in 12 experienced sexual dating violence. Sexual, racial and ethnic minority groups are disproportionately affected by many types of violence.</p> <h2>Effect on your teen's health</h2> <p>Teen dating violence is associated with unintended teen pregnancy, sexually transmitted infections, injuries, substance use, poor mental health and thoughts of suicide. It also sets the stage for future relationship problems and the potential for being a victim or perpetrator of intimate partner violence.</p> <h2>Identifying teen dating violence</h2> <h3>Whether in person or electronically, teen dating violence can include:</h3> <ul> <li>Intimidation</li> <li>Stalking </li> <li>Emotional and verbal abuse</li> <li>Bullying </li> <li>Physical injury</li> <li>Forced sexual contact</li> <li>Reproductive coercion, which is pressuring a partner to become pregnant or manipulating birth control attempts</li> <li>Isolation</li> <li>Controlling partner behaviors, such as demanding constant access to a partner; frequently checking the partner's text messages, social media sites and cellphone; as well as texting or posting sexual pictures of a partner online.</li> </ul> <h2>Is your teen's relationship healthy or unhealthy?</h2> <h3>According to youth.gov, signs of a healthy relationship include:</h3> <ul> <li>Mutual respect</li> <li>Trust</li> <li>Honesty</li> <li>Individuality and identity</li> <li>Compromise</li> <li>Good communication</li> <li>Problem-solving</li> <li>Anger control</li> <li>Understanding</li> <li>Self-confidence</li> </ul> <h3>Signs that a relationship is unhealthy include:</h3> <ul> <li>Hostility, anger, jealousy, loss of control of emotions</li> <li>Controlling or pressure in decision-making, being possessive or isolating</li> <li>Jealousy</li> <li>Dishonesty and mistrust</li> <li>Disrespect, putting a partner down or "making fun of"</li> <li>Poor boundaries</li> <li>Dependence or co-dependence </li> <li>Intimidation</li> <li>Physical violence</li> <li>Sexual violence or pressuring sexual activity</li> </ul> <h2>What parents can do</h2> <p>Parents play an important role in promoting healthy relationships from an early age, supporting teens as they navigate their early relationships, and recognizing teen dating violence among children and their peers.</p> <h3>Here are some things to consider:</h3> <ul> <li><strong>Take part in community activities.</strong><br /> Teenagers who are involved in community groups, sports and other activities are less likely to take part in violence.</li> <li><strong>Promote healthy use of the internet and social media applications.<br /> </strong>This includes balancing internet and phone use with activities that don't involve the internet and phone, as well as boundaries and communication with parents. <a rel="noopener" href="https://www.healthychildren.org/English/family-life/Media/Pages/default.aspx" target="_blank" title="Opens in a new window.">Learn more about healthy internet use</a>.</li> <li><strong>Talk to your teens about healthy relationships.<br /> </strong>For information on dating and sex, check out <a rel="noopener" href="https://www.healthychildren.org/English/ages-stages/teen/dating-sex/Pages/default.aspx" target="_blank" title="Opens in a new window.">healthychildren.org</a>.</li> <li><strong>Role-model healthy relationships.</strong><br /> Show your children what it means to be in a healthy relationship. This includes demonstrating loving and peaceful conflict resolution with friends and partners.</li> <li><strong>Recognize signs of an unhealthy relationship.</strong><br /> If your teen shows signs that he or she may be in an abusive or violent relationship, talk to him or her about it and get help. Your health care team can connect you and your teen with resources for developing more positive relationships and getting out of relationships that are potentially dangerous.</li> <li><strong>Empower your teen to intervene.</strong><br /> Encourage all teenagers to be "positive upstanders" when they see peers who are displaying disrespectful, harmful or violent behaviors. Becoming an upstander is about moving from silence to action. Let your teen know it's OK to speak out or take actions to stop bullying behaviors.</li> <li><strong>Help your teen resist sexual pressure.</strong><br /> "<a rel="noopener" href="https://www.healthychildren.org/English/ages-stages/teen/dating-sex/Pages/Helping-Teens-Resist-Sexual-Pressure.aspx" target="_blank" title="Opens in a new window.">Helping Teens Resist Sexual Pressure</a>," an article from the American Academy of Pediatrics, outlines strategies for parents and teens.</li> <li><strong>Consider counseling or psychotherapy.</strong> The <a rel="noopener" href="https://www.aacap.org/" target="_blank" title="Opens in a new window.">American Academy of Child and Adolescent Psychiatry</a> has resources for managing mental health symptoms, trauma and abuse.</li> </ul> <h2>What teens can do</h2> <h3>These strategies can help teens avoid an abusive relationship:</h3> <ul> <li>Respect your partner and yourself.</li> <li>Set healthy boundaries in your relationship.</li> <li>Have a life, friends and family outside of your relationship.</li> <li>Resolve disagreements with your significant other with love and respect.</li> <li>Recognize healthy and unhealthy relationships.</li> <li>Stand up when you see signs of abuse.</li> <li>Know your supports in your family and community.</li> <li>Seek counseling or therapy services if you feel you need help.</li> </ul> <p>Sometimes seeking help can be difficult when you or a friend is in a violent or abusive relationship. If you or your friend are involved in an abusive or violent relationship, ask an adult for help. Your parents, health care professional and teachers are good places to start.</p> <h2>Other resources for parents and teens</h2> <ul> <li><a rel="noopener" href="https://www.cdc.gov/intimate-partner-violence/about/about-teen-dating-violence.html#cdc_behavioral_basics_prevention-prevention" target="_blank" title="Opens in a new window.">Preventing teen dating violence</a></li> <li><a rel="noopener" href="https://www.healthychildren.org/English/ages-stages/teen/dating-sex/Pages/Dating-Violence-Tips-for-Parents.aspx" target="_blank" title="Opens in a new window.">Signs of teen dating violence</a></li> <li><a rel="noopener" href="https://www.aacap.org/" target="_blank" title="Opens in a new window.">American Academy of Child and Adolescent Psychiatry</a></li> </ul> <p><a href="/providers/patrick-bigaouette-md" target="_self" title="Opens in same window."><em>Patrick Bigaouette, M.D.</em></a><em>, is a psychiatrist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Anxiety disorders</li> <li>LGBTQIA+ populations</li> <li>Medical education</li> <li>Mood disorders</li> <li>Peripartum psychiatry</li> <li>Psychopharmacology</li> <li>Trauma- and stressor-related disorders</li> <li>Women's health</li> </ul>M.D.<p>I enjoy working with patients in managing a wide spectrum of psychiatric disorders across psychosocial stages of life. I work in a collaborative, shared decision-making approach based on biologic, psychologic and social factors. My goal is to provide high-quality, evidence-based, patient-centered care to achieve the best possible outcomes in managing psychiatric distress.</p> <p>Outside of my clinical work, I am passionate about medical education and enjoy working with resident physicians and students.</p> <p>In moving back to Minnesota from the East Coast, I enjoy staying active outdoors, going to local theater, and I am always open to book recommendations.</p><p><strong>Education</strong></p> <ul> <li>Georgetown University School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Psychiatry, Mount Sinai-Beth Israel, Icahn School of Medicine at Mount Sinai</li> </ul> <p> <strong>Residency</strong> </p> <ul> <li>Psychiatry, Mount Sinai-Beth Israel, Icahn School of Medicine at Mount Sinai, New York</li> </ul> <p><strong>Certification</strong> </p> <ul> <li>Psychiatry, American Board of Psychiatry and Neurology </li> </ul> <p><strong>Membership</strong> </p> <ul> <li>American Psychiatric Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Psychiatry, Mayo Clinic College of Medicine and Science</li> </ul>Bigaouette<img src="/-/media/shared-files/images/medical-professionals/full/mankato/patrick-bigaouette-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4A09A81BD845D197A88A6FB7DC116F24" alt="Patrick Bigaouette MD" width="280" height="280" DisableNVelocity="true" />Patrick<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30014612Patrick Bigaouette, M.D.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2022/teen-dating-couple.jpg?h=370&iar=0&w=660&sc_lang=en&hash=53D56A1191E6B9907DB265F6D1569C81" alt="Teen dating couple" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Dawn Haller12/27/2022If you get a twinge or ache when lifting your arm, it could be caused by anything from arthritis to tendonitis to a rotator cuff tear. Learn how an orthopedic professional can provide relief.Why does my shoulder ache?<p>If you find yourself rubbing your shoulder after reaching up to take a coffee mug off the shelf, hammering in a nail just over your head or climbing into a pickup cab, you're among millions of Americans — particularly those over 60 — with a shoulder issue. Shoulder pain could be a sign of arthritis, tendonitis, a rotator cuff tear or shoulder instability.</p> <p>Whatever the cause, you may want to consult with an orthopedic professional. That first meeting will include a health history, physical exam and possibly an X-ray to determine the underlying cause and extent of your shoulder issue. Sometimes additional imaging, such as an MRI, may be needed.</p> <p>Your orthopedic professional will walk you through treatment options and help you decide what may be the best for you.</p> <h2>The first line of treatment can include:</h2> <ul> <li>Taking over-the-counter anti-inflammatory medications</li> <li>Resting of the affected shoulder and arm</li> <li>Icing the shoulder</li> <li>Modifying your activities to avoid further injury</li> <li>Undergoing steroid injections</li> <li>Doing physical therapy to strengthen the muscles of the shoulder and arm</li> </ul> <p>Many studies show that people with shoulder injuries respond well to these treatments and are able to go about their daily activities. However, if you're still experiencing pain and weakness, your orthopedic professional may recommend surgery.</p> <p>One cause of pain and weakness is a rotator cuff tear. The rotator cuff is a group of muscles and tendons. It holds the shoulder joint in place and assists in arm motion and strength. If the MRI reveals a tear in the rotator cuff, it may require surgery, although the vast majority don't.</p> <p>Surgery typically is outpatient, and you can go home the same day. In this procedure, the surgeon inserts a tiny camera called an arthroscope and tools through small incisions to reattach the torn tendon to the bone. You may need to wear a sling for four to six weeks following surgery to allow your shoulder to heal.</p> <p>After four to six weeks, you may still have some work restrictions and need to modify your activity. Your orthopedic professional also may recommend physical therapy.</p> <p>Whether you respond to noninvasive treatments or need surgery, your orthopedic professional's goal is to relieve your aching shoulder so you can go about your daily activities without pain or restrictions.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/reaching-stacking-orange-hose.jpg?h=370&iar=0&w=660&sc_lang=en&hash=082AE40DE66E3B6CCC7BE6D3A21E8C51" alt="Reaching stacking orange hose" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller1/12/2023Meaty, nutty chickpeas, also known as garbanzo beans, can pump up protein and lower saturated fat in your diet. Discover how they can be a year-round, versatile addition to healthy dishes.Check out chickpeas for year-round healthy eating<p>If you're interested in learning more about plant-based proteins or a whole-food eating plan, check out chickpeas. Also known as garbanzo beans, chickpeas may not be as familiar to you as other legumes, like black beans and green peas. They're a nutrient powerhouse, budget-friendly protein and versatile choice for year-round healthy eating.</p> <h2>Naturally low in saturated fat, loaded with nutrients</h2> <p>Nearly three-quarters of Americans exceed the daily recommended amount of saturated fat, much of which comes from animal-based proteins, such as beef, pork and full-fat dairy products. One of the best ways to lower saturated fat intake is to add more plant-based proteins, including chickpeas, to your diet.</p> <p>While naturally low in saturated fat, chickpeas are nutrient-dense. They provide nearly 20 grams of protein in a ½-cup serving and 5 grams of dietary fiber. Chickpeas also are a source of folate, iron, vitamin C and phosphorus.</p> <h2>Budget-friendly, easy to prepare</h2> <p>Aside from being a nutritional powerhouse, chickpeas are relatively inexpensive and easy to prepare. If you buy them canned, rinse them in cold water to remove excess salt.</p> <h3>You also can buy dried chickpeas. There are two simple ways to rehydrate them:</h3> <ol> <li>Rinse the chickpeas, place in a large pot and cover with 3-4 inches of cold water. Cover the pot and let stand overnight. Drain. </li> <li>Fill a large pot with water, add the chickpeas and bring to a boil. Cook for 45 minutes to an hour, stirring occasionally and adding water as needed. Drain.</li> </ol> <p>Keep in mind that chickpeas double in size when rehydrated.</p> <h2><strong>Year-round versatility</strong></h2> <p>Chickpeas are found in many cuisines. Stir them into soups, stews and pasta dishes, toss in salads or puree for a healthy appetizer.</p> <h3>These three recipes from Mayo Clinic showcase the year-round versatility of chickpeas:</h3> <h4>Homemade hummus</h4> <p>Serve as a dip or side dish, or add to sandwiches or salads. Change up this basic recipe with sun-dried tomatoes, cumin, garlic or roasted red peppers.</p> <p>Makes 14 1/4-cup servings</p> <p>2 15-ounce cans of chickpeas, drained (reserve ¼ cup of the chickpea liquid)<br /> 1 tablespoon extra-virgin olive oil<br /> 3 tablespoons of tahini (sesame paste)</p> <p>Add chickpeas and olive oil to a blender or food processor, and puree until smooth. Add tahini and mix well. Add reserved liquid as needed until the mixture has the consistency of a thick spread. </p> <p>Nutrition for ¼ cup: 88 calories, 4 grams total fat, less than 1 gram saturated fat, 9 grams carbohydrates, 3 grams fiber, 4 grams protein</p> <h4>Gazpacho with chickpeas</h4> <p>This soup is served cold and makes the most of fresh summer veggies.</p> <p>Serves 6</p> <p>1 15-ounce can chickpeas, rinsed and drained<br /> 6 cups unsalted vegetable juice<br /> 1 cup (about 16) cherry tomatoes, quartered<br /> ½ cup chopped, seeded cucumber<br /> ¼ cup chopped, red onion<br /> ¼ cup chopped, fresh cilantro or parsley<br /> ¼ teaspoon hot pepper sauce<br /> 1 to 3 garlic cloves, minced<br /> ¼ cup lime juice<br /> 6 lime wedges</p> <p>In a large bowl, add the chickpeas, vegetable juice, tomatoes, cucumber, onion, cilantro, hot pepper sauce, garlic and lime juice. Stir well. Cover and place in the refrigerator for at least 1 hour or until well-chilled. To serve, ladle the cold soup into chilled bowls and garnish with a lime wedge.</p> <p>Nutrition for 1 1/2 cups: 125 calories, 24 grams total carbohydrates, 5 grams fiber, 156 milligrams sodium, 1 gram total fat, 7 grams protein</p> <h4>Linguine with chickpeas and arugula</h4> <p>Arugula is a peppery, tart, leafy green popular in Italian dishes.</p> <p>Serves 4</p> <p>6 ounces whole-grain linguine or spaghetti<br /> 1/2 tablespoon olive or canola oil<br /> 1 cup fresh or frozen stir-fry vegetables (onions and green, red and yellow peppers), chopped<br /> 3 cloves garlic, minced<br /> 1 15-ounce can unsalted garbanzo beans, drained<br /> 1/4 teaspoon crushed red pepper<br /> 1 lemon, juiced and zested<br /> 1 cup shredded Parmesan cheese<br /> 4 ounces (about 4 cups) arugula or baby spinach, coarsely chopped</p> <p>Cook linguine for 5 minutes in boiling water. Drain, reserving 2 cups cooking water. In a large skillet, heat oil over medium-low heat. Add stir-fry vegetables and garlic. Cook for 3 minutes. Add the pasta, cooking water, chickpeas, crushed red pepper, lemon zest and lemon juice to skillet. Cook for about 5 minutes or until the pasta is al dente. Remove pan from heat and stir in cheese and arugula or spinach. Toss to combine until greens are wilted.</p> <p>Nutrition for 1 1/2 cups: 374 calories, 51 grams carbohydrates, 20 grams protein, 9 grams fiber, 10 grams total fat, 459 milligrams sodium</p> <p><em><a href="/providers/caitlin-terpstra-rdld" target="_self" title="Opens in same window.">Caitlin Terpstra</a> is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2022/spoonful-of-soup-with-chickpeas.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B117EE7A873D3D35A7FC76D95A7A194B" alt="Spoonful of soup with chickpeas" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller1/26/2023Up to 80% of people with dementia experience pain. Learn how to recognize it and advocate for pain management for your loved one.Dementia-related pain: What caregivers need to know<p>Dementia isn't a specific disease. Instead, it describes a collection of symptoms that affect a person's thinking and social abilities enough to interfere with daily life. There are more than 55 million people worldwide living with dementia. Of these, 50% to 60% have Alzheimer's disease. Dementia is the seventh leading cause of death worldwide.</p> <p>There is a constellation of dementia symptoms, and memory loss is the primary feature. Other common symptoms are physical functional decline and difficulty with mental tasks, like planning or spatial ability. Pain is another frequent symptom, although it is often overlooked and undertreated.</p> <h2>Dementia-related pain</h2> <p>As dementia progresses, so does the likelihood that patients are experiencing pain. Between 50% and 80% of patients with moderate to severe dementia experience pain daily. Many patients receive inadequate treatment due lack of recognition. Alzheimer's disease causes the person to develop a mask-like facial expression. This minimizes typical facial expressions of pain, like a drawn mouth or furrowed brows. Also, patients may have lost the cognitive ability to tell caregivers about their pain with phrases such as "this hurts" or "I am in pain."</p> <p>Unfortunately, many patients with dementia are left with only basic expressions of pain presented through negative behaviors. These include screaming, cursing or striking out, particularly at caregivers.</p> <p>Untreated pain also may cause patients to become more withdrawn or fatigued. This may be due to their discomfort or lack of solid sleep. Even though patients may feel drowsy and sleep more than before, their sleep is disturbed and not restorative. Patients may become more alert and interactive once their pain is treated, even if medications have a possible side effect of drowsiness.</p> <p>Importantly, there is a marked increase in caregiver stress in those caring for patients experiencing pain.</p> <h2>Types of dementia-related pain</h2> <p>Chronic pain is pain that lasts longer than three months. It is associated with cognitive, emotional and social decline. The link between chronic pain and Alzheimer's disease is widely accepted despite not being fully understood.</p> <p>Chronic pain affects some of the same areas of the brain that are affected by Alzheimer's disease. The changes occur in the area called locus coeruleus and affect a chemical messenger called norepinephrine. As this messenger is released, it causes the pain-relaying cells in the brain to become inflamed.</p> <p>The degree of cognitive decline in a patient with Alzheimer's can be directly correlated with the severity of pain experienced. This means that a patient that does not have another apparent known cause of pain could still be experiencing significant pain. This is likely due to the neuroinflammation in the brain.</p> <p>Other causes of pain include previous injuries and areas of surgery. Perhaps the patient had a knee or hip replacement or a tennis elbow injury when younger. These former injuries or conditions can become painful as patients become less mobile. Joints can become stiff and sore when not used regularly. The patient may avoid being repositioned or using painful body parts. This can contribute to developing contractures, which is the tightening of muscle, skin, tendons and tissues. Pressure ulcers can develop from spending a significant amount of time in the same position and lead to pain.</p> <p>Other medical conditions, like cancer, heart disease or kidney disease, can cause pain. These types of pain can be more difficult to assess. Caregivers may not realize the disease has worsened because patients cannot verbally express how they are feeling. Swelling or other symptoms may not be easily noticed if the person is bedridden. And patients have a hard time expressing nuanced symptoms like chest or flank pain.</p> <p>Finally, mental pain can be exasperated by dementia. Patients may experience significant loss or grief, even when confused or disoriented. This can lead to social, spiritual or emotional pain, which is felt physically like other types of pain.</p> <h2>Assessing pain</h2> <p>Patients often are asked to rate their pain on a scale of 1 to 10. This isn't an option for patients with moderate to severe dementia. They're not able to verbally express or rate their pain or discomfort.</p> <p>The Pain Assessment in Advanced Dementia Scale (PAINAD) was developed to assess pain and reduce the likelihood that it is unrecognized and untreated. It's easy to learn and use by people without prior medical training and does not require the patient to have language skills.</p> <img alt="PAINAD scale" width="100%" src="/-/media/national-files/images/hometown-health/2023/painad-scale.jpg?sc_lang=en&hash=456BC98D67B40E7CC6A040BB7E0F0013" /> <h2>Medication treatment</h2> <p>When treating pain, health care teams always want to prescribe the lowest dose of medication. Narrowing in on the type of pain that a patient is experiencing helps achieve this goal. For example, a patient likely has neuropathic pain if the pain burns, tingles or travels from one area to another. This requires medications that are specific to the nervous system. Other medications are used to treat inflammation.</p> <p>Some pain is caused by many things, such as cancer pain. This may require several medications, each with a specific role. When used together, lower doses of each medication may be all that is necessary to ease the pain. This is referred to as multimodal pain therapy.</p> <h2>Nonmedication treatment</h2> <p>Sometimes, pain medication is not necessary, and patients can get pain relief through other treatments.</p> <p>Massage can be beneficial and ease the pain. A caregiver doesn't need to be a trained massage therapist to help. If you know that your grandmother had a knee replacement and her knee feels warm or swollen, gently massage it and gauge her reaction. She may not be able to tell you that it feels good, so watch if her body position and facial expression relax and her breathing slows. These physical cues will help you know that what you are doing is helpful.</p> <p>Music therapy is a beautiful approach to pain management. You don't need to be a trained music therapist, as just knowing what grandpa liked to listen to in his youth can help. Playing music can distract him temporarily and release natural endorphins to reduce pain. Music also can help orient patients and bring pleasant feelings and memories.</p> <p>Other treatments could include aromatherapy, a visit from a pet therapy animal or drawing with your loved one. Families can do these activities together with no additional training needed.</p> <p>Finally, don't underestimate the power of repositioning. If your loved one looks uncomfortable, gently shift him or her into a new position. Watch for relaxed facial expressions or body language to ensure the new position feels better. Frequent position changes enhance comfort and improve blood flow to the skin, which protects against pressure sores.</p> <h2>Caregiver tips</h2> <p>Caregivers play an important role in assessing pain and advocating for treatment.</p> <h4>Understand how to assess signs or symptoms of pain using the PAINAD scale and follow the ALTAR acronym to address potential pain in your loved one with dementia:</h4> <ul> <li><strong>Anticipate</strong><br /> Expect that your loved one with dementia will experience pain at some point. Be proactive early in the disease process to help ensure pain is not left untreated. Familiarize yourself with the PAINAD scale. Be prepared to advocate for your loved one through caregiver education and physician visits. Review advocacy tips.</li> <li><strong>Look</strong><br /> Watch for common causes of pain. Look, touch, listen and think about the different types of pain your loved one may be experiencing. Inspect your loved one's mouth for oral sores due to decay or ill-fitting dentures. Inspect feet for skin lesions or issues from ingrown toenails. Do you see your loved one wince or guard against gentle pressing on the abdomen? Feel large joints, like knees and hands. Do they feel warm or is one swollen? Does your loved one appear more comfortable in certain positions?</li> <li><strong>Treat</strong><br /> Review nonmedication treatment options and incorporate these into your care. Bring music from their youth, massage sore joints or color together. Talk with the health care team about any concerns and if medications are necessary.</li> <li><strong>Avoid comparisons</strong><br /> It's easy to compare your loved ones today to past selves. This is not helpful and should be avoided. People with dementia don't process pain in the same way they did before their diagnoses. Your loved one may have bragged about having a high pain tolerance in the past but is experiencing pain differently now. Medications and other treatments may be necessary.</li> <li><strong>Revisit</strong><br /> Treatments that worked last week may not work today. A few "good days" does not mean the pain is under control over the long term. Consistently revisit the types of pain, treatments, positioning, time of day and other factors affecting your loved one's pain.</li> </ul> <h2>Advocacy tips</h2> <p>Caregivers play an important role in advocating for their loved ones' pain management, especially if they cannot advocate for themselves.</p> <p>Follow these tips when navigating appointments, hospital stays and long-term care needs:</p> <ul> <li>Attend all appointments or hospital rounds.</li> <li>Write down questions and topics you want to discuss with the care team.</li> <li>For sensitive topics, send questions to the care team before the appointment or ask to speak in private.</li> <li>Ask about the different types of pain and explain previous injuries or chronic conditions that could contribute to pain levels.</li> <li>Document your loved one's baseline functionality and the changes you witness.</li> <li>Document pain levels often and note the time of day, position, mood, etc.</li> <li>Make sure your loved one wears needed eyeglasses, dentures, hearing aids or other assisted devices.</li> <li>Bring comfort items, like your loved one's favorite blanket, to appointments.</li> </ul> <p>Most patients with moderate to severe dementia, including Alzheimer's disease, experience pain. Work with your loved one's care team to get the pain under control. This will increase comfort and peace of mind while decreasing outbursts, aggression, withdrawal and delirium.</p> <p><a href="/providers/jennifer-winegarden-do" target="_self" title="Opens in same window."><em>Jennifer Winegarden, D.O.</em></a><em>, is a physician in <a href="/services-and-treatments/palliative-care" target="_self" title="Opens in same window.">Palliative Care</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Acute- to chronic-pain neurophysiology</li> <li>Dementia-related pain and contractures</li> <li>Noninvasive pain medicine</li> <li>Opioid-induced hyperalgesia</li> </ul>D.O.<p>I have dedicated the last 15 years of practice to providing relief of symptoms for patients with serious disease. Whether patients are receiving ongoing treatments for a current problem or have not recovered from a previous illness, symptom control can be a high priority. Working with a team of committed professionals, I strive to improve the patient’s quality of life based on their individual goals.</p><p><strong>Education</strong></p> <ul> <li>Michigan State University College of Osteopathic Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Rotating, Garden City Hospital</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Garden City Hospital</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Family Medicine, American Academy of Osteopathic Family Physicians</li> <li>Hospice & Palliative Medicine, American Academy of Osteopathic Family Physicians</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Hospice & Palliative Medicine</li> <li>American Academy of Pain Medicine</li> <li>American College of Osteopathic Family Medicine</li> <li>American Osteopathic Association</li> </ul>Winegarden<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/jennifer-winegarden-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=1D5410BA7661DF6ECCB035FE9054DCD3" alt="Jennifer Winegarden, D.O." width="280" height="280" DisableNVelocity="true" />{F2AB5DBB-AF52-47CD-8C27-EEF2575B60CB}Jennifer<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30177101Jennifer Winegarden, D.O.1{DE2DF507-F890-423E-9BCC-5A4E8001261F}<img src="/-/media/national-files/images/hometown-health/2023/hands-holding-hand-with-ring.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E32DE393C0E1756B2D7A02AD10D5C31E" alt="Hands holding hand with ring" width="660" height="370" DisableNVelocity="true" />Dementia/Alzheimer's DiseaseDementia isn't a specific disease. Instead, dementia describes a group of symptoms affecting thinking and social abilities severely enough to interfere with daily functioning. Many causes of dementia symptoms exist. Alzheimer's disease is the most common cause of a progressive dementia. Palliative CarePalliative care offers pain and symptom management, and emotional and spiritual support when you face a chronic, debilitating or life-threatening illness.AgingLife expectancy is 75 for males and 80 for females according to the National Center for Health Statistics. We'll help you keep you informed about potential issues with aging, and steps you can take to maintain your health and keep active.Pain ReliefApproximately 50 million people in the U.S. live with chronic pain. If you experience chronic pain, you're not alone. Learn about the ways to deal with painful disorders, from at-home solutions to drug treatments, injectable or implantable therapies to surgery.Dawn Haller1/16/2023If you experience excruciating heel pain when taking those first steps in the morning, think plantar fasciitis. This common condition is easily treated. Learn who's susceptible and how to get relief.Heel pain? It might be plantar fasciitis<p>"My heel is killing me!" is without a doubt one of the most common sentences uttered in podiatry offices worldwide. Heel pain can range from slightly uncomfortable to utterly debilitating. Most often, it's caused by plantar fasciitis.</p> <p>The plantar fascia is a band of tissue extending from the heel to the ball of the foot. Plantar fasciitis is caused by excessive stress, which brings on inflammation and, typically, heel pain.</p> <p>Plantar fasciitis can affect anyone. However, it's most common in middle-aged, active adults. Other risk factors include obesity, occupations that require you to be on your feet all day and flat feet or high arches.</p> <p>The primary signs of plantar fasciitis include excruciating heel pain when you take your first steps in the morning, recurring pain when standing up from a seated position and pain associated with standing for a long time.</p> <p>The great news about plantar fasciitis is that it's highly treatable. Early detection makes the condition more manageable and prevents further complications. If left untreated, plantar fasciitis can lead to various problems caused by compensating for the discomfort, including knee, hip and back pain.</p> <h2>Nonsurgical treatment often has satisfactory results and includes:</h2> <h3>Rest</h3> <p>Pain is the body's way of warning you something is wrong. Listen to your body and avoid activities that make the pain worse, such as running, hiking or dancing.</p> <h3>Stretching</h3> <p>Your podiatrist will give you a list of stretches that reduce tension on the plantar fascia and help with healing. Tight calf muscles often play a role in heel pain.</p> <h3>Ice</h3> <p>Place ice on the heel for 20 minutes, three to four times a day. Ice therapy is a wonderful way to decrease inflammation and manage pain.</p> <h3>Medication</h3> <p>Pain relievers, such as ibuprofen and naproxen, can help decrease inflammation and speed healing.</p> <h3>Night splint</h3> <p>These sock-like wraps with built-in supports help stretch the plantar fascia while you're sleeping or resting. A splint can help alleviate pain experienced with those first few steps in the morning.</p> <h3>Orthotics and shoes</h3> <p>Adequate arch support is essential when treating plantar fasciitis. Discuss with your podiatrist whether over-the-counter or custom orthotic inserts are right for you. In addition, avoid going barefoot and choose supportive, hard-soled shoes, such as sneakers. </p> <p>Surgical treatment isn't recommended often and is reserved for those not responding to conservative treatment. To prevent recurrence of plantar fasciitis, stretch properly before exercising and wear supportive shoes if you'll be on your feet for a long time.</p> <p><a href="/providers/stephanie-kvas-dpm" target="_self" title="Opens in same window."><em>Stephanie Kvas, D.P.M.</em></a><em>, is a <a href="/services-and-treatments/podiatry" target="_self" title="Opens in same window.">podiatrist</a> in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a> and <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><ul> <li>Ankle arthroscopy</li> <li>Arthritic conditions</li> <li>Bunion surgery</li> <li>Community education and outreach</li> <li>Community health and wellness</li> <li>Diabetic wound care</li> <li>Flatfoot reconstruction</li> <li>Hammertoe surgery</li> <li>Limb salvage</li> <li>Pediatric foot and ankle conditions</li> <li>Reconstructive foot and ankle surgery  </li> <li>Sports injuries</li> <li>Traumatic fracture care</li> </ul>D.P.M. <p>I am committed to developing a meaningful patient-doctor relationship with each of my patients. I encourage patients to take an active role in their medical care and work with them to select a treatment plan that is right for them. </p> <p>As a Minnesota native, I'm exceptionally excited to join Mayo Clinic Health System in New Prague. My extensive training in reconstructive foot and ankle surgery has prepared me for my role as a surgical podiatrist at Mayo Clinic Health System. </p> <p>I look forward to providing foot and ankle care to the region and being an active member of the community. </p><p><strong>Education</strong></p> <ul> <li>Midwestern University Arizona College of Podiatric Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Podiatric Medicine & Surgery, Reconstructive Rearfoot/Ankle, Hennepin County Medical Center</li> </ul> <p><strong>Certification</strong></p> <ul> <li>State of Minnesota Board of Podiatric Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Foot and Ankle Surgeons</li> <li>American Podiatric Medical Association</li> <li>Minnesota Podiatric Medical Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Podiatric Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Kvas<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/stephanie-kvas-dpm.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A7F1FBFFDD180559BD4211C661476E99" alt="Stephanie Kvas DPM" width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Utilization+of+Fluorescence+Microangiography+in+Pediatric+Acute+Compartment+Syndrome%3A+A+Case+Report" target="_blank" title="Opens in new window. ">Utilization of Fluorescence Microangiography in Pediatric Acute Compartment Syndrome: A Case Report</a>, January 2020</li> <li><a rel="noopener noreferrer" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Utilization+of+Fluorescence+Microangiography+in+Pediatric+Acute+Compartment+Syndrome" target="_blank" title="Opens in new window. ">Utilization of Fluorescence Microangiography in Pediatric Acute Compartment Syndrome: A Case Report</a>, February 2019</li> </ul>{ED85D0D4-A69F-4AFC-8DF7-CC90B84DFB35}Stephanie <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21681643Stephanie Kvas, D.P.M.1{D170DE7F-251A-4290-9CC3-0A9B8D67B28A}<img src="/-/media/national-files/images/hometown-health/2022/rolling-foot-bottom-on-ball.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CDA0F78E3AABEA04813391F49FB5D5E1" alt="Rolling foot bottom on ball" width="660" height="370" DisableNVelocity="true" />Foot HealthPodiatry is a branch of medicine devoted to the study of diagnosis, medical and surgical treatment of disorders of the foot, ankle and lower extremity.Dawn Haller1/27/2023The icy grip of winter is blanketing much of the U.S. Learn how bitter cold temperatures affect the lungs and what you can do to protect yours when outdoors.Is the extreme cold bad for your lungs?<p>Winter weather can impact travel plans when snow falls and temperatures drop to below zero digits. And when you have to be outside in extremely cold temperatures, it's common to experience discomfort or a burning sensation from breathing in those bitter-cold temperatures.</p> <h2>Can freezing temperatures freeze your lungs?</h2> <p>Your body does its best to keep your core temperature between 97 and 99 degrees Fahrenheit, and your lungs are encased within the thoracic cavity. Unless your whole body is at risk, freezing your lungs should not be a risk.</p> <p>Your body is well-designed to adapt to cold air. There are many mechanisms that allow for warming and humidification of the air before it hits your lungs, where a gas exchange happens. Cold air is generally drier, and your body works to humidify this. In that process, it can cause irritation to the airways, which results in a process called bronchospasm, where those airways narrow and tighten, and you get that feeling of shortness of breath.</p> <h2>How does breathing in cold weather affect those with chronic lung disease?</h2> <p>The extreme cold air can be dangerous for anyone, but the cold can make things worse for those with chronic lung diseases, such as chronic obstructive pulmonary disease, or COPD. With emphysema, for instance, the cold air can cause spasms in the bronchial passage, making breathing more difficult.</p> <p>People with respiratory disease, whether that's asthma, COPD or other lung diseases, are more prone to aggravated symptoms if facing cold winter conditions. The best thing they can do to protect themselves is to be prepared, whether that's having an extra supply of their inhaler regiment for a few days in case of an emergency or having an emergency generator for their medical equipment, such as ventilators, CPAP machines or oxygen concentrators.</p> <h2>Breathing safely in cold weather</h2> <h3> If you have to be outside, follow this breathing advice:</h3> <ul> <li><strong>Breathe in through your nose and exhale through your mouth.</strong><br /> Your nose does a better job at humidifying and warming the air than your mouth.</li> <li><strong>Wear a ski mask or scarf to wrap around your nose and mouth.</strong><br /> These items can trap some of the heat and moisture from your breath.</li> <li><strong>Avoid exercising outside.</strong><br /> Breathing heavier during exercise in cold weather can increase symptoms of asthma, COPD or chronic lung conditions.</li> </ul> <p><a href="/providers/aryan-shiari-md" target="_self" title="Opens in same window."><em>Aryan Shiari, M.D.</em></a><em>, is a <a href="/services-and-treatments/pulmonology" target="_self" title="Opens in same window.">pulmonologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em> </p><ul> <li>Asthma and chronic obstructive lung disease</li> <li>Endobronchial ultrasound (EBUS) bronchoscopy</li> <li>Mechanical ventilation</li> <li>Medical education</li> <li>Pulmonary complications of hematopoietic stem cell transplantation</li> <li>Thoracic oncology, including diagnosis and management of lung nodules, masses and tumors</li> </ul>M.D.<p>My role as a doctor is to help you achieve your health and life goals. That involves knowing all the latest medical practices and presenting them clearly and concisely, without medical jargon. I believe the most crucial part of developing a successful doctor-patient relationship includes active listening, treating you with empathy, and responding honestly to your questions and concerns.</p> <p>As a pulmonologist, I specialize in treating various lung diseases, such as asthma, chronic obstructive pulmonary disease, or COPD, and diagnosing and managing lung nodules. My clinical practice includes outpatient consultative appointments and caring for hospitalized patients with complex lung diseases. I also specialize in critical care medicine, and provide care through diagnosis, treatment and support of critically ill patients.</p> <p>During my free time, I enjoy reading, hiking, game nights with family and friends, and participating in soccer.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Biochemistry, University of Ottawa</li> <li>St. George’s University School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Ascension St. John’s Hospital</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Clinical Educator Track Fellow, Wayne State University School of Medicine</li> <li>Pulmonary and Critical Medicine, Wayne State University School of Medicine</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Internal Medicine, American Board of Internal Medicine</li> <li>Pulmonary Medicine, American Board of Internal Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Chest Physicians</li> <li>American College of Physicians</li> <li>American Medical Association</li> <li>American Thoracic Society</li> <li>Society of Critical Care Medicine</li> </ul>Shiari<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/aryan-shiari-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B71950940132EF33C8799CF05B738808" alt="Aryan Shiari, M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/34468286/" target="_blank" title="Opens in new window">A female with recurrent pleural effusion</a>; September 2021</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/34107323/" target="_blank" title="Opens in new window">Major pulmonary complications following Hematopoietic stem cell transplantation: What the pulmonologist needs to know</a>; August 2021</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/34281915/" target="_blank" title="Opens in new window">Incidence of bleeding in patients on different anticoagulants and antiplatelet therapies undergoing thoracentesis</a>; July 2021</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/33660247/" target="_blank" title="Opens in new window">Miniforceps EBUS-guided lymph node biopsy: impact on diagnostic yield</a>; 2021</li> </ul>Aryan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30111562Aryan Shiari, M.D.1{1A90F4B2-3C68-421C-89C5-AC045A6F8F56}|{1D6651B0-86E1-4FF6-9A93-07B8EE2D26EE}<img src="/-/media/national-files/images/hometown-health/2023/outdoors-wearing-hat-hoodie-and-mask.jpg?h=370&iar=0&w=660&sc_lang=en&hash=20696F0FEACEA6307E19487B67AC3A17" alt="Person outdoors in the cold wearing hat, hoodie and facemask" width="660" height="370" DisableNVelocity="true" />PulmonologyTreatment for diseases and conditions affecting lung and airway function.BreathingMost cases of shortness of breath are due to heart or lung conditions. Your heart and lungs are involved in transporting oxygen to your tissues and removing carbon dioxide, and problems with either of these processes affect your breathing.Dawn Haller1/5/2023Slippery sidewalks and icy streets call for strategies to stay safe when walking in the winter. To keep your balance, try these techniques.Walk like a penguin: Keeping your winter balance<p>When winter storms hit, good balance can prevent falls and injuries — ranging from broken arms, legs or hips to back injuries and concussions.</p> <p>The National Center for Injury Prevention and Control says slips and falls are the leading cause of nonfatal injury across all age groups, except the 10–24 group. One in every 5 falls results in a serious injury, such as head trauma or broken bones. That’s more than 800,000 people being hospitalized each year.</p> <p>To remain upright and steady, the even distribution of weight over your feet is vital. Many parts of your body play key roles in your <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/balance-problems/symptoms-causes/syc-20350474" target="_blank" title="Opens in a new window.">balance</a>. Muscles, bones, joints, eyes, the balance organ in the inner ear, nerves, heart and blood vessels must work normally to maintain your balance. When these systems aren't functioning well, balance problems can arise.</p> <h2>Keeping your balance no matter the weather</h2> <p>Your arms are one of the greatest aids in maintaining your balance, especially when it's icy. Start with your hands, and wear gloves. Gloves keep your hands warm and out of your pockets, which frees up your arms so you can extend them out from your sides to improve your ability to stay upright.</p> <p>Your feet also aid in balance. Assume that all wet, dark areas on pavements are slippery and icy. Slow down, take short, careful steps at first, and then adjust your pace to surface conditions. Or walk like a penguin. Point your feet slightly outward, and put your center of gravity directly over your feet as much as possible.</p> <h4>Other tips to tackle tricky walking conditions include:</h4> <ul> <li>Use a backpack or a cross-body bag when carrying something to free up your hands. If you need to carry groceries or heavy bags, take them one at a time.</li> <li>Wear winter assistive devices with built-in grippers over your shoes or boots. Or wear lace-up shoes that fit well and have deep-grooved, nonskid, rubber treads.</li> <li>Wipe your shoes and boots thoroughly on the floor mat when coming inside.</li> <li>Use a cane or walking poles when out in winter weather.</li> <li>Avoid texting when walking on snow or ice. It can be an accident waiting to happen.</li> <li>Get in and out of your vehicle slowly, holding onto the door and steering wheel while stepping on or off a slippery surface.</li> </ul> <h2>Getting back on your feet</h2> <p>If you do fall, make sure you're not injured. Then, roll onto your hands and knees. Take one foot and place it between your hands, then bring the other foot between your hands. Keep your feet shoulder-width apart, and push yourself up from there.</p> <p>If you think you might be hurt or are unsure if an injury is serious, seek medical care immediately.</p> <p>Once you've recovered, think back on the fall and ask yourself: "What was I doing?" and "What could I have done differently to help prevent that fall from happening?"</p> <p><a href="/providers/kariline-bringe-md" target="_self" title="Opens in same window.">Kariline Bringe, M.D.</a>, is an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgeon</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</p><ul> <li>Adult reconstructive surgery</li> <li>Muscle sparing anterior total hip replacement</li> <li>Orthopedic trauma care which includes fracture care</li> <li>Primary and revision hip and knee replacement</li> <li><a href="/locations/la-crosse/services-and-treatments/orthopedic-surgery/robotic" target="_self" title="Opens in same window.">Robotic orthopedic surgery</a></li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Mayo Clinic Alix School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, University of Washington</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Adult Reconstruction, Carilion Clinic</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Orthopaedic Surgery</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Orthopedic Surgeons </li> <li>American Association of Hip and Knee Surgeons</li> </ul> <p>Academic Appointment </p> <ul> <li>Instructor in Orthopedics, Mayo Clinic College of Medicine and Science </li> </ul>Bringe<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/kariline-bringe-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B82E94878EE1907FB0BB50353742D357" alt="Kariline Bringe, M.D." width="280" height="280" DisableNVelocity="true" />{5C37287E-52DE-4384-94B2-B531BF0A7E09}Kariline<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15285901Kariline Bringe, M.D.1{DEF55970-853F-4E96-9A4D-3413874FF059}<img src="/-/media/national-files/images/hometown-health/2022/walking-on-ice-with-boots.jpg?h=370&iar=0&w=660&sc_lang=en&hash=174EFA3DEF661953F3B85076984E3E83" alt="Walking on ice wearing boots" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller1/26/2023Kegel exercises aren't just for women. They can help improve bladder control and improve sexual function in men. Here are tips for doing Kegel exercises correctly.Kegels are for men too<p>Women often are told about the importance of Kegel exercises to strengthen pelvic muscles. It turns out that men can benefit from these exercises as well.</p> <p>Pelvic floor muscles span the bottom of the pelvis and support the internal pelvic organs. In men, this includes the bladder, prostate and rectum. The muscles also wrap tightly around the anus and urethra. They can weaken with age or due to diabetes, an overactive bladder or prostate surgery.</p> <p><img alt="Male pelvic floor musculature illustration" width="100%" src="/-/media/national-files/images/hometown-health/2023/male-pelvic-floor-musculature-illustration.jpg?sc_lang=en&hash=A45EDE32EB21F9C9A1F8EF8B20EAA8D4" /></p> <h2>When done correctly, Kegel exercises have many benefits for men. Stronger pelvic muscles can help improve:</h2> <ul> <li>Frequent nighttime voiding called nocturia</li> <li>Dribbling after urination</li> <li>Urinary hesitation</li> <li>Ability to empty bladder fully</li> <li>Constipation</li> <li>Sexual function</li> </ul> <p>Any exercise to strengthen muscles involves squeezing or contracting and releasing or lengthening.</p> <h2>Kegel exercises are intentionally contracting and releasing the pelvic floor muscles. Here's how to get started:</h2> <ul> <li><strong>Find the right muscles.</strong><br /> About 40% of people don't perform a Kegel correctly the first time. The outer layer of pelvic floor muscles assists with stopping the flow of urine. To ensure you're contracting the right muscles, stop urination in midstream. You shouldn't do this often, at most once per month, as it could create a habit of contracting while urinating. Another option is to lie down and place a hand on the perineum. This is the area between the rectum and scrotum. Your hand will feel the perineum lift slightly as you squeeze your pelvic floor muscles. A physical therapist can help you identify the correct muscles using biofeedback if you are uncertain or have questions.</li> <li><strong>Perfect your technique.</strong><br /> Tighten your pelvic floor muscles for three or four seconds and then relax for an entire breath. It's important to get the full contraction and lengthening of each exercise. Don't rush or flex the muscles in your abdomen, thighs or buttocks. As your muscles get stronger, gradually increase each contraction to 10 seconds.</li> <li><strong>Schedule and focus.</strong><br /> Some try squeezing Kegel reps into daily tasks like washing dishes or sitting at a traffic light. I don't recommend this approach. It's best to dedicate quiet time to focus on your Kegel reps. This minimizes the chance of forgetting to do them and helps you contract your muscles correctly. I recommend completing a set of 10 reps before you get out of bed in the morning and before each meal during the day. </li> <li><strong>Repeat daily.</strong><br /> Like other exercises, the results from Kegels are better the more often you do them. Aim to do four sets of 10 reps for a total of 40 Kegels per day. Try to do them while lying down, sitting, standing or walking. Your muscles will become fatigued if you do more than 40 reps daily or hold each for longer than 10 seconds.</li> <li><strong>Drink up.</strong><br /> Some people with urinary incontinence restrict the amount of water they drink, which can cause other bothersome conditions or symptoms. For example, it can cause constipation, fatigue or bladder irritation. This could lead to the bladder quickly expelling urine in an uncontrolled manner. Drink at least 64 ounces of water each day.</li> </ul> <p>If you have trouble doing Kegel exercises, don't feel embarrassed to ask for help. A physical therapist can help you learn to isolate and strengthen the correct muscles. Biofeedback can help as well.</p> <p><a href="/providers/angela-imhoff-dpt" target="_self" title="Opens in same window."><em>Angela Imhoff</em></a><em> is a <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapist</a> in <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em> </p><ul> <li>Dancers</li> <li>Female athletes</li> <li>Pediatrics</li> <li>Pilates & Yoga</li> <li>Women's health including pelvic floor rehabilitation</li> </ul>D.P.T.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Dance and Psychology, University of Montana</li> <li>Master's degree, Dance, Sarah Lawrence College</li> <li>Doctorate degree, Physical Therapy, Mayo Clinic School of Health Sciences</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Physical Therapy Association – Section on Women's Health</li> </ul> <p> </p>Imhoff<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/angela-imhoff-dpt.jpg?h=280&iar=0&w=280&sc_lang=en&hash=EE017F3B9145A1618D714125CFBEA3A0" alt="Angela Imhoff DPT" width="280" height="280" DisableNVelocity="true" />Angela<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15958329Angela Imhoff DPT1<img src="/-/media/national-files/images/hometown-health/2023/senior-couple-by-lake.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6BBC1097129A9E58C5A9B76A2B666EB4" alt="Senior couple by lake" width="660" height="370" DisableNVelocity="true" />Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Dawn Haller1/24/2023From mild to debilitating symptoms, inflammatory bowel disease, including Crohn's disease or colitis, can affect all aspects of your health. Learn about risk factors and effects, and get coping tips.Living with Crohn's disease or colitis<p>More than half a million people in the U.S. have Crohn's disease, and 600,000 to 900,000 people in the U.S. have ulcerative colitis, according to the National Institute of Diabetes and Digestive and Kidney Diseases.</p> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/symptoms-causes/syc-20353315" target="_blank" title="Opens in a new window.">Inflammatory bowel disease</a>, or IBD, is an umbrella term that describes disorders involving chronic digestive tract inflammation. For some people, inflammatory bowel disease is only a mild illness. For others, it can be debilitating and sometimes leads to life-threatening complications.</p> <h2>Crohn's disease and ulcerative colitis are two types of inflammatory bowel disease:</h2> <ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/crohns-disease/symptoms-causes/syc-20353304" target="_blank" title="Opens in a new window.">Crohn's disease</a> is characterized by inflammation of the lining of your digestive tract, which often spreads deep into affected tissues.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/ulcerative-colitis/symptoms-causes/syc-20353326" target="_blank" title="Opens in a new window.">Ulcerative colitis</a> causes long-lasting inflammation and ulcers in the innermost lining of your large intestine and rectum.</li> </ul> <p>Crohn's disease and ulcerative colitis usually cause diarrhea, rectal bleeding, abdominal pain, fatigue and weight loss. The symptoms of Crohn's disease and colitis don't just affect you physically. They also take an emotional toll.</p> <p>With Crohn's disease, any part of your small or large intestine can be involved, and it may be continuous or involve multiple segments. Signs and symptoms of Crohn's disease can range from mild to severe. They usually develop gradually, but they sometimes come on suddenly and without warning. You also may have periods of remission.</p> <p>Although there's no firm evidence that any particular foods cause Crohn's disease, certain things seem to aggravate flare-ups. A food diary can help you identify personal triggers. Avoid highly processed foods and foods with high sugar, particularly refined sugars; limit dairy products; eat smaller meals; stay hydrated; and avoid caffeine, alcohol and carbonation.</p> <p>It's important to understand that while inflammatory bowel disease increases your risk of colon cancer, it doesn't necessarily lead to colon cancer. Treatment for ulcerative colitis usually involves drug therapy or surgery. Treatment for Crohn's disease also involves drug therapy and may include nutrition therapy or surgery.</p> <p>Therapies can significantly reduce its signs and symptoms and even bring about long-term remission and healing of inflammation. With treatment, many people can function well.</p> <h2>IBD risk factors</h2> <h3>Risk factors for inflammatory bowel disease include:</h3> <ul> <li><strong>Age</strong><br /> Most people who develop inflammatory bowel disease are diagnosed before they're 30. But some people don't develop the disease until 50 or older.</li> <li><strong>Race or ethnicity</strong><br /> Although inflammatory bowel disease is more common in white people, it can occur in any race. Cases are increasing in other races and ethnicities.</li> <li><strong>Family history</strong><br /> You're at higher risk if you have a close relative, such as a parent, sibling or child, with the disease.</li> <li><strong>Cigarette smoking</strong><br /> Cigarette smoking is the most important controllable risk factor for developing Crohn's disease. Smoking may help prevent ulcerative colitis. However, its harm to overall health outweighs any benefit and quitting smoking can improve the general health of your digestive tract and provide many other health benefits.</li> <li><strong>Nonsteroidal anti-inflammatory medications</strong><br /> Nonsteroidal anti-inflammatory medications may increase the risk of developing inflammatory bowel disease or worsen the disease in people with inflammatory bowel disease. These include ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve), diclofenac sodium and others.</li> </ul> <h2>Gut health and brain health connection</h2> <p>Psychological stress also can heighten pain in the body, regardless of the source of pain. The gut is especially susceptible to this because of the brain-gut connection — the linking of the emotional and cognitive centers of the brain with intestinal functions. Anxiety, worry, depression and post-traumatic stress disorder can heighten pain experiences in patients with IBD.</p> <p>Living with a <a href="/hometown-health/speaking-of-health/differences-between-ibd-and-ibs" target="_self" title="Opens in same window.">chronic and often painful illness</a> can affect your mental health and emotional well-being. It can be challenging and frustrating to manage not only the physical symptoms of Crohn's disease or ulcerative colitis but also the emotional toll it can have on you. Stress, depression and anxiety can play a significant role in how you might deal with your situation.</p> <h3>For people living with Crohn's disease or ulcerative colitis, consider these tips to help you cope:</h3> <ul> <li><strong>Be informed.<br /> </strong>One of the best ways to be more in control is to learn as much as possible about inflammatory bowel disease. </li> <li><strong>Join a support group</strong>.<br /> Although support groups aren't for everyone, they can provide valuable information about your condition and emotional support. <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://connect.mayoclinic.org/" target="_blank" title="Opens in a new window.">Mayo Clinic Connect</a> has a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://connect.mayoclinic.org/group/digestive-gastrointestinal-problems" target="_blank" title="Opens in a new window.">Digestive Health Support Group</a> to connect with others talking about Crohn's disease and colitis. Mayo Clinic moderates this online patient community.</li> <li><strong>Talk to a therapist</strong>.<br /> Some people find it helpful to consult a mental health professional familiar with inflammatory bowel disease and the emotional difficulties it can cause.</li> </ul> <p><a href="/providers/daisy-batista-md" target="_self" title="Opens in same window."><em>Daisy Batista, M.D.</em></a><em>, is a <a href="/services-and-treatments/gastroenterology-and-hepatology" target="_self" title="Opens in same window.">gastroenterologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Diagnostic and therapeutic endoscopy</li> <li>Management of advanced inflammatory bowel disease and Crohn's disease</li> </ul>M.D.<p>My area of expertise is in the care of patients with inflammatory bowel disease, such as ulcerative colitis and Crohn's disease. I also see patients with a variety of general gastrointestinal (GI) complaints, such as diarrhea, constipation and reflux.</p> <p>I enjoy teaching patients about their disease as a tool to empower them to make decisions that would help them get relief of their symptoms and achieve the highest quality of life possible.</p><p><strong>Education</strong></p> <ul> <li>University of Chicago, Pritzker School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Massachusetts General Hospital</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Massachusetts General Hospital</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Gastroenterology, University of Florida, Shands University Hospital</li> <li>Advanced Inflammatory Bowel Disease, Mayo Clinic</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Gastroenterology, American Board of Gastroenterology</li> <li>Hepatology, American Board of Internal Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Gastroenterology</li> <li>American Gastroenterology Association</li> <li>American Society of Gastrointestinal Endoscopy</li> <li>Crohn's and Colitis Foundation of America</li> </ul>Batista<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/daisy-batista-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4A32C6488B16AA601137C0EACEFA17E6" alt="Daisy Batista, M.D." width="280" height="280" DisableNVelocity="true" />Daisy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15833224Daisy Batista, M.D.1{CDA27FD1-23E5-4D31-BD85-567A48B862F7}|{63CBB755-37F9-4058-9120-6CD50C94BD16}|{164A5F93-090D-40B1-B93B-7C91986AE546}<img src="/-/media/national-files/images/hometown-health/2023/sitting-writing-in-notebook.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9E7BBA6295191F7BEF723585DA2C9D5F" alt="Sitting and writing in notebook" width="660" height="370" DisableNVelocity="true" />Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Dawn Haller1/23/2023Mushrooms are small, but mighty ingredients in meals. Learn about the health benefits and how their versatility works magic in meals from stews to stir-fries.Mushrooms make healthy meal magic<p>Mushrooms can be found in so many dishes, from omelets to stir-fries, that they're often overlooked. But mushrooms not only are versatile, they also provide a variety of health benefits ranging from brain health to cancer prevention. They're naturally low in sodium and fat, two things that can affect heart health by raising blood pressure.</p> <h2>There are more health-related reasons for eating these almost-magical fungi, including:</h2> <ul> <li><strong>Cancer prevention</strong><br /> Researchers have found that incorporating any variety of mushrooms into your daily diet will lower your risk of cancer by as much as 45%. How many mushrooms do you need to eat? The recommended amount is as few as two medium per day.</li> <li><strong>Brain health</strong><br /> Mushrooms also are a natural source of fiber, which promotes gut health by feeding the "good" bacteria in the intestines. These bacteria have been found to make neurotransmitters or chemicals that send messages between nerves. These neurotransmitters promote mood stability, concentration, brain health and mental well-being. One mushroom that's been getting a lot of attention when it comes to brain health is lion's mane, identified by its long, white, fluffy top. Early research shows the lion's mane's potential to protect against neurological damage and promote the growth of nerve tissue, which is important for those with Alzheimer's disease, multiple sclerosis and Parkinson's disease.</li> <li><strong>Vitamin D increase</strong><br /> Mushrooms exposed to ultraviolet (UV) light, whether from sunlight or a UV lamp, contain vitamin D, a vital nutrient that can be hard to come by in nature. Vitamin D helps the body absorb calcium, strengthening bones and teeth. Appropriate vitamin D levels also are linked to preventing dementia, Type 2 diabetes and risk of premature death.</li> <li><strong>Micronutrients source</strong><br /> These tiny amounts of nutrients support a healthy immune system. Mushrooms are one of the best sources of selenium, which helps your body make antioxidants that can reduce cell damage.</li> <li><strong>B vitamins source</strong><br /> Mushrooms are a good source of vitamins B2, B3, B5 and B9, also known as folate. B vitamins are essential for cell growth and formation. This means that your hair, skin and nails could become more healthy, as well as your brain and heart.</li> <li><strong>Calcium and potassium increase</strong><br /> A <a rel="noopener" href="https://newsnetwork.mayoclinic.org/discussion/diets-higher-in-calcium-and-potassium-may-help-prevent-recurrent-symptomatic-kidney-stones-mayo-clinic-study-finds/" target="_blank" title="Opens in a new window.">recent study by Mayo Clinic</a> showed that adding more calcium and potassium to your diet may prevent kidney stones from forming and recurring.</li> </ul> <h2>How to use mushrooms in meals</h2> <p>The mushroom you may be most familiar with is the common button mushroom. But there are thousands of mushroom varieties in various shapes, sizes and colors. Mushrooms grow in the wild, but safe varieties may be hard to identify, so it's best to stick to the farm-grown varieties found at your supermarket.</p> <p>Taste and texture vary from one type of mushroom to the next. Button or cremini mushrooms are milder in flavor and have a softer texture than shiitake mushrooms, which are chewier and have an earthier flavor. While canned and fresh mushrooms have health benefits, fresh mushrooms have a different texture.</p> <p>One distinctive characteristic of mushrooms is they provide umami to dishes. Umami often is considered the fifth basic taste, along with sweet, sour, salty and bitter. This brothy, savory taste makes it a good meat alternative. Try replacing one-quarter to one-half of the meat in a recipe with chopped mushrooms. Add mushrooms to dishes across a world of cuisines, including soups, salads, casseroles and pastas.</p> <p>Before using them raw or prepping to cook, clean mushrooms under gently running water to rinse away any dirt, or brush with a damp paper towel.</p> <p>If you need a little inspiration as you explore the health benefits and versatility of mushrooms, give these <a rel="noopener" href="https://www.mayoclinic.org/search/search-results?q=mushrooms" target="_blank" title="Opens in a new window.">recipes from Mayo Clinic</a> a try.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2023/food-made-with-mushrooms.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E5F2B3D367FDC74B1D82EBA97FF77CFA" alt="Food made with mushrooms" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller1/4/2023If you've set a goal to participate in a distance run, be sure you're ready on race day. Learn how a plan can help you prepare physically and mentally for a successful event.Planning for your big run<p>You've thought about it for years. You've dreamed of crossing the finish line. It's on your bucket list, or maybe it's become a tradition. You've registered for a long-distance race like a 5K, 10K, half-marathon or marathon. So now's the time to plan and prepare for your big day.</p> <p>This critical process will be shaped by your experience and fitness level. First, get real and be honest with yourself. It can take eight to 12 months to go from the couch to a full marathon. For some people, it may be a better choice and more realistic goal to plan for a shorter race, like a 5K or half-marathon.</p> <h2>For first-time runners or those looking to restart after taking time off, keep these tips in mind as you plan and prepare for your first big run:</h2> <h3>Assess your fitness level</h3> <p>If you're just starting a running program, you should meet with your primary care clinician and other health care professionals, such as a physical therapist or athletic trainer. They'll assess your heart and lung capacity and if your body can handle the rigors of long-distance running.</p> <h3>Pick a training program</h3> <p>If you've run long-distance races before, you might want to try a different plan this time around. Variety can help maintain motivation. If you encountered issues during your previous training or race, it's time to shop around and find a plan that works best for you.</p> <h4>For new runners, your plan should include:</h4> <ul> <li><strong>Adequate time to train</strong><br /> You can complete 5K or 10K training in a few months. For first-time marathon runners, training can take up to a year to build up your tolerance and endurance.</li> <li><strong>Cross-training</strong><br /> To avoid injury, your plan should include cross-training — combining weight training, plyometric and other cardiovascular activities, such as biking, rowing or swimming, with your running routine. For rookie runners, a training program that includes a regimen combining running and walking can help you gradually build up endurance and strength.</li> <li><strong>Strength training</strong><br /> Every running program should have a strength training component. This will reduce the imposed loads on your body and prevent overuse injuries, such as tendonitis and stress fractures. Core and hip strength are some of the most important areas to work on.</li> <li><strong>Active warm-up</strong><br /> To improve performance, you should spend five to 10 minutes of walking or light jogging, along with movements that cover the full range of motion, such as lunges.</li> <li><strong>Stretching</strong><br /> Static stretching hasn't been shown to improve performance or reduce injury, but it can feel good after a run, especially if stretching is already part of your usual routine. Stretching can improve range of motion, as well.</li> <li><strong>Recovery</strong><br /> Help your body recover with adequate rest in between sessions of exercise. However, consistency is essential to continue improving your endurance. Novice runners will want to avoid the same exercise multiple days in a row until they build up their tolerance.</li> <li><strong>Healthy eating</strong><br /> Quality plans also include nutrition and hydration recommendations. Not only are you eating and drinking for optimum overall health, but you also need these nutrients to support the changes in your body brought on by running.</li> </ul> <p>No matter which training plan you choose, listen to your body, which at times will speak to you loud and clear. The idea of "no pain, no gain" is incorrect. If you have swelling or pain that worsens, don't just power through and follow your plan. Get the problem checked out and be prepared to adjust. Every plan can be modified to meet your needs. While it's common to have muscle soreness after increasing distance, running shouldn't be painful.</p> <h3>Choose the right running shoes</h3> <p>Now that you've decided to start adding up the miles, it's important to have the right shoes for the job. Evaluate your feet so that you get the right shoe. Do you have flat feet or a high arch? Each foot type requires a different type of shoe to provide support and reduce the risk of injury.</p> <p>If you're not sure about your foot arch type, dip your foot in water. Then step on a piece of cardboard and examine the footprint that remains. After examining the footprint, <a href="/-/media/national-files/documents/hometown-health/2019/determine-your-foot-arch-type.pdf?sc_lang=en&hash=42110BECE9A8CD11AE32BB4914C83AEA" target="_blank" title="Opens in a new window.">use our chart to determine your foot arch</a>.</p> <p>When you buy shoes is vital. When you first start training, invest in a new pair, and don't rely on a pair you've had for a while. The older pair will break down too quickly and not provide the support your feet need. A good shoe for long-distance runners typically lasts 300-500 miles. Some runners make the mistake of buying a new pair of shoes right before a race. Instead, buy them a few weeks before the race so you have time to break them in.</p> <p>Now it's time to lace up and start training. Good luck!</p> <p><em><a href="/providers/troy-hoehn-atc" target="_self" title="Opens in same window.">Troy Hoehn</a></em><em> is a licensed athletic trainer in </em><em><a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">Orthopedics</a></em><em> and </em><em><a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">Sports Medicine</a>, and </em><em><a href="/providers/peter-johnson-dpt" target="_self" title="Opens in same window.">Peter Johnson</a></em><em> is a </em><em><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapist</a>, both</em><em> in </em><em><a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a></em><em>, Minnesota.</em></p><ul> <li>Acute care</li> <li>Concussion identification and management</li> <li>Injury care and prevention </li> <li>Rehabilitation</li> <li>Sports medicine</li> </ul>L.A.T., A.T.C.<p>I listen to my patient's concerns and work hard to find the right solution for them. I also try to relate to my patients and show empathy to their health conditions.</p> <p>When I'm not working I like to spend time with my wife and two sons. I'm also a sports fan and enjoy exercising. </p><p><strong>Education</strong></p> <ul> <li>Bachelor of Science, Athletic Training, Minnesota State University, Mankato</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Licensed Athletic Trainer</li> <li>Certified Athletic Trainer</li> <li>Certified Skinfold Technician</li> <li>Certified Strength and Conditioning Specialist</li> <li>ImPACT Trained Athletic Trainer</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Great Lakes Athletic Trainers Association </li> <li>Minnesota Athletic Trainers Association</li> <li>Minnesota Board of Medical Practice Athletic Trainer Advisory Committee </li> <li>MN Department of Human Services Traumatic Brain Injury Committee </li> <li>National Athletic Trainers Association</li> <li>National Strength and Conditioning Association</li> <li>Safety coordinator for the Mankato North Mankato Youth Football League</li> </ul>Hoehn<img src="/-/media/shared-files/images/medical-professionals/full/mankato/troy-hoehn-atc.JPG?h=280&iar=0&w=280&sc_lang=en&hash=82912D4AD31B73A9ACEA7F22FE5C1394" alt="Troy Hoehn ATC" width="280" height="280" DisableNVelocity="true" />Troy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21616418Troy Hoehn LAT1{7746ADF8-715B-4593-8AAB-55D7F0467848}<ul> <li>Orthopedics and sports medicine</li> </ul>D.P.T.<p><strong>Education</strong></p> <ul> <li>Doctor of Physical Therapy, Mayo Clinic School of Health Sciences, Minnesota</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Physical Therapy Orthopedic Residency, Mayo Clinic School of Health Sciences, Minnesota</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Clinical Instructor – Level I, American Physical Therapy Association</li> <li>Orthopedic Clinical Specialist, American Board of Physical Therapy Specialties</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Physical Therapy Association</li> </ul>Johnson<img src="/-/media/shared-files/images/medical-professionals/full/mankato/peter-johnson-dpt.jpg?h=280&iar=0&w=280&sc_lang=en&hash=97C8629587C6EF46F44A3F7BA0A06A56" alt="Peter Johnson PT" width="280" height="280" DisableNVelocity="true" />Peter<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16074726Peter Johnson DPT1<img src="/-/media/national-files/images/hometown-health/2022/runner-wearing-number-tag.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F7697659F2652165ABC60E45C246CDC5" alt="Runner wearing number tag" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller1/6/2023Back pain is a common complaint during pregnancy. Get tips to ease pain, and learn when to consult a health care professional.Oh, my aching pregnancy back: 5 tips to help find relief<p>Back pain is a common complaint during pregnancy. As you gain weight, your center of gravity shifts forward. To avoid falling forward, you compensate by leaning back, which can strain the muscles in your lower back. The pregnancy hormone also contributes to back pain because it relaxes the ligaments in the joints of the pelvis to make them more flexible to prepare for the baby to pass through the birth cannel. Unfortunately, this also can cause back pain.</p> <h2>You can ease back pain during pregnancy with these five helpful tips:</h2> <h3>1. Practice good posture.</h3> <p><a href="/hometown-health/speaking-of-health/proper-posture-is-important-for-good-health" target="_self" title="Opens in same window.">Good posture</a> can help alleviate back pain. Stand up straight, hold your chest high while keeping your shoulders back and relaxed, and don't lock your knees. Good posture also means sitting with care. Choose a chair that supports your back. Or place a small pillow behind your lower back. Use a comfortable, wide stance for the best support when you stand. If you <a href="/hometown-health/speaking-of-health/7-tips-to-lower-varicose-vein-risk" target="_self" title="Opens in same window.">stand for long periods of time</a>, you may want to rest one foot on a low stool.</p> <h3>2. Choose the proper attire.</h3> <p><strong> </strong>Wear low-heeled — not flat — shoes with good arch support. Avoid high heels. You may consider wearing a maternity support belt. Research on the effectiveness of maternity support belts is limited, but some women find it helpful. </p> <h3>3. Take a daily walk.</h3> <p>With your health care team's OK, include daily physical activity in your routine to keep your back strong. <a href="/hometown-health/speaking-of-health/exercise-during-pregnancy" target="_self" title="Opens in same window.">Gentle activities</a>, such as walking, are OK during pregnancy. Stretching your back also can be beneficial. Rest on your hands and knees with your head in line with your back. Pull in your stomach, rounding your back slightly. Hold for several seconds, and then relax your stomach and back, keeping your back as flat as possible. Gradually work up to 10 repetitions.</p> <h3>4. Lift properly.</h3> <p>To lift a small object, squat down and lift with your legs. Don't bend at your waist or lift with your back. It's important to know your limits and ask for help if you need to lift something. </p> <h3>5. Sleep in a good position.</h3> <p>Sleep on your side as opposed to your back. Keep one or both knees bent. You also may want to use pregnancy or support pillows between your bent knees, under your abdomen and behind your back. Applying a heating pad or ice pack, as well as massaging sore areas also may help relieve discomfort.</p> <h2>When to consult your health care team</h2> <p>If you have severe back pain or pain that lasts more than two weeks, talk with your health care team. They may recommend over-the-counter medication, such as acetaminophen, or other treatments, like stretching and exercises with a physical therapist.</p> <p>Back pain during pregnancy can be a sign of preterm labor or a urinary tract infection. If you have back pain with vaginal bleeding, fever or burning during urination, contact your health care team right away. </p> <p><em><a href="/providers/abbey-rose-cnm-apnp" target="_self" title="Opens in same window.">Abbey Rose</a> is a <a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">certified nurse midwife</a> in <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/tomah" target="_self" title="Opens in same window.">Tomah</a>, Wisconsin. </em></p><ul> <li>Lactation support</li> <li>Postpartum depression management and support</li> </ul>CNM, A.P.N.P.<p>I pursued by master's in midwifery to give women a different option of care. I strive to educate and empower women to take ownership of their health care experience. It is important for me to ask each woman I care for to share with me her story. I want women to be heard in their own voice.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Nursing, Viterbo University</li> <li>Master's degree, Nursing, Frontier Nursing University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Internation Board Certified Lactation Consultants</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Nurse Midwives (ACNM)</li> <li>American Collete of Obstetricians and Gynecologists (ACOG)</li> <li>Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN)</li> </ul>Rose<img src="/-/media/shared-files/images/medical-professionals/full/tomah/abbey-rose-cnm-apnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A10B8590322E2098992335DE530EC543" alt="Abbey Rose, CNM, A.P.N.P." width="280" height="280" DisableNVelocity="true" />Abbey<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21231567Abbey Rose, CNM, A.P.N.P.1{54693F31-87AF-4B21-91DB-1DEC1E21F878}<img src="/-/media/national-files/images/hometown-health/2022/sliding-foot-into-flats.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F45AE1F26A71F43B3825153FA115532E" alt="Sliding foot into flats" width="660" height="370" DisableNVelocity="true" />Prenatal CareOB-GYN and Family Medicine providers offer exactly the care you need for starting or growing your family, including pregnancy planning and prenatal care.Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Pain ReliefApproximately 50 million people in the U.S. live with chronic pain. If you experience chronic pain, you're not alone. Learn about the ways to deal with painful disorders, from at-home solutions to drug treatments, injectable or implantable therapies to surgery.Dawn Haller1/27/2023Throughout the pandemic, people adopted strategies that strengthened relationships, improved self-care and slowed down daily life. What are the positives worth preserving?Preserving pandemic positives<p>The arrival of the COVID-19 pandemic was a life-changing event. From switching to remote work or school to canceling long-anticipated events, the pandemic forced us to separate from loved ones to try to keep ourselves and others safe and healthy. Even our day-to-day activities changed dramatically. Almost overnight, we were forced to develop strategies to help us cope and move through this ever-changing situation.</p> <p>Many of these adaptations and strategies strengthened relationships, improved self-care and allowed us to step away from the hustle and bustle of life pre-pandemic.</p> <h2>These are some of the healthy adaptations made:</h2> <ul> <li><strong>Spending more time with immediate family.</strong><br /> We started movie nights, pizza nights, puzzle and game nights; and new holiday traditions and ways to celebrate life events, such as birthdays, weddings and graduations.</li> <li><strong>Collaborating with others.</strong><br /> For some families, it meant creating "bubbles" so kids could study and play together.</li> <li><strong>Learning new skills.</strong><br /> From taking up a new hobby to learning to play an instrument to mastering home repairs, we engaged and stretched our minds.</li> <li><strong>Embracing homemade meals.</strong><br /> Cooking and baking from scratch, and sharing those activities with family, introduced not only new dishes, but also renewed interest in healthy eating. Home gardens flourished and provided the satisfaction of raising and preparing our own produce.</li> <li><strong>Exploring the outdoors.</strong><br /> When we had to stay socially distanced, being outdoors let us burn off cooped-up energy. Whether it was hiking, bike riding, camping, stargazing, bird-watching or just watching a summer sunset, being in nature helped calm, relax, rejuvenate and restore us during a trying time.</li> <li><strong>Assessing our nests.</strong><br /> Rooms were rearranged. Closets, basements and garages were organized. Painting became the rage. New outdoor living spaces were created.</li> <li><strong>Helping others.</strong><br /> From writing cards to checking up on an old friend to doing yard work for an elderly neighbor, we elevated our random acts of kindness.</li> <li><strong>Putting technology to work.</strong><br /> We moved online, ordering everything from groceries to furniture to holiday gifts. We met up with friends and families on apps. We also adapted to seeking physical and mental health care via technology.</li> </ul> <p>We all have our own lists of how we coped. Now we're transitioning from a time of not being able to do a lot to a time that's once again packed with too many things to do. And as disorienting as the locked-down life was, the in-full-swing life can be too.</p> <p>During the pandemic, we became skilled at self-care and giving ourselves time for what was enjoyable, inspirational, motivational and restorative. You may have positives from the pandemic that you'd like to preserve, but determining which ones can be overwhelming.</p> <p>Start by giving yourself permission not to do everything or say yes to every request. Remind yourself that everything isn't going to get done, and that's OK. It means letting some things go as you take on others.</p> <h2>With busy lives, that means prioritizing and planning, but not to the point of generating more stress:</h2> <ul> <li><strong>Look back at your pandemic positives.</strong><br /> Think about why you liked them and why you would want to continue them. Just remembering how much you enjoyed something can shift your brain, motivate you and spur creativity.</li> <li><strong>Examine what's important in the long term and how you want to fill your buckets.</strong><br /> Ask if it's helpful to you or just one more thing to do. If something is a "keeper," think about how you can make a regular place for it in your life. Some things may be no-brainers, like telehealth or online grocery ordering, which opens up time for something else.</li> <li><strong>Do some brainstorming.</strong><br /> You may not be able to keep all those pizza-movie-game nights going, but maybe you can set aside one night a week as family night. Rather than preparing elaborate meals together, pick one breakfast, lunch or dinner to gather in the kitchen. If one-on-one time is what you miss, maybe it's spending more time at bedtime talking with your kids or sitting around a backyard fire pit making s'mores.</li> <li><strong>Be flexible.</strong><br /> Make a plan, but be ready to regroup. For some, setting an alert on your phone for "homemade pizza night" works. But if a meeting runs late, get carryout pizza to enjoy together.</li> </ul> <p>It takes about six months to solidify a new habit. Recognize that you haven't lost all your pandemic positives, but they may not look quite the same. What's important is they still bring you satisfaction and fulfillment.</p> <p>Among the positives, there's the other side of COVID-19 that brought deaths, long-lasting illness, food and financial instability, stress, fear and despair. These things aren't easy to move on from. Check in with yourself, and be aware of your mental health. You don't need to suffer alone. Contact a mental health professional, and seek the help you need to cope with the effects of the pandemic.</p> <p> <a href="/providers/jolene-hanson-licsw" target="_self" title="Opens in same window."><em>Jolene Hanson</em></a><em> is a clinical social worker in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><p>Children ages six through adult:</p> <ul> <li>Adjustment disorders</li> <li>Anxiety disorders</li> <li>Obsessive-compulsive disorders</li> <li>Phobias</li> <li>Posttraumatic stress disorder</li> <li>Trauma-related disorders</li> </ul>L.I.C.S.W.<p>I have been practicing in the mental health field for over 15 years. My work is a collaborative approach with the patient to determine goals for treatment and ways to achieve these goals. I am passionate about my practice and continue to strive for the best patient care possible through on-going education, attentive listening and empathetic communication.</p> <p>In my free time, I enjoy being outdoors with my family along with running and playing volleyball.</p><p><strong>Education</strong></p> <ul> <li>Master’s degree, Social Work, Minnesota State University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Clinical Social Work, Mayo Clinic Health System</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Certified in Cognitive Processing Therapy</li> <li>Certified in Trauma-focused Cognitive Behavioral Therapy</li> <li>Trained in Eye Movement Desensitization and Reprocessing (EMDR)</li> <li>License Independent Clinical Social Worker, State of Minnesota</li> </ul> <p><strong>Membership</strong></p> <ul> <li>EMDR International Association </li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor of Social Work, Mayo Clinic College of Medicine and Science</li> </ul>Hanson<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jolene-hanson-licsw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7483CB6D0C345431B3BDB2662F609078" alt="Jolene Hanson LICSW" width="280" height="280" DisableNVelocity="true" />Jolene<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15448835Jolene Hanson, L.I.C.S.W.1<img src="/-/media/national-files/images/hometown-health/2023/people-playing-jenga.jpg?h=370&iar=0&w=660&sc_lang=en&hash=299858EB46F0E234CE52BC13E5172D31" alt="People playing Jenga" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Dawn Haller1/3/2023Planning a trip overseas can be exciting. Learn why you should schedule an appointment with a travel medicine specialist to get the vaccinations and information you need to be healthy and safe on your journey.9 common questions about vaccines and travel<p>Travel does more than just transport you to a different place. It can broaden your perspective, increase your happiness, give you a chance to try new things, boost your creativity and help you recharge. Even planning a trip can be an exciting task. The anticipation of mapping an itinerary and scheduling your must-see attractions can bring a lot of joy and happiness.</p> <p>One of the most important tasks before taking a trip is to make an appointment with a travel medicine specialist. These health care professionals help keep travelers safe and happy before and after their journeys.</p> <h2>Here are answers to common questions about travel medicine:</h2> <h3>1. Who should make an appointment with a travel medicine specialist?</h3> <p>Anyone planning a trip overseas can benefit from seeing a travel medicine specialist. However, a travel clinic appointment is critical if you are traveling to underdeveloped or developing countries where there's a higher risk of contracting severe communicable illnesses while abroad. It is also important for patients with certain medical conditions that make their immune systems weaker and more vulnerable to infectious diseases.</p> <h3>2. What vaccinations do I need to travel overseas?</h3> <p>All travelers should be vaccinated against the flu and current with COVID-19 vaccines and boosters.</p> <h4>In addition, it's important to complete the adult vaccination schedule that includes vaccinations for:</h4> <ul> <li>Chickenpox (varicella)</li> <li>Diphtheria, tetanus and pertussis (DTP)</li> <li>Pneumococcal</li> <li>Measles, mumps and rubella (MMR)</li> <li>Polio</li> <li>Shingles</li> </ul> <p>Additional vaccines may be recommended depending on your travel itinerary. For example, hepatitis A vaccination is recommended if you are traveling to Southeast Asia. During your appointment, we can discuss which vaccines are appropriate for your itinerary.</p> <h3>3. Are there travel destinations that have different vaccination recommendations?</h3> <p>Yes. Infectious diseases thrive in different climates. If you travel to a new climate, you may be exposed to diseases to which you don't have any immunity.</p> <p>Some infections are more prevalent in tropical settings compared to temperate climates. For example, typhoid and hepatitis A are more common in Southeast Asia because these communicable diseases can be spread through contaminated water. Some areas of Africa and South America have a higher prevalence of yellow fever and malaria, which are mosquito-borne infections.</p> <p>The <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://wwwnc.cdc.gov/travel/destinations/list/" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention (CDC)</a> has good information online for travelers for each travel destination.</p> <h4>Recommended vaccines may include:</h4> <ul> <li>Hepatitis A</li> <li>Hepatitis B</li> <li>Japanese encephalitis</li> <li>Meningitis</li> <li>Rabies</li> <li>Typhoid</li> <li>Yellow fever</li> </ul> <h3>4. Can my primary care provider give me travel vaccinations?</h3> <p>It depends on your travel destinations and vaccine recommendations. I recommend starting the conversation with your primary care provider and reviewing the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://wwwnc.cdc.gov/travel/destinations/list/" target="_blank" title="Opens in a new window.">CDC recommendations</a>.</p> <p>If you have a complex itinerary with multiple countries or are traveling to Southeast Asia or Africa, it's better to make an appointment at the travel clinic. I also would recommend patients with organ transplants and immunocompromising conditions seek travel medicine consultation to reduce the risk of illness during travel. During that appointment, we will review your itinerary, provide necessary vaccinations and discuss ways to prevent mosquito-borne or tick-borne diseases.</p> <h3>5. How long before my trip should I go to the travel clinic?</h3> <p>Plan to have an appointment at least four weeks before you travel. Some vaccines require several weeks for immunity to develop, while others require more than one dose of vaccine for full protection.</p> <p>If your trip is to an underdeveloped or developing country, you may need to schedule an appointment up to two months in advance to receive a complete set of immunizations. This gives your body time to produce the protective antibodies, so you are well protected when you land at your destination.</p> <h3>6. Can I only go to the travel clinic before I travel?</h3> <p>No. The Travel and Tropical Medicine Clinic is available before or after travel. The team can provide consultative services and treatment if you get sick after you return home.</p> <h3>7. I'm going to an all-inclusive resort. Will I have a lower risk of getting sick?</h3> <p>Maybe, but no traveler should take safety for granted. Even in an all-inclusive resort, knowing how food is prepared or the water supply quality is not possible. Mosquitos and other insects could still be a concern. It's important to take all necessary precautions and follow vaccination recommendations when you travel, regardless of your accommodations.</p> <h3>8. How do I lower my risk of malaria when traveling?</h3> <p>Malaria is a disease caused by a parasite. It's spread to humans through the bites of infected mosquitoes. Prophylactic malaria medications are available and are started before the travel, continued during the stay and for a certain duration after returning home. A travel medicine specialist can review the risks and benefits of all prevention and treatment options.</p> <h3>9. How do I stay healthy while traveling?</h3> <p>Nothing can ruin a trip like illness. Make sure all your vaccinations and boosters are up to date, and get any new vaccinations recommended for your destinations.</p> <p>Food and water safety is important while traveling. Only eat well-cooked food. Avoid eating from roadside stands and uncooked foods, like salad and raw vegetables. Drink bottled beverages only, including bottled water. This is especially important if you travel in resource-limited regions, such as Southeast Asia or Africa.</p> <p>Hand hygiene is important at home and overseas. Wash your hands often using soap and hot water. Avoid crowded places, follow respiratory etiquette and consider optional masking. Mosquitos and bugs can transmit parasites and diseases, like yellow fever and malaria. Use mosquito repellents. Mosquito nets may be appropriate in some parts of the world, as well.</p> <p>As you make travel plans, schedule an appointment with a travel medicine specialist to get the vaccinations and information you need to be healthy and safe on your journey.</p> <p><em>Raj Palraj, M.D., is a physician in <a href="/services-and-treatments/infectious-diseases" target="_self" title="Opens in same window.">Infectious Diseases</a> and <a href="/locations/la-crosse/services-and-treatments/infectious-diseases" target="_self" title="Opens in same window.">Travel and Tropical Medicine</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em> </p><img src="/-/media/national-files/images/hometown-health/2022/on-wooden-boat-tropical-location.jpg?h=370&iar=0&w=660&sc_lang=en&hash=61588FC7A39A418DC2180E3A243CC732" alt="Person sitting in wooden boat on the water in a tropical location" width="660" height="370" DisableNVelocity="true" />Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Immunizations<p>Disease prevention is crucial to your health. Getting vaccinated is one of the best ways to maintain good health, and protect you and those you care about against infectious diseases. Vaccinations offer protection against serious diseases by stimulating the immune system to create antibodies against certain bacteria or viruses.</p><br/><p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/vaccine-guidance/art-20536857" target="_blank" title="Opens in a new window.">Get vaccine guidance from Mayo Clinic</a>, including benefits, safety, side effects and what to know about recommended vaccines for babies, children, teens, adults and during pregnancy. For recommended vaccines based on age, refer to the <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/adult" target="_blank" title="Opens in a new window.">adult</a> or <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/child" target="_blank" title="Opens in a new window.">child and adolescent</a> schedules.</p><br/><p>Review the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/coronavirus-covid-19/history-disease-outbreaks-vaccine-timeline" target="_blank" title="Opens in a new window.">history of infectious disease outbreaks and vaccines timeline</a> for information about major disease outbreaks, epidemics and pandemics, and the impact of vaccines and research.</p>Dawn Haller1/20/2023Elevated levels of radon are the No. 1 cause of lung cancer among nonsmokers. So it's vital to test your home to discover if radon abatement is needed. Learn more about this invisible health hazard.Radon: The odorless, invisible threat<p>Radon is an odorless, invisible radioactive gas. It's naturally released from rocks, soil and water — and it can get trapped inside your home, office or school. There's no known safe level of radon. Unfortunately, there are no symptoms of radon exposure as there are with carbon monoxide poisoning.</p> <h2>What makes radon so dangerous</h2> <p>Breathing high levels over time can lead to lung cancer. In fact, radon is a Class A carcinogen. It's the No. 1 cause of lung cancer in nonsmokers and the second-leading cause of lung<span style="color: red;"> </span>cancer overall. Nationwide, 21,000 people die from radon-caused lung cancer each year.</p> <p>Smoking and secondhand smoke, combined with exposure to high radon levels, increase your risk of lung cancer. If you or your family are experiencing breathing issues, consult with a pulmonologist.</p> <p>Radon can be found in any home — old or new — and typically enters through cracks in the foundation caused by natural settling and windows. Radon levels often are higher in lower levels and basements. Across the U.S., 1 in 15 homes have elevated radon levels, and levels are higher in the Midwest. For Minnesota homes, the average radon level is about 4.5 picocuries per liter of air (pCi/L) compared to 1.3 pCi/L nationwide.</p> <h2>Test your nest for radon</h2> <p>There's a simple solution to this close-to-home health hazard: Test your nest. That's what the Environmental Protection Agency (EPA) urges all homeowners to do, especially those in high-radon areas. Testing is the only way to determine the radon level in your home.</p> <p>You can find radon testing kits at hardware or other home maintenance stores. They run about $20 or less, and are easy to use. It typically takes two to seven days for results. Since there's no safe level of radon, you should always aim for the lowest level. The EPA recommends 4 pCi/L or less.</p> <p>If your home tests higher than 4 pCi/L, then you'll need to have a professional<span style="color: red;"> </span>fix the radon issue, which includes installing venting equipment. The equipment looks like a big tube that reaches below the foundation<span style="color: red;"> </span>of your home and vents radon up and out of the house. Unfortunately, the system can be expensive, but you may be able to apply for assistance from your state.</p> <p>Once the mitigation system has been installed, your home should be tested again to make sure the fix is effective. Even if your home passes the first test, you should retest every two years.</p> <p>Also, radon testing is not required when selling a home. So, as a buyer, you should insist on it. If levels are high, you can negotiate costs with the seller.</p> <h2>Learn more about radon, testing and abatement:</h2> <ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.epa.gov/radon/find-radon-test-kit-or-measurement-and-mitigation-professional" target="_blank" title="Opens in a new window.">How to find testing kits and abatement professionals</a></li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.epa.gov/radon/epa-map-radon-zones-and-supplemental-information#datainfo" target="_blank" title="Opens in a new window.">State assistance programs</a></li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.epa.gov/radon/radon-resources-home-buyers-and-sellers" target="_blank" title="Opens in a new window.">Home buyers and sellers guide</a></li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.epa.gov/radon/radon-hotlines-and-information-resources#hotlines" target="_blank" title="Opens in a new window.">Radon hotlines</a></li> </ul> <p><a href="/providers/elizabeth-morton-pac" target="_self" title="Opens in same window."><em>Elizabeth Morton</em></a><em> is a physician assistant in <a href="/services-and-treatments/pulmonology" target="_self" title="Opens in same window.">Pulmonology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Asthma</li> <li>Chronic obstructive pulmonary disease (COPD)</li> <li>Lung cancer</li> </ul>P.A.-C.In my free time, I enjoy spending time with my family, hiking and traveling.<p><strong>Education</strong></p> <ul> <li>Bachelor's  degree, Human Nutrition, Arizona State University, Tempe</li> <li>Master's degree, Physician Assistant Studies (MPAS), University of North Dakota, Grand Forks</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Certified Tobacco Treatment Specialist, Mayo Clinic Nicotine Dependence Center</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of CHEST Physicians</li> <li>American Thoracic Society</li> </ul>Morton<img src="/-/media/shared-files/images/medical-professionals/full/mankato/elizabeth-morton-pac.jpg?h=280&iar=0&w=280&sc_lang=en&hash=90765CDFA21569B650BDD2B9AEC3E2D6" alt="Elizabeth Morton PAC" width="280" height="280" DisableNVelocity="true" />Elizabeth<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16014782Elizabeth Morton, P.A.-C.1<img src="/-/media/national-files/images/hometown-health/2023/child-being-pushed-in-laundry-basket.jpg?h=370&iar=0&w=660&sc_lang=en&hash=FC9891C8C556CC23932007DFF8F14ABE" alt="Child being pushed in laundry basket" width="660" height="370" DisableNVelocity="true" />PulmonologyTreatment for diseases and conditions affecting lung and airway function.Lung CancerLung cancer is a type of cancer that begins in the lungs. It is the leading cause of cancer deaths in the U.S., among both men and women. Lung cancer claims more lives each year than do colon, prostate, ovarian and breast cancers combined. <br/><br/>BreathingMost cases of shortness of breath are due to heart or lung conditions. Your heart and lungs are involved in transporting oxygen to your tissues and removing carbon dioxide, and problems with either of these processes affect your breathing.Dawn Haller1/9/2023Tiny tools, cameras and incisions make a big difference during minimally invasive surgery. Patients have less pain and scarring with faster recovery. Here's what you should know if you need surgery.Minimally invasive surgery: small incisions, big benefits<p>A lot has changed in operating practices in the last 30 years, with the most significant advancements in minimally invasive techniques. In the 1990s, removing an inflamed appendix required a 2- to 4-inch incision, and the patient needed to stay in the hospital for many days. Now the appendix can be removed through a few small abdominal incisions, usually less than one-half inch, and most patients can go home the same day.</p> <h2>If you're facing the prospect of surgery, here's what you should know about minimally invasive procedures.</h2> <h3>What is minimally invasive surgery?</h3> <p>In minimally invasive surgery, surgeons use various techniques to operate with less injury to the body than with open surgery. Most patients who have a minimally invasive surgery can go home the same day or remain in the hospital for a shorter period.</p> <p>Laparoscopy was one of the first types of minimally invasive surgery. It's completed through one or more small incisions. The surgeon uses small tubes, cameras and surgical instruments to complete the surgery.</p> <p>Another minimally invasive surgery is robotic surgery. It provides a magnified, 3D view of the surgical site and helps the surgeon operate with precision, flexibility and control.</p> <h3>Types of minimally invasive surgeries</h3> <h4>Minimally invasive surgeries have now become the standard surgical techniques in many routine operations, including:</h4> <ul> <li>Anti-reflux surgery, sometimes called <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/hiatal-hernia/diagnosis-treatment/drc-20373385" target="_blank" title="Opens in a new window.">hiatal hernia repair</a>, to relieve gastroesophageal reflux disease (GERD)</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/appendectomy-surgery-to-remove-the-appendix/" target="_blank" title="Opens in a new window.">Appendectomy</a>, removal of the appendix</li> <li>Cancer surgery, to diagnose or remove the cancer</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/cholecystectomy/about/pac-20384818" target="_blank" title="Opens in a new window.">Cholecystectomy</a>, removal of the gallbladder</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/colectomy/about/pac-20384631" target="_blank" title="Opens in a new window.">Colectomy</a> to remove parts of a diseased colon or colon cancer</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/departments-centers/ent-head-neck-surgery/sections/overview/ovc-20424084" target="_blank" title="Opens in a new window.">Ear, nose and throat surgery</a></li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/departments-centers/vascular-and-endovascular-surgery/overview/ovc-20458819" target="_blank" title="Opens in a new window.">Endovascular surgery</a> to treat or repair blood vessels</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/departments-centers/minimally-invasive-gynecologic-surgery/overview/ovc-20424071" target="_blank" title="Opens in a new window.">Gynecologic surgery</a> to treat the uterus and ovaries</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/splenectomy/about/pac-20395066" target="_blank" title="Opens in a new window.">Splenectomy</a> to remove the spleen</li> <li>Urologic surgery for bladder and kidney surgeries</li> </ul> <h3>Minimally invasive surgery benefits</h3> <p>Continual innovations in minimally invasive surgery make it beneficial for people with a wide range of conditions.</p> <h4>The advantages of minimally invasive operating techniques include:</h4> <ul> <li>Less pain</li> <li>Faster recovery</li> <li>Quicker return to work</li> <li>Better cosmetic results with little scarring</li> </ul> <p>For many patients, the cosmetic results have been outstanding, resulting in surgeries with little to no scarring. Often, the incisional scars are virtually invisible three months after the operation.</p> <p>Patients often report that their postoperative pain is significantly less than expected and can easily be managed by over-the-counter pain medications. Most can return to daily activities quickly with little or no postoperative restrictions. Occasionally, a patient has undergone a minimally invasive surgical procedure on a Friday and returned to work on the following Monday.</p> <p>Minimally invasive surgery is appropriate for many patients and conditions. Talk with a surgeon if you need surgery and think you may be a candidate for minimally invasive techniques.</p> <p><a href="/providers/michael-young-md" target="_self" title="Opens in same window.">Michael Young, M.D.</a>, is a <a href="/services-and-treatments/surgery" target="_self" title="Opens in same window.">general surgeon</a> in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</p><ul> <li>Colon and gastrointestinal surgery</li> <li>Endoscopy</li> <li>Gallbladder and appendix</li> <li>Hernia surgery</li> <li>Robotic surgery</li> <li>Varicose vein treatment</li> </ul>M.D.<p>I believe every patient and their family are different with their own unique needs. My goal is to listen carefully and prioritize the needs of the patient to create a truly personalized care plan. I also strive to utilize advanced technology and minimally invasive techniques to achieve the best possible outcome, decrease pain and minimize recovery time.</p> <p>I grew up in Chaska, Minnesota, and enjoy being able to work in the area and provide the best possible surgical care to our community. In my spare time, I enjoy golfing, watching Minnesota sports teams and spending time with my family.</p><p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Internship</strong></p> <ul> <li>General Surgery, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Residency</strong></p> <ul> <li>General Surgery, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li> General Surgery, The American Board of Surgery</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Fellow, American College of Surgeons</li> <li>Midwest Surgical Society</li> <li>American Medical Association</li> </ul>Young<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/michael-young-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=808E3B64B40BDEF0C17C56689014A09A" alt="Michael Young MD" width="280" height="280" DisableNVelocity="true" />Michael<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16088212Michael Young, M.D.1{CE631A85-B409-4C11-907C-39868E49E636}<img src="/-/media/national-files/images/hometown-health/2022/reading-book-hand-on-temple.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BC7EA6E0918A376BCC33E8B51A85DF91" alt="Reading book, hand resting on temple" width="660" height="370" DisableNVelocity="true" />SurgeryHaving surgery is a major event in your life. We know this and make every effort to keep you as comfortable as possible, focusing on you as an individual. Our surgeons and staff work as a coordinated team treating a wide variety of illnesses ranging from simple to complex. We offer comprehensive, advanced care and service to every patient.Dawn Haller1/25/2023Up to 10% of babies are born with tongue-tie, which is a thick band of tissue that restricts the tongue's motion. Learn how it can affect eating and speech, and if treatment is needed.The truth about tongue-tie<p>Some people get nervous or have a hard time finding the right words in social or stressful situations. They may say that they were "tongue-tied" in the moment. While this could be an embarrassing or stressful moment, it's usually temporary. Yet, the term "tongue-tie" also is used to describe a medical condition called ankyloglossia.</p> <h2>Tongue-tie basics</h2> <p>Tongue-tie, or ankyloglossia, is when an unusually short, thick or tight band of tissue tethers the bottom of the tongue's tip to the floor of the mouth. The band of tissue is called the frenulum. When it is too short or tight, it can restrict the tongue's range of motion. Up to 10% of all newborns are born with ankyloglossia.</p> <img alt="Tongue tie illustration" src="/-/media/national-files/images/hometown-health/2023/tongue-tie-illustration.jpg?h=390&w=625&sc_lang=en&hash=0D23B259967CF9AAA115114D6887F7CE" style="width: 100%;" /> <p>The most common type of tongue-tie affects the anterior frenulum, which is visible near the front of the tongue. Research studies are exploring posterior tongue-tie, which is when the frenulum is restricted further back underneath the tongue.</p> <h2>Tongue-tie symptoms</h2> <p>The most common symptom of tongue-tie in newborns is difficulty with breastfeeding or bottle-feeding. This is because a baby must be able to get the tongue to the roof of the mouth to squeeze the nipple and express milk while feeding. If a tongue has a limited range of motion, the child can't create a good seal and is less effective with expressing milk from the bottle or nipple and pushing it to the back of the mouth to initiate the swallowing mechanism.</p> <p>When newborns have a posterior tongue-tie, they may be able to protrude their tongues past their gums, but the tongue is tethered further back and causes feeding or swallowing issues.</p> <p>Latching and feeding challenges can be caused by various issues, not just tongue-tie. It's important to rule out other causes before seeking tongue-tie treatment. Additional issues could include a recessed jaw, infection, jaundice, poor positioning, engorgement or others.</p> <p>Some people are diagnosed later in life, especially if the tongue-tie wasn't significant enough to cause breastfeeding issues in infancy. Teens often are diagnosed with tongue-tie after expressing concerns and becoming self-conscious about their tongues as they become involved in romantic relationships.</p> <h3>Other tongue-tie signs include:</h3> <ul> <li>Difficulty lifting the tongue to the roof of the mouth or moving the tongue side to side</li> <li>Trouble sticking the tongue past the lower lip</li> <li>A tongue that appears notched or heart-shaped when stuck out</li> <li>Challenges making specific letter sounds such as "t," "d," "l" and "th"</li> </ul> <p>Tongue-tie does not cause sleep apnea or snoring.</p> <h2>Tongue-tie treatments</h2> <p>Not all people with tongue-tie require treatment. Some health care professionals recommend treating it right away, while others take a wait-and-see approach. Otorhinolaryngology, or ear, nose and throat, professionals work in concert with lactation consultants and speech therapists to recommend the right treatment option for each patient.</p> <p>If treatment is recommended, a frenotomy is a quick, low-risk procedure to correct tongue-tie. In an office setting, a laser or sterile scissors is used to snip the frenulum free. The healing time is quick, with minimal pain and blood loss.</p> <p>The risks for the procedure are low. However, your health care team must carefully avoid the glands, ducts and nerves located under the tongue to prevent injury, especially if treating a posterior tongue-tie.</p> <h2>Living with tongue-tie</h2> <p>As a person grows and develops, tongue anatomy does not change. People will not grow out of the condition, but most learn to manage the symptoms as they age. For example, having tongue-tie can be a problem for newborns who rely on breastfeeding. Adults have little or no issues with eating because they can cut up food into smaller pieces and place food further back into the mouth using a utensil. Speech therapy can help with letter sounds and pronunciation.</p> <p>Talk to your child's pediatrician or otorhinolaryngology professional if you have tongue-tie concerns or questions.</p> <p><a href="/providers/quintin-cappelle-md" target="_self" title="Opens in same window."><em>Quintin Cappelle, M.D.</em></a><em>, is an <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">otorhinolaryngologist</a> and head and neck surgeon in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Chronic ear disease</li> <li>Chronic sinusitis</li> <li>Ear tubes/tympanostomy tubes</li> <li>Endoscopic dacryocystorhinostomy (tear duct surgery)</li> <li>Head and neck cancer</li> <li>Hearing loss</li> <li>Nasal polyps</li> <li>Nose and sinus disease</li> <li>Parathyroid adenomas</li> <li>Parotid disease</li> <li>Salivary gland/parotid</li> <li>Thyroid nodules</li> <li>Thyroid/parathyroid disease</li> <li>Tonsillectomy and adenoidectomy</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Illinois at Chicago College of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Otolaryngology – Head and Neck Surgery, University of Illinois at Chicago Eye & Ear Infirmary</li> </ul> <p><strong>Membership</strong></p> <ul> <li>Head and Neck Surgery, American Academy of Otolaryngology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Otolaryngology, Mayo Clinic College of Medicine and Science</li> </ul>Cappelle<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/quintin-cappelle-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=AAB359B4BA7F1209F2C019BFA15FE31E" alt="Quintin Cappelle MD" width="280" height="280" DisableNVelocity="true" />{B48121EC-8A20-45D5-9673-3DDA968CB0D1}Quintin<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20279493Quintin Cappelle, M.D.1{18E5E65E-45C8-4C48-BD32-A914794E2AA4}|{E9B8BDBE-375B-4E7D-A1D2-2B64B5513AF7}<img src="/-/media/national-files/images/hometown-health/2023/bottle-feeding-baby-in-arms.jpg?h=370&iar=0&w=660&sc_lang=en&hash=22A0D7A51EC627EC76E5ED073FD7ECBA" alt="Bottle-feeding baby in arms" width="660" height="370" DisableNVelocity="true" />Ear, Nose and Throat (ENT)Get information about symptoms, disorders and diseases affecting the ear, nose and throat, and related head and neck structures.Dawn Haller1/3/2023Changing wet sheets in the middle of the night isn't fun for anyone. While bed-wetting is common for kids under 7, here's what to do if your older child continues to struggle.Soggy sheets, embarrassed kids: Tips for overcoming bed-wetting<p>"Mom, dad? I'm wet."</p> <p>Parents quickly spring into action when they hear these words. Changing wet sheets and comforting an upset or embarrassed child isn't fun for anyone in the middle of the night.</p> <p>Many families struggle with bed-wetting. It's a normal part of child development. It isn't anyone's fault, but that doesn't mean it can't be stressful, especially for older kids. Here's what you need to know about this common condition.</p> <h2>Types of bed-wetting</h2> <p>Bed-wetting, also known as nocturnal incontinence or nocturnal enuresis, is the involuntary release of urine while asleep. It happens after the age at which staying dry at night is reasonably expected. Bed-wetting up to age 7 is common and not a concern. Most kids outgrow bed-wetting on their own by the time they are 12.</p> <h3>There are two general types of bed-wetting:</h3> <ul> <li><strong>Primary bed-wetting</strong><br /> This is when a child has not been able to stay dry through the night. This usually happens in younger children. For example, the child may be able to remain dry during the day, but needs to wear a pull-up while asleep.</li> <li><strong>Secondary bed-wetting<br /> </strong>This is a reoccurrence of bed-wetting. The child has been able to stay dry at night for a long period, six months or longer, but then starts having trouble again at an older age. For example, a child that has been dry at night since age 4, but then starts wetting the bed again at age 6.</li> </ul> <h2>Causes of bed-wetting</h2> <p>When a child starts to experience bed-wetting, especially secondary bed-wetting, we work with parents to figure out why it is happening. There is a strong family connection with bed-wetting. About 40% to 50% of kids with nocturnal bed-wetting had a parent who struggled with bed-wetting as a child.</p> <h3>Other possible causes include:</h3> <ul> <li>Diabetes</li> <li>Urinary tract infection</li> <li>Vaginitis</li> <li>Deep sleeper</li> <li>Small bladder or bladder nerves slow to mature</li> <li>Chronic constipation</li> </ul> <h2>Tips for helping a child stay dry</h2> <p>Treatment usually isn't necessary for primary bed-wetting or children under 7. A watch-and-see approach is usually the best option, as we can expect an 8% to 10% improvement every year the child grows. Most children outgrow bed-wetting on their own.</p> <h3>There are things that parents can do to help a child with secondary bed-wetting or who is older than 7, including:</h3> <ul> <li><strong>Restrict fluids in the evening.</strong><br /> Encourage the child to drink plenty of fluids during the day to remain hydrated and reduce thirst in the evening. Avoid high-sugar or caffeinated drinks during the evening. Restrict drinks within two hours of bedtime.</li> <li><strong>Build voiding into the bedtime routine.</strong><br /> Start the bedtime routine by urinating and then encourage the child to go again before falling asleep.</li> <li><strong>Set alarm for overnight voiding.</strong><br /> Some children can stay dry by voiding in the middle of the night. For example, a parent can set the alarm to wake the child at midnight, the child uses the bathroom and then returns to bed.</li> <li><strong>Use a moisture alarm.</strong><br /> These over-the-counter pads, also called bed-wetting alarms, are connected to a battery-operated alarm. This approach takes time, motivation and patience. It can take one to three months to see results, but this option is low-risk and may be a better long-term solution than medications.</li> <li><strong>Try prescription medications.</strong><br /> Occasionally, a child could be prescribed desmopressin as a short-term solution for bed-wetting. This medication retains water in the body, so the child's bladder does not get too full overnight. There are a few possible side effects with medication, which should be discussed with your child's health care team. The medication is more effective in older children, and the overall success rate is about 30%. Usually, other strategies, including time, are tried before medications.</li> </ul> <h2>What not to do</h2> <p>Bed-wetting can be frustrating and embarrassing for children. It can cause anxiety, especially for children planning sleepovers with friends. Children look to their parents for their response to the situation and for acceptance regardless of their struggles.</p> <h3>If your child is experiencing secondary bed-wetting, here are four things you should not do:</h3> <ul> <li><strong>Reprimand or scold.</strong><br /> Children don't wet the bed because of laziness or spite. Yelling or expressing your disappointment does not help children's bed-wetting and can hurt their confidence.</li> <li><strong>Withhold liquids all day.</strong><br /> Depending on age, children need between 4 and 8 cups of water each day to remain hydrated. This improves mood, memory, energy and attention while decreasing the risk of constipation. Consider restricting liquids in the evenings, but encourage fluids during the day.</li> <li><strong>Purposely embarrass your child.</strong><br /> Discussing children's bed-wetting with peers or family can increase anxiety and embarrassment. It doesn't motivate and can create lasting emotional scars.</li> <li><strong>Compare children.</strong><br /> All children are different and develop at their own rates. They can't control how quickly the nerves in their bladders mature or their bladder sizes. Don't compare children to siblings or peers, as this will only increase stress and lower self-esteem.</li> <li><strong>Expect instant results.</strong><br /> Sometimes, all a child needs is time and a supportive parent. There are no quick fixes for solving bed-wetting. Be patient, kind and compassionate.</li> </ul> <p>Remember, bed-wetting isn't anyone's fault. Your child isn't lazy and isn't doing it on purpose. Most likely, it's a familial gift passed down by one of the parents. </p> <p>Talk with your child's health care team about weight loss, burning or cloudy urine, daytime incontinence, or increased thirst, as they could be a sign of a different, treatable condition. </p> <p><a href="/providers/manjunatha-md" target="_self" title="Opens in same window."><em>Manjunatha</em></a><em><a href="/providers/manjunatha-md" target="_self" title="Opens in same window.">, M.D.</a>, is a pediatrician in <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">Pediatric & Adolescent Medicine</a> in ;<a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Adolescent acne</li> <li>Allergy and asthma</li> <li>Anemia in children</li> <li>Anxiety</li> <li><span style="color: #202124; background-color: #ffffff;">Attention-deficit/hyperactivity disorder (</span>ADHD)</li> <li>Bedwetting issues</li> <li>Depression</li> <li>Lyme disease</li> <li>Migraine headache</li> <li>Newborn care</li> <li>Urinary and kidney problems</li> </ul>M.D.<p>I chose to work at Mayo Clinic Health System since it provides the highest quality of medical care in the Midwest.</p> <p>I look forward to helping create individualized care plans for my patients and their wellness goals. I manage the physical, mental and emotional well-being of children in every stage of development. I believe in developing a trusting relationship and always value parents’ input in childcare decision-making.</p> <p>In my spare time, I enjoy playing cricket and tennis, watching movies, listening to music and spending time with my wife and two sons.</p><p><strong>Education</strong></p> <ul> <li>Jawaharlal Nehru Medical College</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Pediatrics, Marshfield Clinic Health System</li> <li>Pediatrics, Royal College of Pediatrics and Child Health</li> <li>Pediatrics, Mysore Medical College and Research Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Pediatrics</li> <li>Neonatal Resuscitation Program</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Pediatrics, Mayo Clinic College of Medicine and Science</li> </ul>Manjunatha<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/fnu-manjunatha-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=DF32FB2C272DE3D15C5BB00CDBA7B053" alt="Fnu Manjunatha, M.D." width="280" height="280" DisableNVelocity="true" />Fnu<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20712260Fnu Manjunatha, M.D.1{61776FD2-05E8-47E9-AB55-EE465BD29A19}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}|{9B57996D-7C65-499B-8DB5-FBB37D1A5DD1}<img src="/-/media/national-files/images/hometown-health/2022/sleeping-child.jpg?h=370&iar=0&w=660&sc_lang=en&hash=996EA2655487A0572618E2E982506583" alt="Sleeping child" width="660" height="370" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller1/24/2023<span style="color: black;">Upper arm muscles do your heavy lifting. Despite their strength, biceps and triceps can be damaged by overuse or forceful injury. Learn what to do when that happens.</span>Sprains, strains and tears: What can go wrong with upper arms<p>Having well-defined, muscular upper arms often is the goal of anyone seeking a fit, toned appearance. But there's more to these hardworking muscles than good looks. The biceps, the muscle in front of your arm, and triceps, the one at the back, do the heavy lifting when flexing or extending your arm and making twisting motions.</p> <h2>What can go wrong</h2> <p>Despite their strength, these muscles can be damaged through overuse or forceful injury, such as lifting a heavy object out of a truck bed or incorrectly using weights at the gym. Overuse can irritate the tendons, which connect muscles to bones, causing pain and inflammation. A forceful injury can tear or rupture the tendon.</p> <p>Injuries to the upper arm muscles and tendons are most common in men 30–50, but women may also experience them.</p> <p>If the tendon ruptures, you may feel a tearing sensation and actually hear a pop, usually around the elbow but sometimes at the shoulder. The muscle tends to ball up, forming a "Popeye" bulge that doesn't improve. It's usually accompanied by swelling, bruising, cramping and extreme pain, as well as loss of function.</p> <p>The sooner a rupture is treated, the better the recovery since scar tissue can form and the arm muscles can begin to weaken or atrophy. Consult with an orthopedic surgeon to learn about both nonsurgical and surgical options.</p> <h2>Treating upper arm injuries</h2> <p>Some patients choose to forego surgery. However, pain, arm function and appearance (the Popeye bulge) won't improve over time.</p> <p>If a tendon ruptures, the first line of treatment is to reattach it to the bone using sutures and anchors. This surgery is typically an outpatient procedure, with patients going home the same day.</p> <p>Recovery may take three months or more. After surgery, the arm is immobilized by a splint with a 90-degree bend at the elbow and sling for several weeks, giving the repair time to heal.</p> <p>Passive therapy, where someone moves your arm for you, is designed to help you regain range of motion and prevent the elbow from stiffening. You may want to continue using the sling for protection and comfort.</p> <p>At four to five weeks post-op, active motion helps you regain strength. At that point, you'll be able to do light activities such as getting dressed, personal care and working at a computer. By three months, you'll be gradually rebuilding strength through increased activity.</p> <h2>Preventing injury</h2> <p>To prevent injury to your upper arm muscles and tendons, maintain overall strength, avoid overloading your arm muscles and be sure you're using proper technique when working with weights at home or the gym.</p> <p><a href="/providers/doug-bartels-md" target="_self" title="Opens in same window."><em>Douglas Bartels, M.D.</em></a><em>, is an orthopedic surgeon in <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">Orthopedics</a> and <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">Sports Medicine</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>ACL injuries</li> <li>Cartilage restoration and transplantation</li> <li>Hip arthroscopy</li> <li>Knee arthroscopy</li> <li>Meniscus tears</li> <li>Multi-ligament knee injuries</li> <li>Open surgery of the knee </li> <li>Open surgery of the shoulder</li> <li>Patellar instability</li> <li>Rotator cuff injury</li> <li>Shoulder arthroscopy</li> <li>Shoulder instability</li> <li>Shoulder replacement surgery</li> <li>Sports medicine</li> <li>Tendon tears (Achilles, pec, tricep, bicep)</li> </ul>M.D.<p>I chose a career in sports medicine to help patients of all ages and activity levels regain function and get back to doing the things they love. In my practice, I enjoy taking care of acute and chronic shoulder, hip and knee injuries and issues. I take pride in providing individualized care and making sure you are a part of the decision-making process. As a lifelong athlete, my main goal is to get patients back to work, school, hobbies, and sports feeling better than they did before their injury.</p> <p>I grew up in the Midwest and am thrilled to be providing orthopedic care in Northwest Wisconsin. As a college athlete I was exposed to sports-related injuries, which sparked my interest in orthopedics and sports medicine. During my residency and fellowship, I was able to be a team doctor for athletes at the high school level all the way to the professional level with the San Francisco 49ers.</p> <p>In my spare time, I enjoy spending time with my family and dogs along with traveling and fishing.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Biological Anthropology, Northwestern University</li> <li>Master's degree, Liberal Studies, Northwestern University</li> <li>Doctor of Medicine, Rush Medical College</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Sports Medicine and Shoulder Surgery, Stanford Health Care</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Alpha Omega Alpha Honor Medical Society</li> <li>American Academy of Orthopedic Surgeons (AAOS)</li> <li>American Medical Association (AMA)</li> <li>American Orthopedic Society for Sports Medicine (AOSSM)</li> <li>Football Team Physician, San Francisco 49ers</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Orthopedics, Mayo Clinic College of Medicine and Science</li> </ul>Bartels<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/douglas-bartels-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A5E506A9AEFC8F3CA64AF69A13885600" alt="Douglas (Doug) Bartels M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/35188900/" target="_blank" title="Opens in new window">Antibiotic prophylaxis with cefazolin is associated with lower shoulder periprosthetic joint infection rates than non-cefazolin alternatives</a>; May 2022</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/33764935/" target="_blank" title="Opens in new window">Revision reverse shoulder arthroplasty for anatomical glenoid component loosening was not universally successful: A detailed analysis of 127 consecutive shoulders</a> May 2021</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/31039055/" target="_blank" title="Opens in new window">Mid-term radiological results of a cementless short humeral component in anatomical and reverse shoulder arthroplasty</a>; May 2019</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/30968051/" target="_blank" title="Opens in new window">Epidemiology of hand and wrist injuries in NCAA men's football: 2009-2010 to 2013-2014</a>; April 2019</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/30393556/" target="_blank" title="Opens in new window">Arthroscopy and arthrotomy to address intra-articular pathology during PAO for hip dysplasia demonstrates similar short-term outcomes</a>; June 2018</li> </ul>{C36F83B1-9C26-4B21-BA7B-739F5EB4C565}Douglas (Doug)<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20090200Douglas (Doug) Bartels, M.D.1{DEF55970-853F-4E96-9A4D-3413874FF059}|{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2023/arms-lifting-dumbells.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B40DBA5A761FDC6547017FB41BFF1315" alt="Arms lifting dumbells" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller1/25/2023As the seasons change, youth athletes transition gear from one sport to the next. Intense training changes an athlete's heart over time. Read what parents and athletes should know about heart health.Youth athletes shouldn't skip a beat when it comes to heart health<p>As the seasons change, so do the sports seasons. Youth athletes transition sports gear like cleats, nets, basketball shoes, hockey sticks, and singlets. From outdoor training to indoor activities, sports conditioning requires stamina and endurance from the body's <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/departments-centers/sports-cardiology/overview/ovc-20442146" target="_blank" title="Opens in a new window.">cardiovascular system</a>.</p> <h2>Sports activity and its effects on the body</h2> <p>Intense training and exercise increase the body's need for oxygen. The heart is vital as the engine that supplies oxygen-rich blood to the muscles. With regular, vigorous aerobic activity, an athlete's heart begins to change over time, growing larger and stronger with increased capacity.</p> <p>Physical activity, especially mild to moderate exercise, is beneficial in many ways. It reduces the risk of chronic disease, improves balance and coordination, helps you lose weight, and even boosts self-esteem. Highly strenuous physical activities, however, can potentially put uncertain stress on the heart.</p> <h2>Heart conditions and youth athletes</h2> <p>Sports-related deaths are mainly caused by <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/syc-20350613" target="_blank" title="Opens in a new window.">coronary artery disease</a> in adults and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/cardiomyopathy/symptoms-causes/syc-20370709" target="_blank" title="Opens in a new window.">cardiomyopathy</a> or <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/heart-arrhythmia/symptoms-causes/syc-20350668" target="_blank" title="Opens in a new window.">arrhythmia</a> in youths according to a 2018 review. </p> <p>Other heart conditions, like <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/myocarditis/symptoms-causes/syc-20352539" target="_blank" title="Opens in a new window.">myocarditis</a>, can contribute to sudden cardiac death, but these conditions do not occur suddenly. Generally, a person with myocarditis would likely feel sick and not participate in the sport.</p> <p>There is an occasion where bad outcomes like sudden cardiac arrest occur in an athlete. Sudden cardiac arrest is the leading cause of death in young athletes. Estimates vary, but some reports suggest that about 1 in 50,000 to 1 in 80,000 young athletes die of sudden cardiac death each year. For comparison, the incidence of sudden cardiac arrest in the general population is about 1 in 1,000 people yearly. </p> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/sudden-cardiac-arrest/symptoms-causes/syc-20350634" target="_blank" title="Opens in a new window.">Sudden cardiac death</a> is often caused by faulty electrical signaling in the heart. A very fast heartbeat causes the lower heart chambers (ventricles) to quiver uselessly instead of pumping blood. This irregular heart rhythm is called ventricular fibrillation. Any condition that strains the heart or damages heart tissue can increase the risk of sudden death. </p> <h3>Some conditions that can lead to sudden cardiac death in young people are:</h3> <ul> <li><strong>Thickened heart muscle, or hypertrophic cardiomyopathy</strong><br /> The most common cause of sudden cardiac death in young people is this genetic condition that causes the heart muscle to grow too thick.</li> <li><strong>Blunt chest injury</strong><br /> A hard hit to the chest that causes sudden cardiac death is called commotio cordis. Commotio cordis may occur in athletes hit hard in the chest by sports equipment or another player./li> </li> <li><strong>Heart structure problem present at birth, or congenital heart defect</strong><br /> Some people are born with heart and blood vessel changes that can reduce blood flow and lead to sudden cardiac death.</li> <li><strong>Certain rare heart rhythm disorders</strong></li> </ul> <h2>Cardiac evaluation and testing in youth athletes</h2> <p>Sometimes it can be difficult to tell the difference between arrhythmias and the fact that the heart is going fast. In athletes, especially young athletes, <a href="/-/media/national-files/images/hometown-health/2021/know-your-numbers-heart-rate.jpg" target="_self" title="Opens in same window.">heart rates</a> will naturally increase. A young athlete's heart rate may increase to 200 beats per minute or more and can still be considered within the physiological range. It can be difficult to tell whether there is an arrhythmia disorder.</p> <p>If an underlying condition is present, an athlete's health care team may recommend further evaluation of heart health. Recommended testing, such as an <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/ekg/about/pac-20384983" target="_blank" title="Opens in a new window.">EKG</a>, could add insight to support the use of medical intervention if needed. </p> <p>Based on the evaluation and testing results, medication or surgery may be recommended to reduce the risk of sudden death. For example, an <a rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/implantable-cardioverter-defibrillators/about/pac-20384692" target="_blank" title="Opens in a new window.">implantable cardioverter-defibrillator</a> (ICD) device might be implanted in the chest to continuously monitor the heart's rhythm. The ICD delivers electrical shocks to reset the heart if a life-threatening heart rhythm problem occurs.</p> <h2>Return to play evaluation for athletes</h2> <p>If an athlete is found to have a heart issue, shared decision-making for a return to play is critical to the success of the process. This begins with thorough testing, a customized treatment plan, discussion of risks and a review of current guidelines for sports participation. </p> <p>Close attention to an athlete's heart patterns and symptoms is the key to overall health. When beating patterns or a racing sensation in the chest are noticed, that's a sign something isn't right.</p> <p>Parents and youth should not deter from participating in sports or other cardiovascular exercises. Sudden death in the young is rare. Measures like early cardiopulmonary resuscitation and automatic external defibrillators are available and effective in preventing sudden cardiac death in case of an emergency. Cardiovascular exercise is beneficial and encouraged for overall health.</p> <p><a href="/providers/xiaoke-ken-liu-md-phd" target="_self" title="Opens in same window."><em>Xiaoke (Ken) Liu, M.D.</em></a><em>, is a <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Atrial fibrillation</li> <li>Atrial flutter</li> <li>Cardiac devices</li> <li>Cardiac resynchronization devices</li> <li>Clinical cardiac arrhythmias</li> <li>Supraventricular tachycardia (SVT)</li> </ul>M.D., Ph.D.<p>I believe being able to practice clinical medicine is a privilege granted by our patients, and they have the rights to be treated the same way as our family members and friends would be. It brings me tremendous happiness and joy to see my patients feel better or completely recover from frequently debilitating heart rhythm conditions through treatment. I strive to achieve that for every patient I see, often through a multidisciplinary, team approach offered at the Mayo Clinic Health System and often involving a shared decision-making process.</p> <p>My years of training and experience have also taught me the need to stay up to speed with the latest development in the field, to be humble and stay open-minded in evaluating different ideas and options as the disease may be the same, but the individual patient is not and may benefit from tailored treatment.</p> <p>In my free time, I love to spend time with my family, hike, sightsee and attend sports events. I also enjoy ping-pong, pickleball and swimming. If time allows, I would really like to learn more about fishing and boating in the future.</p><p><strong>Education</strong></p> <ul> <li>Hunan Medical University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Internal Medicine, Mayo Clinic</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>Cardiovascular, Mayo Clinic School of Graduate Medical Education</li> <li>Internal Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Cardiology and Electrophysiology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Cardiovascular Disease, American Board of Internal Medicine</li> <li>Clinical Cardiac Electrophysiology, American Board of Internal Medicine</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American College of Cardiology</li> <li>Heart Rhythm Society</li> </ul>Liu<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/xiaoke-ken-liu-md-phd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=E9FC7400B73A9B49BDB8842EA2B6196E" alt="Xiaoke Ken Liu, M.D., Ph.D." width="280" height="280" DisableNVelocity="true" /><p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/35870261/" target="_blank" title="Opens in new window">Aging-associated susceptibility to stress-induced ventricular arrhythmogenesis is attenuated by tetrodotoxin</a>; October 2022</p> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/36055436/" target="_blank" title="Opens in new window">Role of adjunctive cryoballoon left atrial posterior wall isolation in non-paroxysmal atrial fibrillation: A meta-analysis</a>; August 2022 </p> <p><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/34026498/" target="_blank" title="Opens in new window">Successful fluoroless deviation of the esophagus during atrial fibrillation ablation</a>; April 2021</p> <p><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/30194724/" target="_blank" title="Opens in new window">Outcomes of 200 consecutive, fluoroless atrial fibrillation ablations using a new technique</a>; November 2018</p> <p><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/28748143/" target="_blank" title="Opens in new window">Successful fluoroless ablation of an incessant atypical atrial flutter attributed to AtriClip usage during mini-MAZE surgery for persistent atrial fibrillation</a>; July 2017</p>{E157CC36-5C02-406C-AE55-B6A48D97C400}Xiaoke (Ken)<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13433016Xiaoke (Ken) Liu, M.D., Ph.D.1<img src="/-/media/national-files/images/hometown-health/2023/young-athletes-playing-lacrosse.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0776F8D9401DA4F25646E9449C717CDF" alt="Young athletes playing lacrosse" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Michele Halterman2/1/2023Training for a spring run starts during the cold winter months. It takes dedication and care. Before you head out, consider these tips to stay safe and warm as you log those miles.Tips for safe cold-weather training<p>Preparing for a marathon takes months of hard work, and some of those months may be during a Midwestern winter when the air can make your face hurt. That's when it takes a little extra dedication — and some extra care to stay safe when training in the cold.</p> <h2>Here are some tips to consider:</h2> <h3>Know yourself.</h3> <p>Exercising in the cold is safe for almost everyone, but you should talk to a health care professional first if you have certain conditions, such as asthma, heart problems or <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.mayoclinic.org/diseases-conditions/raynauds-disease/basics/definition/con-20022916" target="_blank" title="Opens in a new window.">Raynaud's disease</a>.</p> <h3>Watch the weather forecast and wind chill.</h3> <p>When the wind chill gets below minus 18, frostbite can occur on exposed skin within 30 minutes or less. The wind can penetrate your clothing, even if you're bundled up. Some days, it may be best to take a break or bring your workout indoors if the temperature dips below zero, the wind chill is extreme or if visibility has been reduced by falling or blowing snow.</p> <h3>Know the signs of frostbite and hypothermia.</h3> <p>Exposed skin, such as your cheeks, nose and ears, are most at risk for frostbite. It also can affect your hands and feet. Early warning signs include numbness, loss of feeling or a stinging sensation. Get out of the cold, and slowly warm the affected area. Don't rub the area because that can damage the skin. Seek emergency care if the numbness doesn't go away.</p> <p>Hypothermia is abnormally low body temperature. Signs and symptoms include intense shivering, slurred speech, loss of coordination and fatigue. Get emergency help right away if you or your running partner experience these symptoms.</p> <h3>Dress in layers.</h3> <p>Your mom probably told you this one, but it's wise advice. Why? Because as you sweat, you can peel off a layer to avoid losing heat from evaporation. Start with a thin layer of synthetic material, such as polypropylene, which draws sweat away from your body. Avoid cotton, which stays wet next to your skin. Add a layer of fleece or wool for insulation. Top this with a waterproof, breathable outer layer.</p> <p>You might need to experiment a bit. A rule of thumb for layers is if you feel a little chilly at the start of your warmup, you've probably layered correctly. If you're warm before your warmup, you're probably overdressed.</p> <h3>Protect your head, hands, feet and ears.</h3> <p>Wear thin glove liners made of a wicking material, such as polypropylene, under heavier gloves or mittens lined with wool or fleece. Remove the outer pair when your hands get sweaty. Wear a hat or headband and thermal socks. You may need running shoes one size larger than usual to accommodate thicker socks. If it's extremely cold, consider wearing a scarf or ski mask to cover your face.</p> <h3>Don't forget safety gear and sunscreen.</h3> <p>It gets dark early this time of year, so it's always best to run during daytime hours if you can. If you're not able to make that work and are running as it gets dark, wear reflective clothing so you're more visible, and run in well-lit areas.</p> <p>Choose footwear with enough traction to stay steady on your feet. If some or all of your run will be over ice and snow, consider investing in a pair of ice traction devices to improve grip in icy and snowy conditions.</p> <p> It's as easy to get sunburned in winter as in summer, especially when there's snow on the ground. Wear a sunscreen that blocks UVA and UVB rays, and a lip balm with sunscreen. Protect your eyes from snow and ice glare with sunglasses.</p> <h3>Drink plenty of fluids.</h3> <p>Don't forget about hydration. It's just as important during cold weather as it is in the heat. Drink water or sports drinks before, during and after your workout, even if you're not thirsty.</p> <h3>Tell someone where you're running.</h3> <p>It's a good idea to tell a friend or family member what your running path will be and when you can be expected to return. They can alert authorities if you happen to become injured or worse and don't return on time.</p> <p>Your hard work will pay off. Keep at it, and stay safe no matter the weather.</p> <p><a href="/providers/corey-wencl-lat" target="_self" title="Opens in same window."><em>Corey Wencl</em></a><em> is an athletic trainer in <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">Sports Medicine</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p>A.T.C.<p>I understand not all patients are traditional athletes looking to get back to high-level, competitive athletics. Some patient goals may be to enjoy going on walks or working in the garden again without the pain. Knowing this information and understanding that each patient's capacity and level of activity differ, I am able to offer a personalized treatment plan at the initial visit to Sports Medicine.</p> <p>I grew up in Blooming Prairie, Minnesota, and pursued my athletic training degree from Winona State University. My athletic training practice and experience spans high school and college athletics, as well as clinical and industrial settings.</p> <p>Outside of work, I enjoy spending time outdoors with my wife, son and two dogs. I like golfing and spending time on the river in the summer months.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Exercise Science: Athletic Training, Winona State University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Certified Orthopedic Physician Extender, American Society of Orthopedic Professionals</li> <li>Certified Athletic Trainer, Board of Certification</li> <li>ImPACT Trained Athletic Trainer, ImPACT Applications</li> <li>Licensed Athletic Trainer, State of Wisconsin</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Society of Orthopedic Professionals</li> <li>Great Lakes Athletic Trainers Association</li> <li>National Athletic Trainers Association</li> <li>Wisconsin Athletic Trainers Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> <p> </p> </ul>Wencl<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/corey-wencl-lat.jpg?h=280&iar=0&w=280&sc_lang=en&hash=25578FE537C9FB6FAF102FB818CE2CD9" alt="Corey Wencl, L.A.T." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/33585801/" target="_blank" title="Opens in new window">Use of Electrocardiographic Screening to Clear Athletes for Return to Sports Following COVID-19 Infection</a>, February 2021.</li> </ul>Corey<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20959338Corey Wencl, A.T.C.1<img src="/-/media/national-files/images/hometown-health/2023/running-outdoors-in-winter.jpg?h=370&iar=0&w=660&sc_lang=en&hash=165B27542B10E59C87FF0F3B41844728" alt="Running outdoors in winter" width="660" height="370" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller2/20/2023Dental infections are one of the most common infections in children. Read why establishing healthy dental habits in children should start at an early age, and get tips for keeping your child's teeth healthy.Keeping children's teeth healthy<p>Dental infections are one of the most common infections in children. Even though dentistry has come a long way with the latest dental advancements, you still have to play an active role in your dental care — and your children's. Oral health is whole-person health, and untreated dental disease has been linked to stroke, heart disease and diabetes in adulthood.</p> <p>Dental caries — otherwise known as tooth decay or cavities — affect many children and adults. Dental caries are an infectious disease caused by bacteria transferred from your mouth, or another caregiver's mouth, to your children's mouth. This disease is nearly entirely preventable through good dental habits and routine checkups with a dentist. </p> <h2>Start dental health early</h2> <p>Starting at 6 months, formula should be mixed with fluoride water to make bottles. Nighttime eating increases the risk of tooth decay due to lactose, which is milk sugar. In general, the more carbohydrates a child consumes, the greater chance for cavities.</p> <p>Every child should have an oral health exam by age 1, or when the first tooth emerges. Regular dental visits should follow 3 to 6 months. Dental care is different for each family, and could include a pediatric dentist or family dentist; Women, Infants and Children (WIC) clinics; and even your health care professional's office. </p> <p>Fluoride varnish should be applied to your children's teeth every 3 to 6 months, and often can be applied at their well-child visit by the health care team. This topical fluoride can prevent and even reverse early cavities.</p> <p>You can <a href="/-/media/national-files/documents/hometown-health/2020/keeping-childrens-teeth-healthy.pdf?sc_lang=en&hash=9C4641682FB6884983F485F2CD228E0F" target="_blank" title="Opens in a new window.">establish healthy habits</a> with your child when they are young. By 6 months, children should have fluoride in their water, and children of brushing age should use soft brushes and fluoridated toothpaste. If you don't have access to fluoridated water, your children's health care team can recommend a source of fluoride, including nursery water or fluoride drops/tablets.</p> <p>Children need supervision with brushing at least halfway through grade school. Parents should always supervise. You can stop supervision when you think your child is doing as good of a job as you would. Brushing two times a day is usually enough, and children should begin flossing as soon as their dentist recommends it.</p> <h2>Eat a diet that promotes healthy teeth</h2> <p>Frequent snacking increases your children's risk for cavities. The saliva in their mouth is important to prevent cavities. If the mouth frequently has food or sugary liquid, the saliva cannot protect the teeth from decay. </p> <p> Avoid soda pop, juice and frequent snacking. Not only do they increase the risk of obesity, but the combination of sugar and acid breaks down teeth. The same goes for juice. Juice is just a form of soda pop without carbonation. Instead, choose water to drink between meals and select 1 or 2 times daily to have a snack.</p> <p><a href="/providers/erin-westfall-do" target="_self" title="Opens in same window."><em>Erin Westfall, D.O.</em></a><em>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Community-based participatory research</li> <li>Health equity and the social determinants of health</li> <li>Medical and dental integration in primary care</li> <li>Osteopathic principles and practice</li> <li>Preventive care</li> <li>Women's and children's health</li> </ul>D.O. <p>I believe that physicians have a responsibility to their patients and the community to work to ensure that all people have the opportunity to achieve their optimal health. </p> <p>Within the clinic, I am dedicated to bringing my true, authentic self to each patient interaction. I will be present for you, listen to you and engage in shared decision-making to facilitate high quality, evidence-based, comprehensive and individualized care.</p> <p>Within the community, I am dedicated to working with community partners to address the health and wellness needs of the Greater Mankato area.</p> <p>I grew up in a very rural community in Eastern Colorado three hours from anywhere, so I learned how to be creative and "make fun" from a very young age. Thus, I'm easily entertained (which is good, because my husband is an entertainer). I enjoy being outdoors; hiking, bicycling, and gardening. I enjoy traveling to the high country in Colorado and up to the Boundary Waters with my husband, two girls and our goofy dog.</p><p><strong>Education</strong></p> <ul> <li>Kirksville College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, University of Minnesota Department of Family Medicine and Community Health</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Family Medicine, American Board of Family Medicine</li> <li>Family Medicine, American Osteopathic Board of Family Physicians</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians </li> <li>American College of Osteopathic Family Physicians</li> <li>Minnesota Academy of Family Physicians </li> <li>Minnesota Osteopathic Medical Society </li> <li>Society for Teachers of Family Medicine </li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Westfall<img src="/-/media/shared-files/images/medical-professionals/full/mankato/erin-westfall-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=1C760F992836E9DB1ECA64170A7E1FFA" alt="Erin Westfall, D.O." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/36689960/" target="_blank" title="Opens in new window">Family physicians are using neighborhood navigator to address social determinants of health</a>, January 2023.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/36219436/" target="_blank" title="Opens in new window">Racial bias in test performance: Primary language and a more holistic knowledge assessment</a>, October 2022.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/35603490/" target="_blank" title="Opens in new window">Development and early experience of a primary care learning collaborative in a large health care system</a>, January 2022.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/36300432/ " target="_blank" title="Opens in new window">Calling your Aunt Bertha for social assets: Family medicine and social determinants of health</a>, January 2022.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/34409899/" target="_blank" title="Opens in new window">Kitchen adequacy and child diet quality in a racially/ethnically diverse sample</a>, August 2021.</li> </ul>{D79B8138-EB69-42FD-AC3B-392763DB1C4E}Erin<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14794217Erin Westfall, D.O.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}<img src="/-/media/national-files/images/hometown-health/2023/adult-brushing-toddlers-teeth.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CC334DC1D695A778ECE5E3F1C99FB36F" alt="Adult brushing toddler's teeth" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller2/23/2023If you have moderate-to-severe hearing loss, a cochlear implant might be an option for you. Learn if you're a good candidate for an implant and how they differ from hearing aids.Beyond hearing aids: Cochlear implants replace silence with sound<p>Do you struggle to hear a conversation in a noisy restaurant or are told that the volume of your TV is too high? You may have some hearing loss.</p> <p>You aren't alone because over 37 million adults in the U.S. have trouble hearing. Hearing aids can increase your ease of hearing. Cochlear implants are another option for some people when hearing aids no longer work well.</p> <h2>Hearing basics</h2> <p>To hear, the ear needs to convert sound waves into electrical signals for the brain to interpret. The outer ear funnels sound waves to the eardrum and middle ear bones, where waves are converted into vibrations. Then the vibrations are transferred to the fluids of the cochlea, which is a snail-shaped chamber in the inner ear. Tiny sensors that line the cochlea convert the vibrations into electrical impulses that are transferred along the auditory nerve to the brain. </p> <p>Damage to the cochlea sensors can cause partial or complete hearing loss. It could be caused by a genetic condition, age, noise exposure, illness or medication. </p> <h2>Cochlear implants</h2> <p>Hearing aids amplify sound and use people's residual acoustic hearing. It makes sound waves louder as they pass through the ear into the inner ear. They are not effective for people who are unable to perceive sound waves anymore due to cochlea damage. </p> <p>A cochlear implant doesn't make sounds louder. Instead, it bypasses the parts of the ear that aren't working correctly, specifically the missing or damaged cochlea sensors. It uses electricity to stimulate the auditory nerve directly.</p> <p>There are a few parts of a cochlear implant. A small bundle of wires, called an electrode array, is inserted into the cochlea and attached to a small device surgically implanted under the skin behind the ear. The device includes a stimulator that sends tiny electrical currents into the cochlea and the auditory nerve. It also has a receiver that gets sound signals from the external microphone and processor that sits behind the person's ear.</p> <p><img alt="Cochlear implant illustration" width="100%" src="/-/media/national-files/images/hometown-health/2023/cochlear-implant-illustration.jpg?sc_lang=en&hash=2003FE2CA22F5E11CF5875A288DC4BD4" /></p> <h2>Cochlear implant candidates</h2> <p>Not every person with hearing loss can receive a cochlear implant. Good candidates are patients who are deaf, have moderate-to-profound hearing loss in both ears, or have profound and severe hearing loss in one ear.</p> <p>These patients usually have a hard time maintaining a conversation on the phone, understanding people in noisy environments, distinguishing between multiple conversations in noisy settings or have not benefited from using traditional hearing aids. Many also tend to avoid social situations because they feel isolated and are unable to participate in the conversations around them. About 118,000 adults in the U.S. have received a cochlear implant. </p> <h2>Implantation surgery</h2> <p>During surgery, the surgeon makes an incision behind the ear and creates a space in the mastoid bone. Doing this creates a passage to the middle ear space, and the surgeon inserts the electrode array into the cochlea. After that, the implantable device is secured to the mastoid bone and the surgeon closes the incision. </p> <p>The surgery takes two to four hours, and most people can go home the same day. Patients need to rest for a few days after surgery and avoid strenuous activity and heavy lifting. The surgical risks for this procedure are low, but it could cause facial weakness and dizziness. These are rare and, in most cases, temporary.</p> <h2>Implant activation</h2> <p>Usually, the implant is not turned on immediately after surgery because the incision is given a few weeks to heal. The patient then meets with the Audiology team to activate the implant. At this point, the patient will begin to hear again or for the first time in their life. Most of the time, this is an emotional moment for the patient, their family and the care team. </p> <p>Implants need to be programmed, which audiologists do with the patient over several months after surgery. This optimizes and tunes the implant to the patient's hearing loss. Audiologists are critical members of the cochlear implant team because they identify patients who may be good candidates for implants and conduct ongoing care after the surgery. </p> <h2>Life after activation</h2> <p>Outcomes after cochlear implantation generally are good. On average, patients can expect improvement in their ability to understand speech and words by about six to seven times with the cochlear implant over what they could hear before the surgery. </p> <p>Patients can turn the external processor off and on. They also can remove the external portion of the implant completely when they don't want to use it, which effectively turns it off. There are waterproof external processor options so patients can swim and bathe without removing their implants. Most patients opt to take the external portion off while sleeping, but it also can remain in place. </p> <p>Talk with your health care team about your hearing loss and ask if a cochlear implant is a possible treatment for you. </p> <p><a href="/providers/nathaniel-nathan-connell-md" target="_self" title="Opens in same window."><em>Nathan Connell, M.D.</em></a><em>, is an <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">otolaryngologist</a> and head and neck surgeon in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/rice-lake" target="_self" title="Opens in same window.">Rice Lake</a>, Wisconsin, who performs adult cochlear implant surgery.</em></p><ul> <li>Cochlear implantation and hearing rehabilitation</li> <li>Chronic sinusitis</li> <li>Functional nasal and sinus surgery</li> <li>Head and neck cancer</li> <li>Nasal polyps</li> <li>Nose and sinus disease</li> <li>Sleep surgery</li> <li>Tonsillectomy and adenoidectomy</li> </ul>M.D.<p>I am honored to be on the Mayo Clinic Health System team. I look forward to getting to know you personally and providing comprehensive care for all of your ear, nose and throat (ENT) concerns. </p> <p>I enjoy spending time with my family, hiking, water skiing, snowboarding, gardening and playing guitar.</p><p><strong>Education</strong></p> <ul> <li>University of Wisconsin School of Medicine and Public Health</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Otolaryngology–Head and Neck Surgery, Indiana University Health</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Otolaryngology–Head and Neck Surgery</li> <li>American Medical Association</li> </ul>Connell<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/nathaniel-connell-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=9F0FDBDDDCAEAAF01FD7E039364AA2B5" alt="Nathaniel (Nathan) Connell, M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/34399646/" target="_blank" title="Opens in new window">Speech recognition outcomes in adults with slim straight and slim modiolar cochlear implant electrode arrays</a>; May 2022</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/27668790/" target="_blank" title="Opens in new window">Flat-panel CT for cochlear implant electrode imaging: Comparison to multi-detector CT</a>; December 2016</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/26823643/" target="_blank" title="Opens in new window">A useful modification of the Evans magnesium halide-catalyzed anti-aldol reaction: Application to enolizable aldehydes</a>; January 2016</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.sciencedirect.com/science/article/pii/S0040402013003645" target="_blank" title="Opens in new window">Divergent reactivity of allene-containing a-diazoesters using Cu and Rh catalysis</a>; July 2013</li> </ul>Nathan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30060798Nathaniel (Nathan) Connell, M.D.1{E9B8BDBE-375B-4E7D-A1D2-2B64B5513AF7}<img src="/-/media/national-files/images/hometown-health/2023/person-laughing-with-friends.jpg?h=370&iar=0&w=660&sc_lang=en&hash=DAD607C356747B1074253D6B3DE8CCAC" alt="Person laughing with friends" width="660" height="370" DisableNVelocity="true" />Ear HealthAn audiologist specializes in evaluating and treating people of all ages with hearing loss, dizziness and balance disorders. Specialty audiology consultation is available for assessment and treatment of hearing loss, tinnitus, dizziness and balance disorders.Dawn Haller2/16/2023Daily work with your hands can cause pain, numbness and weakness, leading to carpal tunnel syndrome. Learn more about the causes, get prevention strategies and find out how the condition is treated.Work with your hands? Watch out for carpal tunnel syndrome<p>Working with your hands day after day can take a toll on them, causing pain, numbness and weakness. Carpal tunnel syndrome is one condition that farmers, truck drivers, factory and construction workers, and others can experience.</p> <p>This condition is caused by compression of the median nerve located in the wrist. This nerve provides feeling to the thumb, index, middle and part of the ring finger, and also sends signals to the muscles around the base of the thumb.</p> <p>Some causes of carpal tunnel syndrome include medical conditions like arthritis, gout, diabetes, amyloidosis (a build-up of proteins in some organs), infections, masses and severe wrist injuries. Other causes are environmental or workplace conditions that involve forceful and repetitive gripping, and using heavy machinery and vibrating manual tools.</p> <h2>The symptoms of carpal tunnel syndrome include:</h2> <ul> <li>Numbness and tingling in the fingers</li> <li>Swelling and discomfort of the hands and fingers</li> <li>Weakness, especially when pinching and gripping</li> <li>Dropping things</li> <li>Waking up at night to shake out the hands</li> <li>Numbness of the fingers first thing in the morning</li> </ul> <h2>Diagnosing carpal tunnel syndrome</h2> <p>To determine if you have carpal tunnel syndrome, an orthopedic specialist will discuss the history of your symptoms and perform a physical examination of your hands and wrists.</p> <h3>Other tests may be performed or requested, including:</h3> <ul> <li>Two-point discrimination test on your fingertips to identify which fingers have decreased sensation</li> <li>Tinel's test which is conducted by tapping the nerve in the carpal tunnel at the wrist to see if it causes tingling in your fingers</li> <li>Durkan's test involves pressing a thumb over the nerve in the carpal tunnel at the wrist to see if the numbness or tingling gets worse</li> <li>X-rays of your affected hand</li> <li>Specialized nerve studies and ultrasound exams</li> </ul> <h2>Treating the condition</h2> <p>Treatment strategies are divided into nonsurgical or surgical measures. Nonsurgical treatments include wearing a wrist brace during the night and undergoing cortisone injections. Surgical intervention for carpal tunnel syndrome is a carpal tunnel release. The roof of the carpal tunnel is divided which relieves pressure on the median nerve. Surgery may be open or endoscopic.</p> <p>Both open and endoscopic surgery are outpatient procedures. Endoscopic surgery is minimally invasive. It's performed in an operating room with or without light sedation. After medication is injected to numb the palm and wrist, a small incision is made near the wrist. A tiny camera is inserted through the incision into the carpal tunnel. The surgeon inspects the tunnel and then uses a blade attached to the camera to cut the transverse carpal ligament ― the roof of the tunnel ― to relieve nerve compression.</p> <p>For the best results after surgery, be sure to consult an orthopedic hand surgeon while numbness and tingling are still intermittent rather than constant.</p> <h2>Preventing carpal tunnel syndrome</h2> <h3>There are no proven strategies to prevent carpal tunnel syndrome, but you can minimize stress on the hands and wrists by:</h3> <ul> <li><strong>Reducing your force and relaxing your grip.<br /> </strong>If your work involves a cash register or keyboard, for instance, hit the keys softly.</li> <li><strong>Taking short, frequent breaks.</strong><br /> Gently stretch and bend hands and wrists periodically. Alternate tasks when possible. This is especially important if you use equipment that vibrates or requires you to exert a great amount of force. Even a few minutes each hour can make a difference.</li> <li><strong>Watching your form.</strong><br /> Avoid bending your wrist all the way up or down. A relaxed middle position is best.</li> <li><strong>Improving your posture.</strong><br /> Incorrect posture rolls shoulders forward, shortening the neck and shoulder muscles and compressing nerves in the neck. This can affect the wrists, fingers and hands, and can cause neck pain.</li> <li><strong>Keeping your hands warm.</strong><br /> You're more likely to develop hand pain and stiffness if you work in a cold environment. If you can't control the temperature at work, put on fingerless gloves that keep the hands and wrists warm.</li> </ul> <p>If you're experiencing symptoms, consult with an orthopedic specialist to determine the best treatment to keep you on the job or get you back to work.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2023/roofers-shingling.jpg?h=370&iar=0&w=660&sc_lang=en&hash=721D0D1287C723F6055A2CC410A49378" alt="Roofers shingling" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller2/28/2023Colorectal cancer is the second-leading cause of cancer-related death in men and women combined. Test your knowledge of why and how you can be screened with myths and facts.Colorectal cancer myths and facts<p>It can be easy to feel confused by screening recommendations for common types of cancer. Your health care team is a trusted resource for keeping you up to date on screenings, including screening for colorectal cancer.</p> <h2>Test your knowledge of why, when and how you can be screened with these myths and facts:</h2> <h3>Colorectal cancer is rare.</h3> <p><strong>Myth.</strong> Colorectal cancer is the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.cancer.org/cancer/colon-rectal-cancer/about/key-statistics.html#:~:text=Deaths%20from%20colorectal%20cancer,about%2052%2C550%20deaths%20during%202023." target="_blank" title="Opens in a new window.">second-leading cause</a> of cancer-related death in men and women combined. Roughly 1 in 25 women will have colorectal cancer, and about 1 in 23 men will have colorectal cancer. To put that in perspective, when watching a football game, of all the players on the field, about one player would be diagnosed with colorectal cancer in their lifetime.</p> <h3>Colorectal cancer can happen when you are young.</h3> <p><strong>Fact.</strong> The rate of colorectal cancer is increasing in people under 50. Rates of colorectal cancer in people under 50 have doubled since 1990. In people over 65, the diagnosis rates have been decreasing, most likely because of colorectal cancer screening. </p> <h3>Screening for colorectal cancer starts at age 45.</h3> <p><strong>Fact.</strong> In 2021, the recommendation for colorectal cancer was updated to begin screening at age 45. This is because the rate of diagnosis is increasing at younger ages. </p> <h3>Colorectal cancer can be prevented with screening.</h3> <p><strong>Fact.</strong> The goal of colorectal cancer screening is to prevent cancer, not just find it when it has already developed. Most colorectal cancer develops from a <a href="/hometown-health/speaking-of-health/polyps-colon-cancer-culprits" target="_self" title="Opens in same window.">polyp</a>, a small, precancerous growth. The presence of polyps can easily be identified using colonoscopy screening tests. Polyps can be removed during a <a href="/hometown-health/speaking-of-health/what-to-expect-before-and-during-a-colonoscopy" target="_self" title="Opens in same window.">colonoscopy</a> to prevent them from developing into cancer. </p> <h3>Family history is the only risk factor for colorectal cancer.</h3> <p><strong>Myth.</strong> While a family history of colorectal cancer influences your risk of developing cancer, other important risk factors increase the risk of developing colorectal cancer. Medical conditions include obesity and <a href="/hometown-health/speaking-of-health/differences-between-ibd-and-ibs" target="_self" title="Opens in same window.">inflammatory bowel disease</a> (IBD), and lifestyle choices, such as a diet high in red meats, smoking and alcohol use, increase risk. Because colorectal cancer is common, all adults over 45 should be screened regardless of family history. </p> <p>African Americans have a higher risk of developing colorectal cancer, and American Indian/Alaska Native people have the highest risk of colorectal cancer.</p> <h3>A positive stool-based screening for colorectal cancer is the same as a cancer diagnosis.</h3> <p><strong>Myth.</strong> A <a href="/hometown-health/speaking-of-health/5-questions-about-stool-dna-tests-for-colon-cancer" target="_self" title="Opens in same window.">stool-based test</a> looks for more than cancer and can identify precancerous lesions or polyps. Stool-based tests do not address the polyp if a polyp is present in the colon. A follow-up colonoscopy is needed to identify the polyp and potentially remove it. </p> <p>Talk with your health care team about screening options for colorectal cancer at age 45. </p> <em>Derek Ebner, M.D., specializes in <a href="/services-and-treatments/gastroenterology-and-hepatology" target="_self" title="Opens in same window.">gastroenterology</a> in Rochester, Minnesota.</em><img src="/-/media/national-files/images/hometown-health/2023/person-blue-shirt-and-beard.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6DC0311497DBF9E0FF219F677E1D79C2" alt="Person with beard wearing a blue shirt" width="660" height="370" DisableNVelocity="true" />Colorectal HealthGet screening and treatment for colorectal cancer symptoms, and learn about risk factors and prevention strategies.Dawn Haller9/5/2025When training for or running a race, it's essential to give your body the fuel it needs to cross the finish line. Get the details on the right mix of fuels.Fueling your run with good nutrition<p>To train for and run a long-distance race requires a lot of energy. Good nutrition will give your body the fuel it needs to cross the finish line. The best advice I received while training for my first marathon was simple, yet effective: Eat when you're hungry. In other words, let your body be your guide. While eating enough is vital, what you eat is equally important.</p> <p>Your body's muscles run on two primary fuel sources: carbohydrates and fat. Dietary carbohydrates are broken down into simple sugars called glucose. During the start of a run, your body pulls glucose from your bloodstream. When this is exhausted, the body then taps into stored glucose, called glycogen, in your liver and muscles. The rate at which glycogen is depleted depends on the intensity and duration of exercise and how much glycogen is stored..</p> <p>When the glycogen is depleted, fat is then burned as a backup energy source. For fat to be used for energy, it must be broken down into fatty acids and other components, which requires time and makes it a less-efficient fuel source. Regular running also will train your body to be better at converting fat to fuel.</p> <p>Long-distance runners should aim to get most of their calories from carbohydrates — the body's preferred fuel source. Choose complex carbohydrates, such as pasta, oatmeal and potatoes, for sustained energy. Before a long run, focus on simple carbohydrates that can be used immediately. Sources for these include fruit, regular sports drinks and energy gels.</p> <p>During a long run or race — generally more than 90 minutes — aim to consume 30 to 60 grams of carbohydrates every hour. This goal can be met with beverages or food. Two cups of a regular sports drink contain about 30 grams of carbohydrates.</p> <p>Because fats aren't quickly converted to energy, avoiding a high-fat meal before a run is best. Instead, make fats part of your meals throughout the day. Focus on healthy fats from seeds, nuts, fatty fish, hummus and avocados.</p> <p>While protein isn't necessarily a fuel source during a run, it's essential for muscle repair after a run. Eating adequate protein will allow you to recover more quickly. Choose good sources of protein throughout the day at meals and within 30 minutes after a workout for optimal recovery. Good protein sources include meat, chicken, fish, eggs, dairy products, tofu and beans.</p> <p>Specific needs for calories, carbohydrates, protein and fat differ from person to person and depend on age, gender, activity level and medical conditions. The months spent training for your race allow you time to optimize your diet. Most runners can figure out what works best for them with trial and error. However, seeking guidance from a registered dietitian can help simplify the process of fueling your run.</p> <p>Try this orange juice smoothie for a pre- or post-run recovery snack. Orange juice is an excellent source of potassium, a mineral that helps regulate blood pressure and cell function. You lose potassium through sweating, and low potassium levels can reduce your energy and endurance.</p> <h2>Orange juice smoothie</h2> <p>Makes 2 servings</p> <p>1 cup fat-free, no-sugar-added vanilla frozen yogurt<br /> 3/4 cup fat-free milk<br /> 1/4 cup frozen, no-sugar-added orange juice concentrate</p> <p>Combine ingredients in a blender, and blend until smooth. Pour into chilled glasses and serve immediately.</p> <p>Nutrition per 1-cup serving: 200 calories, 4 milligrams cholesterol, 177 milligrams sodium, trace total fat, 41 grams total carbohydrates, 5 grams dietary fiber, 12 grams protein, 26 grams total sugars</p> <p><em>By Mayo Clinic Health System staff. </em></p><img src="/-/media/national-files/images/hometown-health/2023/runner-eating-protein-bar.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F74026BACEA00E8A4135D6E67894B31A" alt="Runner eating protein bar" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller2/20/2023Barriers to receiving mental healthcare include fear, finances and stigma. Learn how a trusted relationship with a mental healthcare professional can lead to progress.Overcoming stigmas, barriers to mental healthcare<p>The COVID-19 pandemic shined a glaring light on the deep underlying need for mental healthcare — and the barriers and stigmas surrounding access to care. These barriers and stigmas aren't new. They affect people of all ages, genders, races and ethnicities, and socioeconomic levels, as well as those from cultures and religions who view mental health according to their traditions. But they particularly affect people of color and those with fewer resources.</p> <p>One of the biggest barriers to care is navigating the system. It's not easy. And, for many, they're already navigating healthcare, education, employment and other systems. It's just one more, and it can be overwhelming. Once they do make progress, they still may not be matched with the right care at the right time.</p> <p>Fear is another barrier, including fear of seeking unfamiliar care and of unfamiliar conditions; fear of how they'll be viewed if friends and family know they're receiving mental health support; fear of appearing weak or not capable enough to cope; fear of fallout from what a child may share with a mental health professional; fear of the cost; and fear of further stress on an already fragile family.</p> <p>Cultures and religions may have differing views of mental health. There may be pressure to be as strong and capable as previous generations. Not living up to that standard may make people feel "less than" and that they need to be better.</p> <h2>Breaking barriers, building relationships</h2> <p>Sometimes it may take a heartfelt talk with a friend or a crisis to break a barrier and take that first step toward mental healthcare. Once a connection is made with a trained professional, treatment is most effective when a trusting relationship forms.</p> <p>The same barriers and stigmas affect kids, too. They also have the 24/7 pressure of social media, just at a time when their social status is tied to their self-worth.</p> <p>But most children have a parent, relative, caregiver, teacher or other trusted adult to take the initial step for them. Changes in behavior, acting out, not able to focus, being withdrawn, not doing well in school and other easily-observed clues can be indicators of underlying mental health concerns, such as depression or anxiety.</p> <p>When adults see children struggling, they'll seek the avenues to help them. That also may mean seeking mental healthcare for the entire family to ensure struggling children have a wraparound, supportive environment.</p> <p>The main thing is for adults and kids to get the help they need to manage symptoms and make progress along their mental health journey.</p> <p>The glaring light of the pandemic significantly raised awareness and acceptance of mental healthcare. And with that awareness has come funding, especially for children, to increase the number of counselors and overall access to care.</p> <p><em>Laquita Becker is a clinical therapist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin, and Youth and Family Services director for Boys & Girls Clubs of Greater La Crosse.</em></p><img src="/-/media/national-files/images/hometown-health/2023/smiling-child-in-ivory-sweater.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C4AD45BE370933690F9DAA63C086530C" alt="Smiling child in ivory sweater" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller2/16/2023Pain management historically has addressed a symptom rather than the underlying cause. Learn how an implanted restorative neurostimulation device treats the cause of pain and not just the symptoms.Targeting pain with restorative neuromodulation<p>The field of pain medicine traditionally has been a specialty associated with palliative treatments. Therapies were designed to treat a symptom or pain rather than correct an underlying condition causing the symptom.</p> <p>Over the last decade, a shift in focus has transitioned to include minimally invasive treatments to improve or correct an underlying painful condition. Among these new treatments, one of the most exciting involves restorative neuromodulation.</p> <h2>Addressing painful symptoms</h2> <p>In the past, neuromodulation in pain medicine has been defined by implanted electrical devices. These devices scramble pain signals traveling through the spinal cord to the brain. The devices addressed various painful conditions, including persistent low back pain in people in whom spine surgery is unlikely to be successful or beneficial. </p> <p>The purpose has been not to correct the underlying condition but to reduce the painful symptoms. This works very well in many cases, but in some patients, the response is neither substantial nor long-lasting. </p> <h2>What is restorative neuromodulation?</h2> <p>Restorative neuromodulation distinguishes itself from other forms of neuromodulation by correcting an underlying problem that results in pain reduction.</p> <p>With a condition such as knee <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/arthritis/symptoms-causes/syc-20350772" target="_blank" title="Opens in a new window.">arthritis</a>, the body can respond to a painful joint by inhibiting or shutting down the surrounding muscles. This process, known as arthrogenic inhibition, ultimately worsens the problem by creating instability in the joint. </p> <p>A similar process can take place in the spine. An injury or stress to the tissues, including soft tissues, muscles, bones and joints, in and around the spine can result in persistent low back pain. As a result of this pain, there can be a loss of control of the multifidus muscles, the largest stabilizing muscles of the spine. The failure of control in those essential stabilizing muscles can result in instability and misalignment. This can compound ongoing pain and risk for further injury. </p> <h2>Treating pain caused by muscle instability or misalignment</h2> <p>This instability and misalignment can be identified during physical examination. Loss of muscle control can be confirmed using <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/mri/about/pac-20384768" target="_blank" title="Opens in a new window.">MRI</a>. Once these muscles have lost control, they atrophy and become replaced by fat. Fat within the muscle is easy to identify by MRI. </p> <p>Until now, an effective way to regain control of these stabilizing muscles, restore lumbar stability and reduce low back pain has been challenging to achieve.</p> <h3>Previously, the only treatments for this type of "mechanical" low back pain have been preventing normal biological function through:</h3> <ul> <li>Surgically fusing the spine</li> <li>Ablating spinal nerves</li> <li>Blocking painful sensations with opioids and spinal cord stimulation</li> </ul> <h2>Implanted device for pain reduction</h2> <p>Using an implanted restorative neurostimulation device can cause repeated contraction of the multifidus muscles to reestablish their strength and restore stability in the spine. This results in pain reduction and prevention of further injury. </p> <p>The implanted restorative neurostimulation device treats the cause of pain and not just the symptoms. Because this is a restorative therapy, it takes some time for the effect to reduce pain and improve function. </p> <p>Scientific evidence shows that patients treated with the implanted restorative neuromodulation device experience long-lasting progressive improvement in pain and function over time. Mayo Clinic Health System <a href="/services-and-treatments/pain-medicine">Pain Medicine</a> services are evaluating patients for this new therapy.</p> <em>By Mayo Clinic Health System staff</em><img src="/-/media/national-files/images/hometown-health/2023/turning-around-in-car-front-seat.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2488D9D4D5274848817A45465422F0A0" alt="Turning around in car front seat" width="660" height="370" DisableNVelocity="true" />ArthritisArthritis is inflammation of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis.Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.Pain ReliefApproximately 50 million people in the U.S. live with chronic pain. If you experience chronic pain, you're not alone. Learn about the ways to deal with painful disorders, from at-home solutions to drug treatments, injectable or implantable therapies to surgery.Dawn Haller2/14/2023Most people occasionally eat too much, but it becomes excessive when a person has a binge-eating disorder. Here's how to know if your eating patterns are a concern and how treatment can help.Shame and guilt eating: Tackling binge-eating disorders<p>Most people occasionally eat too much. They may fill up an extra plate with seconds at a special event, enjoy another piece of pie at a holiday gathering or eat popcorn until stuffed at the movies.</p> <p>But for some people, overeating becomes excessive. It crosses the line from an occasional indulgence to a binge-eating disorder when overeating feels out of control and happens on a regular basis. It's the most common eating disorder in the U.S.</p> <p>People with a binge-eating disorder may feel embarrassed about overeating but have a strong, compulsive urge to continue eating. They often eat alone or in secret because they feel ashamed or guilty about their eating.</p> <p>Binge-eating disorders are different from other eating disorders like bulimia nervosa and anorexia nervosa. Anorexia nervosa is when people severely restrict the amount of food they eat, often to the point of near starvation. When people have bulimia nervosa, they binge on food, but then quickly purge or vomit all of it, or they exercise excessively. A person with a binge-eating disorder may purge or exercise occasionally, but it's not a regular part of their routine and doesn't happen after every food binge.</p> <h2>Who is at the greatest risk for developing a binge-eating disorder?</h2> <p>Binge-eating disorder is more common in women than in men. People of any age can have binge-eating disorder, but it's most common in younger and middle-aged people. The average age when it first occurs is about 25. It can affect people who are underweight, overweight or at an average weight.</p> <p>Many people who have a binge-eating disorder have a long history of dieting. They have tried and failed many diets and may have poor body image as a result. While dieting, they restrict calories or specific foods for a while, but then are triggered to binge eat. It's also more common in people who have depression, a high level of stress in their lives or use food to cover intense emotions.</p> <h2>How do I know if I have a binge-eating disorder?</h2> <h3>Binge-eating disorder mainly is distinguished by a regular occurrence of eating more food than most other people would in a similar situation. Other signs include:</h3> <ul> <li>Eating unusually large amounts of food in a specific amount of time, such as over a two-hour period.</li> <li>Feeling that eating behavior is out of control.</li> <li>Eating even when full or not hungry.</li> <li>Eating rapidly during binge episodes.</li> <li>Eating until uncomfortably full.</li> <li>Frequently eating alone or in secret..</li> <li>Feeling depressed, disgusted, ashamed, guilty or upset about eating.</li> <li>Frequently dieting, possibly without weight loss.</li> </ul> <p>People with binge-eating disorders often have become experts at hiding their eating behaviors. They may deny there is an issue or lie about the amount of food they eat.</p> <p>Binge-eating can lead to obesity, joint problems, heart disease, Type 2 diabetes and sleep apnea. It can be difficult to function in social settings, and the person may isolate or withdraw from others. This can increase anxiety, depression and substance use disorders.</p> <h2>How is binge eating treated?</h2> <p>Overcoming any eating disorder is a challenge because you can't avoid food or social situations that include food during recovery. Your body needs food to survive and thrive. Yet, recovery is possible, and many people overcome binge eating completely.</p> <p>Treatment needs to address the emotions tied to binge eating, including shame and poor self-image. Relapse is likely until these are tackled, and professional help is usually necessary. A combination of cognitive behavioral therapy and medications, such as antidepressants, can help a person cope with triggers, negative body image and depression. These treatments can regain a sense of control over behaviors and improve stress management skills.</p> <p>At the same time, a dietitian can work with you to reframe your relationships with food, ensure you are getting the right balance of nutrients, help develop meal plans and offer support for navigating social events that involve food.</p> <p>Binge-eating disorders are serious, but full recovery is possible with professional treatment. Talk with your health care team if you are concerned about your eating or the eating patterns of a loved one.</p> <p><em><a href="/providers/romi-londre-rdn" target="_self" title="Opens in same window.">Romi Londre</a> is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2023/arm-up-hand-lifting-hair.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C96463A0B609EAD04882BA239F6513DB" alt="Person's arm up with hand lifting hair" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller2/3/2023How do you know if or when it's OK to use a medication off-label? Learn about possible benefits, risks and unintended consequences when an on-label use causes a spike in demand.Weigh benefits, risks carefully before taking off-label medication<p>You may have heard of off-label medication use from your health care team, friends or even the internet. How do you know if or when it's OK to use a medication off-label?  What could be some of the unintended consequences when an off-label use causes a spike in demand? Let's dive in.</p> <h3>What is off-label use?</h3> <p>The term "off-label" means prescribing medications for health conditions or using a dose or dose form that has not been approved by the Food and Drug Administration (FDA). It also includes prescribing medications to children approved for adults only.  </p> <p>Since the FDA does not regulate the practice of medicine, off-label medication use has become common. And it happens more often with groups of patients who are less likely to be included in clinical trials, such as children, pregnant women or people with psychiatric disorders. A 2006 study found that about 1 in 5 prescriptions were for off-label use among commonly prescribed medications. Another study from 2007 found that about 78% of children are given at least one off-label medication when discharged from a pediatric hospital.</p> <h3>What are some benefits and risks of off-label use?</h3> <p><strong> </strong></p> <p>Off-label medication use comes with risks and benefits. Medications and treatments seeking FDA approval must undergo a rigorous review of data for safety, effectiveness and manufacturing processes. This process can be costly and time-consuming, but it assures patients that their medications are as safe and effective as possible.</p> <p>There are examples of widely practiced off-label medications in every specialty of medicine, and, in some cases, these have become predominant treatments for a specific health condition. An example of this is aspirin. It has FDA approval for pain, fever, rheumatic diseases, heart disease and other conditions. Yet, aspirin was never studied in people with both diabetes and heart disease. Therefore, a low-dose aspirin regimen for someone with Type 2 diabetes is considered a mainstream, yet off-label, recommendation.</p> <p>There are situations that off-label medication use may be helpful for your care, but it does come with risks. The off-label medication could interact with your other medications or worsen other health conditions. There may not have been rigorous studies to demonstrate the safety and effectiveness of the medication in patients like you. There could be long-term side effects that should be considered cautiously.</p> <p>Importantly, your health care team will review your health history and weigh all benefits and risks carefully before prescribing an off-label medication for you.</p> <h3>How does off-label use affect medication supply and demand?</h3> <p><strong> </strong></p> <p>Recently, there has been an increased demand for some medications for off-label use, ranging from weight loss to headaches and erectile dysfunction to addiction. This has led to some patients having difficulties getting the medications they need due to supply shortages.</p> <p>For example, many medications for diabetes are out of stock or back-ordered. This is because medications previously used for lowering glucose levels in people with Type 2 diabetes, called GLP-1 receptor agonists, also were approved recently for weight loss. Generally, prescription drug coverage plans do not cover weight loss medications. People's desire for weight loss has led to some using a medication available for people with diabetes. This led to a spike in demand. The unintended consequence is that people with diabetes can't get the medications they need because of limited supply.</p> <p>Talk with your health care team if you are struggling to fill a prescription. They may be able to help you get it from a different pharmacy or recommend a substitute to keep your diabetes under control.</p> <p>Finally, it's best to critically evaluate online claims and discuss all benefits and risks with your health care team before considering an off-label medication.</p> <p><a href="/providers/sumit-bhagra-md" target="_self" title="Opens in same window."><em>Sumit Bhagra, M.D.</em></a><em>, is an <a href="/services-and-treatments/endocrinology" target="_self" title="Opens in same window.">endocrinologist </a>in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a> and <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</em></p><ul> <li>Diabetes mellitus</li> <li>Hormonal conditions</li> <li>Thyroid disorders</li> <li>Pituitary and adrenal disorders</li> <li>Osteoporosis</li> <li>Obesity</li> <li>Metabolism</li> <li>Nutrition</li> </ul>M.D. <p><strong>Education</strong></p> <ul> <li>All-India Institute of Medical Sciences</li> </ul> <p><strong>Residency</strong></p> <ul> <li><strong> </strong>Internal Medicine, Mayo Clinic</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li><strong> </strong>Division of Endocrinology, Mayo Clinic</li> </ul> <p><strong>Certifications</strong></p> <ul> <li><strong></strong>Endocrinology, ABIM</li> <li>Endocrinology, ABMS</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Bhagra<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/sumit-bhagra-md.JPG?h=280&iar=0&w=280&hash=EFE8D54E344CB387E357698F91F85F6D" alt="Sumit Bhagra MD" width="280" height="280" DisableNVelocity="true" />Sumit<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16124812Sumit Bhagra, M.D.1<img src="/-/media/national-files/images/hometown-health/2023/two-people-talking-indoors.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7C02653B910F72BF832D6954244F1DEC" alt="Two people talking indoors" width="660" height="370" DisableNVelocity="true" />Medication ManagementNearly 70% of Americans take at least one prescription drug, and more than half take two.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller2/3/2023Eczema and psoriasis can cause itchy, uncomfortable skin for children, as well as pain and embarrassment. Learn about these common conditions and how to soothe their skin.Uncomfortable skin conditions in kids: Eczema, psoriasis<p>Itchy, uncomfortable skin is bothersome for adults, but it can be especially difficult for children. It can interrupt sleep for the entire family and be a distraction during the day, or cause pain and embarrassment.</p> <p>Two common causes of itchy skin in children are eczema and psoriasis. These chronic, inflammatory diseases of the skin cause dry, itchy and inflamed skin. These conditions can go through cycles, flaring up and then subsiding. They can cause intermittent flares or be unrelenting. Importantly for family and friends, eczema and psoriasis are not contagious.</p> <h2>If your child has skin issues, here's what you need to know about these common types of skin conditions:</h2> <h3>Eczema basics</h3> <p>Eczema, also called atopic dermatitis, is a common, itchy skin condition in childhood. Most cases begin before age 5, but eczema can occur at any age. It is long-lasting and can appear anywhere on the body.</p> <p>When a child has eczema, the skin becomes dry and cracked. It can be especially itchy and look like small, raised bumps on the skin. Sometimes, the skin can thicken or darken. It can even become painful when the skin gets raw from intense scratching.</p> <p>At its core, eczema is a barrier problem of the skin. Under normal circumstances, the skin acts as a barrier for things moving in and out of the body. When a person has eczema, the barrier is not working as effectively. This allows environmental contaminants to penetrate the skin and protective moisture to leave.</p> <p>Many items can trigger eczema. Common culprits are fragrances and dyes in products, like laundry detergents, soaps and lotions. Keeping a journal of potential triggers and the child's skin reaction can be helpful. This doesn't need to be elaborate but having a way of documenting symptoms helps to identify eczema triggers for your child.</p> <p>People with eczema may have other conditions in the atopic triad, namely asthma and allergic rhinitis also called seasonal allergies. Some children have one or two of these conditions, while their siblings have other ones. Researchers are still trying to understand the link between these conditions, but there is clearly a genetic component.</p> <h3>Treating eczema</h3> <p>The best way to treat eczema is to avoid triggers that cause a flare. When a child develops eczema, I recommend that the entire family switch to fragrance-free, dye-free products. This includes family members who do not have eczema. Children like to hug and snuggle with parents and siblings, so their clothing and bedding should be fragrance and dye-free as well to prevent eczema flares.</p> <p>Medical treatment of eczema begins by controlling skin inflammation. If we can treat skin inflammation, we can control the itch. In the past, eczema often was treated with antihistamines, partly because of the sleepiness they could induce. These medications are used less now because the itch in atopic dermatitis does not appear to be histamine-based.</p> <p>Usually, the first line of medical treatment is topical steroids. They are effective and time-tested. When a family makes an appointment, I often recommend treating eczema using a method called "wet wraps" consistently for two weeks. This is cumbersome but very effective, and it remains a tool for use in the future for subsequent flares. Taking photos before and after treatment is reassuring because improvement in the skin may be subtle at first.</p> <h4>There are lifestyle changes that families can do at home to reduce eczema flares, such as:</h4> <ul> <li><strong>Apply cream or ointment on the skin at least twice a day to seal in moisture.</strong><br /> These products should be specifically formulated for sensitive skin. Generally, lotions are not very effective in atopic dermatitis because they can promote additional water loss.</li> <li><strong>Take a short, daily bath or shower using warm, not hot, water.</strong><br /> The frequency of bathing is not as important as is following the bath or shower with liberal application of a moisturizer.</li> <li><strong>Use gentle cleansers free of dyes, alcohols and fragrances.</strong> </li> <li><strong>Pat the skin dry after bathing and avoid rubbing.</strong><br /> Apply the moisturizer to the slightly damp skin to help "seal in" the moisture.</li> </ul> <p>Most kids will outgrow the constant need to have topical steroids, but the condition is genetically determined, so they will need to maintain diligence as they get older. Avoiding products with perfumes and dyes will be a lifelong commitment.</p> <h3>Psoriasis basics</h3> <p>While psoriasis is less common than eczema in children, it still can cause itchy or painful skin issues. It's primarily a skin disease with sometimes itchy, scaly and well-defined patches. Most commonly, psoriasis occurs on the knees, elbows, trunk and scalp, but it is often seen on children's faces as well. Another type unique to children is guttate psoriasis, where hundreds of small, scaly, drop-like bumps appear on the body, often following a strep throat infection. Classic psoriasis is a chronic condition with no cure, but guttate psoriasis tends to resolve with time.</p> <p>Psoriasis rashes vary widely in how they look, ranging from dandruff-like scaling to major eruptions over large portions of the body. Small, scaling spots are more common in children. Dry and cracked skin can bleed and cause intense itching, burning or soreness.</p> <p>When a person has psoriasis, there is an issue with the internal regulator of skin growth and turnover. Psoriasis causes the regulator to be in hyperdrive or sped up. It causes redness and flakiness of the skin because the body doesn't have enough time to shed old skin cells. This leads to a buildup of dead cells on the surface of the skin.</p> <h3>Psoriasis treatment</h3> <p>The goal of the treatment of psoriasis is to stop the inflammation, generally with topical steroids on the flares located on a person's trunk and limbs. Facial psoriasis is more common in children. In these cases, steroids are not used as often. Instead, a topical calcineurin inhibitor is used to stop the inflammation.</p> <p>Light therapy may be recommended if your child has moderate to severe psoriasis. This involves exposing the skin to controlled amounts of natural or artificial light.</p> <p> Talk with your child's health care team if you notice an ongoing, itchy or uncomfortable rash. Treatment can help soothe your child's skin and ease your concerns.</p> <p><a href="/providers/kevin-boyd-md" target="_self" title="Opens in same window."><em>Kevin Boyd, M.D.</em></a><em>, is a pediatric <a href="/services-and-treatments/dermatology" target="_self" title="Opens in same window.">dermatologist</a> and dermatopathologist in <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Acne</li> <li>Childhood psoriasis</li> <li>Eczema</li> <li>Warts</li> </ul>M.D.<p>I enjoy exploring the outdoors, especially with my dog, Wolfie. My interests include international and domestic travel, environmental issues/tree hugging, and classical music, both as a soloist and ensemble member.</p><p><strong>Education</strong></p> <ul> <li>University of Missouri School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Pediatrics, Nationwide Children's Hospital</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Dermatology, University of Alabama at Birmingham</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Dermatopathology, New York University</li> <li>Pediatric Dermatology, Mayo Clinic School of Graduate Medical Education</li> <li>Dermatology and Genetics, University of Alabama at Birmingham</li> <li>Pediatric Dermatology Clinic Research Fellowship, Rady Children's Hospital</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Dermatology</li> <li>American Boards of Dermatology and Pathology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Dermatology</li> <li>Society for Pediatric Dermatology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Dermatology, Mayo Clinic College of Medicine and Science</li> </ul>Boyd<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/kevin-boyd-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=E9C5B9DE7FB503047DD0292ABE459DBF" alt="Kevin Boyd, M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/29415745/" target="_blank" title="Opens in a new window.">Cutaneous neurofibromas in Neurofibromatosis type I: a quantitative natural history study</a>, February 2018.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/22471276/" target="_blank" title="Opens in a new window.">Acute inpatient presentation of kwashiorkor: not just a diagnosis of the developing world</a>, April 2013.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/22940405/" target="_blank" title="Opens in a new window.">Nonmalignant cutaneous findings associated with vemurafenib in patients with metastatic melanoma</a>, December 2012.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/20605257/" target="_blank" title="Opens in a new window.">Phenotypic variability among café-au-lait macules in neurofibromatosis type 1</a>, June 2010.</li> </ul>{103D783B-8DB5-44CF-96A4-9F331C1EDEAA}Kevin P.<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30011372Kevin P. Boyd, M.D.1{276FDCB2-F341-4C45-B04B-F71FB963B8CB}<img src="/-/media/national-files/images/hometown-health/2023/parent-examining-childs-back.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1FA100DE51D78AB4F08BC7B05065EC58" alt="Parent examining child's back" width="660" height="370" DisableNVelocity="true" />Cosmetic ServicesGet information about taking care of your skin from enhancing your beauty to repairing results from a condition or traumatic injury.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller7/17/2023Training for a distance run or another event? Protein is a key nutrient for building and repairing muscle,, and helping reach peak performance. A quick quiz can help assess your protein needs.Assessing protein needs for performance<p>If you are training for an upcoming distance race or another athletic event, you may be looking for ways to fine-tune your program and up your performance. Now's the time to take another look at what you're eating since nutrition is a key component of your training plan.</p> <p>Do you know how much protein you need when exercising? Judging by all the protein bars, shakes and powders out there, you could be led to believe you need a protein supplement.</p> <p>Contrary to the hype that everyone needs more protein, most people in the U.S. meet or exceed their daily protein needs. This is especially true for males ages 19–59. The <a rel="noopener" href="https://www.dietaryguidelines.gov/resources/2020-2025-dietary-guidelines-online-materials" target="_blank" title="Opens in a new window.">Dietary Guidelines for Americans 2020–2025</a> indicate that men in that age range exceed their protein recommendations, especially from meat, poultry and eggs. Even athletes often get more protein than they need without supplements because their calorie requirements are higher. With more food comes more protein.</p> <h2>Where does protein come from?</h2> <p>The healthiest protein options are plant sources, such as soy, nuts, seeds, beans and lentils. But lean meats, such as skinless, white-meat chicken or turkey; a variety of fish or seafood; egg whites; and low-fat dairy also are excellent protein sources.</p> <p>Meet your dietary protein needs with whole foods like these rather than supplements whenever possible. Manufactured supplements are no more effective in building lean muscle mass than whole foods, as long as you're eating enough whole foods each day. Supplements also don't contain the additional nutrients you get from whole foods.</p> <h2>Complete and incomplete protein differences</h2> <p>Proteins are made up of 20 amino acids, and each plays an important role. The body can make 11 of these amino acids, called nonessential, but not the remaining nine, called essential. A food is considered a complete protein when it contains all nine essential amino acids. Incomplete proteins contain some, but not all, of them. An incomplete protein doesn't mean that it's a bad food source. It just means that you need to include complementary foods throughout the day.</p> <p>Incomplete protein sources often are plant-based, such as nuts, seeds, beans and whole grains. To make a complete protein, incomplete protein foods can be combined. Examples of these complementary combinations include peanut butter on wheat bread or with oatmeal, hummus with pita bread or brown rice and black beans.</p> <p>We now know that complementary foods don't need to be eaten together in the same meal. Your body can create a complete protein if you include a variety of these foods in your meals and snacks.</p> <h2>How much protein do you need?</h2> <h3>This true-or-false quiz can help you assess how much protein you need.</h3> <h4>True or false: Bigger steaks equal bigger muscles.</h4> <p><strong>False.</strong> Although adequate daily protein is necessary, extra strength training leads to muscle growth — not additional protein intake. You can't build muscle without the exercise to go with it.</p> <p>The body can't store protein, so once your needs are met, any extra is used for energy or stored as fat. Excess calories from any source will be stored as fat in the body.</p> <p>Extra protein intake also can lead to elevated blood lipids and heart disease because many high-protein foods are high in total and saturated fat. Excess protein intake, which can tax the kidneys, poses an additional risk to people predisposed to kidney disease.</p> <h4>True or false: 50% of daily calories should come from protein.</h4> <p><strong>False.</strong> Anywhere from 10% to 35% of your calories should come from protein. So if your needs are 2,000 calories, that's 200–700 calories from protein or 50–175 grams. The recommended dietary allowance to prevent deficiency for an average sedentary adult is 0.8 grams per kilogram of body weight. For example, a person weighing 165 pounds, or 75 kilograms, should consume 60 grams of protein daily.</p> <p>To convert your body weight in pounds to kilograms, divide your weight by 2.2.</p> <p>Once you reach ages 40–50, sarcopenia, or loss of muscle mass, begins to set in. To prevent it and maintain independence and quality of life, your base protein needs increase to about 1–1.2 grams per kilogram body weight or 75–90 grams per day for a 165-pound person.</p> <p>People who regularly exercise have higher protein needs of about 1.1–1.5 grams per kilogram of body weight. People who regularly lift weights, or are training for a running or cycling event need 1.2–1.7 grams per kilogram. Excessive protein intake would be more than 2 grams per kilogram of body weight each day.</p> <p>If you're overweight, you may want to consult with a dietitian who can help you calculate your protein and other nutrition needs.</p> <h4>True or false: It's best to eat protein throughout the day.</h4> <p><strong>True.</strong> On average, people get most of their protein during evening meals and the least amount at breakfast. Some newer studies show that moving some protein from supper to breakfast can help with weight management by decreasing hunger and cravings throughout the day. More research is needed before these claims can be verified.</p> <p>General recommendations are to consume 15–30 grams of protein at each meal. Studies show higher intakes — those more than 40 grams — in one sitting are no more beneficial than the recommended 15–30 grams at one time.</p> <h4>True or false: Planning meals with 15–30 grams of protein is complicated.</h4> <p><strong>False.</strong> Here's what 15–30 grams of protein look like:</p> <ul> <li><strong>Breakfast</strong><br> A banana, Greek yogurt and a hard-boiled egg will get you 19 grams of protein, on average. Or start your day with an egg bake. Each serving can have approximately 17 grams of protein.</li> <li><strong>Lunch</strong><br> An egg and bean burrito with a glass of milk is about 28 grams of protein. A black bean quesadilla offers approximately 14 grams of protein. Boost the protein by adding chicken or shrimp.</li> <li><strong>Dinner</strong><br> A 3-ounce chicken breast with a half-cup of rice and a half-cup of vegetables amounts to 25 grams of protein.</li> </ul> <p>As you can see, getting the recommended 15–30 grams per meal is easy. Most people — even athletes — can reach their protein needs by including a serving of dairy at each meal and a piece of meat the size of a deck of cards at lunch and supper.</p> <p>Protein shouldn't be the entire meal, but should be paired with fruits, vegetables and whole grains. If you think you need more protein, consider adding more beans, lentils, soy or seafood rather than processed supplements.</p> <h4>If you choose to use a protein supplement, here's what to look for:</h4> <ul> <li>About 200 or fewer calories</li> <li>2 grams or less of saturated fat</li> <li>No trans fat or partially hydrogenated oils</li> <li>5 grams of sugar or less</li> <li>Avoid long lists of ingredients you can't pronounce</li> </ul> <p>Need additional advice and recommendations for building a nutrition plan to support your training program? Consider consulting with a dietitian.</p> <p><em><a href="/providers/kristi-wempen-rdn" target="_self" title="Opens in same window.">Kristi Wempen</a> is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Chronic kidney disease</li> <li>General health and wellness</li> <li>Weight management</li> </ul>RDN, LD<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Minnesota State University-Mankato</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Iowa State University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration</li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul> <p><strong>Membership</strong></p> <ul> <li>Academy of Nutrition and Dietetics</li> </ul>Wempen<img src="/-/media/shared-files/images/medical-professionals/full/mankato/kristi-wempen-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=BB7EFDC16603EA67B00B7CD0DBD528E1" alt="Kristi Wempen RDN" width="280" height="280" DisableNVelocity="true" />Kristi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14834341Kristi Wempen, R.D.N.1{2BEE5070-65FF-4406-9E59-103E06C5A535}<img src="/-/media/national-files/images/hometown-health/2023/scrambled-eggs-on-toast.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CEA8EF9BBD0812982CD5EE93DC2E577D" alt="Scrambled eggs on toast" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller3/22/2023Athletic and personal trainers have different skills, education and focus areas. If you're seeking personalized advice, these tips can help you choose the professional who best fits your needs.Athletic or personal trainer: What's the best fit for you?<p>You may have seen athletic trainers on the sidelines of team sports and personal trainers working one-on-one with people at the gym. If you're seeking personalized advice and support to help you refine or advance your physical activity, which type of trainer would be the best fit for you? Here are some tips to consider.</p> <h2>What's the difference between an athletic and a personal trainer?</h2> <h3>While the two terms often are used interchangeably, these professionals have different skills, education and focus areas:</h3> <ul> <li><strong>Athletic trainers</strong><br /> These professionals are multiskilled health care specialists with undergraduate and, often, graduate degrees in athletic training. They must maintain national certification and state licensure. They work in various settings, including sports, athletics, the military, sports medicine clinics and industrial sites, and are experts in injury prevention and rehabilitation. As health care professionals, they may be a member of your health care team. Seek an athletic trainer if you're physically active and want to return to your form or regain function specific to your activity.</li> <li><strong>Personal trainers</strong><br /> These professionals are experts in physical fitness and exercise. They combine that expertise with interpersonal and motivational skills to guide you through exercises to safely achieve and maintain physical fitness. While there's no formal curriculum, many personal trainers have an educational background in exercise science or kinesiology. Unlike athletic trainers, personal trainers can choose from various national certifications and may be certified in specific fitness techniques. They usually work in gyms and fitness centers, as well as in-home. Seek a personal trainer if you want to start or improve your health and fitness goals.</li> </ul> <h2>Do trainers offer long- and short-term programs?</h2> <p>The short answer is yes. Athletic trainers may work with you on a short-term basis to evaluate an injury, provide recommendations and develop an at-home exercise program customized for you. If you see them as part of an athletic program or in a work setting, you may see them over a longer period for rehabilitation and to reduce the risk of future injuries.</p> <p>You may work with personal trainers either long- or short-term. They may create an exercise program for you, followed by periodic check-ins to evaluate your progress and make any changes to your program. Or you may see them weekly or several times a week over an extended period for motivation and continuous improvement toward your goals.</p> <h2>What should I look for when choosing a trainer?</h2> <p>When choosing athletic trainers, look for someone with expertise in the area you need to work on, along with continuing education certifications that help them specialize in soft-tissue treatment, movement screening or other areas related to your situation.</p> <p>As with athletic trainers, personal trainers should match your needs and goals. Years of experience and continuing education in their specialty areas also should be part of your decision-making.</p> <h2>Is there anything I should look out for?</h2> <p>Ensure the athletic trainers you're considering are licensed in your state, have been through an accredited program and are nationally certified.</p> <p>Anyone can call themselves personal trainers, even with little or no background or training. You may want to work with a personal trainer who already is vetted and hired by a reputable gym or fitness center. And finally, beware of anyone trying to sell you products or supplements.</p> <p> With athletic and personal trainers, the goal is to find someone who will meet you where you are in your fitness or recovery journey, and help you achieve your activity and health and wellness goals.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2023/trainer-teaching-trx.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B31999409D8E33452A7C13F2EF0B22CA" alt="Trainer teaching student to use TRX" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller3/29/2023About 25% of the U.S. blood supply is donated to patients during cancer treatments. Here's how it’s used, why it's important and how you can help.How blood donations help patients with cancer<p>Regular blood drives are held in schools, churches, senior centers and businesses in many communities. People need blood products for a wide variety of reasons. They could have a chronic health condition, like kidney failure or anemia, or need a blood transfusion during surgery or after a traumatic accident.</p> <p>It may come as a surprise to learn that about 25% of the U.S. blood supply is given to patients during cancer treatments. You may know people with cancer but not if they've received blood transfusions. When patients with cancer don't get the blood products they need, it can delay their treatments or make them feel sick.</p> <h2>In this Q&A, learn how donated blood products are used when a person has cancer:</h2> <h3>Why do people with cancer need blood products?</h3> <p>Cancer patients need a lot of blood for many different reasons. Some types of cancer cause blood loss. For example, people can bleed internally if they have colon or stomach cancer. They need blood replacement for their bodies to function and help them feel well.</p> <p> People who have a blood cancer, such as leukemia, lymphoma or multiple myeloma, require blood products during treatment. As these diseases progress, their bone marrow gets crowded out by cancer cells, and they can't produce enough blood themselves. Donated blood products keep their organs functioning, provide strength and help them feel better.</p> <p> Finally, other cancers can suppress the production of blood or bone. Kidney cancer can change a person's hormone levels, which decreases blood production. These patients benefit from getting blood transfusions during treatment.</p> <h3>Why can't blood be manufactured like other medicines or treatments?</h3> <p>People with cancer get many manufactured products, medicines and fluids as part of their treatment plans. Yet, unfortunately, blood can't be created in a lab.</p> <p>Donated blood products provide proteins and clotting factors different from anything manufactured in a lab or designed in a pharmacy. Blood products are lifesaving and life-changing. The health care system relies on community members donating blood for patients in need.</p> <h3>How do platelets help patients with cancer?</h3> <p>Platelets, which prevent or stop active bleeding, are critical to the health of patients with cancer. They prevent or stop active bleeding. Chemotherapy and radiation often suppress the bone marrow, so these patients can't produce enough blood or platelets. Often, patients with cancer are weak, fragile and at risk of falling. Additional platelets can help stop bleeding and decrease the risk of bleeding after a fall.</p> <h3>How many units of blood does a cancer patient need?</h3> <p>It depends on the type of cancer and if treatment requires blood. People with chronic blood disorders may indefinitely require two or three units a week. Patients with colon cancer may only need one or two blood transfusions over a short period of time. Some people with cancer need bone marrow stem cell transplants, which replace bone marrow entirely. These patients require many units of blood during their treatments.</p> <p>The important thing to remember is that many people with cancer require blood products at some point during their treatment, and the community often underestimates the need for these products.</p> <h3>I get calls all the time to donate blood. Is there really a shortage?</h3> <p>The appeals for blood donations may seem unrelenting. But the need for blood products doesn't stop. Every two seconds, someone in the U.S. needs blood products. Yet less than 3% of eligible U.S. adults donate blood each year. That's a problem because the need for blood products remains every day.</p> <p>Donated blood products have a limited shelf life. Red cells can be safely stored for 42 days, whereas platelets can be stored for just five days.</p> <p>The good news is that it's quick and easy to <a href="/hometown-health/speaking-of-health/blood-donation-simple-selfless-act-to-save-lives" target="_self" title="Opens in same window.">donate blood</a>. When you do so regularly, you support your family, friends and community during a time of need.</p> <p><a href="/providers/anna-jones-md" target="_self" title="Opens in same window."><em>Anna Jones, M.D.</em></a><em>, is an <a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">oncologist</a> and <a href="/services-and-treatments/hematology" target="_self" title="Opens in same window.">hematologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>University of New Mexico School of Medicine</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>General Surgery, University of New Mexico School of Medicine</li> <li>Internal Medicine, University of New Mexico School of Medicine</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Hematology/Oncology, University of New Mexico School of Medicine</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Fundamental Critical Care Support (FCCS) Provider, Society of Critical Care Medicine</li> <li>Internal Medicine, American Board of Internal Medicine (ABIM)</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Fellow, American Association for Physician Leadership</li> <li>Fellow, American Society of Hematology</li> <li>Fellow, American Society of Oncology</li> <li>Resident, American Medical Women's Association</li> </ul>Jones<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/anna-jones-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=271EED3CF11BBBBA33F043A644A23C6F" alt="Anna Jones, M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li>Hematology</li> <li>Oncology</li> </ul>{84F2CF0D-96B8-4757-A472-A3ADC9FE777E}Anna<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30153914Anna Jones, M.D.1<img src="/-/media/national-files/images/hometown-health/2023/wearing-cancer-cap-smiling.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1A6615A4CC6209AD6645554A1FF4494B" alt="Person wearing cancer cap smiling at another person" width="660" height="370" DisableNVelocity="true" />CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Dawn Haller3/1/2023Changes to your breast can cause worry. The good news? Not all changes are due to breast cancer. Learn about a few types of benign breast disease and which types increase the risk of breast cancer.Not all lumps are breast cancer: Benign breast disease<p>Changes to your breast can cause a lot of worry. This is understandable. But not all breast changes are a result of breast cancer.</p> <p>Any breast symptoms, such as a breast lump, nipple discharge or breast pain, should be evaluated by a medical professional. If they are diagnosed as benign, it means they are not cancer. Noncancerous breast symptoms are known as benign breast disease.</p> <p>Some cases of benign breast disease are discovered during a screening mammogram. Some are felt at home. For any lump or symptoms felt at home, it's recommended that you seek a health care professional for a thorough exam. If there are findings on a mammogram, your health care team will decide if additional imaging is required. This could include another mammogram to get more images of the spot and an ultrasound of the breast. Often, we can determine if the cause is benign or not through imaging alone. Sometimes a biopsy may be necessary.</p> <p>The good news is that benign breast disease is not cancer. However, some benign breast disease needs treatment and can increase the risk of developing breast cancer in the future.</p> <h2>Here are a few common types of benign breast disease:</h2> <h3>Fibroadenoma</h3> <p>Fibroadenomas are the most common benign tumor in the breast. Most often, they occur in people between ages 15 and 35. They often present as a firm, round, smooth and rubbery breast lump on a breast exam. Many fibroadenomas are managed by following repeat ultrasounds over time. They do not increase your risk for breast cancer in the future.</p> <h3>Breast cyst</h3> <p>Sometimes, cysts can develop in the breast. Cysts are fluid-filled masses. They can present as lumps noted in breast tissue or found on a mammogram. They don't always cause symptoms, but cysts that grow can lead to breast pain and tenderness. They are common between the ages of 35 and 60, and can fluctuate with menstrual cycles. Breast cysts do not increase your risk of breast cancer.</p> <h3>Mastitis</h3> <p>This is inflammation of the breast tissue caused by blocked milk ducts or bacteria in the breast. It commonly affects women who are breastfeeding, but it can occur in women who aren't breastfeeding. The inflammation leads to breast pain, swelling, warmth and redness.</p> <p>Mastitis is treated using antibiotics and pain relievers. It does not increase your risk of developing breast cancer.</p> <h3>Papilloma</h3> <p>A papilloma is a growth in a milk duct and can present as nipple discharge. It also may present as a small lump behind or next to the nipple. A biopsy can help understand whether papillomas need to be treated, as they can sometimes contain atypical cells that can increase your risk for breast cancer. Treatment also depends on size, if there are multiple lumps or if they are causing symptoms. Surgery may be recommended to remove the papillomas as well.</p> <h3>Atypical hyperplasia</h3> <p>This type of benign breast disease is diagnosed by a breast biopsy of an abnormal finding on an exam or breast imaging. It is an accumulation of abnormal cells in the milk ducts or lobules of the breast. Atypical hyperplasia isn't cancer, but it increases the risk of breast cancer. For this reason, the area is sometimes removed with surgery. Often, health care teams recommend intensive breast cancer screenings and medications to reduce breast cancer risk.</p> <h2>Watch this video to get answers to common questions about mammogram screenings, which are important in discovering benign breast tissue and breast cancer:</h2> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/oPiAXKfNm84" title="Ask Mayo Clinic Health System - Mammogram Screening" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <p> All breast changes should be discussed with your health care team. In addition, an annual physical exam is a good way to review your risk for breast cancer and discuss an appropriate screening schedule for you.</p> <p><a href="/providers/caroline-clune-md" target="_self" title="Opens in same window."><em>Caroline Clune, M.D.</em></a><em>, provides <a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">breast cancer care</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin, and Rochester, Minnesota.</em></p><ul> <li>Benign breast disease</li> <li>Breast cancer survivorship and surveillance</li> <li>Breast lump</li> <li>Breast pain</li> <li>Contraception</li> <li>Dense breast tissue and supplemental screening</li> <li>Evaluation, counseling and management of patients with breast cancer-related genetic mutations and family history of breast cancer</li> <li>High-risk breast lesions, including atypical hyperplasia and lobular carcinoma in situ</li> <li>Irritable bowel</li> <li>Menopause</li> <li>Mental health</li> <li>Migraines</li> <li>Preventive medications to decrease risk of breast cancer</li> <li>Sexual health</li> <li>STI screening</li> <li>Video visits or telehealth</li> <li>Wellness and exercise</li> <li>Women's health</li> </ul>M.D.<p>I try to connect with my patients as individuals and use this understanding to move forward in shared decision-making about medical care. I am honored to be part of the team serving my patients.</p> <p>In my free time, I enjoy traveling, cooking and staying active outside.</p><p><strong>Education</strong></p> <ul> <li>Medical College of Wisconsin</li> </ul> <p><strong>Internship/Residency</strong></p> <ul> <li>Internal Medicine, Washington University School of Medicine</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Chief Resident, Washington University School of Medicine</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Internal Medicine, American Board of Internal Medicine</li> </ul> <p><strong>Membership</strong></p> <ul> <li>Society of Hospital Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Clune<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/caroline-clune-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=29946D5FB3C261AADD8DBEB9EDF05A45" alt="Caroline Clune, M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener" href="https://www.dovepress.com/articles.php?article_id=83835" target="_blank" title="Opens in new window">Prevalence, impact, and diagnostic challenges of benign breast disease: A narrative review</a>, May 2023.</li> <li><a rel="noopener" href="https://www.mydigitalpublication.com/publication/?m=46092&i=764910&view=articleBrowser&article_id=4365096&id=19880&ver=html5" target="_blank" title="Opens in a new window.">Clinical implications and utility of polygenic risk scores in women at elevated risk for breast cancer</a>, September 2022.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/34032171/" target="_blank" title="Opens in a new window.">Influence of social and cultural factors on the decision to consent for monoclonal antibody treatment among high-risk patients with mild-moderate COVID-19</a>, December 2021.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/34816096/" target="_blank" title="Opens in a new window.">Computer-based patient bias and misconduct training impact on reports to incident learning system</a>, November 2021.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/34279629/" target="_blank" title="Opens in a new window.">Real-world clinical outcomes of bamlanivimab and casirivimab-imdevimab among high-risk patients with mild to moderate coronavirus disease 2019</a>, October 2021.</li> </ul>Caroline<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15806375Caroline Clune, M.D.1{0DD9D3C9-86C5-47FC-A2CF-8AEEA4717B70}<img src="/-/media/national-files/images/hometown-health/2023/fingers-checking-for-breast-lumps.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E5CD274521F0560DD526D64D71E7A4BC" alt="Fingers checking for breast lumps" width="660" height="370" DisableNVelocity="true" />Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.Dawn Haller3/30/2023The thyroid gland often is incorrectly accused of causing symptoms like weight gain and fatigue. Learn why this tiny gland gets so much blame and which thyroid conditions cause issues.Don't blame your thyroid<p>Sometimes, figuring out what's causing a person's symptoms is easy. A cavity causes tooth pain, a paper cut causes bleeding or eating expired food brings on a stomachache.</p> <p>It's harder to determine symptoms that have many causes. Weight gain could be due to heart disease, diet, exercise, genetics, stress, poor sleep, steroid use, depression, medications or a combination. The challenge is to figure out and treat the primary cause.</p> <p>People often blame their thyroid glands for symptoms ranging from brain fog and constipation to dry hair and feeling cold. A popular misconception is that ongoing fatigue and weight gain indicate that a person's thyroid isn't working correctly. Most of the time, it's more complicated than that, and the thyroid gland isn't causing these symptoms.</p> <h2> Diagnosing thyroid conditions</h2> <p>Several thyroid conditions cause symptoms, and a physical exam and blood test can help confirm a diagnosis. This also rules out other health conditions.</p> <p>A person sometimes can experience multiple symptoms, but their thyroid test results are normal. If the same person is tested again later, test results may indicate a thyroid condition. This doesn't necessarily mean the condition was missed before or the person was misdiagnosed. The condition likely developed over time, and the person's previous symptoms weren't due to a thyroid problem.</p> <h3>The most common thyroid conditions are:</h3> <h4>Hypothyroidism</h4> <p>This is when the thyroid gland doesn't make enough thyroid hormone. Sometimes, it's called underactive thyroid. It may not cause any symptoms, especially in early stages.</p> <p>Hypothyroidism is the most common thyroid condition and affects up to 5% of people in the U.S. Symptoms can include fatigue, constipation, feeling cold, weight gain, puffy face, hoarse voice, slowed heart rate, memory problems, depression and muscle aches. These symptoms could be due to hypothyroidism, but they also are caused by other health conditions, aging or even seasonal factors, such as dry, winter air.</p> <p>Most of the time, hypothyroidism can be managed by your primary care provider. Treatment with hormone medication is simple, safe and effective.</p> <h4>Hyperthyroidism</h4> <p>The opposite of hypothyroidism is hyperthyroidism, which is when the gland makes too much thyroid hormone. This is called overactive thyroid and is less common than hypothyroidism, affecting about 1% of people in the U.S.</p> <p>Hyperthyroidism can cause weight changes, hand tremors, hunger, anxiety, sweating, and rapid or irregular heartbeat. Again, these symptoms could be due to other health conditions, including menopause, caffeine, alcohol use, diabetes or low blood sugar.</p> <p>Rarely, hyperthyroidism develops into a condition called thyroid storm. This is uncommon, but it can be life-threatening. If you're diagnosed with hyperthyroidism, your condition will be managed by an endocrinologist.</p> <h4>Thyroid nodules or cancer</h4> <p>If you notice a lump on the front of your neck, it could be a thyroid nodule. Most nodules aren't cancer, but all should be evaluated. If a nodule is cancerous, surgery is recommended. Some people also receive a treatment called radioactive iodine. Chemotherapy isn't necessary for most thyroid cancers.</p> <h4>Hashimoto's disease</h4> <p>This autoimmune disorder affects 1% to 2% of people in the U.S. It causes a person's immune system to attack the thyroid's hormone-producing cells. This leads to a decline in hormone production and hypothyroidism. The symptoms may develop slowly over time and are the same as hypothyroidism. Hashimoto's disease is treated with medications.</p> <h4>Graves' disease</h4> <p>This immune system disorder causes an overproduction of thyroid hormones and affects about 1% of people in the U.S. About 30% of people with Graves' disease have symptoms, with many similar to hyperthyroidism. Some experience Graves' ophthalmopathy, which affects the muscles and tissues around the eyes. This leads to bulging eyes, pain, redness, puffiness or a gritty sensation in the eyes. Medications and radioactive iodine therapy may be used to treat Graves' disease.</p> <h2>The causes of fatigue are complex and nuanced. In this video, Lisa Hayes, M.D., explains how fatigue is evaluated and it's connection to stress:</h2> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/AxLS7-aLlL0" title="Ask Mayo Clinic Health System - Fatigue & Overall Heatlh: Why Am I So Tired?" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <p> It may be easy to blame your thyroid gland for your symptoms, but this approach isn't correct for most people. It's important to talk with your health care team about all the symptoms you're experiencing. They'll work with you to determine the cause and develop a treatment plan to help you feel better.</p> <p><a href="/providers/jane-korducki-md" target="_self" title="Opens in same window."><em>Jane Korducki, M.D.</em></a><em>, is an <a href="/services-and-treatments/endocrinology" target="_self" title="Opens in same window.">endocrinologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><p>Diseases of the Pituitary, Thyroid and Adrenal<br /> Osteoporosis<br /> Diabetes<br /> Pediatric Endocrinology and Diabetes</p>M.D.<p><strong>Medical School</strong> <br />Medical College of Wisconsin, Milwaukee, WI </p> <p><strong>Residency</strong> <br />Cleveland Clinic Foundation, Cleveland, OH </p> <p><strong>Fellowship</strong> <br />Mayo Graduate School of Medicine, Rochester, MN </p> <p class="bold12"><strong>Certifications</strong> <br />American Board of Endocrinology, Diabetes, Metabolism</p>Korducki<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/jane-korducki-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=AF1F0159B24E6CCF6A80B054A3B9A9FA" alt="Jane Korducki MD" width="280" height="280" DisableNVelocity="true" />Jane<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>10483560Jane Korducki MD1<img src="/-/media/national-files/images/hometown-health/2023/hand-holding-plaid-blanket-close.jpg?h=370&iar=0&w=660&sc_lang=en&hash=437F0610D2FA4BFB2D67DA7243A3924C" alt="Person's hand holding plaid blanket close to their body" width="660" height="370" DisableNVelocity="true" />Thyroid HealthThe thyroid is a gland at the base of your neck. This important part of your body produces hormones that regulate blood pressure, body temperature, heart rate and weight. When your thyroid has problems, many aspects of your well-being can be negatively impacted. Learn more about the thyroid here.Dawn Haller10/29/2025New findings show that "baby fat" doesn't routinely melt away as children grow. Now's the time to help a child struggling with obesity reach a healthy weight. These tips can help you on this journey.How to help your child reach a healthy weight<p>You've taken your children to see their health care professional and received the news that one of them meets the criteria for being obese. What does that mean? And what do you and your family need to consider?</p> <p><a href="/topics/childhood-obesity" target="_self" title="Opens in same window.">Obesity</a> is one of the most common diseases among children in the U.S. New findings show that "baby fat" doesn't routinely melt away as children grow. Those extra pounds from childhood can start kids on the path toward health problems that once were only seen as adult issues. Being overweight is a risk factor for several types of cancer, <a href="/topics/heart-health" target="_self" title="Opens in same window.">heart disease</a>, <a href="/hometown-health/speaking-of-health/stroke-what-it-is-and-the-different-types" target="_self" title="Opens in same window.">stroke</a>, <a href="/-/media/national-files/images/hometown-health/2021/know-your-numbers-blood-pressure.jpg" target="_self" title="Opens in same window.">high blood pressure</a>, <a href="/hometown-health/speaking-of-health/do-i-have-sleep-apnea" target="_self" title="Opens in same window.">sleep apnea</a>, <a href="/hometown-health/speaking-of-health/can-children-develop-type-2-diabetes" target="_self" title="Opens in same window.">Type 2 diabetes</a> and <a href="/hometown-health/speaking-of-health/what-you-need-to-know-about-aching-joints" target="_self" title="Opens in same window.">osteoarthritis</a>.</p> <p>Add teasing and bullying that obese kids are frequently subjected to by their peers, and the result can be a loss of self-esteem and increase their risk of depression and anxiety.</p> <h2>Factors beyond food</h2> <p>Obesity is a complex disease involving more than choices about food. Genetics, environmental factors and socioeconomic influences all play a role. Social determinants of health can make prevention and treatment of obesity even more challenging.</p> <p>For example, a child who lives in a neighborhood that doesn't have safe playgrounds, parks or a full-service grocery store is at higher risk of obesity than a child living in a community with safe play spaces and easy access to healthy foods such as fruits and vegetables.</p> <h2>How parents can help</h2> <p>Changing your child's eating habits and physical activity level is a good place to start.</p> <p>The first step is to have an open conversation with your child's primary care provider, who can discuss a treatment plan based on your child's age and whether there are other medical conditions that need to be considered. Your health care team also can recommend a range of resources for your child and the whole family. Many of these are free or low cost.</p> <h3>There are other ways you can help your child achieve and maintain a healthy weight:</h3> <ul> <li><strong>Set a good example.</strong><br /> Make healthy eating a family affair. Everyone will benefit, and no one will feel singled out. It can be fun, too. Involve the family in choosing healthy recipes, shopping for ingredients and preparing meals.</li> <li><strong>Be encouraging and supportive.</strong><br /> The journey toward reaching and maintaining a healthy weight isn't a straight path, and there will be bumps along the way. Avoid shaming or comparing your child with others. Focus on healthy habits and positive body image.</li> <li><strong>Be sure your child gets adequate sleep.</strong><br /> Some studies indicate that too little sleep may increase the risk of obesity. Sleep deprivation can cause hormonal imbalances that lead to increased appetite.</li> <li><strong>Choose nonfood rewards.</strong><br /> Instead of using a high-calorie treat, consider rewarding good behavior with a family-time event, such as playing a game, letting your child pick a movie to watch with you or doing an outdoor activity they enjoy. </li> <li><strong>Get moving.<br /> </strong>Physical activity is good for children's physical and mental health. Whether it's shooting baskets after school, playing tag, jumping rope, participating in sports or going for an after-dinner walk as a family, physical activity of any kind is good. When kids are on screened devices, they're typically not moving. Aim for limiting screen time to two hours or less per day.</li> <li><strong>Have healthy snacks available.</strong><br /> Healthy snack options can include air-popped popcorn without butter, fruits with low-fat yogurt, baby carrots with hummus or whole-grain cereal with low-fat milk.</li> <li><strong>Offer new foods multiple times.</strong><br /> Don't be discouraged if your child doesn't immediately like a new food. It usually takes multiple exposures to a food to gain acceptance.</li> </ul> <p>Now is the time to address your child's weight rather than waiting. You'll be protecting their health and ingraining healthy habits to last a lifetime.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2023/child-eating-apple.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CBAE24AF71D3CD4EF49A2205A3B5A996" alt="Child eating apple" width="660" height="370" DisableNVelocity="true" />Childhood ObesityUnderstanding what causes obesity and providing healthy alternatives can help lead your child down a lifelong path of wellness.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller3/15/2023A strong core is required for physical activity, including running. It provides overall strength, endurance and power, and supports good posture and prevents injuries. Develop your core with these exercises.How to strengthen your core<p>When you're starting or recharging a running program, you may be tempted to focus only on leg strength. But there's another major group of muscles that's just as important to your overall strength, endurance and power — your core muscles.</p> <p>These are the muscles around your pelvis, lower back, hips and stomach. They work together to provide stability and balance. To play sports and participate in most physical activities, a strong core is a necessity. A strong core also plays a role in posture and preventing injuries.</p> <h2>Building a strong core</h2> <h3>What can you do to build and maintain strong core muscles? Here are some tips:</h3> <ul> <li>When performing core exercises, use a mat or lie on the carpet.</li> <li>Take deep, slow breaths and exhale with the effort of the movement to activate your core muscles.</li> <li>Try yoga or Pilates. These activities require the use of your core muscles, build strength, and help with balance and flexibility.</li> <li>Implement a well-rounded fitness program that includes not only core exercises but also aerobic and plyometric exercises, and strength training.</li> </ul> <h2>Basic core-building exercises</h2> <p>These are some basic core-building exercises to work on. Repeat each of these core-strength exercises about five times, building up to 10–24 repetitions. <a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/fitness/multimedia/core-strength/sls-20076575" target="_blank" title="Opens in a new window.">View a slideshow</a> and description of each of these exercises and more. If you have back problems, osteoporosis or other health concerns, talk to someone on your health care team before doing these exercises.</p> <h3>Bridge</h3> <p><strong> </strong></p> <ul> <li>Lie on your back with your knees bent. </li> <li>Breathe out as you raise your hips off the floor. </li> <li>To check if you're doing this exercise correctly, make sure your hips are aligned with your knees and shoulders. </li> <li>Hold this position briefly, lower hips and repeat.</li> </ul> <h3>Bridge with stability ball</h3> <ul> <li>Lie on your back with your legs resting on top of the ball. Inhale deeply.</li> <li>Exhale to tighten your core, lifting your hips and buttocks off the floor into a bridge. Hold steady for three deep breaths. This works your core muscles and the muscles along your backside — the gluteal muscles and hamstrings — as they contract to hold you in place.</li> <li>Return to the starting position and repeat.</li> <li>For added challenge, raise your right leg off the ball. Repeat with your left leg.</li> </ul> <h3>Segment rotation</h3> <ul> <li>Lie on your back with your knees bent and your back in a neutral position. Keeping your shoulders on the floor, let your knees fall slowly to the left. Go only as far as is comfortable. You should feel a stretch, but not pain. Hold for three deep breaths.</li> <li>Return to the start position. Repeat the exercise to the right.</li> </ul> <h3>Quadruped</h3> <ul> <li>Start on your hands and knees. Place your hands directly below your shoulders, and align your head and neck with your back.</li> <li>Exhale to engage your core as you raise your right arm off the floor and reach ahead. Hold for three deep breaths. Lower your right arm and repeat with your left arm.</li> <li>Exhale to engage your core as you raise your right leg off the floor. Tighten your trunk muscles for balance. Hold for three deep breaths. Lower your right leg and repeat with your left leg.</li> <li>For an added challenge, raise your left arm and your right leg at the same time. Repeat with your right arm and left leg.</li> </ul> <h3>Bent over rows with free weights</h3> <ul> <li>With one foot on the ground, bend over and place the other knee on the edge of a chair. Let one arm hang straight down from your shoulder; hold a free weight in that hand. Use the other arm for support. </li> <li>Exhale as you lift the weight, bending your elbow and keeping the weight parallel to the floor.</li> <li>Keep your shoulder down and back, and away from your ear.</li> </ul> <p>Not only does adding free weights build core strength, but it also gives other muscle groups a workout.</p> <h3>Weighted arm swings</h3> <ul> <li>Stand in a lunge position with your right foot forward. Hold a weight in each hand.</li> <li>Keeping elbows bent, swing the weights forward and back. This motion mimics pumping your arms when you run.</li> <li>Change your stance so your left foot is forward and repeat the arms swings.</li> </ul> <h2>Beyond core strength</h2> <p>Core strength is key to your running performance, but so is power. These exercises focus on the muscles that generate the power to climb hills and add bursts of speed:</p> <h3>Jump lunges</h3> <ul> <li>Stand in a low lunge position with your right foot forward.</li> <li>Jump straight upward, switching your leg position and landing back in the lunge position.</li> <li>Repeat these lunges, alternating your leg position each time. Avoid holding your breath.</li> </ul> <h3>Sideways tape jumps</h3> <ul> <li>Place a strip of tape on the floor. Stand on one side of the tape.</li> <li>With both feet, jump sideways over the tape, landing with slightly bent knees and toes pointing forward.</li> <li>Repeat, returning to your starting position.</li> <li>Once you've mastered the two-footed jump, try it with one leg. You also can add hand weights.</li> </ul> <h3>Strong body, strong run</h3> <p>With a strong core, you're setting yourself up for a successful big run — and overall improved strength, stability, power and endurance.</p> <p><em><a href="/providers/denise-grabowski-mpt" target="_self" title="Opens in same window.">Denise Grabowski</a> is a <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p> <p>I work with patients who are within the range of 5 to 100 years of age. I will work with you on your general orthopedic and pelvic health concerns, including treatment for symptoms of incontinence, urgency, constipation and/or pelvic pain.</p> P.T. <p><strong>Education</strong></p> <ul> <li>Master's degree, Physical Therapy, Marquette University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Board Certified Orthopedic Clinical Specialist</li> <li>Certificate of Achievement Pelvic Physical Therapy</li> <li>Strength and Conditioning Specialist</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Physical Therapy Association</li> <li>Women's Health, American Physical Therapy Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Physical Therapy, Mayo Clinic College of Medicine and Science</li> </ul> Grabowski<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/denise-grabowski-mpt.jpg?h=280&iar=0&w=280&sc_lang=en&hash=C8CCE3D14AFA48522304765E3CCB23B1" alt="Denise Grabowski MPT" width="280" height="280" DisableNVelocity="true" /> Denise<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14212056Denise Grabowski MPT 1{DEF55970-853F-4E96-9A4D-3413874FF059}|{83EB2AA2-1436-4DDC-B7BB-51F8E6A87FC9}<img src="/-/media/national-files/images/hometown-health/2023/planking-on-stability-ball.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7CD71FC00BDA15BE9ADDDEF03A68EFA4" alt="Planking on stability ball" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Dawn Haller3/31/2023Kids explore the world with all their senses, which can lead to injury. Use this guide to know what to do when kids do weird things with everyday items.You swallowed what? Parents' guide to keeping kids safe at home<p>Anyone who has spent time with small children has noticed they explore their world with all their senses. While this sensory curiosity helps them learn their environment, it also puts them at risk of injury or infection when everyday items end up lodged in dangerous places like mouths, ears and noses.</p> <p>Think only the children in your life do this? It's such a common practice that a museum at Boston Children's Hospital displays items removed from kids' throats, nostrils and ears dating back to 1918.</p> <h2>Here's a guide for parents to know what to do when kids do weird things with everyday items and how to keep children safe at home:</h2> <h3>When kids lodge items in ears and noses</h3> <p><strong> </strong></p> <p>Toddlers and preschoolers sometimes stick household items into their noses or ears when no one is watching. Symptoms of something stuck include nasal discharge from one nostril that may be foul smelling or complaints of ear pain or difficulty hearing.</p> <p>Don't try to pull the object out yourself. Block the other nostril with your finger and have the child "blow." If the object doesn't come out, the child should be seen by a health care professional.</p> <p>If you suspect the object is a button battery, paired disc magnet or superabsorbent polymer — also called a hydrogel and found in household items like diapers, hot-and-cold packs and watch-it-grow toys — the child should be seen immediately for an examination and removal of the material.</p> <p>Foreign objects that remain in place for a long time can cause infection or damage to the ear or nose.</p> <h3>When kids swallow, inhale or choke on foreign items</h3> <p>Kids 6 months to 3 years old are most at risk of choking or inhaling foreign objects.</p> <h4>The most dangerous of these items include:</h4> <ul style="margin-top: 0in; list-style-type: disc;"> <li>Button batteries and magnets</li> <li>Long objects, such as toothbrushes or spoons</li> <li>Superabsorbent polymers or hydrogels</li> <li>Lead-containing objects, including fishing sinkers, air rifle pellets and lead-based paint</li> <li>Sharp objects</li> </ul> <p>The most common items infants inhale are small pieces of food, such as nuts, seeds or popcorn. In older children, the most common are nonfood items, such as jewelry, paperclips, pins and pen caps. At any age, toy balloons and similar objects are the most fatal if inhaled.</p> <p>Children who inhale or swallow any of these items should be seen by a health care professional who can remove the item and provide treatment if necessary.</p> <p>Symptoms that kids have swallowed or inhaled a foreign object include trouble swallowing food, pain in the neck or chest, drooling, coughing, breathing trouble or noisy breathing. Children who suddenly begin drooling excessively, have difficulty breathing, are making high-pitched breathing noises, or coughing and wheezing should be taken to the <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">Emergency Department</a>.</p> <h3>When kids chew or lick jewelry or paint</h3> <p>Some jewelry can contain harmful chemicals, such as cadmium and lead. With children under 6, be careful when buying or letting them play with jewelry.</p> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/lead-poisoning/symptoms-causes/syc-20354717" target="_blank" title="Opens in a new window.">Lead-based paints</a> were banned in residential homes in 1978. In homes built before then, lead-based paint can be found on surfaces, including windows and sills, doors and door frames, stairs, railings, banisters and porches. Children should be discouraged from chewing on or licking these surfaces. If a home has chipping, peeling or cracking lead-based paint, this damage requires immediate attention.</p> <h3>When kids eat dirt or grass</h3> <p>Kids occasionally eat dirt or grass. A small amount in an otherwise healthy child isn't necessarily dangerous. Keep kids away from dirt and grass treated with chemicals or that have come in contact with animal feces.</p> <p>If your child consistently eats dirt or nonfood items, such as paper, paint or hair, the child should be evaluated by a primary care provider. This behavior can be a sign of underlying health conditions or nutrient deficiencies.</p> <h3>When kids stick things in electrical outlets</h3> <p>Kids don't just stick weird objects in their mouths, ears and noses. They also like to stick objects into things around the house. The most dangerous are electric outlets, and the most common things stuck into them are metallic objects, including hairpins, keys, paperclips, utensils and small toy parts. Metallic objects inserted into an outlet can shock the child.</p> <p>If you suspect your child has been electrocuted, seek medical care immediately because not all electric shock injuries are visible.</p> <p>All homes built or renovated after 2008 should have tamper-resistant receptacles. These outlets contain an internal shutter that blocks foreign objects. However, older homes may not have them. Consider upgrading the outlets in your home. Another option is installing outlet plates or covers that small children can't remove and are large enough so they're not a choking hazard.</p> <h3>How to keep kids safe at home</h3> <p>Keep objects like spare button batteries, jewelry, coins and magnets out of reach of young children. When cleaning the house, do a final search at child level for objects that might have fallen under furniture and evaded the broom or vacuum.</p> <p>If you've got kids in a range of ages, keep in mind that toys appropriate for older children may contain small parts, such as Legos, board game pieces, action figure or doll accessories, that are a choking hazard to younger ones. Educate older siblings about keeping small toy parts away from young children.</p> <p>Create cleanup routines that round up these small toy pieces, and supervise young children around choking hazards.</p> <p>And finally, it's a good idea for anyone in your household caring for the kids to be certified in <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/first-aid/first-aid-cpr/basics/art-20056600" target="_blank" title="Opens in a new window.">CPR</a> and choking first aid.</p> <p><a href="/providers/jessie-wilburn-pac-ms" target="_self" title="Opens in same window."><em>Jessie Wilburn</em></a><em> is a physician assistant in <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">Emergency Medicine</a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a>, <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a> and <a href="/locations/red-wing" target="_self" title="Opens in same window.">Red Wing</a>, Minnesota.</em></p><ul> <li>Emergency medicine</li> <li>Ultrasound</li> <li>Wilderness medicine</li> </ul>P.A.-C., M.S.Wilburn<img src="/-/media/shared-files/images/medical-professionals/full/austin/jessie-wilburn-pac-ms.jpg?h=280&iar=0&w=280&sc_lang=en&hash=35FA627F2F8B8BFE0DFD1171DF4A3552" alt="Jessie Wilburn, P.A.-C., M.S." width="280" height="280" DisableNVelocity="true" />Jessie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30035557Jessie Wilburn, P.A.-C., M.S.1<img src="/-/media/national-files/images/hometown-health/2023/toddler-holding-greens-by-mouth.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1C7692D8B500F10B43C198D186F0AAFB" alt="Toddler holding greens by mouth" width="660" height="370" DisableNVelocity="true" />Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller3/16/2023African American women are two to three times more likely to die from pregnancy-related causes. Read how breaking down structural barriers and fostering open communication enriches all people.Maternal-fetal health in African American women<p>African American women are two to three times more likely to die from pregnancy-related causes, according to the Centers for Disease Control and Prevention. </p> <h2>A host of factors contribute to the increase in mortality, including:</h2> <ul> <li>Underlying chronic conditions</li> <li>Unconscious or implicit bias</li> <li>Economic, physical and emotional health</li> <li>Access to care</li> <li>Variation in the quality of prenatal and postpartum care </li> </ul> <p>Access to health care can be an issue for women of color who live in certain areas. Women may be less likely to receive prenatal care and care during childbirth if they've had a poor experience previously. </p> <p>For women with a high-risk pregnancy or who have pregnancy complications, being unable to afford required medications or taking medication consistently can affect the outcome of the pregnancy. </p> <p>Women who are Black, Hispanic, American Indian and Asian American have a higher risk of developing gestational diabetes. Screening for this condition is done with a glucose challenge test during pregnancy. It may be recommended earlier in pregnancy for women considered at high risk. </p> <p>While most women with gestational diabetes deliver healthy babies, the condition can lead to complications such as <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/preeclampsia/symptoms-causes/syc-20355745" target="_blank" title="Opens in a new window.">preeclampsia</a>. Black women are more likely to develop preeclampsia than white, Hispanic or Asian American women. Preeclampsia may require preterm delivery for the safety of the mother and baby. </p> <h2>Impact of COVID-19 pandemic on maternal health</h2> <p>The COVID-19 pandemic has had a profound effect on maternal health. Fear of the unknown during the pandemic and navigating uncharted terrains led to increased emotional trauma, including depression and loneliness. </p> <p>Early in the pandemic, pregnant women were seen via <a href="/hometown-health/speaking-of-health/is-virtual-prenatal-care-right-for-you" target="_self" title="Opens in same window.">virtual visits</a> and had fewer one-on-one interactions with their care team. Some women didn't have access to the internet or a device with video capability, making it more challenging to reach people when needed. </p> <p>On the other hand, the pandemic provided some benefits. The increased use of virtual visits may have opened new opportunities for access to care. For patients with logistical challenges, like access to transportation or child care resources, virtual visits have allowed them to connect with their care team and receive consistent prenatal care.</p> <h2>Care team communication</h2> <p>Building trust between patients and their care teams is an essential determinant of good quality care. Where there is trust, patients are more likely to seek care and return for follow-up care. </p> <p>Such an atmosphere encourages patients to be open about concerns knowing their needs will be heard and addressed. This leads to a fulfilling experience for the patient and the care team. </p> <p>Programs such as <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/about-mayo-clinic/minority-health-wellness/services" target="_blank" title="Opens in a new window.">SomaliCARES</a>, a group prenatal program for Somali American women, strive to improve health literacy and pregnancy outcomes. Offered at Mayo Clinic in Rochester, Minnesota, OB-GYN care team members lead classes with culturally appropriate learning methods to educate women about prenatal care. </p> <h2>Breaking down health care barriers</h2> <p>Many organizations, including Mayo Clinic Health System, are committed to tackling the systemic and structural barriers that lead to health care disparity in women of color. Improvement happens through conversations and advancements and not taking an adversarial lens. </p> <p> The common goal and driving force of all interactions is quality patient care, safety and satisfaction. Everyone is enriched when we care for all people, regardless of color, background or culture.</p> <h3>Read more:</h3> <ul> <li><a href="/hometown-health/speaking-of-health/overcoming-mental-health-care-barriers" target="_self" title="Opens in same window.">Overcoming stigmas, barriers to mental health care</a></li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/postpartum-complications/art-20446702" target="_blank" title="Opens in a new window.">Postpartum complications: What you need to know</a></li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/womens-wellness-pregnancy-complication-called-preeclampsia/" target="_blank" title="Opens in a new window.">Women's Wellness: Pregnancy complication called preeclampsia</a></li> </ul> <p><a href="/providers/okechukwu-osuebi-md" target="_self" title="Opens in same window."><em>Okechukwu Osuebi, M.D.</em></a><em>, is an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a>, Minnesota.</em></p><ul> <li>Fertility</li> <li>Hysterectomy</li> <li>Hysteroscopy</li> <li>Minimally invasive surgery</li> <li>Obstetrical care</li> <li>Preconception counseling</li> <li>Vulvar diseases</li> <li>Women's health</li> </ul>M.D.<p>My guiding philosophy is the need of the patient comes first. I strongly believe in patient-centered care that aims to provide the best care through collaborative efforts with the patient being an integral part of the decision making process. Patient education is an integral part of my practice.</p> <p>I enjoy travelling, discovering and learning about new places and cultures, being outdoors and reading.</p><p><strong>Education</strong></p> <ul> <li>University of Nigeria College of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Obstetrics-Gynecology, Howard University Hospital</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Obstetrics and Gynecology, American Board of Obstetrics and Gynecology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Obstetricians and Gynecologists</li> <li>Fellow, American Board of Obstetrics and Gynecology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Obstetrics and Gynecology, Mayo Clinic School of Medicine and Science</li> </ul>Osuebi<img src="/-/media/shared-files/images/medical-professionals/full/fairmont/okechukwu-osuebi-md.jpg?h=280&iar=0&w=280&hash=4F2C4FB876EE0180B8F0A9CDABEE140A" alt="Okechukwu Oseubi M.D." width="280" height="280" DisableNVelocity="true" />{565FE410-796E-4B7A-A005-C8951C6BAF2A}Okechukwu<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15593614Okechukwu Osuebi, M.D.1{54693F31-87AF-4B21-91DB-1DEC1E21F878}|{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}<img src="/-/media/national-files/images/hometown-health/2023/pregnant-person-using-tablet.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4B5F641F64A38BBBA3B55A0C8E176D2F" alt="Pregnant person using tablet" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Prenatal CareOB-GYN and Family Medicine providers offer exactly the care you need for starting or growing your family, including pregnancy planning and prenatal care.Dawn Haller3/8/2023Osteoporosis is when the creation of new bone can’t keep up with bone loss. It’s often a silent disease until a bone breaks. Learn if habits in your 20s affect your risk and what you can do now.Osteoporosis: Breaking down this silent disease<p>Sometimes, people develop symptoms and know something isn't quite right with their bodies. For example, a sore throat, swollen joint or digestive troubles will prompt a call to their health care team.</p> <p>Other diseases and conditions aren't as apparent. This includes osteoporosis. I tell my patients that it's a silent disease. It's impossible to know if you have osteoporosis until you break a bone or have a bone density screening.</p> <h2>What is osteoporosis?</h2> <p>Throughout our lives, bone tissue is constantly being broken down and replaced. Osteoporosis occurs when the creation of new bone can't keep up with bone loss. Bones that become weak are more likely to fracture with no or minimal trauma.</p> <p>Healthy bone mass is established with a healthy diet and weight-bearing exercise. People reach peak bone mass in their early 30s. After this age, the progress slows, and bone is lost faster than it's created.</p> <p>Osteoporosis shouldn't be confused with osteoarthritis, a condition where the cartilage between bones breaks down over time. Osteoarthritis can be accompanied by joint pain, stiffness and swelling.</p> <h2>Who can develop osteoporosis?</h2> <p>Bone loss accelerates in the early postmenopausal years, but can occur before menopause, especially if women have other risk factors. Many people think that osteoporosis only affects older white women. While white and Asian women have the highest risk, osteoporosis can affect men and women of all races.</p> <h3>Other risk factors include:</h3> <ul> <li>Small body frame, since you have less bone mass to draw from as you age.</li> <li>Family history, especially if your father or mother broke a hip.</li> <li>Early menopause.</li> <li>Hyperthyroidism or too much thyroid medication.</li> <li>Low calcium intake, which is needed for bone growth.</li> <li>Certain medications, such as steroids, acid blockers and seizure medications.</li> <li>Other medical problems, such as rheumatoid arthritis, celiac disease and inflammatory bowel disease.</li> </ul> <h2>How do I know if I have osteoporosis?</h2> <p><strong> </strong></p> <p>Unfortunately, there are no symptoms when you start to lose bone mass. Osteoporosis doesn't hurt unless you break a bone. An unexpected bone break, like fracturing a vertebra in your spine or a forearm from a small pull, is a sign that your bones have weakened. Other signs could be a stooped posture or significant height change.</p> <p>A bone density scan — also called densitometry or DXA scan — determines whether you have or are at risk of osteoporosis. It's available for people over 50 and recommended for women 65 and older and men 70 and older. </p> <h2>Are there medications to help with osteoporosis?</h2> <p><strong> </strong></p> <p>Yes, medications are available to preserve bone mass in people with a high risk of breaking a bone in the next 10 years or treat documented osteoporosis. These medications reduce the risk of fractures.</p> <p>Commonly prescribed medications include denosumab, under the brand name Prolia, and bisphosphates in generic formulas or brand names, such as Fosamax, Boniva, Actonel and Reclast. New medications also are being developed.</p> <p>Hormone replacement therapy also can be used for both men and women in certain instances. Finally, bone-building medications are available for people with severe osteoporosis when other treatment options didn't work well or in other special circumstances.</p> <p>In addition, one field of research is focused on sequencing existing medications, combining drugs and determining the right medication for each person. Essentially, it's developing an individualized approach for each patient.</p> <h2>I'm worried about medication side effects. Are they safe?</h2> <p>Osteoporosis prevention medications are generally safe and well-tolerated. But like all medications, there is the potential for side effects.</p> <p>Rare complications include unusual thigh bone fractures and sores in the jawbone following dental extractions, implants or trauma. For most people, the benefits of reducing fractures far outweigh the low risk of rare complications. Talk with your health care team if you're planning an invasive dental procedure and are taking osteoporosis prevention medication.</p> <h2>What can I do to preserve my bone mass?</h2> <h3>There are healthy habits you can incorporate into your daily routine to help maintain your bone mass and keep your bones strong:</h3> <ul> <li><strong>Add calcium to your diet.</strong><br /> For adults 19 to 50 and men 51 to 70, the recommended dietary allowance (RDA) is 1,000 milligrams of calcium a day. The recommendation increases to 1,200 milligrams a day for women 51 and older and for men 71 and older. Look for calcium in dairy products, almonds, broccoli, kale and tofu. Or talk with your health care team about supplements.</li> <li><strong>Don't forget about vitamin D.<br /> </strong>Your body needs vitamin D to absorb calcium. For adults 19 to 70, the RDA of vitamin D is 600 international units a day. The recommendation increases to 800 international units a day for adults 71 and older. A supplement may be necessary, but you can find vitamin D in oily fish, mushrooms, eggs and fortified cereals. Sun exposure for 15 minutes a day can help your body produce vitamin D as well, although this is more challenging during winter months in the Midwest.</li> <li><strong>Get moving.</strong><br /> Weight-bearing exercises can help you build strong bones and slow bone loss. Try walking, jogging or climbing stairs.</li> <li><strong>Avoid substance abuse.</strong><br /> Don't smoke or drink more than two alcoholic drinks a day.</li> <li><strong>Talk with your health care team.</strong><br /> They can help you evaluate your risk and develop a prevention plan right for you.</li> </ul> <h2>Learn more about bone health:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/5-ways-to-build-strong-bones-as-you-age" target="_self" title="Opens in same window.">5 ways to build strong bones as you age</a></li> <li><a href="/hometown-health/speaking-of-health/falls-and-fall-prevention" target="_self" title="Opens in same window.">Falls and fall prevention</a></li> <li><a href="/hometown-health/speaking-of-health/dont-be-bad-to-the-bone-how-to-preserve-bone-mass" target="_self" title="Opens in same window.">How to preserve bone mass</a></li> </ul> <p><a href="/providers/jane-korducki-md" target="_self" title="Opens in same window."><em>Jane Korducki, M.D.</em></a><em>, is an <a href="/services-and-treatments/endocrinology" target="_self" title="Opens in same window.">endocrinologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><p>Diseases of the Pituitary, Thyroid and Adrenal<br /> Osteoporosis<br /> Diabetes<br /> Pediatric Endocrinology and Diabetes</p>M.D.<p><strong>Medical School</strong> <br />Medical College of Wisconsin, Milwaukee, WI </p> <p><strong>Residency</strong> <br />Cleveland Clinic Foundation, Cleveland, OH </p> <p><strong>Fellowship</strong> <br />Mayo Graduate School of Medicine, Rochester, MN </p> <p class="bold12"><strong>Certifications</strong> <br />American Board of Endocrinology, Diabetes, Metabolism</p>Korducki<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/jane-korducki-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=AF1F0159B24E6CCF6A80B054A3B9A9FA" alt="Jane Korducki MD" width="280" height="280" DisableNVelocity="true" />Jane<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>10483560Jane Korducki MD1<img src="/-/media/national-files/images/hometown-health/2023/middle-aged-women-walking-outdoors.jpg?h=370&iar=0&w=660&sc_lang=en&hash=41B971CB5D8D3EAF9D2DB8BC9A18D7D7" alt="Middle-aged women walking outdoors" width="660" height="370" DisableNVelocity="true" />Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller3/21/2023Feelings of loneliness can develop after the loss of a loved one, a job change or divorce. Physical signs of loneliness can be difficult to overcome. Start with small steps to engage with others.Overcoming the physical, emotional signs of loneliness<p>Humans, by our very nature, need connection with others. Many people, however, do not have the necessary social connections that are vital for well-being.</p> <p>The COVID-19 pandemic caused loneliness and isolation to deepen the lack of connection. During the pandemic, many people isolated, began working from home, endured lockdowns and shelter-in-place orders, and didn't spend time with friends and family as usual. Many people who were living a relatively solitary lifestyle saw their loneliness intensify. These feelings may have continued even with lockdowns over, and things returned to normal.</p> <p>Loneliness can be caused by many things other than the pandemic. The loss of a loved one, a change of jobs, a change in living situation, or a breakup or divorce can bring a powerful feeling of loneliness, <a href="/hometown-health/speaking-of-health/the-space-in-between-grief-and-growth" target="_self" title="Opens in same window.">grief and loss</a>. It can feel like no one understands, and you might wonder where to turn. Spending time alone may feel safer and more comfortable than trying to develop new friendships and connections.</p> <p>It's important to note that not everyone who's alone feels lonely. Some people enjoy their own company a lot. Over time, others become more comfortable with being alone and learn to enjoy that time.</p> <h2>What are the physical signs of loneliness?</h2> <p>Physical signs of loneliness may include cold or flu-like symptoms that linger longer than usual, <a href="/hometown-health/speaking-of-health/common-questions-about-headaches" target="_self" title="Opens in same window.">headaches</a>, body aches, and insomnia or hypersomnia. With loneliness and isolation, attention is more inwardly focused. You may be more aware of physical symptoms you would have otherwise ignored or brushed off.</p> <p>The physical symptoms can be challenging to work through, and if they persist for a period of time, they can feel even harder to shake. Often, loneliness goes hand-in-hand with depression, with mild to severe symptoms. This also can heighten the awareness and experience of physical symptoms accompanying depression and tends to add to the problem.</p> <p>If you're experiencing physical signs of loneliness for longer than a few weeks, consider scheduling an appointment with your primary care provider to discuss your symptoms.</p> <h2>Tips to overcome loneliness</h2> <p>You can begin to work on your loneliness by taking care of yourself first. <a href="/hometown-health/speaking-of-health/recharge-with-planned-mental-health-day" target="_self" title="Opens in same window.">Self-care</a> always is important, but during times of loneliness, your self-worth may be at a low point. Doing good things for yourself is a good way to lift your spirits and rediscover your value.</p> <h3>Consider these ideas for self-care:</h3> <ul> <li><strong>Treat yourself.</strong><br /> Do something nice for yourself, such as buying flowers, taking a hot bubble bath or listening to your favorite music.</li> <li><strong>Engage your brain.</strong><br /> Find a new podcast to listen to, check out a new book from the library, or listen to an uplifting guided meditation on an app.</li> <li><strong>Discover beauty around you.</strong><br /> Find time to view interesting art or <a href="/hometown-health/speaking-of-health/get-healthy-stay-safe-outside-in-spring" target="_self" title="Opens in same window.">visit a beautiful natural area</a>.</li> </ul> <h2>Take small steps to begin interacting with others</h2> <p>If you've been isolated and feel lonely, jumping back into social gatherings and events can be a little overwhelming. You may find yourself turning down offers to spend time with family or friends because you don't feel ready. Taking things slow and spending time in smaller groups or one-on-one with a friend or family member is a simple way to ease into being more social.</p> <p>Finding groups or activities you enjoy in the community, through a church or other <a href="/hometown-health/speaking-of-health/3-health-benefits-of-volunteering" target="_self" title="Opens in same window.">volunteer organization</a> could also feel overwhelming. Setting small goals, such as making one friendly comment to a stranger, is one way to start coming out of your shell. Another goal would be to look up a friend you haven't talked to in a while. You may find that the person has been lonely too.</p> <p>Whatever and however you decide to try to work through your loneliness, be gentle with yourself, and take it slow. Remember, you are not alone. You might find that others around you have more in common with you than you thought.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2023/smiling-looking-at-computer-screen.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A023AB0DC8534F6E195665686FCF49F3" alt="Person smiling while looking at computer screen" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller3/8/2023The spine is susceptible to arthritis because of its range of motion. But not everyone who has arthritis has symptoms or needs treatment. Learn how being active can keep the pain away.Pain in the back: Spinal arthritis<p>Many types of arthritis can affect your musculoskeletal system. Joints are physical points of connection between two bones, and cartilage is the tissue that covers the surface of the bone at the joint. A membrane, called the synovial membrane, lines the joint and is filled with fluid known as synovial fluid. All these components work together to make movement easy.</p> <p>Over time, the cartilage in joints can break down and cause swelling and tenderness. It's common in the joints used daily, such as the hands and knees. The spine comprises 33 bones stacked one over the other like Lego blocks, connected by three different joints. Arthritis can affect various joints in the body that are load-bearing and where movement occurs, including the spine.</p> <h2>Arthritis in the spine</h2> <p>The most common types of arthritis are osteoarthritis and rheumatoid arthritis. <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/osteoarthritis/symptoms-causes/syc-20351925" target="_blank" title="Opens in a new window.">Osteoarthritis</a> occurs when the cartilage that caps your bones wears away. Degenerative changes can happen over time in joints used daily for motion. Osteoarthritis is the most common type of arthritis.</p> <p>Rheumatoid arthritis is caused when your body's immune system mistakenly attacks your joints. You may experience pain and swelling, and your bones and joints slowly erode and deform. You can get this type of arthritis at any age, but it is usually more common in adults 40 or older.</p> <p>The spine is susceptible to osteoarthritis because of the motion between the vertebrae. It's most common in the lower back, or lumbar spine, because these joints carry most of the body weight. When a person stands upright, the lumber spine experiences additional strain and wears out faster than nonmobile levels like the middle of the spine.</p> <p>The neck also is susceptible to arthritis. This is because of the millions of flexions, extensions and rotary movements made by the joints in the neck. Over time, the disc cartilages and facet joints tend to wear out.</p> <h2>Preventing spinal arthritis</h2> <p>There are several factors that can increase the risk of osteoarthritis. We can modify some of these risk factors, but the others are inherent and not modifiable. The factors that cannot be changed include our age, genetics, gender and ethnicity.</p> <p>For risk factors that can be changed, the saying "an ounce of prevention is better than a pound of cure" applies to spinal arthritis. The modifiable risk factors include obesity, metabolic syndrome, previous injury, occupation, diet and physical activity.</p> <h3>There are things that you can do to lower your risk of arthritis developing and causing painful symptoms, such as:</h3> <ul> <li><strong>Remain active.</strong><br /> The more sedentary people are, the more likely they will have issues with arthritis pain. Strenuous physical activity isn't necessary. Simple exercises, like walking, help keep your joints healthy and you mobile.</li> <li><strong>Maintain a healthy weight.</strong><br /> Carrying extra weight is hard on the joints in your back. Aim for a healthy body weight to keep your joints happy.</li> <li><strong>Don't use tobacco.</strong><br /> People may understand that smoking affects lung health, but it also speeds up cartilage loss in joints and aggravates back pain. Don't start smoking, and if you do smoke, quit.</li> </ul> <h3>Treating spinal arthritis</h3> <p>Many people have some degree of degenerative changes in their spines due to arthritis. But not everybody who has arthritis on diagnostic imaging has symptoms. Treatment is only considered if a person is experiencing symptoms that don't go away with exercise or weight loss, and arthritis is present on images, like an X-ray.</p> <p>It can be difficult to find the exact source of pain due to multiple joints, levels or nerves in the spine. Images, like an MRI scan or X-ray, help the health care team identify where the pain is coming from.</p> <p>To develop an individualized treatment plan, the health care team will match the image results with the patient's reported symptoms. Any surgical procedure carries risk, so the goal is to medically manage arthritis symptoms without surgery in most cases. Conservative medical options for treating symptomatic spinal arthritis include physical therapy, chiropractic manipulation, exercise, massage, medications and weight loss. For most patients, these options lessen back pain and improve mobility.</p> <p>Additional treatments may be necessary if symptoms aren't improving or the arthritis is causing compression of the nerves, leading to weakness or loss of mobility. Surgical options range from a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/laminectomy/about/pac-20394533" target="_blank" title="Opens in a new window.">laminectomy</a> to a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/spinal-fusion/about/pac-20384523" target="_blank" title="Opens in a new window.">spinal fusion</a>.</p> <p>It's important to remember that nearly everyone will experience back pain at some time in their lives. Members of the health care team, including pain management, physical medicine and rehabilitation, primary care, physical therapy, and finally, the spine surgeon, carefully evaluate each patient and identify who may be a candidate for surgical intervention versus those who may not benefit from surgery and need to continue medical treatment options.</p> <p>It's essential that you talk with your health care team if you are struggling with ongoing back pain or pain and weakness that radiates down your legs or arms.</p> <p><a href="/providers/gazanfar-rahmathulla-mbbs-md" target="_self" title="Opens in same window."><em>Gazanfar Rahmathulla, M.B.B.S., M.D.</em></a><em>, is a <a href="/services-and-treatments/neurosurgery" target="_self" title="Opens in same window.">neurosurgeon</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Brain tumors</li> <li>Cervical myelopathy</li> <li>Cranial trauma</li> <li>Spinal degenerative disease</li> <li>Spinal fusion surgery</li> <li>Spinal trauma</li> <li>Spine tumors</li> </ul>M.B.B.S., M.D.<p>I am excited to be providing neurosurgical care to the patients of Mayo Clinic Health System in Northwest Wisconsin. I like being part of an exceptional team of physicians, nurses, advanced practice providers and allied health care providers, all of whom are dedicated to the single philosophy of the patient always coming first.</p> <p>I provide a holistic team-based approach which uses medical, surgical options and expertise of my health care partners to treat patient's neurosurgical disease in an optimal manner. My area of practice incudes the surgical treatment of spinal disease, certain types of tumors and general neurosurgical disorders.</p> <p>I enjoy spending time with my family and being part of the community. Traveling locally, hiking and cycling are other activities I enjoy.</p><p><strong>Education</strong></p> <ul> <li>Kasturba Medical college</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Neurosurgery, Manipal Hospital</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Neurosurgical Oncology-Research, Cleveland Clinic</li> <li>Neurosurgical Oncology, Cleveland Clinic</li> <li>Neurological Surgery, Cleveland Clinic</li> <li>Neurosurgery, Mayo Clinic</li> <li>Neurosurgery Spine, Mayo Clinic</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Educational Commission for Foreign Medical Graduates</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Neurological and Orthopaedic Surgeons</li> <li>American Association of Neurological Surgeons</li> <li>American College of Healthcare Executives</li> <li>American College of Surgeons</li> <li>Congress of Neurological Surgeons</li> <li>North American Spine Society</li> </ul>Rahmathulla<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/gazanfar-rahmathulla-mbbs-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=6244FC5F91DA4EC604F3F29C0B4C7527" alt="Gazanfar Rahmathulla, M.B.B.S., M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/36174944/" target="_blank" title="Opens in new window">Outcomes following minimally invasive sacroiliac joint fusion: A scoping review</a>, September 2022.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/35948216/" target="_blank" title="Opens in new window">Appropriateness of cervical magnetic resonance imaging in the evaluation and management of C1 Jefferson fractures</a>, August 2022.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/35945993/" target="_blank" title="Opens in new window">Upper extremity monoplegia following prone surrender position for spinal surgery</a>, June 2022.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/35068815/" target="_blank" title="Opens in new window">Ankylosing spondylitis traumatic subaxial cervical fractures: An updated treatment algorithm</a>, October 2021.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/34319211/" target="_blank" title="Opens in new window">Halo vest immobilization - an institutional review of safety in acute cervical spine injury from 2013 to 2017</a>, October 2021.</li> </ul>Gazanfar<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15733181Gazanfar Rahmathulla, M.B.B.S., M.D.1{993AF103-0FE1-4CF2-9F2A-3D064CDA9F32}|{4EA2A40E-3721-48EC-AFC9-E6D0E13BCDEC}<img src="/-/media/national-files/images/hometown-health/2023/florist-arranging-hydrangea-blossoms.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A80DDBAAEF803D3F2A586A121F942FFD" alt="Florist arranging hydrangea blossoms" width="660" height="370" DisableNVelocity="true" />Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.NeurosurgeryNeurosurgery treats disorders that impact any part of the nervous system, which may include the brain, spine or peripheral nerves. Conditions treated range from life-threatening brain tumors, to disorders impacting quality of life, such as back pain and carpel tunnel syndrome.Pain ReliefApproximately 50 million people in the U.S. live with chronic pain. If you experience chronic pain, you're not alone. Learn about the ways to deal with painful disorders, from at-home solutions to drug treatments, injectable or implantable therapies to surgery.Dawn Haller3/15/2023Having a sense of purpose provides a wealth of mental and physical benefits from reduced stress to better sleep. But how do you identify your purpose? These ideas can get you started.Does purpose play a positive role in mental health?<p>The importance of having a purpose is in the headlines and on podcasts. It's the theme of sermons and the subject of self-help books — and for good reason. Studies show that those with a purpose live longer, sleep better and have a more robust immune system, lower stress levels and better cognitive function.</p> <p>One way a sense of purpose can lead to a longer life is because people with a sense of purpose tend to take better care of themselves through exercise, healthy eating and addressing health issues when they arise.</p> <p>Lower stress levels mean less cortisol, a hormone that regulates the fight-or-flight response, is released into your system. High cortisol levels have been linked to anxiety, depression, weight gain, headaches, digestive problems, muscle tension, heart disease, high blood pressure, sleep issues, and memory and concentration impairment.</p> <p>Lower cortisol production tends to make you less reactive and more resilient. So you bounce back when you're stressed rather than becoming overwhelmed.</p> <p>Helping others can pull you out of yourself, give you a different perspective and lead to connecting with others who share common interests.</p> <h2>What is a sense of purpose?</h2> <p>When people hear "a sense of purpose," they often think it has to be something big and world-changing, like finding a cure for cancer. But a sense of purpose also can be less grand. At its most basic, a sense of purpose directs your actions and behaviors. It's an abiding intention to achieve a long-term goal that's both personally meaningful and makes a positive mark on the world. A sense of purpose often is other-focused, something that can improve the lives of others, something bigger than yourself. A sense of purpose is not a box you check off and move on.</p> <p>Your sense of purpose may be obvious, such as a lifelong desire to find a cure for cancer. For others, their sense of purpose may come from a traumatic incident, such as losing a loved one to suicide or addiction. For most, a sense of purpose is a journey, it changes and develops as they move through life.</p> <h2>How do you identify your sense of purpose?</h2> <h3>Identifying what gives your life purpose requires thought and reflection. Here's how that process may work:</h3> <ul> <li><strong>Start with your values.</strong><br /> If you're not sure what your specific values are, download a list from the internet — there are many to choose from. Go through the list and circle the top 10 that resonate most with you. Then narrow those down to five. These five will help you think about the values most important to you. </li> <li><strong>Compare your values with your behavior.</strong><br /> Do you practice what you say? Do your values align with where you spend your time and money? For example, maybe you're the go-to dog sitter when neighbors are out of town, volunteer to walk dogs at the local shelter or donate to a dog rescue group. If those activities are fulfilling and you love supporting the dog-people connection, then it's pretty compelling that dogs give you a sense of purpose.</li> <li><strong>Explore ways to live your purpose.</strong><br /> Try an activity related to it, like volunteering as a shopper at a pet food shelf. Then reflect on if you got something out of it and if it connected you with others. If it didn't seem like a good fit, then try another activity. Look at what you're doing now that will help you live your purpose.</li> </ul> <h2>Can your sense of purpose change?</h2> <p>As you go through transitions in your life, you may need to adjust, expand on or even find a new purpose. For example, parents' purpose may be raising children who are ethical, kind and critical thinkers. But once those children are launched into adulthood, parents may channel this purpose into volunteering at a preschool or a parenting class.</p> <p>As retirement approaches, you may have your financial ducks in a row, but haven't given much thought to how you'll spend your time in a meaningful way once you no longer have work as your focus. So before you log out for the last time, get engaged with those things that give you a sense of purpose and meaning. Once you're retired, you may find you have the time to really focus on those things that take your purpose to the next level.</p> <p> Your sense of purpose should give you satisfaction and bring you joy as you connect with and give to others.</p> <p><a href="/providers/rosean-bishop-lp" target="_self" title="Opens in same window."><em>Rosean Bishop, Ph.D.</em></a><em>, is a psychologist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Family medicine resident education</li> <li>Integrated behavioral medicine</li> <li>Resilience training</li> </ul>Ph.D., L.P.<p><strong>Education</strong></p> <ul> <li>Doctor of Philosophy, Counseling Psychology, Pennsylvania State University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Counseling Center, University of Rochester, New York</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Counseling Center, Vanderbilt University, Nashville, Tennessee</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Licensed Psychologist, Minnesota Board of Psychology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Psychological Association</li> <li>Minnesota Psychological Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine and Psychology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota</li> </ul>Bishop<img src="/-/media/shared-files/images/medical-professionals/full/mankato/rosean-bishop-phd-lp.jpg?h=200&iar=0&w=200&sc_lang=en&hash=D37783EF34004E64C8CDA884C074F5C1" alt="Rosean Bishop LP" width="200" height="200" DisableNVelocity="true" />Rosean<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15429687Rosean Bishop LP1<img src="/-/media/national-files/images/hometown-health/2023/writing-in-a-weekly-planner.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CA998A26B006187E0AD61DFA6E6FF91C" alt="Writing in a weekly planner" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller3/20/2023Ramadan includes refraining from food and drink from dawn to sunset. This shouldn't have a negative health effect for most people. But some need to prepare to avoid worsening a health condition.Managing your health during Ramadan fasting<p>Fasting during Ramadan involves abstaining from food and drink from dawn to sunset. Depending on geography and the time of year when Ramadan occurs, daily fasting can range from as little as 10 hours in the winter months to more than 17 hours during the summer.</p> <p>This daily fast shouldn't have a negative effect on health for most people. However, even if you have a chronic condition, including coronary artery disease, kidney disease, high blood pressure or diabetes, you can fast safely if your condition is well managed and uncomplicated. </p> <p>Anyone with a chronic health condition who chooses to fast should take time to plan and prepare in order to avoid experiencing problems or worsening your condition. This is essential for people who take medications to manage the condition or have had complications previously.</p> <p>Fasting isn't intended to cause harm, yet it's important to consider consulting your primary care clinician before Ramadan — or anytime you fast — to plan how best to maintain good health or determine whether fasting is safe for you. </p> <p><strong>Some questions to ask include:</strong></p> <ul> <li>Is fasting safe based on my health conditions?</li> <li>How is it best to take my medications?</li> <li>Can medications that are taken multiple times a day be changed to once-a-day dosing?</li> <li>Should I check blood glucose (sugar) levels more frequently, or change my insulin or other medication dosing? </li> </ul> <h2>Taking medications</h2> <p>Medications taken by mouth or intravenous feeding are considered breaking your fast. If you choose to fast, these types of medications should be given or administered before dawn or after sunset. Consult with your primary care clinician to ensure this approach is safe for you.</p> <p>However, Islamic scholars generally recognize that other types of medications don't break the fast and may be taken during hours of fasting. These include medicated skin patches or creams, eye and ear drops, injections given in the skin or muscle (including insulin), supplemental oxygen, mouthwash or gargles that aren't swallowed. In addition, many scholars also hold that nasal sprays and inhalers don't break your fast. </p> <p>For those planning to fast, it's recommended you drink plenty of liquids before and after fasting, and limit caffeinated or highly sugared beverages. It's also recommended that you avoid or limit highly processed foods or foods high in fat, and eat healthy, balanced meals with moderate portion sizes. </p> <h2>Vaccinations</h2> <p>The consensus among Islamic scholars is that getting a vaccine doesn't break a fast. So it's completely acceptable to receive any recommended vaccination while fasting, even during the day. </p> <h2>Helpful resources</h2> <p>If you have a health condition or a concern, consult with your health care team to ensure you remain in the best possible health during Ramadan.</p> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/providers/muhamad-elrashidi-md" target="_blank" title="Opens in a new window."><em>Muhamad Elrashidi, M.D.</em></a><em>, is an internal medicine physician at Mayo Clinic Primary Care in Rochester and Kasson, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2023/ramadan-lantern.jpg?h=608&iar=0&w=1080&sc_lang=en&hash=9318B2EB883D4FC7E8308D894FC90A1A" alt="Ramadan lantern" width="1080" height="608" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller3/7/2023Robotic-assisted bronchoscopy maps out the airways in the lungs and safely gets to previously unreachable spots. Read four common questions about the technology and how it betters lung cancer outcomes.4 common questions about robotic-assisted bronchoscopy<p>Our lungs are a maze of interwoven airway passages of all sizes. Sometimes abnormal growths develop and need to be evaluated to determine if they are benign or cancerous.</p> <p>A new technology is available for evaluating and getting samples of abnormal growths in the lungs. It provides a road map of the lungs and can access even the smallest passageways. This is good news because lung cancer is the second most common cancer and the No. 1 cause of cancer deaths worldwide. Finding and treating it early increases the chance of survival and a full recovery.</p> <h2>Here are four common questions about robotic-assisted bronchoscopy:</h2> <h3>1. What is robotic-assisted bronchoscopy?</h3> <p>A traditional bronchoscopy is a widely used procedure where a thin, flexible tube, called a catheter, is passed through the nose or mouth into the lungs. It's equipped with a small camera at the end that helps the pulmonologist visualize the patient's airway passages on a monitor. The catheter also can obtain tissue samples, remove objects or administer treatment.</p> <p>Not all airway passages can be accessed during conventional bronchoscopy because the tube is too big and relatively inflexible. Robotic-assisted bronchoscopy uses an ultrathin, ultramaneuverable catheter to get into smaller airways that were previously inaccessible.</p> <p>The robotic-assisted bronchoscopy team at Mayo Clinic Health System has highly trained health care professionals across multiple specialties, including <a href="/services-and-treatments/pulmonology" target="_self" title="Opens in same window.">Pulmonology</a>, <a href="/services-and-treatments/respiratory-therapy" target="_self" title="Opens in same window.">Respiratory Therapy</a> and <a href="/services-and-treatments/pathology" target="_self" title="Opens in same window.">Pathology</a>.</p> <p>Using images from a CT scan, the health care team can create a 3D map of the patient's lungs. Then the software generates the safest, most efficient route through the lung to the lesion, nodule or mass. Once the optimal route is determined, the catheter is guided by a robotic arm controlled by the physician to the site of the lung lesion, where it's safely biopsied with precision and stability. A biopsy, or tissue sample, is needed to determine if the lesion is lung cancer. Robotic-assisted bronchoscopy is performed while the patient is under general anesthesia and unconscious. The patient does not feel any pain or discomfort during the procedure.</p> <h3>2. How does robotic-assisted bronchoscopy benefit patients?</h3> <p>The most significant benefit is that robotic-assistant bronchoscopy can access lung nodules that previously required more invasive biopsy techniques or even surgery. Because it allows pulmonologists to reach tiny distal airways in the lungs, they can detect lung cancer in an earlier stage when it is easier to treat and potentially cure.</p> <p>It's often combined with another procedure known as endobronchial ultrasound to evaluate chest lymph nodes to determine if cancer has spread to them. This helps with the staging of lung cancer. It decreases the time from diagnosis to treatment so patients can receive the care they need faster.</p> <h3>3. Who is eligible for robotic-assisted bronchoscopy?</h3> <p>Robotic-assisted bronchoscopies are performed on eligible patients who are diagnosed with a lung nodule or lung mass that needs a biopsy to find out if it's cancerous.</p> <p>If you've already been diagnosed with a lung nodule or lung cancer, ask a <a href="/services-and-treatments/pulmonology" target="_self" title="Opens in same window.">pulmonologist</a> or <a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">oncologist</a> if robotic-assisted bronchoscopy is right for you.</p> <h3>4. What are the risks of robotic-assisted bronchoscopy?</h3> <p>Robotic-assistant bronchoscopy is a minimally invasive outpatient procedure with no incisions and a lower risk of complications than surgery. In most cases, patients can go home the same day as the procedure with little or no restrictions. Serious complications, such as significant airway bleeding or collapsed lung, known as pneumothorax, are rare. Common temporary adverse events include bloody phlegm, sore throat, hoarseness, nausea, fever and cough.</p> <p>Talk with your health care team if you have any symptoms of lung cancer, including a new cough that doesn't subside, changes in chronic cough, shortness of breath or coughing up blood.</p> <p>Learn more about <a href="/hometown-health/transforming-healthcare/robotic-technology-and-lung-cancer" target="_self" title="Opens in same window.">robotic-assisted bronchoscopy and lung cancer</a>.</p> <p><a href="/providers/ali-zaied-md" target="_self" title="Opens in same window."><em>Ali Zaied, M.D.</em></a><em>, is a <a href="/services-and-treatments/pulmonology" target="_self" title="Opens in same window.">pulmonologist</a> and <a href="/services-and-treatments/intensive-and-critical-care">intensivist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Acute respiratory distress syndrome management</li> <li>Asthma</li> <li>Benign lung mass</li> <li>Chronic cough</li> <li>Critical care ultrasound</li> <li>Endobronchial ultrasound (EBUS) bronchoscopy</li> <li>Lung cancer screening and lung cancer</li> <li>Lung infections</li> <li>Lung nodule</li> <li>Pulmonary hypertension</li> <li>Robotic-assisted bronchoscopy</li> </ul>M.D.<p>I believe it is critical that patients are involved in all aspects of health care decision-making, and their needs will come before everything else. I hope that patients will find that I am passionate about their care and view me as a friend as we move through their journey to health.</p> <p>In my free time, I enjoy hiking, playing soccer and spending time with family.</p><p><strong>Education</strong></p> <ul> <li>University of Jordan in Amman</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>Internal Medicine, King Hussein Cancer Center</li> <li>Internal Medicine, University of Texas Medical Branch-Galveston</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Pulmonary and Critical Care Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Pulmonary Disease, American Board of Internal Medicine</li> <li>Pulmonary Disease, American Board of Medical Quality</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Zaied<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/ali-zaied-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=7291FA714A60574F195E6EBFC31C6E52" alt="Ali Zaied, M.D." width="280" height="280" DisableNVelocity="true" />{65E1B297-8127-4877-863E-295726AC6ECB}Ali<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16200039Ali Zaied, M.D.1{1D6651B0-86E1-4FF6-9A93-07B8EE2D26EE}<img src="/-/media/national-files/images/hometown-health/2023/person-bending-with-hands-on-knees.jpg?h=370&iar=0&w=660&sc_lang=en&hash=DB768FEB7F8567A989E42C79AF2681DA" alt="Person bending with hands on knees" width="660" height="370" DisableNVelocity="true" />Lung CancerLung cancer is a type of cancer that begins in the lungs. It is the leading cause of cancer deaths in the U.S., among both men and women. Lung cancer claims more lives each year than do colon, prostate, ovarian and breast cancers combined. <br/><br/>PulmonologyTreatment for diseases and conditions affecting lung and airway function.BreathingMost cases of shortness of breath are due to heart or lung conditions. Your heart and lungs are involved in transporting oxygen to your tissues and removing carbon dioxide, and problems with either of these processes affect your breathing.Dawn Haller3/28/2023If you or a loved one is in an abusive situation, learn about the services and support available for people affected by domestic or sexual assault.Speak out about abuse or assault<p>Safety planning is extremely important if you or a loved one is in an abusive situation. Some people may find themselves in circumstances where they feel there is no way out due to financial burdens or emotional stress.</p> <p>There are services to help and support people affected by domestic violence or sexual assault. Learn about your community's local resources to help you remain safe and explore options. </p> <h2>What is domestic, emotional, physical and sexual abuse?</h2> <ul> <li><strong>Domestic abuse</strong> is a pattern of coercive tactics used to gain and maintain power and control in an ongoing, familiar relationship. Generally, several forms of abuse, such as psychological, emotional, physical, sexual or economic, are used in combination. </li> <li><strong>Emotional abuse</strong> is the use of coercion, threats, insults and other measures which control the victim and result in loss of self-esteem and victims believing they deserve the abuse.</li> <li><strong>Physical abuse</strong> is the use of physical force, including pushing, slapping, hitting, strangling, biting, kicking, isolating and using weapons.</li> <li><strong>Sexual abuse</strong> is any unwanted, coerced or inappropriate sexual contact.</li> </ul> <h2>Sexual assault or abuse assistance</h2> <p>Sexual assault is any unwanted or forced sexual contact between adults or any sexual contact between an adult and a minor. Sexual assault may involve physical force or more subtle coercion, such as threats, intimidation, alcohol or drugs, and abuse of authority.</p> <p>Sexual assault can happen to anyone, regardless of gender, age, race, religion, marital status, social status or sexual orientation. Strangers perpetrate only about 7% of sexual assaults. Sometimes, sexual assaults that occurred during childhood or decades ago continue to have a negative effect during adulthood.</p> <h3>Different types of sexual assault include:</h3> <ul> <li>Acquaintance</li> <li>Child</li> <li>Co-worker</li> <li>Dating</li> <li>Elder</li> <li>Incest</li> <li>Male </li> <li>Marital</li> <li>Same-sex</li> <li>Stranger</li> </ul> <p>Sexual abuse involves pressuring or manipulating a person, often a child or teen, to have sexual contact. It may begin as exposure to sexually explicit images or ambiguous touching and then gradually progress to sexual contact.</p> <p>Victims of sexual abuse are not to blame, regardless of the circumstances of their participation in sexual contact. Coercion and a prior relationship with the perpetrator can create a confusing situation for the victim, who may lack understanding of the dynamics of the abuse.</p> <h2>Have you been sexually assaulted?</h2> <h3>Take a few minutes to answer these questions to determine whether you have been a victim of sexual assault:</h3> <ul> <li>Have you had unwanted sexual contact with someone?</li> <li>Has someone touched you sexually without your permission?</li> <li>Have you been pressured to engage in sexual activities in a dating situation?</li> <li>Has a family member involved you in sexual behavior?</li> <li>As a child, were you drawn into or exposed to sexual activity?</li> <li>Have you been subjected to obscene telephone calls, flashing or pornography against your will?</li> <li>Have you participated in sexual activity with someone in a position of authority while they were supposed to maintain a professional relationship with you?</li> </ul> <p>If you answered "yes" to any of these questions, you have been sexually assaulted. Emergency departments and clinics in your area provide care and support. Seek medical care as soon as possible. You may need treatment for injuries, sexually transmitted infections or pregnancy. You may want a forensic examination to find evidence that could be useful if you decide to report the assault to law enforcement.</p> <p>Because sexual assault is a very difficult experience, specially trained sexual assault nurse examiners, or SANEs, care for people who have been sexually assaulted. They are registered nurses with advanced education in the medical-forensic examination of sexual assault victims.</p> <p>The SANE will conduct the examination in a sensitive, respectful, nonthreatening manner. They will help you report the assault if you choose to do that and will collect evidence that may be useful in court.</p> <p>Do not bathe, shower, douche, comb your hair, brush your teeth or change clothing after an assault to preserve evidence. If you have already done so, you can still have a SANE exam and, sometimes, evidence still can be found.</p> <h3>What to do if someone you know has been sexually assaulted</h3> <h4>If you or someone you know has been sexually assaulted, finding safety and getting the care the victim needs is important. You should:</h4> <ul> <li>Tell a friend or someone you trust.</li> <li>Go to a safe environment in which you feel secure.</li> <li>Seek medical attention for injuries, pregnancy and sexually transmitted diseases, or to collect legal evidence.</li> <li>Consider contacting local law enforcement to report the assault. Sexual assault is a crime.</li> <li>Seek help from someone knowledgeable about helping people who have been sexually assaulted.</li> <li>Know that the assault was not your fault. Even if you were drinking, getting a ride from someone, or at a party, it does not give anyone the right to assault you.</li> <li>Don't sympathize with or excuse the person who committed the assault. That person is responsible for what happened regardless of what excuses might be given, and deserves consequences for the assault.</li> <li>Don't simply try to forget the pain of the assault. Find others who can support and help you.</li> <li>Expect that healing will take time and that it comes differently for everyone.</li> </ul> <h3>Reduce your risk for sexual assault</h3> <h4>There are no guaranteed methods of preventing sexual assault, but these tips may reduce your risk:</h4> <ul> <li>Think about the level of intimacy you want in a relationship, and clearly state your limits.</li> <li>Clearly say "no" to unwanted touch, sex, gifts or assistance.</li> <li>Don't allow yourself to be alone with someone you don't know and trust.</li> <li>When you go to a party or bar, go with a group of friends. Arrive together, watch out for each other and leave together.</li> <li>Don't accept a drink from an open container. Never leave your beverage unattended.</li> <li>Be aware of your surroundings at all times and take action to prevent a potentially unsafe situation from worsening.</li> <li>Trust your instincts that a situation may not be safe and act on them.</li> <li>Realize that alcohol and drug use can affect your judgment about safe and unsafe situations.</li> </ul> <p>Remember, no one has the right to invade your personal and sexual boundaries without your permission. Coerced or forced sexual contact, however slight, is a crime.</p> <h4>Consider these actions to create a plan — an important part of remaining safe:</h4> <ul> <li>Reach out to your local domestic violence agency or the National Domestic Violence Hotline. </li> <li>Remain in contact with supportive people, such as friends, advocates or family members.</li> <li>Designate a safe space and a way to call emergency services. An old cellphone can be used to call 911 in an emergency.</li> <li>Pack a bag if you need to leave quickly and stay with a family member or friend. In addition to clothing, don't forget to include important documents, medications and other necessary items.</li> </ul> <h2>How to help others</h2> <p>In abusive relationships, victim isolation is a way to maintain power and control over someone. Reach out virtually if you know someone who is in an abusive situation. Be supportive, listen and do not judge the person's situation.</p> <h3>Review these additional abuse or assault resources:</h3> <ul> <li><a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/domestic-violence/art-20048397" target="_blank" title="Opens in a new window.">Domestic violence against women: Recognize patterns, seek help</a></li> <li><a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/domestic-violence-against-men/art-20045149" target="_blank" title="Opens in a new window.">Domestic violence against men: Know the signs</a></li> <li><a rel="noopener" href="https://ncadv.org/" target="_blank" title="Opens in a new window.">National Coalition Against Domestic Violence</a></li> <li><a rel="noopener" href="https://www.thehotline.org/" target="_blank" title="Opens in a new window.">National Domestic Violence Hotline</a></li> <li><a rel="noopener" href="https://www.rainn.org/" target="_blank" title="Opens in a new window.">Rape Abuse and Incest National Network</a></li> </ul> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2023/two-sets-of-hands-clasped-together.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9374C50A9C17FFA28CFD77EA1C7FE44C" alt="Two sets of hands clasped together" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Dawn Haller3/6/2023Lymphedema is a common side effect of cancer. A new surveillance program lowers this risk by painlessly tracking tiny changes in a person's lymph system.Stopping chronic lymphedema in its tracks<p>Lymphedema is a common side effect of cancer and its treatments. It occurs when tissues swell due to the buildup of lymph fluid that usually drains through the body's lymphatic system. Lymphedema can lead to pain, swelling, limited range of motion, infections and skin changes.</p> <p>About 40% of people with breast cancer will develop lymphedema within the first five years of diagnosis, usually in the arm or chest wall. A new surveillance system using bioimpedance technology aims at lowering this risk. A randomized control study found that 92% of cancer survivors in a lymphedema surveillance program didn't develop chronic lymphedema.</p> <p>Lymphedema can be triggered in many ways during a cancer journey. The most common is the removal of lymph nodes during cancer surgery. Lymphedema also may develop because of cancer's location. A tumor can obstruct the lymph system, affecting drainage and causing swelling. Finally, radiation can cause tissue to tense and scar tissue to form, leading to drainage issues and swelling.</p> <h2>Bioimpedance surveillance</h2> <p>Lymphedema is a chronic condition. It's important to catch it early before it causes pain, limited motion and skin issues.</p> <p>To accomplish this, patients diagnosed with breast cancer complete a baseline assessment of the amount of fluid in and out of the cells in their bodies. This is done before cancer surgery and treatment using bioimpedance technology.</p> <p>The bioimpedance device looks like a standard scale. Patients step onto the machine with two electrodes on their feet and two electrodes held in their hands. This painless scan takes about 30 seconds to complete.</p> <p>The first scan provides a baseline measurement for each patient. Scans are repeated every three months for two years and then every six months. Bioimpedance technology can identify tiny changes in a patient's baseline measurements, often before the patient notices symptoms or tape measurements in the clinic detect changes.</p> <h2>Preventive treatment plans</h2> <p><strong> </strong></p> <p>Using scan measurements as a guide, certified lymphedema therapists develop preventive treatment plans to lower the risk of lymphedema.</p> <p>For example, when patients' scan values are higher than their baseline numbers, they will be directed to wear a compression sleeve for 12 hours a day for four weeks. Compression keeps lymph from pooling and lymphedema from developing. If scan values are at or near the previous baseline, patients are considered free of lymphedema. If symptoms don't resolve and values remain elevated, patients undergo complete decongestive therapy to address swelling and reduce symptoms.</p> <p>Complete decongestive therapy is noninvasive treatment for lymphedema including compression, exercise, stretching, scar management and skin care routines. Skin care is important because there is a higher risk of skin infections if you have lymphedema.</p> <p>I've found that many women don't like to complain about bothersome side effects, especially after being treated for cancer. They often tell me they're happy to have survived and don't want to grumble about pain, weakness or scars due to lymphedema.</p> <p>Cancer survivors don't need to live with and accept lymphedema. Prevention and treatment options can make a significant difference in the quality of their lives.</p> <p>Health care teams want to help patients get back to their lives without restrictions. A lymphedema surveillance program with individualized treatment plans helps minimize the risk of chronic lymphedema and helps survivors avoid unnecessary painful side effects after cancer.</p> <p>Bioimpedance monitoring for lymphedema isn't available at all Mayo Clinic Health System locations. Check with your preferred location in advance.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2023/adult-wearing-chemo-cap-hugging-child.jpg?h=370&iar=0&w=660&sc_lang=en&hash=DC3CF5E3F659289FC304903F36CC9314" alt="Adult wearing chemo cap hugging child" width="660" height="370" DisableNVelocity="true" />CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.Dawn Haller3/23/2023Joy is a remedy for stress-related burnout and good for overall health and well-being. It isn't always feeling happy; instead, it's feeling content and purposeful. Get tips for finding joy in your life.Tips for embracing joy in daily life<p>Stress isn't new. Modern technology has made some tasks easier, but stress levels have stayed the same or increased. About 27% of U.S. adults report that they are so stressed most days that they are unable to function. Over 75% experienced at least one stress-related symptom in the last month, like headache, fatigue, nervousness or feeling depressed.</p> <p>Joy is a powerful emotion and harnessing it can be a remedy for stress-related burnout. Contentment and joy can positively <a href="/hometown-health/speaking-of-health/can-expressing-gratitude-improve-health" target="_self" title="Opens in same window.">improve physical and mental health</a> and overall well-being. Here's what you need to know to build, cultivate and sustain joy in your life.</p> <h2>Joy versus happiness</h2> <p>It's easy to confuse the emotions of joy and happiness because they often are experienced at the same time. Yet, some nuances should be distinguished. Often, <a href="/hometown-health/speaking-of-health/how-to-create-happiness" target="_self" title="Opens in same window.">happiness</a> is the emotional reaction to what is happening around you. Whereas joy isn't reactionary and often is driven by internal motivations like working toward a goal or finding a purpose in life.</p> <p>"Happiness is an emotion, whereas joy is more a state of being," says <a href="/providers/rebekkah-frunzac-md" target="_self" title="Opens in same window.">Rebekkah Frunzac, M.D.</a>, general surgeon and chief wellness officer at Mayo Clinic Health System in <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a> and <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a>, Minnesota. "When you are joyful, it doesn't mean you are always giddy or happy. But it means you can appreciate moments of happiness within the bigger context of life."</p> <p>Karizma Maxson agrees. She is a neonatal ICU nurse manager at <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/" target="_blank" title="Opens in a new window.">Mayo Clinic</a> in Rochester, Minnesota, and previously implemented joy activities at Mayo Clinic Health System in <a href="/locations/la-crosse">La Crosse</a>, Wisconsin.</p> <p>"Happiness is fleeting, but my joy still drives me on a terrible day," says Karizma. "Because I have a purpose in life, I still have joy even during a horrible time."</p> <h2>Compounding joy</h2> <p>Joy isn't experienced in a vacuum. Most of the time, it's a feeling or sentiment that spreads to others through your attitude and actions.</p> <p>"I think of joy as a ripple or a domino. On my team, we share a connection of wanting to care for women and children," says Karizma. "This shared purpose, and joy, builds a connection between everyone on the team. When you link joy together, it becomes even stronger."</p> <h2>Tips for discovering joy</h2> <p>Joy looks different to each person and can be found in everyday situations. Some people find joy in caring for others, spiritual connections, spending time in nature or continually learning. Other people discover joy in different activities, relationships or personal empowerment.</p> <p>Karizma refers to these pursuits as "filling my cup" and encourages people to feel empowered to seek and discover what brings them joy. Having activities or a purpose replenishes physical and emotional energy and helps people be more resilient when times are tough.</p> <h3>Dr. Frunzac and Karizma offer additional tips for embracing joy daily:</h3> <h4>Focus on what you can control.</h4> <p>Many possible stressors in life are outside of your control. The weather, how others treat you, your past, natural disasters, your relatives and other aspects of your life exist without your input. While building joy, focus your time and attention on things you can control.</p> <p>"I've learned to not internalize the things I can't control," says Dr. Frunzac. "This frees me up to better navigate the situation and focus on my personal happiness and mental health."</p> <p>This can be easier said than done. Write out the details of a stressful situation and outline which aspects are in and outside your control. Then make an intentional decision to shift your attention to things you can change, including your attitude.</p> <p>"Our attitudes are often a choice. We can spend time ruminating on something that is negative and out of our control or decide to see the good in something and choose joy," says Karizma.</p> <h4>Express gratitude. </h4> <p>Gratitude is being thankful or showing appreciation for the things and people around you. This could be sending positive thoughts to someone special, writing a text message to a friend or listing three things you are grateful for each day. Practicing this daily helps your brain shift its focus to appreciation and blessings, instead of problems and challenges.</p> <p>"It's easy to get bogged down in what we don't have, what we want or situations where we feel like we have been taken advantage of," says Dr. Frunzac. "Being deliberate about listing our blessings helps us recognize that, even with stressors, most people are very lucky and fortunate."</p> <h4>Assume good intent.</h4> <p>When stressed, any additional inconvenience or misunderstanding could be viewed as unjust and an intentional barrier to your joy. In most cases, people are simply doing their best with the information and skills they possess, and their actions are not malicious or spiteful.</p> <p>"When you start a relationship from the position that somebody else is bad or wrong, then that relationship is set up for failure," says Dr. Frunzac. "But if you can assume positive intent and approach every problem as though you are sitting on the same side of the table attacking the problem together, rather than attacking one another, you can find common ground and fulfillment."</p> <h4>Concentrate on building relationships.</h4> <p>To various degrees, all people need social connections with others. For many, helping lift others creates a sense of purpose and joy. If building healthy relationships is at the core of your efforts, you can find happiness and joy in your life.</p> <p>"One of the best parts of leadership is finding out what fills the cups of your team," says Karizma. "Part of being a good friend, good partner and good spouse is to recognize what is great in everyone and lift them up. Sharing in their joy and cheering them on helps us recognize the good things in ourselves, too."</p> <h4>Keep perspective.</h4> <p>Some decisions or situations have serious, long-lasting effects on your life. But often, things that seem important today may only matter a little or not at all in five or 10 years. It's common to recall the feeling of stress or worry years later, but not the actual scenario that caused it.</p> <p>As you strive for joy, remember to keep perspective on which situations and decisions are monumental and which are not, like little annoyances.</p> <p>"Everyone has aspects of their jobs that they don't enjoy," says Dr. Frunzac. "But learning to accept those parts helps compartmentalize them. Not everything we do is a defining moment in our lives. Sometimes, it's just a job that needs to be done."</p> <h2>Help is available</h2> <p>Even joyful people have difficult or unhappy days. Dr. Frunzac and Karizma stress that help is available for anyone struggling with depression or anxiety more days than not. Your health care team can help assess your symptoms and offer local resources to help you.</p> <h3>Mayo Clinic Health System invites you to try one or more of these free, self-guided virtual programs to help you improve different aspects of your health and wellness:</h3> <ul> <li><a href="/wellness/gratitude" target="_self" title="Opens in same window."><strong>Discover Gratitude</strong></a><br /> This monthlong program will help improve your mental well-being through daily journaling.</li> <li><a href="/wellness/journey" target="_self" title="Opens in same window."><strong>Journey to Wellness</strong></a><br /> This yearlong program focuses on different aspects of healthy living each month. Using the provided resources and activities, choose those important to you, and complete them on your schedule.</li> <li><a href="/wellness/kindness" target="_self" title="Opens in same window."><strong>Kickstart Kindness</strong></a><br /> During this monthlong program, you'll complete as many activities as you'd like from the list of nearly 100 ideas. You're invited to extend kindness to co-workers, community, environment, home and family, neighborhood, school and yourself.</li> <li><a href="/wellness/slim-your-screen-time" target="_self" title="Opens in same window."><strong>Slim Your Screen Time</strong></a><br /> This two-month program encourages you to increase physical activity, build social relationships that contribute to resiliency, and improve your mood and mental health. Play, explore and connect more by completing as many activities as you'd like from a list of nearly 100 ideas.</li> </ul> <em>Mayo Clinic has identified joy as a key driver of the overall success of its workforce, patients and organization. The Joy @ Mayo Clinic program was created to spread joy in the workplace and funded small projects to remove barriers to joy and foster acts of kindness.</em><img src="/-/media/national-files/images/hometown-health/2023/expressing-joy.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CCECF920AFD1DD41A192C243E2B55FC1" alt="Person with arm up, expressing joy" width="660" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller3/22/2023Urinary incontinence can occur in up to 10% of men who have had prostate cancer surgery. Learn about two outpatient surgical treatment options that can stop leaks and ease worry.Surgical options for urinary leakage in men<p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/urinary-incontinence/diagnosis-treatment/drc-20352814" target="_blank" title="Opens in a new window.">Urinary incontinence</a> takes many forms, including these three main types:</p> <ul> <li><strong>Stress incontinence</strong> — due to leakage with activities, such as lifting, climbing stairs or strenuous activity</li> <li><strong>Urge incontinence</strong> — related to leakage associated with the feeling or urge to urinate</li> <li><strong>Mixed incontinence</strong> — a combination of the stress and urge incontinence</li> </ul> <p>Stress urinary incontinence is a possible side effect of prostate cancer surgery and can have negative effects on a patient's quality of life. Up to 10% of men may experience some degree of stress incontinence after their surgery.</p> <h2>Stress incontinence in men</h2> <p>Stress incontinence in men after prostate surgery is due to multiple factors related to the patient's anatomy, prostate cancer and the surgery performed. Ultimately, this leads to a weakened sphincter muscle and laxity of the pelvic floor. The sphincter muscles control the release of urine, and the urethra is the small tube that empties the bladder. A prostatectomy procedure removes some of the control provided by the prostate and bladder, making the patient reliant solely on the external sphincter muscle.</p> <p>Normally, the sphincter remains closed as the bladder fills with urine until you can reach a restroom. The weakened muscles and relaxed pelvic floor have trouble holding urine, so any movement that exerts a force on the abdominal and pelvic muscles puts pressure on the bladder and can cause leakage. This force could be sneezing, bending over, lifting or even laughing.</p> <p>Stress incontinence symptoms that begin after prostate surgery may resolve on their own with time and pelvic physical therapy. Usually, patients can see continued improvement for 12 months after surgery and try nonsurgical treatments, such as physical therapy, before considering surgical treatment options, such as male urethral slings and artificial urinary sphincters.</p> <h2>Male urethral slings</h2> <p>Male urethral slings are indicated for men with mild to moderate stress urinary incontinence, which is defined as using one to four pads per day. The surgeon uses a synthetic mesh material to create a sling, or hammock, to support and pull the urethra and pelvic floor back toward their original locations. Some slings also provide compression support for the sphincter muscles.</p> <p>A cystoscopy test will be needed before the surgery to confirm that the sphincter muscles are working.</p> <p>Male urethral slings are performed as an outpatient procedure, and patients can go home the same day. Heavy lifting and strenuous exercise are restricted for about six weeks. Patients need to be careful climbing ladders and squatting for about three months after surgery because significant hip flexing can loosen the sling.</p> <p>About 80% of men with male urethral slings see an improvement in their symptoms after surgery, with the majority of them no longer needing pads after surgery.</p> <h2>Artificial urinary sphincters</h2> <p>This surgical procedure is more invasive than male urethral slings and appropriate for men with severe stress incontinence, which is defined as using more than four pads per day. It's also a good option for patients who have damage to sphincter muscles from radiation therapy or a failed male urethral sling.</p> <p>Artificial urinary sphincters placement has multiple components. A small cuff is placed around the urethra. This replaces the sphincter muscle's function. Tubes connect the cuff to a pressure-regulating balloon placed in the lower pelvic region and a pump in the scrotum. The pump is manually operated to open the cuff on the urethra and allow urine to be released from the body.</p> <p>Some patients can go home the same day as surgery, while others will require an overnight hospital stay to recover.</p> <p>After surgery, the artificial urinary sphincter isn't activated for about a month while the body heals. During this time, heavy lifting and exercise are restricted. Patients return to the clinic and are taught how to properly use the device. With proper training and consistent use, artificial urinary sphincters are effective at treating symptoms of severe stress urinary incontinence in men.</p> <p>Talk with your health care team if you're experiencing urinary incontinence symptoms or are concerned about your prostate or urinary health.</p> <p><a href="/providers/david-yang-md" target="_self" title="Opens in same window."><em>David Yang, M.D.</em></a><em>, is a <a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">urologist</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Male infertility (microscopic variocelectomy)</li> <li>Male stress incontinence (male sling, artificial urethral sphincter)</li> <li>Male urethral stricture disease (urethroplasty)</li> <li>Men’s health</li> <li>Men’s sexual medicine (erectile dysfunction, penile prosthesis/prosthetic surgery)</li> <li>Peyronie's disease (penile plication, penile incision and grafting)</li> <li>Robotic surgery</li> <li>Urethral stricture disease</li> </ul>M.D.<p>My goal is for every patient to leave our visit with a newfound understanding of their condition and options for management, and they feel comfortable with the future plan. I try to treat every patient as family, and will deliver information and guidance as such. My clinical interests include urologic oncology and men's sexual health, including erectile dysfunction, Peyronie's disease and male infertility.</p> <p>I grew up in Indianapolis but have lived in Minnesota for the last seven years. In my free time, I like to golf, hike, and spend time with my wife and two Newfoundland dogs.</p><p><strong>Education</strong></p> <ul> <li>Indiana University School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Urology, Mayo Clinic</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Urology, Mayo Clinic School of Graduate Medical Education </li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Andrology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Urology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Urologic Association</li> <li>Sexual Medicine Society of North America</li> <li>Society for the Study of Male Reproduction</li> <li>Society of Genitourinary Reconstructive Surgeons</li> <li>Society of Urologic Prosthetic Surgeons, Inc.</li> </ul>Yang<img src="/-/media/shared-files/images/medical-professionals/full/mankato/david-yang-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=3161395B079F288AA0229E441F6302D1" alt="David Yang, M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/33223428/" target="_blank" title="Opens in new window">The Tubing, Hitch and Lasso, Intussusception Anchor (THALIA) Technique: A novel approach to fixate the penile implant reservoir</a>, January 2021.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/32198103/" target="_blank" title="Opens in new window">Multicenter experience using collagen fleece for plaque incision with grafting to correct residual curvature at time of inflatable penile prosthesis placement in patient’s with Peyronie’s disease</a>, June 2020.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/33676956/" target="_blank" title="Opens in new window">Patient attitudes towards surgical management of Peyronie’s Disease prior to men’s health consultation</a>, June 2020.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/30701330/" target="_blank" title="Opens in new window">Damage control considerations during IPP surgery</a>, January 2020.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/25240762/" target="_blank" title="Opens in new window">Oncologic and quality-of-life outcomes with wide resection in robot-assisted laparoscopic radical prostatectomy</a>, February 2015.</li> </ul>David<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16240391David Yang, M.D.1<img src="/-/media/national-files/images/hometown-health/2023/holding-2x4-wearing-safety-glasses.jpg?h=370&iar=0&w=660&sc_lang=en&hash=59A50629625828450300895B1B0ADCB7" alt="Person holding 2x4 and wearing safety glasses" width="660" height="370" DisableNVelocity="true" />Urinary IncontinenceThe loss of bladder control is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that's so sudden and strong you don't get to a toilet in time. For most people, simple lifestyle changes or medical treatment can ease discomfort or stop urinary incontinence.Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Dawn Haller9/18/2025Finding asparagus in the market signals that spring has arrived. Its vivid green, dark purple or creamy white spears add pops of color to the lighter dishes that usher in a new season of eating.Brighten spring dishes with asparagus<p>Asparagus is a perennial flowering plant brought from Europe to North America hundreds of years ago. However, its history dates back to ancient Egypt, where images of it can be found on the walls of tombs. It originally grew wild along riverbanks or the seashore, preferring a soil too salty for other plants.</p> <p>The world's top producers of asparagus are China, Peru and Germany. Most of the asparagus grown in the U.S. comes from three states: California, Washington and Michigan. Asparagus can take up to three years to produce a crop. It's harvested in the spring, and one plant will continue to produce for about 15 years. Under perfect growing conditions, asparagus can grow up to 10 inches in 24 hours.</p> <p>Green is the most common color of asparagus, but white and purple have gained popularity. The white variety is picked before the spear breaks through the soil, so it's never exposed to the sun. Since it's only available for a few weeks, white asparagus is more expensive than green. Purple asparagus is pretty when raw but loses its color during cooking. The main difference between the colors is taste and texture. The nutritional value is virtually the same.</p> <p>Asparagus can be part of a well-balanced diet. Low in fat and calories, one-half cup or five spears cooked contain only 20 calories. The primary nutrients in asparagus are vitamin K and folate. People on blood thinners may need to watch their vitamin K intake and should talk to their health care team to find out if it's OK to include asparagus in their diets.</p> <p>After eating asparagus, some people notice their urine has a funky smell. That's due to asparagusic acid, which digestion breaks down into sulfur-containing compounds that give urine the distinctive asparagus odor and color. Only some people can smell this odor, and scientists are still trying to figure out why. But the temporary odor is no reason to pass on this healthful, versatile spring vegetable.</p> <h2>Usher in the season with one of these asparagus recipes from Mayo Clinic staff:</h2> <h3>Penne with tomatoes, asparagus and goat cheese</h3> <p>Serves 2</p> <p>1/3 pound whole-wheat penne pasta<br /> 1 cup asparagus, cut or snapped into 1-inch pieces<br /> 1 tablespoon water<br /> 1/2 cup halved cherry tomatoes<br /> 1/4 cup chopped fresh basil, plus whole leaves for garnish<br /> 1 tablespoon minced garlic<br /> 1/8 teaspoon freshly ground black pepper<br /> 2 ounces goat cheese</p> <p>Fill a large pot 3/4 full of water and bring to a boil. Add the pasta and cook according to the package directions. Drain the pasta. While the pasta is cooking, put the asparagus and water in a microwave-safe bowl. Heat the asparagus on high power until tender-crisp, about 3 minutes. In a bowl, combine the cherry tomatoes, basil, garlic and pepper. Add the asparagus, pasta and goat cheese, and toss until well-mixed. Cool in the refrigerator for at least 20 minutes.</p> <p>Divide the pasta between the plates. Garnish with fresh basil leaves and serve.</p> <p><em>Nutritional information per 2-cup serving: 392 calories, 8 grams fat, 4 grams saturated fat, 150 milligrams sodium, 65 grams carbohydrates, 10 grams fiber, 17 grams protein</em></p> <h3>Asparagus with hazelnut gremolata</h3> <p>Serves 4</p> <p>Gremolata is a chunky green sauce traditionally eaten in Italy with meat, poultry or fish.</p> <p>1 pound asparagus, tough ends removed, then peeled if skin is thick<br /> 1 clove garlic, minced<br /> 1 tablespoon chopped fresh flat-leaf (Italian) parsley, plus sprigs for garnish<br /> 1 tablespoon finely chopped toasted hazelnuts (filberts)<br /> 1/4 teaspoon finely grated lemon zest, plus extra for garnish<br /> 2 teaspoons fresh lemon juice<br /> 1 teaspoon extra-virgin olive oil<br /> 1/4 teaspoon salt</p> <p>In a large pot fitted with a steamer basket, bring about 1 inch of water to a boil. Add the asparagus, cover and steam until tender-crisp, about 4 minutes. Remove from the pot. In a large bowl, combine the asparagus, garlic, chopped parsley, hazelnuts, 1/4 teaspoon lemon zest, lemon juice, olive oil and salt. Toss well to mix and coat. Arrange the asparagus neatly on a serving platter and garnish with parsley sprigs and lemon zest. Serve immediately.</p> <p><em>Nutritional information per 3/4-cup serving: 50 calories, 2 grams fat, 0 grams saturated fat, 148 milligrams sodium, 5 grams carbohydrates, 3 grams fiber, 3 grams protein</em></p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2023/asparagus-in-pasta-dish.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5232BF4C80F7E3425816CBF662378C8A" alt="Asparagus in pasta dish" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller4/10/2023Ambiguous loss is when a person experiences a profound sense of loss and sadness not associated with death. While common, it can be a challenge to work through. Get five tips for coping.Unnamed pain: Coping with ambiguous loss<p>The death of a loved one can be among the most distressing experiences people face. It's a clear loss with expected and validated feelings of grief and sadness. Many times, however, people can feel significant loss when there isn't a death. It can be more difficult to recognize and validate these emotions.</p> <p>Ambiguous loss is a person's profound sense of loss and sadness that is not associated with a death of a loved one. It can be a loss of emotional connection when a person's physical presence remains, or when that emotional connection remains but a physical connection is lost. Often, there isn't a sense of closure.</p> <p>Ambiguous loss can feel lonely, stressful and confusing. Your feelings need to be validated and the significance of the experience recognized. However, there's often no formal recognition from others that a loss has occurred — or if others do acknowledge it, they show no recognition that it is of any major significance. You may have intense sorrow, numbness, bitterness, persistent longing, pain, rumination, guilt and anger.</p> <h2>Types of ambiguous loss</h2> <p>Feelings of loss and sorrow are complicated and complex. Ambiguous loss is no exception.</p> <h3>Many scenarios could generate feelings of ambiguous loss, which usually fall into one of these general categories:</h3> <h4>Goodbye without leaving</h4> <p>This happens when the person you are grieving is physically alive but not emotionally or relationally part of your life. Examples include divorce, estrangement, incarceration, relocating to a new country or a chronic illness like dementia. The relationship you had with the person is over or substantially changed. This can result from your decisions or be a situation entirely outside of your control.</p> <p>A couple in conflict is a common situation where someone might experience ambiguous loss. A partner may say, "I want the person he or she used to be." A similar sentiment is shared by a caregiver for someone with memory loss, who yearns for the relationship before their loved one's dementia progressed. In these cases, the wanted person is no longer available, leading to significant feelings of loss.</p> <h4>Leaving without a goodbye</h4> <p>You may mourn a person who is physically gone under circumstances where you are unsure if they are dead or alive. For example, the person may have an addiction that leads to abandonment or a missing person scenario. These situations are difficult because you aren't able to say your farewells. There may not be a traditional funeral or another mourning period, which can lead to a lack of closure. This sense of loss also is experienced by children when a parent leaves the family due to a divorce.</p> <h4>Situational goodbye</h4> <p><strong></strong>Sometimes, feelings of ambiguous loss aren't due to a relationship change but occur because of other situations. They could affect you personally or occur elsewhere but cause significant feelings of loss in your life. This could include the COVID-19 pandemic, a change in future plans, natural disasters, political unrest or a loss of financial or personal security.</p> <h2>Ambiguous loss coping tips</h2> <p>People follow different paths through the grieving experience. There's no right or wrong way to grieve. There are no specific phases. It's rarely a linear path and instead has ups and downs and moves forward and back.</p> <h3>Remember these coping tips as you navigate your ambiguous loss journey:</h3> <h4>Identify your loss.</h4> <p>It's important to validate your ambiguous loss. One way to do this is to write down everything in your life that has changed or will change due to your loss. Nothing is too small to include. Don't minimize your list, as that can short-circuit your journey. A list for a parental estrangement may include wedding dress shopping together, sending Mother's Day cards or holiday gifts, having inside jokes and more. The list for an incarcerated loved one may include lost holidays and milestones, vacations, daily conversations and physical intimacy. The list for a loved one suffering from dementia may include planned trips, sharing holidays, living in the same place and shared memories. When you are done with your list, share it with a trusted friend, family member or mental health counselor.</p> <h4>Recognize multiple emotions.</h4> <p>During the grieving process, many people experience multiple emotions simultaneously. You can feel relieved to have your divorce finalized but saddened over the loss of the future you envisioned. A loved one's dementia diagnosis can make you distressed, even as you welcome the opportunity to spend more quality time together and continue to visit often.</p> <h4>Don't compare.</h4> <p>It's impossible to compare emotions because people aren't simple or the same. There are many variables or contributing factors that are more or less important to each person. It's not helpful to minimize your grief because your situation doesn't include death.</p> <p>Remember that grieving can compound as well. For example, a person could be moving a child to college, caring for an ill family member and coming to terms with an estranged loved one. Separately, these situations may be manageable, but when they happen simultaneously, the person could struggle with deep feelings of ambiguous loss.</p> <h4>Consider ceremonies.</h4> <p>When there is a physical death, it's common for the community to gather to pay tribute to the lost person and lend support to those grieving. Traditions vary, but there is usually a memorial service, sharing of meals and retelling of happy memories. While full closure may not be possible with ambiguous loss, ceremonial activities can provide therapeutic benefits. You could write a letter to the person, plant a tree, donate money or time, host a remembrance ceremony or do other meaningful activities. A mental health counselor can help you find a creative way to process your loss through such ceremonies.</p> <h4>Seek support.</h4> <p>People aren't meant to carry their emotions alone. Most need others to help them work through their feelings and move forward. Family members, friends, social support groups and your faith community are good resources to help you work through your feelings. You may be able to find a <a href="/classes-and-events" target="_self" title="Opens in same window.">support group</a> focused on a particular type of ambiguous loss, such as divorce, estrangement, addiction or missing persons. Professional counseling can help you explore your emotions and develop healthy coping skills.</p> <p>Feelings of loss and sadness due to ambiguous loss are valid. Talk with a professional mental health counselor if you have anxiety or trouble performing daily tasks. There's nothing wrong with your reactions or emotions, but a counselor can help you live more freely.</p> <p><a href="/providers/richard-oswald-lpc" target="_self" title="Opens in same window."><em>Rich Oswald</em></a><em> is a psychotherapist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/menomonie" target="_self" title="Opens in same window.">Menomonie</a>, Wisconsin.</em></p><ul> <li>Addicted family member</li> <li>Anxiety</li> <li>Bi-polar disorder</li> <li>Boundaries</li> <li>Career issues</li> <li>Conflict resolution</li> <li>Grief</li> <li>Healing abuse issues (emotional, mental, spiritual)</li> <li>Healing trauma issues</li> <li>Identity</li> <li>Life direction</li> <li>Low self-esteem</li> <li>Marital counseling (affair recovery, communication, conflict, parenting concerns, sexual issues)</li> <li>Relationship problems</li> <li>Sexual issues</li> <li>Spiritual/faith concerns</li> </ul>L.P.C.<p>Deep and lasting change is my goal while acknowledging short term changes are the steps in the journey. I view therapy as the opportunity to come alongside you during your journey to help you heal and grow, to live truer to who you are and make the healthiest decisions you can. I address both immediate issues and long-term patterns of thought, behavior and relating.</p> <p>I utilize a Christian worldview to understand people’s value, motivations, challenges and needs but work with people of all faiths. I use my education and experiences in engineering and carpentry work to provide practical and relatable illustrations.</p> <p>I grew up in Eastern Pennsylvania, learning to work on cars in my dad's mechanic shop. I had good times riding bikes and motorcycles, fishing, boating and building and driving RC Cars. After college and various jobs, I realized I was good with people and wanted to become a counselor.</p> <p>During my life journey, I became aware of my own mental disorders and addressed them in therapy. I spent 22 years in Atlanta, Georgia, with 19 of them working in counseling and running my own handyman business. However, I missed the snow of the North, so Wisconsin became my family's new home. I am married and have four daughters. I love being outside, riding motorcycles, fixing things, learning new things and meeting new people.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Mechanical Engineering, Penn State University</li> <li>Master's degree, Mechanical Engineering, Penn State University</li> <li>Master's degree, Professional Counseling, Richmont Graduate University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Outpatient Counseling, Mount Paran North Church</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Certified Professional Counseling Supervisor</li> <li>Certified Trauma Resolutions Therapist</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Christian Counselors</li> <li>Professional Counseling Association of Georgia</li> <li>Professional Counseling Association of Wisconsin</li> </ul>Oswald<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/richard-oswald-lpc.jpg?h=280&iar=0&w=280&sc_lang=en&hash=07E6DC8C4784E3E146B16A66D64F1E4F" alt="Richard Oswald LPC" width="280" height="280" DisableNVelocity="true" />Rich<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30181503Richard Oswald, L.P.C.1<img src="/-/media/national-files/images/hometown-health/2023/holding-flame-in-small-cup.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3B2D87851DA053318F600CC52A1410FE" alt="Holding flame in small cup" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller4/4/2023Some kids are prone to painful ear infections. A common treatment is inserting ear tubes to drain fluid and circulate air. Get answers to common questions about this simple procedure.Does my child need ear tubes?<p>Middle ear infections are caused by bacteria or a virus that infects fluid that has builds up in the middle ear. These infections often happen when a child has a cold, allergy or upper respiratory illness. <a href="/hometown-health/speaking-of-health/questions-about-earaches-and-ear-infections" target="_self" title="Opens in same window.">Ear infections</a> can be painful and cause difficulty sleeping or hearing. Unfortunately, they also are one of the most common infections for children.</p> <h2>Inserting tubes in the ear is a treatment for chronic ear infections. Here are answers to questions about this procedure:</h2> <h3>What are ear tubes?</h3> <p>Ear tubes are tiny, hollow cylinders made of soft plastic. They are placed in the eardrums and allow air to circulate between the outer and middle ear. </p> <h3>Are ear tubes common in children?</h3> <p>Myringotomy, the procedure to insert ear tubes, is the most common surgical procedure performed on children. Kids have a higher risk of runny noses and ear infections because their eustachian tubes are shorter and narrower than those of adults. Because the eustachian tubes in children aren't as developed, they can become inflamed or irritated more easily. This leads to ear infections. Ear tubes can help relieve the pressure that builds up during an infection or altogether prevent infection. </p> <p>While the procedure is more common in children, inserting ear tubes also can help adults who experience recurring ear infections. </p> <h3>How do I know if my child needs ear tubes?</h3> <p>Ear tubes likely will help kids who have chronic ear infections. This means those who have had at least three ear infections within six months or four infections within one year, all with persistent middle ear fluid. If a child has had fluid buildup in the ears for at least three months, the health care team may recommend a hearing test to show if a child has a loss of hearing</p> <p>For adults, the most common symptoms that may improve with ear tubes are muffled hearing and ear pressure. These symptoms can cause a sense of imbalance or dizziness — like rocking in a boat — if there is fluid buildup in one ear but not the other. In these cases, placing an ear tube can help the person regain balance.</p> <h3>How are ear tubes placed?</h3> <p>The process of placing ear tubes is simple and quick. The surgeon makes a small incision in the eardrum to suction out fluid from the middle ear. Then a tiny tube is inserted in the opening to ventilate the ear and prevent fluid buildup in the future. Patients experience little to no pain.</p> <img height="301" alt="Ear tube illustration" width="400" src="/-/media/national-files/images/hometown-health/2023/ear-tube-illustration.jpg?sc_lang=en&hash=676BE1B3DBFCCC3F315A336676431D9B" /> <p>For adults, a surgeon can place tubes during a clinic appointment, using topical medication to numb the eardrum. There is minimal recovery necessary for adults. They can go back to work or school the same day.</p> <p>Young kids may not be able to sit still during the procedure, so ear tubes are inserted in an operating room. They receive anesthesia to make them fall asleep. The entire procedure can last less than one minute. I joke with parents that it takes longer to put children to sleep than to put in the ear tube. I encourage parents to keep kids home for the rest of the day after surgery, but they can return to school or day care the next day.</p> <h3>Do ear tubes provide relief?</h3> <p>Yes. For many patients, relief from the pain and discomfort of a middle ear infection is almost immediate. Once the fluid is removed and the pressure decreases, patients usually feel and hear better immediately. Any dizziness also improves right away. After the procedure, children aren't in constant pain so most behave better, aren't as clingy and sleep well.</p> <h3>Do ear tubes fall out?</h3> <p>Yes, ear tubes are made to fall out on their own. Over time, the eardrum heals, pushing the tube into the ear canal. <a href="/hometown-health/speaking-of-health/the-scoop-on-earwax" target="_self" title="Opens in same window.">Ear wax</a> moves it to the outer ear. Most tubes remain in children's ears for about one year. For adults, it's about six months.</p> <p>Children may need tubes placed again if they start having ear infections after the original tubes fall out. If a second set of tubes is needed, your child's health care team may recommend removing the adenoid glands as well. These are two small pads of tissue found on the back of the nose. The eustachian tubes drain the ears on either side of the adenoids. If the adenoids are enlarged, they can block drainage and cause ear infections.</p> <p>Talk with your child's health care team if you're concerned about chronic ear infections and think ear tubes may help. Or talk with your health care team if you are experiencing muffled hearing or dizziness.</p> <p><a href="/providers/pao-vang-md" target="_self" title="Opens in same window."><em>Pao Vang, M.D.</em></a><em>, is an <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">otolaryngologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>and <a href="/locations/rice-lake" target="_self" title="Opens in same window.">Rice Lake</a>, Wisconsin.</em></p> <ul> <li>Airway surgery</li> <li>Chronic sinusitis</li> <li>Ear surgery</li> <li>Endocrine surgery</li> <li>General otolaryngology</li> <li>Head and neck cancer</li> <li>Nasal polyps</li> <li>Nose and sinus disease</li> <li>Pediatric otolaryngology</li> <li>Sinus surgery</li> <li>Tonsillectomy and adenoidectomy</li> <li>Voice disorders</li> </ul> M.D. <p> I am a firm believer that listening to the patient is the best form of medicine. Often, patients know what is wrong with them or they know that something is not right. They just need someone to listen to them and help treat their illness. It is this principle that has guided me as a physician and propelled me to pursue a career in medicine.</p> <p>I was attracted to the practice of ear, nose and throat (ENT) medicine because of a personal experience. In junior high school, my younger brother needed ear surgery, and since my parents didn't speak English, I had to do a lot of reading on it so I could interpret for them. I was absolutely amazed when his hearing improved dramatically after the surgery.</p> <p>After medical school, I started in general surgery to be a transplant surgeon. The idea of taking a human organ from one person and putting it into another fascinated me (and it still does). I changed course and went into ENT instead.</p> <p>Today, I am the first and only Hmong ENT surgeon in this country, and I am proud to be a part of Mayo Clinic Health System.</p> <p>In my free time, I enjoy biking and hiking. My favorite pastime is to go out into the countryside, pick a road and bike on it to see where it goes. It’s amazing the people I come across and the things I see when I take the time to look around. I once biked from Providence, Rhode Island, to Denver, Colorado. It was breathtaking to see the things I saw on that trip. I would do it again in a heartbeat.</p> <p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Internship</strong></p> <ul> <li>University of Nebraska Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Ear, Nose and Throat, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Otolaryngology – Head and Neck Surgery</li> <li>American Board of Otolaryngology</li> </ul> Vang<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/pao-vang-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=033E415DACE1C36268AC812E8C2D5272" alt="Pao Vang, M.D." width="280" height="280" DisableNVelocity="true" /> {6E33A01E-3D8E-4CFB-A7D2-440C4D160777}Pao<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13562746Pao Vang, M.D. 1<img src="/-/media/national-files/images/hometown-health/2023/child-at-piano-keyboard.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4D8423954560BFAAE6795B6C858E09B2" alt="Child at piano keyboard" width="660" height="370" DisableNVelocity="true" />Ear, Nose and Throat (ENT)Get information about symptoms, disorders and diseases affecting the ear, nose and throat, and related head and neck structures.Ear HealthAn audiologist specializes in evaluating and treating people of all ages with hearing loss, dizziness and balance disorders. Specialty audiology consultation is available for assessment and treatment of hearing loss, tinnitus, dizziness and balance disorders.Dawn Haller7/16/2025The foods you eat give your body energy and nutrition. But they can irritate the bladder, and worsen overactive bladder symptoms and pain. Here's what foods to limit or avoid.Link between food and bladder symptoms<p>Food isn't just a source of energy and nutrition for the body. Diet can have a significant effect on bladder health.</p> <p>People with healthy bladders don't need to worry about foods that can be irritating, but those with overactive bladder or bladder pain need to pay attention to what they eat. Certain foods can trigger symptoms and make their conditions worse.</p> <h2>Overactive bladder</h2> <p>People who experience a sudden urge to urinate may have overactive bladder. The urge may be difficult to stop and can lead to the involuntary loss of urine, known as urge incontinence.</p> <p>The urgency and frequency of overactive bladder symptoms can increase after eating certain foods. They stimulate the sensation that the bladder is full and needs to be urgently emptied.</p> <h3>Foods that have been known to amplify overactive bladder symptoms include:</h3> <ul> <li>Alcohol</li> <li>Caffeinated beverages</li> <li>Carbonated beverages</li> <li>Citrus foods</li> <li>High water-content foods, like watermelon, cucumbers and strawberries</li> <li>Onions</li> <li>Salsa </li> <li>Spicy food</li> <li>Tomatoes</li> </ul> <p>If you have an overactive bladder, you don't need to cut these foods out of your diet completely. Being aware of your food choices and planning accordingly can help decrease symptoms. For example, limit yourself to one cup of coffee before you leave on a three-hour car trip instead of having two or three cups. Or, recognize you may need to use the restroom more if you eat chips and salsa with a few beers.</p> <p>Some foods cause more intense symptoms than others. Keep track of the foods you eat and your symptoms in a bladder diary. This will help you determine which foods affect you most so you can take those into account when planning meals.</p> <h2>Bladder pain</h2> <p>Certain foods exacerbate bladder pain for some people, causing intense pain as their bladders fill. Instead of feeling the relief of urinating, they report feeling their bladders being squeezed or wrung out. The symptoms often mirror those of a urinary tract infection, but an infection isn't present.</p> <p>Multiple conditions can cause bladder pain, including interstitial cystitis and chronic bladder pain syndrome. These conditions can be difficult to treat, and there isn't a cure.</p> <p>Symptoms can flare based on people's diets.</p> <h3>It may be necessary to entirely eliminate foods to keep symptoms under control, including:</h3> <ul> <li>Alcohol</li> <li>Carbonated beverages</li> <li>Caffeine in all forms, including chocolate and supplements</li> <li>Citrus fruits and products</li> <li>Foods with high concentrations of vitamin C </li> <li>Pickled foods</li> <li>Tomatoes </li> </ul> <h2>Importance of water</h2> <p>Many people with overactive bladder or bladder pain restrict their fluid intake due to worry about possible symptoms. Some people avoid drinking any fluids all day. This can cause them to become constipated, which stops the bladder from expanding and contracting as expected and will make urinary symptoms worse.</p> <p>While there's no universally recommended amount, most people should aim to drink approximately 60 ounces of fluids each day. The goal is to have urine that is a light yellow color most of the time.</p> <p>Talk with your health care team if you are concerned about your urinary health. In addition to dietary changes, various treatments can provide relief, including physical therapy, oral medications and outpatient procedures.</p> <h2>Next steps:</h2> <ul> <li>Find a <a href="https://www.mayoclinichealthsystem.org/providers?service=Urology" target="_self" title="Opens in same window.">urology specialist</a> near you.</li> <li>Read about <a href="/hometown-health/speaking-of-health/what-can-you-do-for-an-overactive-bladder" target="_self" title="Opens in same window.">treatments for overactive bladder</a> including <a href="/hometown-health/speaking-of-health/how-do-bladder-botox-injections-work" target="_self" title="Opens in same window.">Botox injections</a>.</li> <li><a href="/request-appointment" target="_self" title="Opens in same window.">Request an appointment</a> for urinary symptoms.</li> </ul> <p><a href="/providers/gretchen-zinsli-aprn-cnp" target="_self" title="Opens in same window.">Gretchen Zinsli</a> is a nurse practitioner in Urology in Faribault and Owatonna, Minnesota.</p>APRN, CNP<p><strong>Education</strong></p> <ul> <li>Master's degree, Nursing, Walden University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Acute and Critical Care Nursing - Adult, American Association of Critical-Care Nurses</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Association of Critical-Care Nurses</li> </ul>Zinsli<img src="/-/media/shared-files/images/medical-professionals/full/owatonna/gretchen-zinsli-aprn-cnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=0B39A92760CB32892CC904EA39635E48" alt="Gretchen Zinsli, APRN, CNP" width="280" height="280" DisableNVelocity="true" />Gretchen<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14645050Gretchen Zinsli, APRN, CNP1<img src="/-/media/national-files/images/hometown-health/2023/bbq-chicken-drummies.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6892E86D9ED7D44F3A2B11991A5E74DC" alt="BBQ chicken drummies" width="660" height="370" DisableNVelocity="true" />Dawn Haller4/20/2023Inherited genetic mutations can predispose you to develop certain cardiac conditions. Identifying genetic variants that increase the risk of these diseases allows you to make informed health choices.Genetic testing gives insight into cardiac conditions<p>Many health conditions have a genetic link. A gene is like an instruction manual for your body that tells your body how to function, develop and stay healthy. </p> <p>Some cardiac conditions have a genetic component to them. These genetic components, called inherited genetic mutations, can predispose a person to develop a <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiac condition</a>. Cardiomyopathy, high cholesterol, coronary artery disease, aortic aneurysm and dissection, and arrhythmia all can have genetic risk factors associated with the condition.</p> <p>If a genetic component may be associated with a cardiac condition, your health care team may refer you to a genetic counselor. </p> <h2>Meeting with a genetic counselor</h2> <p>When a referral from a health care professional, or a self-referral, is made to see a genetic counselor, the counseling appointment can be in person or virtual. The genetic counselor will discuss personal health history, medications, and a three-generation <a href="/hometown-health/speaking-of-health/know-your-numbers-family-health-history" target="_self" title="Opens in same window.">family health history</a>, called a pedigree. </p> <h3>Cardiac-related conditions gathered for the pedigree can include family history for: </h3> <ul> <li>Aortic aneurysm or dissection</li> <li>Arrhythmias</li> <li>Cardiomyopathy</li> <li>Coronary bypass surgery</li> <li>Echocardiogram or electrocardiogram testing </li> <li><a href="/hometown-health/speaking-of-health/what-should-i-do-if-i-might-be-having-a-heart-attack" target="_self" title="Opens in same window.">Heart attacks</a></li> <li>High cholesterol</li> <li>Stent placement procedures</li> <li><a href="/hometown-health/speaking-of-health/young-athletes-and-heart-health" target="_self" title="Opens in same window.">Sudden cardiac arrest</a></li> </ul> <p>The person's age when these cardiac-related conditions occurred or developed is important. </p> <p>Building and understanding a family pedigree explains how conditions are passed on through families and helps identify patterns of inheritance. </p> <h2>Genetic testing for hypertrophic cardiomyopathy</h2> <p>With hypertrophic cardiomyopathy, the heart muscle thickens, reducing the heart's ability to pump blood effectively. In severe cases, it can lead to heart failure or cardiac arrest.</p> <p>A significant portion of people with hypertrophic cardiomyopathy have a hereditary form of the condition. If you have a first-degree relative with the disease, which includes a parent or sibling, it is recommended that you undergo regular cardiac diagnostic evaluation. First-degree relatives have a 50% risk of having this mutation. </p> <p>If your testing identifies a genetic mutation for hypertrophic cardiomyopathy, other relatives also may choose to undergo testing to determine if they carry the genetic risk, known as cascade testing. </p> <p>Cascade testing involves informing family members of a genetic condition found within a blood relative. After identifying a specific genetic mutation, first-degree family members can be tested to determine if they also inherited the mutation. </p> <p>If cascade testing shows a family member carries the genetic mutation, they are at increased risk of developing the associated condition and can be appropriately monitored. </p> <p>When cascade testing does not show the same genetic mutation, the family member is not at increased risk of developing the condition and can consult with their health care team to determine if monitoring is necessary. </p> <h2>Dilated cardiomyopathy</h2> <p>Dilated cardiomyopathy is another cardiac condition that can run in families. With dilated cardiomyopathy, the heart wall thins, the chamber enlarges, and the heart cannot pump blood as efficiently to the rest of the body. A family history of dilated cardiomyopathy, heart failure or sudden cardiac arrest increases the suspicion of a genetic risk for the condition. </p> <p>Cascade testing is recommended for first-degree relatives to determine if they carry the genetic mutation for dilated cardiomyopathy after it is identified in a family member. As with hypertrophic cardiomyopathy, first-degree relatives have a 50% risk of having this mutation. </p> <h2>Familial hypercholesterolemia</h2> <p>About 1 in every 250 people has familial hypercholesterolemia, and up to 90% of people are undiagnosed. The genetic changes that cause familial hypercholesterolemia are inherited. Although symptoms may not appear until adulthood, genetic risk is present from birth and the condition can be diagnosed in children.</p> <p>Familial hypercholesterolemia affects how the body processes <a href="/hometown-health/speaking-of-health/know-your-numbers-cholesterol" target="_self" title="Opens in same window.">cholesterol</a>. People with familial hypercholesterolemia have a higher risk of heart disease and early heart attack.</p> <p>Adults and children with familial hypercholesterolemia have very high levels of low-density lipoprotein (LDL) cholesterol in their blood, typically 190 milligrams per deciliter or higher for adults and 130 to 160 milligrams per deciliter for children. LDL cholesterol is known as "bad" cholesterol because it can build up in the walls of the arteries, making them hard and narrow.</p> <p>Most people with this condition receive one affected gene from one parent. But in rare cases, a child can get the affected gene from both parents. This can cause a more severe form of the condition.</p> <p>If a parent with familial hypercholesterolemia is identified, their children can be evaluated through genetic testing. </p> <h2>Next steps after genetic testing</h2> <p>Genetic testing results are shared with the patient, referring health care professional and primary care provider. If testing identifies a genetic mutation, the patient is given a letter to provide to family members informing them that someone in their family has a gene mutation and explaining why genetic counseling and testing should be considered. Those relatives can then refer themselves for genetic counseling. </p> <h3>Identifying genetic variants that may indicate your risk of inheriting or developing certain illnesses or diseases allows you to make informed health decisions, such as:</h3> <ul> <li><strong>Lifestyle or environmental changes</strong><br /> Some health conditions are almost completely determined by your genes, while others are more influenced by your environment. While you can't change your genes, you can control some aspects of your environment, <a href="/hometown-health/speaking-of-health/easy-tips-to-improve-your-heart-health" target="_self" title="Opens in same window.">such as diet</a>, physical activity and tobacco use.</li> <li><strong>Preventive treatment</strong><br /> Knowing your risk of developing a condition allows you to seek <a href="/hometown-health/speaking-of-health/know-your-numbers-family-health-history" target="_self" title="Opens in same window.">preventive care tailored to you</a>, such as starting screenings earlier than the recommended age or more frequently.</li> </ul> <p><em><a href="/providers/rachel-keppers-ms-cgc" target="_self" title="Opens in same window."><em>Rachel Keppers</em></a> specializes in <a href="/services-and-treatments/medical-genetics" target="_self" title="Opens in same window.">genetic counseling</a> for inherited diseases.</em></p><ul> <li>Cardiovascular genetics (familial hypercholesterolemia [high cholesterol and heart disease], dilated cardiomyopathy, hypertrophic cardiomyopathy, aortic aneurysm)</li> <li>Genetic testing (diagnostic testing, presymptomatic and predictive testing)</li> <li>Oncology (cancer) genetics (personal and family history of breast, ovarian, uterine, colon, prostate, melanoma, pancreatic cancer)</li> </ul>M.S., CGC<p>I specialize in genetic counseling for cancer and cardiac genetics. I see individuals with a personal or family history of cancer or certain cardiac conditions (i.e., high cholesterol, cardiomyopathy, aortic aneurysm).</p> <p>The main goal I have as I enter every patient appointment is patient empowerment. My role is to educate you on the option of genetic testing for you and your family. We will discuss the benefits, limitations and risks of genetic testing. I enjoy assisting in the decision-making process as you determine whether genetic testing is something you will find beneficial to you. I appreciate spending time with you and hearing your personal and family stories.This helps me to gather an idea of your goals and how genetic testing could aid in your health care.</p> <p>I joined Clinical Genomics in Eau Claire in June of 2020. I have enjoyed seeing the department grow through all health system sites. I appreciate the opportunity to offer genetic counseling services to individuals via video visits to allow patients to access care closer to home.</p> <p>I am originally from the south metro of Minnesota. My husband and I have lived in Eau Claire since May of 2020 and have enjoyed exploring all the awesome food, nature and Wisconsin culture the city has to offer. In my free time, I enjoy baking new treats, traveling to new places, and in the fall, continuing to humble myself as a natural-born Vikings fan.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Biology and Psychology, North Dakota State University</li> <li>Master's degree, Genetic Counseling, University of Minnesota-Twin Cities</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Genetic Counseling, Mayo Clinic School of Health Sciences</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Genetic Counseling, American Board of Genetic Counseling</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>National Society of Genetic Counselors</li> <li>Wisconsin Genetic Counselors Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Medical Genetics, Mayo Clinic College of Medicine and Science</li> </ul>Keppers<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/rachel-simon.jpg?h=280&iar=0&w=280&sc_lang=en&hash=3C66CDE23A6756DCCA406F1D7791CCD3" alt="Rachel Simon" width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/34514687/" target="_blank" title="Opens in new window">Differences in genetic counseling student responses to intense patient affect: A study of students in North American programs</a>, April 2022</li> </ul>Rachel<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21405336Rachel Keppers, M.S., CGC1{546684F5-41C6-4BEA-AD6B-DE3D7D6451C1}<img src="/-/media/national-files/images/hometown-health/2023/mother-and-daughter-sitting-close.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7F66DFA688B008F53577EE5C77F26F1C" alt="Mother and daughter sitting close" width="660" height="370" DisableNVelocity="true" />Genetic TestingGenetic testing examines your DNA — the chemical database that carries instructions for your body's functions — to reveal changes or alterations in your genes that may cause illness or disease. <br/><br/>Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller4/28/2023Injuring your Achilles tendon can bring activities like running, tennis, golf and walking the dog to a halt for months while you heal. Learn who's at risk and how to avoid injury.How one tendon can throw you off your stride<p>The Achilles tendon is a long band of tissue that connects calf muscles at the back of the lower leg to your heel bone. This tendon is used when walking, running, jumping or pushing up on your toes.</p> <p>But if it's injured, the pain, typically located in the back of your calf, and lack of function can throw you off your stride for months.</p> <p>Recognizing when you're at risk for Achilles tendinitis and knowing how to prevent it can keep you walking, running and exercising without pain.</p> <h2>Who's at risk</h2> <p>Achilles tendinitis most commonly occurs in people who suddenly begin increasing the intensity or duration of exercise or haven't been appropriately trained for their sport.</p> <h3>Overuse activities, such as walking the dog, hiking, basketball and golf, also can lead to injury and make the problem worse. But you're also susceptible due to:</h3> <ul> <li><strong>Your sex</strong><br /> Achilles tendinitis is most common in men.</li> <li><strong>Age</strong><br /> You're at a higher risk as you get older.</li> <li><strong>Flat feet</strong><br /> A naturally flat arch in your foot can put more strain on the Achilles tendon. </li> <li><strong>Obesity</strong><br /> Carrying extra pounds also increases tendon strain.</li> <li><strong>Poor footwear</strong><br /> Running in worn-out shoes or wearing footwear inappropriate for your sport can injure the tendon. </li> <li><strong>Weather and terrain</strong><br /> Tendon pain occurs more frequently in cold weather than when it's warm out. Running on hills also can put more stress on your Achilles tendon.</li> <li><strong>Medical conditions and medications</strong><br /> People with psoriasis, high blood pressure or who take certain types of antibiotics, called fluoroquinolones, are at higher risk of developing Achilles tendinitis.</li> </ul> <h2>Preventing tendon injury</h2> <h3>Although you may be at risk, these simple strategies can help prevent injury to your Achilles tendon:</h3> <ul> <li><strong>Increase your activity level gradually.</strong> <br /> If you're beginning an exercise regimen, start slowly and gradually increase the duration and intensity of the training.</li> <li><strong>Take it easy.</strong><br /> Avoid activities that place excessive stress on your tendons, such as hill running. If you participate in a strenuous activity, warm up first by exercising at a slower pace. If you notice pain during a particular exercise, stop and rest.</li> <li><strong>Choose your shoes carefully.</strong> <br /> The shoes you wear while exercising should provide adequate heel cushioning and firm arch support to help reduce the tension in the Achilles tendon. Replace your worn-out shoes. If your shoes are in good condition but don't support your arch, try adding supports in both shoes.</li> <li><strong>Stretch daily.</strong> <br /> Take the time to stretch your calf muscles and Achilles tendon in the morning, before exercise and after exercise to maintain flexibility. This is especially important to avoid a recurrence of Achilles tendinitis.</li> <li><strong>Strengthen your calf muscles.</strong> <br /> Strong calf muscles enable the calf and Achilles tendon to handle activity and exercise stress better.</li> <li><a href="/hometown-health/speaking-of-health/offseason-sports-training-tips" target="_self" title="Opens in same window."><strong>Cross-train</strong></a>.<br /> Alternate high-impact activities, such as running and jumping, with low-impact activities, such as cycling and <a href="/hometown-health/speaking-of-health/aquatic-exercise-gentle-on-your-bones-joints-and-muscles" target="_self" title="Opens in same window.">swimming</a>.</li> </ul> <h2>Treating Achilles tendon injuries</h2> <h3>Most Achilles tendon injuries can be treated at home using the RICE guidelines:</h3> <ul> <li><strong>Rest</strong><br /> You may need to avoid exercise for several days or switch to an activity that doesn't strain the Achilles tendon, such as swimming. In severe cases, you may need to wear a walking boot and use crutches.</li> <li><strong>Ice</strong><br /> To decrease pain or swelling, apply an ice pack to the tendon for about 15 minutes after exercising or when you experience pain.</li> <li><strong>Compression</strong><br /> Wraps or compressive elastic bandages can help reduce swelling and reduce movement of the tendon.</li> <li><strong>Elevation</strong><br /> Raise the affected foot above the level of your heart to reduce swelling. Sleep with your affected foot elevated at night.</li> </ul> <p>Over-the-counter medications, such as ibuprofen or naproxen, can help reduce inflammation and relieve pain.</p> <p>If the pain continues or worsens, you may want to talk with your primary care provider or a foot and ankle specialist who can address both orthopedic and podiatry issues. You may need imaging tests, including X-ray, ultrasound or MRI, to better diagnose the injury to the tendon.</p> <h3>Your health care team may recommend that you see a physical therapist. Typical physical therapy includes:</h3> <ul> <li><strong>Exercises</strong><br /> Therapists often prescribe specific stretching and strengthening exercises to promote the healing and strengthening of the Achilles tendon and its supporting structures. Eccentric, or negative, strengthening involves slowly raising and lowering a weight. It's especially helpful for persistent Achilles problems.</li> <li><strong>Orthotic devices</strong><br /> A shoe insert or wedge that slightly elevates your heel can relieve strain on the tendon and provide a cushion that lessens the force exerted on your Achilles tendon.</li> </ul> <p>If several months of conservative treatments don't work or if the tendon has torn, your health care team may suggest surgery to repair your Achilles tendon. Healing can take months, so it's best to be aware of your risks and practice preventive strategies to keep you active and pain-free.</p> <h2>Next Steps:</h2> <ul> <li>Learn how to <a href="/hometown-health/speaking-of-health/expert-advice-on-finding-the-best-shoe-fit" target="_self" title="Opens in same window.">choose the best shoes</a> for exercising.</li> <li>Consider seeing an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic or sports medicine specialist</a> to aid your recovery.</li> <li>Discover the right way to <a href="/hometown-health/speaking-of-health/taking-the-first-step-starting-restarting-an-exercise-program" target="_self" title="Opens in same window.">start or restart an exercise program</a>.</li> <li><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Find a physical therapist</a> near you.</li> <li>Want to shave off some pounds? Try these tips to <a href="/hometown-health/speaking-of-health/getting-your-weight-loss-back-on-track" target="_self" title="Opens in same window.">get your weight loss back on track</a>.</li> </ul> <p><a href="/providers/heather-schaefbauer-dpm" target="_self" title="Opens in same window."><em>Heather Schaefbauer, D.P.M.</em></a><em>, is a <a href="/services-and-treatments/podiatry" target="_self" title="Opens in same window.">podiatrist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p>Foot and ankle reconstruction, trauma care, diabetic limb salvage, and sports medicineD.P.M.<p><strong>Education</strong></p> <ul> <li>Doctor of Podiatric Medicine, Dr. William M. Scholl College of Podiatric Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Foot and Ankle Surgery, Regions Hospital</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Podiatry, American Board of Foot and Ankle Surgery</li> <li>Podiatry, National Board of Podiatric Medical Examiners</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Orthopedics, Mayo Clinic College of Medicine and Science</li> </ul>Schaefbauer<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/heather-schaefbauer-dpm.jpg?h=280&iar=0&w=280&sc_lang=en&hash=890810C90E8AC89C0D6E1F8A66646E7D" alt="Heather Schaefbauer DPM" width="280" height="280" DisableNVelocity="true" />Heather<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21303258Heather Schaefbauer DPM1{D170DE7F-251A-4290-9CC3-0A9B8D67B28A}<img src="/-/media/national-files/images/hometown-health/2023/close-up-legs-playing-tennis.jpg?h=370&iar=0&w=660&sc_lang=en&hash=559E1EC5F55030EE9FF397D913216607" alt="Close-up of legs of person playing tennis" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller4/12/2023Bipolar disorder causes extreme mood swings of emotional highs with energy and euphoria, and lows of depression and hopelessness. Learn the symptoms and strategies for living with this condition.Living with bipolar disorder<p>Your friend recently bought a new car on a whim and announced he was leaving on a cross-country trip without planning a destination or duration. Now you discover he's uninterested in any activity and doesn't want to leave home. The spontaneous actions followed by inactivity could be a sign of a mental health condition called bipolar disorder.</p> <p>Previously known as manic depression, bipolar disorder causes extreme mood swings of emotional highs and lows called episodes. The highs create a mania or hypomania state with euphoria and energy. A hypomania state is a less extreme mood shift than mania. The lows cause <a href="/hometown-health/speaking-of-health/could-you-be-depressed" target="_self" title="Opens in same window.">depression</a>, sadness and hopelessness.</p> <h2>Types of bipolar disorder</h2> <p>The type of bipolar disorder is diagnosed based on the occurrence of mania, hypomania and depressive episodes.</p> <p>People with bipolar I disorder have had at least one manic episode preceded, or followed by hypomanic or major depressive episodes.</p> <p>Bipolar II disorder is a separate diagnosis and is not a milder form of bipolar I disorder. People with bipolar II disorder have had at least one major depressive episode and at least one hypomanic episode but have not had a manic episode.</p> <h2>For every high, there is a low</h2> <p>Everyone has periods of elevated mood, typically lasting for several hours. For someone with bipolar disorder, that elevated mood can last up to four days. Typical early warning signs include increased activity level and decreased need for sleep, along with an extended elevated mood.</p> <p>During this time, the person may demonstrate risky behaviors, poor decision-making and an inability to think clearly. Their level of impulsivity is high, particularly with drug or alcohol use. </p> <p>The body's physical response is raised, causing speech to have a quicker cadence or more force, and movement and actions to be more pronounced.</p> <p>Usually, a person will spend more time in a depressive state with slowed actions, speech and responses. The person may lose interest in activities, need more sleep and experience intense sadness and hopelessness.</p> <p>This is different from major depressive disorder, in which people do not experience the highs of bipolar disorder.</p> <h2>Risk factors for bipolar disorder</h2> <h3>Certain factors increase the risk of developing the condition or may trigger the first episode of bipolar disorder, including:</h3> <ul> <li>Drug or alcohol misuse or abuse</li> <li>Having a first-degree relative, such as a parent or sibling, with bipolar disorder</li> <li><a href="/hometown-health/speaking-of-health/tips-to-keep-stress-from-hurting-your-heart" target="_self" title="Opens in same window.">Stressful life events</a> paired with latent genes for bipolar disorder</li> </ul> <h2>Living with bipolar disorder</h2> <p>Getting treatment early can help prevent bipolar disorder from worsening. Knowledge is power. Learn the symptoms of the disorder to manage them better.</p> <p>As part of psychotherapy, psychoeducation provides the tools needed to anticipate and control changing moods. It can increase your feelings of empowerment and hope by understanding how treatable the condition is.</p> <h3>These strategies can lessen disruptions in your life due to bipolar disorder:</h3> <ul> <li><strong>Avoid drugs and alcohol.</strong><br /> <a href="/hometown-health/speaking-of-health/have-you-talked-to-your-children-about-alcohol-use" target="_self" title="Opens in same window.">Using alcohol</a> or nonprescription drugs changes the chemicals in the brain. This can worsen symptoms and make them more likely to return.</li> <li><strong>Watch for early warning signs.</strong><br /> Addressing symptoms early can prevent episodes from getting worse. Over time, you may have identified a pattern to your bipolar episodes and what triggers them.</li> <li><strong>Involve friends and family.</strong><br /> Share the warning signs and triggers you have identified with family, close friends and your health care team so they can better support you. Develop a specific plan and share how you would like them to cue you into your symptoms when you show signs of mania. They often can identify the behaviors and actions that signal a mania episode first and help you prevent your symptoms from reaching the highest level.</li> <li><strong>Engage in a purpose.</strong><br /> Explore ways to create a <a href="/hometown-health/speaking-of-health/purpose-and-mental-health" target="_self" title="Opens in same window.">sense of purpose</a> by evaluating your values and beliefs. Identify what is important to you and set goals matching those ideals.</li> <li><strong>Manage stress and recharge.</strong><br /> The brain and body react similarly to positive or negative stress, which can trigger an episode. Consider keeping a daily journal or record of your feelings, mood and any activities that affect your stress level. Find a <a href="/hometown-health/speaking-of-health/coloring-is-good-for-your-health" target="_self" title="Opens in same window.">creative outlet</a> or physical activity to channel your energy. Yoga or meditation can be helpful relaxation techniques.</li> <li><strong>Keep a sleep schedule.</strong><br /> Sleep disturbance is a core symptom of bipolar disorder. Maintaining a <a href="/hometown-health/speaking-of-health/5-ways-to-get-better-sleep" target="_self" title="Opens in same window.">consistent, scheduled sleep</a> pattern with the same sleep-wake schedule daily is vital. Getting seven to nine hours of sleep per night is important. A work schedule that requires changing shift times can predispose a person with bipolar disorder to episodes.</li> <li><strong>Take your medications exactly as directed.</strong><br /> You may be tempted to stop treatment — but don't. Stopping your medication or reducing your dose on your own may cause withdrawal effects, or your symptoms may worsen or return. For some people, it can be tempting to stop medication during a manic episode because the symptoms produce a good feeling. This can lead to negative consequences, including taking longer to stabilize when back on medication. </li> </ul> <p>Bipolar disorder is a lifelong condition, but it is treatable. Learn to manage your mood swings and other symptoms with the help of those who love and care for you. Call your health care team if you feel you're falling into an episode of depression or mania.</p> <p><a href="/providers/janice-schreier-lcsw" target="_self" title="Opens in same window."><em>Janice Schreier</em></a><em> is a child and adolescent clinical therapist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Anxiety</li> <li>Attention deficit hyperactivity disorder</li> <li>Bipolar disorders</li> <li>Chemical dependency</li> <li>Depression</li> <li>Eating disorders</li> <li>Facilitates social skills groups for adolescents with autism spectrum disorders</li> <li>Individual, family and group therapy</li> <li>Obsessive-compulsive disorders</li> <li>Post-traumatic stress disorder</li> <li>Reactive attachment disorder</li> <li>Trauma</li> <li>Treatment for children 7–17 and young adults</li> </ul>L.C.S.W.<p><strong>Education</strong></p> <ul> <li>Addiction Counseling, Viterbo University</li> <li>Bachelor's degree, Social Work, University of Wisconsin-La Crosse</li> <li>Master's degree, Social Work, University of Wisconsin-Milwaukee</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Autism Spectrum Disorders</li> <li>Licensed Clinical Social Worker, Substance Abuse Specialty</li> </ul>Schreier<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/janice-schreier-msw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=42215A8A31EDEE2903AC5F89E6D23B11" alt="Janice Schreier MSW" width="280" height="280" DisableNVelocity="true" />Janice<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15449963Janice Schreier, L.C.S.W.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2023/laughing-while-looking-at-someone.jpg?h=370&iar=0&w=660&sc_lang=en&hash=271DACD428EE5C72986FD883D37DD84E" alt="Person laughing while looking at someone" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller4/21/2023Poor posture and movement patterns can lead to pain and inability to make certain moves. Four strategies can help you avoid and alleviate these issues, and improve your overall well-being.Posture: More than standing up straight<p>Poor posture may look like slouching, slumping, rounded shoulders or a forward head position. These postures often are accused of causing or contributing to various orthopedic problems, such as shoulder, back and neck pain. Parents, teachers, friends or fitness and health professionals might have said you need to fix your posture by standing up "nice and straight," with shoulders back and chest up.</p> <p>However, these common and long-held beliefs about posture are based more on appearance as opposed to what truly matters when it comes to movement health.</p> <h2>No ideal posture</h2> <p>There's no single ideal posture. Different tasks require different postures and movement strategies. A slouched posture isn't a problem unless it's the only option the body has available to work with. The same could be said for standing up straight. Having limited movement options to work with is a problem. Rather than an ideal posture, what matters is being able to move in a variety of ways to perform different tasks effectively.</p> <h2>Development of movement habits</h2> <p>Movement is complex. The brain plays a significant role in coordinating information, memories and even feelings about movement. Bones, muscles, fluids, blood flow, pressures and airflow all must adjust to allow for and create movement.</p> <p>For instance, if you side bend your trunk to the left, some muscles shorten, others lengthen, bones shift, you compress the left side of your abdomen, expand on the right side and even your organs shift position.</p> <p>On the inside, your body is not the same side to side and front to back. These differences make it easier to expand, compress, move or position your body. Increased time in these postures and repetition of tasks is habit forming. Your brain and body can develop habits of living, breathing and moving. By default, your brain and body use movement strategies that are the easiest and most familiar, but not necessarily the best for every task.</p> <h2>Limiting movement can lead to problems</h2> <p>Your brain and body compensate for movement limitations. For example, if your hip can't rotate appropriately, the whole body will move differently to accommodate it. This will alter how you walk. After thousands of steps, the inside of your knee may hurt, your back may be stiff and your feet may ache.</p> <p>Compensating for a long time or to a high degree can exert significant stress on joints, muscles, ligaments, tissues and movement patterns. These stresses can manifest as tendonitis, muscle injuries, bone spurs, bunions, chronic pain, pain with specific movements or a wide range of other orthopedic problems. Coupled with higher-movement speed or force, posture compensation can lead to sprains, ACL tears or other significant injuries.</p> <h2>Finding solutions for posture issues</h2> <h3>Posture and movement issues can be avoided and alleviated. Strategies include:</h3> <ul> <li><strong>Grow your movement library.</strong><br> Your body needs a variety of movement strategies to choose from. Expose yourself to different movements, exercises and physical challenges. This will grow your movement library. You'll have an easier time accessing a good movement strategy when necessary. This takes effort and making movement part of your life at every age.</li> <li><strong>Watch out for repetition.</strong><br> Work, hobbies and how you exercise can include the same movements, such as sitting or standing in the same position or walking on hard floors all day. Even athletic movements can be repetitive. An avid golfer may make thousands of swings in one direction while rarely rotating the opposite way. To avoid repetitive movements, analyze your habits, then break them up by mixing in something new. For instance, occasionally rearrange your desk layout and move the computer screen around. Try using your computer mouse, utensils or toothbrush with your nondominant hand occasionally. It isn't easy, but it makes a difference.</li> <li><strong>Breathe to move, move to breathe.</strong><br> Breathing is a way of regulating pressure in your body. Movement is affected by your ability to compress, expand and change these pressures. Breathing and airway disorders can indicate movement and posture issues, including chronic obstructive pulmonary disease, snoring and sleep apnea. Your health care team can help identify what movements are helping or hindering your breathing.</li> <li><strong>Body mass affects movement.</strong><br> Carrying excess pounds can limit your body's ability to attain a broad range of postures and positions. You may compensate more, which can lead to pain or injury.</li> </ul> <p>If you're already experiencing symptoms, such as body aches or sharp pain; have difficulty performing particular movements, such as reaching above your head; or have other concerns about your posture and how you move, consult with your health care team. A physical therapist or orthopedic movement specialist can help you identify and address your limitations.</p> <p><em>Gabe Champeau</em><em> is a <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2023/artist-arm-lifted.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9B354331E1C58C9637A41612004C1008" alt="Artist working with arm lifted" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Rehabilitation TherapyRestoring movement and function to people injured or impaired by disease or injury.Dawn Haller4/13/2023The tonsils play an essential role in keeping you healthy but can cause pain if inflamed. Read about why kids have more trouble with their tonsils and when it's appropriate to have them removed.Tonsils: Tiny, but pack a big punch<p>The tonsils play an essential role in keeping you healthy. These small, oval-shaped pads at the back of the throat are part of the immune system and make white blood cells. These cells attack and prevent germs that enter your body and making you sick.</p> <p>While small in size, the tonsils can cause considerable pain and discomfort if inflamed. This inflammation is called tonsillitis and typically is due to a viral infection, although bacterial infections can cause tonsillitis as well.</p> <img height="210" alt="Tonsils illustration" width="300" src="/-/media/national-files/images/hometown-health/2023/tonsils-illustration.jpg?sc_lang=en&hash=64DD9A6D11CC7EA4387697F9F92F9C9F" /> <p>Children are more susceptible to tonsillitis than adults for a few reasons. First, they're constantly surrounded by germs at day care or school. Kids aren't as good at <a href="/hometown-health/speaking-of-health/clean-up-your-hand-washing-skills" target="_self" title="Opens in same window.">hand-washing</a> and sneezing or coughing etiquette, so there are more germs in their environments. They easily catch a cold, which can cause a runny nose and lead to tonsillitis. Their throats are smaller and many have big tonsils, which can lead to breathing problems and sleep apnea.</p> <p>Sometimes, a person can have tonsillitis once or twice with no issues. But for some people, it occurs repeatedly, doesn't respond to treatments or causes complications. A common procedure called a tonsillectomy, which is the surgical removal of the tonsils, may be recommended in these cases.</p> <p>Tonsillectomies are more common in children, but some adults also need them. Tonsillectomies are the second-most common procedure performed by <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">otolaryngologists</a>, who specialize in diagnosing and treating <a href="/topics/ear-nose-and-throat" target="_self" title="Opens in same window.">conditions of the ear, nose, throat, head and neck</a>.</p> <h2>People who experience these symptoms may benefit from a tonsillectomy:</h2> <ul> <li><strong>Recurrent or chronic sore throat<br /> </strong>A recurrent sore throat is having a sore throat several times a year, while a chronic sore throat lasts two or three months. These painful conditions don't seem to resolve on their own.</li> <li><strong>Frequent tonsillitis</strong><br /> Usually, this is defined as at least seven episodes in the previous year, at least five episodes per year for the last two years or at least three episodes per year for the past three years.</li> <li><strong>Sleep apnea caused by enlarged tonsils</strong><br /> When tonsils are too big, they can cause obstructive sleep apnea. The oversized tonsils block the airway, interrupting breathing and sleep.</li> <li><strong>Tonsils of different sizes</strong><br /> Typically, tonsils are about the same size. When one is significantly bigger than the other, both tonsils should be removed to rule out throat cancer or other serious conditions.</li> </ul> <p>In the past, people needed to remain in the hospital after a tonsillectomy, sometimes for days. This has changed, and most patients can return home the same day as their surgery. The procedure takes 30–45 minutes and is performed under general anesthesia in an operating room.</p> <p>Most patients experience some pain after surgery, similar to a bad sore throat. This usually lasts about a week. I recommend that most people stay home from school or work during this time, drink lots of fluids and eat soft foods.</p> <p>The pain usually subsides, and most people are back to normal after about two weeks. They may continue to have some pain for longer when yawning because that motion stretches the surgical site and throat. This is normal and will decrease with time.</p> <p>Overall, a tonsillectomy is a safe procedure, but there is a small risk of bleeding at the incision sites. Over time, a scab forms over the incision similar to one your body forms over a cut on your arm. There's a slight risk of bleeding when the scabs fall off about seven to 10 days after surgery.</p> <p>Talk with your health care team if your or your child’s tonsils appear large or different sizes, or if either of you suffer from chronic sore throats.</p> <p><a href="/providers/pao-vang-md"><em>Pao Vang, M.D.</em></a><em>, is an <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">otolaryngologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/rice-lake" target="_self" title="Opens in same window.">Rice Lake</a>, Wisconsin.</em></p> <ul> <li>Airway surgery</li> <li>Chronic sinusitis</li> <li>Ear surgery</li> <li>Endocrine surgery</li> <li>General otolaryngology</li> <li>Head and neck cancer</li> <li>Nasal polyps</li> <li>Nose and sinus disease</li> <li>Pediatric otolaryngology</li> <li>Sinus surgery</li> <li>Tonsillectomy and adenoidectomy</li> <li>Voice disorders</li> </ul> M.D. <p> I am a firm believer that listening to the patient is the best form of medicine. Often, patients know what is wrong with them or they know that something is not right. They just need someone to listen to them and help treat their illness. It is this principle that has guided me as a physician and propelled me to pursue a career in medicine.</p> <p>I was attracted to the practice of ear, nose and throat (ENT) medicine because of a personal experience. In junior high school, my younger brother needed ear surgery, and since my parents didn't speak English, I had to do a lot of reading on it so I could interpret for them. I was absolutely amazed when his hearing improved dramatically after the surgery.</p> <p>After medical school, I started in general surgery to be a transplant surgeon. The idea of taking a human organ from one person and putting it into another fascinated me (and it still does). I changed course and went into ENT instead.</p> <p>Today, I am the first and only Hmong ENT surgeon in this country, and I am proud to be a part of Mayo Clinic Health System.</p> <p>In my free time, I enjoy biking and hiking. My favorite pastime is to go out into the countryside, pick a road and bike on it to see where it goes. It’s amazing the people I come across and the things I see when I take the time to look around. I once biked from Providence, Rhode Island, to Denver, Colorado. It was breathtaking to see the things I saw on that trip. I would do it again in a heartbeat.</p> <p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Internship</strong></p> <ul> <li>University of Nebraska Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Ear, Nose and Throat, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Otolaryngology – Head and Neck Surgery</li> <li>American Board of Otolaryngology</li> </ul> Vang<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/pao-vang-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=033E415DACE1C36268AC812E8C2D5272" alt="Pao Vang, M.D." width="280" height="280" DisableNVelocity="true" /> {6E33A01E-3D8E-4CFB-A7D2-440C4D160777}Pao<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13562746Pao Vang, M.D. 1<img src="/-/media/national-files/images/hometown-health/2023/child-drinking-orange-juice.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A61802F98F955C842156B940BEA4C396" alt="Child drinking orange juice" width="660" height="370" DisableNVelocity="true" />Ear, Nose and Throat (ENT)Get information about symptoms, disorders and diseases affecting the ear, nose and throat, and related head and neck structures.Dawn Haller4/19/2023Many athletes do well in training, only to cave on race day. These tips can help you address and overcome mental barriers that can keep you from achieving your goals.Train your mind as you train your body for race day<p>Typically, training for a distance race means preparing yourself for the physical demands of the event. But don't overlook the mental aspects of performance.</p> <p>Most experts know the importance of mental training. Roger Bannister, the first person to run a mile under four minutes, said, “It's the brain, not the heart or lungs, that's the critical organ.”</p> <h2>Mental barriers</h2> <p>All athletes, no matter how strong or physically gifted, can struggle to be successful if they have mental barriers, such as low confidence, high anxiety, nerves or feeling too much pressure, that overtake them in the heat of competition.</p> <p>Often, mental barriers are why many athletes do well in training, only to cave when it comes to actual race or game situations.</p> <p>Overthinking is when runners shift their focus from process goals — What am I doing now to maximize my performance or effort? — to outcome issues — What if I don't finish? What if I get passed? This leads to anxiety, doubt and distraction.</p> <h2>Strategies for success</h2> <p>Fortunately, there are mental strategies that athletes can practice to overcome mental roadblocks and promote successful performance. They can help athletes set realistic, challenging and flexible goals.</p> <p>Mental approaches, such as relaxation techniques, positive self-talk, focus plans, visualization and choking or panicking strategies, can help athletes confront mental barriers and trust their training to maintain confidence. They encourage athletes to expect competition discomfort, embrace it as an ally and use discomfort as valuable information — Am I working hard enough? Should I adjust body position?</p> <p>Using mental strategies helps athletes focus on the process of performance rather than outcome issues, such as winning or losing to other competitors. This encourages them not to overthink.</p> <p>Goal flexibility allows people to adjust when needed and helps athletes to avoid feeling frustrated or down on themselves. Visualization helps athletes practice seeing themselves performing well during competition, preparing for any unforeseen situations and making adjustments.</p> <p>Mental strategies encourage positive thought management. Many people have an internal critic. This well-practiced thought pattern is highly critical, lowers sense of self-worth, creates fear and hinders athletes from performing their best.</p> <p>Mental training is finding keywords, images and thoughts to combat the internal critic and positively reframe negative thoughts if they develop.</p> <h2>Gearing up mentally</h2> <h3>You can use these mental strategies as race day gets closer and throughout your race:</h3> <ul> <li>Before your event, plan positive daydreams or things you want to think about to help divert your attention.</li> <li>Divide the race into segments, such as mile markers or water stops, and consider it a success when you complete each one.</li> <li>A week before the race, think of several reassuring thoughts or positive cue words to use during your event. These may be: <ul> <li>I can do this; this is my opportunity.</li> <li>Full effort is full victory.</li> <li>I'm meant to be here.</li> <li>I'm tough and strong.</li> <li>Run strong.</li> <li>Run tall.</li> <li>Race discomfort is temporary.</li> </ul> </li> <li>Visualize the race and how good you want to feel. Imagine being relaxed with easy strides, light feet and efficient movements. Picture this repeatedly. </li> <li>Imagine yourself maintaining a positive attitude if something unexpected happens. Plan on adjusting if this situation occurs. Remember: There are no musts or shoulds. When things happen that you can't control — weather, competition, recurring injury, course terrain — focus on what you can influence, like changing your stride, adjusting your pace and relaxing your arms.</li> <li>The day and moments before your event, remind yourself of your dream of attempting this run. Think about all the training and other efforts you've made to reach this goal.</li> <li>Embrace race discomfort. Allow any discomfort — unless you're in pain — to remind you that you are working with effort. Trust your body. Trust your training.</li> <li>Use other runners and spectators as motivation and energy. They're supporting you.</li> </ul> <h2>Returning to racing after an injury</h2> <p>If you’re returning to racing after an injury, you may have additional mental barriers to overcome. Try focusing on the little victories that marked your recovery. First run without pain? Celebrate. First 30-minute run since your injury? Celebrate it. Finally able to run both up and down the big hill on your training route without having to stop? Celebrate it, and then do it again if you can.</p> <p>All of those wins throughout the training journey can help combat the feelings of insecurity, doubt and fear about returning from an injury. On the day of and during the race, think about how it felt to achieve the little victories. These intermittent reminders of your accomplishments can help you through the race. </p> <p>No matter how strong or physically gifted you might be, it's crucial to have a positive frame of mind and be mentally prepared so you'll have a successful running event.</p> <p><em><a href="/providers/anna-duggan-dpt">Anna Duggan</a></em><em> is a </em><em><a href="/services-and-treatments/physical-therapy">physical therapist</a></em><em> in </em><em><a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin</em><em>.</em></p> <ul> <li>Functional dry needling</li> <li>Return to sport</li> <li>Running gait video analysis</li> </ul> D.P.T. <p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Athletic Training, University of Wisconsin-Stevens Point</li> <li>Doctor of Physical Therapy, University of Wisconsin-La Crosse</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Credentialed Clinical Instructor, American Physical Therapy Association</li> </ul> Duggan<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/anna-stoecklein-pt.jpg?h=280&iar=0&w=280&sc_lang=en&hash=CD0EEBB2B6282ED3F8446E93EC7F4EB1" alt="Anna Duggan, D.P.T." width="280" height="280" DisableNVelocity="true" /> Anna<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15824659Anna Duggan, D.P.T. 1{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2023/runner-wearing-arm-smartphone-holder.jpg?h=370&iar=0&w=660&sc_lang=en&hash=53BC472E95E91B6073BB057F198B86B5" alt="Runner wearing arm smartphone holder" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller4/5/2023As your event nears, it's tempting to amp up your training. But it's also a prime time for overtraining injuries. Here are some warning signs to watch for and what to do if you overdo.What are some signs of overtraining?<p>We're surrounded by warning signs on roads, at work, and on packaging and equipment. Your body sends warning signs too. As your race date nears, it's tempting to pull out all the stops in your training. That makes this a prime time to watch for warning signs of overtraining.</p> <p>Overtraining or overuse injuries are any muscle or joint injuries, such as tendinitis or a stress fracture, that result from repetitive trauma. Overuse injuries typically occur because of training or technique errors.</p> <p>Runners are tenacious athletes. When you dramatically increase your training intensity, don't ignore your body's warning signs. Pulling back and slowing down may be tough. While some overtraining issues can be resolved with simple rest, others may evolve into more significant problems.</p> <h2>How overtraining and overuse injuries occur</h2> <p>Going too fast, exercising for too long or simply doing too much of one type of activity can strain your muscles and lead to an overuse injury. Improper technique also takes a toll on your body. For example, if you use poor form while running or doing strength training exercises, you may overload certain muscles and cause an overuse injury.</p> <h3>Thankfully, most overuse injuries are avoidable. Try these suggestions to prevent them:</h3> <ul> <li><strong>Use proper form and gear.</strong><br /> Whether you're starting a new activity or have been playing a sport for a long time, taking lessons can help ensure you're using the correct technique. Talk with an expert about proper form, equipment and <a href="/hometown-health/speaking-of-health/expert-advice-on-finding-the-best-shoe-fit" target="_self" title="Opens in same window.">gear fit</a> to help ensure success.</li> <li><strong>Pace yourself.</strong><br /> Rely on your training program, which should be spreading your <a href="/hometown-health/speaking-of-health/know-your-numbers-heart-rate" target="_self" title="Opens in same window.">aerobic activity</a> throughout the week. Take time to warm up before physical activity and cool down afterward.</li> <li><strong>Gradually increase your activity level.</strong><br /> When <a href="/hometown-health/speaking-of-health/progressive-overload-get-stronger-in-a-healthy-way" target="_self" title="Opens in same window.">changing the intensity or duration of physical activity</a>, do so gradually. Try not to increase anything by more than about 10% per week. Your body needs time to adapt to the new stress.</li> <li><strong>Mix up your routine.</strong><br /> Instead of focusing on one type of exercise, <a href="/hometown-health/speaking-of-health/offseason-sports-training-tips" target="_self" title="Opens in same window.">build variety</a> into your training program. Doing a variety of low-impact activities prevents overuse injuries by allowing your body to use different muscle groups.</li> </ul> <h2>Overtraining signs and what to do</h2> <p>It can be hard to know when you're pushing through your training for continuous improvement and when you're moving into overtraining. Focusing on your diet, hydration and sleep can help you figure out what your body is telling you. If you don't recover after two to three days of little or no activity, it may be time to look further.</p> <h3>Your feet and legs take a pounding as you run mile after mile, so watch for these issues: </h3> <ul> <li>Callous blistering and broken toenails are common overtraining problems. </li> <li>Early morning pain on the sole of your foot can be a sign of <a href="/hometown-health/speaking-of-health/heel-pain-might-be-plantar-fasciitis" target="_self" title="Opens in same window.">plantar fasciitis</a>. </li> <li>Tendinitis can leave you with pain in the back of your ankle or in the front of your shins, also called <a href="/hometown-health/speaking-of-health/dont-let-shin-splints-halt-your-workout" target="_self" title="Opens in same window.">shin splints</a>.</li> </ul> <p>These typically can be treated with rest and medication to relieve pain and inflammation. Slow down your training. Return to the level you were at before the problem or consider cross-training with low- or no-impact exercise, such as a stationary bike, elliptical or swimming. Take an extra day off. These symptoms can be short-term if you treat them early and appropriately.</p> <p>If pain continues despite rest or gets worse, it could indicate a bone issue, which potentially is serious. Stress reactions or stress fractures are common in the mid-foot, mid-shin or, most concerning, high up in your leg by your hip. Pain that doesn't go away is a symptom, so consult your health care team.</p> <h2>What to do if you suspect an overuse injury</h2> <p>Tell your health care team if you've recently changed your workout technique, intensity, duration, frequency or types of exercises. Identifying the cause of your overuse injury will help you correct the problem and avoid repeating it. You can seek further guidance by talking with specialists, such as sports medicine physicians, athletic trainers and physical therapists.</p> <p>Once your injury has healed, ask your health care team to check that you've completely regained strength, motion, flexibility and balance before beginning the activity again. Pay special attention to proper technique to avoid future injuries.</p> <h2>Staying strong</h2> <p>Don't allow an overuse injury to prevent you from being physically active. By working with your health care team, listening to your body and pacing yourself, you can avoid this common setback and safely increase your activity level.</p> <p> Knowing you worked hard to prepare will add to your feeling of accomplishment on race day, but don't overdo it. You're almost there. Take care of yourself so you can keep going strong all the way to the finish line.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2023/athlete-sitting-holding-knee.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7041774EBBF384735CCB7CDEA8D65955" alt="Athlete sitting holding knee" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller4/7/2023Testicular cancer is considered a young man's disease because it's most common under age 45. The bad news is there is no way to prevent it, but the good news is that it's highly curable. Get the facts.Young man's disease: Testicular cancer<p>The risk of many types of cancer increases with age. <a href="/topics/prostate-health" target="_self" title="Opens in same window.">Prostate</a>, <a href="/topics/skin-cancer" target="_self" title="Opens in same window.">skin</a>, <a href="/topics/breast-cancer" target="_self" title="Opens in same window.">breast</a> and <a href="/topics/lung-cancer" target="_self" title="Opens in same window.">lung</a> cancers are more common among older people. However, testicular cancer is considered a "young man's disease" because people under 45 are at the greatest risk.</p> <p>Testicular cancer is the abnormal growth of cells in the testicles, which are located in the loose bag of skin underneath the penis. The testicles make sperm and the hormone testosterone.</p> <p>There is good and bad news about testicular cancer. The good news is that it's not a common cancer. Fewer than 10,000 new cases are diagnosed in the U.S. each year. It's also highly curable when caught early. The bad news is that testicular cancer is the most common solid tumor cancer diagnosed in young men. It's usually diagnosed between the ages of 15 and 45 but can develop at any age.</p> <p>Testicular cancer diagnoses can be emotionally difficult for young teens contemplating their futures and young men who are starting their families and careers. They often find that the disease and necessary treatments affect their daily routines, personal relationships and future plans.</p> <p>It's unclear why testicular cancer develops. It starts when something triggers changes to the DNA of testicle cells, which causes the cells to grow and multiply quickly. Most of the time, men discover a lump or swelling of the testicle, or feel a general heaviness or dull ache in the scrotum or groin. Testicular cancer usually develops in one testicle, but also can develop in both.</p> <h2>There's no way to prevent testicular cancer, but these factors increase the risk:</h2> <ul> <li>Family history</li> <li>Undescended testicle</li> <li>HIV infection</li> <li>Sex chromosome abnormalities</li> </ul> <h2>Broadly, there are two categories of testicular cancer:</h2> <ul> <li><strong>Seminoma</strong><br /> These testicular cancers tend to happen at an older age. Seminomas often grow and spread more slowly than nonseminomas.</li> <li><strong>Nonseminoma</strong><br /> These testicular cancers tend to happen earlier in life. They grow and spread quickly. Several types of nonseminomas exist: choriocarcinoma, embryonal carcinoma, teratoma and yolk sac tumor.</li> </ul> <p>Overall, testicular cancer is highly curable. Health care teams develop treatment plans based on the type and stage of cancer.</p> <p>Often, the first steps are to have a blood test and an ultrasound of the testicle. If there's a concern for cancer, a surgeon will remove the testicle. The surgeon can insert a prosthetic, gel-filled testicle in its place in the scrotum if the patient chooses. Then the patient will have a CT scan to see if the cancer has spread, or metastasized, to other areas of the body. Depending on the results, further treatment could include chemotherapy, radiation, additional surgery or ongoing monitoring. </p> <p>Before treatment for testicular cancer, a patient should discuss fertility with their health care team. Most men will be able to produce enough sperm in the unaffected testicle after treatment. However, chemotherapy, radiation and surgery can affect testosterone and sperm production, possibly jeopardizing future fertility. A patient also should consider sperm banking for future use before undergoing treatment. </p> <p><a href="/providers/david-yang-md" target="_self" title="Opens in same window."><em>David Yang, M.D.</em></a><em>, is a <a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">urologist</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Male infertility (microscopic variocelectomy)</li> <li>Male stress incontinence (male sling, artificial urethral sphincter)</li> <li>Male urethral stricture disease (urethroplasty)</li> <li>Men’s health</li> <li>Men’s sexual medicine (erectile dysfunction, penile prosthesis/prosthetic surgery)</li> <li>Peyronie's disease (penile plication, penile incision and grafting)</li> <li>Robotic surgery</li> <li>Urethral stricture disease</li> </ul>M.D.<p>My goal is for every patient to leave our visit with a newfound understanding of their condition and options for management, and they feel comfortable with the future plan. I try to treat every patient as family, and will deliver information and guidance as such. My clinical interests include urologic oncology and men's sexual health, including erectile dysfunction, Peyronie's disease and male infertility.</p> <p>I grew up in Indianapolis but have lived in Minnesota for the last seven years. In my free time, I like to golf, hike, and spend time with my wife and two Newfoundland dogs.</p><p><strong>Education</strong></p> <ul> <li>Indiana University School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Urology, Mayo Clinic</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Urology, Mayo Clinic School of Graduate Medical Education </li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Andrology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Urology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Urologic Association</li> <li>Sexual Medicine Society of North America</li> <li>Society for the Study of Male Reproduction</li> <li>Society of Genitourinary Reconstructive Surgeons</li> <li>Society of Urologic Prosthetic Surgeons, Inc.</li> </ul>Yang<img src="/-/media/shared-files/images/medical-professionals/full/mankato/david-yang-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=3161395B079F288AA0229E441F6302D1" alt="David Yang, M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/33223428/" target="_blank" title="Opens in new window">The Tubing, Hitch and Lasso, Intussusception Anchor (THALIA) Technique: A novel approach to fixate the penile implant reservoir</a>, January 2021.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/32198103/" target="_blank" title="Opens in new window">Multicenter experience using collagen fleece for plaque incision with grafting to correct residual curvature at time of inflatable penile prosthesis placement in patient’s with Peyronie’s disease</a>, June 2020.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/33676956/" target="_blank" title="Opens in new window">Patient attitudes towards surgical management of Peyronie’s Disease prior to men’s health consultation</a>, June 2020.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/30701330/" target="_blank" title="Opens in new window">Damage control considerations during IPP surgery</a>, January 2020.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/25240762/" target="_blank" title="Opens in new window">Oncologic and quality-of-life outcomes with wide resection in robot-assisted laparoscopic radical prostatectomy</a>, February 2015.</li> </ul>David<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16240391David Yang, M.D.1<img src="/-/media/national-files/images/hometown-health/2023/bearded-man-reading-book.jpg?h=370&iar=0&w=660&sc_lang=en&hash=46B1BA302E9305A8D0D7C4F5C59C50F8" alt="Bearded man reading book" width="660" height="370" DisableNVelocity="true" />Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Dawn Haller5/24/2023The unconditional love shown by dogs and their need for regular exercise are a boon for physical and mental health. Learn about the benefits of dog ownership and why they're doggone fun.No bones about it: Dogs are good for your health<p>People with dogs know the benefits of pet ownership. The unconditional love, trust and loyalty shown by your canine companions, coupled with their unbridled enthusiasm on your return home each day, is hard to put into words.</p> <p>There's another plus of having a dog by your side: It improves your overall physical and mental health. Here's how.</p> <h2>Dogs get you moving</h2> <p>One notable benefit is that dogs force you to get up and move. One research study found that dog owners are more likely to report regular physical activity than people who don't own dogs. Activities associated with dog ownership, like feeding, grooming, playing and letting them outside, all increase physical activity levels. Physical activity improves blood flow, induces muscle contraction and reduces joint stiffness.</p> <p>Dogs also require regular exercise, and will greet it with smiles and wagging tails. In addition to a typical walk, you can work hiking and running into your outings with your dog depending on its breed. People who regularly perform aerobic exercise have improved blood pressure, reduced blood sugar levels, better controlled weight and a reduced risk of developing cardiovascular disease. Other studies have demonstrated that exercise can improve depression and anxiety.</p> <p>Over time, exercise will help strengthen your muscles, bones and joints. You may notice that your usual route is feeling easier and decide to stay out longer or walk up that extra hill.</p> <p>When selecting a new puppy or dog, carefully consider its energy levels and exercise requirements. It's best when your lifestyle and activity levels match that of your canine buddy.</p> <h2>Dogs help your weight</h2> <p>Exercise burns calories and helps you maintain a healthy weight. In one <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/your-hearts-best-friend-dog-ownership-associated-with-better-cardiovascular-health/?mc_id=us&utm_source=newsnetwork&utm_medium=l&utm_content=content&utm_campaign=mayoclinic&geo=national&placementsite=enterprise&cauid=100721" target="_blank" title="Opens in a new window.">study</a>, adults who regularly walked their dogs were less likely to be obese than their nondog-owning neighbors. The same research found that dog owners also are more likely to report a healthy diet and blood sugar at ideal levels, which improves overall heart health. Walking for 30 minutes a day will reduce the risk of coronary heart disease, osteoporosis, colon and breast cancer, and Type 2 diabetes.</p> <p>That 30 minutes of light-to-moderate dog walking also can help you <a href="/hometown-health/speaking-of-health/5-ways-to-get-better-sleep" target="_self" title="Opens in same window.">achieve deeper, more restful sleep</a>.</p> <p>Health care professionals recommend adults aim for 150 minutes of aerobic exercise per week.</p> <h2>Dogs promote social connection</h2> <p>Owning a dog has been linked to better mental health and a lower perception of social isolation, which can reduce the risk of heart attacks and cognitive issues. Being socially isolated is a strong risk factor for worse health outcomes and premature death. Dog owners interact more with other people, such as other dog owners and people they encounter on walks, and are less likely to experience depression.</p> <h3>For people who work from home, there are four significant ways pets can help with your mental health:</h3> <ul> <li><strong>Reducing work-related </strong><strong>stress.</strong><br> Two out of three employees say work <a href="/hometown-health/speaking-of-health/5-tips-to-manage-stress" target="_self" title="Opens in same window.">stresses</a> them out, and 40% say their job gets in the way of their health. Pets in the workplace, even at home, reduce stress and improve employee satisfaction.</li> <li><strong>Managing anxiety. <br> </strong>With the increase in work-from-home jobs, more people are struggling with mental health. Pets can provide the companionship and support once found in the office.</li> <li><strong>Increasing activity.</strong> <br> Dogs give you a reason to go outside, breathe in fresh air and get some physical activity.</li> <li><strong>Combating </strong><strong>loneliness</strong><strong>.</strong> <br> The bond with pets helps people <a href="/hometown-health/speaking-of-health/overcoming-loneliness" target="_self" title="Opens in same window.">feel less alone</a>. Owners can touch, see, hear or talk to their companion animals, which brings happiness, connection and physical contact.</li> </ul> <p>There's also <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/23642347/" target="_blank" title="Opens in a new window.">research</a> showing the benefits of animal-assisted therapy during rehabilitation for nervous system conditions, such as strokes, seizure disorders, brain trauma and infections. Dogs can be a valuable part of <a href="/services-and-treatments/cardiovascular-rehabilitation-and-services" target="_self" title="Opens in same window.">cardiac rehabilitation</a>, <a href="/services-and-treatments/occupational-therapy" target="_self" title="Opens in same window.">occupational therapy</a> and <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapy</a> programs. They can provide social support, and trained dogs can even participate in your rehabilitation or therapy sessions.</p> <h2>Big decision, win-win solution</h2> <p>Welcoming a dog into your home is a big decision, and you should carefully consider the responsibilities. However, you also should consider the many wonderful health and emotional benefits that come from of dog ownership.</p> <p>The bottom line is that a dog can help you be more active and socially connected while improving your overall health. It's a win-win solution — and doggone fun.</p> <h2>Next steps:</h2> <ul> <li>Find a <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiologist</a>.</li> <li>Start a <a rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/get-walking-with-this-12-week-walking-schedule/" target="_blank" title="Opens in a new window.">walking program</a> with your canine partner.</li> <li>Consider training your dog for <a href="/hometown-health/speaking-of-health/a-day-in-the-life-of-luna-a-facility-dog" target="_self" title="Opens in same window.">pet therapy</a> to gain the dual benefits of connection and volunteering.</li> </ul> <p><em>Tahir Tak, M.D.</em><em>, is a <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a> and <a href="/locations/prairie-du-chien" target="_self" title="Opens in same window.">Prairie du Chien</a>, Wisconsin. Heidi Grafft is an exercise physiologist in <a href="/services-and-treatments/cardiovascular-rehabilitation-and-services" target="_self" title="Opens in same window.">Cardiac Rehabilitation</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2023/corgi-walking-on-leash.jpg?h=370&iar=0&w=660&sc_lang=en&hash=934140535CCDA7A5590DA01E7FEE1388" alt="Corgi walking on leash" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller5/3/2023You've put in the training, you're feeling strong and now it's almost race day. A few last-minute tips can help you prepare for the big day so you'll perform at your best.What last-minute tips will help before my race?<p>Are you breathless with anticipation? Finding it hard to sleep at night? It's like waiting for a holiday or birthday celebration — race day is almost here. You've worked hard for weeks preparing for this big event. It's finally time to put your feet on the pavement and show what you can do.</p> <h2>Let's go over a few last-minute tips as you prepare for the big day:</h2> <h3>Final fueling</h3> <p>You may receive helpful advice about what to eat as your race day approaches. These tips might include loading up on carbs the night before to give you an energy base, or using energy gels or bars to give you a boost.</p> <p>Diverging from your regular diet or adding new variables on race day isn't recommended. Stick to your dietary training schedule so race day is just another day. For example, if you opt for energy bars or gels, add them to your training runs before your race to avoid a shock to your digestive system.</p> <p>Your biggest prerace meal should be lunch the day before the event. Light exercise that evening will help transport fuel to your muscles in preparation for the race. It's OK to have extra carbs, but eat them at lunch instead of dinner.</p> <h3>Foot care</h3> <p>Proper foot care is essential before putting your feet up against the punishment of a long race. Trim your toenails. Breaking a toenail in a race can ruin your day. Don't buy a new pair of shoes just before the race.</p> <h3>Race pacing</h3> <p>Excitement on race day can lead some runners to push harder and run faster than they have during training. Do your best to stay within your planned pace. Mentally prepare yourself to avoid letting the adrenaline rush cause you to leap off the starting line too quickly. Once underway, try not to stress about your pace. Realize that some days you'll have better runs than other days.</p> <h3>Rehydrating</h3> <p>Rehydrate at a couple of points along the route. Plan to rehydrate around miles six or seven and again around miles 13 to 15. Once you've finished the race, make sure you rehydrate and take something that also replenishes your electrolytes in tablet or liquid form.</p> <h3>Warning signs</h3> <p>Stay alert for signs of heat exhaustion or heatstroke in yourself or other competitors. Notify medical personnel if you or another runner experience cramps or lightheadedness or go from profuse sweating to nausea and vomiting.</p> <p>Heat exhaustion can transition to heatstroke, which is much more dangerous. Warning signs of heatstroke include rapidly elevated body temperature, rapid heart rate, rapid breathing and loss of mental capacity. Seek medical attention immediately.</p> <h3>Ready to run</h3> <p>This is what you've been working toward, and you're ready. As you wait for the starting signal, take a moment to appreciate how far you've come. Running a distance race should be rewarding and fun. Have a good time, and enjoy the race.</p> <p><a href="/providers/beau-johnson-pt" target="_self" title="Opens in same window."><em>Beau Johnson</em></a><em> is a <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapist</a> in <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Sports medicine</li> </ul>P.T.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Exercise Science, University of Minnesota-Duluth</li> <li>Master's degree, Physical Therapy, University of Mary</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Certified Spinal Manual Therapist (CSMT)</li> </ul>Johnson<img src="/-/media/shared-files/images/medical-professionals/full/holmen/beau-johnson-pt.jpg?h=280&iar=0&w=280&sc_lang=en&hash=2FEA4FD6BAEEBFE6D31E1284FD8FD26F" alt="Beau Johnson, PT, MPT, CSMT" width="280" height="280" DisableNVelocity="true" />Beau<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15511979Beau Johnson, P.T.1<img src="/-/media/national-files/images/hometown-health/2023/tying-athletic-shoe.jpg?h=370&iar=0&w=660&sc_lang=en&hash=577FE5C3F11C227655524D9006D2E46B" alt="Close-up of water bottle and person tying athletic shoe" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller5/9/2023Typically diagnosed in childhood, ADHD can persist into adulthood and impact you at work and home. Learn about options to effectively manage ADHD to help you meet the demands of daily life.Navigating ADHD in adulthood<p><a href="/hometown-health/speaking-of-health/what-is-adhd" target="_self" title="Opens in same window.">Attention-deficit/hyperactivity disorder</a>, or ADHD, is a neurodevelopmental disorder of childhood that often persists into adulthood. The Diagnostic and Statistical Manual, referenced by health care professionals, describes ADHD as "persistent patterns of inattention and/or hyperactivity-impulsivity that interferes with functioning or development." </p> <p>Symptoms of ADHD must be present before age 12 for a diagnosis of ADHD. People with more severe symptoms tend to be diagnosed <a href="/hometown-health/speaking-of-health/helping-a-child-with-adhd-develop-social-skills" target="_self" title="Opens in same window.">earlier in childhood</a>, and boys are more likely to be diagnosed with ADHD because their symptoms can be more observable.</p> <p>In my practice, I spend quite a bit of time explaining to children what it means to have ADHD. During this process, parents often comment that the disorder's symptoms sound like their feelings or actions, but they haven't been diagnosed with ADHD. This is probable because if a <a href="/hometown-health/speaking-of-health/parenting-a-child-or-teen-with-adhd" target="_self" title="Opens in same window.">child has ADHD</a>, there is a strong likelihood that a parent also has ADHD. The exact cause of ADHD is still unclear, but there is a strong genetic component.</p> <p>As people mature, the characteristics of ADHD can change. A hyperactive child may become less hyperactive and more inattentive as they mature.</p> <h2> Adults with ADHD may experience:</h2> <ul> <li>Being tempted to take unnecessary risks.</li> <li>Difficulty with waiting in line and driving in heavy traffic.</li> <li>Elevated risk of <a href="/hometown-health/speaking-of-health/does-drinking-alcohol-kill-brain-cells" target="_self" title="Opens in same window.">substance use</a> or abuse.</li> <li>Feeling restless and having difficulty sitting through activities, especially those that are not highly interesting.</li> <li>Frequently shifting their bodies or tapping their fingers or feet.</li> <li>Having relationship problems, including increased risk of stress in marriage and divorce.</li> <li>Increased likelihood of motor vehicle accidents.</li> <li>Increased issues at work due to daydreaming, poor time management and difficulty finishing tasks on time.</li> <li>Mood swings, such as a quick temper and a low <a href="/hometown-health/speaking-of-health/5-tips-to-manage-stress" target="_self" title="Opens in same window.">stress</a> tolerance.</li> </ul> <h2>Diagnosing ADHD in adults</h2> <p>There is no definitive test to diagnose ADHD. Assessments used by health care professionals to measure attentiveness and concentration help make a diagnosis. The process typically includes a thorough evaluation with a psychologist, therapist or psychiatrist to discuss your developmental, educational and family medical history. Past school reports or job reviews may provide insight into behaviors and traits associated with the disorder. </p> <p>Although most people are born with ADHD, symptoms also can develop after certain types of injury or assault to the brain. Some mental health conditions can mimic symptoms of ADHD, including post-traumatic stress disorder (PTSD) or generalized anxiety disorder (GAD). Some medical conditions can cause ADHD-like symptoms. This is why clinicians look for symptom presentation before age 12 in diagnosing ADHD in adults. </p> <h2>Managing ADHD at home and work</h2> <p>Learning about ADHD is imperative to managing your symptoms. While most people strictly think of ADHD as being hyperactive or inattentive, there are much broader effects to explore. ADHD impacts every executive function skill, which is similar to centralized processing for your brain. For example, it helps regulate your emotions and complete a task, even when it is not interesting or challenging.</p> <p>When you can identify and learn about your symptoms, you can make accommodations to limit their impact. Lifestyle modifications of daily activities and specific considerations in <a href="/hometown-health/speaking-of-health/tips-for-coping-in-the-telework-age" target="_self" title="Opens in same window.">career choices</a> can be helpful. </p> <h3>In your home: </h3> <ul> <li><strong>Ask for help and input from others.</strong><br /> Family and friends can support you in areas where you may feel less motivated or overwhelmed, such as in detailed tasks like balancing a checkbook or cleaning the house.</li> <li><strong>Manage your time.</strong><br /> Use a planner or a calendar. Many apps or tools can help you prioritize your day and create reminders and appointments. Use a to-do list to manage deadlines and priorities in your schedule.</li> <li><strong>Organize your tasks.</strong><br /> Divide big jobs into smaller steps you can check off one by one. Have more than one project or hobby to switch between if you lose interest in a particular activity.</li> </ul> <h3>In your work:</h3> <ul> <li><strong>Be thoughtful in your career choice.</strong><br /> If you are creative and have a high-energy level, avoid repetitive jobs that require sitting for long periods. Consider factors like whether you enjoy being outdoors or working with your hands.</li> <li><strong>Structure your office space and time.</strong><br /> If you work in an office setting, use storage systems, such as drawers and file cabinets to keep your desk organized and clear. Try using headphones or earplugs to block out surrounding noise if it is distracting. Rely on your calendar for appointments and deadline reminders.</li> </ul> <p>Navigating ADHD in adulthood can be challenging. But with a combination of medication and therapy, you can develop strategies to manage symptoms effectively. Talk with your health care team about appropriate treatment options and coping skills to help you meet the demands of daily life. </p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2023/finger-smearing-wood-putty.jpg?h=370&iar=0&w=660&sc_lang=en&hash=055265D22B973CDDC7FE8EC1371B6600" alt="Finger smearing wood putty" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller5/30/2023Physical therapy is a good treatment option for many pelvic floor disorders. Here's how it differs from other therapies, what to expect and why at-home care may not work.Unlocking the benefits of pelvic floor physical therapy<p>Pelvic floor disorders affect many people. Up to 25% of adults have urinary incontinence, pelvic pain, pelvic pressure, sexual problems or pelvic organ prolapse. The risk can increase with age, during or after pregnancy or for people who suffer from chronic constipation.</p> <p>Various treatment options are available, including lifestyle changes, medications and minimally invasive surgery. A good choice for many people is physical therapy. Here's what you need to know about this effective treatment.</p> <h2>Muscle and joint experts</h2> <p>The pelvic floor is a group of 26 muscles that make up the bottom of the pelvic region. These muscles function together like a hammock across the pelvis and attach from the pubic bone in the front to the tailbone in the back.</p> <h3>The pelvic floor has four primary functions:</h3> <ol> <li>Support pelvic organs, including the bladder, uterus, prostate and rectum.</li> <li>Stabilize the pelvis and spine.</li> <li>Assist with sexual function.</li> <li>Support bowel and bladder control.</li> </ol> <p>Pelvic floor muscles are similar to other muscles in the body. They can be weak, stretched out, strong or tight. Pelvic floor weakness or tension leads to pelvic muscle dysfunction. Weakness in the muscles can be a common cause of incontinence, and tension can lead to pelvic pain.</p> <p><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical therapists</a> are experts in the functions of muscles, joints and nerves. Some therapists have additional training and are educated on pelvic floor muscle health. Your primary care provider may refer you to a pelvic floor physical therapist to address pelvic floor function.</p> <h2>What to expect</h2> <p>Pelvic floor therapy differs from other types of physical therapy that people might be more familiar with, such as shoulder or knee therapy.</p> <p>The first step is a consultation with a physical therapist. You can expect a private, one-on-one setting in which the therapist reviews your medical history, symptoms and goals and performs a physical exam. The exam may include assessments of your hips, spine, bony pelvis and pelvic floor muscles. Your comfort and privacy are always a priority throughout this process.</p> <p>After the consultation, the physical therapist will work with you to create an individualized plan to address your pelvic health needs. Sessions could include exercises, stretches, manual therapy, biofeedback therapy or electrical stimulation to strengthen or relax your pelvic floor muscles. The number of sessions needed will vary, and each session is customized to address your needs and symptoms.</p> <h2>Self-care vs. physical therapy</h2> <p>Many people falsely believe Kegel exercises at home will solve any pelvic floor disorder. These exercises may be one element of a larger treatment plan or may not be recommended for your condition. When a person does them incorrectly or without other treatments, their symptoms won't improve or could even worsen.</p> <p>In addition, most people initially perform this exercise incorrectly. This can lead to poor results and frustration. A pelvic floor physical therapist can assess and guide you to ensure that exercises are productive.</p> <p>Various home-based biofeedback technology options are available, including apps and devices. Products sold online or through social media are not recommended. Ask your physical therapist if an app or device would be helpful and for recommendations for specific safe and effective options.</p> <h2>Delayed treatment</h2> <p>Some people hesitate to talk about pelvic floor issues, even with their primary care provider. They incorrectly assume that their symptoms are normal and that they need to live with their conditions. It's important to normalize this conversation and not suffer in silence.</p> <p>Your pelvic floor is vital to daily function. Men and women should feel encouraged to discuss their concerns with their health care teams. It is essential to think of the pelvic floor as another body part requiring care and attention. Most people would not hesitate to seek care for a shoulder or knee injury. The same should apply to the pelvic floor.</p> <p>Talk with your primary care provider about your symptoms and ask if a physical therapy referral can help.</p> <h2>Next steps:</h2> <ul> <li>Find a <a href="https://www.mayoclinichealthsystem.org/providers?service=Physical%20Therapy&searchTerm=Pelvic&populateTracking=True" target="_self" title="Opens in same window.">pelvic floor physical therapist</a> near you. </li> <li>Learn more about <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/kegel-exercises/art-20045283" target="_blank" title="Opens in a new window.">Kegel exercises</a>.</li> <li>Read about the <a href="/hometown-health/speaking-of-health/pregnancy-and-pelvic-floor-health" target="_self" title="Opens in same window.">effect of pregnancy on pelvic health</a>.</li> <li>Watch a video about <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.youtube.com/watch?v=d07SA-dAawE" target="_blank" title="Opens in a new window.">urinary incontinence</a>. </li> </ul> <p><em><a href="/providers/kelly-feddema-pt" target="_self" title="Opens in same window.">Kelly <span class="RadEWrongWord" id="RadESpellError_2">Feddema</span></a> is a </em><em><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapist</a></em><em> specializing in pelvic floor rehabilitation in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota. </em></p><ul> <li>Pelvic floor rehabilitation for men's and women's health</li> <li>Pelvic pain</li> </ul>P.T.<p>I am a physical therapist specializing in pelvic floor rehabilitation. I enjoy working with all aspects of pelvic health servicing men, women and children with issues such as urinary/fecal incontinence, constipation, pelvic pain and pre- and post-natal care.</p> <p>I have been practicing with a pelvic health focus for 20 years. I enjoy working on an individualized care plan with my patients to help as best as I am able to achieve the patient's therapy goals.</p> <p>In my spare time, I enjoy being with my family, Minnesota sports and the great outdoors!</p><p><strong>Education</strong></p> <ul> <li>Bachelor's Degree, Physical Therapy, The College of St. Scholastica</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Pelvic Rehab Practitioner, Herman & Wallace Pelvic Rehabilitation Institute</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Physical Therapy Association</li> </ul>Feddema<img src="/-/media/shared-files/images/medical-professionals/full/mankato/kelly-feddema-pt.jpg?h=280&iar=0&w=280&sc_lang=en&hash=3714117D30428F62D66D42CC9315D17F" alt="Kelly Feddema PT" width="280" height="280" DisableNVelocity="true" />{F89DC859-1DFF-48D7-96A7-39A5F991BB4C}Kelly<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12707899Kelly Feddema, P.T.1{7F12DA7A-1D3B-4F43-96BB-0B69DBAD2F9D}<img src="/-/media/national-files/images/hometown-health/2023/wearing-sunglasses-while-driving.jpg?h=370&iar=0&w=660&sc_lang=en&hash=AECA4ED5897976F482E196AA3A6ABC51" alt="Wearing sunglasses while driving" width="660" height="370" DisableNVelocity="true" />Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Dawn Haller5/23/2023Pregnancy and childbirth can affect pelvic floor health and lead to prolapse, pain and urinary incontinence. Learn how physical and hormonal changes contribute, and get prevention tips.Pregnancy's effect on pelvic floor health<p>Pregnancy and childbirth are transformative experiences for a woman's body, affecting it in many ways. One of the areas that may be affected is the <a href="/topics/pelvic-health" target="_self" title="Opens in same window.">pelvic floor</a>, which is the diaphragm of the pelvis. These muscles support the uterus, bladder, large intestine and rectum.</p> <p>These muscles may be affected by pregnancy and childbirth, altering some of their vital functions. These can include fecal and urinary continence mechanisms, and support of the vaginal walls and uterus. Less support can lead to <a href="/hometown-health/speaking-of-health/pelvic-organ-prolapse-whats-going-on-down-there" target="_self" title="Opens in same window.">prolapse</a>. Trauma to the pelvic floor muscles and nerves also may result in pelvic pain symptoms occurring with or without sexual intercourse.</p> <h2>Here are some factors that may affect the pelvic floor during pregnancy and childbirth, and could lead to pelvic floor disorders in the future:</h2> <h3>Physical changes</h3> <p>About 50% of pregnant women experience symptoms of pelvic floor disorders even before childbirth. During pregnancy, women tend to gain weight — not just the baby's weight but also weight from the placenta, increased blood volume and an enlarged uterus. The extra weight places increased strain on the pelvic floor muscles, resulting in an increased risk of urinary incontinence.</p> <p>Constipation is common during pregnancy, especially in the third trimester. The weight of the growing uterus and hormone changes can affect digestion, leading to infrequent or difficult passing of stools. Any related straining and stress can further weaken pelvic floor muscles and nerves.</p> <h3>Hormonal changes</h3> <p>The body also undergoes significant hormonal changes during pregnancy that affect pelvic floor health. The placenta secretes the hormone relaxin to increase the flexibility of ligaments in the pelvis and soften the cervix. These changes prepare the body for birth. As a result, the connection between the pelvis bones becomes looser, resulting in increased flexibility and instability.</p> <h3>Medical and occupational history</h3> <p>Some women are more susceptible to pelvic floor disorders, and this risk increases with pregnancy. Women with a history of chronic constipation, connective tissue disorders or smoking are at increased risk. Women who are obese or have a history of repeated heavy lifting, either at work or through weight training exercises, also can be at increased risk.</p> <h2>Identifying pelvic floor disorders</h2> <p>Pelvic floor disorders are not easily recognizable, as the symptoms can mimic other conditions. For instance, pelvic pain may be confused for endometriosis, while bladder-related symptoms might mimic some pelvic floor problems. This overlap makes it challenging to pinpoint whether the symptoms are related to pregnancy or pelvic floor disorders.</p> <p>In addition, the pelvic floor can't be easily seen and examined by a woman or her health care team.</p> <h2>Childbirth and pelvic floor</h2> <p>Labor and delivery are considered risk factors for pelvic floor disorders. Vaginal delivery, in particular, is regarded as the most significant risk factor. During childbirth, the pelvic floor muscles undergo tremendous stress, especially during the second stage of labor when there is active pushing. This risk is increased with operative deliveries using vacuum or forceps.</p> <p>Labor before a cesarean section delivery also increases risk for pelvic floor disorders.</p> <p>Some women's pelvic floors are more resilient and able to recover quickly, while others may be more prone to lasting issues. Studies show that the more vaginal deliveries a woman has, the more likely she is to experience pelvic floor dysfunction.</p> <h2>Preventing pelvic floor disorders</h2> <p>Pelvic floor disorders are not a forgone conclusion during pregnancy. Just as pregnant women take prenatal vitamins and avoid alcohol to lower the risks of some congenital conditions, they can take steps to reduce the risk of pelvic floor disorders.</p> <p>I recommend that patients consider attending birthing classes before childbirth. These often include stretching and breathing exercises to help coordinate the diaphragm and pelvic floor muscles during delivery. Pregnancy yoga and perineal massage can help prepare the pelvic floor by improving the flexibility and stretchability of tissues to limit the risk of perineal injuries at delivery.</p> <p>When done correctly, Kegel exercises strengthen the pelvic floor muscles. About 40% of people don't perform a Kegel correctly the first time. A physical therapist can help you identify the correct muscles if you are uncertain or have questions.</p> <p>A childbirth educator, nurse midwife or OB-GYN can recommend stretches and classes to prepare your pelvic floor for childbirth.</p> <p>Women who experience symptoms of pelvic floor disorders during pregnancy should seek treatment to prevent further complications. In addition, lifestyle modifications, such as regular exercise, a healthy diet and proper management of chronic constipation, can help reduce the risk of pelvic floor disorders.</p> <p><a href="/providers/tarek-khalife-md" target="_self" title="Opens in same window."><em>Tarek Khalife, M.D.</em></a><em>, is an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a> and <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Adenomyosis</li> <li>Endometriosis</li> <li>Female sexual dysfunction, pain and vulvar disease, such as lichen sclerosus and lichen planus</li> <li>Fibroid treatment</li> <li>Heavy or irregular menstrual bleeding</li> <li>In-office treatment, including LEEP procedures, colposcopy and hysteroscopy</li> <li>Minimally invasive surgery for treatment of gynecologic disorders, such as laparoscopy and hysteroscopy</li> <li>Obstetric and advanced gynecologic 3D ultrasound</li> <li>Pelvic pain</li> <li>Robotic surgery</li> <li>Urine incontinence</li> <li>Uterovaginal prolapse</li> <li>Vaginal natural orifice transluminal endoscopic surgery (VNOTES)</li> </ul>M.D.<p>Every patient will have ample time to explain her condition and shed light on what matters to her most, as we navigate her treatment options. It is very imperative that the patient understands our partnership in managing her condition and identifies us as her support team to focus on her treatment and recovery.</p> <p>The most rewarding aspect of my time with the patient is when I get to educate them about their body and how disease affects its balance. It is my goal to allow my patient to graduate from her care with enough knowledge that she would use to teach and advocate for herself and to other women in her community. This way touches the patient’s life and the communities' lives at large.</p> <p>Outside of work, I do enjoy biking, swimming and camping. I am also a remote-control plane hobbyist, and I love grilling and cooking Lebanese cuisine.</p><p><strong>Education</strong></p> <ul> <li>Beirut Arab University</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>Obstetrics and Gynecology, Henry Ford Health System-Wayne State University</li> <li>Obstetrics and Gynecology, American University of Beirut Medical Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Minimally Invasive Gynecologic Surgery, American Board of Obstetrics and Gynecology</li> <li>Fellow, American College of Obstetrics and Gynecology</li> </ul> <p><strong> Memberships</strong></p> <ul> <li>American Association of Gynecologic Laparoscopists</li> <li>American College of Obstetrics and Gynecology</li> <li>International Society for the Study of Women's Sexual Health</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Obstetrics and Gynecology, Mayo Clinic College of Medicine and Science</li> </ul>Khalife<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/tarek-khalife-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A39C3DF2BF499DCA00FE29E1F7699D5D" alt="Tarek Khalife MD" width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/36088274/" target="_blank" title="Opens in new window">Retroperitoneal causes of genitourinary pain syndromes: Systemic approach to evaluation and management</a>, October 2022.</li> <li><a rel="noopener" href="https://www.sciencedirect.com/science/article/pii/S0002937821006074?via%3Dihub" target="_blank" title="Opens in new window">Pregnancy with IUD in place</a>, May 2021.</li> <li><a rel="noopener" href="https://www.liebertpub.com/doi/abs/10.1089/gyn.2021.0041" target="_blank" title="Opens in a new window">Intraoperative genitourinary injuries during a hysterectomy: Risks, management, and mitigation strategies</a>, May 2021.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/30398979" target="_blank" title="Opens in new window. ">The endogenous opioid system: Role and dysfunction caused by opioid therapy</a>, March 2019.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/28118169" target="_blank" title="Opens in new window. ">The K-technique: A novel technique for laparoscopic apical suspension using barbed sutures</a>, April 2017.</li> </ul>{CA02D1B4-DD8D-4C67-B975-FFCAEB25CAEF}Tarek<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20407092Tarek Khalife, M.D.1{83EB2AA2-1436-4DDC-B7BB-51F8E6A87FC9}|{54693F31-87AF-4B21-91DB-1DEC1E21F878}<img src="/-/media/national-files/images/hometown-health/2023/pregnant-using-stability-ball.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0233416F5FDD004BD3E20C3257BED6B3" alt="Pregnant using stability ball" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Dawn Haller5/23/2023Radiofrequency ablation uses precise heat to stop nerves from sending pain signals to the brain from conditions like spinal arthritis and joint pain. Read a Q&A about this innovative treatment.Long-lasting pain relief with radiofrequency ablation<p>Pain can be caused by many factors, including injury, illness, inflammation or nerve damage. Often, it's a signal in the nervous system that something is wrong. The brain processes information gathered from the nerves to identify the source and strength of your pain.</p> <p>Chronic pain is ongoing and lasts for three months or longer. More than just an inconvenience, chronic pain can be debilitating, and affect your work, family and daily activities.</p> <p>Radiofrequency ablation is a treatment for chronic pain due to <a href="/topics/arthritis" target="_self" title="Opens in same window.">arthritis</a> or other joint issues. This procedure targets the nerves that are sending pain signals from the joints and is a mainstay of treatment for <a href="/topics/back-pain" target="_self" title="Opens in same window.">back pain</a>. It can produce long-lasting relief by shutting off the communication between the nerves and the pain processing center in the brain.</p> <p>Here's what you need to know about this innovative treatment.</p> <h2>What is radiofrequency ablation?</h2> <p>Radiofrequency ablation is a pain-management procedure primarily intended to treat arthritis or joint pain of the spine. There are small sensory nerves along these joints whose only job is to tell the brain how the joint feels. These nerves are the primary source of pain signals coming from the joints of the back.</p> <p>During radiofrequency ablation, a pain medicine physician places specialized needles over the affected nerves and then sends thermal energy or heat signals through the needles. This temporarily disconnects the nerves. While it doesn't fix the underlying cause of the pain, radiofrequency ablation does block the number of pain signals coming from the joints. For most patients, it leads to excellent back pain relief.</p> <h2>Who are good candidates for radiofrequency ablation?</h2> <p>Patients with arthritis or joint pain of the low back and neck benefit from the procedure. It can also be used for patients with painful arthritis at large joints like the knees, hips or shoulders. To qualify, patients need to have had chronic pain for more than six months and haven't found relief with conservative measures like medications, physical therapy or chiropractic care.</p> <h2>What types of pain can be helped with radiofrequency ablation?</h2> <p>This treatment has been used primarily to treat arthritis of the spine, but it can be helpful for targeting joint pain involving the knees, <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/sacroiliitis/multimedia/sacroiliac-joints/img-20005962" target="_blank" title="Opens in a new window.">sacroiliac joints</a>, hips or shoulders.</p> <h2>What can you expect during a treatment?</h2> <p>Radiofrequency ablation treatments are performed in a hospital procedure room. After changing into a gown, you'll receive a mild sedative to help you remain comfortable. A heavier sedative, called moderate sedation, is an option if desired. You'll be given an IV in your arm and a numbing medication will be injected into your skin at the site of your treatment.</p> <p>A pain medicine physician then will use a fluoroscope, which is a special X-ray machine, to precisely guide a special needle to the troublesome nerve. The needle delivers radio waves to the nerve and disconnects the nerve's ability to send pain signals. Only one painful area is addressed during each procedure.</p> <p>Most patients tolerate the procedure well. You may feel some pain or tenderness at the injection site, but this usually subsides in a few days. After resting, you'll be able to go home the same day.</p> <h2>How long will pain relief last with radiofrequency ablation?</h2> <p>Pain relief can occur anywhere from immediately after the procedure to about four to six weeks later. The hope is that relief from this intervention will last approximately nine to 12 months, although this varies. Some patients have experienced multiple years of pain relief after radiofrequency ablation.</p> <p>Pain can return after the nerves regenerate. The procedure can be repeated on the same nerve if you used it in the past for successful pain relief. For some patients, radiofrequency ablation is a long-term management option for chronic pain.</p> <p>Talk with your health care team if you're suffering from chronic pain. A variety of treatment options are available that can make a significant difference, including radiofrequency ablation.</p> <p><a href="/providers/melissa-kenevan-md" target="_self" title="Opens in same window."><em>Melissa Kenevan, M.D.</em></a><em>, is a <a href="/services-and-treatments/pain-medicine" target="_self" title="Opens in same window.">pain medicine</a> specialist in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/menomonie" target="_self" title="Opens in same window.">Menomonie</a>, Wisconsin.</em></p>M.D.<p>I am passionate about providing the best care for patients and am excited to have the opportunity to care for this great community. When you come to see me, you can expect me to spend time listening and learning about your pain, because I believe each patient and their pain experience is unique.</p> <p>I am an avid sports fan and played hockey, soccer and golf growing up. I also love spending time up at the cabin with my daughter, husband and other family members.</p><p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Transitional Year, Hennepin County Medical Center</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Anesthesiology, Mayo Clinic College of Medicine and Science</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Pain Medicine, Mayo Clinic College of Medicine and Science</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Pain Medicine</li> <li>American Society of Anesthesiology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Anesthesiology, Mayo Clinic College of Medicine and Science</li> </ul>Kenevan<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/melissa-kenevan-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=280965B1B9DA36CFE660E949008DEE90" alt="Melissa Kenevan, M.D." width="280" height="280" DisableNVelocity="true" />{86292A23-2DE6-46BF-A8B3-9E949535A9BC}Melissa<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16367812Melissa Kenevan, M.D.1{4EA2A40E-3721-48EC-AFC9-E6D0E13BCDEC}<img src="/-/media/national-files/images/hometown-health/2023/wearing-lifejacket-bending-on-dock.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CFA0ADD92839FD981FB491ACE3A7827D" alt="Wearing lifejacket bending on dock" width="660" height="370" DisableNVelocity="true" />Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.ArthritisArthritis is inflammation of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis.Pain ReliefApproximately 50 million people in the U.S. live with chronic pain. If you experience chronic pain, you're not alone. Learn about the ways to deal with painful disorders, from at-home solutions to drug treatments, injectable or implantable therapies to surgery.Dawn Haller5/22/2023Lead lurks in unexpected places, such as soil, food and old house paint. Safety standards have made significant strides to decrease lead exposure. Read how you can reduce lead exposure for children.Reducing lead exposure in children<p>Lead is present in the soil, food supply and water sources. Lead also may be present in pottery dishes, antique toys, skin care products and paint in a house built before 1978. Most of the lead that enters the body comes from eating and breathing it in.</p> <p>There is no known safe blood level concentration of lead. That's why it's important to know about lead sources, recent progress in reducing lead exposure and recommendations on how to avoid lead poisoning, especially in children.</p> <p>The good news is that safety standards implemented in the last 20 to 30 years have significantly decreased people's exposure to lead. You can no longer buy paint products with lead, and lead has been removed from gasoline. Testing for lead has become more common and precise. For example, water can be measured in the number of parts per trillion.</p> <h2>Decreasing lead exposure in children</h2> <p>Lead poisoning results from too much lead built up in the body. It can cause learning, behavior and health problems in children. Your children can have blood tests to check their lead levels if you're concerned about their lead exposure.</p> <p>Children under 6 are at greatest risk for lead poisoning, particularly if they spend time in homes built before 1978. Prior to that date, lead was allowed in household paint. Children may be exposed to lead in homes being renovated, or with chipping or peeling paint. Lead also can be found in the soil around homes and buildings where children play.</p> <p>Toys should not contain lead, but some toys put children at risk for lead exposure. Antique toys or collectible items may have lead paint. Do not give children toys with peeling or chipping paint.</p> <h2>Lead exposure during pregnancy</h2> <p>If you are pregnant, you can pass your lead exposure to your fetus through the placenta. You can mitigate this exposure by maintaining a good iron level and getting checked for anemia during prenatal care. Prenatal vitamins contain iron supplements. </p> <p>Pregnant or breastfeeding women also should avoid being around renovations to a home built before 1978 since dust and particles from paint that is disrupted during construction can pose a risk for lead exposure. Pipes in homes also may be a source of lead exposure.</p> <h2>Lead in baby food and water</h2> <p>Adults absorb only about 1% of the lead in food or water. But for babies and children, the absorption rate is about 50% of the lead in water and food products.</p> <p>Breastfeeding decreases the exposure of toxic metals to a baby, including lead. Complementary foods usually are introduced at six months in an exclusively breastfed baby. For other babies, foods typically are introduced at about four months. As with an adult, lead exposure from food can be decreased with a diverse diet.</p> <p>Because some baby foods have higher levels of heavy metals, including lead, parents should consider feeding their babies a variety of foods to decrease their lead exposure. For example, rather than just using rice cereal, which may have a higher amount of lead, consider feeding a variety of grains, including oat, barley and multigrains. Read the food labels for information and recommendations based on age and possible allergens.</p> <p>The water supply in certain cities or states may be tested regularly by the municipality. If you get your water from a well, it can be tested for lead.</p> <p>Babies and adults have less exposure to lead now than 30 years ago. Lead is measured more precisely, and food and environmental standards continue to increase. Talk with your health care team if you have concerns about lead exposure.</p> <p><a href="/providers/dennis-costakos-md" target="_self" title="Opens in same window."><em>Dennis Costakos, M.D.</em></a><em>, is a neonatologist in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Folic acid to prevent neural tube defects in minority populations as part of equity and inclusion</li> <li>Hyperbilirubinemia</li> <li>Newborn screening for biotinidase deficiency</li> <li>Predictive analytics</li> <li>Pulmonary surfactant and inter-hospital transfer</li> <li>Vitamin K and the newborn</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Dartmouth Medical School </li> </ul> <p><strong>Residency</strong></p> <ul> <li>Pediatrics, Mount Sinai Hospital</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Neonatal/Perinatal Medicine, New York Hospital/Cornell University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Neonatology, American Board of Pediatrics</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Pediatrics, Fellow in Neonatal-Perinatal Medicine and Epidemiology</li> <li>American Federation for Medical Research</li> <li>American Medical Association</li> <li>Society of Neuroscience </li> <li>Wisconsin Association for Perinatal care</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Pediatrics, Mayo Clinic College of Medicine and Science</li> </ul>Costakos<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/dennis-costakos-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=0A58CB05C01B2118F3FD82CC17315366" alt="Dennis Costakos MD" width="280" height="280" DisableNVelocity="true" /><p>See my publications at <a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/?term=costakos+dt" target="_blank" title="Opens in a new window">PubMed</a>.</p>Dennis<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12794287Dennis Costakos, M.D.1<img src="/-/media/national-files/images/hometown-health/2023/child-hands-making-mud-pie.jpg?h=370&iar=0&w=660&sc_lang=en&hash=53D98C6C4A6CA1F425B56AC595144EF5" alt="Child hands making mud pie" width="660" height="370" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller5/5/2023Advancements in eyeglasses are making them more comfortable, durable and stylish. Learn how multifocal lenses can be customized and how coatings reduce ocular symptoms.See clearly: Advances in eyewear<p>New and exciting developments in eyeglasses make them easier to wear and more effective in bringing your world into focus. From lenses to frames to coatings, eyeglasses are becoming more comfortable, durable and stylish. Let's take a look at some of the latest advancements in eyeglasses.</p> <h2>Lenses</h2> <p>The lenses are one of the most important parts of any pair of eyeglasses. Today, new lens materials have made glasses lighter, thinner and more appealing to the wearer.</p> <h3>Here are some lens improvements:</h3> <h4>Shatterproof</h4> <p>In the past, lenses were made from glass, which was heavy and more prone to shattering on impact. For safety reasons, most new lens materials are shatterproof. That's a nice feature for all wearers, especially children and people who depend primarily on one eye for sight.</p> <h4>Multifocal</h4> <p>Bifocals garnered a bad reputation in the past, but today's lenses aren't the same bifocals your grandparents wore. Most lined bifocal designs today have a more subtle line than those of the past. Progressive, or no-line, bifocal designs also are popular.</p> <h4>Office</h4> <p>New progressive lens options are called "office lenses," with room, desk and book designs. The right lens design makes seeing — and feeling more comfortable — at different distances easier:</p> <ul> <li><strong>Room lens</strong> — designed for indoor vision and offers clear vision to 14 feet in front of the wearer</li> <li><strong>Desk lens</strong> — offers clear vision to seven feet</li> <li><strong>Book lens</strong> — designed for clear vision within three to four feet</li> </ul> <p>Office lenses are great options for people working on a computer or reading for extended periods. They allow people to see near distances efficiently without leaning toward a screen or tipping their heads back to see through a small portion of a traditional progressive lens.</p> <h4>Fatigue-reducing</h4> <p>Another lens option for people who look at a computer screen or small detailed work most of the day is the marketed as the Eyezen lens. It's designed to help with eye fatigue and digital eye strain. It's available in a single-vision digital lens and offers a small amount of accommodative help, similar to a multifocal lens but at a lower power. It is a great option for young professionals and students who do a lot of near work or use computers often.</p> <h4>Executive</h4> <p>Several different types of multifocal lenses are helpful for specific professions as well. An executive lens is a bifocal that goes across all of the lens area and is not confined to a small box or area. For example, police officers have reported having good experiences with executive lenses, as they only have to shift their eyes, not their entire heads, to look at their computer in a squad car.</p> <h4>Reverse bifocal</h4> <p>This is when the part of the lens for seeing close objects is at the top of the frame rather than the bottom. While this might not be helpful for everyone, it can be a great option for people who work on detailed items above their heads, like auto mechanics, electricians or plumbers.</p> <h2>Frames</h2> <p>Eyeglasses frames are not just about style — they also play an important role in how comfortable and functional your glasses are.</p> <p>In the past, frames were typically made from a nickel metal alloy or plastic called zyl. While these materials are still popular today, there are other options available. Titanium, magnesium and carbon fiber materials are ultralight, flexible and durable.</p> <p>Frames also can be made from materials like wood, bamboo and recycled denim. These glasses can be stylish, lightweight and comfortable to wear.</p> <p>The most important part in picking out frames is making sure you have the correct size. If your frames are too wide or narrow, the lenses won't be centered correctly for your sight. The right shape of the frame is also important in relation to your prescription. If you need a strong prescription, your lenses may be thicker at the edges and cosmetically unappealing in the wrong frame design.</p> <h2>Coatings</h2> <p>Eyeglasses coatings protect the lenses and improve their functionality. One of the most common coatings is an anti-reflective or anti-glare coating, which helps to reduce glare and improve vision in bright light conditions. Another common coating is a scratch-resistant coating, which helps protect the lenses from scratches and damage.</p> <p>Specialty tints on lenses can reduce ocular side effects of migraine headaches, concussions or traumatic brain injuries. A tinted lens, often a shade of blue, purple or red, decreases bothersome symptoms accompanying those conditions by reducing light sensitivity and stimulation.</p> <p>Lenses that change when exposed to UV light have been available for decades. Recent enhancements, such as extra darkened lenses, work better in a vehicle, and other newer options can transition quicker than lenses in the past. It's important to talk with your optician about your needs so you get the right lens for you.</p> <p>From custom multifocal lenses to tinted coatings, eyeglasses are becoming more comfortable, durable and functional. Whether you need glasses for reading, driving or everyday use, more options are available now than ever before. Talk with your optometrist about the best lens, frame and coating options for you so you can see clearly and comfortably.</p> <p><a href="/providers/logan-kiekhafer-od" target="_self" title="Opens in same window.">Logan Kiekhafer, O.D.</a>, is an <a href="/services-and-treatments/ophthalmology" target="_self" title="Opens in same window.">optometrist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</p><ul> <li>Contact lenses, such as RGP, scleral hybrid, prosthetic and soft</li> <li>Corneal disease and glaucoma management</li> <li>Ocular disease</li> <li>Myopia management</li> </ul>O.D.<p>Getting to know my patients and their lifestyles allows me to tailor their care to achieve their visual goals. I believe in treating every patient like they are a member of my family.</p> <p> In my spare time, I enjoy hunting, fishing, playing golf, watching sports and spending time with my family.</p><p><strong>Education</strong></p> <ul> <li>Illinois College of Optometry</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Diplomat, American Board of Optometry</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Optometric Association</li> <li>Wisconsin Optometric Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Ophthalmology, Mayo Clinic College of Medicine and Science</li> </ul>Kiekhafer<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/logan-kiekhafer-od.jpg?h=280&iar=0&w=280&sc_lang=en&hash=FC9EDBE943CC4A44E5DC136AFA419A52" alt="Logan Kiekhafer, O.D." width="280" height="280" DisableNVelocity="true" />Logan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14956039Logan Kiekhafer, O.D.1{C5680DDD-C649-4B63-AFCC-B52A244736B7}<img src="/-/media/national-files/images/hometown-health/2023/person-wearing-glasses.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B0D072D46575CA91837EBA70439C2EDF" alt="Person wearing glasses" width="660" height="370" DisableNVelocity="true" />Eye HealthYour eyes are responsible for providing you with vision, perhaps the most important of the senses. However, the eye is a delicate and complicated structure that needs protection. The ugly truth is that eye injuries can happen at any time and place.Dawn Haller5/31/2023With summer officially underway, everyone will be spending more time outdoors. No matter the activity, make sure you and your family know what it takes to stay safe. Check out these reminders.Tips for making safety part of your summer fun<p>Summer is officially underway. With more time spent outdoors comes more opportunities for injuries, many of which are preventable. Don't let an injury bring your fun in the sun to an end. No matter the activity, make sure you and your family know what it takes to stay safe.</p> <h2>Sun safety</h2> <p>After a long winter, it's easy to forget the strength of the summer sun.</p> <h3>To protect yourself from skin cancer and sunburn:</h3> <ul> <li>Apply an appropriate amount of <a href="/hometown-health/speaking-of-health/3-sun-safety-reminders" target="_self" title="Opens in same window.">broad-spectrum sunscreen</a> according to the directions. Remember to apply sunscreen to easy-to-forget areas like the back of your neck, tips of your ears and tops of your feet.</li> <li>Wear a hat, sunglasses and ultraviolet (UV) light-blocking clothing.</li> <li>Avoid <a href="/hometown-health/speaking-of-health/simple-steps-to-prevent-skin-cancer" target="_self" title="Opens in same window.">sun exposure</a> between 10 a.m. and 4 p.m. — even on cloudy days — when the sun is at its peak.</li> </ul> <h2>Skin safety</h2> <p>Summer increases your chance of <a href="/hometown-health/speaking-of-health/taming-ticks" target="_self" title="Opens in same window.">tick bites</a>, <a href="/hometown-health/speaking-of-health/bee-prepared-for-bee-and-wasp-stings" target="_self" title="Opens in same window.">insect stings</a> and rashes from plants.</p> <h3>To protect yourself:</h3> <ul> <li>Wear shoes, not sandals; long pants tucked into your socks; a long-sleeved shirt; a hat; and gloves when outdoor activities take you into an area where there may be ticks. </li> <li>Stay on designated trails when possible, and avoid walking through low bushes and long grass.</li> <li>Use insect repellents with at least 20% DEET. Repellents with up to 30% DEET can be applied to children over 2 months old. Apply to clothes and exposed skin but avoid your hands.</li> <li>Before taking a drink from an opened beverage, inspect cans and straws to make sure your drink hasn't attracted a stinging insect. </li> <li>Mowing the lawn or trimming vegetation could disturb a beehive or wasp nest, so be aware of your surroundings.</li> <li>Avoid contact with poison ivy, sumac or oak. Itching, reddening of the skin, blisters and hive-like swelling usually begins within 48 to 72 hours after exposure.</li> </ul> <h2>Vehicle safety</h2> <p><a href="/hometown-health/speaking-of-health/get-ready-to-wheel-into-spring" target="_self" title="Opens in same window.">Wheel into summer</a>, but do it safely. Each year in the U.S., bicycle accidents account for 130,000 emergency department visits; skateboards, 200,000 visits; ATVs, 100,000 visits; and motorcycle accidents, 82,000 visits.</p> <h3>To ensure a safe ride:</h3> <ul> <li>Wear a helmet while on all wheeled vehicles, including ATVs, motorcycles, bicycles and skateboards, or when horseback riding. A helmet can reduce serious head injuries by up to 80%. </li> <li>Check your child’s helmet for a proper fit.</li> <li>Adults should set a good example by wearing their helmets while biking or skating.</li> <li>Follow seating guidelines on ATVs, and use seatbelts when available on these vehicles.</li> <li>Read the manufacturer's guidelines for age and weight requirements on bikes or ATVs.</li> <li>Supervise ATV riders younger than 16.</li> <li>Don't drink alcohol before or during your time using wheeled vehicles.</li> </ul> <h2>Lawn and yard safety</h2> <p>Yard work is a regular activity during the summer. Each year, however, about 9,000 children in the U.S. end up in the emergency department with lawn-mowing injuries.</p> <h3>Follow these tips for yard safety for all ages:</h3> <ul> <li>Avoid mowing on steep banks when the lawn is damp or when there's not enough daylight.</li> <li>Clear the mowing area of any objects such as twigs, stones and toys that could be picked up and thrown by the lawnmower blades.</li> <li>Wear ear and eye protection, long pants and closed-toed shoes when mowing.</li> <li>Make sure children are physically capable of <a rel="noopener" href="https://www.healthychildren.org/English/safety-prevention/at-home/Pages/Lawnmower-Safety.aspx" target="_blank" title="Opens in a new window.">using a lawnmower</a>. The American Academy of Pediatrics recommends children be 12 or older to operate a push mower and 16 or older for a riding mower.</li> <li>Never touch the lawnmower blade with your hands or feet, even if the engine is off.</li> <li>Store lawn chemicals and pesticides in their original containers and out of reach of children. Read the labels for instructions on using and disposing of chemicals.</li> <li>Wear a helmet, safety glasses and ear protection when cutting wood or trimming trees.</li> <li>Consider hiring someone to do jobs at high risk for falls or injuries, such as climbing ladders, carrying fertilizer or seed bags, cleaning out gutters or trimming trees.</li> </ul> <h2>Water safety</h2> <p>Every year in the U.S., about 4,000 people die by drowning. Children, men and nonwhite people are at the highest risk. More than 70% of water recreation deaths are related to alcohol use.</p> <h3> To stay safe on the water:</h3> <ul> <li>Always wear an approved flotation device when on or near the water.</li> <li>Don't drink alcohol and drive a <a href="/hometown-health/speaking-of-health/boating-this-summer-make-safety-your-top-priority" target="_self" title="Opens in same window.">boat</a> or personal watercraft.</li> <li>Encourage swimming readiness by enrolling children in swim lessons. </li> <li>Keep pool gates closed at all times, and consider an alarm to alert you if the gate is opened. </li> <li>Before diving into a body of water, know the water depth and if there are any underwater obstacles.</li> <li>Supervise children when they're swimming, and stay close enough to reach out to the child at any time. </li> <li>Don't go swimming alone.</li> </ul> <h2>Food safety</h2> <p>Safe summertime food handling can reduce your risk of food poisoning.</p> <h3>Follow these steps:</h3> <ul> <li>Wash your hands. If soap and hot, running water are unavailable, clean your hands with disposable hand wipes before and after working with food. Remember, pets can carry germs, so don't go directly from petting the cat to paring potatoes.</li> <li>Cook food thoroughly. Make sure fish, poultry and other meats are safely thawed in the refrigerator before cooking. Many raw foods, especially poultry and other meats, can harbor bacteria. Follow preparation recommendations for cooking temperatures to be sure meats and seafood are cooked all the way through.</li> <li>When grilling, avoid using the same platters or utensils for uncooked and cooked meats.</li> <li>Keep utensils and food covered until serving time, because flies, other insects and pets can carry germs or salmonella.</li> </ul> <h2>Farm safety</h2> <p>Farms are busy places during the summer.</p> <h3>Keep your family and visitors safe with these tips: </h3> <ul> <li>Avoid baggy clothing, loose jewelry or long hair when near moving equipment.</li> <li>Before moving machinery, make sure all children and adults are clear of the wheels.</li> <li>Don't allow children to ride on tractor fenders or trailers.</li> <li>Make sure safety shields, roll bars or guards are securely installed.</li> <li>Supervise children near animals.</li> <li>Turn equipment off before making repairs or adjustments. Don't reach into equipment while parts are moving.</li> <li>Use safety glasses, noise protection and other precautions, including masks when using chemicals and pesticides.</li> </ul> <h2>General summer safety</h2> <h3>Follow these additional tips:</h3> <ul> <li>Stay <a href="/hometown-health/speaking-of-health/water-essential-to-your-body-video" target="_self" title="Opens in same window.">hydrated</a> when the temperature and humidity are high. Avoid alcoholic or caffeinated beverages on hot days because they don’t provide necessary hydration for your body.</li> <li>Supervise children when they’re on trampolines or playground equipment.</li> <li>Handle <a href="/hometown-health/speaking-of-health/use-caution-with-fireworks" target="_self" title="Opens in same window.">fireworks</a> safely.</li> </ul> <p>While we hope you don't need us, <a href="/services-and-treatments/urgent-care" target="_self" title="Opens in same window.">Urgent Care</a>, <a href="/services-and-treatments/express-care" target="_self" title="Opens in same window.">Express Care</a> and <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">Emergency Department</a> services are here if you do.</p> <p>Remember, most injuries are preventable. Incorporating these precautions into your daily life will help you avoid life-altering accidents. Enjoy your summer and be safe.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2023/children-in-life-jackets.jpg?h=370&iar=0&w=660&sc_lang=en&hash=59C7A81CFCA0E2EE8BF967C45A187738" alt="Children in life jackets" width="660" height="370" DisableNVelocity="true" />SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Dawn Haller5/8/2023It can be tough to talk with your teen about drugs and alcohol. It's essential to have these conversations long before events, such as graduations and weddings. These tips can get you started.Help your teen navigate celebrations substance-free<p>Milestone-marking celebrations, from graduations to weddings, can pose a dilemma for young people who prefer to party substance-free. They want to join in the fun but can face powerful peer pressure to drink alcohol or use drugs.</p> <p>These tips can help parents — and teens — have conversations and develop strategies for celebrating and making memories while remaining sober and safe.</p> <h2>Start the conversation early</h2> <p>The week of a graduation party isn't the time to start talking with your teen about your family's beliefs, expectations and boundaries about drinking or using drugs. An open, honest discussion about drugs and alcohol can help ensure there are fewer surprises for you or your teen when an event like graduation arises. While these conversations can be anxiety-provoking and nerve-wracking at first, they can save a teen's life.</p> <h2>Set aside enough time</h2> <p>Pick a neutral time to talk when both you or your teen aren't rushed so you can have a respectful discussion. That could be while making dinner, driving home from school, doing a project together or just relaxing. Plan on having more than one conversation.</p> <h2>Ask and learn</h2> <h3>Ask open-ended questions to get the conversational rolling, such as:</h3> <ul> <li>Do kids in your school drink alcohol?</li> <li>What kind of drugs are kids using at school?</li> <li>How easy are those drugs to get?</li> <li>Is drug use pretty widespread or just among certain kids?</li> <li>What do you think about alcohol and drug use?</li> <li>Have you tried drugs or alcohol?</li> <li>How would you handle it if you felt pressured to use them?</li> </ul> <p>By asking these questions, you'll gain insights into the substance-use environment your teen navigates every day. The answers also will give you a sense of whether your child is exploring substance use or has had issues at school with drugs or alcohol.</p> <h2>Focus on safety</h2> <p>No parent want to be seen as the "mean" one who keeps their kids from having fun. Stress throughout your conversations that your teen's safety is your primary concern.</p> <p>Recognize that situations can arise that are beyond your teen's control or maturity. Sometimes just saying no isn't enough. Develop strategies together to address the situations so your child has an "out" and the opportunity to safely get home. This could be calling or texting you or another responsible adult, using public transportation or calling a ride-share service.</p> <p>Discuss and agree on consequences for overstepping the boundaries for drinking or using drugs at a celebration. Implementing those consequences should wait until your teen returns to a safe environment.</p> <h2>Prepare for party season</h2> <h3>As the invitations for formal celebrations and impromptu parties come in, it's OK to ask your teen questions, such as:</h3> <ul> <li>Where is the event taking place?</li> <li>What adults are going to be there?</li> <li>How will it be supervised?</li> <li>How are you getting there? Who's driving?</li> <li>Who will be there?</li> </ul> <p>Remember those conversations you've been having over the years? Because of them, your teen should be expecting these questions and be able to provide clear answers. It all comes down to safety.</p> <p>Call event hosts for details when the celebration is at a home, including their policies for teen drug or alcohol use.</p> <p>Based on what you learn, talk with your teen about why it's OK to go to specific parties but not others. Give your reasons, such as lack of supervision or the high probability of it being a risky environment.</p> <h2>Look at the big picture</h2> <p>It's easy for teens to get swept up in the excitement and fun of celebration season. Remind teens that graduation is more than an opportunity to party — it's their first steps toward their futures. They don't want that future marred by taking risks with drugs or alcohol.</p> <h3>Share these tips with your teens:</h3> <ul> <li>Try to avoid events that seem risky to you. Often, drug and alcohol use can lead to unsafe and dangerous situations.</li> <li>Go with someone you trust. You can help each other if something occurs.</li> <li>If you're concerned about being tempted into using substances, your friend also can help you say no and make wise decisions.</li> <li>If you're in over your head, call your parents or a trusted adult.</li> </ul> <h2>Create memories for a lifetime</h2> <p>Teens will look back on the memories they create during this phase in life. Having open, nonconfrontational conversations about drugs and alcohol can help ensure they will cherish — rather than regret — those memories.</p> <p><a href="/providers/glenn-kauppila-do" target="_self" title="Opens in same window."><em>Glenn Kauppila, D.O.</em></a><em>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin, and also is board-certified in addiction medicine.</em></p> <ul> <li>Addiction treatment (alcohol and other substances)</li> <li>Chronic disease management (diabetes, hypertension, etc.)</li> <li>Exercise and healthy eating</li> <li>Health and Wellness promotion</li> </ul> D.O.<p>My practice philosophy is to see you as a whole person and address all of those aspects to promote health and wellness through the ages. As a physician, my role is to advise and partner with you as you travel along the journey of your life. Taking the time to listen to you is most important. I use an evidence-based approach to utilize the best and most current science to diagnose and treat. </p> <p>I have additional training in the care of those with alcohol and other substance addictions.</p> <p>Outside of the practice of medicine, I enjoy spending time with my family, travel and running ultra-marathons.</p><p><strong>Education</strong></p> <ul> <li>A.T. Still University – Kirksville College of Osteopathic Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Family Medicine, Horizon Health System</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Practice, Henry Ford Health System/Michigan State University</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Addiction Medicine, University of Wisconsin-Madison</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Family Medicine, American College of Osteopathic Family Practitioners</li> <li>Department of Transportation (DOT) Exams</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Society of Addiction Medicine</li> <li>Wisconsin Medical Society</li> <li>Wisconsin Society of Addiction Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Kauppila<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/glenn-kauppila-do.JPG?h=280&iar=0&w=280&sc_lang=en&hash=3FF4643FE207A1FCEE384E7F78F88C0C" alt="Glenn Kauppila, D.O." width="280" height="280" DisableNVelocity="true" /> <ul> <li><a rel="noopener noreferrer" href="https://www.aafp.org/afp/2021/0301/p272.html" target="_blank" title="Opens in a new window.">Alcoholics Anonymous and other 12-step Facilitation Programs for Alcohol Use Disorder</a>, March 2021</li> </ul> {B8C019FF-98BC-40C6-BAF8-0ADE2A7503A0}Glenn<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16129652Glenn Kauppila, D.O. 1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{67744200-E25F-439A-8B70-572A5A091172}<img src="/-/media/national-files/images/hometown-health/2023/graduates-in-black-cap-and-gown.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E9741C94D8276876C4B06F76B3CBF188" alt="Graduates in black cap and gown" width="660" height="370" DisableNVelocity="true" />Substance AbuseInformation for helping those with alcohol and other drug abuse concerns.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller5/25/2023Lung nodules are small masses of tissue in the lungs. Most nodules aren't cancer, but all should be evaluated. Learn how your health care team discovers which should be tested for lung cancer.Understanding lung nodules: Determining risks and diagnosing<p>The lungs are an impressive organ. They're one of the biggest in the body, with a surface area about the size of a tennis court and about 1,500 miles of airways. The lungs are efficiently adapted to deliver oxygen and remove carbon dioxide to keep the body running smoothly. They circulate air exchange in about 17,000 or more breaths every day.</p> <p>Yet, like other organs, issues can develop in the lungs. Lung nodules are a common condition that should be evaluated by medical professionals. Nodules are areas that are denser than normal lung tissue and usually don't cause symptoms.</p> <p>Lung nodules often are discovered incidentally during imaging for other health conditions, such as a chest X-ray or CT scan. For example, lower lobe lung nodules often are found during a CT scan of the abdomen or pelvis.</p> <p>Most lung nodules aren't cancer, and no additional treatment is necessary. However, some nodules are cancerous. All lung nodules should be carefully evaluated because lung cancer is the No. 1 cause of cancer deaths in U.S. adults. Early detection of lung cancer is critical. Like other cancers, it's more difficult to treat as it advances.</p> <h2>Risk factors</h2> <p>Lung nodules can vary in size and location within the lung. They're caused by various factors but usually are caused by scar tissue due to previous infections or irritants, inflammation or cancer.</p> <p>The most common risk factors for lung nodules are tobacco use and radon exposure. About 90% of men who died from lung cancer had been smokers. Nonsmokers have a 20% to 30% higher risk of developing lung nodules or cancer if they have been exposed to secondhand smoke.</p> <p>Radon exposure often is an overlooked risk factor. This odorless, invisible radioactive gas is the leading cause of lung cancer in nonsmokers. It's more common in the homes of <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.epa.gov/radon/epa-map-radon-zones-and-supplemental-information" target="_blank" title="Opens in a new window.">some areas of the U.S.</a></p> <p>Finally, people with suppressed immune systems are at a greater risk of developing lung nodules.</p> <h2>Risk stratification</h2> <p>Most lung nodules aren't cancer, but a careful review of the patient's risks and a nodule's characteristics is important to identify those that could be. This is called risk stratification.</p> <p>When a nodule is identified, the health care team will review the patient's medical history, including past and current tobacco use, exposure to radon, recent infections, inflammation and history of cancer. The risk stratification process also considers the nodule's location, size, speed of growth, calcification and whether the border margins are smooth, irregular or spiculated.</p> <h2>Nodule growth</h2> <p><strong> </strong></p> <p>The growth rate of a nodule is important to consider when determining the risk that the it's cancer. Nodules that are small and aren't growing are not likely to be cancerous.</p> <p>A series of images can provide a snapshot of the nodule over time. If a nodule isn't growing, it's usually not cancer. However, if the nodule is enlarging, then the patient will be put into active surveillance with serial imaging, generally with CT scans. The interval and frequency of those scans will be determined by the health care team.</p> <h2>Additional tests</h2> <p>PET scans may be offered to identify high metabolic activity in nodules that are growing or larger than 1 centimeter. A PET scan cannot definitively diagnose cancer, but it can identify areas with high metabolic activity. A biopsy is the only true way to determine if the nodule is cancerous.</p> <p>Biopsies can be performed using a <a href="/hometown-health/speaking-of-health/robotic-assisted-bronchoscopy-faq" target="_self" title="Opens in same window.">robotic-assisted bronchoscopy</a>. With this technology, the patient's CT scan is used to create a road map of the airways that will lead to the nodule. Using a catheter with fiber optic shape-sensing technology, the pulmonologist can navigate to nodules in the lung and confirm their position with real-time integrated imaging before biopsying them. This greatly increases safety and diagnostic precision. </p> <p>The catheter takes tissues from the nodule, which then can be tested to determine if the nodule is cancerous. The bronchoscopy has a built-in ultrasound probe to also check the lymph nodes in the chest. This is called endobronchial ultrasound (EBUS) and — if the nodule is found to be cancer — helps the health care team stage the nodule, which helps determine the appropriate treatment plan.</p> <p>Although not all lung nodules are cancerous, it's important to be aware of the risk factors for lung cancer and to talk with your health care team about any lung nodules you might have. Take steps to reduce your risk for lung cancer. If you smoke, quit. Regularly check your home for radon. Ask your health care team if you qualify for low-dose, CT scan lung cancer screening.</p> <p><a href="/providers/june-chae-md" target="_self" title="Opens in same window."><em>June Chae, M.D.</em></a><em>, is a <a href="/services-and-treatments/pulmonology" target="_self" title="Opens in same window.">pulmonologist</a> and <a href="/services-and-treatments/intensive-and-critical-care" target="_self" title="Opens in same window.">intensive care</a> physician in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Airway management</li> <li>Benign lung mass</li> <li>Endobronchial ultrasound EBUS) bronchoscopy</li> <li>Lung cancer screening & lung cancer</li> <li>Lung nodule</li> <li>Robotic-assisted bronchoscopy</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Illinois College of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Emergency and Internal Medicine, University of Illinois at Chicago</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>European Respiratory Society</li> <li>Society of Critical Care Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Chae<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/june-chae-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=302571F931ADD278B79439015B063DFF" alt="June Chae, M.D." width="280" height="280" title="June Chae, M.D." DisableNVelocity="true" />June<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>19990812June Chae MD1{5AB5D42E-3625-4D5D-9685-35585C564C3D}|{1A90F4B2-3C68-421C-89C5-AC045A6F8F56}|{1D6651B0-86E1-4FF6-9A93-07B8EE2D26EE}<img src="/-/media/national-files/images/hometown-health/2023/resting-head-against-hand.jpg?h=370&iar=0&w=660&sc_lang=en&hash=651B9A06F2FC7960C052EED457B27149" alt="Resting head against hand" width="660" height="370" DisableNVelocity="true" />Lung CancerLung cancer is a type of cancer that begins in the lungs. It is the leading cause of cancer deaths in the U.S., among both men and women. Lung cancer claims more lives each year than do colon, prostate, ovarian and breast cancers combined. <br/><br/>PulmonologyTreatment for diseases and conditions affecting lung and airway function.Dawn Haller5/9/2023Panic attacks are sudden periods of deep fear without clear cause, during which you may have mental and physical symptoms. Get answers to common questions about these sometimes scary events, and learn how panic disorders are related.What is a panic attack?<p>A panic attack is an episode of intense fear with an abrupt onset, lasting from several minutes to up to an hour. It has many mental and physical symptoms such as chest pain, shortness of breath, nausea, dizziness, chest pain and a sense of pending doom. These symptoms may cause significant worry in people as they may mimic signs of medical problems such as heart issues. However, panic attacks can occur when there isn't a real danger or apparent cause.</p> <p>Panic attacks aren't life-threatening, but they can be frightening for the person experiencing the attack and their loved ones. These attacks can affect your quality of life, especially if you have multiple or unexpected panic attacks.</p> <h2>What are the signs of a panic attack?</h2> <p>A panic attack usually begins suddenly and without warning. Typically, symptoms peak in minutes, and you may feel tired and worn out after it subsides. Panic attacks can cause chest pain and breathing problems that lead some people to seek medical care.</p> <h3>To be diagnosed as a panic attack, the episode must have at least four of these symptoms simultaneously:</h3> <ul> <li>Chest pain or discomfort</li> <li>Chills or heat sensations</li> <li>Derealization (feelings of unreality) or depersonalization (being detached from oneself)</li> <li>Fast beating, fluttering or pounding heart</li> <li>Fear of dying</li> <li>Fear of losing control or "going crazy"</li> <li>Feeling dizzy, unsteady, light-headed or faint</li> <li>Feelings of choking</li> <li>Nausea or abdominal distress</li> <li>Numbness or tingling sensations</li> <li>Sensations of shortness of breath or smothering </li> <li>Sweating</li> <li>Trembling or shaking</li> </ul> <h3>Panic attack symptoms may also resemble other psychiatric conditions, such as:</h3> <ul> <li><strong>Agoraphobia</strong> — marked fear or avoidance of two or more places or situations</li> <li><strong>Caffeine or nicotine dependence</strong> — high doses of either substance may result in increased anxiety</li> <li><strong>Obsessive-compulsive disorder</strong> — obsessions often leading to ruminations or brooding</li> <li><strong>Phobias</strong> — fear of specific objects or situations</li> <li><strong>Post-traumatic stress disorder</strong> — involves emotions from previous events affecting a current situation</li> <li><strong>Separation anxiety disorder</strong> — fear of separation from attachment figures</li> <li><strong>Social anxiety disorder</strong> — fear of social situations</li> </ul> <h2>Do I need to go to the emergency room if I have a panic attack?</h2> <p>In most cases, a single panic attack episode does not require emergency medical care. However, it's important to discuss your symptoms with your health care team. They will evaluate you for medical disorders that may contribute to your symptoms, such as cardiac arrhythmia, respiratory diseases, pulmonary emboli, thyroid disorders, adrenal tumors or medication side effects.</p> <h2>What's the difference between a panic attack and panic disorder?</h2> <p>A person with ongoing, unexpected panic attacks who spends time worrying about another panic attack may have a panic disorder. People with panic disorders may be afraid of experiencing more panic attacks and live in a constant state of fear that affects the quality of their lives. Often, they change their behaviors and habits so much that it interferes with daily activities. This could result in the person missing social events, school or work.</p> <p>People with panic disorder have panic attacks with mental and physical symptoms. The attacks happen without warning and can last several minutes to an hour.</p> <h3>Such people also may:</h3> <ul> <li>Worry about having panic attacks in the future.</li> <li>Avoid situations that might cause them to have a panic attack.</li> <li>Seek medical care at a clinic or Emergency Department when experiencing a panic attack.</li> </ul> <h2>Is there a test for panic disorder?</h2> <p>No. There is no test, but your health care team can determine if you have panic disorder or another condition based on your symptoms. You may have a complete physical exam, blood test or psychological evaluation to discuss your symptoms, fears, stress and family history.</p> <h2>Can panic attacks be treated?</h2> <p>Yes, treatment can reduce the intensity and frequency of panic attacks and panic disorder.</p> <h3>Treatment may include:</h3> <ul> <li><strong>Cognitive behavioral therapy</strong><br /> Usually, this is the first treatment offered for panic attacks and panic disorder. During cognitive behavioral therapy, you talk with a psychologist or counselor about your experiences and learn how to react to situations differently. This teaches you how to cope better with your feelings and overcome fears of situations you may have avoided because of panic attacks. In some cases, it is possible to participate in cognitive behavioral therapy virtually, such as meeting with a therapist online or through a video call, rather than in person.</li> <li><strong>Medications</strong><br /> Medications can help reduce symptoms associated with panic attacks and depression. There are many options, and if one medication doesn't work for you, your health care team may switch you to a different medication. All medications have a risk of side effects, so talk with your health care team about the best choice for your situation. </li> </ul> <p>You don't need to suffer alone or avoid aspects of life because of panic attacks. Talk with your health care team about your symptoms and about treatment options that can make a difference.</p> <p><a href="/providers/brian-hesler-md" target="_self" title="Opens in same window."><em>Brian Hesler, M.D.</em></a><em>, is a psychiatrist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a>, Minnesota.</em></p><ul> <li>Anxiety</li> <li>Bipolar disorder</li> <li>Depression</li> <li>Dual diagnosis</li> <li>Schizophrenia</li> </ul>M.D.<p>I believe in the patient-centered, individual approach to treating mental health. Collaboration between inpatient-stabilization providers and consistent outpatient providers is the cornerstone of delivering high quality care.</p> <p>I enjoy the outdoors with my dog. I have a small farm in Wisconsin, but I am originally from Chicago.</p><p><strong>Education</strong></p> <ul> <li>University of Illinois College of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Anesthesiology, Cleveland Clinic Foundation</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Psychiatry, Rush University Medical Center</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Clinical Research, Cleveland Clinic Foundation</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Psychiatry, American Board of Psychiatry and Neurology</li> </ul>Hesler<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/brian-hesler-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=0E7711987358B86719CC2FE323ECE5FE" alt="Brian Hesler, M.D." width="280" height="280" DisableNVelocity="true" />Brian<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30190397Brian Hesler, M.D.1{C4130004-0F31-48C4-AC9F-A4350A75AB24}|{2B88C934-922C-4130-B661-197B59D83899}<img src="/-/media/national-files/images/hometown-health/2023/purposeful-relaxation-eyes-closed.jpg?h=370&iar=0&w=660&sc_lang=en&hash=74E0952A791445EA02B6C29B316E5ACA" alt="Person purposefully relaxing, sitting with eyes closed" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller5/25/2023While losing weight appears to be simple, many people find it challenging. Now there's a new tool to help. Get the details on a prescription medication that can curb your appetite.What's the skinny on weight-loss drugs?<p>Want to lose weight? It's really just basic math. Burn more calories than you take in. The best way to do that is by eating a healthy diet — reducing your calorie intake — and being physically active, which increases the number of calories burned.</p> <p>While it appears to be simple, many people find it challenging to effectively lose weight and keep the pounds off. Now, Mayo Clinic experts say there is a new tool to help in the battle against obesity: a prescription medication that can curb your appetite. And a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.eurekalert.org/news-releases/989853" target="_blank" title="Opens in a new window.">recent study at Mayo Clinic</a> shows it can be effective for weight loss.</p> <p>It's a medication called <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/drugs-supplements/semaglutide-subcutaneous-route/description/drg-20406730" target="_blank" title="Opens in a new window.">semaglutide</a> — better known by the brand names Ozempic and Wegovy. Ozempic is approved by the Food and Drug Administration to treat Type 2 diabetes. Wegovy is now approved to help with <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.eurekalert.org/news-releases/989853" target="_blank" title="Opens in a new window.">weight loss</a>.</p> <p>"These drugs have been shown to help people lose, on average, about 15% of their body weight," says <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/shah-meera-m-b-ch-b/bio-20114165" target="_blank" title="Opens in a new window.">Meera Shah, M.B., Ch.B.</a>, a Mayo Clinic endocrinologist.</p> <p>It works by tricking your brain and stomach into feeling full, so you don't overeat.</p> <p>"It's really changed how we think about these weight-loss medications," says Dr. Shah.</p> <p>It's a prescription medication. The FDA advises it only for people with a <a href="/healthy-weight" target="_self" title="Opens in same window.">body mass index</a>, or BMI, greater than 30, or a BMI of 27 or more with a weight-related health condition. A common side effect is nausea.</p> <p>"These are injections, and you give them once a week to yourself, typically in the belly, so much like an insulin injection would be," she says.</p> <p>They're also expensive and oftentimes not covered by insurance. So check with your provider.</p> <p>"I think it's a great tool," says Dr. Shah. "I think for a lot of people, it certainly makes a significant difference to how they feel about food and how they feel about their own hunger signals and their ability to control that. And that's very powerful."</p> <h2>Next steps:</h2> <ul> <li>Weigh benefits, risks carefully before taking<a href="/hometown-health/speaking-of-health/taking-off-label-medication" target="_self" title="Opens in same window."> off-label medication.</a></li> <li>Visit <a href="/wellness-hub" target="_self" title="Opens in same window.">Live Well</a> for healthy lifestyle information. </li> <li>Discover nonsurgical options for <a href="/services-and-treatments/weight-management" target="_self" title="Opens in same window.">weight management</a>.</li> <li>Take the <a href="/hometown-health/speaking-of-health/are-you-ready-to-change-habits-to-lose-weight" target="_self" title="Opens in same window.">Weight Loss Readiness Assessment</a> to see if you're ready to start a weight loss plan.</li> </ul> <p><em>This article originally appeared on the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/5-23-mayo-clinic-minute-whats-the-skinny-on-weight-loss-drugs/" target="_blank" title="Opens in a new window.">Mayo Clinic News Network</a>.</em></p><img src="/-/media/national-files/images/hometown-health/2023/two-people-looking-at-cellphone.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4059865B0735BD1DE63E2627C4BDE188" alt="Two people looking at cellphone" width="660" height="370" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller6/8/2023Nearly 1 in 3 women experience pelvic floor dysfunction, such as incontinence, bulging, pelvic pain or sexual problems. Learn why effectively treating pelvic health disorders takes a team approach.Addressing pelvic health disorders<p>Nearly 1 in 3 women experience some form of pelvic health dysfunction. The pelvic organs include the uterus, bladder, large intestine and rectum. Pelvic floor issues are more common in women but also can affect men.</p> <p>Common symptoms of pelvic health disorders include <a href="/hometown-health/speaking-of-health/6-helpful-tips-for-managing-urinary-retention-and-incontinence" target="_self" title="Opens in same window.">incontinence</a>, frequency and urgency of urination, pelvic pressure or bulging, pelvic pain and sexual problems. Symptoms may cause some people to fear social settings outside their homes, feel isolated or experience sexual problems. These unseen issues can have an adverse effect on daily activities, work and relationships.</p> <h2>Factors that can contribute to pelvic health disorders include:</h2> <ul> <li>Age</li> <li>Constipation</li> <li>Family history of pelvic health conditions, such as prolapse</li> <li>Genetic factors</li> <li><a href="/hometown-health/speaking-of-health/menopause-ensuring-a-tranquil-transition" target="_self" title="Opens in same window.">Menopause</a></li> <li>Occupational risks, such as heavy lifting</li> <li>Pregnancy</li> <li>Smoking</li> </ul> <h2>Take these steps to address pelvic health disorders:</h2> <h3>1. Start the discussion.</h3> <p>Your primary care provider is a trusted partner in your overall health and well-being. Many people delay speaking with their health care team due to lack of information about pelvic floor disorders. Talking about your symptoms may be uncomfortable and seem minor to you compared to other conditions. But don't hesitate to talk about your pelvic health symptoms during an appointment or ask to be referred to a specialist.</p> <h3>2. Find reputable resources.</h3> <p>Learning about pelvic health disorders, risk factors and treatments can help you feel more comfortable speaking with your health care team. Look for information from trustworthy sources, such as Mayo Clinic, to get accurate and up-to-date resources about your symptoms.</p> <h3>3. Seek expert care.</h3> <p>Your primary care provider can refer you to a specialist who will evaluate your risk factors and symptoms. Your care team can provide options for the best combination of treatments ranging from lifestyle changes and <a href="/hometown-health/speaking-of-health/pelvic-floor-physical-therapy-benefits" target="_self" title="Opens in same window.">physical therapy</a> to medication or surgical options. No single treatment is appropriate for every pelvic health condition, so discuss your options with an expert for an individualized treatment plan. </p> <h2>Pelvic floor disorder treatments</h2> <p>Effectively treating pelvic health disorders takes a team approach. In addition to your primary care provider, your care team may include an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a>, <a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">urologist</a>, urogynecologist, and pelvic floor <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapist</a>. </p> <h3>Nonsurgical treatments</h3> <p>You may benefit from simple lifestyle modifications and exercises. As with other areas in the body, muscles and tissues lose strength and elasticity with age. Exercises like <a href="/hometown-health/speaking-of-health/kegels-are-for-men-too" target="_self" title="Opens in same window.">Kegels</a> can build pelvic floor muscle strength and lessen your symptoms. Pelvic floor physical therapy also can address muscle weakness or tension that could be causing your symptoms. </p> <p>Other nonsurgical options include medications and <a href="/hometown-health/speaking-of-health/how-do-bladder-botox-injections-work" target="_self" title="Opens in same window.">Botox injections</a> into the bladder muscle to reduce the frequency of bladder contractions.</p> <p>Many women find these nonsurgical treatment alternatives helpful in easing symptoms and improving quality of life.</p> <h3>Surgical treatments</h3> <p>Simple lifestyle changes, physical therapy or medications sometimes aren't enough to treat pelvic floor conditions, and surgery may be needed. The care team will work to understand your needs and determine goals to develop custom treatment plans.</p> <p>Many surgeries are minimally invasive and often can be performed as outpatient procedures, meaning most patients can go home the same day.</p> <h4>Surgical treatment options include:</h4> <ul> <li>Vaginal, laparoscopic or robotic surgery for <a href="/hometown-health/speaking-of-health/pelvic-organ-prolapse-whats-going-on-down-there" target="_self" title="Opens in same window.">pelvic organ prolapse</a>.</li> <li><a href="/hometown-health/speaking-of-health/is-urine-incontinence-normal-for-women" target="_self" title="Opens in same window.">Mid-urethral sling or urethral bulking procedures</a> for urinary incontinence.</li> <li><a href="/hometown-health/speaking-of-health/nerve-stimulation-to-treat-urinary-incontinence" target="_self" title="Opens in same window.">Sacral neuromodulation</a> therapy for urge incontinence or fecal incontinence. </li> </ul> <p>Many pelvic floor procedures are done vaginally, with no external incisions. This approach may help shorten recovery time and decrease restrictions following the procedure.</p> <p>In the short term, most people will have minor restrictions for up to six weeks or less and can return to normal activities within a few weeks. Talk with your health care team about your healing time, including sexual activity.</p> <p>For long-term success managing pelvic health, consider lifestyle changes to maintain a healthy weight and activity level.</p> <h2>Next steps:</h2> <ul> <li>Watch a video about <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://youtu.be/cPHJ_PT1eP4" target="_blank" title="Opens in a new window.">pelvic organ prolapse</a>.</li> <li>Read about <a href="/hometown-health/speaking-of-health/pregnancy-and-pelvic-floor-health" target="_self" title="Opens in same window.">pregnancy and pelvic health</a>.</li> <li>Learn how <a href="/hometown-health/speaking-of-health/strengthening-pelvic-floor-muscles-can-help-prevent-bladder-leakage" target="_self" title="Opens in same window.">strengthening pelvic floor muscles</a> can help prevent bladder leakage. </li> <li>Find <a href="/topics/pelvic-health" target="_self" title="Opens in same window.">pelvic health services</a> and treatments near you. </li> </ul> <em><a href="/providers/gokhan-anil-md" target="_self" title="Opens in same window."><em>Gokhan Anil, M.D.</em></a>, is an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em><ul> <li>Advanced laparoscopy and robotic surgery </li> <li>Fecal incontinence</li> <li>Minimally invasive pelvic surgery</li> <li>Overactive bladder </li> <li>Pelvic organ prolapse </li> <li> Sacral neuromodulation (Interstim) therapy</li> <li>Urinary incontinence</li> <li>Urogynecology</li> <li>Women's health</li> </ul>M.D.<p>I manage a patient-centric, collaborative practice and have a strong desire to heal and inspire hope to my patients. I strongly believe that there is no “doctor” without the “patient,” and I entrust my team to deliver the best care to meet the needs of our patients. </p> <p>In my free time, I love to travel with my family and read. I also enjoy problem solving. </p><p><strong>Medical School</strong></p> <ul> <li>University of Ankara Faculty of Medicine</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>Obstetrics & Gynecology, Baylor College of Medicine</li> <li>Obstetrics & Gynecology, West Virginia University - Charleston Division, Charleston Area Medical Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Obstetrics & Gynecology (ABOG)</li> <li>Female Pelvic Medicine & Reconstructive Surgery</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Obstetrics & Gynecology, Mayo Clinic College of Medicine and Science</li> </ul>Anil<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/gokhan-anil-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=6C4C4DE9D551A107FCA92ACD73B4EA64" alt="Gokhan Anil MD" width="280" height="280" DisableNVelocity="true" /><li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.liebertpub.com/doi/abs/10.1089/gyn.2021.0041" target="_blank" title="Opens in a new window">Intraoperative Genitourinary Injuries During a Hysterectomy: Risks, Management, and Mitigation Strategies</a>, May 2021</li>{0C431270-7870-45F2-83FE-F912E09A9495}Gokhan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14974142Gokhan Anil, M.D.1<img src="/-/media/national-files/images/hometown-health/2023/watering-plant-while-crouching.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C2B2980EE2364AA4B99E9A42994A7F24" alt="Watering plant while crouching" width="660" height="370" DisableNVelocity="true" />Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Dawn Haller6/14/2023Summer increases outdoor time — and the chance of coming in contact with bees and wasps. Stings can range from annoying to life-threatening. Learn how to avoid being stung and what to do if you are.'Bee' prepared for bee and wasp stings<p>Summer's the season for gardening, playing outside, backyard picnics and enjoying the outdoors. It's also the season of stinging insects, such as honeybees and wasps. According to the American College of Allergy, Asthma and Immunology, about 5% of people are allergic to stinging insects.</p> <h2>Reactions to stings</h2> <p>Reactions to stings from honeybees and wasps range in severity from minor to potentially fatal. In most cases, stings only are annoying, and cause a brief, sharp pain, along with slight swelling and redness. Only home treatment is needed to ease the pain.</p> <p>If you're allergic to insect venom, a more severe reaction, called <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/anaphylaxis/symptoms-causes/syc-20351468" target="_blank" title="Opens in a new window.">anaphylaxis</a>, can occur. This requires emergency medical attention.</p> <p>Here's what happens when you're stung and have an allergic reaction: Your immune system reacts to the venom injected by the insect, and triggers your body's release of histamine and other chemicals. This response can cause severe reactions in some cases, such as:</p> <ul> <li>Difficulty breathing</li> <li>Dizziness and nausea</li> <li>Itching and hives throughout the body</li> <li>Swelling of the throat and tongue</li> <li>Stomach cramps and diarrhea</li> <li>Rapid fall in blood pressure, resulting in shock and, possibly, death</li> </ul> <p>If you or someone you're with experiences any of these symptoms, you should immediately seek emergency medical care.</p> <h2>Treating stings</h2> <p>After any sting, remove the stinger as soon as possible. Use your fingernails or tweezers to scrape away the stinger. Don't squeeze the stinger or venom sac, which can cause more venom to be pushed into the sting area. Once the stinger is removed, wash the area with soap and water.</p> <p>If you notice a minor to moderate reaction, such as redness, warmth or swelling around the sting, apply a cold compress and take an over-the-counter oral antihistamine. You also may want to apply hydrocortisone cream or calamine lotion to the area to ease symptoms.</p> <p>Call 911 if you have a more severe reaction to a single sting or multiple stings, even if it's just one or two of the serious symptoms listed above.</p> <h2>Preventing stings</h2> <h3>These tips can reduce your risk of getting stung by honeybees and wasps:</h3> <ul> <li>Take care when drinking sweet beverages outside. Use cups with lids or water bottles with straws. Inspect cans and straws before drinking from them.</li> <li>Tightly cover food containers and trash cans.</li> <li>Clean up dirty dishes and remove food when you're done eating so they don't attract stinging insects.</li> <li>Wear closed-toe shoes when walking outside.</li> <li>Avoid wearing floral-scented perfume and lotions, as well as bright colors or floral prints, which can attract stinging insects.</li> <li>Be careful when mowing the lawn or trimming vegetation, which might disturb a beehive or wasp nest. If you come across a nest or hive, leave it alone.</li> <li>Have hives and nests near your home removed by a professional.</li> <li>If a few bees are flying around you, stay calm and slowly walk away. Swatting at an insect may cause it to sting.</li> <li>If you are stung or if many insects start to fly around, cover your mouth and nose and quickly leave the area. If you can, get into a building or closed vehicle. When a honeybee stings, it releases a chemical that attracts other bees.</li> </ul> <p>If you've experienced an allergic reaction to a honeybee or wasp sting, talk with your primary care provider or an allergy specialist about prevention and treatment options. This could include being prescribed emergency medication, such as an epinephrine auto-injector, to use if stung.</p> <p>Allergy shots may be recommended as a long-term solution. Venom immunotherapy has been found to be 95% effective in preventing future allergic reactions to stinging insects. It increases your tolerance to venom by injecting a small, increasing amount of venom weekly. Over time, your body stops perceiving the venom as a threat and reduces or eliminates your allergic response to it.</p> <p>Be prepared to prevent and treat honeybee and wasp stings as you enjoy outdoor summer activities.</p> <p><a href="/providers/adela-taylor-md" target="_self" title="Opens in same window."><em>Adela Taylor, M.D.</em></a><em>, is an <a href="/services-and-treatments/immunology" target="_self" title="Opens in same window.">allergist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/rice-lake" target="_self" title="Opens in same window.">Rice Lake</a>, Wisconsin.</em></p><ul> <li>Angioedema (welts below the skin)</li> <li>Atopic dermatitis</li> <li>Food allergies</li> <li>Medication allergy</li> <li>Pediatric asthma</li> <li>Urticaria (hives)</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Medical University of Warsaw</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Pediatric and Adolescent Medicine, Mayo Clinic School of Graduate Medical Education</li> <li>Pediatric Allergy and Immunology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Pediatric Allergy and Immunology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Allergy and Immunology, American Board of Allergy and Immunology</li> <li>Diplomate, American Board of Pediatrics</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Allergy, Asthma & Immunology</li> <li>Joint Council of Allergy, Asthma and immunology</li> <li>Wisconsin Medical Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Taylor<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/adela-taylor-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=FF6FA06FF41A37127EEE585DCA8A3F55" alt="Adela Taylor, M.D." width="280" height="280" DisableNVelocity="true" />{94F9636D-A44F-4A1B-BB6B-110B3CA6B06B}Adela<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>11922869Adela Taylor, M.D.1{9D6C5FE2-E6DA-4A63-9DD8-CE124BD4E4B7}<img src="/-/media/national-files/images/hometown-health/2019/bee-pollinating-purple-flower.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E3EEC14B57D8CC62BFC5B11DD960CCB1" alt="Bee pollinating purple flower" width="660" height="370" DisableNVelocity="true" />Allergy and AsthmaOur allergists provide care for your allergies, asthma and conditions that affect the immune system's ability to defend the body against foreign or abnormal cells. The main treatment goal is your satisfaction when your condition is under control and quality of life is improved.Dawn Haller6/9/2023Smoke from wildfires can pose a health risk when ultrafine particles are inhaled deep into the lungs. Monitor air quality, and learn how to protect yourself if you're in an affected area.What to know about breathing issues due to wildfires, smoke<p>Breathing is becoming increasingly difficult for residents across some areas of the U.S. as wildfires continue to spread across large portions of several Canadian provinces, according to news reports.</p> <p>"Because of the upper-level winds in the areas involved, exposure to wildfire smoke can even occur if a person is located several hundred miles away from the actual fire," says <a rel="noopener" href="https://www.mayoclinic.org/biographies/cowl-clayton-t-m-d-m-s/bio-20053299" target="_blank" title="Opens in a new window.">Clayton Cowl, M.D.</a>, a Mayo Clinic pulmonologist and clinical toxicologist.</p> <h2>Ultrafine particles pose health risk</h2> <p>Although wildfire smoke contains some respiratory irritants, such as particulate matter, hydrocarbons and other organic chemicals, Dr. Cowl says the most significant health risk is from ultrafine particles that can be inhaled deep into the lungs.</p> <p>He adds that, unfortunately, using a standard paper dust mask, while probably better than nothing, does not fully protect the respiratory tract from most particulate matter that becomes airborne. The <a rel="noopener" href="https://www.cdc.gov/wildfires/risk-factors/" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention advises</a> that an N95 mask may offer some protection if worn properly.</p> <p>These particles can create nasal congestion and cause eyes to sting and burn. Still, they also can aggravate the respiratory status of people with chronic heart and lung disease — who are at the most significant risk for inhaling these particulates.</p> <p>"The most vulnerable populations include the elderly, children, pregnant women, and those with chronic lung or heart disease," says <a rel="noopener" href="https://www.mayoclinic.org/biographies/bhasin-arveen-k-m-d/bio-20055626" target="_blank" title="Opens in a new window.">Arveen Bhasin, M.D.</a>, a Mayo Clinic allergist. "Common symptoms include coughing, wheezing, trouble breathing, chest pain, irritated eyes, sneezing and scratchy throat."</p> <h2>Airborne chemicals released during wildfires</h2> <p>All types of smoke inhalation, from cigarettes to <a href="/hometown-health/speaking-of-health/ouch-ive-burned-my-hand" target="_self" title="Opens in same window.">campfires</a>, have a common denominator, according to Dr. Cowl: You are breathing in air from combustible products. He says the wildfires consume vegetation, homes, and building structures with plastics and other products that release thousands of airborne chemicals.</p> <p>"Some of those chemicals are extremely toxic, such as nitrogen oxides, carbon monoxide and chlorine-based compounds," says Dr. Cowl. "Most of what can be seen with the human eye involves larger particles that can cause upper respiratory tract irritation. Our respiratory system is equipped to filter much of this, but for those with compromising pulmonary conditions, these exposures may exacerbate their symptoms."</p> <h2>Ways to protect yourself from poor air quality</h2> <p>Dr. Bhasin recommends that people stay indoors, keeping windows and doors closed at home and in the car.</p> <p>"Run the air conditioner to recirculate <a href="/hometown-health/speaking-of-health/cleaner-air-layer-of-protection-from-covid-19" target="_self" title="Opens in same window.">clean air</a>, and avoid <a href="/hometown-health/speaking-of-health/a-smokers-guide-to-quitting" target="_self" title="Opens in same window.">cigarette</a> smoke or <a href="/hometown-health/speaking-of-health/a-doctors-warning-about-the-dangers-of-vaping" target="_self" title="Opens in same window.">vaping</a>," says Dr. Bhasin. "Do not burn anything in the home, including wood, gas stoves or candles."</p> <p>Dr. Cowl agrees and says air purifiers can be considered, as can personal respiratory protection. He says the best type of air purifier is one with a high-efficiency particulate air filter. "Use of ozone or ionic air purifiers are not typically suggested for protection from wildfire smoke since they provide minimal protection from the very small particles released, referred to as ultrafine particles of less than 0.3 microns in diameter," says Dr. Cowl.</p> <p>Dr. Bhasin reminds people that taking medications as prescribed and having refills available is essential. Keep an eye on local air quality reports, and if you or someone you know is experiencing symptoms, it's important to seek medical care.</p> <p>"Maintaining adequate oral hydration by <a href="/hometown-health/speaking-of-health/water-essential-to-your-body-video" target="_blank" title="Opens in a new window.">drinking water</a> and other fluids is also important to preserve the function of cilia, the microscopic broomlike cells in the airways that help sweep out particulate contaminants inhaled from the environment," adds Dr. Cowl.</p> <h3>The health effects of breathing in smoke may include:</h3> <ul> <li>Asthma attack</li> <li>Chest pains</li> <li>Coughing</li> <li>Fast heartbeat</li> <li><a href="/hometown-health/speaking-of-health/6-tips-for-headache-relief" target="_self" title="Opens in same window.">Headaches</a></li> <li>Irritated sinuses</li> <li>Runny nose</li> <li>Scratchy throat</li> <li>Stinging eyes</li> <li>Tiredness</li> <li>Trouble breathing normally</li> <li>Wheezing and shortness of breath</li> </ul> <p>See the <a rel="noopener" href="https://www.airnow.gov/" target="_blank" title="Opens in a new window.">U.S. Air Quality Index</a> to view areas currently affected by smoke and fire. Follow local media reports for up-to-date information on your area.</p> <p><em>This article was originally published on the <a rel="noopener" href="https://newsnetwork.mayoclinic.org/discussion/what-to-know-about-breathing-issues-due-to-wildfires-and-smoke/" target="_blank" title="Opens in a new window.">Mayo Clinic News Network</a>.</em></p><img src="/-/media/national-files/images/hometown-health/2023/hazy-orange-scenery.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0D72A8EBD1A83C22B2E2741031AB670A" alt="Hazy orange scenery" width="660" height="370" DisableNVelocity="true" />BreathingMost cases of shortness of breath are due to heart or lung conditions. Your heart and lungs are involved in transporting oxygen to your tissues and removing carbon dioxide, and problems with either of these processes affect your breathing.Dawn Haller6/23/2023Approximately 80% of children who develop a genetic disorder have no family history of the condition. Carrier screening can identify genetic conditions that may be passed on through genes of the parents.Understanding carrier screening for family planning<p>When planning a family, you and your partner may choose to have genetic testing before having children to determine if you have a risk of passing on specific genetic disorders.</p> <p><a href="/hometown-health/speaking-of-health/genetic-testing-and-cardiac-conditions" target="_self" title="Opens in same window.">Genetic testing</a> is available to people who are pregnant or planning a pregnancy. Carrier screening has gained importance in family planning as it helps identify genetic conditions that can be passed on to children.</p> <h2>Based on your family history, or pedigree, a genetic counselor can advise you on:</h2> <ul> <li>Genetic screening to consider, insurance coverage and cost</li> <li>What genetic testing may or may not determine</li> <li>Your potential risk of passing genetic disorders onto your children</li> </ul> <p>People should consider genetic counseling and testing regardless of their <a href="/hometown-health/featured-topic/knowing-and-recording-your-family-health-history" target="_self" title="Opens in same window.">family history</a> of inherited conditions, such as cystic fibrosis, spinal muscular atrophy or muscular dystrophy. Approximately 80% of children who develop a genetic disorder have no family history of the condition.</p> <h2>What is carrier screening?</h2> <p>People receive two copies of each gene in their body: one inherited from the mother and the other from the father. Carrier screening determines if a person carries a nonworking copy of a gene associated with a specific genetic condition.</p> <p>People with one working copy and one nonworking copy of a gene are referred to as a "carrier" for the condition. They typically are not affected by the condition themselves. This is because carriers have one copy of the gene that functions normally, providing them protection against the condition. Most people are carriers of at least one genetic condition, and some are carriers of more than one condition.</p> <h2>Autosomal recessive conditions</h2> <p>Autosomal recessive conditions, like cystic fibrosis, occur when a person inherits two nonworking copies of a gene, one gene from each of the parents who are carriers.</p> <p>If a person is identified as a carrier, their partner, egg donor or sperm donor are offered the same testing to determine if they are carriers of the same conditions. If both partners are carriers of the same condition, there is a 25% chance that their child may inherit two nonworking copies of the gene and be affected by the condition. Approximately 2% to 3% of couples are carriers of the same condition.</p> <p>Although certain genetic conditions may be individually rare, collectively, their prevalence is more significant and accounts for more than 10% of pediatric deaths.</p> <h2>Carrier screening for family planning</h2> <p>While carrier screening can be done when a person is pregnant, it's especially beneficial for preconception planning. Couples are empowered to make informed decisions about <a href="/hometown-health/speaking-of-health/genetic-counseling-for-family-planning" target="_self" title="Opens in same window.">family planning</a>, taking into account their carrier status for specific conditions. Based on the screening findings, some people may opt for alternative reproductive measures, such as in vitro fertilization, or IVF.</p> <p>Carrier testing may look for a single genetic condition based on family history. Expanded carrier screening looks for genes linked to many genetic diseases that are not only based on family history or ethnic background.</p> <p>Carrier screening now is more accessible and affordable than ever before. Couples discussing family planning can ask their care team for a referral to <a href="/services-and-treatments/medical-genetics" target="_self" title="Opens in same window.">genetic counseling</a>. Self-referral for the service also is available. Genetic counseling appointments can be conducted virtually with genetic testing performed through a blood draw or a saliva test.</p> <p>After genetic testing, the genetic counselor explains the results and risks are identified. The information is shared with the patient's primary care provider or OB-GYN.</p> <p>Carrier screening is a valuable tool in family planning, offering couples vital information about their carrier status for up to 500 genetic conditions. It can help people make informed decisions about reproductive options, allows for early intervention and treatment, if necessary, and informs the risk of passing on genetic conditions to their children.</p> <p><em><a href="/providers/rebecca-jirik-cgc" target="_self" title="Opens in same window."><em>Rebecca Jirik</em></a> specializes in <a href="/services-and-treatments/medical-genetics" target="_self" title="Opens in same window.">genetics</a> or inherited diseases.</em></p><ul> <li>Carrier testing</li> <li>Diagnostic testing</li> <li>Genetic testing</li> <li>Oncology genetics</li> <li>Prenatal testing</li> <li>Presymptomatic and predictive testing</li> </ul>CGC <p>I am happy to be a part of the Mayo Clinic Health System team. As a genetic counselor, I assist patients in making informed decisions regarding genetic testing and educate patients about risks for genetic health conditions.</p> <p>In my free time, I enjoy mountain biking, reading, knitting and spending time with my cute Corgi.</p> <p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Biology and Latin American Studies, St. Olaf College</li> <li>Master's degree, Genetic Counseling, Augustana University</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Society of Clinical Oncology</li> <li>National Society of Genetic Counselors</li> <li>Wisconsin Genetic Counselors Association</li> </ul> Jirik<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/rebecca-jirik-cgc.jpg?h=280&iar=0&w=280&sc_lang=en&hash=AD40FABC73C9EF6FB036CB8A70BB2CFA" alt="Rebecca Jirik, CGC" width="280" height="280" DisableNVelocity="true" /> {989E41E3-AE44-4BDF-9B20-3F9188FCB4E2}Rebecca <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30174601Rebecca Jirik, CGC 1{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}|{546684F5-41C6-4BEA-AD6B-DE3D7D6451C1}<img src="/-/media/national-files/images/hometown-health/2023/hiking-couple-with-dog.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3CB14F6531E5DED6109685065B3F2D18" alt="Hiking couple with dog" width="660" height="370" DisableNVelocity="true" />Genetic TestingGenetic testing examines your DNA — the chemical database that carries instructions for your body's functions — to reveal changes or alterations in your genes that may cause illness or disease. <br/><br/>Dawn Haller6/2/2023Celery often is relegated to veggie trays and brown-bag lunches. But it's also a key ingredient in dishes around the world. Discover the good things celery has to offer, and get two recipes to try.Celery: Not just for veggie trays<p>Celery often is relegated to veggie trays where its built-in scoop makes it ideal for dipping. It's also used to add extra crunch to holiday stuffing, or tuna or chicken salad. But celery offers far more.</p> <h2>Low in calories, rich in nutrients</h2> <p>Celery is a nutrient-rich, low-calorie food. Two stalks of celery contain only 15 calories. Aside from its low calorie count, celery contains dietary fiber, vitamin K, and small amounts of vitamins A and C, calcium and iron. Although celery also contains some natural sodium, it’s still considered a low-sodium food. Celery also has antioxidant properties, which may help reduce the risk of some chronic conditions. Made up of almost 95% water, celery is a great snack to have on hand during warm summer months to help maintain hydration.</p> <h2>Pick of the crop</h2> <p>Choose celery with crisp, firm and bright stalks in tightly formed bunches. If the leaves are attached, they should be fresh and green. Avoid celery that is soft, dry, yellowing or has brown patches. Refrigerate celery in a plastic bag for a week or more. Trim the base, and wash the stalks only when you’re ready to use them. You may want to peel or pull away any tough outer strings on the celery before cooking it or eating it raw.</p> <p>Don’t confuse celery with celeriac, which is the root variety of celery. Celeriac can be prepared and enjoyed like other root vegetables, such as potatoes and parsnips.</p> <h2>Delicious in dishes and snacks</h2> <p>Celery is an essential ingredient in cuisines from around the world. For example, mirepoix — pronounced meer-PWAH — is an aromatic base of carrots, celery and onions, which is a staple in French soups and stews. Celery also is one of the holy trinity of vegetables, along with peppers and onions, found in traditional Cajun dishes, such as gumbo and jambalaya.</p> <p>Celery can enhance flavors and add texture to dishes, such as salads, soups and stews. Celery pairs perfectly with dips or hummus for an easy snack. Stuff the channels in celery sticks with peanut or other nut butters and dot with raisins. Or fill the channels with a combination of softened cream cheese, chopped walnuts, dried apricots and dates.</p> <h3>Try celery as a side dish or in a summery main dish with these recipes:</h3> <h4>Braised Celery with Herbs</h4> <p>By <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://fruitsandveggies.org/" target="_blank" title="Opens in a new window.">Produce for Better Health Foundation</a></p> <p>Serves 6</p> <p>4 1/2 cups celery, sliced (about 1 small bunch)<br /> 2 1/2 cups reduced-sodium canned chicken broth<br /> 1/2 cup chopped onion<br /> 1 tablespoon chopped parsley<br /> 2 teaspoons dried thyme, crushed<br /> 1 teaspoon dried rosemary, crushed<br /> 1/4 teaspoon black pepper<br /> 1/4 teaspoon salt<br /> 3/4 teaspoon butter<br /> 2 teaspoons chopped herbs, such as parsley or chives, for garnish</p> <p>Cut celery stalks into diagonal slices about 1/4-inch wide. In large saucepan, bring chicken broth to a rolling boil over high heat, adding chopped onion with herbs and seasonings. Add sliced celery and reduce broth to a simmer. Cook for 4–5 minutes or until just tender; celery should remain slightly crisp. Drain immediately and place in a serving bowl. Toss with butter and additional herbs. Serve hot.</p> <p>Nutrition for 1 serving: 33 calories, 1 gram total fat, 1 milligram cholesterol, 401 milligrams sodium, 6 grams carbohydrates, 2 grams fiber, 2 grams protein.</p> <h4>Shrimp Salad-Stuffed Tomatoes</h4> <p>By Mayo Clinic staff</p> <p>Serves 4</p> <p>1 tablespoon water<br /> 48 extra-small frozen shrimp, thawed (about 1 cup)<br /> 2 tablespoons chopped red onion<br /> 2 medium apples, cored and cubed<br /> 1/4 cup lemon juice<br /> 1/2 cup diced celery<br /> 1 tablespoon chopped parsley<br /> 1 teaspoon dried dill<br /> 4 teaspoons horseradish<br /> 1/2 cup fat-free mayonnaise<br /> Ground black pepper, to taste<br /> 4 tomatoes, cored</p> <p>In a nonstick frying pan, heat the water over medium heat. Add the shrimp and onion and sauté until the shrimp is opaque and the onions are translucent, 5–7 minutes. Transfer to a bowl, cover and refrigerate until well-chilled.</p> <p>In a small bowl, combine the apples and lemon juice. Toss to coat evenly and set aside. In a large bowl, combine the celery, parsley, dill, horseradish and mayonnaise. Season with black pepper to taste. Stir in the shrimp mixture and the apples. Refrigerate until well-chilled, 45–60 minutes. Just before serving, stuff the shrimp salad into the cored tomatoes. Serve immediately with a whole-grain roll or bagel or low-fat, whole-grain crackers.</p> <p>Nutrition per 1 stuffed tomato: 201 calories, 1 gram total fat, 346 milligrams sodium, 35  grams carbohydrates, 6 milligrams fiber, 13 grams protein.</p> <p><a href="/providers/allyn-wergin-rdn" target="_self" title="Opens in same window."><em>Allie Wergin</em></a><em> is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Bariatric surgery</li> <li>Diabetes management</li> <li>Oncology</li> <li>Weight management</li> </ul>RDN<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, St. Catherine University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration </li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul>Mahowald<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/allyn-wergin-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=74F690ED261F537AA65B66929A3356D1" alt="Allie Mahowald, RDN" width="280" height="280" DisableNVelocity="true" />{9209F8EC-1016-41AA-985F-014D9B877417}Allie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15971546Allyn Mahowald, RDN1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2023/cutting-celery.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1EEBF8A61EB03B99C947917F3C462436" alt="Cutting celery" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller6/15/2023Marijuana is a widely used substance in the U.S. But is it safer than smoking tobacco? Can it cause lung issues or lung cancer? Here's what you need to know.Does smoking marijuana increase lung cancer risk?<p>Marijuana laws are changing rapidly across many states, and <a rel="noopener" href="https://onlinelibrary.wiley.com/doi/10.1111/add.16016" target="_blank" title="Opens in a new window.">researchers</a> have found that legalization increases its use by about 20%. It's a widely used substance and the most commonly used federally illegal drug in the U.S. In 2021, about 52.5 million people <a rel="noopener" href="https://www.cdc.gov/cannabis/data-research/facts-stats/" target="_blank" title="Opens in a new window.">used marijuana</a> in the previous 12 months.</p> <p>With more people smoking marijuana, it's important to consider how it can affect lung health. Here's what you need to know.</p> <h2>Chemicals in marijuana</h2> <p>People may wonder if smoking marijuana is less harmful than smoking cigarettes because cigarettes have more obvious cancer-causing substances. It's important to understand that marijuana isn't chemical-free. It contains a mixture of compounds and chemicals including tar, ammonia, polycyclic aromatic hydrocarbons, carbon monoxide, cyanide, benzene and many others.</p> <p>Some of these chemicals and compounds have been linked to various types of lung diseases, including cancer.</p> <h2>Marijuana and lung cancer</h2> <p>Smoking marijuana may be associated with an increased risk of developing lung cancer. <a rel="noopener" href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2755855" target="_blank" title="Opens in a new window.">Additional research</a> is needed to fully understand the long-term health effects of marijuana smoking and how it affects a person's risk for lung cancer.</p> <p>However, researchers know that marijuana smoke contains many of the same harmful chemicals and compounds found in tobacco smoke. The issue is made more complex because many marijuana users also smoke tobacco, so it can be difficult to determine the cause of diseases they develop. For these reasons, physician researchers believe there still is cause for concern about smoking marijuana and lung health.</p> <p>It's important to note that not all marijuana or tobacco users will develop lung cancer, and many factors, such as genetics and other lifestyle habits, can influence a person's risk.</p> <h2>Marijuana and lung irritants</h2> <p>Irritants in the lungs can cause harm to the delicate lung tissue. These irritants can be dust or pollen, but also chemicals or marijuana smoke. Smoking marijuana can lead to acute bronchospasm, which is a sudden constriction or narrowing of the airways. This can make breathing difficult, and cause coughing, wheezing and shortness of breath.</p> <p>In addition to acute bronchospasm, smoking marijuana can increase the risk of developing chronic bronchitis, a long-term condition that occurs when the airways become inflamed, leading to increased mucus production, coughing and difficulty breathing. This can be a major concern for regular users of marijuana.</p> <p>Smoking marijuana also can weaken the immune system, exposing users to more respiratory infections. Inhaling smoke from burning marijuana can irritate the lining of the lungs, making it easier for bacteria and viruses to cause infections.</p> <h2>Vaping marijuana</h2> <p>Some marijuana users prefer vaping over other methods. Vaping has been marketed as a safer alternative to smoking, but some research has shown that it can still cause harm to your health.</p> <p>Vaping marijuana was tied to a <a rel="noopener" href="https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2762714" target="_blank" title="Opens in a new window.">2019 outbreak</a> of <a rel="noopener" href="https://www.ncbi.nlm.nih.gov/books/NBK560656/#:~:text=According%20to%20the%20CDC%20criteria,possible%20etiology%2C%20such%20as%20infection." target="_blank" title="Opens in a new window.">e-cigarette or vaping product use-associated lung injury</a>, or EVALI. At that time, the Centers for Disease Control and Prevention cautioned people on using vaping projects containing marijuana, especially from informal sources like family, friends or acquaintances, due to EVALI outbreaks.</p> <p>In addition, vaping often is associated with high-potency concentrates of marijuana, which can lead to a higher risk of <a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7757764/" target="_blank" title="Opens in a new window.">mental and physical problems</a>.</p> <p>More research is needed to fully understand the risks associated with vaping marijuana, and it should not be considered a safe alternative to smoking. If you choose to use marijuana, be aware of the potential risks, and consider alternative methods of use that may be safer for your lungs, such as gummies or other edibles.</p> <h3>Get more information on the risks associated with smoking marijuana from these reliable sources:</h3> <ul> <li><a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/medical-marijuana/art-20137855" target="_blank" title="Opens in a new window.">Mayo Clinic</a></li> <li><a rel="noopener" href="https://www.cdc.gov/marijuana/" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention</a></li> <li><a rel="noopener" href="https://nida.nih.gov/research-topics/cannabis-marijuana" target="_blank" title="Opens in a new window.">National Institute on Drug Abuse</a></li> <li><a rel="noopener" href="https://www.lung.org/quit-smoking/smoking-facts/health-effects/marijuana-and-lung-health" target="_blank" title="Opens in a new window.">American Lung Association</a></li> </ul> <p><a href="/providers/aryan-shiari-md" target="_self" title="Opens in same window."><em>Aryan Shiari, M.D.</em></a><em>, is a <a href="/services-and-treatments/pulmonology" target="_self" title="Opens in same window.">pulmonologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Asthma and chronic obstructive lung disease</li> <li>Endobronchial ultrasound (EBUS) bronchoscopy</li> <li>Mechanical ventilation</li> <li>Medical education</li> <li>Pulmonary complications of hematopoietic stem cell transplantation</li> <li>Thoracic oncology, including diagnosis and management of lung nodules, masses and tumors</li> </ul>M.D.<p>My role as a doctor is to help you achieve your health and life goals. That involves knowing all the latest medical practices and presenting them clearly and concisely, without medical jargon. I believe the most crucial part of developing a successful doctor-patient relationship includes active listening, treating you with empathy, and responding honestly to your questions and concerns.</p> <p>As a pulmonologist, I specialize in treating various lung diseases, such as asthma, chronic obstructive pulmonary disease, or COPD, and diagnosing and managing lung nodules. My clinical practice includes outpatient consultative appointments and caring for hospitalized patients with complex lung diseases. I also specialize in critical care medicine, and provide care through diagnosis, treatment and support of critically ill patients.</p> <p>During my free time, I enjoy reading, hiking, game nights with family and friends, and participating in soccer.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Biochemistry, University of Ottawa</li> <li>St. George’s University School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Ascension St. John’s Hospital</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Clinical Educator Track Fellow, Wayne State University School of Medicine</li> <li>Pulmonary and Critical Medicine, Wayne State University School of Medicine</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Internal Medicine, American Board of Internal Medicine</li> <li>Pulmonary Medicine, American Board of Internal Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Chest Physicians</li> <li>American College of Physicians</li> <li>American Medical Association</li> <li>American Thoracic Society</li> <li>Society of Critical Care Medicine</li> </ul>Shiari<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/aryan-shiari-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B71950940132EF33C8799CF05B738808" alt="Aryan Shiari, M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/34468286/" target="_blank" title="Opens in new window">A female with recurrent pleural effusion</a>; September 2021</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/34107323/" target="_blank" title="Opens in new window">Major pulmonary complications following Hematopoietic stem cell transplantation: What the pulmonologist needs to know</a>; August 2021</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/34281915/" target="_blank" title="Opens in new window">Incidence of bleeding in patients on different anticoagulants and antiplatelet therapies undergoing thoracentesis</a>; July 2021</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/33660247/" target="_blank" title="Opens in new window">Miniforceps EBUS-guided lymph node biopsy: impact on diagnostic yield</a>; 2021</li> </ul>Aryan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30111562Aryan Shiari, M.D.1{1A90F4B2-3C68-421C-89C5-AC045A6F8F56}|{1D6651B0-86E1-4FF6-9A93-07B8EE2D26EE}<img src="/-/media/national-files/images/hometown-health/2023/two-people-sitting-outdoors.jpg?h=370&iar=0&w=660&sc_lang=en&hash=AB77422BFBE38116DEE7618C0F5983F4" alt="Two people sitting outdoors" width="660" height="370" DisableNVelocity="true" />PulmonologyTreatment for diseases and conditions affecting lung and airway function.Lung CancerLung cancer is a type of cancer that begins in the lungs. It is the leading cause of cancer deaths in the U.S., among both men and women. Lung cancer claims more lives each year than do colon, prostate, ovarian and breast cancers combined. <br/><br/>BreathingMost cases of shortness of breath are due to heart or lung conditions. Your heart and lungs are involved in transporting oxygen to your tissues and removing carbon dioxide, and problems with either of these processes affect your breathing.Dawn Haller6/16/2023Getting older has benefits, like being eligible for a Medicare Annual Wellness Visit. Find out how this snapshot of your health gives you a personalized prevention care plan for a healthy future.Staying healthy as you age: Medicare Annual Wellness Visits explained<p>Getting older has many advantages. You have the wisdom that comes with experience, plenty of stories to share and are usually more comfortable with who you are. If you have Medicare Part B coverage, another benefit is that you qualify for an Annual Wellness Visit.</p> <p>This visit aims to keep you healthy and give you the tools to have a good quality of life as you age. The Medicare Annual Wellness Visit allows your health care team to review your health status, design a personalized prevention plan and connect you with critical preventive services covered by Medicare Part B.</p> <p>Medicare Annual Wellness Visits create a snapshot of your health and provide a reference point for future visits. This improves the chances that a potentially serious health issue is caught early.</p> <p>It's important to understand that Medicare Annual Wellness Visits differ from a physical exam conducted by your primary care provider.</p> <h2>Here are three major differences between these types of appointments:</h2> <h3>1. Provider seen</h3> <p>A nurse or nurse practitioner typically conducts a Medicare Annual Wellness Visit. In most cases, you will not see your primary doctor or health care provider during this appointment.</p> <p>A physical exam is conducted by your primary care provider, who may be a doctor, nurse practitioner or physician assistant.</p> <h3>2. What's included</h3> <p>A Medicare Annual Wellness Visit is meant to enhance your health and focuses on your well-being through interviews and assessments of your lifestyle factors. You will also be asked to fill out a health risk assessment before your appointment.</p> <h4>During a Medicare Annual Wellness Visit, the nurse will:</h4> <ul> <li>Evaluate your fall risk.</li> <li>Measure your height, weight and blood pressure.</li> <li>Offer referrals to other health education or preventive services.</li> <li>Provide information related to voluntary advance care planning.</li> <li>Screen for cognitive impairments like dementia.</li> <li>Screen for depression.</li> <li>Update your medical and family history.</li> </ul> <p>A physical exam includes an age and gender-appropriate comprehensive head-to-toe checkup. This exam is completed to detect and prevent illnesses or injuries.</p> <h4>During a physical exam, your primary care provider may:</h4> <ul> <li>Check your vital signs.</li> <li>Discuss acute or urgent health issues.</li> <li>Review chronic health conditions.</li> <li>Review your medications.</li> <li>Perform a physical exam.</li> <li>Ask about your activity level, relationships and home environment.</li> </ul> <h3>3. Frequency and cost</h3> <p>A Medicare Annual Wellness Visit can be scheduled after you have Medicare Part B coverage for at least 12 months and each year after that. Subsequent visits must be at least 365 days, or one full year, after your previous year's visit. Medicare offers the Annual Wellness Visit at no cost for those who have Medicare Part B coverage.</p> <p>A physical exam can be scheduled at any time. You or your insurance carrier will be responsible for the cost of this exam. The total will vary based on what tests and services are completed during the visit. Ask your insurance carrier for coverage details.</p> <p>Medicare Annual Wellness Visits and physical exams are best scheduled for the same day, with the wellness visit occurring first. Contact your health care team and ask if you qualify for a Medicare Annual Wellness Visit.</p> <p><a rel="noopener" href="https://www.mayoclinic.org/biographies/stroebel-robert-j-m-d/bio-20054118" target="_blank" title="Opens in a new window."><em>Robert Stroebel, M.D.</em></a><em>, is a Community Internal Medicine, Geriatric and Palliative Care physician at <a rel="noopener" href="https://communityhealth.mayoclinic.org/" target="_blank" title="Opens in a new window.">Mayo Clinic Primary Care</a> in Rochester and Kasson, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2023/swimmer-wearing-swim-cap-in-pool.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4D37FC854E32E0B035D709B2B738F960" alt="Swimmer wearing swim cap in pool" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.AgingLife expectancy is 75 for males and 80 for females according to the National Center for Health Statistics. We'll help you keep you informed about potential issues with aging, and steps you can take to maintain your health and keep active.Dawn Haller6/11/2024People in the LGBTQ+ community may face challenges that affect their health and pregnancies. Regardless of gender or identity, prenatal care is essential for all people who are pregnant.Supporting pregnancy and family-building for LGBTQ+ community<p>According to a recent <a rel="noopener" href="https://news.gallup.com/poll/470708/lgbt-identification-steady.aspx" target="_blank" title="Opens in a new window.">Gallup poll</a>, 8% of millennials — people born between 1981–1996 — and 22.3% of Generation Z — people born between 1997–2004 — identify as <a href="/hometown-health/speaking-of-health/coming-out-as-lgbtq" target="_self" title="Opens in same window.">LGBT</a>, or lesbian, gay, bisexual, transgender or intersex, among other identifiers.</p> <p>People who identify as LGBTQ+ can have healthy pregnancies and babies through multiple paths of conception. However, they may face challenges that affect their health and pregnancies.</p> <p>Pregnancy care most often is focused on the pregnant person. However, not all people who are pregnant identify as women. Their gender identity may be different from their assigned sex at birth. Regardless of gender or identity, <a href="/hometown-health/speaking-of-health/is-virtual-prenatal-care-right-for-you" target="_self" title="Opens in same window.">prenatal care</a> is essential for people who are pregnant.</p> <h2>Care before and during pregnancy</h2> <p>Obstetric care providers ensure that all patients receive comprehensive, compassionate care regardless of their gender identity or sexual orientation. Prepregnancy planning before conception, <a href="/hometown-health/speaking-of-health/genetic-counseling-for-family-planning" target="_self" title="Opens in same window.">genetic counseling</a> or <a href="/hometown-health/speaking-of-health/carrier-screening-for-family-planning" target="_self" title="Opens in same window.">carrier screening</a> can be vital to family-building. Anyone thinking about becoming pregnant should consider those services and any personal health risk factors. Also, anyone considering hormone therapy for gender-affirming care should discuss with their healthcare team whether they want to pursue fertility preservation before starting medication.</p> <p>Open, respectful communication between patients and their care team creates an environment that fosters trust and inclusivity, including using gender-neutral or gender-affirming pronouns. People should <a href="/hometown-health/speaking-of-health/lgbtq-health-easing-fear-of-seeking-care" target="_self" title="Opens in same window.">find a care team</a> with whom they feel comfortable having honest, proactive conversations about any concerns, including prior obstetric or pregnancy experiences, trauma, <a href="/hometown-health/speaking-of-health/speak-out-about-abuse-or-assault" target="_self" title="Opens in same window.">abuse</a> or chronic health conditions.</p> <p>Each pregnancy, labor and delivery is unique, and focusing on healthy outcomes for the pregnant person and baby can decrease anxiety and worry.</p> <h2>Focus on support and well-being</h2> <p>Support during pregnancy is a priority, regardless of relationship type or status. A strong <a href="/hometown-health/speaking-of-health/preparing-for-a-baby-together" target="_self" title="Opens in same window.">support system</a> can include a partner, family or friends. It's crucial to care for the mental health of a person who is pregnant during pregnancy and the postpartum period.</p> <p>Studies show that rates of postpartum depression tend to be higher in LGBTQ+ families. LGBTQ+ adults have a <a rel="noopener" href="https://www.health.state.mn.us/people/womeninfants/pmad/lgbtq.html" target="_blank" title="Opens in a new window.">higher likelihood</a> of experiencing a mental health condition than heterosexual adults. Risk factors for postpartum and anxiety disorders can be related to pregnancy, infant loss or preterm delivery.</p> <p>Mental health screening can identify depression symptoms during pregnancy and the postpartum period. While there's a tendency to focus on a person's physical health during pregnancy, it's imperative to continually evaluate their emotional health during obstetric care. People shouldn't hesitate to discuss their feelings or <a href="/hometown-health/speaking-of-health/too-embarrassed-to-ask-i-just-had-a-baby-whats-wrong-with-my-moods" target="_self" title="Opens in same window.">changes in mood</a> during pregnancy with their care team.</p> <p>An obstetrics professional can discuss and recommend mental health treatment options that are safe during pregnancy.</p> <h2>Creating an inclusive care environment</h2> <p>Inclusive obstetric care for LGBTQ+ people is a vital part of delivering equitable and compassionate healthcare. From prepregnancy planning and prenatal care to labor and delivery, care teams should support and respect everyone, meeting patients where they are, regardless of their sexual orientation, gender identity or family composition. </p> <p>Ongoing efforts and education strive to create an inclusive environment where everyone receives the care and support they need. Open conversations between patients and their care teams help those teams provide quality care, mental health support and address reproductive concerns so all people feel respected throughout their pregnancies and family-building journeys. </p> <em><a href="/providers/sara-robinson-md" target="_self" title="Opens in same window.">Sara Robinson, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em><ul> <li>Behavioral health</li> <li>LGBTQ+ health</li> <li>Preventive health</li> <li>Women's and children's health</li> </ul>M.D.<p>I am a resident in the Mayo Clinic Family Medicine Residency Program and see patients in our clinics in Mankato.</p> <p>My favorite thing in the world is spending time with family and friends. I also love reading, and I have always been a huge fan of musical theater. I enjoy swimming, being outside and Zumba. I am currently learning how to play the banjo.</p><p><strong>Medical School</strong></p> <ul> <li>Central Michigan University College of Medicine</li> </ul>Robinson<img src="/-/media/shared-files/images/medical-professionals/full/mankato/sara-robinson-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=8982B94E8AB7A99FDBD6C494194C6461" alt="Sara Robinson, M.D." width="280" height="280" DisableNVelocity="true" />Sara<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30031049Sara Robinson, M.D.1{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{986C767E-E5DE-43F5-957F-B4212DB8E384}|{61776FD2-05E8-47E9-AB55-EE465BD29A19}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}<img src="/-/media/national-files/images/hometown-health/2024/partners-hands-on-pregnant-belly.jpg?h=370&iar=0&w=660&sc_lang=en&hash=FE83B21AC11B55D91C9B876E92C004E1" alt="Partners hands on pregnant belly" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Prenatal CareOB-GYN and Family Medicine providers offer exactly the care you need for starting or growing your family, including pregnancy planning and prenatal care.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller6/12/2023Substance abuse poses unique challenges for the LGBTQ+ community, with higher rates of substance misuse and addiction. Learn how tailored treatment can help, and get tips for finding an inclusive support group.Tailoring substance use recovery for LGBTQ+ people<p>People in the LGBTQ+ community may face specific health concerns, including a higher risk of substance misuse than people who identify as heterosexual. </p> <p>According to the National Institutes of Health, LGBTQ+ people are more than twice as likely to use marijuana, opioids and alcohol than the overall adult population. They have a greater risk of suffering from a substance use disorder, also called alcohol abuse or drug addiction.</p> <h2>Substance use disorder</h2> <p>A substance use disorder is a disease that affects the person's brain and behavior, leading to the inability to control the use of the preferred legal or illegal substance. Often, the substance use starts as an experiment in a social setting and a way to escape reality.</p> <p>For some people, drug and alcohol use becomes more frequent over time and progresses to a point where larger doses are needed and it's increasingly difficult for them to go without it. This can lead to problems at school or work, money issues and changes in their behavior or physical appearance.</p> <h2>Contributing factors</h2> <p>People of any age, economic status or sexual orientation can develop a substance use disorder, but LGBTQ+ people have an increased risk. There are many factors that may influence this, including the challenges they face with social isolation, discrimination, harassment, lack of support and social stigma. The pressure and fear surrounding their sexual orientation, particularly if they haven't come out to their family or friends, can lead to feelings of shame and guilt.</p> <p>LGBTQ+ people have a higher risk for <a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/adult-health/basics/lgbtq-health/hlv-20049421" target="_blank" title="Opens in a new window.">anxiety, stress and depression</a> as well. These conditions often occur together and can stem from the challenges and discrimination this community faces. These conditions also can increase a person's risk for substance use disorder.</p> <p>For many people, misusing substances becomes a way to numb negative emotions and offers a temporary escape from daily stress and challenges. They rely on substances as a primary coping mechanism, mainly because they don't have other healthier options. However, this can create a cycle where substance use worsens mental health symptoms, leading to an increased desire to numb feelings and perpetuating the reliance on substances.</p> <h2>Commonly used substances</h2> <p>Alcohol, marijuana, opioids and methamphetamine are commonly used by LGBTQ+ adults. In 2020, 21.8% had an alcohol use disorder, 41.3% used marijuana and 6.7% misused opioids, according to the National Institutes of Health. Comparatively, heterosexual people had lower reported rates of 11% for alcohol use disorder, 18.7% for marijuana use and 3.6% for opioid misuse.</p> <p>Methamphetamine has become a popular "party drug" and often is used with other substances. Opioid use is growing as well, including using painkillers like fentanyl and Percocet.</p> <p>People may use one substance exclusively or combine them. The type of substances they use varies based on what's available in each person's community and through their social networks.</p> <p>Typically, substance use is higher in young people and gradually declines with age, regardless of sexual orientation. Younger people tend to progress with substance use more rapidly, while the progression for older people is slower.</p> <p>Substance use rates for LGBTQ+ people may be higher in the early stages of self-discovery but decrease as they develop stronger support networks and experience social acceptance and increased comfort with their sexual identities. It's crucial to recognize substance use patterns early and provide appropriate, timely support.</p> <h2>Tailored treatment plans</h2> <p>Treating substance use doesn't take a one-size-fits-all approach. While all plans include agreed-upon goals, scheduling details and relapse-prevention strategies, other components are customized for each patient regardless of sexual orientation. Some plans focus more on addressing mental health while others build on environmental or social factors.</p> <p>A counselor can help identify substance use support group options. This can be an important step toward recovery and maintaining sobriety. In-person groups are effective, but not practical for everyone, so now there are many virtual options. These can be especially helpful for people who live in rural areas, have transportation challenges or have difficult schedules.</p> <p>Finding the right support group can take some time.</p> <h3>Here are some tips for LGBTQ+ people looking for an inclusive and accepting substance use support group:</h3> <ul> <li><strong>Consider your personal preferences.</strong><br /> Support groups are available in many sizes, compositions and settings. Spend time thinking about what would be best for you. For example, some people prefer larger group sessions that allow them to listen quietly and not talk. Others want smaller groups that allow for more intimate discussions. Do you want a same-sex or mixed group? Virtual or in-person? Exploring multiple options can increase your chances of finding a supportive community that meets your needs.</li> <li><strong>Look for a specialized group.</strong> <p>There are many support groups that cater to specific needs or circumstances. In addition to groups tailored for LGBTQ+ people, there are options for veterans, specific religious beliefs, substance type, people with dual diagnoses and for family members. </p> </li> <li><strong>Ask for recommendations.</strong><br /> Peer support can be crucial in recovery. Connect with LGBTQ+ people who have experience with support groups or are in recovery themselves. They can provide firsthand recommendations and insights based on their own journeys. You can also ask your counselor for recommendations. </li> <li><strong>Give it a chance.</strong><br /> Attend several meetings to get a sense of the atmosphere, group dynamics and the support offered. Pay attention to how members interact, the level of participation and if the group provides a safe and welcoming environment.</li> </ul> <p>While substance use is higher among LGBTQ+ populations, there's reason for hope. Sobriety and recovery are possible, and many addiction treatment programs are committed to providing individualized care in inclusive and supportive environments for all people.</p> <p>Talk with your health care team if you're concerned with your substance use. They can help guide you to sobriety and recovery.</p> <p><a href="/providers/holly-louwagie-ladc" target="_self" title="Opens in same window.">Holly Louwagie</a> is a Fountain Centers <a href="/services-and-treatments/addiction-treatment" target="_self" title="Opens in same window.">alcohol and drug counselor</a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a>, <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, <a href="/locations/fairmont" target="_self" title="Opens in same window.">Fairmont</a>, <a href="/locations/faribault" target="_self" title="Opens in same window.">Faribault</a>, <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a> and <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</p>L.A.D.C.<p>I have worked in the chemical dependency/substance use field for over 10 years and have been providing chemical use assessments the entire time. </p> <p>I believe fully in meeting you where you're at to give you the best care possible. I believe individualized treatment is best practice and strive to help you reach your full potential in your recovery journey.</p> <p>In my spare time, I enjoy spending time with my family and supporting my kids at all their sporting events. Something I enjoy for myself is running. I have run a marathon, along with many other races such as half marathons, 10Ks and 5Ks. I have even won a few races!</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Justice Administration, Southwest Minnesota State University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Alcohol and Drug Counselor, Ridgewater College</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Secretary/Treasurer, Minnesota Certification Board</li> <li>Team Member, Southwest Community Treatment Court</li> </ul>Louwagie<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/holly-louwagie-ladc.jpg?h=280&iar=0&w=280&sc_lang=en&hash=50EFF66192483FC9675C8BB51AC8213A" alt="Holly Louwagie, L.A.D.C." width="280" height="280" DisableNVelocity="true" />Holly<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30219570Holly Louwagie, L.A.D.C.1{67744200-E25F-439A-8B70-572A5A091172}<img src="/-/media/national-files/images/hometown-health/2023/holding-hands-close-up.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7263CA9483D7A6BF62B322359A5DB3A5" alt="Holding hands close-up" width="660" height="370" title="Holding hands close-up" DisableNVelocity="true" />Substance AbuseInformation for helping those with alcohol and other drug abuse concerns.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller6/13/2023PTSD is a common, natural reaction to a traumatic event. Explore key aspects of diagnosis, and how treatment can help people control mental and physical reactions, and regain their lives.From nightmare to recovery: Unraveling the mysteries of PTSD<p>Waking up screaming from a nightmare, ducking for cover after a loud noise or having all-consuming thoughts of guilt or fear. These and other dramatic symptoms often are shown as depictions of post-traumatic stress disorder in movies or TV shows. Some portrayals are accurate while others are far-fetched.</p> <p>Post-traumatic stress disorder, also called PTSD, doesn't just happen to characters on the screen. It's a normal, natural response to trauma and happens when the nervous system, which is designed to protect you from danger, gets stuck in the fight or flight response.</p> <p>People may develop post-traumatic stress disorder when they go through, see or learn about an event involving actual harm, threatened death or serious injury; or have another shocking experience. </p> <h2>Common events that cause PTSD symptoms include:</h2> <ul> <li>Accidents</li> <li>Being threatened with a weapon</li> <li>Combat exposure</li> <li>Life-threatening medical diagnosis or treatment</li> <li>Natural disaster</li> <li>Physical, emotional, verbal, mental or sexual abuse or violence</li> </ul> <p>The good news is that PTSD is treatable, and many people manage it well or recover from their symptoms. Here's what you need to know about this condition.</p> <h2>Protective factors</h2> <p>Not everyone who experiences or witnesses a traumatic event will develop PTSD. It's unclear why some people develop PTSD while others do not, but the cause is likely a mix of trauma and personal protective factors.</p> <p>Protective factors are crucial elements that contribute to a person's ability to cope with and recover from trauma. Some examples include support, validation, their current feeling of safety, and whether they have existing coping strategies or can learn them. Having protective factors may help people be less likely to develop debilitating PTSD after a traumatic event or allow them to heal better after a traumatic experience.</p> <h2>PTSD symptoms</h2> <p><strong> </strong></p> <p>Some people experience distressing symptoms for a short time after a traumatic event but get better with time and self-care. For others, the symptoms worsen over time and begin to interfere with daily activities.</p> <h3><strong>PTSD symptoms usually are grouped into four categories:</strong></h3> <ul> <li><strong>Intrusive thoughts<br /> </strong>Recurrent and unwanted memories of the traumatic event can cause significant emotional distress or physical reactions. The person may experience nightmares or flashbacks, which is reliving the traumatic event again.</li> <li><strong>Avoidance</strong><br /> People with PTSD may avoid talking about the event or steer clear of places, activities or people that remind them of the event.</li> <li><strong>Mood and thought disturbances</strong><br /> This category of PTSD symptoms can mirror depression, with people experiencing hopelessness, negative thoughts about themselves or others, detachment from loved ones, lack of interest in activities, emotional numbness and relationship difficulties.</li> <li><strong>Reactivity</strong><br /> These symptoms may include being easily startled, always on guard for danger and overwhelming feelings of guilt or shame. The person may be irritable or have angry outbursts. They could have trouble sleeping or concentrating and engage in self-destructive behaviors like drinking too much or taking illicit drugs.</li> </ul> <h2>PTSD diagnosis</h2> <p>A thorough examination by a mental health professional is necessary to diagnose PTSD. Often, the counselor will review the person's past for potentially traumatic events or experiences. Then, the counselor will assess symptoms that fall into the four categories outlined above. Each category requires confirmation of specific criteria for an official PTSD diagnosis.</p> <p>It's important to note that some people may have a few PTSD symptoms but not enough for an official diagnosis of the condition. In these cases, treatment can still be helpful and can guide people toward self-care strategies and coping mechanisms.</p> <h2>Recovery spectrum</h2> <p>Many people are able to achieve remission or experience a decrease of their PTSD symptoms to a manageable level after treatment. Some protective factors are especially helpful during recovery, including having positive social support, using existing or new coping strategies, and developing an awareness of what PTSD is and how to heal.</p> <p>PTSD treatment involves addressing both the physical and mental aspects of the condition. Treatment plans developed by a health care professional are tailored to meet the needs of each person.</p> <p>Certain treatments calm the nervous system and help people regain control over their physical responses to triggers. These tactics help the person having an automatic physical response tell their body that a perceived threat isn't accurate. Examples include grounding techniques, breath awareness and body-focused interventions. For example, short and shallow breaths can be signs of the nervous system reacting to a trigger. Through treatment, people can identify this reaction and learn to take slow, breaths which can calm the physical reactions.</p> <h3>Common PTSD treatments include:</h3> <ul> <li><strong>Cognitive processing therapy<br /> </strong>An important part of treatment is identifying and challenging negative thoughts and beliefs related to the traumatic event. Cognitive processing therapy helps people with PTSD distinguish between feelings and facts, and develop a more accurate understanding of their experiences, negative beliefs and self-perceptions.</li> <li><strong>Exposure therapy</strong><br /> This therapy helps people safely experience frightening situations and memories in incremental steps so that their nervous system can realize that situation is not an actual threat.</li> <li><strong>Eye movement desensitization and reprocessing<br /> </strong>Also, called EMDR therapy, this treatment helps with accessing traumatic memories in small, targeted ways with bilateral stimulation. This could be eye movement from side to side, like people do when dreaming and processing images. Other stimulations that could be incorporated include bilateral movements like tapping of hands and bilateral sounds with the use of headphones. These help the person associate the memories with new and accurate information about the trauma. This allows the person to complete the processing of that memory in an accurate way. It can help the person to feel less distress and develop accurate insights about the memories.</li> <li><strong>Medications<br /> </strong>In addition to other therapies, medications may be helpful for people struggling with severe PTSD symptoms. Antidepressants and anti-anxiety drugs may help people in combination with other treatment options. Medications alone are not comprehensive solutions and should be evaluated carefully.</li> </ul> <p>Each person's reaction to a traumatic event is valid, and one person's trauma can't be compared to another's as "better" or "worse." It's normal if one person's reaction and symptoms are different from others in a similar situation. PTSD isn't a sign of weakness, and a person shouldn't be expected to just "get over it." It takes great courage to manage these symptoms.</p> <p>PTSD is a normal response to traumatic events and appreciating this can help ease self-blame or misconceptions. With a combination of interventions, people can learn to manage their symptoms, challenge negative thoughts, regulate their physical responses and regain control over their lives. Talk with your health care team about your symptoms.</p> <p><a href="/providers/jackie-richter-lpc" target="_self" title="Opens in same window."><em>Jackie Richter</em></a><em> is a licensed professional counselor in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>General mental health</li> <li>Healing for families/partners of those with sexual addictions, PTSD and trauma recovery</li> <li>Sex addiction</li> <li>Substance addictions</li> </ul>L.P.C.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Psychology, University of Wisconsin-Platteville</li> <li>Master's degree, Mental Health Counseling, Capella University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Certified Sex Addiction Therapist</li> <li>Clinical Substance Abuse Counselor, Wisconsin</li> <li>Licensed Professional Counselor, Wisconsin</li> </ul>Richter<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/jackie-richtermoser-ms-sac.jpg?h=280&iar=0&w=280&sc_lang=en&hash=85FC185F22EBB2B15BB97691F380B26B" alt="Jackie RichterMoser MS SAC" width="280" height="280" DisableNVelocity="true" />Jackie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15801209Jackie Richter, L.P.C.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2023/mixing-paint-colors-on-palette.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BE45929382893D719DD59EB68FC6F9F7" alt="Mixing paint colors on palette" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller6/7/2023Millions of U.S. adults have obstructive sleep apnea. If you struggle with your CPAP setup, upper airway stimulation therapy may be a good option. Ditch the tubes, mask and loud machine for good.Treating sleep apnea made easier: Upper airway stimulation therapy<p>A restful night's sleep is more than just rejuvenating, it improves your health, memory and mood. Yet for millions of U.S. adults, restful sleep is elusive because they have obstructive sleep apnea.</p> <p>Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops partially or completely. These events can result in low oxygen levels and cause frequent episodes of waking. Obstructive sleep apnea is the most common form of sleep apnea, and occurs when the throat muscles relax and block the airway during sleep. About 18 million U.S. adults have moderate to severe obstructive sleep apnea.</p> <p>The most common treatment for obstructive sleep apnea is called continuous positive airway pressure, or CPAP. The person with sleep apnea wears a mask while sleeping that uses a continuous stream of air pumped by a machine to keep the upper airway open.</p> <p>Some people find the mask and associated machine cumbersome, uncomfortable or loud; feel that it interrupts their partners' sleep; or say the machines are difficult to clean properly. A study of CPAP users found that 34% stopped using the machine. Common problems were difficulty tolerating the air pressure, poor mask fit, dry mouth and feelings of claustrophobia. People also have difficulty sticking to their CPAP therapy. Another study showed that 46% of patients with sleep apnea had stopped treatment by three years after diagnosis.</p> <p>There is good news. Upper airway stimulation therapy using a hypoglossal nerve stimulator is an option for people who are unable to tolerate their CPAPs. It's been approved by the Food and Drug Administration for the treatment of obstructive sleep apnea.</p> <h2>Placing the device</h2> <p>The treatment involves implanting a small device under the skin in the upper chest during a short outpatient procedure. While monitoring breathing while you sleep, the device delivers mild stimulation when the user turns it on with a remote control. This helps keep your upper airway open and reduces breathing pauses that occur with sleep apnea. </p> <img alt="Nerve stimulator illustration" src="/-/media/national-files/images/hometown-health/2023/nerve-stimulator-illustration.jpg?h=287&w=400&sc_lang=en&hash=CAC7307ECCDAC63CAF398FF6228D81C7" width="400" height="287" /> <p>The device is placed during a same-day procedure at the hospital.</p> <h3>It's inserted using two small incisions:</h3> <ul> <li>Under the chin to place a small cuff on the nerve that controls the tongue</li> <li>In the upper chest to place the device and the sensing lead</li> </ul> <h2>How it works</h2> <p>Using upper airway stimulation therapy is easy. When it's time for sleep, you press the button on the remote to activate the device. While sleeping, the device opens your airway to allow for normal breathing and a peaceful night's rest. It's usually set for a specific length of time based on your usual sleep pattern, then automatically turns off.</p> <p>The results of upper airway stimulation therapy are good. One study showed a decrease in apnea-hypopnea index, or AHI, from 29 to nine events per hour at the 12-month follow-up. AHI is the average number of breathing pauses per hour. The typical value is less than five.</p> <p>Hours of usage also are significantly higher when compared to CPAP therapy. The overall complication rates are low, with fewer than 0.5% of patients experiencing severe complications after the implant.</p> <h2>Candidates for upper airway stimulation therapy</h2> <p>Upper airway stimulation therapy is a safe, effective option for many people with obstructive sleep apnea; however, it's not appropriate for everyone.</p> <h3>You must meet these criteria to be considered for this therapy:</h3> <ul> <li>Age 18 or older, or 13 or older with Down syndrome and sleep apnea</li> <li>Failure or intolerance of CPAP therapy</li> <li>Body mass index less than 35, or 32 in some cases</li> <li>Apnea-hypopnea index between 15 and 65</li> <li>Completed sleep study within the last two years</li> <li>Less than 25% central and mixed apneas</li> <li>Appropriate airway anatomy assessed by endoscopy prior to the implant</li> </ul> <p>Additional testing may be necessary to confirm your eligibility.</p> <h2>Treatment benefits</h2> <p>Getting consistent quality sleep improves your overall health and well-being in many ways. Untreated sleep apnea can cause various problems, including excessive daytime sleepiness that may lead to accidents, memory problems, and an increased risk of heart attacks and heart rhythm problems.</p> <h3>Benefits of upper airway stimulation therapy include:</h3> <ul> <li>Staying awake during the day</li> <li>Protecting memory function</li> <li>Being more productive</li> <li>Eliminating additional equipment and tubing that requires sanitizing and maintenance</li> <li>Doing away with a mask while sleeping</li> <li>Eliminating noise and possible interruption of your partner's sleep</li> </ul> <p> Talk with your health care team about your symptoms, and ask if you could benefit from upper airway stimulation.</p> <p><a href="/providers/christopher-williams-md" target="_self" title="Opens in same window."><em>Christopher Williams, M.D.</em></a><em>, is a <a href="/services-and-treatments/pulmonology" target="_self" title="Opens in same window.">pulmonologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Acute respiratory distress syndrome</li> <li><a href="/locations/eau-claire/services-and-treatments/pulmonology/alternative-cpap-therapy" target="_self" title="Opens in same window.">Alternative CPAP therapy</a></li> <li>Chronic obstructive pulmonary disease (COPD)</li> <li>Chronic respiratory failure</li> <li>Intensive care</li> <li>Narcolepsy</li> <li>Obstructive sleep apnea</li> <li>Pulmonary embolism</li> <li>Sleep medicine</li> </ul>M.D.<p>I believe in treating the patient as a whole and not just a specific disease. I like spending quality time with my patients and helping them understand their disease process. I want to walk with them through their journey of recovery. I am honored and excited to be a part of Mayo Clinic Health System.</p> <p>In my free time, I enjoy fountain pen collecting, reading and working out.</p><p><strong>Medical School</strong></p> <ul> <li>Vinayaka Mission's Medical College</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, St. Barnabas Hospital</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Pulmonary/Critical Care, University of South Alabama Medical Center</li> <li>Sleep Medicine, Yale University School of Medicine</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Critical Care Medicine, American Board of Internal Medicine</li> <li>Internal Medicine, American Board of Internal Medicine</li> <li>Pulmonary Disease, American Board of Internal Medicine</li> <li>Sleep Medicine, American Board of Sleep Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Chest Physicians</li> <li>American Society of Sleep Medicine</li> <li>American Thoracic Society</li> <li>Wisconsin Medical Society</li> </ul>Williams<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/christopher-williams-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=40FC28730938B55F51EAB0AD4C2F2B3F" alt="Christopher Williams, M.D." width="280" height="280" DisableNVelocity="true" />{4A1FA153-D77E-46DD-9393-052D7317398E}Christopher<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20893931Christopher Williams, M.D.1{1D6651B0-86E1-4FF6-9A93-07B8EE2D26EE}|{1A90F4B2-3C68-421C-89C5-AC045A6F8F56}|{B98A8ABA-9382-4804-A585-EA5B53B1D179}<img src="/-/media/national-files/images/hometown-health/2023/using-outdoor-exercise-equip.jpg?h=370&iar=0&w=660&sc_lang=en&hash=824ECD5DF62B9DE0BDB01BACD0790BE6" alt="Person with yellow shirt using outdoor exercise equipment" width="660" height="370" DisableNVelocity="true" />SleepSleep is essential to good health. It's one of the body's basic needs. But, what do you do when you have troubles sleeping, or getting enough hours of sleep? Dawn Haller6/26/2023You know something is going on with your kneecap if it slips to the side, either due to an injury or an activity as simple as standing up from a chair. Learn more about kneecap dislocation.What's going on with my kneecap?<p>If your kneecap pops or slides to the outside of your knee, you'll definitely know that something's going on. Typically, that "something" is a partial or full dislocation, which means the kneecap, also known as the patella, has slipped partly or all the way out of its groove over the knee joint.</p> <p>Dislocation can be caused by a sudden blow, such as taking a hard hit playing a contact sport like football or hockey, or by a chronic condition like a stretched ligament. Some people have a particular knee anatomy that makes it more common. In those cases, a dislocation could be caused by something as simple as normal walking or standing up from a chair. With chronic dislocation, it may feel as though your knee is buckling or giving way. There's often no pattern or regular causes of the dislocations.</p> <h2>What happens when a kneecap dislocates</h2> <p>When the kneecap dislocates, it's painful and the knee area may swell. Whether it happens from an acute or chronic situation, dislocation can damage the cartilage of the groove that the kneecap sits in or the cartilage underneath the kneecap.</p> <p>Acute or chronic dislocation indicates you have a stretched or torn medial patellofemoral ligament, or MPFL, a tough band of tissue that connects to the inside of the kneecap and prevents it from sliding to the outside of the knee.</p> <h2>Treating acute dislocation</h2> <p>If the dislocation is caused by an acute injury, you may be able to ease the kneecap back into place, or you may need to go an emergency department where health care professionals can correct the dislocation and evaluate if there's additional injury to your knee. Following the dislocation, you should see an orthopedic specialist.</p> <p>An X-ray provides an overall view of the anatomy of the kneecap and knee joint. The orthopedic specialist can determine if there is damage to the groove the kneecap rests in, how high the kneecap sits above the joint and if the patellar tendon, which connects below the kneecap, is pulling to one side.</p> <p>If this is the first time your kneecap has dislocated, the X-ray also can help determine if you're at risk of it happening again. Your orthopedic specialist also may order an MRI to check if a piece of the cartilage has broken off.</p> <p>Younger patients may need to undergo surgery to remove or fix a cartilage piece that has broken off and reconstruct the MPFL. Recovery following surgery typically involves wearing a brace, physical therapy and limited weight bearing to give the cartilage the best chance to heal. It may take up to six months before you're able to fully return to sports.</p> <p>For older patients, cartilage is less likely to heal, so surgery isn't always recommended. However, if you're experiencing a catching sensation in your knee, an orthopedic surgeon may decide to surgically remove the piece of cartilage. Rehabilitation will include limited weight bearing, using a brace and physical therapy.</p> <h2>Treating chronic dislocation</h2> <p>The first time your knee dislocates — unrelated to an injury — it may slide back into place on its own. However, you should see an orthopedic specialist who can evaluate if there has been any injury to the cartilage and determine your risk for dislocations happening again. If there isn't any cartilage damage, the orthopedic specialist may order physical therapy to strengthen your hip and quadricep muscles. This can help overcome any stretch in the MPFL ligament and stabilize your kneecap, as well as decrease the risk of arthritis over time.</p> <p>However, you eventually still may require surgery to reconstruct the MPFL, as well as other procedures to correct chronic dislocations. These include deepening the groove where the kneecap sits or moving the location where the patellar tendon connects.</p> <p>Recovery from MPFL reconstruction may take several months before you're able to return to normal activities and regain your range of motion. Overall recovery for more complex surgeries may take four to six months.</p> <h2>Preventing kneecap dislocations</h2> <p>The best way to lessen your chance of acute and chronic kneecap dislocations is to maintain overall leg, quadricep and hip strength. For chronic dislocations, learn what tends to cause them, such as twisting, and avoid those motions. A physical therapist also can teach you how to correct a kneecap dislocation on your own.</p> <p>For athletes who have suffered an acute dislocation, prompt care, possible surgery and rehabilitation can get you back to playing again.</p> <h2>Next steps:</h2> <ul> <li><a href="https://www.mayoclinichealthsystem.org/providers?service=Orthopedic%20Surgery&populateTracking=True" target="_self" title="Opens in same window.">Find an orthopedic specialist near you</a> to learn about options for treating a kneecap dislocation.</li> <li>Ask your orthopedic specialist about relieving joint pain with <a href="/hometown-health/speaking-of-health/injection-therapy-for-nonoperative-joint-pain-relief" target="_self" title="Opens in same window.">injection therapy</a> or <a href="/hometown-health/speaking-of-health/radiofrequency-ablation-pain-relief" target="_self" title="Opens in same window.">radiofrequency ablation</a>.</li> <li><a href="https://www.mayoclinichealthsystem.org/providers?service=Physical%20Therapy&populateTracking=True" target="_self" title="Opens in same window."> Consult with a physical therapist</a> to find ways to improve your overall leg strength.</li> <li>Read more about the <a href="/hometown-health/speaking-of-health/treating-your-knees-shock-absorbers" target="_self" title="Opens in same window.">cartilage in your knees</a> and other <a href="/hometown-health/speaking-of-health/get-the-facts-about-knee-pain" target="_self" title="Opens in same window.">possible causes of knee pain</a>.</li> <li>Follow these <a href="/hometown-health/speaking-of-health/staying-active-with-joint-pain" target="_self" title="Opens in same window.">tips for staying active with joint pain</a>.</li> </ul> <p><a href="/-/media/shared-files/images/medical-professionals/full/eau-claire/douglas-bartels-md.jpg" target="_self" title="Opens in same window."><em>Douglas Bartels, M.D.</em></a><em>, is an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgeon</a>, specializing in orthopedics and <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">sports medicine</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>ACL injuries</li> <li>Cartilage restoration and transplantation</li> <li>Hip arthroscopy</li> <li>Knee arthroscopy</li> <li>Meniscus tears</li> <li>Multi-ligament knee injuries</li> <li>Open surgery of the knee </li> <li>Open surgery of the shoulder</li> <li>Patellar instability</li> <li>Rotator cuff injury</li> <li>Shoulder arthroscopy</li> <li>Shoulder instability</li> <li>Shoulder replacement surgery</li> <li>Sports medicine</li> <li>Tendon tears (Achilles, pec, tricep, bicep)</li> </ul>M.D.<p>I chose a career in sports medicine to help patients of all ages and activity levels regain function and get back to doing the things they love. In my practice, I enjoy taking care of acute and chronic shoulder, hip and knee injuries and issues. I take pride in providing individualized care and making sure you are a part of the decision-making process. As a lifelong athlete, my main goal is to get patients back to work, school, hobbies, and sports feeling better than they did before their injury.</p> <p>I grew up in the Midwest and am thrilled to be providing orthopedic care in Northwest Wisconsin. As a college athlete I was exposed to sports-related injuries, which sparked my interest in orthopedics and sports medicine. During my residency and fellowship, I was able to be a team doctor for athletes at the high school level all the way to the professional level with the San Francisco 49ers.</p> <p>In my spare time, I enjoy spending time with my family and dogs along with traveling and fishing.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Biological Anthropology, Northwestern University</li> <li>Master's degree, Liberal Studies, Northwestern University</li> <li>Doctor of Medicine, Rush Medical College</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Sports Medicine and Shoulder Surgery, Stanford Health Care</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Alpha Omega Alpha Honor Medical Society</li> <li>American Academy of Orthopedic Surgeons (AAOS)</li> <li>American Medical Association (AMA)</li> <li>American Orthopedic Society for Sports Medicine (AOSSM)</li> <li>Football Team Physician, San Francisco 49ers</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Orthopedics, Mayo Clinic College of Medicine and Science</li> </ul>Bartels<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/douglas-bartels-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A5E506A9AEFC8F3CA64AF69A13885600" alt="Douglas (Doug) Bartels M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/35188900/" target="_blank" title="Opens in new window">Antibiotic prophylaxis with cefazolin is associated with lower shoulder periprosthetic joint infection rates than non-cefazolin alternatives</a>; May 2022</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/33764935/" target="_blank" title="Opens in new window">Revision reverse shoulder arthroplasty for anatomical glenoid component loosening was not universally successful: A detailed analysis of 127 consecutive shoulders</a> May 2021</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/31039055/" target="_blank" title="Opens in new window">Mid-term radiological results of a cementless short humeral component in anatomical and reverse shoulder arthroplasty</a>; May 2019</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/30968051/" target="_blank" title="Opens in new window">Epidemiology of hand and wrist injuries in NCAA men's football: 2009-2010 to 2013-2014</a>; April 2019</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/30393556/" target="_blank" title="Opens in new window">Arthroscopy and arthrotomy to address intra-articular pathology during PAO for hip dysplasia demonstrates similar short-term outcomes</a>; June 2018</li> </ul>{C36F83B1-9C26-4B21-BA7B-739F5EB4C565}Douglas (Doug)<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20090200Douglas (Doug) Bartels, M.D.1{DEF55970-853F-4E96-9A4D-3413874FF059}|{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2023/athlete-landing-jump-in-sand.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1A9A7FD2F26FB181ED0B450AF05BC3E6" alt="Athlete landing jump in sand" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller7/28/2023Are you tired of dealing with back pain, feeling confused about its causes and wondering about the best remedies? Let's debunk some common myths about back pain.8 common myths about back pain<p>Back pain is more common than homeownership in the U.S. While about 65% of adults own a home, nearly 80% of adults will have back pain at some point. Despite how common this type of pain is, some myths persist.</p> <h2><strong>Get the truth about these eight common back pain myths:</strong></h2> <h3>Myth: Lifting heavy objects is the primary cause of back pain.</h3> <p>Fact: While lifting heavy objects with poor form can certainly contribute to back pain, it's not the sole cause. Sedentary lifestyles, poor posture, obesity and genetic factors can all play a role in the development of back pain.</p> <h3>Myth: Bed rest will make my back pain better.</h3> <p>Fact: Probably not, but it depends on the cause of your pain. If your back pain is due to a muscle strain, taking it easy for a few days may help. However, in other cases, bed rest can make back pain last longer or even worsen it. If your pain is nerve compression, a disc issue or joint degeneration, inactivity can lead to tightening of muscles and worsening pain, the loss of physical condition and more debility. In those cases, I recommend that people modify their activities, switch to low-impact exercises like walking and swimming, and avoid movements that could worsen pain like bending, twisting or lifting.</p> <h3>Myth: Back pain is caused by sitting on a fat wallet.</h3> <p>Fact: Frequently sitting with a large wallet in your back pocket can cause leg or hip pain and numbness, but it doesn't usually cause back pain. A large wallet can compress your sciatic nerve and tilt your pelvis. The sciatic nerve is the largest in your body, and it branches from the lower back through your hips, buttocks and down each leg. Compression of the nerve causes pain or numbness while sitting or driving. After sitting for a long time, you may find walking difficult or feel pins and needles in your leg. If you're bothered by symptoms, take over-the-counter anti-inflammatory medications and remove your wallet from your back pocket. Many times, these steps resolve the issue.</p> <h3>Myth: Back pain is always due to a serious underlying condition.</h3> <p>Fact: Back pain is usually caused by muscle strains or sprains, not by a serious condition like a disc or vertebrae issue. Most back pain resolves on its own without requiring extensive medical intervention.</p> <h3>Myth: Exercise should be avoided when experiencing back pain.</h3> <p>Fact: In most cases, exercise and physical activity are recommended for managing and preventing back pain. Strengthening the core muscles, improving flexibility and maintaining a healthy weight can all contribute to a healthier back.  Again, modification of these activities may be required depending on your pain. Listening to your body is important. You know your body best. If something is progressively worsening or not getting better and you're worried, always contact a health care professional to get evaluated.</p> <h3>Myth: Surgery is the only solution for chronic back pain.</h3> <p>Fact: Back pain is often caused by issues that aren't relieved with surgery. Non-surgical treatments like physical therapy, medications, injections and lifestyle modifications are often effective in managing and reducing chronic back pain.</p> <h4>Surgery may be necessary if you have pain that: </h4> <ul> <li>Intensifies, especially at night or when you lie down.</li> <li>Spreads down one or both legs.</li> <li>Causes weakness, numbness or tingling in one or both legs.</li> <li>Occurs with new bowel or bladder control problems.</li> </ul> <p>You should seek an immediate medical evaluation if you have weakness, numbness, pain or are losing control of your bowels or bladder.</p> <h3>Myth: A firm mattress is the best for alleviating back pain.</h3> <p>Fact: The ideal mattress firmness varies from person to person. Some people may find relief with a firm mattress, while others may prefer a medium or soft mattress. When shopping for a new mattress, look for one that provides proper support and comfort based on your preferences and needs. Also, many companies offer generous return policies so you can try a mattress for a few weeks, or even a few months, before deciding if it's right for you.</p> <h3>Myth: Poor posture doesn't contribute to back pain.</h3> <p>Fact: Many people spend hours staring at a computer while slouching rather than sitting at attention, or focused on cellphones that draw the eyes down and curve the neck. These habits can strain muscles and joints, causing body pain over time. Practice good posture habits and take advantage of ergonomic office equipment to help prevent and alleviate back pain.</p> <p>Some back issues can't be avoided, like those caused by injuries, arthritis or genetics.</p> <h4>Yet, there are things you can do to preserve the health of your back, including:</h4> <ul> <li><strong>Maintaining an ideal body weight.</strong><br /> Excess weight causes increased stress on all joints, including the spine.</li> <li><strong>Strengthening your core.</strong><br /> Stronger core muscles, including abdominal and intrinsic back muscles, can help offload stress on your spine.</li> <li><strong>Staying active.</strong><br /> Regular movement is essential for keeping your body active.</li> </ul> <h2>Next steps:</h2> <ul> <li>View a <a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/adult-health/multimedia/back-pain/sls-20076817" target="_blank" title="Opens in a new window.">slideshow on how to prevent back pain with good posture</a>.</li> <li>Read <a href="/hometown-health/speaking-of-health/7-common-low-back-pain-faq" target="_self" title="Opens in same window.">seven FAQ about low back pain</a>. </li> <li>Read other <a href="/topics/back-pain" target="_self" title="Opens in same window.">back pain articles</a>. </li> <li>Find a <a href="https://www.mayoclinichealthsystem.org/providers?service=Neurosurgery" target="_self" title="Opens in same window.">neurosurgeon near you</a>.</li> </ul> <p><a href="/providers/meghan-murphy-md" target="_self" title="Opens in same window."><em>Meghan E. Murphy, M.D.</em></a><em>, is a neurosurgeon in<a href="/locations/mankato" target="_self" title="Opens in same window."> </a><a href="/services-and-treatments/spine-care" target="_self" title="Opens in same window.">Spine Care</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Degenerative diseases of the spine (stenosis, spondylolisthesis, scoliosis, radiculopathy)</li> <li>Education of medical students and advanced practice providers (physician assistants and nurse practitioners)</li> <li>Mentorship of women pursuing the medical field and surgical specialties</li> <li>Metastatic disease of the brain and spine</li> <li>Spinal tumors</li> <li>Traumatic brain and spine injuries</li> </ul>M.D.<p>Medicine is my vocation. I feel that I have been called to serve others by helping address spinal and brain pathology that is impacting quality of life and potentially quantity of life. It is a joy to play a role in empowering my patients to achieve the quality of life they desire. </p> <p>You can expect my full attention and dedication to your symptoms and concerns at the time of our consultation. I will be honest in discussion of what I can or cannot offer you. If I am unable to recommend surgery that will benefit you — with benefits outweighing the risks — I will help ascertain the best next step and connect you with those resources. </p> <p>I grew up in Colorado and completed my education and subsequent training at Notre Dame, Georgetown, and Mayo Clinic.</p> <p> Family and faith are important to me. I have a wonderful husband with whom I have two young boys — being a boy mom definitely suits me. I also have a goofy golden retriever, and we all love to be outside and active. </p><p><strong>Education</strong></p> <ul> <li>Georgetown University School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Neurologic Surgery, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Neurologic Surgery, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Neurosurgery Spine Enfolded, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Neurological Surgery, American Board of Neurological Surgery</li> </ul> <p><strong>Membership</strong></p> <ul> <li>Alpha Omega Alpha Medical Honor Society</li> <li>Congress of Neurological Surgeons</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Neurosurgery, Mayo Clinic College of Medicine and Science</li> </ul>Murphy<img src="/-/media/shared-files/images/medical-professionals/full/mankato/meghan-murphy-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=488A8D1221A32E0ADEE87A1875CC8219" alt="Meghan Murphy MD" width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=28486638" target="_blank" title="Opens in new window.">Predictors of Discharge to a Nonhome Facility in Patients Undergoing Lumbar Decompression Without Fusion for Degenerative Spine Disease</a>, October 2017.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=27858534" target="_blank" title="Opens in new window.">Lumbar decompression in the elderly: increased age as a risk factor for complications and nonhome discharge</a>, March 2017.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=27908218" target="_blank" title="Opens in new window.">Risk factors for dural tears: a study of elective spine surgery</a>, February 2017.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=27866034" target="_blank" title="Opens in new window.">Micro vs. macrodiscectomy: Does use of the microscope reduce complication rates?</a>, January 2017.</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=26838173" target="_blank" title="Opens in new window.">Unique cause of right hemispheric syndrome: Embolism of myocardium after open septal myectomy</a>, April 2016.</li> </ul>{65C398B7-CDF4-4A31-BA46-251A97B286EA}Meghan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15411991Meghan Murphy, M.D.1{4EA2A40E-3721-48EC-AFC9-E6D0E13BCDEC}<img src="/-/media/national-files/images/hometown-health/2023/wearing-safety-vest-holding-back.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7DED9E4FDA272FD1EAC6A9E79438CA61" alt="Wearing safety vest holding back" width="660" height="370" DisableNVelocity="true" />Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.NeurosurgeryNeurosurgery treats disorders that impact any part of the nervous system, which may include the brain, spine or peripheral nerves. Conditions treated range from life-threatening brain tumors, to disorders impacting quality of life, such as back pain and carpel tunnel syndrome.Pain ReliefApproximately 50 million people in the U.S. live with chronic pain. If you experience chronic pain, you're not alone. Learn about the ways to deal with painful disorders, from at-home solutions to drug treatments, injectable or implantable therapies to surgery.Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller7/18/2023Cancer and its treatments can have long-term effects on fertility. Learn about the cancers with higher fertility risks and preservation options that can provide hope for future family-building.Fertility considerations in cancer treatment: Preserving hope for the future<p>When a person is diagnosed with cancer, the focus is often on immediate treatment and recovery. However, it's important to consider the long-term effects of cancer and its therapies on fertility. These treatments can significantly affect a person's reproductive organs, potentially altering their ability to have children in the future.</p> <p>If you or a loved one is facing a cancer diagnosis, here's what you need to know about potential fertility implications.</p> <h2>Cancers with higher fertility risks</h2> <p>Cancer and its treatments can cause changes in your body. For some people, cancer damages a part of the reproductive process and affects fertility. For others, the necessary cancer treatments interfere with fertility. The likelihood that cancer treatment will harm your fertility depends on the type and stage of cancer, the cancer treatment method and your age at the time of treatment.</p> <p>Cancers that are more common in women, or people with ovaries, of reproductive age have a greater risk of affecting fertility. This includes breast cancer, uterine cancer, cervical cancer, ovarian cancer, thyroid cancer and blood cancers like lymphomas.</p> <p>For men, or people with testicles, cancers in the pelvic area or those that require chemotherapy have a greater effect on fertility. This includes prostate cancer, testicular cancer, lymphomas, thyroid cancer and colon cancer.</p> <h2>Cancer treatment</h2> <p>Certain cancer treatments can harm your fertility. The effects might be temporary or permanent.</p> <h3>Cancer treatment and its effects might include:</h3> <ul> <li><strong>Chemotherapy</strong><br /> This common cancer treatment targets and destroys active cells in the body. The ovaries and testicles, which are vital reproductive organs, contain a high number of active cells and are susceptible to damage from chemotherapy. This damage can affect the ability of the ovaries or testicles to produce viable eggs or sperm after cancer treatment, thus affecting fertility. Future fertility depends on various factors such as the type, duration and dose of chemotherapy and the patient's age. Patients who received alkylating chemotherapeutic agents may have higher risks compared to other medications.</li> <li><strong>Radiation</strong> <br /> This therapy also can affect fertility, primarily when administered in the pelvic area at high doses. In some cases, patients may opt to have surgery to reposition the ovaries from the radiation field, reducing the risk of damage. </li> <li><strong>Surgery</strong><br /> Fertility also can be harmed by the surgical removal of the testicles, uterus or ovaries.</li> <li><strong>Other cancer medications</strong><br /> Hormone therapies used to treat certain cancers, including breast cancer, can affect fertility. But the effects often are reversible. Once treatment stops, fertility may be restored.</li> </ul> <h2>Preservation options</h2> <h3>Various fertility preservation options may be available for cancer patients before they undergo cancer treatment.</h3> <ul> <li><strong>Freezing</strong><br /> For women, egg freezing or embryo freezing are standard practices, with minor differences depending on whether the patient has a partner or intends to use donor sperm. These methods involve hormonal stimulation with injections over a few weeks and retrieval of eggs from the ovaries. The eggs can be immediately cryopreserved or mixed with sperm for fertilization for the cryopreservation of embryos.</li> <li><strong>Cryopreservation</strong><br /> Another option is ovarian tissue cryopreservation, which involves removing and freezing part or all of an ovary. The ovarian tissue is divided into small strips and cryopreserved for future use. This method is particularly suitable for young girls who haven't reached puberty or women who need to start cancer treatment immediately. Men may consider sperm cryopreservation, which involves freezing and storing sperm for use at a later date. Testicular tissue cryopreservation also could be a consideration for boys before puberty.</li> <li><strong>Suppression</strong><br /> Ovarian suppression may be considered but is not a proven method of fertility preservation. Ovarian suppression involves medications temporarily suppressing ovarian activity, potentially protecting the ovaries from chemotherapy's effects.</li> </ul> <p>During cancer treatment, radiation shields can protect fertility in men and women. This procedure places small lead shields over the ovaries or testicles to reduce the radiation exposure they receive. Proton radiotherapy also can preserve fertility by delivering targeted therapy and minimizing exposure to adjoining organs and tissues.</p> <h2>Timing considerations</h2> <p>If you are planning cancer treatment and want to preserve your fertility, talk to your oncologist and a fertility specialist as soon as possible. A fertility specialist can help you understand your options, answer questions and serve as your fertility advocate during your treatment.</p> <p>It's important to know that some preservation options may be limited if you are facing an urgent treatment need or other significant time constraints.</p> <p>The diagnosis of cancer and the treatment process can be overwhelming. However, you have options if you're concerned about how cancer treatment might affect your fertility. Don't wait. Talk with your care team about fertility preservation methods before you begin cancer treatment to help you make an informed choice.</p> <p><a href="/providers/alicia-ogle-np" target="_self" title="Opens in same window."><em>Alicia Ogle</em></a><em> is a nurse practitioner in <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin. <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://college.mayo.edu/academics/residencies-and-fellowships/reproductive-endocrinology-and-infertility-fellowship-minnesota/department-and-faculty/" target="_blank" title="Opens in a new window.">Jessica Bleess</a> is a physician assistant in <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/departments-centers/reproductive-endocrinology-and-infertility-in-minnesota/overview/ovc-20424328" target="_blank" title="Opens in a new window.">Reproductive Endocrinology and Infertility</a> at Mayo Clinic in Rochester, Minnesota.</em></p> <ul> <li>Infertility</li> <li>Women's health</li> </ul> A.P.N.P., R.N. <p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Nursing, Cedarville University</li> <li>Master's degree, Nursing, University of Wisconsin-Eau Claire</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Nurse Practitioner, American Nurses Credentialing Center</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Society of Reproductive Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Obstetrics and Gynecology, Mayo Clinic College of Medicine and Science</li> </ul> Ogle<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/alicia-ogle-np.jpg?h=280&iar=0&w=280&sc_lang=en&hash=BC96CD4910532A55886115C7A5D18166" alt="Alicia Ogle, N.P." width="280" height="280" DisableNVelocity="true" /> {25F09A55-D529-46B4-A68F-D93F9C967DDA}Alicia<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14443937Alicia Ogle, A.P.N.P., R.N. 1{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{54693F31-87AF-4B21-91DB-1DEC1E21F878}<img src="/-/media/national-files/images/hometown-health/2023/hugging-from-the-back.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7D1E5FA5230C4B7637B337DA03003CAF" alt="Hugging from the back" width="660" height="370" DisableNVelocity="true" />CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.FertilityFertility issues may be due to a single cause with you or your partner or a combination of factors that may prevent a pregnancy from occurring or continuing. There are multiple safe, effective fertility therapies available.Transforming HealthcareExpert insight into using innovative technology to identify trends and develop procedures, diagnostics and next-generation care models to advance medicine, and provide healing today and in the future.Dawn Haller7/20/2023The CDC recommends taking steps to avoid being bitten by mosquitoes in areas where malaria outbreaks are reported. Learn how to protect against malaria and vector-borne diseases.Malaria in the U.S.: Mayo Clinic expert offers insight, tips for prevention <p>Malaria, a severe and potentially fatal disease most often caused by the bite of an infected mosquito, has been reported in the U.S. The Centers for Disease Control and Prevention released a <a rel="noopener" href="https://emergency.cdc.gov/han/2023/han00494.asp#:~:text=Malaria%20is%20a%20serious%20and,an%20infective%20female%20anopheline%20mosquito." target="_blank" title="Opens in a new window.">health advisory</a> because there have been instances of people getting infected with Plasmodium vivax malaria in Florida and Texas, even though they hadn't <a href="/hometown-health/speaking-of-health/questions-about-vaccines-and-travel" target="_self" title="Opens in same window.">traveled outside the country</a>. Malaria does not spread from person to person.</p> <p>"Malaria is caused by parasites in the genus Plasmodium that are usually injected into people through the bite of a mosquito," says <a rel="noopener" href="https://www.mayoclinic.org/biographies/pritt-bobbi-s-m-d/bio-20514068" target="_blank" title="Opens in a new window.">Bobbi Pritt, M.D.</a> director of the Clinical Parasitology Laboratory at Mayo Clinic.</p> <p>Dr. Pritt says most people become infected with Plasmodium parasites through the bite of an infected Anopheles species mosquito.</p> <p>"Plasmodium falciparum is the deadliest of the Plasmodium parasites. But occasionally, Plasmodium vivax also can cause human fatalities, and all of the malaria species can cause quite severe disease. Malaria is usually transmitted through the bite of an infected Anopheles female mosquito," she says. "The parasite is injected into the bloodstream through the mosquito's bite when she takes a blood meal. Less commonly, people can get infected with malaria through a transfusion receipt of an infected blood product or organ donation by receipt of an infected organ."</p> <p>These parasites invade red blood cells, leading to fever, chills, body aches and fatigue. Additional symptoms may include nausea, vomiting and diarrhea. Without timely treatment, the infection can worsen, resulting in organ failure, coma or death.</p> <p>Malaria is found in many parts of the world, although mainly in the tropics and subtropics. It was eliminated in the U.S. in 1951 through public health efforts, though the mosquitoes that transmit malaria are still present today. Most cases now are imported from endemic countries. However, the disease sometimes is brought to the U.S. by mosquitoes or travelers who already are infected.</p> <h2>Testing for malaria</h2> <p>Early treatment for malaria is crucial. Dr. Pritt says laboratory <a rel="noopener" href="https://www.mayocliniclabs.com/-/media/it-mmfiles/Special%20Instructions/7/6/6/Malaria_Laboratory_Testing_Algorithm" target="_blank" title="Opens in a new window.">testing</a> is necessary for definitive diagnosis of malaria.</p> <p>"The gold standard test for detecting malaria is conventional thick and thin blood films prepared on glass slides, and then looked at through a microscope," says Dr. Pritt. "Every laboratory in the U.S. that sees patients that potentially have malaria should be able to provide testing locally. We offer confirmatory testing here at Mayo Clinic, but it should never be used as the initial test. It should only be used for confirmation."</p> <h2>Mosquito bite and malaria prevention</h2> <p>Dr. Pritt says those living where the malaria outbreak occurs should take steps to protect themselves from malaria and other <a href="/hometown-health/speaking-of-health/west-nile-virus" target="_self" title="Opens in same window.">vector-borne diseases</a> by avoiding mosquito bites.</p> <h3>Consider these tips to prevent mosquito bites:</h3> <ul> <li>Remove standing water where mosquitoes could lay eggs.</li> <li>Remove items that hold water, such as vases and flowerpot saucers.</li> <li>Use an outdoor insect spray made to kill mosquitoes in areas where they rest, including dark, humid areas; under patio furniture; the carport; or in a garage.</li> <li>Keep mosquitoes out of your home by ensuring window screens are intact, and keep doors closed.</li> </ul> <p>"It's also important for physicians seeing patients in those areas to keep malaria in their differential diagnosis, even if the patient hasn't traveled outside of the U.S., at least while this outbreak is occurring until it's contained," Dr. Pritt adds.</p> <p>Some treatments can help prevent mild malaria cases from becoming more severe, but there isn't an absolute way to guarantee malaria prevention.</p> <p>"There is not currently a good <a href="/hometown-health/speaking-of-health/9-reasons-to-see-a-travel-medicine-specialist" target="_self" title="Opens in same window.">preventive vaccine</a> that is 100% effective for malaria, although there are a number of people working on vaccines, and there is a vaccine that's used in some parts of endemic areas that offers some protection against severe disease," she says.</p> <p><em>This article originally appeared on the </em><a rel="noopener" href="https://newsnetwork.mayoclinic.org/discussion/malaria-in-the-us-a-mayo-clinic-expert-offers-insight-tips-on-prevention/" target="_blank" title="Opens in a new window."><em>Mayo Clinic News Network</em></a><em>.</em></p><img src="/-/media/national-files/images/hometown-health/2023/backpackers-in-woods.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3F69E5774B06D8DE142C9DD07526D585" alt="Backpackers in woods" width="660" height="370" DisableNVelocity="true" />Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Dawn Haller7/11/2023People with high-functioning anxiety hide behind successful facades, while on the inside, they have persistent feelings self-doubt, worry and fear of not measuring up. Learn the symptoms and get coping strategies.Behind the mask: Managing high-functioning anxiety<p>It's normal to feel anxious at times, especially in a stressful situation. But for some people, excessive and ongoing anxiety can be challenging to control and often interferes with daily activities. This can be a sign of an anxiety disorder.</p> <p>Anxiety disorders are common, affecting millions of people worldwide. About 6.8 million U.S. adults have been diagnosed with generalized anxiety disorder, but the number of people experiencing anxiety likely is significantly higher.</p> <p>High-functioning anxiety is a subset of generalized anxiety disorder that often goes unnoticed or undiagnosed. It occurs when a person has anxiety symptoms, but rather than retreating from situations or interactions, they work hard to face their fears and are skilled at covering up symptoms.</p> <h2>Defining high-functioning anxiety</h2> <p>High-functioning anxiety is not recognized in the Diagnostic and Statistical Manual of Mental Disorders. Instead, it usually is diagnosed as generalized anxiety disorder.</p> <p>The term "high-functioning anxiety" represents people who exhibit anxiety symptoms while maintaining a high level of functionality in various aspects of their lives. They often are successful in careers or other roles, yet internally struggle with persistent feelings of stress, self-doubt and the fear of not measuring up. They feel extremely uncomfortable inside and struggle with significant self-criticism.</p> <p>To an outside observer, people with high-functioning anxiety may appear to excel and be in control. They don't appear to avoid or retreat from life. They may have successful careers, participate in many volunteer or community activities and have strong personal relationships. Yet behind this facade, these people have persistent thoughts of worry, fear and high-stress levels or feel on edge.</p> <h2>High-functioning anxiety symptoms</h2> <p>There are emotional and physical symptoms associated with generalized anxiety disorder. The symptoms of high-functioning anxiety mirror many of these, but some may be more prominent.</p> <h3>In addition to general nervousness, worry and feeling tense, people with high-functioning anxiety may internally struggle with: </h3> <ul> <li>Fears of criticism or significant self-criticism</li> <li>Fears of looking inadequate or foolish to others</li> <li>Feeling on the edge or on the verge of losing control</li> <li>Feeling a sense of impending doom</li> <li>Significant stress</li> </ul> <h3>People with high-functioning anxiety may also experience physical symptoms, such as:</h3> <ul> <li>Excessive sweating</li> <li>Feeling off-balance or lightheaded</li> <li>Headaches or migraines</li> <li>Intestinal discomforts, such as diarrhea or ulcers</li> <li>Muscle tension</li> <li>Racing heart rate</li> <li>Rubbery or jelly legs</li> <li>Sleep disturbances</li> <li>Tingling or numbness in toes or fingers</li> </ul> <p>The intensity of these symptoms varies depending on a person's level of functioning.</p> <h2>Who is at risk</h2> <p>High-functioning anxiety can affect people of any age and gender, but some people have a greater risk of experiencing it. Women are more than twice as likely as men to be affected by generalized anxiety disorder in their lifetimes. This may be due to societal pressures, gender roles and relationship concerns.</p> <h3>Others at risk of developing high-functioning anxiety include people: </h3> <ul> <li>Experiencing significant stressors</li> <li>Having a genetic predisposition to anxiety</li> <li>Who grew up in families where they felt less secure</li> <li>Who had caregivers who also were anxious or had high expectations of them</li> </ul> <h2>Effect on daily life</h2> <p>High-functioning anxiety can significantly affect various areas of a person's life, despite their outward success and achievement. People with high-functioning anxiety tend to overfunction. They may work extra hours, volunteer for extra assignments or try to perfectly do all tasks. They look for clues on how society defines success and pressure themselves to achieve or surpass these often unrealistic expectations. This intense push can lead to burnout because of their constant drive to overachieve and their fear of failure.</p> <p>People with high-functioning anxiety also may put their personal relationships at risk because they spend so much time focusing on other areas in their lives. Criticism, even constructive feedback, can be particularly difficult for people with high-functioning anxiety. They may overreact to any criticism and harshly internalize it. They may neglect self-care like sleep, exercise and nutrition, and face physical health problems associated with chronic stress.</p> <h2>Managing high-functioning anxiety</h2> <p>It's important to remember that there are good characteristics that come along with being anxious. People with anxiety often are caring, empathetic, peacemakers, rule followers and good citizens. Many have a strong desire to overcome their challenges. I believe that anxious people are awesome. They just need to believe in themselves, and develop tools to become more confident and self-accepting. Identifying their core values will help them set goals that truly match what is important to them.</p> <p>Counseling and therapy play crucial roles in helping people with high-functioning anxiety effectively manage their symptoms. Going to therapy doesn't mean a person is weak or cannot function. It's a strong sign that a person is intelligent, humble, teachable and proactive.</p> <p>Cognitive behavioral therapy works by helping people learn to reframe their thoughts about life and transform behaviors that may feed their anxiety. Instead of being self-critical and looking for what could go wrong, a person with high-functioning anxiety is taught to manage their thoughts, seek solutions and guide themselves through anxious feelings.</p> <p>Instead of being afraid of anxious feelings, the person may be taught to embrace it and say something like, "I have anxiety, and that's OK. My anxiety doesn't make me a bad person. It's just how my body and mind react to situations, and I can deal with it."</p> <h3>In addition to therapy, coping strategies to ease anxiety symptoms include:</h3> <ul> <li><strong>Forgetting comparisons</strong><br> People with anxiety tend to compare themselves to others, feel the need to improve and want to be more like someone else. Comparison can rob you of joy and contentment. </li> <li><strong>Seeking a healthy life flow</strong><br> Each person has different needs and energy levels. Some people thrive when constantly moving, while others need time to decompress. Your needs for sleep, self-care, nutrition, exercise and work-life balance will differ from others. You will know you have found the proper flow when you feel at peace with yourself with the amount of busyness versus rest and work versus play.  </li> <li><strong>Creating a support network</strong><br> People with high-functioning anxiety may believe they must deal with their behaviors alone because they fear criticism or negative outcomes. A positive support network of people who care for you, regardless of outcomes, can help ease anxiety symptoms. </li> <li><strong>Identifying core values</strong><br> Some people with high-functioning anxiety become fixated on society-defined success, like having the "right" job, car, house and material possessions. These items often are important only because other people believe they are important. A therapist can help you uncover what is important to you outside society's expectations, and align your thoughts and actions with your core values. </li> <li><strong>Practicing mindfulness<br> </strong>This is the practice of purposefully being aware of and focusing on the present moment. Concentrating on one thing or moment can increase feelings of calm and peace. </li> <li><strong>Establishing healthy boundaries <br> </strong>This can help improve relationships with others and establish rules for yourself. The importance of saying "no" often is talked about as part of boundary setting. That's because many people overextend themselves. But some people with high-functioning anxiety also should embrace saying "yes" to opportunities that stretch their comfort levels. Their lives grow in experiences and fulfillment the more they face their fears.</li> <li><strong>Learning to accept criticism<br> </strong>This can be difficult for many people but especially people with high-functioning anxiety. They may snap back or get defensive. A therapist can help you identify ways to step back at this moment and evaluate the feedback neutrally without emotion. </li> </ul> <p>Medications can help some people with high-functioning anxiety but should only be used in conjunction with other coping strategies and under the care of a health care professional.</p> <p>While high-functioning anxiety may not be a recognized diagnosis, it represents a significant subset of people who experience anxiety symptoms while maintaining a high level of functionality. These people face internal struggles like persistent self-doubt, fear of failure, and a constant drive for perfection and pleasing others, which profoundly affect their daily lives.</p> <p>Talk with your health care team if you are experiencing anxiety symptoms like persistent self-doubt, fear of failure and a constant drive for perfection. They can connect you to therapy and help you develop coping strategies so you can foster healthier ways of managing your anxiety and lead a fulfilling life.</p> <p><em>Linda Hubbard</em><em> is a psychotherapist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2023/person-with-blue-shirt-talking.jpg?h=370&iar=0&w=660&sc_lang=en&hash=099BBDD499BD9BDC122B5BCC233ADB6D" alt="Person with blue shirt talking" width="660" height="370" DisableNVelocity="true" />AnxietyFeelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. Symptoms may start during childhood or the teen years and continue into adulthood. We have the experts who can help diagnose and treat anxiety concerns.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller7/10/2023Discover the preventive health benefits available to Medicare recipients through annual wellness visits. Get answers to common questions about this visit that can guide you toward optimal well-being.Common questions about Medicare annual wellness visits <p>If you are a Medicare recipient, you can take advantage of annual wellness visits. These visits are a preventive health benefit available after having Medicare Part B coverage for at least one year. All Medicare Advantage Plans are required to offer annual wellness visits for their members. A nurse or nurse practitioner reviews your health status and helps you plan for health and wellness needs.</p> <p>In most cases, the annual wellness visit will be followed by a <a href="/hometown-health/speaking-of-health/medicare-annual-wellness-visits-explained" target="_self" title="Opens in same window.">separate medical visit</a> with your primary care professional to close any health care gaps and address any problems identified during the visit.</p> <h2>Here are answers to common questions about annual wellness visits.</h2> <h3>Why are annual wellness visits important?</h3> <p>The annual wellness visit allows you to review your health history and identify any current or potential health risks with a health care professional. The visit enables the nurse to focus on prevention and wellness while making sure you are current on recommended immunizations and health screenings like colonoscopies or mammograms. It also allows your primary care professional more time to focus on your medical concerns and needs at a separate physical exam.</p> <h3>Do I need to be 65 or older to have an annual wellness visit?</h3> <p>You do not need to be 65 or older to qualify for an annual wellness visit as long as you've been on Medicare Part B for at least one year.</p> <h3>How is an annual wellness visit scheduled?</h3> <p>If you are due for an annual wellness visit, you may be prompted to self-schedule the visit in the <a href="/patient-online-services" target="_self" title="Opens in same window.">patient portal</a>. You also may call your care team and ask to be scheduled.</p> <p>If your visit is with a nurse or nurse practitioner, it's recommended to schedule this visit before the visit with your primary care professional. This allows your primary care professional the chance to address any concerns mentioned during your annual wellness visit.</p> <h3>How can I prepare for my annual wellness visit?</h3> <p>You may be asked to complete some questionnaires before arriving for your appointment, which will be sent to your patient portal account. If you cannot access the questionnaires before the appointment, plan to arrive at your appointment early to complete them.</p> <h4>It's helpful to come prepared to your visit with this information:</h4> <ul> <li>All medications, vitamins and supplements you take, including how much and how often you take them</li> <li>Additional medical records, including immunization records</li> <li>Dates of your most recent preventive services, like a colonoscopy or mammogram, if completed by another health care facility</li> <li>Family health history, with as much detail as possible</li> <li>List of medical providers and suppliers who provide you care, equipment or services</li> </ul> <h3>What can you expect during an annual wellness visit?</h3> <h4>During the visit, you'll meet with a nurse or nurse practitioner to:</h4> <ul> <li>Evaluate your fall risk</li> <li>Measure your height, weight and blood pressure</li> <li>Offer referrals to other health education or preventive services</li> <li>Provide information related to voluntary advance care planning</li> <li>Screen for cognitive impairments like dementia</li> <li>Screen for depression</li> <li>Update your medical and family history</li> </ul> <h3>What is the cost of an annual wellness visit?</h3> <p>Medicare offers the visit at no cost for people who have Medicare Part B coverage for at least one year before the visit. If you are referred for other tests or services, they will be billed to your insurance. If you have a separate visit with your primary care professional following your annual wellness visit, you or your insurance carrier will be responsible for the cost of that visit.</p> <p><a rel="noopener" href="https://www.mayoclinic.org/biographies/stroebel-robert-j-m-d/bio-20054118" target="_blank" title="Opens in a new window."><em>Robert Stroebel, M.D.</em></a><em>, is a Community Internal Medicine, Geriatric and Palliative Care physician at <a rel="noopener" href="https://communityhealth.mayoclinic.org/" target="_blank" title="Opens in a new window.">Mayo Clinic Primary Care</a> in Rochester and Kasson, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2023/senior-and-young-person-hugging.jpg?h=370&iar=0&w=660&sc_lang=en&hash=179A05F74CEF9408B7E2E95DE2F00957" alt="Senior and young person hugging" width="660" height="370" DisableNVelocity="true" />AgingLife expectancy is 75 for males and 80 for females according to the National Center for Health Statistics. We'll help you keep you informed about potential issues with aging, and steps you can take to maintain your health and keep active.Dawn Haller7/24/2023For millions of people, living with chronic pain can significantly affect daily activities, relationships, work and well-being. Read ways you can support a loved one with chronic pain.How to support a loved one with chronic pain<p>For millions of people, living with chronic pain can significantly affect daily activities, relationships, work and well-being. Chronic pain typically is categorized based on the duration of pain experienced. </p> <p>The pain or discomfort people feel while recovering from an injury or illness is considered acute or subacute. Pain lasting beyond usual recovery from a trauma-related event or surgery, typically 12 weeks, is considered chronic. Pain can transition from acute to chronic, depending on a person's recovery process.</p> <h2>Effect of chronic pain on daily life</h2> <p>Chronic pain can cause a person to avoid activities that cause further pain. This can lead to muscle weakness, joint problems and being more prone to injury. These avoidance behaviors also can lead to psychological isolation and stress. Moving the body and being physically active are crucial for long-term pain management. Encouragement from family, friends and caregivers to stay active and motivated is vital in improving physical health and psychological well-being for a person with chronic pain.</p> <p><a href="/hometown-health/speaking-of-health/8-tips-for-managing-chronic-pain" target="_self" title="Opens in same window.">Central sensitization pain</a> presents additional challenges, including mood changes and fatigue. Patients with central sensitization pain may experience heightened pain responses during physical activity.</p> <h2>Supporting loved ones with chronic pain</h2> <p>It's important that loved ones understand the effect of chronic pain on a person's daily life. Not being able to engage with family and friends can lead to mood symptoms like anxiety, helplessness and hopelessness.</p> <p>It's beneficial to encourage people with chronic pain to maintain a sense of normalcy, remain involved in social activities and stick to a routine sleep schedule. </p> <p>However, <a href="/hometown-health/featured-topic/caregiving-self-care-during-beyond-the-covid-19-pandemic" target="_self" title="Opens in same window.">caregivers</a> should balance encouraging activity and enabling passivity, as helping can exacerbate physical and psychological limitations and dependency.</p> <h3>When supporting someone with chronic pain, here are some ways a loved one can help:</h3> <ul> <li><strong>Understand the nature of chronic pain.</strong><br /> Recognize that chronic pain differs from acute pain and can last beyond the expected recovery period. Be aware of the different types of chronic pain and the effect on your loved one's life.</li> <li><strong>Encourage movement and physical activity.</strong><br /> Motivate the person to do gentle exercises, stretching or physical therapy, even if it initially causes some discomfort. Gradually increasing activity levels can help improve pain and overall functioning.</li> <li><strong>Support a balanced routine.</strong><br /> Help establish a regular <a href="/hometown-health/speaking-of-health/5-ways-to-get-better-sleep" target="_self" title="Opens in same window.">sleep schedule</a> and ensure the person is exposed to daylight during the day. Encourage healthy habits such as maintaining a nutritious diet and avoiding substances like drugs or smoking. Understand that someone with chronic pain may have fluctuating levels of pain. Encourage them to participate in social events and integrate into family meals or outings when they feel up to it.</li> <li><strong>Provide emotional support.</strong><br /> Chronic pain can take a toll on a person's mental health. Listen when needed, offer emotional support and encourage open communication about their feelings and experiences. Help them seek professional help if needed. Understand that chronic pain can be unpredictable, and the person may have good and bad days. Practice patience, flexibility and adaptability to accommodate their needs and limitations.</li> <li><strong>Avoid enabling behaviors.</strong><br /> While being empathetic is important, avoid reinforcing a sedentary or inactive lifestyle. Encourage independence and motivate the person to participate in their daily activities as much as possible.</li> <li><strong>Stay informed and advocate for proper medical care.</strong><br /> Educate yourself about the specific condition causing chronic pain, available treatments and strategies for managing pain. This knowledge will help you better understand and support the person's journey. Help the person find health care providers who specialize in <a href="/services-and-treatments/pain-medicine" target="_self" title="Opens in same window.">chronic pain management</a>. Advocate for their needs and ensure they receive appropriate medical attention, including seeking second opinions if necessary.</li> <li><strong>Encourage self-care.</strong><br /> Remind the person to prioritize self-care, including practicing <a href="/hometown-health/speaking-of-health/mindfulness-meditation-improve-your-quality-of-life" target="_self" title="Opens in same window.">relaxation techniques</a>, pursuing hobbies and engaging in activities that bring joy and reduce stress.</li> </ul> <p>Remember, a person's experience with chronic pain is unique to them, so it's essential to tailor your support to their needs.</p> <p><a href="/providers/qasim-raza-mbbs-md" target="_self" title="Opens in same window."><em>Qasim Raza, M.B.B.S., M.D.</em></a><em>, is a <a href="/services-and-treatments/pain-medicine" target="_self" title="Opens in same window.">pain medicine</a> specialist in <a href="/locations/barron" target="_self" title="Opens in same window.">Barron</a> and <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Chronic pain</li> <li>Spinal pain</li> </ul>M.B.B.S., M.D.<p>I provide a more holistic approach towards treating chronic pain. I believe chronic pain affects multiple aspects of our lives, and it needs to be addressed as such, by a multifaceted approach.</p><p><strong>Education</strong></p> <ul> <li>Nishtar Medical College</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Psychiatry, Harlem Hospital Center</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Pain Medicine, University of Washington</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Pain Medicine</li> <li>American Board of Psychiatry and Neurology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Psychiatric Association</li> <li>Fellow, College of Physicians and Surgeons of Pakistan</li> <li>Wisconsin Medical Society</li> </ul>Raza<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/qasim-raza-mbbs-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=19DAB40D26239567720FC47CC6CB1922" alt="Qasim Raza, M.B.B.S., M.D." width="280" height="280" DisableNVelocity="true" />Qasim<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30209434Qasim Raza, M.B.B.S., M.D.1{4EA2A40E-3721-48EC-AFC9-E6D0E13BCDEC}<img src="/-/media/national-files/images/hometown-health/2023/young-couple-smiling-arm-in-arm.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C3E7D74F1B6DA37A3B17BFBC247F584E" alt="Young couple smiling arm in arm" width="660" height="370" DisableNVelocity="true" />Pain ReliefApproximately 50 million people in the U.S. live with chronic pain. If you experience chronic pain, you're not alone. Learn about the ways to deal with painful disorders, from at-home solutions to drug treatments, injectable or implantable therapies to surgery.Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.ArthritisArthritis is inflammation of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis.HeadacheHeadache is pain in any region of the head that feels like a sharp pain, throbbing sensation or dull ache. It may develop gradually or suddenly, and last for minutes or days.Dawn Haller7/14/2023Y-90 radioembolization is an innovative treatment for liver cancer that precisely delivers radiation to a tumor. Learn about the benefits and if this may be an option for you.Targeted radiation therapy: Y-90 and liver cancer<p>The liver is the largest solid internal organ in the body and performs over 500 essential functions, ranging from filtering toxins and processing nutrients to storing glucose and regulating blood clotting. </p> <p>Liver cancer may develop in the cells of the liver or spread to the liver from another area of the body. About 41,000 people in the U.S. are diagnosed with liver cancer each year, and nearly 29,000 people will die of the cancer.</p> <p>Treating liver cancer depends on the stage and location of the tumors, along with the patient's overall health. Targeted radiation therapy, called Y-90, is an innovative option for select patients.</p> <h2>Treating liver cancer</h2> <p>Surgery often remains the gold standard for treating and removing tumors in the liver when it's a viable treatment. However, surgery isn't the only option. Transarterial therapy and percutaneous ablation are minimally invasive treatments that target specific areas in the liver.</p> <p>Transarterial therapy involves injecting treatment directly into the tumor's blood supply. The injection can be larger particles that block or plug the blood supply and starve the tumor or smaller particles that dispense radiation treatment through the blood supply to the tumors. These methods are effective at treating localized or dispersed tumors in the liver.</p> <p>Percutaneous ablation uses special needles and image guidance to deliver energy into the tumors. This energy either freezes or heats the tissue and destroys tumors. Ablation usually is limited to smaller lesions in locations favorable for treatment within the liver.</p> <p>Minimally invasive treatments are completed as outpatient procedures, and patients may go home the same day. These treatments offer additional benefits, such as preserving more liver tissue, shortening recovery times and targeting smaller or more widespread lesions in the liver.</p> <p>Liver cancer treatment plans are personalized for each patient and may include surgery, minimally invasive procedures or a combination of treatments. The specific plan is determined by the size and location of the tumors and if any tumors are located in the body beyond the liver.</p> <h2>Y-90 radioembolization</h2> <p>Radioembolization is a type of transarterial therapy that strategically attacks liver tumors with localized, high doses of radiation. The treatment often is called Y-90. This refers to the radioactive isotope yttrium-90 that is inserted into tiny glass beads and injected into the tumor's blood supply. The radioactive beads accumulate inside the tumors and emit radiation to suppress tumor growth. Over time, the tumor dies, but the healthy part of the liver remains unaffected.</p> <p>Y-90 is a targeted way to deliver radiation to a tumor because it radiates less than half an inch into adjacent tissues. This limits the amount of the liver exposed to radiation, and spares normal liver tissue and other nearby organs from unnecessary exposure.</p> <h2>What to expect</h2> <p>After reviewing all treatment options with you, your cancer care team may recommend Y-90 treatment. The first step is to examine your liver's blood supply. A series of CT or MRI scans help map out the liver's blood vessels. These images also determine the size and location of your liver tumors.</p> <p>Next, the team determines a treatment plan and identifies which vessels will be injected with Y-90. They also will recommend the number of treatments.</p> <p>An interventional radiologist inserts a small tube, called a catheter, into an artery in the groin or wrist and threads it to the identified vessels that supply blood to your tumors. The radioactive beads are injected through the catheter into the blood vessels. The beads emit radiation into the tumor's blood supply for a short period.</p> <p>Y-90 treatments are completed in a hospital procedure room, and you can go home the same day as the treatment. Side effects are usually limited but may include fatigue or mild abdominal pain. Multiple treatments may be necessary depending on the stage and location of your liver cancer.</p> <h2>Combined treatment approach</h2> <p>Y-90 can be used with other cancer treatments. It helps shrink large tumors that cannot be surgically removed, making surgery possible. For patients not eligible for liver transplants due to tumor size, Y-90 helps shrink tumors and improves their chances of transplantation. In select cases, having Y-90 as part of a cancer treatment plan may provide different chemotherapy options later.</p> <p>Overall, Y-90 treatment is a promising option for patients with liver cancer. This safe, effective treatment can help improve patient outcomes with this challenging disease. If you or a loved one has been diagnosed with liver cancer, ask your health care team if Y-90 treatment may be right for you.</p> <h2>Next steps:</h2> <ul> <li><a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">Find an oncologist or cancer treatment</a> near you. </li> <li>Attend a <a href="/classes-and-events" target="_self" title="Opens in same window.">cancer support group</a>. </li> <li>Read about the <a href="/locations/eau-claire/services-and-treatments/oncology/cancer-center" target="_self" title="Opens in same window.">Albert J. and Judith A. Dunlap Cancer Center</a>. </li> <li>Discover other <a href="/topics/cancer" target="_self" title="Opens in same window.">cancer topics</a>. </li> </ul> <p><a href="/providers/jeremy-mcbride-md" target="_self" title="Opens in same window."><em>Jeremy McBride, M.D.</em></a><em>, is an <a href="/locations/eau-claire/services-and-treatments/radiology-and-imaging/interventional-radiology" target="_self" title="Opens in same window.">interventional radiologist in Eau Claire</a>, Wisconsin.</em></p><ul> <li>Ablation (microwave and cryoablation)</li> <li>Biopsy</li> <li>Chemoembolization</li> <li>Embolization</li> <li>Image-guided treatment of cancer</li> <li>Interventional oncology</li> <li>Interventional radiology</li> <li>Radioembolization</li> <li>Sclerotherapy</li> <li>Treating tumors by freezing, heating or poisoning</li> <li>Varicose vein treatment</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>The Johns Hopkins University School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Diagnostic Radiology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Vascular Interventional Radiology, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Interventional Radiology/Diagnostic Radiology, American Board of Radiology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Radiology, Mayo Clinic College of Medicine and Science</li> </ul>McBride<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/jeremy-mcbride-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=C5282C18A6F60FE505B8E5049496F755" alt="Jeremy McBride, M.D." width="280" height="280" DisableNVelocity="true" />{68C07389-8BBA-43CE-A1BF-B042B66FA8C1}Jeremy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14914883Jeremy McBride, M.D.1<img src="/-/media/national-files/images/hometown-health/2023/wearing-glasses-greying-hair.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D1FBC89119DBCDCEB589DD59FBD41704" alt="Person with short, greying hair wearing glasses" width="660" height="370" DisableNVelocity="true" />Liver DiseaseLiver disease can be genetic or caused by factors such as viruses, alcohol use and obesity.CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Dawn Haller7/27/2023Gardens, roadside stands and farmers markets are bursting with summer's bounty. Learn the best ways to store and wash fresh fruits and vegetables to preserve their flavor, freshness and nutrients.Tips for keeping summer produce fresh and flavorful<p>During peak growing months, summer's bounty is bursting in gardens, farmers markets, roadside stands and grocery stores. Now's the time to savor this abundance of fresh fruits and vegetables, enjoy old favorites and try some new-to-you produce.</p> <h2>Check out these tips for storing and washing fruits and vegetables properly to help them stay fresh, flavorful and retain their nutrients:</h2> <h3>Storing produce</h3> <p>Properly storing produce will help preserve its texture and flavor, and extend its shelf life. As a guideline, wait to wash produce until you're ready to use it.</p> <h4>Utilize these storage tips:</h4> <ul> <li><strong>Apples</strong><br /> Leave at room temperature if you'll be eating them within a few days. Otherwise, store apples in a perforated plastic bag in the coldest part of your refrigerator.</li> <li><strong>Asparagus</strong><br /> Although best if cooked the day it's purchased, keep asparagus in the refrigerator for up to five days. Wrap the bottoms of the stalks in a damp paper towel, place the bunch in a paper bag and store in the coldest part of the refrigerator.</li> <li><strong>Berries and cherries</strong><br /> Remove the fruit from its container, pick through the berries or cherries and remove any mushy or damaged fruit. Line the container with paper towels, gently refill it with fruit and refrigerate for up to a week.</li> <li><strong>Corn</strong><br /> Store in the refrigerator with the husks on so the ears last a week or longer.</li> <li><strong>Cucumbers and bell peppers</strong><br /> Refrigerate unwashed cucumbers in a plastic bag in the refrigerator for up to a week. Put peppers in a paper bag in the coldest part of your refrigerator for up to five days.</li> <li><strong>Lettuce and leafy greens</strong><br /> Store salad leaves in a resealable plastic bag in the refrigerator for no more than two days. Leafy greens like kale, spinach and chard are stored best in a loosely closed plastic bag.</li> <li><strong>Melons</strong><br /> Leave whole, uncut melons out of the refrigerator for up to a week. Cover the cut flesh of a leftover portion with a silicone bowl cover or put slices in an airtight container. Store in the refrigerator.</li> <li><strong>Onions and garlic</strong><br /> Store in a cool, dry and well-ventilated place so onions will last about month. Put fresh garlic in an open container away from other foods, and keep it in a cool, dark place for up to eight weeks. Individual cloves will keep for three to 10 days.</li> <li><strong>Potatoes</strong><br /> Don't store potatoes in the refrigerator. Instead, keep them in a cool, dry, dark place. Before using, cut away any green spots and eyes.</li> <li><strong>Root vegetables</strong><br /> Keep carrots in a sealed plastic bag, and store them in the refrigerator's vegetable bin. If they become limp, refresh them in a bowl of ice water. Loosely wrap parsnips, and keep them in the produce drawer of the refrigerator for up to three weeks.</li> <li><strong>Stone fruits</strong><br /> Store plums, nectarines and peaches at room temperature. If you won't be eating them for a few days, put them in the refrigerator for up to five days.</li> <li><strong>Tomatoes</strong><br /> Keep tomatoes out of the refrigerator because they'll lose flavor and turn mealy. Leave on the counter out of direct sun for up to five days.</li> <li><strong>Zucchini and summer squashes</strong><br /> Store whole squashes in the refrigerator's crisper drawer for up to two weeks. Stored in a resealable plastic bag, they'll last even longer.</li> </ul> <h3>Washing produce</h3> <p>Don't skip this essential step. Washing is crucial for food safety because it removes dirt and pathogens like E. coli, listeria and salmonella that can cause food-borne illnesses. It's especially important for raw fruits and vegetables as the heat of cooking typically destroys these harmful pathogens.</p> <p>Produce from your garden or farmers market will need to be cleaned more thoroughly. While produce from the supermarket has been commercially washed, it's still a good idea to give it a quick rinse.</p> <p>Remove any stickers before washing because they will stick more firmly once they become wet. If you use a soft-bristled or silicone brush to help remove dirt, reserve it only for fruits and vegetables.</p> <p>All produce should be washed under cool running water to prevent pathogens from entering the pores of the fruits and vegetables and rinse away dirt. Don't let produce soak in the water it's been washed in.</p> <p>There's no need to use soap, vinegar or produce washes. Plain water does the job.</p> <h4><strong>Here's how to wash a variety of vegetables:</strong></h4> <ul> <li><strong>Beans and peas</strong><br /> Wash in a colander. Gently stir during rinsing to loosen any dirt.</li> <li><strong>Cruciferous vegetables</strong><br /> Cut or chop broccoli, cauliflower or broccolini while dry, then place in a strainer and rinse.</li> <li><strong>Garlic and onions</strong><br /> Wash before cutting to avoid carrying pathogens from the skin into the inner portions. Use a soft-bristled produce brush to remove any loose dirt.</li> <li><strong>Leafy greens</strong><br /> Fill a large bowl or salad spinner with cool water. Submerge the leaves in the water and gently swish them around, loosening any dirt or grit. Wash in batches, if needed, and change the water between each batch. Remove from the water, and place on single layers of paper towel to dry or spin them dry in a salad spinner. If you're buying bagged or chopped greens at the supermarket, there's no need to wash them again if they are labeled prewashed.</li> <li><strong>Mushrooms</strong><br /> Wash just before you need them so they don't get soggy. Cut off the stems, dunk the cap in a bowl of water and gently swish until clean. Pat dry with a clean cloth or paper towel.</li> <li><strong>Root vegetables</strong><br /> Scrub carrots, potatoes and radishes with a produce brush under cool running water until all dirt is removed.</li> <li><strong>Tomatoes and eggplants</strong><br /> Wash before cutting to prevent them from absorbing water and becoming mushy. You also can use a damp cloth to remove any grit or dirt.</li> <li><strong>Zucchini and summer squashes</strong><br /> Wash using a brush to remove any soil.</li> </ul> <p>Explore ideas for <a href="/hometown-health/speaking-of-health/start-savoring-your-homegrown-nutrition" target="_self" title="Opens in same window.">using summer's bounty</a> from your garden or local markets.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2023/rinsing-strawberries.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3F7A8FE72CD34CAA2FB45398E20F8F9F" alt="Rinsing strawberries" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller7/12/2023Over summer break, kids can lose new skills learned during the school year. As a parent or caregiver, try these fun, creative tips to help kids retain learning.Tips for preventing 'summer slide'<p>Waterslides and playground slides are part of summer's fun. But there's one slide to avoid when the weather gets warm: the "summer slide." That's the loss over the long summer break of new skills gained during the school year.</p> <p>Summer slide isn't new, but it has worsened because of education setbacks brought on by the disruption of schooling during the pandemic.</p> <p>On average, students lose two months of reading skills and nearly three months of math skills during summer break. What that means is they have to relearn those skills before they can move on to new material in the next school year. The good news is that parents and other caregivers can help minimize the learning losses.</p> <p>While that doesn't necessarily mean enrolling your kids in summer school, it does mean intentionally weaving learning and skills practice into everyday activities.</p> <p>Starting a summer routine of reading at least 20 minutes a day goes a long way. Let kids choose their own reading material, even if it's below their grade level. Being successful readers will give them a boost of confidence. Look for reading challenges like Pizza Hut's "Book It!" or set up a friendly reading contest with family and friends.</p> <h2>Getting started</h2> <p>Everyday activities are loaded with opportunities for learning. Add in the extras of summer, like spending more time outdoors, free programs offered by libraries and parks, camps and vacations, and you've got some great starting points for schoolwork that doesn't seem like work.</p> <p>You don't have to go this alone. Involve your kids — and other parents — when possible. Your children will be more excited about learning through the summer months if the activities center on their interests, including new things they'd like to try.</p> <h3>Here are some ideas I've used with my children to help them retain those skills they worked so hard to learn.</h3> <h4>At the grocery store, have your student:</h4> <ul> <li>Write down the grocery list.</li> <li>Read signs throughout the store.</li> <li>Weigh produce.</li> <li>Use a calculator to add up the grocery bill as you go.</li> <li>Compare multiple items/sizes/quantities to determine the best deal.</li> <li>Count the number of items in the cart.</li> </ul> <h4>In the kitchen, use cooking and baking for your kids to practice numbers and math:</h4> <ul> <li>Measure the size of the pan needed.</li> <li>Read recipes out loud.</li> <li>Measure both dry and liquid ingredients.</li> <li>Count the number of ingredients.</li> <li>Cut fruits and vegetables into specific sizes, such as 1/2 of an apple or 1/4 of a banana.</li> <li>Read about healthy eating at sites like MyPlate.</li> <li>Calculate nutrient intake such as calories or protein.</li> <li>Divide foods into portions at meals.</li> </ul> <h4>In the car, whether it's a short or long trip, have your kids:</h4> <ul> <li>Sing songs.</li> <li>Practice spelling by doing a spelling bee.</li> <li>Run through math facts like counting by twos or multiplication tables.</li> <li>Spot objects that begin with each letter of the alphabet.</li> <li>Read road signs and billboards out loud.</li> <li>Practice directions like turn left or turn south.</li> <li>Turn off the verbal prompts on a map app and read directions out loud.</li> <li>Listen to kid-oriented podcasts on topics like science, space or mysteries</li> </ul> <h4>At the park, participate in the park's built-in learning to:</h4> <ul> <li>Look for and identify different leaves, trees, rocks, insects, clouds, wildflowers and weeds.</li> <li>Listen for birds using a free app like Merlin to identify them by how they look or their songs.</li> <li>Go on a free planned walk like stargazing, butterfly or pond exploration with a naturalist.</li> <li>Sign up for other free programs that capture their interest.</li> <li>Research the name of the park and where it came from.</li> </ul> <h4>At the community library, kids can explore these free resources:</h4> <ul> <li>Check out the various clubs, programs and reading options offered.</li> <li>Choose something new like comic books, magazines, cookbooks or music recordings.</li> <li>Visit the library's exhibits and special events.</li> <li>Sign up for summer reading challenges.</li> <li>Do an in-depth study of a person, place or event in history.</li> </ul> <h4>On a trip or vacation, whether for a weekend or week, open up a world of new experiences and learning by:</h4> <ul> <li>Researching where you're going, what there is to do, the history of the place, how you'll get there and more.</li> <li>Letting them plot your travels on a paper map that you download and print.</li> <li>Having them keep track of the miles, fuel use and costs.</li> <li>Creating a photo album of experiences and findings big and small.</li> <li>Writing and sending postcards.</li> </ul> <h4>At home, try some of these activities to spark learning:</h4> <ul> <li>Play board and card games, do jigsaw puzzles, do word puzzles like crosswords and sudoku.</li> <li>Practice dexterity skills with little ones like tying or fastening shoes, working zippers and buttoning shirts.</li> <li>Buy an inexpensive outdoor thermometer and rain gauge to keep track of weather events and compare findings with professional meteorologists.</li> <li>Learn a new skill like cursive writing, coding or knitting via the internet or books.</li> <li>Become a pen pal with a family member or friend, and write and send paper letters or practice typing skills by sending email messages.</li> <li>Plan a backyard scavenger hunt; older kids can do this on their own.</li> <li>Start a book club or book swap in your neighborhood.</li> <li>Create a scrapbook of the summer with photos, writing and found items.</li> </ul> <p>Summer is the perfect time to teach your kids that learning doesn't just happen in a classroom. Preventing summer slide will require some out-of-the-box thinking by adults, but the effort will be worth it when your students start a new school year ready to keep learning.</p> <p><a href="/providers/maegen-storm-cnp" target="_self" title="Opens in same window."><em>Maegen Storm</em></a><em> is a nurse practitioner in <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">Pediatric & Adolescent Medicine</a> in <a href="/locations/faribault" target="_self" title="Opens in same window.">Faribault</a>, Minnesota.</em></p><ul> <li>Breastfeeding</li> <li>Health promotion of children</li> <li>Pediatric chronic diseases, i.e. asthma, ADHD, depression, anxiety</li> </ul>C.N.P.<p><strong>Education</strong></p> <ul> <li>Master of Nursing degree at Saint Catherine University, St. Paul, Minnesota</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Certified pediatric nurse practitioner</li> <li>Certified lactation consultant</li> </ul>Storm<img src="/-/media/shared-files/images/medical-professionals/full/faribault/maegen-storm-cnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=D28412CDBBE6AF6BDD77256E83CFB7E2" alt="Maegen Storm CNP" width="280" height="280" DisableNVelocity="true" />{68BA5C85-D987-4133-8B70-C32E52B1235A}Maegen<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15977226Maegen Storm CNP1<img src="/-/media/national-files/images/hometown-health/2023/kids-reading-a-book-together.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4C6CBA643AF229BA3D13BA405E44423A" alt="Kids reading a book together" width="660" height="370" DisableNVelocity="true" />Back to SchoolChildren's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller7/17/2023A Mayo Clinic expert shares how to safeguard yourself and your loved ones from West Nile virus, mainly transmitted through mosquito bites. Learn preventive measures you can take to avoid mosquitos.West Nile virus: What you need to know<p>The Centers for Disease Control and Prevention (CDC) have <a rel="noopener" href="https://www.cdc.gov/west-nile-virus/data-maps/current-year-data.html" target="_blank" title="Opens in a new window.">confirmed reports</a> of West Nile virus in 10 U.S. states. The bite of an infected mosquito most commonly spreads the virus.</p> <p>"West Nile virus is the leading cause of mosquito-borne illness in the U.S.," says <a rel="noopener" href="https://www.mayoclinic.org/biographies/pritt-bobbi-s-m-d/bio-20514068" target="_blank" title="Opens in a new window.">Bobbi Pritt, M.D.</a>, director of the Clinical Parasitology Laboratory at Mayo Clinic. </p> <p>West Nile virus is a flavivirus — a specific type of RNA virus that can infect humans, birds and horses.</p> <p>"West Nile virus is transmitted predominantly through the bite of an infected mosquito. Less commonly, it can be transmitted through other means, like blood transfusion," says Dr. Pritt. "The mosquito that's most commonly implicated is the Culex mosquito, different from the Anopheles mosquito that transmits malaria."</p> <h2>West Nile virus symptoms</h2> <p>Most people infected with the West Nile virus do not experience any symptoms. Some people may develop a fever, headache, body aches, joint pains, vomiting and rash. While most people fully recover, some may experience ongoing weakness and fatigue for months.</p> <p>Severe symptoms from West Nile virus are uncommon though people over 60 face a higher risk of severe illness if infected.</p> <h3>People are at an increased risk of serious health complications due to the virus if they have medical conditions including:</h3> <ul> <li>Cancer</li> <li>Diabetes</li> <li>High blood pressure</li> <li>Kidney disease</li> <li>Having undergone an organ transplant</li> </ul> <p>Severe symptoms affecting the nervous system develop in about 1 in 150 infected people, <a rel="noopener" href="https://www.cdc.gov/west-nile-virus/symptoms-diagnosis-treatment/" target="_blank" title="Opens in a new window.">according to the CDC</a>. Severe symptoms may include inflammation of the brain, known as encephalitis, or of the membranes surrounding the brain and spinal cord, known as meningitis.</p> <p>Seek medical attention immediately if you have signs or symptoms of a serious infection, such as severe headaches, a stiff neck, disorientation or confusion. Hospitalization is usually necessary for a serious infection.</p> <h2>Testing and diagnosis for West Nile virus</h2> <p>"West Nile virus infection is usually diagnosed by detecting antibodies in a patient's blood sample. It's a type of test that we call serology," says Dr. Pritt. "Mayo Clinic Laboratories also offers a polymerase chain reaction, or PCR, test that's particularly good for the first day to several days of infection. Usually, PCR would be combined with serology so that you don't miss infection."</p> <p>Read more about <a rel="noopener" href="https://news.mayocliniclabs.com/2021/06/08/west-nile-virus-a-test-in-focus/" target="_blank" title="Opens in a new window.">Mayo Clinic Laboratories' West Nile virus test.</a></p> <h2>Prevention</h2> <p>Mosquitoes can transmit a number of harmful pathogens, says Dr. Pritt, including the West Nile virus and malaria.</p> <h3>The best way to avoid mosquito-borne illness is to avoid mosquitoes. Consider these tips:</h3> <ul> <li>Empty standing water in outdoor areas, including pet bowls and rain barrels.</li> <li>Install screens in windows.</li> <li>Use insect repellent with DEET, picaridin or oil of lemon eucalyptus.</li> <li>Wear permethrin-treated clothing while outdoors or in the woods.</li> </ul> <p>"There are also measures people can take to control mosquito populations around their home," she says. "It's important to know that mosquitoes breed and lay their eggs in bodies of water. One of those preventive measures is to remove standing bodies of water around the house, such as bird baths and other containers that may collect rainwater, for example. Then you could also pay to have the outside of your home professionally treated."</p> <p><em>This article originally appeared on the </em><a rel="noopener" href="https://newsnetwork.mayoclinic.org/discussion/west-nile-virus-what-you-need-to-know/" target="_blank" title="Opens in a new window."><em>Mayo Clinic News Network</em></a><em>. </em></p><img src="/-/media/national-files/images/hometown-health/2023/sitting-with-feet-in-the-water.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9B033928096F4CD4FB97D847AA8C9649" alt="Sitting with feet in the water" width="660" height="370" DisableNVelocity="true" />Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller8/24/2023Life-threatening bleeding can happen anywhere at any time. Learning the steps you can take for swift action to stop the bleeding can make the difference between life and death.ABCs of bleeding control<p>Life-threatening bleeding can happen to anyone, anywhere, at any time. Injuries can occur on the farm, at home, in your vehicle or in the community. Knowing how to control bleeding can make the difference between life and death for you or a loved one.</p> <p>A medical background isn't necessary to learn the basics of bleeding control. Education focuses on recognizing and responding to life-threatening bleeding with simple actions like applying pressure, packing wounds and using a tourniquet.</p> <h2>Remember the steps of bleeding control with this acronym: ABC.</h2> <h3>Alert 911.</h3> <p>After ensuring you're not in immediate danger, the first step is to call 911 to request emergency services.</p> <h3>Bleeding assessment.</h3> <p>When emergency services are on the way to provide advanced medical care, you should assess the bleeding. Locate the source of the bleeding by looking for injuries causing blood pooling. Clothing can affect the bleeding, so ensure you identify the wound's location on the body. </p> <h3>Control the bleeding.</h3> <p>After you find the source of the bleeding, applying pressure is the simplest, yet most effective, technique to slow it. You can use your hand to apply direct, firm pressure or cover the wound with any available cloth, like a shirt or towel and apply pressure to that. Push hard and maintain the pressure for a minimum of 20 minutes or until emergency services arrive.</p> <p>The injured person may feel pain or discomfort from the pressure applied to the wound. Tell the person that the pressure level is necessary to slow the life-threatening bleeding. </p> <p>For severe wounds, applying pressure may not be enough to control bleeding. If the wound is large, pack it with any available cloth to help decrease bleeding. For packing material, use clothing or towels; they don't need to be sterile or new. Any potential risk of infection from the packing material can be treated with antibiotics. The first priority is to stop the bleeding immediately.</p> <p>A tourniquet is a valuable tool when applied appropriately and correctly, especially if the source of bleeding is on an extremity, such as an arm or leg. Tourniquets are now more available and easier to use, even allowing people to apply a tourniquet to themselves.</p> <p>Applying a tourniquet requires training to ensure proper placement and tightness to control bleeding. Once a tourniquet is applied, do not remove it even if bleeding slows or stops. Releasing the tourniquet may allow the bleeding to resume. It's vital for medical professionals, like emergency department staff, to assess the bleeding before releasing the tourniquet.</p> <h2>First aid preparedness</h2> <p>Basic first aid knowledge can make the difference between life and death when someone is bleeding. Knowing the simple steps to take before emergency services arrive will ensure you're prepared if there's an injury.</p> <p>Remember the ABCs: Alert 911, conduct a bleeding assessment and control bleeding with pressure, packing or a tourniquet.</p> <p>The Trauma program at Mayo Clinic Health System offers bleeding control education to schools, community groups and organizations. Contact a Trauma program coordinator at the <a href="/locations" target="_self" title="Opens in same window.">hospital nearest to you</a> to learn more. The American College of Surgeons (ACS) Committee on Trauma's national <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.stopthebleed.org/" target="_blank" title="Opens in a new window.">Stop the Bleed</a> program offers an online course and in-person training. Raising awareness and providing training allows people to respond in a time of crisis to potentially save a life.</p> <p><em>Gail Norris is a regional trauma program manager in <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">Emergency Medicine</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2023/working-on-tractor.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B9C78F87CFCB833E690ABBADD42D3865" alt="Working on tractor" width="660" height="370" DisableNVelocity="true" />Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Dawn Haller8/15/2023Summertime can mean fun adventures and late nights for kids. When it's time to go back to school, early mornings and structured routines can be a difficult adjustment unless you prepare in advance.Back to school: Building routines, overcoming anxiety in kids<p>For many kids, summer is a time to stay up late, sleep in and hang out with friends. Waking up for that first day of a new school year can be a shock if young children, teenagers, parents or caregivers have not developed a routine.</p> <h2>Tips for getting into a back-to-school routine</h2> <p>Transitioning from a laid-back summer schedule to the structure of a new school year doesn't have to be a rude awakening. Developing routines for morning, bedtime and any other recurring event can make things run more smoothly at home and at school.</p> <h3>Start routines slowly</h3> <p>Routines are a natural part of life to provide structure and help kids predict and expect what will happen. One way to help make the transition a little smoother is to give your family time to ease into the new routine.</p> <p>Consider taking a week or so before school starts to help kids adjust to waking up earlier, getting ready and having breakfast as soon as they get up.</p> <p>And parents shouldn't stress if things don't go exactly as planned. Kids need to learn that they can handle change. Having a routine is good. Knowing that you can handle life not following that routine is equally good.</p> <h3>Overcome anxiety</h3> <p>While heading back to school after a long summer break can be an exciting time for kids and caregivers, for some students, the anxiousness of heading back to school may be fueled by fears or worry.</p> <p>Many tactics parents and caregivers can use to help kids with back-to-school worries are straightforward.</p> <p>The first one is to stay calm and warm. Realize that when kids are nervous and worry, they often express that through acting up, being more irritable. Kids usually take those emotions out on their parents because that's the safe place to do so.</p> <p>Some kids might feel overwhelmed at the thought of interacting and reconnecting with peers. Consider scheduling play dates for kids to reconnect before the new school year. Reconnecting with kids they know through school but don't see so much during the summer can be helpful.</p> <h3>Make a plan</h3> <p>Finally, making sure kids get good, structured sleep, are eating well, limiting screen time and emphasizing physical activities can help kids feel better. When they feel better, fears and worries are easier to manage.</p> <p>One sign of back-to-school anxiety that parents and caregivers may look out for is their student asking a lot of questions about what may or may not happen. Making a plan can help ease that worry.</p> <p>Let kids know that it's perfectly normal to feel nervous about change and experience a combination of nervousness and excitement to return to school. Handle change together by making a plan and following the steps to prepare for back to school.</p> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/whiteside-stephen-p-ph-d-l-p/bio-20054748" target="_blank" title="Opens in a new window."><em>Stephen Whiteside, Ph.D.</em></a><em>, is a child psychologist at Mayo Clinic. </em></p> <p><em>This article originally appeared on the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/" target="_blank" title="Opens in a new window." data-di-id="di-id-7d2c3b0-5ba7c6c2">Mayo Clinic News Network</a>.</em></p><img src="/-/media/national-files/images/hometown-health/2023/kids-in-school-bus.jpg?h=370&iar=0&w=660&sc_lang=en&hash=AC4BF27C38AF6B84AB6B9E99296E3027" alt="Kids in school bus" width="660" height="370" DisableNVelocity="true" />Back to SchoolBehavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller8/29/2023Is your bladder trying to tell you something important? From frequency to nighttime waking, your bladder's signals can reveal hidden issues. Pay attention to these 10 symptoms.Listen to your bladder: 10 symptoms that demand attention<p>Every day, you get direct feedback from a vital organ: your bladder. Most people urinate six to eight times a day, and this regular act can reveal much about your bladder's health.</p> <p>Some messages are easier to explain. If you down a lot of water, it's likely that you'll need to urinate soon. Some medications, like diuretics or decongestants, can increase your need to urinate.</p> <p>Some messages, however, are a sign of more serious issues like urinary tract infections, bladder stones, trauma, ureteral obstruction, an enlarged prostate or even bladder cancer. When you pay close attention to your bladder health, you're more likely to identify signs and symptoms earlier and help your healthcare team determine the cause.</p> <h2>Here are 10 bladder symptoms that you should discuss with your healthcare team:</h2> <h3>1. Frequent urination</h3> <p>On average, most people urinate six to eight times in 24 hours. This varies based on the amount of liquid you drink, along with whether you are pregnant or taking medications that increase urination. A sudden increase in urination that can't be explained, especially at night, can be a sign of a bladder problem or diabetes. Dietary bladder irritants can also increase urinary frequency and urgency.</p> <h3>2. Urgency</h3> <p>Most of the time, adults can hold their urine until they reach a restroom. A sudden, strong urge to urinate that's difficult to control can indicate a urinary tract infection, urge incontinence or other bladder conditions.</p> <h3>3. Incontinence</h3> <p>Involuntary leakage of urine is a common bladder condition. There are two types of incontinence. Stress incontinence occurs when a person coughs, laughs or sneezes. It can also happen during physical activities. Urge incontinence happens after a sudden and intense urge to urinate, quickly followed by the involuntary loss of urine. You can have both types of incontinence.</p> <h3>4. Painful urination</h3> <p>Urinating shouldn't be painful. A burning or stinging sensation while urinating can be a sign of bladder issues like a urinary tract infection or bladder stones.</p> <h3>5. Hematuria</h3> <p>It can be scary to see blood in your urine, also called hematuria. Blood in the urine can be a sign of a serious illness such as kidney or bladder stones, an infection, or bladder or kidney cancer. Sometimes blood can be seen and appears pink, red or brown. In other cases, it can only be detected by a microscope when a lab tests the urine. Either way, it's important to figure out the reason for the bleeding.</p> <h3>6. Difficulty emptying the bladder</h3> <p>Most people feel relief when the bladder is emptied. But if you can't completely empty your bladder after urinating, it can be a sign of bladder dysfunction.</p> <h3>7. Weak urine stream</h3> <p>Changes in urine stream strength often develop over time, especially with age. A weak or interrupted urine stream could be a symptom of an enlarged prostate in men.</p> <h3>8. Pain or pressure</h3> <p>Pelvic pain can feel like a dull ache, built-up pressure or a sharp, localized pain. In addition to the pelvic area, the pain can be in your lower abdomen or back. While there are many possible causes of pelvic pain or pressure, it can be related to bladder issues.</p> <h3>9. Recurrent urinary tract infections</h3> <p>Frequent infections can be a sign of an underlying bladder problem. You may have chronic or recurrent bladder infections if you have two or more bladder infections in six months or three or more infections in a year.</p> <h3>10. Nocturia</h3> <p>Waking up more than once each night to pass urine is called nocturia. This can disrupt your sleep pattern and can be a sign of many different bladder issues or underlying health issues like obstructive sleep apnea or glucosuria, which is glucose in the urine.</p> <p>It's important to understand that symptoms vary based on the type and severity of any bladder condition, your lifestyle and whether you have other chronic health conditions.</p> <p>Talk with your healthcare team if you're experiencing any of these symptoms. After a thorough exam and tests, they can determine the cause of your symptoms and recommend appropriate treatment options.</p> <p><a href="/providers/marla-carlson-pa" target="_self" title="Opens in same window."><em>Marla Carlson</em></a><em> is a physician assistant in <a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a> in <a href="/locations/red-wing" target="_self" title="Opens in same window.">Red Wing</a>, Minnesota.</em></p><ul> <li>Managing issues related to urology.</li> </ul>P.A.<p><strong>Education</strong></p> <ul> <li><strong> </strong>Master’s degree in physician assistant studies, Butler University, Indianapolis</li> </ul>Carlson<img src="/-/media/shared-files/images/medical-professionals/full/red-wing/urology/marla-carlson-pa.jpg?h=280&iar=0&w=280&sc_lang=en&hash=742A8E62F3D960E0321708E116F2D869" alt="Marla Carlson PA" width="280" height="280" DisableNVelocity="true" />{DAD90F8F-565B-496D-844F-6AC6F0780412}Marla <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20658672Marla Carlson PA1<img src="/-/media/national-files/images/hometown-health/2023/outdoors-with-backpack-on-shoulder.jpg?h=370&iar=0&w=660&sc_lang=en&hash=011F53168B52C04810C5E076C3B33752" alt="Outdoors with backpack on shoulder" width="660" height="370" DisableNVelocity="true" />Urinary IncontinenceThe loss of bladder control is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that's so sudden and strong you don't get to a toilet in time. For most people, simple lifestyle changes or medical treatment can ease discomfort or stop urinary incontinence.Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Dawn Haller8/8/2023Pain is experienced differently by everyone. That's why it's important to have a diverse healthcare team to help address your symptoms. Here's how experts in physical medicine and rehabilitation help you manage pain and restore functionality.Managing pain and restoring function<p>Pain is different for everyone. Factors like genetics, previous injuries, chronic health conditions and environment shape how you feel and interpret pain. It's important that your healthcare team is diverse because pain sources and experiences are complex.</p> <p>A team approach with experts in physical medicine and rehabilitation, pain medicine, pharmacy, psychology, physical therapy and others ensures you'll find the best approach to manage your pain and relieve your symptoms.</p> <h2>Physical medicine and rehabilitation</h2> <p><strong> </strong></p> <p> <a href="/services-and-treatments/physical-medicine-and-rehabilitation">Physical medicine and rehabilitation</a> professionals manage your pain and help get you back a full range of movement and function. This medical specialty treats a variety of conditions affecting the brain, spinal cord, nerves, bones, joints, ligaments, tendons or muscles.</p> <p>Physical medicine and rehabilitation physicians — also known as physiatrists — focus on preventing, diagnosing, treating and rehabilitating conditions caused by disease, disorder or injury.</p> <h3>Their goals include:</h3> <ul> <li>Decreasing pain</li> <li>Enhancing a range of movement to improve quality of life </li> <li>Maximizing independence with daily living activities</li> </ul> <p>These professionals consider the whole person, not just the problem area. This medical specialty often is called the "quality of life profession" because its aim is to enhance the body's performance.</p> <h2>Working with other specialists</h2> <p>Physical medicine and rehabilitation professionals work with experts in <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapy</a>, <a href="/services-and-treatments/neurosurgery" target="_self" title="Opens in same window.">neurosurgery</a>, <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">psychology</a>, <a href="/services-and-treatments/medication-therapy-management" target="_self" title="Opens in same window.">pharmacology</a> and other areas to address pain. They often also work closely with <a href="/services-and-treatments/pain-medicine" target="_self" title="Opens in same window.">pain medicine</a> professionals to provide you with the best care possible.</p> <p>In the past, experts in physical medicine and rehabilitation and pain medicine had different approaches to treating pain. Today, the line between these two specialties has become less pronounced. In many cases, patient care plans are a blend of treatments provided by pain medicine and physical medicine and rehabilitation. This collaboration is essential to providing the best possible outcome for each patient.</p> <h2>Individualized treatment plan</h2> <p>Each person's pain symptoms are distinctive — so treatment plans should be just as special.</p> <p>During an initial appointment, the healthcare team gathers your health history, discusses your symptoms and performs a thorough physical exam. Any conditions that need immediate attention are ruled out, allowing them to concentrate on developing a conservative, individualized treatment plan.</p> <p>The most common pain conditions treated by physical medicine and rehabilitation professionals are back, musculoskeletal and joint pain.</p> <h3>To address these issues, they use a wide range of diagnostic and treatment options including: </h3> <ul> <li>Ultrasound or fluoroscopy-guided injections to target the exact source of pain</li> <li>Regenerative medicine, including prolotherapy and platelet-rich plasma therapy</li> </ul> <h4>Additional treatments that may be provided or prescribed include: </h4> <ul> <li><a href="/services-and-treatments/physical-therapy">Physical therapy</a></li> <li><a href="/services-and-treatments/occupational-therapy" target="_self" title="Opens in same window.">Occupational therapy</a></li> <li>Manual therapy </li> <li>Trigger point injections</li> </ul> <p>Physiatrists recommend various treatments based on your preferences, the severity of pain and the potential of restoring lost function.</p> <p>It's important that you actively participate in your own care. This means asking questions to understand the causes of and treatment plan for pain, attending all appointments and following any recommended schedule of exercises and stretches.</p> <p>Diet, sleep and stress can influence how you experiences pain, so lifestyle changes may be necessary. Examples include following the <a href="/hometown-health/speaking-of-health/eating-for-your-heart-the-mediterranean-diet" target="_self" title="Opens in same window.">Mediterranean</a>, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-20048456" target="_blank" title="Opens in a new window.">DASH</a> or other recommended diet, adopting <a href="/hometown-health/speaking-of-health/5-ways-to-get-better-sleep" target="_self" title="Opens in same window.">sleep hygiene habits</a> and lowering stress through <a href="/hometown-health/speaking-of-health/mindfulness-meditation-improve-your-quality-of-life" target="_self" title="Opens in same window.">mindful meditation</a> or cognitive behavioral therapy.</p> <p>As pain treatment options evolve, the focus remains on tailoring care to meet your specific needs. This personalized approach gives you the best chance to restore function and improve your quality of life.</p> <p><a href="/providers/evan-nelson-md" target="_self" title="Opens in same window."><em>Evan Nelson, M.D.</em></a><em>, is a <a href="/services-and-treatments/physical-medicine-and-rehabilitation" target="_self" title="Opens in same window.">physiatrist</a> and <a href="/services-and-treatments/pain-medicine" target="_self" title="Opens in same window.">pain medicine</a> physician in <a href="/locations/la-crosse">La Crosse</a>, Wisconsin.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>University of Illinois College of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Physical Medicine & Rehabilitation, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Academy of Pain Medicine</li> <li>American Academy of Physical Medicine and Rehabilitation</li> <li>American Board of Physical Medicine and Rehabilitation</li> <li>American Institute of Ultrasound Medicine</li> <li>Christian Medical and Dental Society</li> <li>International Spinal Injection Society</li> <li>National Forum of Independent Pain Clinicians</li> <li>Subspecialty Certification in Pain Management</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine and Science</li> </ul>Nelson<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/evan-nelson-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=56FE3C3E337DB05FB4511A8C3F08815F" alt="Evan Nelson MD" width="280" height="280" DisableNVelocity="true" />Evan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>11615532Evan Nelson, M.D.1{4EA2A40E-3721-48EC-AFC9-E6D0E13BCDEC}<img src="/-/media/national-files/images/hometown-health/2023/hand-on-back-with-pain.jpg?h=370&iar=0&w=660&sc_lang=en&hash=356D499A356E06CB69055D0E85F81C11" alt="Hand on back with pain" width="660" height="370" DisableNVelocity="true" />Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.Pain ReliefApproximately 50 million people in the U.S. live with chronic pain. If you experience chronic pain, you're not alone. Learn about the ways to deal with painful disorders, from at-home solutions to drug treatments, injectable or implantable therapies to surgery.Dawn Haller8/10/2023Estrogen is thought to act as a fuel for breast cancer cells. Two types of prevention medications block estrogen to reduce breast cancer risk. Learn about the differences and who may benefit.Medications to lower breast cancer risk<p>Each year in the U.S., approximately 265,000 people are diagnosed with breast cancer and 42,000 people die from the disease. Fortunately, survival rates have increased due to early detection and prevention of the disease.</p> <p>Breast cancer causes are multifactorial. Some risk factors can be lowered through changes like eating a healthy diet, exercising and avoiding alcohol and tobacco. Other factors are out of a person's control like genetics and family history.</p> <h2>Assessing breast cancer risk</h2> <p>Estimating breast cancer risk is complicated. At Mayo Clinic Health System, teams use different assessment scales to help patients understand their personal risk for cancer.</p> <p>The <a rel="noopener noreferrer" href="https://bcrisktool.cancer.gov/" target="_blank" title="Opens in a new window.">Breast Cancer Risk Assessment Tool</a>, also called the Gail Model, and the IBIS Risk Assessment Tool, also called the Tyrer-Cuzick Model, are two of these assessment scales. The models examine multiple factors, and taken together can give an estimate of a person's breast cancer risk.</p> <h3>Some of the factors that play a role in risk assessment for developing breast cancer include: </h3> <ul> <li>Genetic alteration, such as a BRCA1 or BRCA2 mutation</li> <li>Previous treatment with chest radiation before age 30</li> <li>Prior breast biopsy showing atypical ductal hyperplasia (ADH), lobular hyperplasia (ALH) or lobular carcinoma in situ (LCIS)</li> <li>Strong family history of breast cancer</li> </ul> <p>Increased breast density also is a risk factor for breast cancer and is incorporated into risk assessment.</p> <p>Being identified as having a higher risk for developing breast cancer doesn't mean you will get cancer. However, you can understand your personal risk and work with your healthcare team to develop options for prevention and screening.</p> <h2>Medications to reduce risk</h2> <p>Medications are available that can reduce a woman's risk of developing breast cancer. If you have been identified by your breast care team as eligible based on your risk assessment, this option may be offered to you. </p> <p>Risk-reducing medication is not recommended for people at a low-to-moderate risk of developing breast cancer and is not a replacement for screenings.</p> <p>It's offered as an option to women at a higher risk of developing cancer and used in addition to the recommended screenings. It's critical to thoroughly discuss the options, benefits, risks and side effects of any medication with your healthcare team before making any decision.</p> <p>There are two primary categories of medications to reduce breast cancer risk. Estrogen is thought to act as a fuel that promotes the growth of cancer cells.</p> <h3>Risk-reducing medications block estrogen in the body in different ways: </h3> <ul> <li><strong>Selective estrogen receptor modulators (SERM)</strong><br /> Tamoxifen is a SERM. It binds to an estrogen receptor on a cell. Tamoxifen is an option for premenopausal and menopausal women. The most common side effects include hot flashes, vaginal dryness and joint pain. Less common side effects include increased risk for blood clots, stroke and uterine cancer.</li> <li><strong>Aromatase inhibitors</strong><br /> These medications decrease the production of estrogen in the body and are an option for postmenopausal women. Side effects include hot flashes, vaginal dryness, joint pain and bone loss leading to osteoporosis. Aromatase inhibitors are not associated with a higher risk for blood clots, stroke or uterine cancer.</li> </ul> <p>SERM and aromatase inhibitors are not taken together. The decision to take one of these medications should be based on your medical history, and the side effects and risks associated with the medication. </p> <p>Talk with your healthcare team to assess your risk factors for breast cancer and discuss whether to use medication as part of your breast cancer screening and prevention path.</p> <p><a href="/providers/caroline-clune-md" target="_self" title="Opens in same window."><em>Caroline Clune, M.D.</em></a><em>, is an internal medicine physician who care for patients in the <a href="/locations/la-crosse/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Center for Breast Care</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Benign breast disease</li> <li>Breast cancer survivorship and surveillance</li> <li>Breast lump</li> <li>Breast pain</li> <li>Contraception</li> <li>Dense breast tissue and supplemental screening</li> <li>Evaluation, counseling and management of patients with breast cancer-related genetic mutations and family history of breast cancer</li> <li>High-risk breast lesions, including atypical hyperplasia and lobular carcinoma in situ</li> <li>Irritable bowel</li> <li>Menopause</li> <li>Mental health</li> <li>Migraines</li> <li>Preventive medications to decrease risk of breast cancer</li> <li>Sexual health</li> <li>STI screening</li> <li>Video visits or telehealth</li> <li>Wellness and exercise</li> <li>Women's health</li> </ul>M.D.<p>I try to connect with my patients as individuals and use this understanding to move forward in shared decision-making about medical care. I am honored to be part of the team serving my patients.</p> <p>In my free time, I enjoy traveling, cooking and staying active outside.</p><p><strong>Education</strong></p> <ul> <li>Medical College of Wisconsin</li> </ul> <p><strong>Internship/Residency</strong></p> <ul> <li>Internal Medicine, Washington University School of Medicine</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Chief Resident, Washington University School of Medicine</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Internal Medicine, American Board of Internal Medicine</li> </ul> <p><strong>Membership</strong></p> <ul> <li>Society of Hospital Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Clune<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/caroline-clune-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=29946D5FB3C261AADD8DBEB9EDF05A45" alt="Caroline Clune, M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener" href="https://www.dovepress.com/articles.php?article_id=83835" target="_blank" title="Opens in new window">Prevalence, impact, and diagnostic challenges of benign breast disease: A narrative review</a>, May 2023.</li> <li><a rel="noopener" href="https://www.mydigitalpublication.com/publication/?m=46092&i=764910&view=articleBrowser&article_id=4365096&id=19880&ver=html5" target="_blank" title="Opens in a new window.">Clinical implications and utility of polygenic risk scores in women at elevated risk for breast cancer</a>, September 2022.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/34032171/" target="_blank" title="Opens in a new window.">Influence of social and cultural factors on the decision to consent for monoclonal antibody treatment among high-risk patients with mild-moderate COVID-19</a>, December 2021.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/34816096/" target="_blank" title="Opens in a new window.">Computer-based patient bias and misconduct training impact on reports to incident learning system</a>, November 2021.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/34279629/" target="_blank" title="Opens in a new window.">Real-world clinical outcomes of bamlanivimab and casirivimab-imdevimab among high-risk patients with mild to moderate coronavirus disease 2019</a>, October 2021.</li> </ul>Caroline<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15806375Caroline Clune, M.D.1{0DD9D3C9-86C5-47FC-A2CF-8AEEA4717B70}<img src="/-/media/national-files/images/hometown-health/2023/two-people-in-car-laughing.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2FA06B2D8A3CEE9F5D17412A43B4C430" alt="Two people in car laughing" width="660" height="370" DisableNVelocity="true" />Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.Dawn Haller8/30/2023Nasal polyps are small growths on the lining of the nasal passages, often caused by chronic inflammation. Get answers to common questions about the tiny lumps that can cause big problems.Nasal polyps: Unassuming growths with a powerful effect<p>The nose is the subject of many sayings. A measurement could be on the nose or an object be right under your nose. You may be reminded to keep your nose clean and keep it out of another's affairs.</p> <p>While often the focus of these idioms, your nose also can be affected by physical conditions, such as nasal polyps. These are soft, painless, noncancerous growths on your nasal passages or sinus linings and hang down like teardrops or grapes.</p> <p>Nasal polyps may form anywhere in your sinuses or nasal passages. But they most often appear in an area where the sinuses near your eyes, nose and cheekbones drain through winding passages into your nose.</p> <p>Here's what you need to know about these small growths.</p> <h2>What causes nasal polyps?</h2> <p>Nasal polyps often result from chronic inflammation of the nasal passages. That's why people who have chronic sinusitis have an increased risk of developing nasal polyps. <a href="/hometown-health/speaking-of-health/chronic-sinusitis-more-than-a-stuffy-nose" target="_self" title="Opens in same window.">Chronic sinusitis</a> is when the sinuses become swollen and inflamed for more than 12 weeks. This causes the lining in the nose to make more mucus, while the swollen lining interferes with drainage.</p> <p>People with asthma, allergies, drug sensitivities or certain immune disorders also have an increased risk for nasal polyps.</p> <p>Scientists don't yet fully understand why certain conditions and inflammation trigger polyps to form in some people and not in others. Nasal polyps can develop at any age but are most common in young and middle-aged adults.</p> <h2>What are the common symptoms of nasal polyps?</h2> <p>A person can have nasal polyps and not know it, especially small ones. Larger or multiple polyps can cause a sensation of nasal congestion, impaired sense of smell and taste, decreased airflow and recurring sinus infections.</p> <p>Some people with nasal polyps develop an intolerance to over-the-counter pain-relieving medications like ibuprofen and naproxen.</p> <h2>Can nasal polyps cause health complications?</h2> <p>Nasal polyps can cause complications because they block airflow, fluid drainage and long-term inflammation underlying their development. In some people, they cause worsening asthma or structural changes in the sinuses.</p> <p>Many people with nasal polyps have recurring sinus infections. This increases antibiotic exposure and could lead to clostridium difficile, also called C-diff, a potentially severe gastrointestinal infection.</p> <h2>How are nasal polyps treated?</h2> <p>The treatment goal for nasal polyps is to reduce their size or eliminate them. Medication usually is the first approach. Surgery sometimes may be needed, but it may not provide a permanent solution because polyps tend to recur.</p> <p>Nasal steroids and budesonide rinses may reduce swelling and irritation. These treatments may shrink polyps or eliminate them completely.</p> <p>If you have nasal polyps and chronic sinusitis, your healthcare team may give you an injection of a medication called dupilumab, commonly known as Dupixent, to treat your condition. This biologic medication may reduce the size of the nasal polyps and lessen congestion. It's often prescribed by an allergist and can be administered at home.</p> <p>Nasal polyps in children typically are treated with topical medications and dupilumab.</p> <h2>Can you prevent nasal polyps?</h2> <p>You may be able to reduce your chances of developing nasal polyps or having polyps come back after treatment by reducing inflammation in your nose and sinuses.</p> <h3>Start by following these tips:</h3> <ul> <li><strong>Manage allergies and asthma.</strong><br /> Follow treatment recommendations from your healthcare team. If your symptoms aren't well-controlled, ask about changing your treatment plan.</li> <li><strong>Avoid nasal irritants.</strong><br /> As much as possible, avoid breathing airborne substances that are likely to contribute to swelling or irritation in your nose and sinuses, such as allergens, or allergy-causing agents; tobacco smoke; chemical fumes; dust; and fine debris.</li> <li><strong>Practice good hygiene.</strong><br /> Wash your hands regularly and thoroughly. This is one of the best ways to protect against bacterial and viral infections that can cause inflammation of the nasal passages and sinuses.</li> <li><strong>Humidify your home.</strong><br /> Using a humidifier may help moisten your breathing passages, improve the flow of mucus from your sinuses, and help prevent blockages and inflammation. Clean the humidifier daily to eliminate bacterial growth.</li> <li><strong>Use a nasal rinse.</strong><br /> Use a saline spray or nasal wash to rinse your nasal passages. This may improve mucus flow, and remove allergens and other irritants.</li> </ul> <h2>How are nasal polyps diagnosed?</h2> <p>Your healthcare team usually can make a diagnosis based on your answers to questions about your symptoms, a general physical exam and an examination of your nose. Polyps may be visible with the aid of a simple lighted instrument called a nasal endoscope.</p> <p>They also may suggest skin tests to determine if allergies are causing chronic inflammation. With a skin prick test, tiny drops of allergens are pricked into the skin of your forearm or upper back. Your healthcare team observes your skin for signs of allergic reactions. If a skin test can't be performed, a blood test can screen for specific antibodies to various allergens.</p> <p>Talk with your healthcare team if you have recurring sinus infections, infections that last longer than 12 weeks, impaired smell or taste, or are having trouble breathing through your nose.</p> <p><a href="/providers/john-wheeler-jr-md" target="_self" title="Opens in same window."><em>John Wheeler Jr, M.D.</em></a><em>, is an allergist in <a href="/services-and-treatments/immunology" target="_self" title="Opens in same window.">Allergy & Asthma</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Allergic rhinitis</li> <li>Asthma</li> <li>Food allergies</li> <li>Nasal polyps</li> </ul>M.D.<p>I enjoy hearing patients’ stories and working together with them to solve their allergy and immunology mysteries. I consider my approach relaxed and laid back, but I can provide intensity when the situation requires.</p> <p>I am also a pediatric allergy physician offering care for patients in Onalaska, Wisconsin.</p> <p>When I’m not in the office, you will find me in search of fresh air and sunshine.</p><p><strong>Education</strong></p> <ul> <li>Ben-Gurion University of the Negev</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Baystate Medical Center</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Allergy & Immunology, State University of New York</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Allergy and Immunology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Allergy, Asthma and Immunology</li> <li>American College of Allergy, Asthma and Immunology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Wheeler Jr.<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/john-wheeler-jr-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=8D1B98AB924C1BA6551E607E2933BC2A" alt="John Wheeler Jr., M.D." width="280" height="280" DisableNVelocity="true" />John<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14588161John Wheeler Jr., M.D.1{9D6C5FE2-E6DA-4A63-9DD8-CE124BD4E4B7}|{E9B8BDBE-375B-4E7D-A1D2-2B64B5513AF7}<img src="/-/media/national-files/images/hometown-health/2023/smelling-flowers.jpg?h=370&iar=0&w=660&sc_lang=en&hash=00F1380AEA5983BC048F9FFAE84661EA" alt="Smelling flowers" width="660" height="370" DisableNVelocity="true" />Allergy and AsthmaOur allergists provide care for your allergies, asthma and conditions that affect the immune system's ability to defend the body against foreign or abnormal cells. The main treatment goal is your satisfaction when your condition is under control and quality of life is improved.Ear, Nose and Throat (ENT)Get information about symptoms, disorders and diseases affecting the ear, nose and throat, and related head and neck structures.Dawn Haller8/14/2023During open enrollment season, families have to sift through health insurance options. Here are some tips for narrowing down your choices and selecting the right plan for your family.7 tips for selecting the right health insurance plan <p>Open enrollment season is approaching, and with it comes the challenge of sifting through a myriad of health insurance options.</p> <p>The process can feel daunting. Plans are full of unfamiliar terminology, it's impossible to predict all of your future healthcare needs, deadlines approach quickly, and you need to carefully evaluate your comfort with risk and expenses.</p> <h2>Here are seven tips as you evaluate the available choices and determine the right one for your family:</h2> <h3>1. Find reputable sources of information.</h3> <p>The internet is full of "too good to be true" offers, so focus your attention on trusted and accurate information sources. Talk with your human resources representative if you have commercial insurance offered by your employer. <a rel="noopener noreferrer" href="https://www.healthcare.gov/" target="_blank" title="Opens in a new window.">Healthcare.gov</a> outlines Affordable Care Act Marketplace coverage options. <a rel="noopener noreferrer" href="https://www.medicare.gov/" target="_blank" title="Opens in a new window.">Medicare.gov</a> and <a rel="noopener noreferrer" href="https://www.medicaid.gov/" target="_blank" title="Opens in a new window.">Medicaid.gov</a> have resources for these programs.</p> <h3>2. Learn the terminology.</h3> <p>You may not use the words deductible, co-payment and health reimbursement account in everyday conversation, but it's important to understand these terms when evaluating plans. Healthcare.gov has a <a rel="noopener noreferrer" href="https://www.healthcare.gov/glossary/" target="_blank" title="Opens in a new window.">comprehensive glossary</a> to clear up any confusion as you sort through plan features.</p> <h3>3. Estimate how much care you'll need.</h3> <p>There's no magic ball for looking into your future, but you can give it your best guess. All plans should include some coverage for catastrophic injuries or illnesses, so think through other types of healthcare your family will likely need. This could include physical exams and screenings such as <a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">mammograms</a> and colonoscopies. Are you pregnant or hope to become pregnant? Need shoulder replacement surgery, allergy testing or hearing aids? Then review how many visits to <a href="/services-and-treatments/urgent-care" target="_self" title="Opens in same window.">Urgent Care</a> and the <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">Emergency Department</a> your family averaged in recent years. Listing these can give you an estimate of what the coming year may look like.</p> <h3>4. Evaluate where you get your care.</h3> <p>Some plans restrict the hospital, clinic or healthcare professionals you can see. If you want the knowledge and expertise of Mayo Clinic, look for a plan that includes it in its choices.</p> <h3>5. Focus on quality value.</h3> <p>You should consider more than just costs when evaluating plans. Make sure the plan you select allows you to access hospitals and clinics with high-quality rankings and a full spectrum of healthcare options. Care doesn't just happen in an exam room, so you may want to look for healthcare facilities that offer <a href="/wellness" target="_self" title="Opens in same window.">wellness programs</a>, virtual appointments and mobile apps to monitor your health.</p> <h3>6. Look for value-added benefits.</h3> <p>Some plans offer helpful services like free health assessments, tobacco cessation counseling, virtual care or nurse advice.</p> <h3>7. Ask your family and friends.</h3> <p>People in your life may have recommendations, especially if they get care from the same healthcare professionals as you. While their exact coverage may differ, they may have insight into customer support or the ease of filing a claim or navigating the plan's website.</p> <h2>Choose Mayo Clinic Health System</h2> <p>You can ensure you have access to Mayo Clinic care by choosing an insurance plan with access to the <a href="/" target="_self" title="Opens in same window.">Mayo Clinic Health System</a> provider network. We have clinics, hospitals and other healthcare <a href="/locations" target="_self" title="Opens in same window.">facilities</a> in Iowa, Minnesota and Wisconsin. More than 100 services and specialties are provided by 1,700 physicians and advanced practice providers. This comprehensive care, paired with the resources and expertise of Mayo Clinic, allows our patients to receive the highest-quality care close to home. Learn more about the <a href="/bestchoice" target="_blank" title="Opens in a new window.">Mayo Clinic difference</a>.</p> <p>Talk with your human resources or health insurance representatives about your needs and for help selecting a plan that provides access to Mayo Clinic care.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2023/couple-with-toddler-on-shoulders.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8FDF3162F3DBCA2E9FD878C546094F85" alt="Couple with toddler on shoulders" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller8/28/2023The FDA has approved a vaccine for pregnant women and infants to provide protection against respiratory syncytial virus. Here's what you need to know to protect your family from RSV.RSV vaccine for moms-to-be and infants<p>The <a rel="noopener" href="https://www.fda.gov/" target="_blank" title="Opens in a new window.">Food and Drug Administration</a> (FDA) has approved a vaccine to help protect pregnant women and infants from <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/respiratory-syncytial-virus/symptoms-causes/syc-20353098" target="_blank" title="Opens in a new window.">respiratory syncytial virus, or RSV</a>.</p> <p>Abrysvo, the single-dose vaccine produced by Pfizer, is approved for use in pregnant women between week 32 and week 36 of pregnancy. Beyfortus, also a single-dose vaccine, has been approved for infants during or entering their first RSV season and for children up to 24 months who remain vulnerable to severe RSV disease during their second RSV season.</p> <p>"This is especially exciting for us in pediatrics because vaccinating pregnant women in the second or third trimester of pregnancy can protect babies when they're most vulnerable for developing severe illness with RSV, usually in the first six to 12 months of life," says <a rel="noopener" href="https://www.mayoclinic.org/biographies/rajapakse-nipunie-s-m-d-m-p-h/bio-20308514?mc" target="_blank" title="Opens in a new window.">Nipunie Rajapakse, M.D.</a>, a pediatric infectious diseases physician with the <a rel="noopener" href="https://www.mayoclinic.org/departments-centers/childrens-center" target="_blank" title="Opens in a new window.">Mayo Clinic Children's Center</a>.</p> <h2>What is RSV?</h2> <p>RSV is often a seasonal illness that typically starts circulating in the fall. It is transmitted from person to person through close contact with an infected person.</p> <p>"This is a relatively common virus that used to be seasonal in the fall and winter. But over the COVID-19 years, we've seen some changes in that seasonality with infections starting earlier or ending later than usual," says Dr. Rajapakse.</p> <p>A <a rel="noopener" href="https://newsnetwork.mayoclinic.org/discussion/rsv-season-what-parents-need-to-know/" target="_blank" title="Opens in a new window.">surge of RSV infection</a> during last season resulted in many young children needing medical attention or being hospitalized. The <a rel="noopener" href="https://www.cdc.gov/media/releases/2023/p-0803-new-tool-prevent-infant-hospitalization-.html" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention </a>says 58,000 to 80,000 infants and children are hospitalized yearly due to RSV.</p> <p>RSV in young children is common. The virus typically infects most children by their second birthday and can also affect adults. Healthy adults and older children may experience mild symptoms that mimic a cold.</p> <p>"RSV, when it presents to young infants or babies, can present initially with cold-type symptoms and may include some cough, runny nose fever," says Dr. Rajapakse. "But in these young children, it tends to move down into the chest and cause <a rel="noopener" href="https://newsnetwork.mayoclinic.org/discussion/world-bronchiectasis-day-targets-chronic-progressive-lung-disease/" target="_blank" title="Opens in a new window.">bronchiolitis</a> or inflammation of the small airways in the lungs. When that happens, kids can have difficulty breathing and shortness of breath. They have to use more of their muscles to breathe and can get tired. And when that happens, their oxygen levels can drop."</p> <p>When their oxygen levels drop, it can result in symptoms like cyanosis, or blueness, around the lips, with lethargy and difficulty feeding.</p> <p>Severe and potentially life-threatening infections can happen in young babies, older adults or anyone with a weakened immune system.</p> <h3>Symptoms usually appear in stages rather than all at once, including:</h3> <ul> <li>Coughing</li> <li>Decrease in appetite</li> <li>Fever</li> <li>Runny nose</li> <li>Sneezing</li> <li>Wheezing</li> </ul> <p>There is no treatment for mild or moderate RSV. In most cases, doctors recommend drinking plenty of fluids, taking over-the-counter pain or fever medication and resting. Symptoms should go away on their own in a week or two.</p> <h2>Preventing RSV and other respiratory diseases</h2> <p>Earlier this year, the <a rel="noopener" href="https://www.cdc.gov/media/releases/2023/s0629-rsv.html" target="_blank" title="Opens in a new window.">CDC backed</a> the FDA's recommendation for an RSV vaccine targeting older adults 60 and above. It is expected the vaccine will be available this fall.</p> <p>The <a rel="noopener" href="https://www.cdc.gov/rsv/php/surveillance/" target="_blank" title="Opens in a new window.">CDC reports</a> that RSV infection leads to hospitalization for an estimated 60,000 to 160,000 adults and causes 6,000 to 10,000 deaths annually among those age 65 and over.</p> <h3>There are steps anyone can take now to help prevent the spread of a virus, including RSV:</h3> <ul> <li>Wash your hands often.</li> <li>Keep hands away from your face.</li> <li>Avoid close contact with people who are sick.</li> <li>Cover your mouth and nose when coughing or sneezing.</li> <li>Clean and disinfect surfaces.</li> <li>Stay home when you are sick or not feeling well.</li> </ul> <p>Talk with your healthcare team to find out if the vaccines are right for you and your family.</p> <p><em>This article originally appeared on the </em><a rel="noopener" href="https://newsnetwork.mayoclinic.org/" target="_blank" title="Opens in a new window."><em>Mayo Clinic News Network</em></a><em>. </em></p><img src="/-/media/national-files/images/hometown-health/2023/parents-with-infant.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E77B6953183D72A27C2E4AD449D42313" alt="Parents with infant" width="660" height="370" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Dawn Haller8/18/2023Weight-loss surgery can help you shed pounds and lower your risk of medical problems brought on by obesity. Here's what you need to know about this procedure.Thinking about weight-loss surgery? 4 things to consider<p>Anyone who's struggled with reaching or maintaining a healthy weight probably has heard comments like, "If you want to lose weight, just eat less and exercise more" or "Losing weight is all about willpower." But weight loss is much more complicated. Genetics, socioeconomic status, mental health issues, such as depression and anxiety, and certain medications can affect your ability to lose weight and keep it off.</p> <p>That's why weight loss requires a complex, multipronged approach, including nutrition education, consulting a dietitian, joining a support group and possibly taking medications or undergoing weight-loss surgery.</p> <h2>Are you ready?</h2> <p>You have to be mentally ready for <a href="/topics/weight-loss-and-bariatric-surgery" target="_self" title="Opens in same window.">weight-loss surgery</a>. Some people reach a turning point when they can't bend over to pick up a child, have to ask for a seat belt extension on an airplane or experience a hospitalization. The reasons people consider weight-loss or bariatric surgery are as personal and varied as the people themselves.</p> <p>You may have considered weight-loss surgery for years, but it takes that turning point to push you to contact your healthcare professional about the procedure. If you've reached that turning point, here are some things to consider.</p> <h2>What weight-loss surgery does</h2> <h3>Weight-loss surgery helps you lose weight and lowers your risk of medical problems brought on by obesity, including:</h3> <ul> <li>Cancer</li> <li>Heart disease</li> <li>High blood pressure</li> <li>High cholesterol</li> <li>Infertility</li> <li>Obstructive sleep apnea</li> <li>Stroke</li> <li>Type 2 diabetes</li> </ul> <p>Candidates for surgery typically have tried to lose weight by improving their diet and exercise habits.</p> <h2>How weight-loss surgery works</h2> <h3>The surgery helps you lose weight in two ways:</h3> <ol> <li>By physically limiting the amount of food your stomach can hold, which decreases the number of calories you can eat</li> <li>By shortening or bypassing the small intestine, which reduces the amount of calories and nutrients your body can absorb</li> </ol> <h3>The two most common bariatric surgery techniques are:</h3> <ol> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/gastric-bypass-surgery/about/pac-20385189" target="_blank" title="Opens in a new window.">Gastric bypass</a><br> Following this surgery, swallowed food will go into a small stomach pouch and then directly into the small intestine.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/sleeve-gastrectomy/about/pac-20385183" target="_blank" title="Opens in a new window.">Sleeve gastrectomy</a><br> With this surgery, about 80% of the stomach is removed, leaving a tube-shaped stomach about the size of a banana.</li> </ol> <p>Both procedures are performed laparoscopically, which involves inserting surgical instruments through multiple small incisions in the upper abdomen. No bariatric surgery is without risks, which can include infection, blood clots and adverse reactions to the anesthesia.</p> <h2>What to expect from surgery</h2> <h3>The benefits of weight-loss surgery include:</h3> <ul> <li>Substantial weight loss, with people often losing 60% to 80% of their excess body weight within the first year after the procedure.</li> <li>Improved overall health and reduced or resolved obesity-related health conditions like Type 2 diabetes, high blood pressure, sleep apnea and joint pain.</li> <li>Enhanced quality of life, including higher energy levels, increased self-esteem and the ability to participate in activities you may have avoided.</li> </ul> <p>You need to understand that bariatric surgery isn't a quick fix, and you won't reach your goal weight overnight. Even with surgery, your body mass index, or BMI, still may be considered overweight, but that doesn't mean the surgery wasn't successful. Losing a significant amount of weight still is transformative and life-changing.</p> <p>There's also a potential financial cost to weight-loss surgery. The surgery itself typically is covered by insurance. In most cases, the removal of excess skin on the stomach and arms isn't covered by insurance. But this additional surgery, performed by a plastic surgeon, can greatly improve your self-esteem and body image.</p> <p>Bariatric surgery gives you a tool for long-term weight management, but it requires a commitment to lifestyle changes, including a balanced, nutritious diet and regular exercise. You'll need to watch not only what you eat but also how much because the surgery can restrict the quantity of food your body can handle.</p> <p>Five years after surgery, people typically have kept off 50% of the weight they've lost by embracing a new lifestyle and way of eating, and staying active.</p> <p>If you've been considering bariatric surgery, contact your healthcare team to discuss if it's a good option for you. Once you've made a decision, they'll connect you with a weight management team, including a dietitian, and behavioral health and exercise physiology professionals to support you through this life change.</p> <p>Kathriena Greenwell, M.D., is a <a href="/services-and-treatments/bariatric-surgery" target="_self" title="Opens in same window.">bariatric surgeon</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</p><img src="/-/media/national-files/images/hometown-health/2023/tying-shoes-while-sitting.jpg?h=370&iar=0&w=660&sc_lang=en&hash=458119C4C286844077E7986DC42AE74E" alt="Tying shoes while sitting" width="660" height="370" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller8/23/2023As people age, so does the prevalence of mitral valve regurgitation. Learn about a new minimally invasive surgery available an alternative to traditional open-heart surgery to treat a leaky valve.Beyond open-heart surgery: A minimally invasive approach to treating a leaky valve<p>Mitral valve regurgitation is the most common type of valvular heart disease in the U.S. The prevalence of the condition increases with age. About 10% of adults over 75 have mitral valve regurgitation.</p> <p>Mitral valve regurgitation may be called leaky valve, mitral regurgitation (MR) or mitral insufficiency.</p> <p>A healthy mitral valve keeps blood moving from the upper left heart chamber to the lower left heart chamber. A leaky valve occurs when a valve between the left chambers of the heart doesn't close completely, allowing blood to leak backward across the valve. If the leakage is severe, not enough blood moves through the heart and to the rest of the body.</p> <h2>Slow or sudden symptoms</h2> <p>Mitral valve regurgitation can make you feel short of breath or tired from the lack of blood flow through the heart.</p> <h3>Other symptoms of a leaky valve include:</h3> <ul> <li>Arrhythmia: irregular heartbeat.</li> <li>Edema: swollen ankles or feet.</li> <li>Heart murmur: sounds of blood flow across the valve.</li> <li>Heart palpitations: a sensation of a rapid, pounding or fluttering heartbeat.</li> </ul> <p>The symptoms of mitral valve regurgitation may develop slowly and be mild. For some people, symptoms may not develop for many years.</p> <p>In other cases, the leaky valve develops suddenly. This is called acute mitral valve regurgitation.</p> <p>Severe, symptomatic mitral valve regurgitation can weaken the heart and lower life expectancy if not treated.</p> <h2>Diagnosing mitral valve regurgitation</h2> <p>Your healthcare team will confirm a diagnosis of mitral valve regurgitation after a thorough exam and testing. This is necessary as other heart conditions can cause similar symptoms to a leaky valve.</p> <p>Common tests for mitral valve regurgitation include chest X-ray, cardiac MRI, echocardiogram, electrocardiogram, exercise tests or cardiac catheterization.</p> <p>Through testing, your healthcare team may tell you the stage of your disease. The stage of the disease is based on symptoms, severity, structure of the valve and blood flow through the heart. The most appropriate treatment option can be determined through staging.</p> <h3>The four stages of heart valve disease are:</h3> <ul> <li><strong>Stage A — At risk</strong><br /> Heart valve disease risk factors are present.</li> <li><strong>Stage B — Progressive</strong><br /> Valve disease is mild to moderate, but there are no heart valve symptoms.</li> <li><strong>Stage C — Asymptomatic severe</strong><br /> Valve disease is severe, but there are no heart valve symptoms.</li> <li><strong>Stage D — Symptomatic severe</strong><br /> Valve disease is severe and causes symptoms.</li> </ul> <h2>Treatment for leaky valve</h2> <p>The goal of treatment is to improve heart function and reduce symptoms. This may include regular monitoring, medication, valve repair or valve replacement.</p> <p>For severe cases, the healthcare team may recommend repairing a leaky valve with open heart mitral valve repair or replacement surgery. In suitable patients, the mitral valve also can be repaired without open heart surgery using a catheter-based endovascular procedure.</p> <p>Your healthcare team will discuss your symptoms and stage of disease with you when evaluating treatment options.</p> <h2>Transcatheter edge-to-edge repair</h2> <p>Transcatheter edge-to-edge repair, or TEER, of the mitral valve is an alternative to traditional open-heart surgery to treat a leaky valve. The minimally invasive procedure is performed in a cardiac catheterization lab.</p> <p>During the TEER procedure, the leaky valve is accessed with a catheter, or thin tube, passed through the right femoral vein in the leg to the heart. A small, implanted clip is attached to the valve to help it close more completely, restoring regular blood flow through the heart. The recovery is quicker because a large chest incision is not needed.</p> <img alt="Mitral valve illustration" src="/-/media/national-files/images/hometown-health/2023/mitral-valve-illustration.jpg?h=279&w=300&sc_lang=en&hash=F8F26CA67A17BAEA676383F717C0484C" style="height: 279px; width: 300px;" /> <p>A TEER procedure may be a good option if you have severe mitral valve regurgitation, aren't a good candidate for open-heart surgery, or have heart failure with mitral valve regurgitation due to heart enlargement.</p> <p>Talk with your healthcare team if you have symptoms of mitral valve regurgitation. A cardiologist can determine if you are a candidate for TEER. Your healthcare team will review the risk of complications, how effective the procedure may be and the possible benefits.</p> <h2>Next steps:</h2> <ul> <li>Learn about <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiology services</a>.</li> <li>Find a <a href="https://www.mayoclinichealthsystem.org/providers?service=Cardiology" target="_self" title="Opens in same window.">cardiologist</a> near you.</li> <li>Read about <a href="/hometown-health/transforming-healthcare/transforming-heart-care" target="_self" title="Opens in same window.">advanced treatment for atrial fibrillation</a>.</li> <li>Read more articles about <a href="/topics/heart-health">heart health</a>.</li> </ul> <p><a href="/providers/gurpreet-singh-md" target="_self" title="Opens in same window.">Gurpreet Singh, M.D.</a>, is a <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</p><ul> <li>Acute pulmonary embolism treatment</li> <li><a href="/locations/eau-claire/services-and-treatments/cardiology/diseases/asd" target="_self" title="Opens in same window">Atrial septal defect </a> closure</li> <li>Clinical cardiology</li> <li>Interventional cardiology</li> <li>Left atrial appendage closure</li> <li>Percutaneous <a href="/locations/eau-claire/services-and-treatments/cardiology/diseases/pfo" target="_self" title="Opens in same window">patent foramen ovale </a>closure</li> <li>Peripheral vascular disease</li> <li>Transcatheter aortic valve replacement</li> <li>Transcatheter edge-to-edge repair</li> </ul>M.D.<p>In my free time, I enjoy traveling, photography and spending time with family.</p><p><strong>Education</strong></p> <ul> <li>Government Medical College, Amritsar</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>Internal Medicine, Government Medical College, Amritsar</li> <li>Internal Medicine, John H. Stroger Jr. Hospital of Cook County</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Cardiovascular Disease and Interventional Cardiology, Rush University Medical Center</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Cardiovascular Diseases. American Board of Internal Medicine</li> <li>Echocardiography. American Board of Echocardiography</li> <li>Internal Medicine, American Board of Internal Medicine</li> <li>Nuclear Cardiology, American Board of Nuclear Cardiology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Singh<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/gurpreet-singh-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=C72A1313EB3B2FC5F56295780330C38B" alt="Gurpreet Singh, M.D." width="280" height="280" DisableNVelocity="true" />{E40002DE-A5D9-4B93-B733-25EE4BF953E4} Gurpreet<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20533586Gurpreet Singh, M.D.1{676428F6-179A-4C9B-9B23-5F1E40032A38}<img src="/-/media/national-files/images/hometown-health/2023/fishing-father-and-son.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A4CCB76B723D378BC49F5357BCB72CA0" alt="Fishing father and son" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller9/26/2023Eating a rainbow of fruits and veggies is a healthy choice, but what about when your urine turns into a range of colors? Learn what urine shades tell about your health and when to seek medical help.The rainbow of urine colors: What's typical, what's not<p>Eating a rainbow of fruits and veggies is great for your health, but what about when your urine turns into one of a spectrum of colors?</p> <p>Regular urine color varies but usually ranges from clear to pale yellow. The exact hue depends on how much water you drink. Fluids dilute the yellow pigments in urine. So the more you drink, the clearer your urine looks. When you drink less, the yellow color becomes stronger.</p> <p>Some foods and medications can change the color of urine. For example, foods like beets, blackberries and fava beans can turn urine pink or red. Some medications also can give urine vivid tones, such as orange or greenish-blue.</p> <p>An unusual urine color also can be a sign of a health problem, however. For instance, some urinary tract infections can turn urine milky white. Kidney stones, some cancers and other diseases sometimes make urine look red due to blood.</p> <p>Here are some unusual urine colors, along with things that can cause them.</p> <h2>Red or pink urine</h2> <h3>Red urine isn't always a sign of a serious health problem. Red or pink urine can be caused by:</h3> <ul> <li><strong>Blood</strong><br /> Health problems that can cause blood in the urine include an enlarged prostate, tumors that aren't cancer, and kidney stones and cysts. Vigorous exercise also can cause blood in the urine. Blood in the urine is common in urinary tract infections and with kidney stones. Those problems often cause pain. Painless bleeding might be a sign of a more serious problem, such as cancer. </li> <li><strong>Foods</strong><br /> Beets, blackberries and rhubarb can turn urine red or pink.</li> <li><strong>Medicines</strong><br /> Red or pink urine is possible if you take medications for tuberculosis, urinary tract pain or constipation.</li> </ul> <h2>Orange urine</h2> <h3>Orange urine can be caused by:</h3> <ul> <li><strong>Medicines</strong><br /> Constipation medicines can turn urine orange, as can medicine that lessens swelling and irritation, and some chemotherapy medicines for cancer.</li> <li><strong>Vitamins</strong><br /> Some vitamins, such as A and B-12, can turn urine orange or yellow-orange.</li> <li><strong>Health problems</strong><br /> Orange urine can be a sign of a problem with the liver or bile duct, mainly if you also have light-colored stools. Dehydration also can make your urine look orange.</li> </ul> <h2>Blue or green urine</h2> <h3>Blue or green urine can be caused by:</h3> <ul> <li><strong>Dyes</strong><br /> Some brightly colored food dyes can cause green urine. Dyes used for some kidney and bladder tests can turn urine blue.</li> <li><strong>Medicines</strong><br /> Some medicines for depression, ulcers and acid reflux can turn urine greenish-blue. Medications for pain, arthritis and sleep also can turn urine green.</li> <li><strong>Health problems</strong><br /> A rare disease called familial benign hypercalcemia can cause children to have blue urine. Urinary tract infections caused by a certain bacteria can cause green urine.</li> </ul> <h2>Dark brown or cola-colored urine</h2> <h3>Brown urine can be caused by:</h3> <ul> <li><strong>Foods</strong><br /> Eating lots of fava beans, rhubarb or aloe can cause dark brown urine.</li> <li><strong>Medicines</strong><br /> Some medicines can darken urine, including those used to treat and prevent malaria, constipation, high cholesterol and seizures. Some antibiotics and muscle relaxers also can darken urine. </li> <li><strong>Health problems</strong><br /> Some liver and kidney disorders and urinary tract infections can turn urine dark brown. So can bleeding inside the body, called a hemorrhage. A group of illnesses mainly affecting the skin or the nervous system, called porphyria, also can cause brown urine.</li> <li><strong>Extreme exercise</strong><br /> A muscle injury from extreme training can cause tea- or cola-colored urine. The injury can lead to kidney damage.</li> </ul> <h2>Cloudy or murky urine</h2> <p>Urinary tract infections and kidney stones can cause urine to look cloudy or murky.</p> <p>Keep in mind that colors can look slightly different to different people. For instance, what looks red to you might look orange to someone else. Talk with your healthcare team if you have</p> <p>Concerns and in particular if you have painful urination or dark orange urine, which can be a sign that your liver isn't working correctly.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2023/using-knife-on-cutting-board.jpg?h=370&iar=0&w=660&sc_lang=en&hash=63FD31DAA530BE65F1FC30F4573D73AA" alt="Using knife on cutting board" width="660" height="370" DisableNVelocity="true" />Dawn Haller9/8/2023Salivary glands are the unsung heroes of oral health. Yet, when disorders and tumors strike, discomfort and complications can arise. Learn about symptoms and treatments.From stones to tumors: Understanding salivary gland conditions<p>Salivary glands play a crucial role in overall oral health. Every day, they produce 0.5 to 1.5 liters of saliva, a complex mixture that aids the body in many ways, including:</p> <ul> <li>Keeping the mouth moist to make chewing, swallowing and speaking easier</li> <li>Lubricating food so it can move smoothly through the digestive tract</li> <li>Protecting against infections</li> <li>Improving taste perception</li> </ul> <p>There are three sets of major salivary glands. The parotid glands are the largest, and are located beneath and in front of the ears. The submandibular glands are the next largest and are located under the lower jaw. Finally, sublingual glands are smaller and found underneath the tongue.</p> <p>In addition to the major glands, everyone has minor salivary glands dispersed throughout the lips, mouth, cheeks and throat.</p> <p>Various disorders and tumors can affect salivary glands, leading to discomfort and potential complications.</p> <h2>Common salivary gland disorders</h2> <h3>Like other glands in the body, the salivary glands can become infected or develop conditions that may cause pain or swelling, such as:</h3> <ul> <li><strong>Salivary gland stones</strong><br /> This condition is also called sialolithiasis. It occurs when calcified deposits form in the salivary ducts and obstruct saliva flow, leading to pain, swelling and infection. These symptoms often are worse during meals when you usually experience increased salivary flow. Treatment typically includes removing the stone or, in severe cases, surgical removal of the affected gland.</li> <li><strong>Sialadenitis</strong><br /> With this condition, a salivary gland becomes inflamed due to a bacterial infection. Treatment involves antibiotics, staying hydrated and increasing salivary flow with lemon drops, warm compresses or gland massage.</li> <li><strong>Sjogren's syndrome</strong><br /> This chronic autoimmune disorder primarily affects the salivary and tear glands, causing dry mouth and eyes. Treatment aims to manage symptoms using salivary substitutes, eye drops and frequent dental exams.</li> <li><strong>Mucoceles</strong><br /> This condition often results from a blocked or damaged salivary gland duct, causing saliva to accumulate and form a bluish, cyst-like structure, typically on the lower lip. While usually painless, mucoceles can be bothersome and may interfere with eating or speaking. Treatment generally involves a simple surgical procedure to remove the mucocele.</li> <li><strong>Salivary gland tumors</strong><br /> Salivary gland tumors are rare, and most are not cancerous. Most of these tumors occur in the parotid glands, but they can also develop in other salivary glands. Some tumors can cause facial weakness. A biopsy is usually recommended to determine the type of tumor. Treatment generally involves surgery. Radiation and chemotherapy may be required if the tumor is malignant, depending on the type and stage of the tumor.</li> </ul> <h2>Treatment options</h2> <p>Salivary gland disorders and tumors share some symptoms, including swelling, pain and a lump or mass in the affected gland.</p> <p>Diagnosis typically involves a thorough medical history review, physical exam and imaging tests, such as an ultrasound, CT scan or MRI. In the case of a tumor, a biopsy may be necessary to confirm the diagnosis and determine the tumor's nature.</p> <p>Maintaining good oral hygiene is key to keeping your salivary glands healthy.</p> <p>Your salivary glands may not get the recognition they deserve, but they play a vital role in your overall oral health. If you experience any worrisome or persistent oral health symptoms, it's essential to consult a healthcare professional.</p> <p><a href="/providers/fareeda-hussain-md" target="_self" title="Opens in same window."><em>Fareeda Hussain, M.D.</em></a><em>, is a head and neck surgeon specializing in ear, nose and throat conditions in <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">Otorhinolaryngology</a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a> and <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</em></p><ul> <li>Ear and hearing-related conditions, including chronic ear disease and cochlear implantation</li> <li>Head and neck endocrine surgeries, including thyroid and parathyroid issues</li> <li>Nonsurgical ear molding</li> <li>Outer ear deformities</li> <li>Pediatric ENT conditions</li> <li>Salivary gland disorders, including parotid masses</li> <li>Sinus and nasal disorders</li> </ul>M.D.<p>I enjoy practicing collaborative, individualized medicine, and including my patients in shared decision-making. I greatly value team care — when the patient, nurses and schedulers all are intimately involved in ensuring we work as a well-functioning team to deliver high-quality care.</p> <p>I grew up in Sri Lanka and moved to Minnesota for college. I did my undergraduate training at Winona State University, then several years of research at Mayo Clinic prior to completing medical school.</p> <p>In my free time, I enjoy being with my family, traveling and staying active.</p><p><strong>Education</strong></p> <ul> <li>Mayo Clinic Alix School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Otolaryngology and Head and Neck Surgery, University of Minnesota</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Head and Neck Surgery, American Academy of Otolaryngology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Otolaryngology-Head and Neck Surgery</li> <li>American Academy of Otolaryngology-Head and Neck Surgery, Women in Otolaryngology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Otolaryngology, Mayo Clinic College of Medicine and Science</li> </ul>Hussain<img src="/-/media/shared-files/images/medical-professionals/full/mankato/fareeda-hussain-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=7E1879B82EFF6247427737390FB8C652" alt="Fareeda Hussain MD" width="280" height="280" DisableNVelocity="true" /><ul> <li><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Detection+of+colorectal+serrated+polyps+by+stool+DNA+testing%3A+comparison+with+fecal+immunochemicaltesting+for+occult+blood+(FIT)" target="_blank" title="Opens in new window.">Detection of colorectal serrated polyps by stool DNA testing: comparison with fecal immunochemical testing for occult blood (FIT)</a>, January 2014</li> <li><a href="https://www.ncbi.nlm.nih.gov/pubmed/23347191" target="_blank" title="Opens in new window.">Stool DNA testing for the detection of colorectal neoplasia in patients with inflammatory bowel disease</a>, March 2013</li> <li><a href="https://www.ncbi.nlm.nih.gov/pubmed/23804918" target="_blank" title="Opens in new window.">Surgical Repair of Tetralogy of Fallot at Age 83</a>, October 2012</li> <li><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Sole+abnormalities+of+chromosome+7+in+myeloid+malignancies%3A+Spectrum%2C+histopathologic+correlates%2C+and+prognostic+implications" target="_blank" title="Opens in new window.">Sole abnormalities of chromosome 7 in myeloid malignancies: Spectrum, histopathologic correlates, and prognostic implications</a>, July 2012</li> </ul>{1026DEB5-A821-4F7A-8AA8-A61170A07A2C}Fareeda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14791757Fareeda Hussain, M.D.1{E9B8BDBE-375B-4E7D-A1D2-2B64B5513AF7}|{18E5E65E-45C8-4C48-BD32-A914794E2AA4}<img src="/-/media/national-files/images/hometown-health/2023/outdoor-dining-salad.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7152DC32E5969E207EF429C99AC291EB" alt="Person dishing salad, dining outdoors" width="660" height="370" DisableNVelocity="true" />Ear, Nose and Throat (ENT)Get information about symptoms, disorders and diseases affecting the ear, nose and throat, and related head and neck structures.Dawn Haller9/5/2023Whiplash is a common neck injury caused by sudden forceful motions. Discover a range of treatments available in Physical Medicine & Rehabilitation that can bring relief and recovery.Understanding whiplash: Roadmap to relief and recovery<p>Whiplash is a neck injury that occurs when the head is abruptly and forcefully thrown backward and then forward. This quick, violent motion can injure soft tissues of the neck and spine, including the ligaments, muscles, nerves, bones, discs between the bones and other neck tissues.</p> <p>Unfortunately, whiplash is a common injury. There are an estimated 3 million cases in the U.S. each year, most commonly caused by rear-end car accidents. Sports accidents, physical abuse or other trauma, like falls, also can cause whiplash.</p> <h2>Whiplash symptoms</h2> <h3>Usually, whiplash symptoms develop within days of the injury and may include:</h3> <ul> <li>Dizziness</li> <li>Fatigue</li> <li>Headaches, most often starting at the base of the skull</li> <li>Loss of range of motion in the neck</li> <li>Neck pain and stiffness</li> <li>Tenderness or pain in the shoulder, upper back or arms</li> <li>Tingling or numbness in the arms</li> <li>Worsening of pain with neck movement</li> </ul> <p>Some people also have blurred vision, sleep issues, memory problems, tinnitus or irritability.</p> <p>You should seek immediate care if you are experiencing severe pain, weakness in the arms or legs, balance problems, or changes in your bowel or bladder function.</p> <p>Most people with whiplash get better within a few weeks. However, some people continue to have pain for several months or years after the injury occurred. This is more likely in people who are older, had existing back or neck pain or previous whiplash, or have whiplash due to a high-speed accident.</p> <h2>Treating whiplash</h2> <p>Whiplash injuries can cause significant pain and limit the range of motion in the neck. Treatment plans focus on controlling pain and restoring movement so you can return to daily activities.</p> <p>Your treatment plan will depend on the extent of your whiplash injury. Some people only need over-the-counter medications and at-home care like rest and applying heat or cold.</p> <p>Others may need additional treatments and may be referred to Physical Medicine & Rehabilitation.</p> <h3>These professionals consider the whole person and effect on function when developing a treatment plan, including:</h3> <ul> <li><strong>Prescription medications</strong><br /> People with more severe pain may be given nonsteroidal anti-inflammatory drugs (NSAIDs) or certain neuromodulating medications that have been shown to help with soft tissue and nerve pain.</li> <li><strong>Muscle relaxants</strong><br /> Short-term use of these drugs may be recommended to loosen tight muscles and soothe pain. The medicine also can make you feel sleepy, so it may help restore typical sleep patterns if pain is preventing you from getting a good night's rest.</li> <li><strong>Physical therapy</strong><br /> A physical therapist may perform manual treatments or modalities like heat, cold, electricity or manipulation treatments. A therapist also can provide instructions for exercises to help with pain and restore range of motion. </li> <li><strong>Injections</strong><br /> Lidocaine or steroid injections may be used to decrease pain. Your team may use ultrasound or X-ray to guide the injection to the correct location and avoid nerves, blood vessels and bones. </li> <li><strong>Transcutaneous electrical nerve stimulation (TENS)</strong><br /> This treatment applies a mild electric current to the skin to temporarily ease neck pain and improve muscle strength.</li> <li><strong>Regenerative medicine injections</strong><br /> These targeted treatments for select patients with chronic neck symptoms after whiplash may accelerate healing and reduce inflammation in your neck. Often, they kick-start the body's healing response. Examples include platelet-rich plasma, prolotherapy and mesenchymal stem cell injections.</li> </ul> <p>Complementary treatments could include acupuncture, chiropractic care and massage. Mind-body exercises like tai chi and yoga may help ease pain and stiffness.</p> <p>In the past, soft foam cervical collars were used for whiplash injuries to hold the neck and head still. However it's been found that this can decrease the neck's muscle strength and slow recovery.</p> <p>Foam collars sometimes are used immediately after the injury to limit movement and reduce pain, usually for no more than a few days. Your healthcare team will tell you if a collar would be helpful and show you how to use it properly.</p> <p>Talk with your healthcare team if you have neck pain or other whiplash symptoms after a car accident, sports injury or other trauma. It's important to be evaluated to rule out broken bones or further damage that could worsen with time.</p> <p><em>By Mayo Clinic Health System Staff.</em></p><img src="/-/media/national-files/images/hometown-health/2023/hand-on-back-of-neck.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1FDE0A20B6225C0467CB9C088D10A7F6" alt="Hand on back of neck" width="660" height="370" DisableNVelocity="true" />NeurosurgeryNeurosurgery treats disorders that impact any part of the nervous system, which may include the brain, spine or peripheral nerves. Conditions treated range from life-threatening brain tumors, to disorders impacting quality of life, such as back pain and carpel tunnel syndrome.Dawn Haller9/11/2023Being awake during hand or wrist surgery isn't for everyone, but the WALANT technique is painless and eliminates post-op grogginess. Learn more about it.Wide-awake hand or wrist surgery: How WALANT works<p>If <a href="/locations/la-crosse/services-and-treatments/plastic-and-reconstructive-surgery/hand-and-upper-extremity-surgery" target="_self" title="Opens in same window.">hand or wrist surgery</a> is in your future, you may have heard about a technique with a name that says it all: wide-awake local anesthesia no tourniquet, or WALANT.</p> <p>This alternative to traditional surgical techniques allows a surgeon to operate while you are awake. Rather than getting general anesthesia that "knocks you out" during the procedure, your hand is numbed with injections, such as epinephrine combined with lidocaine — a pairing commonly used by dentists. </p> <p>Most people are candidates for this technique, which typically is performed in a clinic during regular office hours.</p> <h2>WALANT is used for a number of hand or wrist issues, including:</h2> <ul> <li>Carpal tunnel release</li> <li>Fingertip amputations</li> <li>Fingertip/fingernail injuries</li> <li>Fracture pinning</li> <li>Ganglion cyst removal</li> <li>Hand mass removal</li> <li>Mucous cyst removal</li> <li>Tendon repairs and transfers </li> <li>Trigger finger release</li> </ul> <p>Let's take a look at the benefits of each aspect of this technique.</p> <h3>Wide awake</h3> <p>While being awake during a surgical procedure could seem daunting, it has key benefits. You're able to communicate with your surgeon throughout the procedure. You can ask questions, and the surgeon can describe each step, as well as discuss recovery and follow-up. In tendon repair or transfer cases, you can indicate to your surgeon if the tension on the tendon is too tight or loose.</p> <p>Also, a companion can accompany you, talk with you and hold your nonsurgical hand during the procedure. This can give you comfort, provide distraction and help you relax.</p> <h3>Local anesthesia</h3> <p>Many people are anxious about or at high risk for complications from sedation and general anesthesia. WALANT allows you to avoid these complications and postoperative side effects of sedation, such as nausea or grogginess. The procedure, preparation and recovery take less time, usually about 60 to 90 minutes, since you're not being sedated. You also don't have to undergo preoperative sedation screening, saving you from making additional appointments. On the day of your surgery, you can eat and drink as usual. It's also less expensive because there are no operating room or general anesthesia fees.</p> <h3>No tourniquet</h3> <p>Think about the last time you had your blood pressure checked and how uncomfortable the cuff felt when it was fully inflated. Now imagine that discomfort lasting for 15 to more than 60 minutes caused by the tourniquet used to minimize bleeding during surgery. This intense pressure is not only painful during the procedure but you may also experience tourniquet pain in your arm following surgery.</p> <p>With WALANT, bleeding is controlled with epinephrine, which numbs the area and constricts blood vessels. The anesthetic typically is injected about 20 to 25 minutes before the procedure to allow adequate constriction.</p> <h3>Surgery, recovery remain the same</h3> <p>On the day of your surgery, your surgeon will discuss the procedure with you. Then the surgical site is numbed. While the numbing medication takes effect, you can relax and recline in a chair in the procedure room and watch TV or listen to music.</p> <p>After the area is numb, your hand and arm are thoroughly washed with a cleaning solution to decrease the chances of infection. The procedure is done using the same sterile techniques used in the operating room.</p> <p>Since the surgery itself isn't changing, you'll have the same postoperative instructions and rehabilitation process.</p> <p>For patients who might be anxious about WALANT, I tell them, "The worst part is worrying about the procedure." Afterward, most tell me it "wasn't bad at all" or "they would do that technique again."</p> <h2>Next steps:</h2> <ul> <li>Watch a video demonstrating WALANT:<br /> <div> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/Adx5aHOGYgU" title="WALANT procedure" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> </div> </li> <li>Learn about <a href="/hometown-health/speaking-of-health/carpal-tunnel-syndrome-culprits" target="_self" title="Opens in same window.">carpal tunnel syndrome</a>.</li> <li>Learn about <a href="/hometown-health/speaking-of-health/what-triggers-trigger-finger" target="_self" title="Opens in same window.">trigger finger</a>.</li> <li>Find a <a href="/services-and-treatments/plastic-and-reconstructive-surgery" target="_self" title="Opens in same window.">plastic and reconstructive surgeon</a> near you.</li> </ul> <p><em><a href="/providers/matthew-sherrill-md" target="_self" title="Opens in same window."><em>Matthew Sherrill, M.D.</em></a>, is a <a href="/services-and-treatments/plastic-and-reconstructive-surgery" target="_self" title="Opens in same window.">plastic and reconstructive surgeon</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Breast reconstruction</li> <li>Hand surgery</li> <li>Microsurgery</li> <li>Moh’s surgery reconstruction</li> </ul>M.D., F.A.C.S.<p><strong>Education</strong></p> <ul> <li>Texas A & M University Health Science Center</li> </ul> <p><strong>Residency</strong></p> <ul> <li>General Surgery, University of North Carolina</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Plastic and Reconstructive Surgery, University of Minnesota</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>The American Board of Plastic Surgery</li> <li>The American Board of Surgery </li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Alpha Omega Alpha Medical Honor Society</li> <li>Fellow, American College of Surgeons</li> <li>American Medical Association</li> <li>American Society of Plastic Surgeons</li> </ul> <p> </p>Sherrill<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/matthew-sherrill-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=9182931EA7359A0A698B25596F46AC91" alt="Matthew Sherrill MD" width="280" height="280" DisableNVelocity="true" />Matthew<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13178831Matthew Sherrill MD1<img src="/-/media/national-files/images/hometown-health/2023/giving-a-haircut-closeup.jpg?h=370&iar=0&w=660&sc_lang=en&hash=FB4609F52D1A1DB3F688A23BAF664E51" alt="Giving a haircut closeup" width="660" height="370" DisableNVelocity="true" />Dawn Haller10/23/2023Unlike breast or colon cancer, there isn't a universal screening program for ovarian cancer. Learn why, what tests can be used and the symptoms to watch for.A closer look at ovarian cancer screening<p>There are well-established screening programs for certain cancers, such as <a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">breast,</a> <a href="/locations/la-crosse/services-and-treatments/oncology/common-cancers/colon-cancer" target="_self" title="Opens in same window.">colon</a> and <a href="/hometown-health/speaking-of-health/cervical-cancer-awareness" target="_self" title="Opens in same window.">cervical cancer</a>. Screenings include <a href="/hometown-health/speaking-of-health/what-to-expect-before-and-during-a-colonoscopy" target="_self" title="Opens in same window.">colonoscopies</a>, <a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">mammograms</a>, <a href="/hometown-health/speaking-of-health/too-embarrassed-to-ask-an-update-on-pap-tests" target="_self" title="Opens in same window.">Pap tests</a> and other diagnostic tests which can help prevent cancers from developing or detect them at an early stage when treatments are more effective.</p> <p>Because most people are familiar with these screening tests, it's common for women to wonder if they also should be screened for ovarian cancer. The short answer is no. There isn't a universal screening program in place for ovarian cancer.</p> <p>Many factors determine the effectiveness of a cancer screening program. Some of these factors include how common the cancer is, how well healthcare professionals understand the development of the cancer, how the cancer behaves, what testing options are available and how accessible the affected organ is.</p> <p>A screening program for ovarian cancer is unlikely to be effective for several reasons. The current testing options often lead to high rates of false-positive and false-negative results. Ovarian cancer also is a relatively rare disease, doesn't predictably develop precancerous cells and it's difficult to get tissue samples from the ovaries.</p> <h2>How common is ovarian cancer?</h2> <p>Ovarian cancer is a rare disease with about 10 cases occurring for every 100,000 women annually in the U.S. The <a rel="noopener" href="https://seer.cancer.gov/statfacts/html/ovary.html" target="_blank" title="Opens in a new window.">National Cancer Institute</a> estimates that about 1% of women will develop ovarian cancer during their lifetime.</p> <h2>What tests can help detect ovarian cancer?</h2> <p>The most relevant tools for finding ovarian cancer are imaging tests, such an ultrasound, and tumor markers that can be found in the blood, such as <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/ca-125-test/about/pac-20393295" target="_blank" title="Opens in a new window.">cancer antigen 125</a>, or CA 125.</p> <p>Ultrasounds are good at identifying cysts or other masses growing on the ovaries. The challenging part is that these masses are quite common, and most are not cancers. While the appearance of an ovarian mass can give some clues about its chance of cancer, it's often difficult to tell the difference between masses that are cancers and those that are not cancers with an ultrasound.</p> <h2>What is CA 125?</h2> <p>CA 125 is a protein in the blood that can be elevated when ovarian cancers are present. However, it also can be elevated with other conditions, such as menstruation, uterine fibroids and endometriosis, leading to false-positive results. Early detection is the goal of a good screening program, but CA 125 can miss a significant number of early-stage ovarian cancers.</p> <p>Ultrasounds and CA 125 tests have been evaluated as potential screening tools. Unfortunately, they could not consistently detect ovarian cancer early enough to improve patient outcomes and have a high false-positive result rate, increasing the risk of unnecessary stress, anxiety and surgery.</p> <p>However, there are some situations in which these tests are used to screen for ovarian cancer, such as in patients with genetic mutations that put them at high risk for cancer and in certain patients previously treated for ovarian cancer.</p> <h2>What are the symptoms of ovarian cancer?</h2> <p>Symptoms of ovarian cancer are often vague and also can occur with several other common conditions.</p> <h3>Common symptoms of ovarian cancer include:</h3> <ul> <li>Abdominal bloating</li> <li>Change in bowel function</li> <li>Fatigue</li> <li>Feeling full more quickly when eating</li> <li>Pelvic pain</li> <li>Unintentional weight loss</li> </ul> <p>While experiencing one or more of these symptoms is common and does not mean you have ovarian cancer, discussing them with your healthcare team is a good idea.</p> <h3>Watch a Q&A about ovarian cancer:</h3> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/7QPphoDcP_c" title="Ovarian cancer Q&A" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <h2>Next steps:</h2> <ul> <li>Find an <a href="https://www.mayoclinichealthsystem.org/providers?service=Obstetrics%20and%20Gynecology" target="_self" title="Opens in same window.">OB-GYN provider</a>.</li> <li>Learn about <a href="/hometown-health/speaking-of-health/cancer-treatment-and-fertility" target="_self" title="Opens in same window.">cancer treatment and fertility considerations</a>.</li> <li>Read <a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">Michele's story of living with stage 4 ovarian cancer</a>.</li> </ul> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2023/couple-with-arm-around-shoulder.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BC676B56BB19FBA60A8C862CE37B7B8F" alt="Couple with arm around shoulder" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller10/17/2023Mammograms have been saving lives since the 1970s but aren't the only breast cancer screening option. Learn about newer advanced technologies and which option may be best for you.Beyond the basics: Exploring advanced breast cancer screening options<p>Mammograms have been a standard screening for breast cancer since the 1970s. They have transformed early breast cancer detection and diagnosis by identifying breast cancer before it causes signs and symptoms. Mammograms have been shown to reduce the risk of dying of breast cancer and have saved countless lives.</p> <p>New screening options go beyond traditional mammography with advancements that may not be familiar. Here's what you need to know about the most common options and which might be best for you.</p> <h2>Mammogram</h2> <p>A mammogram is an X-ray image of your breasts and is the breast cancer screening technique that most people think of. It also can be used for diagnostic purposes, such as to investigate symptoms or unusual findings on another type of imaging test.</p> <p>During a mammogram, your breasts are compressed between two firm surfaces to spread the breast tissue. Then an X-ray captures black-and-white images that are displayed on a computer screen and examined by a radiologist for signs of cancer. A traditional mammogram creates two-dimensional images of the breast.</p> <p>At Mayo Clinic Health System, healthcare providers offer screening <a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">mammography</a>, beginning at 40, for women at average risk of breast cancer. <a href="/hometown-health/speaking-of-health/8-faq-about-mammography-screening" target="_self" title="Opens in same window.">Average risk of breast cancer</a> means women with no family history of breast cancer and no other risk factors.</p> <h2>Digital breast tomosynthesis</h2> <p>This screening exam, also known as <a href="/hometown-health/speaking-of-health/3d-technology-provides-enhanced-breast-cancer-detection" target="_self" title="Opens in same window.">3D mammography</a>, has become a best practice in women's health for breast cancer-detecting technology. Breast tomosynthesis differs from traditional mammograms in how the image of the breast is obtained and, more importantly, viewed.</p> <p>Like a traditional mammogram, your breasts are compressed between two firm surfaces to spread the breast tissue. A digital tomographic image is created, and the radiologist can view and manipulate the images on high-resolution computer monitors that enhance visualization of the structures within the breast tissue. The tomographic images help to detect small calcifications, masses and other changes that may be signs of early cancer.</p> <p>Tomosynthesis, or 3D mammograms, are best practice for all women, regardless of their cancer risk.</p> <h3>Watch a demonstration of how 3D images allow breast tissue to be viewed in individual slices:</h3> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/pdDMXaOvJkg" title="Tomosynthesis - Why slices matter in breast cancer screenings" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <h2>Molecular breast imaging</h2> <p>This procedure uses a radioactive tracer and a special camera to take pictures of the breast tissue.</p> <p>During the molecular breast imaging (MBI) exam, a small amount of radioactive tracer is injected into a vein in your arm. The tracer travels through your blood to your breast tissue. Cells growing quickly take up more of the tracer than slowly growing cells. Cancer cells often grow quickly and can be identified if they are taking up more of the tracer.</p> <p>A special camera, called a gamma camera, detects the radiation released by the tracer. In the pictures made by the gamma camera, the cells that take up more of the tracer look brighter than the surrounding cells.</p> <p>MBI provides the greatest benefit for women with <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/mammogram/in-depth/dense-breast-tissue/art-20123968" target="_blank" title="Opens in a new window.">dense breasts</a> or intermediate breast cancer risk. As the density of breast tissue increases, the ability to detect breast cancer with screening mammography becomes more challenging. It's important to know that MBI does not replace, but is used in addition to, screening mammography for early breast cancer detection.</p> <h2>Breast MRI</h2> <p>Magnetic resonance imaging of the breast, also called <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/breast-mri/about/pac-20384809" target="_blank" title="Opens in a new window.">breast MRI</a>, is used to evaluate breast cancer or to help healthcare teams determine the causes of other problems in the breast. Breast MRI also is recommended as a screening exam for women with an elevated lifetime risk of breast cancer, such as a strong family history of breast cancer, genetic risk or other factors.</p> <p>A breast MRI uses powerful magnets, radiofrequency detectors and a computer to create high-detail images of the breasts. A breast MRI may be done after a biopsy shows cancer, as a screening exam or possibly to further investigate a breast finding. Breast MRI also can evaluate the extent of any cancer, as well as evaluate the other breast.</p> <p>Breast MRI may be used with mammography as a screening tool for detecting breast cancer in some people. This includes people with a high risk of breast cancer. It also includes people with a strong family history of breast cancer or who have breast cancer gene changes passed down through the family, called an inherited gene.</p> <p>Talk with your healthcare team about your risk for breast cancer and the benefits, risks and limitations of each screening option. In addition, discuss all changes to your breasts you notice and ask about an appropriate screening schedule for you.</p> <h2>Next steps:</h2> <ul> <li>Get answers to <a href="/hometown-health/speaking-of-health/8-faq-about-mammography-screening" target="_self" title="Opens in same window.">mammogram FAQ</a>.</li> <li>Learn about the types of <a href="/hometown-health/speaking-of-health/benign-breast-disease" target="_self" title="Opens in same window.">benign breast disease</a>.</li> <li>Read about <a href="/hometown-health/speaking-of-health/what-is-dense-breast-tissue-what-do-you-need-to-know" target="_self" title="Opens in same window.">dense breast tissue</a>.</li> <li>Schedule a <a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">mammogram</a> or other breast cancer screening.</li> </ul> <p><a href="/providers/cameron-leitch-md" target="_self" title="Opens in same window."><em>Cameron Leitch, M.D.</em></a><em>, is a <a href="/services-and-treatments/radiology-and-imaging" target="_self" title="Opens in same window.">radiologist</a> in <a href="/locations/eau-claire">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Breast</li> <li>Body</li> <li>Pulmonary</li> <li>Thoracic imaging</li> </ul>M.D.<p>It is an honor to be able to continue my involvement with world-class medical treatment and diagnosis, which is provided by Mayo Clinic. I also look forward to helping to continue innovation at the forefront of technology.</p> <p>I enjoy spending time with my family, fishing, and hockey.</p><p><strong>Medical School</strong></p> <ul> <li>University of North Dakota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Diagnostic Radiology, Mayo Clinic, Rochester, MN</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Breast Imaging, Mayo Clinic, Rochester, MN</li> </ul>Leitch<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/cameron-leitch-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=957902D01CDDDEB8CCCD4881017588FC" alt="Cameron Leitch, M.D." width="280" height="280" DisableNVelocity="true" />Cameron<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15735940Cameron Leitch, M.D.1<img src="/-/media/national-files/images/hometown-health/2023/smiling-person-large-earrings.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9E3DA25A6B036775907DD5DB99BC4832" alt="Smiling person wearing large earrings" width="660" height="370" DisableNVelocity="true" />Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.Dawn Haller10/31/2023Whether it's a severe rotator cuff tear or arthritic shoulder joint, find out about advanced techniques that can relieve pain and get you back to the activities you enjoy.Advanced treatments target advanced shoulder issues<p>Shoulder pain, weakness and range of motion loss can keep you from the activities you need and love to do, whether it's lifting boxes on the job, putting away dishes in the kitchen or hitting that powerful tennis serve.</p> <p>Wear and tear, injury, certain medical conditions and age can take a toll on how your shoulder functions. Sometimes, the treatment is pretty straightforward, with options ranging from physical therapy to injections or surgery.</p> <p>But other times, the condition of your shoulder has advanced beyond those options. Now, there are treatments designed especially for more advanced shoulder issues.</p> <h2>Inserting a balloon for stabilization</h2> <p>When a rotator cuff tear is so severe it can't be repaired, your orthopedic surgeon may use a subacromial balloon spacer. This small device is inserted into the space where the damaged rotator cuff lies using minimally invasive arthroscopic surgical techniques. Once in place, the device is inflated with saline to cushion and stabilize the joint.</p> <p>After six to 12 months, the balloon dissolves. In the meantime, a physical therapist will help you retrain your muscles to move the shoulder using more optimal mechanics. Recovery tends to be faster since the tendons don't need to heal, as they would in traditional rotator cuff surgery. You can return to your daily activities with improved function, range of motion and less pain.</p> <h2>3D printing for reverse shoulder replacement</h2> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/shoulder-replacement/about/pac-20519121" target="_blank" title="Opens in a new window.">Reverse shoulder replacement</a> is another surgical method for treating patients with severe arthritis, unrepairable rotator cuff tears or other damage. Basically, your surgeon changes the mechanics of the shoulder to allow other muscles to move it.</p> <p>Since no shoulder is the same, how closely the replacement implant fits your shoulder's anatomy and how the implant is placed play key roles in the success of a reverse shoulder replacement. Your surgeon is able to choose from metal and plastic implants that are available in a few different shapes and a range of sizes. A 3D-printed model of your shoulder can help your orthopedic surgeon precisely place the implant.</p> <p>The process begins with a CT scan before surgery to create a 3D model of your shoulder on a computer. This allows your surgeon to see how the implant should be placed, how to preserve as much bone as possible and how to identify the best way to secure the implant. A 3D guide is printed that duplicates the template from the computer.</p> <p>During surgery, your surgeon places the 3D guide on the bone so the implant can be placed precisely as planned.</p> <p>3D modeling also helps your surgeon determine if you need a customized implant.</p> <h2>Creating a customized 3D implant</h2> <p>In most cases, your surgeon can choose a standard implant that will give you the shoulder function you need. But for some patients, their anatomy or bone damage won't allow a standard implant to fit appropriately. An implant that doesn't fit well can fail, leading to more surgery.</p> <p>In these cases, an implant can be created to precisely fit a patient. Using a computer-generated 3D model, the custom implant designed for the patient is printed using the same materials as a standard implant. While this is only being used in special cases, it may become the standard in time.</p> <h2>Wider spectrum of customized treatments</h2> <p>There are new options to provide a wide spectrum of treatments for patients with advanced shoulder issues. Having multiple options allows your orthopedic surgeon to choose the one that targets your specific issues to achieve the best outcome.</p> <h3>Watch a video about innovative surgical options for shoulder pain for a quicker recovery and things to consider prior to surgery:</h3> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/GRlcQ3vNSBM" title="Shoulder pain: Innovative surgical options for a quicker recovery" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <h2>Next steps:</h2> <ul> <li>Read about <a href="/hometown-health/speaking-of-health/helping-athletes-with-dislocated-shoulder" target="_self" title="Opens in same window.">recovery from a shoulder dislocation</a>.</li> <li>Learn about <a href="/hometown-health/speaking-of-health/radiofrequency-ablation-pain-relief" target="_self" title="Opens in same window.">treating joint pain with radio-frequency ablation</a>.</li> </ul> <p><a href="/providers/scott-kuzma-md" target="_self" title="Opens in same window."><em>Scott Kuzma, M.D.</em></a><em>, is an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgeon</a> and <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">sports medicine</a> specialist in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Ankle injuries</li> <li>Athletic injuries</li> <li>Complex knee injuries</li> <li>Meniscus and cartilage preservation and restoration</li> <li>Shoulder injuries and instability</li> <li>Sports medicine</li> </ul>M.D.<p><strong>Medical School</strong></p> <ul> <li>Medical College of Wisconsin, Milwaukee</li> </ul> <p><strong>Residency</strong></p> <ul> <li style="margin-bottom: 12px;">Medical College of Wisconsin, Milwaukee</li> </ul> <p style="margin-bottom: 12px;"><strong>Fellowship</strong></p> <ul> <li style="margin-bottom: 12px;">Orthopedic Surgery Sports Medicine, The Ohio State University, Columbus</li> </ul> <p style="margin-bottom: 12px;"><strong>Certification</strong></p> <ul> <li style="margin-bottom: 12px;">American Board of Orthopaedic Surgery</li> </ul> <p style="margin-bottom: 12px;"><strong>Memberships</strong></p> <ul> <li>American Academy of Orthopedic Surgery</li> <li>American Medical Association</li> <li>American Orthopaedic Society for Sports Medicine</li> <li>American Orthopaedic Association Emerging Leaders Program</li> <li>Arthroscopy Association of North America</li> <li>Mid-America Orthopedic Association</li> <li>Wisconsin Orthopedic Society</li> <li>Milwaukee Orthopedic Society</li> </ul>Kuzma<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/scott-kuzma-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B12F250B520326B80D27587E72FD92F7" alt="Scott Kuzma MD" width="280" height="280" DisableNVelocity="true" />{BD124C33-28FB-40BE-BAB7-DD857E212A20}Scott<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15748189Scott Kuzma, M.D.1<img src="/-/media/national-files/images/hometown-health/2023/loading-kayak-on-car-roof.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0E5C5308BAB359D5C03458F2AECC2577" alt="Loading kayak on car roof" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller10/30/2023Women with breast cancer may face a future with a drastically different silhouette. Learn about common reconstruction techniques to discuss with your healthcare team.Reshaping your future: Exploring reconstruction options after breast cancer<p>A cancer journey is full of decisions. This may include where to receive treatment, the type of treatment you want, if you should participate in a clinical trial, if you should seek a second opinion and if reconstructive surgery is right for you.</p> <p>It's common to experience a wide range of emotions over these decisions. After your cancer diagnosis, you may feel anxious, afraid, angry or overwhelmed, and wonder how you can cope during the days ahead. These are expected feelings.</p> <p>One decision that can feel overwhelming and cause stress and anxiety is how your appearance may change after treatment. <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/mastectomy/basics/definition/prc-20012749" target="_blank" title="Opens in a new window.">Mastectomy</a>, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/lumpectomy/basics/definition/prc-20012706" target="_blank" title="Opens in a new window.">lumpectomy</a> and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/radiation-therapy/basics/definition/prc-20014327" target="_blank" title="Opens in a new window.">radiation</a> can drastically change a person's appearance and body contour. While some people decide that breast tissue reconstruction is unnecessary after treatment, others wish to restore their breasts if possible.</p> <p>Many reconstruction options are available to give breasts a more natural appearance after cancer treatment. Talk with your healthcare team about your desires and which option may be best for you.</p> <p>Here are the most common breast reconstruction techniques.</p> <h2>Tissue expansion and implant</h2> <p>During tissue expansion, an expandable, balloon-like implant is inserted in the place of the breast, either above or under your chest muscle. This temporary implant is gradually filled with saline over several weeks or months. This can be done at the time of your mastectomy or at a later time. The tissue expander is gradually inflated to stretch the skin and tissue over your chest and make room for a permanent implant.</p> <p>After the tissue is adequately expanded, your surgeon performs a second surgery to remove the tissue expander and replace it with a permanent implant. This can be a silicone or saline device that reshapes your breast and is filled with silicone gel or salt water.</p> <p><img height="325" alt="Breast tissue expansion and implant illustration" width="325" src="/-/media/national-files/images/hometown-health/2023/breast-tissue-expansion.jpg?h=325&w=325&sc_lang=en&hash=62D553F0AC31CE586AA4912FBDBB50D7"></p> <h2>Flap procedure</h2> <p>Breast reconstruction with flap surgery involves taking a section of tissue from one area of your body and relocating it to create a new breast mound. Most of the time, this is done as a separate procedure from your mastectomy.</p> <p>Breast reconstruction with flap surgery is the most complex breast reconstructive option. Your surgeon transfers a section of skin, muscle, fat and blood vessels from another part of your body to your chest to create a new breast mound. In some cases, the skin and tissue need to be augmented with a breast implant or other surgery to achieve the desired breast size.</p> <p>The tissue for reconstructing your breast most often comes from your abdomen; it may also come from your back or, less commonly, your buttocks.</p> <h3>The most common flap procedures are:</h3> <h4> Pedicle TRAM flap</h4> <p>In a pedicle TRAM flap procedure, the surgeon cuts a section of skin, muscle, fat and blood vessels from your abdomen, tunnels the tissue underneath your skin to its new location and uses it to form a new breast mound.</p> <img height="325" alt="Breast reconstruction: pedicle TRAM flap illustration" width="325" src="/-/media/national-files/images/hometown-health/2023/breast-pedicle-tram-flap.jpg?h=325&w=325&sc_lang=en&hash=ACEF779119C463F1A7E0B7981E13C998"> <h4>Deep inferior epigastric perforation (DIEP) flap</h4> <p>A newer procedure, DIEP flap, is similar to a TRAM flap, but only skin and fat are removed. Most of the abdominal muscle is left in place, and minimal muscle tissue is taken to form the new breast mound. An advantage to this type of breast reconstruction is that you'll retain more strength in your abdomen.</p> <img height="325" alt="Breast reconstruction: Deep inferior epigastric perforation (DIEP) flap illustration" width="325" src="/-/media/national-files/images/hometown-health/2023/breast-diep-flap.jpg?h=325&w=325&sc_lang=en&hash=0456F928AD9E2E5535576E7F111BC30F"> <h4>Latissimus dorsi flap</h4> <p>In this flap procedure, the surgeon takes tissue from the latissimus dorsi muscle with skin from your back, tunnels it underneath your arm to its new location and uses it to form a new breast mound.</p> <img height="325" alt="Breast reconstruction: latissimus dorsi flap illustration" width="325" src="/-/media/national-files/images/hometown-health/2023/breast-latissimus-dorsi-flap.jpg?h=325&w=325&sc_lang=en&hash=ACD0E84CD6C65DA27A26FF0D7F5EE859"> <h2><strong>Goldilocks </strong></h2> <p>The Goldilocks procedure is performed after a mastectomy that removes unhealthy breast tissue. Then the remaining fatty tissue and skin are formed into a breast mound that gives some shape and definition to the breast. This procedure does not produce a large breast mound but does give shape and definition to the breast that can be augmented later if desired.</p> <img height="454" alt="Breast reconstruction: Goldilocks procedure illustration" width="325" src="/-/media/national-files/images/hometown-health/2023/breast-goldilocks.jpg?h=454&w=325&sc_lang=en&hash=833AA87649D223290DBC210F70F4AFC4"> <p>It's called Goldilocks because it represents a middle-of-the-road option between mastectomy with a flat-chest appearance and full reconstruction with implants, expanders or a flap procedure. The operation is typically used in patients with larger and heavier breasts, but it can be used in some patients with smaller breasts.</p> <h2>Nipple reconstruction</h2> <p>If you choose, breast reconstruction may also involve reconstruction of your nipple, including <a href="/hometown-health/speaking-of-health/3d-tattooing-after-breast-reconstruction" target="_self" title="Opens in same window.">3D tattooing</a> to define the dark area of skin surrounding your nipple called the areola.</p> <img height="325" alt="Breast nipple reconstruction illustration" width="325" src="/-/media/national-files/images/hometown-health/2023/breast-nipple-reconstruction.jpg?h=325&w=325&sc_lang=en&hash=5158F1187975EFD3CC597639A7909918"> <p>Breast reconstruction won't recreate the exact look and feel of your natural breast. However, the contour of your new breast may restore a silhouette similar to what you had before mastectomy. While it may not have the same appearance or feel as your natural breast, it does provide a sense of wholeness after undergoing mastectomy for cancer treatment. Discuss your options and preferences with your healthcare team.</p> <p><a href="/providers/matthew-sherrill-md" target="_self" title="Opens in same window."><em>Matthew Sherrill, M.D.</em></a><em>, is a <a href="/services-and-treatments/plastic-and-reconstructive-surgery" target="_self" title="Opens in same window.">plastic and reconstructive surgeon</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Breast reconstruction</li> <li>Hand surgery</li> <li>Microsurgery</li> <li>Moh’s surgery reconstruction</li> </ul>M.D., F.A.C.S.<p><strong>Education</strong></p> <ul> <li>Texas A & M University Health Science Center</li> </ul> <p><strong>Residency</strong></p> <ul> <li>General Surgery, University of North Carolina</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Plastic and Reconstructive Surgery, University of Minnesota</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>The American Board of Plastic Surgery</li> <li>The American Board of Surgery </li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Alpha Omega Alpha Medical Honor Society</li> <li>Fellow, American College of Surgeons</li> <li>American Medical Association</li> <li>American Society of Plastic Surgeons</li> </ul> <p> </p>Sherrill<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/matthew-sherrill-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=9182931EA7359A0A698B25596F46AC91" alt="Matthew Sherrill MD" width="280" height="280" DisableNVelocity="true" />Matthew<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13178831Matthew Sherrill MD1<img src="/-/media/national-files/images/hometown-health/2023/couple-arms-clasped-around.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F59E32F2B9CE28E6E4B39FD1148CC739" alt="Couple with arms clasped around person in front" width="660" height="370" DisableNVelocity="true" />Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller10/3/2023Kidney stones are small, hard formations that can cause big trouble. Learn the types and how they form, plus how lifestyle changes and medications can lower your risk.Preventing kidney stones before they form<p>Kidney stones are small, hard deposits made of minerals and other materials inside the kidneys. Stones often go unnoticed in the kidney until they move into the ureter, which is the tube connecting the kidney and bladder.</p> <p>If a stone leaves the kidney and blocks urine from exiting, usually while in the ureter, it can cause urine to back up and lead to intense pain.</p> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/kidney-stones/symptoms-causes/syc-20355755" target="_blank" title="Opens in a new window.">Kidney stones</a> are common, affecting about 12% of the U.S. population. Kidney stone development usually begins when people are in their 20s or 30s, and the problem can continue for years.</p> <p>Many things can increase your risk for stones, including family history, health factors like diabetes, dietary habits or if your urine lacks substances to prevent crystals from sticking together.</p> <h2>Types of kidney stones</h2> <p>Knowing the type of your kidney stone will help determine its cause and give you clues on how to reduce your chance of developing more stones. If you pass a kidney stone, try to save it to give to your healthcare team for analysis.</p> <h3>The four types of kidney stones are:</h3> <h4>Calcium stones</h4> <p>This is the most common type of kidney stone. About 70% to 80% of kidney stones are calcium stones, which are usually made of calcium and oxalate. Oxalate is a substance produced by the liver and also absorbed from your diet. Certain fruits and vegetables, like spinach, have high oxalate content. Taking high doses of vitamin D and vitamin C, gastric surgery and several metabolic disorders can increase the concentration of calcium or oxalate in your urine.</p> <p>Calcium stones can also be made of calcium phosphate. This type of stone is more common in people with metabolic conditions like renal tubular acidosis. It may also be associated with some medications used to treat migraines, including topiramate, or blood pressure, including furosemide or triamterene.</p> <h4>Struvite stones</h4> <p>Struvite stones can form after a urinary tract infection. These stones can grow quickly and become large, sometimes with few symptoms or little warning.</p> <h4>Uric acid stones</h4> <p>Uric acid stones can form in people who lose too much fluid because of chronic diarrhea or malabsorption, eat a high-protein diet or who have gout. Certain genetic factors also may increase your risk of uric acid stones.</p> <h4>Cystine stones</h4> <p>These stones form in people with a hereditary disorder called cystinuria, which causes the kidneys to excrete too much of a specific amino acid.</p> <h2>Preventing kidney stones</h2> <p>Nearly 50% of people who have developed kidney stones will develop another stone in 10 years if they do not take steps to prevent a recurrence. This usually includes a combination of lifestyle changes and medications.</p> <h3>Lifestyle changes</h3> <h4>You may reduce your risk of kidney stones if you:</h4> <ul> <li><strong>Drink water throughout the day.</strong><br /> People with a history of kidney stones should drink enough fluids to pass about 80 oz., or 2.5 liters, of urine every day. This is the most effective therapy available to prevent future kidney stones. Your healthcare team may ask you to measure your urine output to ensure you drink enough water.</li> <li><strong>Eat fewer oxalate-rich foods.</strong><br /> Switching to a diet low in oxalates can reduce your risk of calcium oxalate stones. Foods that are highest in oxalates include spinach, rhubarb, baked potatoes, lentils, navy beans, bran, grits and almonds. A high amount of salt and animal protein in your diet also can increase your kidney stone risk. A diet lower in sodium and higher in potassium — contained in many fruits and vegetables — can reduce the risk of stone formation.</li> <li><strong>Continue eating calcium-rich foods, but use caution with calcium supplements.</strong><br /> Calcium in food can actually lower your risk of kidney stones. Continue eating calcium-rich foods unless your healthcare team recommends otherwise. Talk with your healthcare team before taking calcium supplements, however, because these may be linked to an increased risk of kidney stones.</li> <li><strong>Take steps to reduce urinary tract infections.</strong><br /> Some people are more susceptible to developing recurrent urinary tract infections. Fewer infections can reduce the risk of developing struvite stones. <a href="/hometown-health/speaking-of-health/5-tips-to-prevent-a-urinary-tract-infection" target="_self" title="Opens in same window.">Get tips for preventing urinary tract infections</a>.</li> </ul> <h3>Medications</h3> <p>Medications can control the amount of minerals and salts in the urine and may be helpful in people who form certain kinds of stones. The type of medication your doctor prescribes will depend on the type of kidney stones you have and the specific makeup of your urine, which is determined by testing. Some medications can reduce uric acid levels in the blood and reduce your risk of uric acid stones, while others increase the solubility of cystine in your urine and lower your risk of cystine stones.</p> <p>Kidney stone formation is specific to each person, so it's important to work with your healthcare team to develop a personalized treatment plan. That plan should consider what kind of kidney stones you have, possible causes for their formation and specific steps to prevent them.</p> <p><a href="/providers/spencer-bershow-md" target="_self" title="Opens in same window."><em>Spencer Bershow, M.D.,</em></a><em> is a <a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">urologist</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a> and <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Medical management of kidney stones</li> <li>Prostate cancer</li> <li>Sexual dysfunction</li> <li>Urinary problems (prostate enlargement and bladder dysfunction) </li> </ul>M.D.<p>After having worked as a family medicine doctor for many years, I chose to focus on an area of medicine of personal interest and one which has a major impact on patient’s quality of life. I still believe in taking care of the whole patient and aim to approach everyone with an understanding of their overall health and health goals. I treat everyone with respect and compassion and hope to help patients understand their own medical issues while offering guidance in finding a solution which is right for them.</p> <p>I grew up in Minnesota and continue to enjoy the natural beauty of the state, from the lakes to the North Shore. I enjoy being outside when I can, whether biking, hiking, skiing or just a walk in the park. I am a family guy at heart, and nothing makes me happier that spending time with my wife and playing with my two kids.</p><p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, University of Minnesota</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Family Medicine</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Academy of Family Physicians</li> </ul>Bershow<img src="/-/media/shared-files/images/medical-professionals/full/mankato/spencer-bershow-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=FE75966A659E6E1B6FB0CA5C822D4A6F" alt="Spencer Bershow, M.D." width="280" height="280" DisableNVelocity="true" />Spencer<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30232378Spencer Bershow, M.D.1{83EB2AA2-1436-4DDC-B7BB-51F8E6A87FC9}|{8BDD56B5-A4A4-4185-9803-6B1616324432}|{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{BFAFB863-D571-4781-ADD9-1398B77B549E}|{986C767E-E5DE-43F5-957F-B4212DB8E384}<img src="/-/media/national-files/images/hometown-health/2023/drinking-bottled-water-towel-on-neck.jpg?h=370&iar=0&w=660&sc_lang=en&hash=41F6DFCBDF44004C2678415280758796" alt="Drinking bottled water towel on neck" width="660" height="370" DisableNVelocity="true" />Kidney HealthYour kidneys are responsible for filtering waste and excess fluids from your body. So when kidney functionality decreases, harmful amounts of fluid and waste can build up in your body. In most cases, you can prevent or manage kidney issues by making healthy, kidney-conscious decisions.Dawn Haller10/16/2023For many, getting a good night's sleep can be a nightmare. Learn how consultations and care for sleep issues conveniently roll into communities served by the Mobile Health Clinic.Sleep issues? Care is as close as the Mobile Health Clinic<p>The vast research and reporting about the importance of sleep are enough to keep you awake at night. But what's really interfering with your sleep may be issues like age, anxiety, insomnia, snoring, stress, menopause, weight, restless leg syndrome or health conditions like sleep apnea, which need to be addressed to avoid more serious problems.</p> <p>Sleep health is a vital part of your overall physical and mental health because sleep accounts for about one-third of your life. But according to the Centers for Disease Control and Prevention (CDC), 1 in 3 people don't get enough sleep for a wide range of reasons. How much sleep is enough? The CDC recommends that adults should snooze for at least seven hours a day.</p> <p>If you're concerned about your sleep, a <a href="/services-and-treatments/neurodiagnostics" target="_self" title="Opens in same window.">Sleep Medicine</a> professional can help. Consultation, testing and care for various sleep disorders can help improve the quality of your sleep.</p> <p>While sleep medicine professionals are available at a number of Mayo Clinic Health System brick-and-mortar clinics, patients across Minnesota now can get their sleep issues assessed close to home at the <a href="/services-and-treatments/mobile-health-clinic" target="_self" title="Opens in same window.">Mobile Health Clinic</a> via a telehealth appointment.</p> <p>Consultations and follow-up appointments are handled much like they would be in a clinic. It's an opportunity for Sleep Medicine professionals to reach more patients over a broader geographic area, and you don't need to invest in as much travel time.</p> <p>After you're referred to Sleep Medicine by your healthcare team, you can make an appointment for the Mobile Health Clinic via the <a href="/patient-online-services" target="_self" title="Opens in same window.">patient portal</a> or by phone. When you arrive at the unit, a staff member will show you to a private room, make sure the virtual connection is functioning and then your one-on-one consultation will begin. The staff member will remain available for technical support if needed.</p> <p>During this telehealth appointment, you can discuss your sleep concerns or issues and if needed, receive a referral for sleep testing or possibly medications for treatment.</p> <p>For example, if a sleep study would help reveal possible causes of sleep issues, the Sleep Medicine specialist may order an at-home study. Home sleep studies grew in popularity during the pandemic and continue to be convenient and beneficial for a large number of patients.</p> <p>During a home sleep study, your sleep is monitored through a device that reports data via an app on your cellphone. The home sleep study device can be mailed to your home or you can pick it up from the Mobile Health Clinic. After the study is complete, you'll have a follow-up appointment at the Mobile Health Clinic to go over the results and any recommendations.</p> <h2>While convenience is a major factor in choosing care at the Mobile Health Clinic, other benefits include:</h2> <ul> <li>Ease of setting up appointments by phone or the patient portal</li> <li>Eliminating the need for a strong internet connection for at-home telehealth appointments</li> <li>Improving access to a broad range of specialists without the travel time</li> <li>Reducing the need for technology skills</li> <li>Receiving care for both acute and chronic conditions</li> <li>Receiving continuity of care with familiar staff</li> </ul> <p>Together, you and a sleep medicine specialist can help determine how best to improve the quality of your sleep.</p> <p><em><a href="/providers/david-dare-md" target="_self" title="Opens in same window."><em>David Dare, M.D.</em></a>, is a <a href="/services-and-treatments/neurodiagnostics" target="_self" title="Opens in same window.">Sleep Medicine</a> specialist in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a> and <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Delayed/Advanced sleep phase disorder</li> <li>Narcolepsy/Cataplexy</li> <li>Obstructive and central sleep apnea</li> <li>REM sleep behavior disorder</li> <li>Restless legs syndrome</li> <li>Sleep deprivation and human performance </li> </ul>M.D.Outside of work, I enjoy sports, exercise and music. <p><strong>Medical School</strong></p> <ul> <li>University of Texas Medical Branch, Galveston</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>University of Utah Hospital, Salt Lake City</li> <li>University of Tennessee, Nashville</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Sleep Medicine, Hennepin County Medical Center, Minnesota Regional Sleep Disorders Center, Minnesota</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Internal Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Sleep Medicine</li> <li>American Medical Association</li> </ul>Dare<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/david-dare-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B20E737965BD14178C8A0656A0319E19" alt="David Dare MD" width="280" height="280" DisableNVelocity="true" />David<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20867603David Dare, M.D.1<img src="/-/media/national-files/images/hometown-health/2023/mobile-health-clinic-vehicle.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9BD3C351537EC8F1428CA15001A0AB7E" alt="Mobile Health Clinic vehicle" width="660" height="370" DisableNVelocity="true" />SleepSleep is essential to good health. It's one of the body's basic needs. But, what do you do when you have troubles sleeping, or getting enough hours of sleep? NarcolepsyNarcolepsy is a chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep. People with narcolepsy often find it difficult to stay awake for long periods of time, regardless of the circumstances. Narcolepsy can cause serious disruptions in your daily routine.<br/><br/>Dawn Haller11/30/2023Together, Mary and Ben Zweber have nearly 50 years of volunteer experience with Mayo Clinic Health System. Learn what keeps this couple — now in their 90s — coming back and giving of their time.Volunteers make connections, reap benefits<p>Every Wednesday, Mary and Ben Zweber arrive at the Mayo Clinic Health System <a href="/locations/new-prague" target="_self" title="Opens in same window.">hospital in New Prague</a>, Minnesota, for their volunteer shift. Mary greets patients at the information desk, provides directions, cleans wheelchairs and keeps the lobby tidy and welcoming. Ben pushes the hospitality cart to approved patient rooms, offering them snacks, beverages and the opportunity for a friendly chat.</p> <p>The Zwebers are old hands at volunteering. After being invited by a friend to join her as a volunteer, Mary, now 91, started at the hospital in 1990; Ben, now 92, signed up in 2007. "Mary inspired me," he says.</p> <p>The Zwebers underscore filling a need and having a purpose as their main reasons for volunteering year after year. But it's knowing that they're helping people and making connections that give them an extra boost.</p> <p>"Recently, an older visitor was nervous about taking the elevator because she'd been stuck in one at another facility," Mary says. "So I rode with her, and she was so grateful and relieved. I ride the elevator every shift, but it made someone else's day this time."</p> <p>Ben tells about taking his cart to a patient who had a knee replacement and was feeling discomfort. "I told him, 'I have two new ones, and it does get better with time and physical therapy. You'll get there, too,'" he says. "The patient's son was visiting and tracked me down to thank me. He said his dad needed to hear that, which lifted his spirits. I was glad I could offer encouragement."</p> <p>When asked what they would say to others about volunteering at Mayo Clinic Health System, the Zwebers say, "Come join us. The environment is great, and the patients and staff are wonderful."</p> <h2>Helping others, benefiting you</h2> <p>Research has shown that volunteering <a href="/hometown-health/speaking-of-health/3-health-benefits-of-volunteering" target="_self" title="Opens in same window.">offers significant health benefits</a>, especially for older adults, including:</p> <ul> <li><strong>Improves physical and mental health.</strong><br /> Volunteering reduces stress and increases positive, relaxed feelings by releasing dopamine. By spending time in service to others, volunteers report feeling a sense of meaning and appreciation, both given and received, which can have a stress-reducing effect.</li> <li><strong>Provides a sense of purpose and teaches valuable skills.</strong><br /> At Mayo Clinic Health System, volunteers serve as greeters and waiting room attendants, provide patient room information and directions, and help transport patients and patient items. Many volunteers use their craft skills to make prayer shawls, blankets, sweaters and hats for newborn babies and people with cancer. Other services that volunteers provide include working in the hospital gift shop, performing clerical duties for staff and <a href="/hometown-health/speaking-of-health/a-day-in-the-life-of-luna-a-facility-dog" target="_self" title="Opens in same window.">offering pet therapy</a> through the Paws Force team.</li> <li><strong>Nurtures new and existing relationships.</strong><br /> Volunteering increases social interaction and helps build a support system based on common interests. One of the best ways to make new friends and strengthen existing relationships is to participate in a shared activity. Volunteers often have diverse backgrounds, and participating in a volunteer activity helps them expand their social network and allows them to practice social skills with others.</li> </ul> <p>People volunteer for different reasons, such as exploring careers, sharpening skills, staying active during retirement, meeting new people and serving their communities. Yet all volunteers share a common desire to improve the health and welfare of people in their communities.</p> <h2>How you can make a difference</h2> <p>If you'd like to make a difference for Mayo Clinic Health System patients and staff, you can find <a href="/volunteer" target="_self" title="Opens in same window.">volunteering opportunities</a> in various service areas with flexible schedules and commitments, along with engagement and enrichment options that fit you best. Check out the options at your preferred location.</p><img src="/-/media/national-files/images/hometown-health/2023/mary-and-ben-zweber.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4834701878FD09246F057E23C0247260" alt="Mary and Ben Zweber" width="660" height="370" DisableNVelocity="true" />Dawn Haller11/13/2023After retiring, John and Terri Pedace have found purpose, fulfillment and a way to give back through volunteering for Mayo Clinic Health System in La Crosse, Wisconsin.Volunteers make a difference one warm welcome at a time<p>When people arrive at a hospital or clinic to receive care, they may be concerned about their health condition and their upcoming appointment, uneasy about not knowing where to go and stressed about having to navigate traffic and find parking. Reducing that stress is the top priority for John and Terri Pedace, Mayo Clinic Health System volunteers in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse, Wisconsin</a>. John and Terri serve as clinic and hospital lobby hosts and wheelchair transporters.</p> <p>"Every day, I do what I can to make sure the patients who come to Mayo Clinic Health System are treated kindly and have their questions and concerns fully addressed," says John, 69, who has volunteered since 2019.</p> <p>Terri, 68, agrees. "I try to reassure patients and their families, acknowledge their worries and provide a caring, pleasant welcome," she says.</p> <p>Terri and John came to their volunteering experience with Mayo Clinic Health System from different backgrounds.</p> <p>No stranger to Mayo Clinic Health System, Terri worked there as a nurse for 42 years. Less than a year after retiring, Terri joined the volunteer service in 2017. "I loved my career as a nurse and felt drawn to continue serving the organization and its patients in my retirement," she says. "As a volunteer, not only am I able to help patients, but I'm continuing to live the mission and values of Mayo Clinic."</p> <p>For 46 years, John was a teacher, working with colleagues, parents and students every day. "After I retired, I wanted to find a volunteering opportunity that would involve helping people while at the same time enabling me to maintain my interpersonal and communication skills," he says.</p> <p>Although the Pedaces take a break over the winter months to escape Wisconsin's harsh weather, you'll find them in their volunteer roles every week from April through late fall. They typically work about four hours a week, although John says he'll pick up extra shifts as lobby host or DART, which stands for dependable and resourceful transport, when slots are open.</p> <p>The couple agrees that their volunteer service is highly gratifying and gives as much back to them as they strive to give patients and their families.</p> <p>"I strongly encourage anyone to be a volunteer and participate in one of the best healthcare institutions in the world," Terri says. "It's a privilege, and every day is filled with rewarding experiences."</p> <p>"I'm constantly reminded how lucky I am to be part of such a great institution that helps so many people," John says. "That underscores why I show up at every shift ready to provide the best possible experience for the patients and staff."</p> <h2>Helping others, benefiting you</h2> <p>Research has shown that volunteering <a href="/hometown-health/speaking-of-health/3-health-benefits-of-volunteering" target="_self" title="Opens in same window.">offers significant health benefits</a>, especially for older adults, including:</p> <ul> <li><strong>Improves physical and mental health.</strong><br /> Volunteering reduces stress and increases positive, relaxed feelings by releasing dopamine. By spending time in service to others, volunteers report feeling a sense of meaning and appreciation, both given and received, which can have a stress-reducing effect.</li> <li><strong>Provides a sense of purpose and teaches valuable skills.</strong><br /> At Mayo Clinic Health System, volunteers serve as greeters and waiting room attendants, provide patient room information and directions, and help transport patients and patient items. Many volunteers use their craft skills to make prayer shawls, blankets, sweaters and hats for newborn babies and patients with cancer. Other services volunteers provide include working in the hospital gift shop, performing clerical duties for staff and <a href="/hometown-health/speaking-of-health/a-day-in-the-life-of-luna-a-facility-dog" target="_self" title="Opens in same window.">offering pet therapy</a> through the Paws Force team.</li> <li><strong>Nurture new and existing relationships.</strong><br /> Volunteering increases social interaction and helps build a support system based on common interests. One of the best ways to make new friends and strengthen existing relationships is to participate in a shared activity. Volunteers often have diverse backgrounds, and participating in a volunteer activity helps expand their social network and allows them to practice social skills with others.</li> </ul> <p>People volunteer for different reasons, such as exploring careers, sharpening skills, staying active during retirement, meeting new people and serving their communities. Yet all volunteers share a common desire to improve the health and welfare of people in their communities.</p> <h2>How you can make a difference</h2> <p>If you'd like to make a difference for Mayo Clinic Health System patients and staff, you can find <a href="/volunteer" target="_self" title="Opens in same window.">volunteering opportunities</a> in a variety of service areas with flexible schedules and commitments, along with engagement and enrichment options that fit you best. Check out the options at your preferred location.</p><img src="/-/media/national-files/images/hometown-health/2023/john-and-terri-peduce.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E07A708E1C9CA5F50899B52CD7EABB07" alt="John and Terri Peduce" width="660" height="370" DisableNVelocity="true" />Dawn Haller12/7/2023Preventing illness during the cold and flu season starts with the who, what, where, when and why of handwashing. Teach your children about hand hygiene with these tips.The 5 Ws of healthy hands can help you avoid germs, illnesses<p>Preventing illness during the cold and flu season starts with knowing how to wash your hands properly, when to wash your hands, what products to use and why you should pay special attention to skin cleanliness.</p> <p>According to the Centers for Disease Control and Prevention, frequent hand-washing is one of the best ways to prevent the spread of illness. Teaching children hygiene habits is essential, as they're more likely to be <a href="/hometown-health/speaking-of-health/7-ways-to-combat-coughs-and-colds" target="_self" title="Opens in same window.">exposed to respiratory illnesses</a> at school or child care.</p> <h2>Keep in mind these 5 Ws when teaching your children about proper hand hygiene:</h2> <h3>1. Who?</h3> <p>Everyone — create routines around hand-washing beginning at an early age. </p> <h3>2. What?</h3> <p>Using running water and plain soap, followed by moisturizer, is best where running water is available. Plain soap and running water — used with good hand-washing technique — are just as effective against common childhood respiratory and <a href="/hometown-health/speaking-of-health/steps-to-prevent-norovirus" target="_self" title="Opens in same window.">stomach, or gastrointestinal, viruses</a> and bacteria as antibacterial soap.</p> <p>Although it may be convenient to grab baby wipes to use on your children's hands, keep in mind that while they may make your hands look clean, they're not designed to remove germs. </p> <h3><strong>3. Where and how?</strong></h3> <ul> <li>If running water and soap are available, wet hands thoroughly.</li> <li>Apply soap and lather, paying particular attention to nails and between fingers.</li> <li>Rub for 10 to 20 seconds — long enough to sing the "Happy Birthday" song twice.</li> <li>Rinse.</li> <li>Dry with a clean towel.</li> <li>Use the towel to turn off the faucet.</li> </ul> <h3><strong>4. When?</strong></h3> <ul> <li>If hands are visibly dirty</li> <li>Before eating, and before and after food preparation</li> <li>After using the bathroom</li> <li>After shaking hands with someone</li> <li>On arrival home from <a href="/hometown-health/speaking-of-health/keep-your-kids-healthy-at-school" target="_self" title="Opens in same window.">school</a>, child care and play dates</li> <li>After touching a dirty surface or item</li> <li>After coughing, sneezing or wiping the nose</li> </ul> <h3>5. Why?</h3> <p>Skin usually is a great barrier to infection. You can help maintain that barrier by regularly using moisturizers during cold, dry winter months to prevent <a href="/hometown-health/speaking-of-health/what-to-do-about-dry-skin" target="_self" title="Opens in same window.">cracked or chapped skin</a>. With regular hand-washing, you can remove infectious organisms from your hands before you transfer them to your eyes, nose or mouth. This often is how common cold and influenza viruses are spread. Research indicates that regular hand-washing in classrooms decreases school absences due to illness.</p> <p>In some situations, hand sanitizer is a good alternative. Use a dime-sized amount and rub it thoroughly over the surfaces of your hands until the hands are dry. Hand sanitizers usually contain 60 to 90% alcohol, which kills many bacteria and viruses that cause infection. Hand sanitizer doesn't work without good contact with the skin, so opt for soap and water when your hands are extremely dirty.</p> <h2>Hand sanitizer safety</h2> <p>Because of its high alcohol content, hand sanitizer has several safety concerns. Children shouldn't use it unsupervised. Some experts recommend limiting how often young children use hand sanitizer. Don't use it on children under 2. </p> <p>Alcohol is flammable, so store sanitizer away from flames and heat sources. There are strict guidelines for placement in schools and child care centers to reduce the risk of fire.</p> <p>Due to the high alcohol content in hand sanitizer, alcohol poisoning and intoxication are possible if someone drinks a large amount, or uses it on damaged skin or on babies who don't have a fully developed skin barrier. </p> <p>It's important to supervise the use of hand sanitizer to limit it to a dime-size amount and ensure safe storage. If accidental ingestion of more than one squirt of hand sanitizer occurs, call the <a rel="noopener" href="http://www.aapcc.org/" target="_blank" title="Opens in a new window.">poison control center</a> at <a href="tel:1-800-222-1222">800-222-1222.</a></p> <h2>Keeping your family healthy</h2> <p>As a parent, you can't prevent your kids from contact with dirt and germs. But you can teach them how to wash their hands properly and protect themselves by making frequent hand-washing a lifelong healthy habit.</p> <p>Remember, frequent hand-washing keeps germs at bay and can go a long way in protecting your child from viruses and bacteria, in addition to <a href="/hometown-health/speaking-of-health/prepare-kids-for-flu-shot-tips-to-help-parents" target="_self" title="Opens in same window.">getting influenza</a> and COVID-19 vaccines. By teaching your child the importance of hand hygiene and of adequately cleaning their hands, you can help them establish healthy habits that will last a lifetime.</p> <p>Learn how to <a href="/hometown-health/speaking-of-health/clean-up-your-hand-washing-skills" target="_self" title="Opens in same window.">clean up your hand-washing skills</a>, and download a flyer and coloring sheet about hand-washing.</p> <p><em><a href="/providers/joslyn-hager-md" target="_self" title="Opens in same window."><em>Joslyn Hager, M.D.</em></a>, is a <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">pediatrician</a> in <a href="/locations/chippewa-falls" target="_self" title="Opens in same window.">Chippewa Falls</a>, Wisconsin.</em></p><ul> <li>Adolescent medicine for acne, contraception and menstrual disorders</li> <li>Baby-led weaning</li> <li>Breastfeeding support and education</li> <li>Mental health – attention-deficit/hyperactivity disorder, anxiety and depression</li> <li>Newborn care</li> <li>Nutrition </li> <li>Providing care to prevent future illness</li> <li>Providing wellness visits with anticipatory guidance – what to expect at each age and stage</li> </ul>M.D.<p>I became a pediatrician to give a voice to those who do not have one yet, to help children grow into happy, healthy young adults and develop their own voices. I enjoy helping children and their families through all stages of life, from the early newborn days to the teenage and college years, when patients are coming into their own.</p> <p>My goal is to build strong and lasting bonds with patients and families. I believe in working as a team, we are stronger together.</p> <p>I grew up in the Upper Peninsula of Michigan, and my training has taken me all over the United States. My heart belongs to the Midwest, and I could not be happier to be here in Northwest Wisconsin. My family is incredibly important to me, and you will find me spending most of my spare moments with my husband, daughter and our Labradoodle. I love traveling, trying new restaurants, being on the water and appreciating nature in all of it's forms.</p><p><strong>Education</strong></p> <ul> <li>Rush Medical College</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Pediatrics, Helen DeVos Children’s Hospital – Grand Rapids Medical Education Partners</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Pediatrics</li> <li>Certified Lactation Counselor</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Academy of Pediatrics</li> </ul>Hager<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/joslyn-hager-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=230DE33E6FEC55F46FF1F218CCB7D93B" alt="Joslyn Hager, M.D." width="280" height="280" DisableNVelocity="true" />{10B96AFD-A682-4276-A141-1128B941B027}Joslyn<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30236620Joslyn Hager, M.D.1{61776FD2-05E8-47E9-AB55-EE465BD29A19}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}|{C4130004-0F31-48C4-AC9F-A4350A75AB24}|{2B88C934-922C-4130-B661-197B59D83899}|{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2023/parent-and-child-handwashing.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7C5FCCBFB1946725641D52FF1B6B6216" alt="Parent and child handwashing" width="660" height="370" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.InfluenzaInfluenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza, commonly called the flu, is not the same as the stomach "flu" viruses that cause diarrhea and vomiting.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Dawn Haller12/5/2023COPD, a chronic inflammatory lung disease most often caused by long-term smoking, is a leading cause of disability and death in the U.S. Learn strategies to cope with COPD and slow lung damage.6 tips for living with COPD<p>Chronic obstructive pulmonary disease, or <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/copd/symptoms-causes/syc-20353679" target="_blank" title="Opens in a new window.">COPD</a>, is a leading cause of disability and death in the U.S., according to the American Lung Association. More than 12.5 million people in the U.S. have a diagnosis of COPD, but millions more may have the disease without knowing it.</p> <p>COPD is a chronic inflammatory lung disease most often caused by long-term smoking, especially cigarettes. Another cause of COPD is breathing in toxic fumes or gases. In rare cases, the cause is a genetic problem. </p> <p>People with COPD are at increased risk of developing respiratory infections, <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/heart-disease/symptoms-causes/syc-20353118" target="_blank" title="Opens in a new window.">heart disease</a>, <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/lung-cancer/symptoms-causes/syc-20374620" target="_blank" title="Opens in a new window.">lung cancer</a>, pulmonary hypertension and depression. Also, people with chronic lung disease like COPD may be at greater risk of severe illness and complications from <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-who-is-at-risk/art-20483301" target="_blank" title="Opens in a new window.">COVID-19</a>.</p> <p>Factors that can increase the risk of COPD include exposure to tobacco smoke, including secondhand smoke; <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/asthma/symptoms-causes/syc-20369653" target="_blank" title="Opens in a new window.">asthma</a>; occupational exposure to dust and chemicals; exposure to fumes from burning fuel; infections; and genetics. </p> <p>According to the American Lung Association, more women are living with COPD than men, and deaths from COPD are higher in women than in men.</p> <h2>Symptoms of COPD</h2> <p>Symptoms of COPD often don't appear until significant lung damage has occurred, and they usually worsen over time, particularly if cigarette smoke exposure continues.</p> <h3>Signs and symptoms of COPD can include:</h3> <ul> <li>Chest tightness</li> <li>Chronic cough that may produce clear, white, yellow or green mucus</li> <li>Frequent respiratory infections</li> <li>Lack of energy</li> <li>Unintended weight loss</li> <li>Shortness of breath</li> <li>Swelling in the ankles, feet or legs</li> <li>Wheezing</li> </ul> <h2>Treatment for COPD</h2> <p>If you have COPD and you smoke, it's vital that you quit. Most cases of COPD in the U.S. are directly related to long-term cigarette smoking. Stopping smoking can prevent COPD from worsening and reducing your ability to breathe.</p> <p>Many people with COPD have mild forms of the disease and need little treatment other than quitting smoking. With advanced stages of the disease, effective treatment is available that can control symptoms, slow progression, reduce your risk of complications and exacerbations, and improve your ability to lead an active life.</p> <p><a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/copd/diagnosis-treatment/drc-20353685" target="_blank" title="Opens in a new window.">Treatment for COPD</a> can include medications, such as inhalers; oxygen; pulmonary rehabilitation; in-home noninvasive ventilation therapy; managing flare-ups, also called exacerbations; endobronchial valves; and surgery.</p> <h2>Coping with COPD</h2> <p>Living with COPD can be a challenge, especially as it becomes harder to catch your breath. You may have to give up some activities you previously enjoyed. Your family and friends also may have difficulty adjusting to some of the changes.</p> <h3>These strategies can help people with COPD feel better and slow the damage to their lungs:</h3> <ul> <li><strong>Avoid smoke and air pollution.</strong><br /> Besides quitting smoking, avoiding places where others smoke is essential. Secondhand smoke may contribute to further lung damage. Other types of air pollution also can irritate your lungs, so check daily air quality forecasts before going out.</li> <li><strong>Clear your airways.</strong><br /> With COPD, mucus tends to collect in air passages and can be difficult to clear. Controlled coughing, drinking adequate amounts of water and using a humidifier may help.</li> <li><strong>Eat healthy foods.</strong><br /> A <a href="/hometown-health/speaking-of-health/whats-the-big-deal-about-the-mediterranean-diet" target="_self" title="Opens in same window.">healthy diet</a> can help you maintain your strength. If you're underweight, your healthcare professional may recommend nutritional supplements. If you're overweight, losing weight can significantly help your breathing, especially during exertion.</li> <li><strong>Exercise regularly.</strong><br /> Exercising when you have trouble breathing may seem challenging, but regular exercise can improve your overall strength and endurance and strengthen your respiratory muscles. Talk to your healthcare team about pulmonary rehabilitation exercise programs.</li> <li><strong>Learn breathing techniques.</strong><br /> Talk to your primary healthcare professional or respiratory therapist about techniques for breathing more efficiently throughout the day. Also, be sure to discuss breathing positions, energy conservation and relaxation techniques you can use when you're short of breath.</li> <li><strong>See your healthcare team regularly.</strong><br /> Stick to your appointment schedule, even if you're feeling fine. It's essential to regularly monitor your lung function and tell your healthcare team if you have worsening symptoms or notice signs of infection. Be sure to get your annual flu shot and COVID-19 vaccine to help prevent infections that can worsen your COPD, and ask your healthcare team when you need the pneumococcal vaccine.</li> </ul> <p>It can help to share your fears and feelings with your family, friends and healthcare team. You also may want to consider joining a support group for people with COPD, and you may benefit from counseling or medication if you feel depressed or overwhelmed.</p> <p>One way to connect with others living with COPD is the <a rel="noopener noreferrer" href="https://connect.mayoclinic.org/group/copd-chronic-obstructive-pulmonary-disease/" target="_blank" title="Opens in a new window.">COPD Support Group</a> on <a rel="noopener noreferrer" href="https://connect.mayoclinic.org/" target="_blank" title="Opens in a new window.">Mayo Clinic Connect</a>, an online patient community moderated by Mayo Clinic.</p> <p><em><a href="/providers/mais-abdou-md" target="_self" title="Opens in same window."><em>Mais Abdou, M.D</em></a>., is a <a href="/services-and-treatments/pulmonology" target="_self" title="Opens in same window.">pulmonologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Asthma</li> <li>Diagnostic bronchoscopy</li> <li>Endobronchial ultrasound bronchoscopy</li> <li>Lung cancer screening and lung imaging</li> <li>Pulmonary hypertension</li> <li>Sarcoidosis</li> </ul>M.D.<p>Pulmonology forms a realm where every breath carries profound significance, and every lung holds a story. Moreover, the essence of this field lies in recognizing the individuality of each patient, where their distinctive needs and preferences serving as the guiding compass for our medical decisions.</p> <p>As a dedicated pulmonologist, my practice is rooted in compassion, transparent communication and the delivery of evidence-based care. Embracing the evolving landscape of medical knowledge and adopting a collaborative multidisciplinary approach, constitutes the essence of my philosophy aimed at ensuring my patients' satisfaction and wellbeing with every inhalation, granting them the care they unequivocally deserve.</p> <p>In my role as an Intensive Care Unit physician, I uphold the believe that critical care scenarios necessitate the fusion of rapid thinking, sound judgment and profound empathy. My unwavering commitment lies in harnessing my clinical expertise and analytical acuity to make judicious decisions, especially when confronting high stakes situation.</p><p><strong>Education</strong></p> <ul> <li>Damascus University, Faculty of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Texas Tech University Health Science Center</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Pulmonary & Critical Care, Wayne State University, Detroit Medical Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Internal Medicine, American Board of Internal Medicine</li> <li>Pulmonary Disease, American Board of Internal Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Chest Physicians</li> <li>American College of Physicians</li> <li>American Thoracic Society</li> </ul>Abdou<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/mais-abdou-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=FD952C10C5E30311B2C443A40D5CE62A" alt="Mais Abdou, M.D." width="280" height="280" DisableNVelocity="true" />{494421EE-650D-49CB-8D02-F5389DD95B6C}Mais<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30287128Mais Abdou MD1{5AB5D42E-3625-4D5D-9685-35585C564C3D}|{1D6651B0-86E1-4FF6-9A93-07B8EE2D26EE}|{1A90F4B2-3C68-421C-89C5-AC045A6F8F56}|{CDC97C32-5198-4615-A006-D1D2AF64C4D5}<img src="/-/media/national-files/images/hometown-health/2023/group-of-three-seniors.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4CA204F586B7FFC92E04D653C81E8C61" alt="Group of three seniors" width="660" height="370" DisableNVelocity="true" />PulmonologyTreatment for diseases and conditions affecting lung and airway function.BreathingMost cases of shortness of breath are due to heart or lung conditions. Your heart and lungs are involved in transporting oxygen to your tissues and removing carbon dioxide, and problems with either of these processes affect your breathing.Dawn Haller12/6/2023Missing out on the sounds of daily life can lead to isolation and have an impact on your brain health. Learn more about the connection between hearing and cognition.You can’t remember what you can't hear: The hearing loss, brain health link<p>Humans by nature are social. People enjoy being with others, sharing stories, laughing at a joke, dancing to a favorite song, greeting a neighbor, discussing concerns or offering consolation. These connections, whether close or casual, are essential to emotional well-being and brain health.</p> <p>But hearing loss can break the connection. When a person can't hear what others are saying, they may feel left out, uncomfortable, anxious or even depressed. You may have seen this happen in your own friend or family group. Someone smiles and nods, but you know they didn't catch the conversations around them.</p> <p>As people withdraw from the work and social activities they enjoy, they become more isolated. Numerous studies show that isolation brought on by hearing loss is harmful to our brain health and cognition. People can't remember what they can't hear.</p> <p>Other benefits of addressing hearing loss include:</p> <ul> <li>Laughter is great medicine. But if you miss the punchline, you don't glean those mental health benefits.</li> <li><a href="/hometown-health/speaking-of-health/4-tips-for-making-music-good-medicine" target="_self" title="Opens in same window.">Music</a> makes memories. You've been collecting a playlist of songs throughout your life. Those songs trigger memories and help build and maintain the ear-to-brain path.</li> <li><a href="/hometown-health/speaking-of-health/purpose-and-mental-health" target="_self" title="Opens in same window.">Purpose</a> adds meaning to life. Social activities, such as working, joining clubs or service organizations, <a href="/hometown-health/speaking-of-health/3-health-benefits-of-volunteering" target="_self" title="Opens in same window.">volunteering</a> or caring for grandchildren, can give you purpose. If you have a standing coffee date, it gives you something to look forward to. Hearing loss may cause you to pull back from these purpose-giving activities.</li> </ul> <h2>Overcoming stigmas</h2> <p>Hearing loss has many causes, including exposure to high levels of industrial or recreational sounds, such as factory work, farm equipment or woodworking; military service; loud music; and genetics. Regardless of the cause, it's essential to have your hearing assessed and, if recommended, be fitted with hearing aids as soon as you get a diagnosis of hearing loss. The longer you wait, the more lost sounds your brain will have to relearn.</p> <p>For many, there's a stigma around getting hearing aids. Unlike needing glasses, people may feel that needing hearing aids is a sign of aging and feebleness. But <a href="/hometown-health/speaking-of-health/is-it-time-to-get-your-hearing-checked" target="_self" title="Opens in same window.">addressing hearing loss</a> is a sign that you're taking care of your overall health and wellness, and sends a message to others that you intend to maintain healthy connections with them.</p> <p>The average age when people get their first hearing test now is the mid to late 50s. Primary care professionals also are increasingly recommending hearing evaluations as part of wellness check-ups. However, it still may take five to seven years or more after a diagnosis of hearing loss before some people decide to get hearing aids.</p> <h2>Not your great-grandparents' hearing aids</h2> <p>Today's hearing aids have entered the digital era. They're often self-adjusting, which allows you to manage the sound environment more successfully. Most hearing aids have an app for smartphones that offers a wide variety of features. Manufacturers have redesigned the look of hearing aids so they're attractive, stylish and comfortable. They're also available at prices to fit different budgets.</p> <p>In the early days of using hearing aids, some wearers may find their new world of hearing difficult. Sounds can feel loud, brittle or annoying. That's because the slow progression of hearing loss is a form of sensory deprivation. The brain gets used to a quieter, more muffled world, so the <a href="/hometown-health/patient-stories/improved-hearing-aids-career-change" target="_self" title="Opens in same window.">immediate restoration of sound</a> with hearing aids can be startling and even distracting. Rather than viewing hearing aids as a quick fix, consider them to be an education process for the brain. It will take time and patience for the brain to recapture, organize and give sounds meanings again.</p> <p>Those who consistently wear their hearing aids full time gain the most benefit. Taking hearing aids in and out throughout the day or leaving them out for days or weeks at a time reduces the benefit and extends the time required for your brain to adapt. Hearing aids are meant to be in your ears, not your sock drawer.</p> <p>Check with your audiologist about hearing aid trial periods or return policies in your state. Your audiologist will be happy to work with you to find successful solutions.</p> <h2>Treat hearing loss early for brain health</h2> <p>The link between hearing loss and brain health has gained more attention and urgency in recent years, including media coverage of discoveries of the connection between hearing and neurocognitive changes, such as Alzheimer's disease and dementia. Talk to your healthcare professional and request a hearing test. Identifying and treating hearing loss early plays a vital role in maintaining and supporting brain health and emotional well-being.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2023/group-with-books.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8765E4CB6496CA396648CF0E2E1D8285" alt="Group with books" width="660" height="370" DisableNVelocity="true" />Ear HealthAn audiologist specializes in evaluating and treating people of all ages with hearing loss, dizziness and balance disorders. Specialty audiology consultation is available for assessment and treatment of hearing loss, tinnitus, dizziness and balance disorders.Karen Sperl12/28/2023This year, don't just make a resolution — make a plan with a healthy vision using SMART goals to help you overcome challenges when making resolutions for the new year.Crafting healthier resolutions: Setting and achieving your goals <p>The end of the year is a time to reflect on the changes you want to make. Whether you're kicking a bad habit or trying to pick up a good one, finding the courage to make a healthy change is the first step.</p> <p>Many people use the start of a new year to make a resolution to live healthier by quitting smoking, <a href="/hometown-health/speaking-of-health/the-4-as-of-stress-relief">reducing stress</a>, working out more or creating a weight-loss goal. Remember to speak with your healthcare team before significantly changing your daily health and fitness routine, especially if you have chronic health issues. </p> <h2>Discover the secret to success</h2> <p>Making significant changes is hard. Habits are easy to fall back into because they provide a sense of comfort. Your life's challenges, changes and stresses may have you pondering setting goals and making resolutions.</p> <p>New Year's resolutions are easy to make but not so easy to achieve. The key to success lies in developing a structured health plan.</p> <h2>Create a health vision</h2> <p>A health vision is a way to clearly visualize your goals. The first step is to create a powerful, broad statement that describes who you want to be once you have met those goals. Think about a healthy future and what that might look like to you. Convert those thoughts into a short, clear statement: your health vision.</p> <p>While there are many ways to write a health vision, one popular format is: "I want ______, so ________."</p> <p>Examples include: </p> <ul> <li>"I want to be physically fit, so I am no longer out of breath."</li> <li>"I want to have a better balance between my work and personal life, so I have more quality time for myself and my family."</li> <li>"I want to lose weight, so I have more energy to enjoy life."</li> </ul> <h2>Identify your motivators</h2> <p>After you create a health vision that you feel confident you can attain, determine which motivators will drive your desire to make those changes.</p> <h3>Some common motivators are:</h3> <ul> <li>Buying clothes in smaller sizes.</li> <li>Having the energy to play with your children. </li> <li>Reducing high <a href="/hometown-health/speaking-of-health/know-your-numbers-blood-pressure">blood pressure</a> medication.</li> <li>Watching your grandchildren grow up.</li> </ul> <h2>Tips for long-term success</h2> <h3>Before making your resolutions, consider these tips for a successful year:</h3> <h4>Take a minute to reflect.</h4> <p>Planning a change in lifestyle and committing to those resolutions takes time and energy. Set aside time to sit down and reflect on the lifestyle you want and the one you're leading now. Is this a good time in your life to make a change? Can you dedicate time to planning and taking action?</p> <h4>Have a solid plan.</h4> <p>It's hard to hit the ground running when you don't know where you're running to. That's why creating an achievable, solid plan is essential before the new year begins. A long-term goal of losing 40 pounds sounds great — but achieving that goal in a healthy manner takes planning and confidence in your ability to take the necessary steps.</p> <p>Set <a href="/hometown-health/speaking-of-health/setting-smart-goals">SMART goals</a> to help keep you focused. Achieving identified goals produces a feeling of accomplishment and much-needed motivation to fuel your health journey.</p> <h5>SMART goals are specific, measurable, achievable, relevant and time-framed:</h5> <ul> <li>Specific: What am I going to do?</li> <li>Measurable: How will I track my progress?</li> <li>Achievable: What steps will I take to make this happen?</li> <li>Relevant: Is this important enough to me to want to do it? </li> <li>Time-framed: When will I do this?</li> </ul> <p>Your SMART goals should consist of long-term and short-term goals. Establish your long-term goal first. An example of a long-term goal is "I will <a href="/hometown-health/speaking-of-health/5-tips-for-walking-your-way-to-better-health">walk briskly</a> for 30 minutes a day at least five days a week."</p> <p>However, if you haven't been exercising regularly, you may need to start with intermediary, short-term goals. For example: "I will walk 15 minutes during my lunch hour at least three days each week for the next month." After reaching your short-term goal, extend your efforts gradually until you ultimately accomplish your long-term goal.</p> <h4>Keep your focus simple.</h4> <p>As the saying goes, "Take it one step at a time." This also applies to losing weight. To lose one pound at a time you need to be patient, confident and stick to your plan. By focusing on small, simple goals, you eventually will achieve your long-term outcome of losing the weight you want and maintaining a healthy lifestyle.</p> <h4>Remember to enjoy your resolution.</h4> <p>Following a diet plan and regularly working out may not sound fun, but feeling good afterward does. Make your exercise enjoyable by trying something you've never done before. Food can be fun, too. Paging through cookbooks and trying new, healthy recipes may become a new hobby.</p> <h4>Don't give up.</h4> <p>It can be challenging to change your lifestyle, so ensure you have a network of family and friends to encourage and partner with you. Consider keeping a health journal to record your activities and achievements, <a href="/hometown-health/speaking-of-health/motivation-for-new-years-resolutions">adding to your motivation</a> and accountability.</p> <p>Embracing a healthy lifestyle is an ongoing, dynamic process. Creating a health plan, engaging your support system, and celebrating short-term and long-term successes are positive behaviors that will deliver benefits this year and beyond. Use the new year as an opportunity to begin the journey of living a healthier life.</p> <p>The finish line isn't far away. Maintaining your confidence and being patient are key to <a href="/hometown-health/speaking-of-health/establishing-healthy-behaviors-that-stick">sticking with your resolution</a>. Follow a plan and set goals, and you will soon be on your way to a healthier lifestyle in the new year.</p> <p><a href="/providers/michael-rogge-md">Michael Rogge, M.D.</a>, is a <a href="/services-and-treatments/family-medicine">Family Medicine</a> physician in <a href="/locations/prairie-du-chien">Prairie du Chien</a>, Wisconsin.</p>M.D.<p><strong>Education</strong></p> <ul> <li>University of Iowa College of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Mayo Clinic Family Medicine Residency Program</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Board of Family Practice</li> <li>American Medical Association</li> <li>Wisconsin Academy of Family Physicians</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Rogge<img src="/-/media/shared-files/images/medical-professionals/full/prairie-du-chien/michael-rogge-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=05D5A341B6BA0DFB616B81ACE1BBAA1A" alt="Michael Rogge MD" width="280" height="280" DisableNVelocity="true" />Michael <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12518492Michael Rogge, M.D.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}<img src="/-/media/national-files/images/hometown-health/2023/adult-and-child-reading-book.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5A4392389CA44C34F118551F6759997B" alt="Adult and child reading book" width="660" height="370" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller12/27/2023Do your daily responsibilities and obligations leave you feeling stretched thin, stressed or anxious? Learn how setting boundaries can be a powerful tool for your mental and emotional health.Map it out: Setting boundaries for your well-being<p>People have various types of relationships, including partners, spouses, children, friends, co-workers, neighbors and acquaintances. Different relationships involve different interactions, responsibilities and influences.</p> <p>Every relationship has boundaries or rules of engagement. You may be deliberate and conscientious about these boundaries, or they may have formed subconsciously.</p> <p>Developing and maintaining healthy boundaries helps you establish and build healthy relationships, and avoid unhealthy connections with people.</p> <h2>Why set boundaries?</h2> <p>Setting healthy boundaries is necessary for your health and the health of your relationships. Living within these boundaries you create is crucial to lowering stress and increasing satisfaction in life, particularly with the responsibilities and tasks in your personal life and work.</p> <p>Anxiety and stress develop when you take responsibility for others' emotions, behaviors and thoughts. Many <a href="/hometown-health/speaking-of-health/tips-to-help-ease-anxiety" target="_self" title="Opens in same window.">anxieties people experience</a> are due to poor boundaries.</p> <p>A principle I refer to is the "law of relationships." It identifies that you can't control what others think, feel or do, and you are solely responsible for what you think, feel and do. Identifying and stating the boundaries in relationships that support this law clarifies where your responsibilities and authority stop, and the other person's responsibilities start.</p> <p>Consider how you feel when you're given a task to complete but not given the resources you need to do the task. That can leave you feeling anxious and worried. The same feelings can happen when someone tries to give you responsibility for their emotions, thoughts and behaviors. Healthy boundaries are critical for your well-being.</p> <h2>Creating your boundaries</h2> <p>Boundary-setting can be challenging at first, especially when your education, training or personal experiences may have led you to establish unhealthy boundaries.</p> <p>Boundaries are driven by our view of our value as a person. Your value shouldn't be based on your performance. It's necessary to recognize how you presently value yourself and determine if that view is accurate.</p> <p>For example, consider how a parent loves their child versus how they respond to their child's behavior. Nothing the child does can change the parent's love for them. The parent may sometimes be displeased with the child's behavior, but their love is not altered based on the child's behavior.</p> <p>Focus on practicing behaviors that support your positive self-worth. Determine healthy boundaries that you can clearly define. Mapping out boundaries for various aspects of your life takes time and diligence. <a href="/hometown-health/speaking-of-health/maintaining-healthy-relationships-is-important-as-we-age" target="_self" title="Opens in same window.">Think about your relationships</a> with your partner, parents and children; your job and co-workers; and your finances.</p> <h3>Answer these questions to help you define the boundaries you want to set for yourself:</h3> <ul> <li>What relationships are <a href="/hometown-health/speaking-of-health/5-tips-to-manage-stress" target="_self" title="Opens in same window.">bringing me stress</a> and anxiety?</li> <li>Am I attempting to control someone's emotions, thoughts or behavior?</li> <li>Do I feel mistreated or taken advantage of?</li> <li>Does the value I feel from others change based on how well I fulfill their requests or obligations?</li> <li>Do I need to adjust my responsibilities to align with the law of relationships?</li> </ul> <p>Also identify false beliefs that have driven you to have unhealthy boundaries in the past. You can do this by determining what experiences caused you to have feelings of guilt or disrespect. Think of times you have felt you would upset someone or cause anger if you didn't do a specific task.</p> <p>Anxiousness involves anticipating something bad is going to happen and not having a healthy response to that feeling. Take note of what you can and can't control and again, remember that you are not responsible for other people's emotions, actions or thoughts.</p> <h2>Communicating your boundaries</h2> <p>Unhealthy boundaries often are driven by believing you can't say no.</p> <p>Validating for yourself that saying no is a way you can help grow your healthy boundaries. Saying yes to the activities and tasks within your boundaries is meaningful only when your no is equally valued.</p> <p>Saying no to things outside your boundaries will most likely cause more pressure to say yes. Have an action plan for how you will respond in a healthy way to something that <a href="/hometown-health/speaking-of-health/7-anger-management-tips-to-prevent-relationship-damage" target="_self" title="Opens in same window.">violates your boundaries</a>. Your action plan may include practicing saying no in a firm, yet kind, way or choosing not to talk to someone who doesn't respect your boundaries.</p> <h2>A long-term plan</h2> <p>Initially, healthier boundaries require much effort to establish and maintain. Over time, you'll find they become more habitual and require less effort. Your previous hurt from unhealthy boundaries will fade away. You will also notice that the pressure to appease others will diminish.</p> <p>Regularly review your actions to ensure you are following the boundaries you've created, especially during stressful or busy times. A weekly or monthly check-in can help you track your goals and priorities.</p> <h3>Ask yourself these questions:</h3> <ul> <li>Do the events you have scheduled bring you <a href="/hometown-health/speaking-of-health/purpose-and-mental-health" target="_self" title="Opens in same window.">joy and purpose</a>? </li> <li>Have your actions aligned with your responsibilities?</li> <li>Did you do something to help you reach a future goal?</li> <li>Did you stick to your budget?</li> </ul> <p>Mapping out clear boundaries in your life will positively affect your self-esteem and overall well-being. Building your self-esteem will help establish healthier relationships.</p> <p><a href="/providers/richard-oswald-lpc" target="_self" title="Opens in same window."><em>Rich Oswald</em></a><em> is a psychotherapist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/menomonie" target="_self" title="Opens in same window.">Menomonie</a>, Wisconsin.</em></p><ul> <li>Addicted family member</li> <li>Anxiety</li> <li>Bi-polar disorder</li> <li>Boundaries</li> <li>Career issues</li> <li>Conflict resolution</li> <li>Grief</li> <li>Healing abuse issues (emotional, mental, spiritual)</li> <li>Healing trauma issues</li> <li>Identity</li> <li>Life direction</li> <li>Low self-esteem</li> <li>Marital counseling (affair recovery, communication, conflict, parenting concerns, sexual issues)</li> <li>Relationship problems</li> <li>Sexual issues</li> <li>Spiritual/faith concerns</li> </ul>L.P.C.<p>Deep and lasting change is my goal while acknowledging short term changes are the steps in the journey. I view therapy as the opportunity to come alongside you during your journey to help you heal and grow, to live truer to who you are and make the healthiest decisions you can. I address both immediate issues and long-term patterns of thought, behavior and relating.</p> <p>I utilize a Christian worldview to understand people’s value, motivations, challenges and needs but work with people of all faiths. I use my education and experiences in engineering and carpentry work to provide practical and relatable illustrations.</p> <p>I grew up in Eastern Pennsylvania, learning to work on cars in my dad's mechanic shop. I had good times riding bikes and motorcycles, fishing, boating and building and driving RC Cars. After college and various jobs, I realized I was good with people and wanted to become a counselor.</p> <p>During my life journey, I became aware of my own mental disorders and addressed them in therapy. I spent 22 years in Atlanta, Georgia, with 19 of them working in counseling and running my own handyman business. However, I missed the snow of the North, so Wisconsin became my family's new home. I am married and have four daughters. I love being outside, riding motorcycles, fixing things, learning new things and meeting new people.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Mechanical Engineering, Penn State University</li> <li>Master's degree, Mechanical Engineering, Penn State University</li> <li>Master's degree, Professional Counseling, Richmont Graduate University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Outpatient Counseling, Mount Paran North Church</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Certified Professional Counseling Supervisor</li> <li>Certified Trauma Resolutions Therapist</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Christian Counselors</li> <li>Professional Counseling Association of Georgia</li> <li>Professional Counseling Association of Wisconsin</li> </ul>Oswald<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/richard-oswald-lpc.jpg?h=280&iar=0&w=280&sc_lang=en&hash=07E6DC8C4784E3E146B16A66D64F1E4F" alt="Richard Oswald LPC" width="280" height="280" DisableNVelocity="true" />Rich<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30181503Richard Oswald, L.P.C.1<img src="/-/media/national-files/images/hometown-health/2023/people-smiling-at-mealtime.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3364781D2A2503593B578BE0965C17C1" alt="People smiling at mealtime" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller12/18/2023Sleep plays a crucial role in athletic performance. It allows your body to recover and your mind to absorb new skills. Learn about more benefits and how to build sleep into your training routine.Sleep your way to better athletic performance<p>Sleep might not be at the top of the list when you think about ways to boost your athletic performance. But it's just as important as your training program, nutrition and hydration.</p> <h2>Why does sleep play such a crucial role not only for performance but also for overall health?</h2> <p>When you sleep, your brain processes all the information you've taken in during the day. It filters out and deletes some information, while storing other information in memory. That includes assimilating new skills or techniques you may have learned that day so they become an intuitive part of your sports performance.</p> <p>As you push your body to be stronger, go faster and be more agile, your tissues undergo continual wear and tear. Sleep provides your body time and energy to repair the wear and tear. Because your body has undergone these repair sessions, you're less likely to be injured. You're also less likely to become ill because sleep strengthens your immune system.</p> <p>Studies of collegiate athletes show that when they don't get enough sleep, their reaction times and accuracy decrease. One study focusing on basketball free throws and three-pointers found that sleep-deprived athletes can see a drop of 50% in accuracy. With 10 or more hours of sleep, accuracy can increase by 10%. That's a 60% potential difference in performance.</p> <p>Getting enough sleep also helps with your mental health and resiliency. The <a></a><a>National Collegiate Athletic Association (NCAA)</a> has added sleep screening to its best practices to monitor for conditions like insomnia and sleep apnea.</p> <h2>How much sleep is enough? </h2> <h3>So, what is adequate sleep? It depends on your age and stage of life:</h3> <ul> <li><strong>Children</strong><br> Kids 6–12 should get nine to 12 hours of sleep. </li> <li><strong>Teens</strong><br> Young people ages 13–18 should get eight to 10 hours of sleep.</li> <li><strong>Adults</strong><br> Those older than 18 need seven or more hours of sleep.</li> </ul> <p>Teenage student athletes face numerous challenges to achieve that sweet spot of eight to 10 hours of sleep, including the demands of training, the times when games and practices are held, school, work, and social and family time.</p> <p>During the teen years, the body undergoes a change in the natural sleep-wake cycle, known as circadian rhythm. Teens tend to stay up later at night and sleep later in the morning. That's why those early-morning practices can play havoc with a teen's sleep reservoir and influence a student athlete's mental and physical health.</p> <h2>Tips for getting a good night's sleep.</h2> <p>Just like a training routine sets you up for athletic success, a bedtime routine sets you up for sleep success.</p> <h3>An effective sleep routine includes:</h3> <ul> <li>Avoiding vigorous exercise, training or competitions one to two hours before bedtime.</li> <li>Holding off on large meals, alcohol and caffeine too late in the evening.</li> <li>Creating a sleep-friendly environment. Your bedroom should be quiet, dark, relaxing and cool. Your mind and body should understand, "This is where I sleep."</li> <li>Going to bed and waking up at the same time each day.</li> <li>Setting aside at least 20 to 30 minutes before bedtime to wind down. That includes putting away all electronics and screens, such as phones, tablets and TVs. Instead, dim the lights, set out your clothes for the next day, write in your journal or do other quiet activities.</li> </ul> <h2>What if I still have trouble sleeping?</h2> <p>Daily life is full of stressors that can sabotage your best attempts to establish a healthy sleep routine. One of those stressors may be a wearable device tracking your sleep. If you're sleep deprived, seeing regular reminders of your lack of sleep can be stressful.</p> <p>Having a good support network of family, friends, coaches and teammates to talk with can help you cope with some of those stressors. If sleep still is elusive, consider counseling, which may include cognitive behavioral therapy, mindfulness, meditation and journaling.</p> <p>Just like learning and gaining proficiency in your sport takes practice, so does getting a good night's sleep. The sleep habits you develop and practice now will last a lifetime.</p> <h2>Next steps:</h2> <ul> <li>Read why <a href="/hometown-health/speaking-of-health/sleep-an-essential-element-of-success-for-children" target="_self" title="Opens in same window.">sleep is so essential for children</a>.</li> <li>Take a quick sleep quiz.</li> <li>Seek a <a href="/hometown-health/speaking-of-health/sleep-care-via-mobile-health-clinic" target="_self" title="Opens in same window.">sleep consultation via a mobile clinic </a>or at a <a href="/services-and-treatments/neurodiagnostics" target="_self" title="Opens in same window.">Sleep Medicine location near you</a>.</li> <li>Learn more about <a href="https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610" target="_self" title="Opens in same window.">cognitive behavioral therapy</a>.</li> </ul> <p><a href="/providers/amy-rantala-md" target="_self" title="Opens in same window.">Amy Rantala, M.D.</a>, specializes in <a href="/locations/eau-claire/services-and-treatments/orthopedic-surgery/sports-medicine" target="_self" title="Opens in same window.">sports medicine in Eau Claire</a>, Wisconsin.</p><ul> <li>Musculoskeletal care</li> <li>Nonsurgical orthopedic care</li> <li>Sports medicine</li> <li>Sports-related concussion management</li> </ul>M.D.<p>I believe in working together with my patients to maximize their health and physical abilities. Actively listening to patients to hear their story and assist them in meeting their health goals is exceptionally important to me. I have been a family medicine physician for 20+ years. It is an honor to serve the Chippewa Valley.</p> <p>My sports medicine practice is inclusive of uniformed athletes; athletes just starting their exercise program and trying to make it to the finish line; athletes trying to set a personal record; and active patients pursuing their passions. We all have an athlete in us and exercise is the best medicine.</p> <p>I am fortunate to be married to my wonderful, supportive husband and have three sons and two dogs. I like to do anything active outside. My personal passions are cross-country and downhill skiing, as well as biking and running. I am an avid reader and really like to travel and eat good food.</p><p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Sports Medicine, University of Chicago</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Family Medicine, American Board of Family Medicine</li> <li>Certificate of Added Qualification in Sports Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Practice</li> <li>American College of Sports Medicine</li> <li>American Medical Society for Sports Medicine</li> <li>Tri-County Medical Society</li> <li>Wisconsin Academy of Family Physicians</li> <li>Wisconsin Medical Society</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Rantala<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/amy-rantala-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B7A534FAE36A7D091C9F77015DD8E152" alt="Amy Rantala, M.D." width="280" height="280" DisableNVelocity="true" />{4F47E9FB-6E1F-41F8-9D4C-335E9C8FAFB8}Amy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13342967Amy Rantala, M.D.1{7746ADF8-715B-4593-8AAB-55D7F0467848}|{DEF55970-853F-4E96-9A4D-3413874FF059}|{2951D78A-CC76-4C49-B556-549282DF4345}<img src="/-/media/national-files/images/hometown-health/2023/gymnast-on-uneven-bars.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F7FDFE33F23996DC6E7ED547B3788785" alt="Gymnast on uneven bars" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.SleepSleep is essential to good health. It's one of the body's basic needs. But, what do you do when you have troubles sleeping, or getting enough hours of sleep? Karen Sperl12/29/2023<p>From a tickle in your throat to a chronic cough, you may wonder why you are coughing so much. Learn how to distinguish if your cough is a minor inconvenience or a sign of illness.</p>Why are you coughing so much?<p>Hearing a chorus of coughs is typical at this time of year. An occasional cough is normal and healthy. A cough that persists for several weeks or brings up discolored or bloody mucus may indicate a condition that needs medical attention. </p> <p>A cough is your body's response when something irritates your throat or airways. An irritant stimulates nerves that send a message to your brain. The brain then tells muscles in your chest and abdomen to push air out of your lungs to force out the irritant. </p> <p>While an occasional cough is expected, a <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/chronic-cough/symptoms-causes/syc-20351575" target="_blank" title="Opens in a new window.">cough</a> that persists may be a sign of a medical problem. At times, coughing can be very forceful. </p> <p>Prolonged, vigorous coughing can irritate the lungs and cause even more coughing. It also can cause sleeplessness, dizziness or fainting, <a href="/hometown-health/speaking-of-health/common-questions-about-headaches">headaches</a>, urinary incontinence, vomiting and even broken ribs.</p> <h2> Acute vs. chronic cough </h2> <p>A cough is considered "acute" if it lasts less than three weeks. Some of the causes of an acute cough include: </p> <ul> <li><a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/common-cold/symptoms-causes/syc-20351605" target="_blank" title="Opens in a new window.">Common cold</a> </li> <li>Influenza</li> <li>Inhaling an irritant, such as smoke, dust, chemicals or a foreign body</li> <li><a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/pneumonia/symptoms-causes/syc-20354204" target="_blank" title="Opens in a new window.">Pneumonia</a>, which is an infection in one or both lungs </li> <li>Whooping cough </li> </ul> <p>Some common causes for a "chronic" cough include: </p> <ul> <li><a href="/hometown-health/speaking-of-health/allergy-q-and-a">Allergies</a></li> <li><a href="/hometown-health/speaking-of-health/create-an-asthma-action-plan-for-your-child">Asthma</a></li> <li>Bronchitis</li> <li><a href="/hometown-health/speaking-of-health/checking-the-facts-of-copd">Chronic obstructive pulmonary disease (COPD)</a> </li> <li><a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/coronavirus/symptoms-causes/syc-20479963" target="_blank" title="Opens in a new window.">COVID-19</a></li> <li> Croup </li> <li>Gastroesophageal reflux disease (GERD) </li> <li>Heart failure</li> <li>Lung cancer </li> <li>Respiratory syncytial virus (RSV) </li> </ul> <h2>Treating a cough </h2> <p>Knowing when to see your healthcare team can be challenging. Usually, a benign cough will be short-lived and often associated with a runny nose or cold-like symptoms. Most of the time, those kinds of coughs will go away on their own. </p> <p>Cough medicines are the most common antidote when the cough is acute, causes much discomfort, interferes with sleep, and is not associated with any potentially worrisome symptoms. Be sure to follow the dosing instructions on the medication. </p> <p>To ease your cough, cough drops or hard candies may help relieve a dry cough and soothe an irritated throat. Don't give them to a child under age 6, however, because of the risk of choking. Also, consider taking a teaspoon of honey to loosen the cough. </p> <p>Other ideas include: </p> <ul> <li>Eating chicken noodle soup. </li> <li>Getting plenty of rest.</li> <li>Using a cool mist humidifier or taking a steamy shower to moisturize the air. </li> <li>Drinking warm liquids, such as broth, tea or lemon juice, to soothe your throat. </li> <li>Avoiding tobacco smoke. </li> </ul> <p>Antibiotics may not be part of the treatment plan. <a href="/hometown-health/speaking-of-health/3-reasons-why-you-did-not-receive-antibiotics-from-your-provider">Antibiotics</a> treat bacterial infections, such as pneumonia, but they won't help viral illnesses, like colds, flu and most sore throats. </p> <p>Talk with your healthcare team if you start coughing up thick, green to brown sputum with fevers and chills. If you have chest pain or feel like you can't breathe, call 911. </p> <h2>Is a cough always a sign of illness?</h2> <p> Coughs are most notably known as a sign of a problem in your body. However, a cough can be a more straightforward issue. </p> <p>A cough usually indicates an irritation in the lungs or the airway. The irritation triggers the nerves that connect to our brain to tell our body to try to expel it. A cough is your body's reflex of trying to get something out that's not supposed to be there. </p> <p>If you have a new cough accompanying other symptoms like a runny nose and congestion, or if you're having fevers, you can consider wearing a mask and doing a COVID-19 test to ensure you're keeping those around you safe. If you have any other concerns, see your healthcare team to discuss them. </p> <p>Pay attention to your cough. Although most coughs are usually minor, they can make you feel poorly. Trying the latest remedy is tempting, but the best thing you can do is take care of yourself. Rest, drink fluids and keep the air around you moist. Also, remember to <a href="/hometown-health/speaking-of-health/5-ws-of-healthy-hands">wash your hands</a> frequently. </p> <p>Liz Husted, M.D., is a <a href="/services-and-treatments/family-medicine">family medicine</a> physician in <a href="/locations/la-crosse">La Crosse</a>, Wisconsin.</p><img src="/-/media/national-files/images/hometown-health/2023/person-holding-warm-beverage.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A6706C16CDA4F2FE9AAEFE8F9DE08312" alt="Person holding a clear mug with dark beverage inside and steam coming out. " width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),BreathingMost cases of shortness of breath are due to heart or lung conditions. Your heart and lungs are involved in transporting oxygen to your tissues and removing carbon dioxide, and problems with either of these processes affect your breathing.PulmonologyTreatment for diseases and conditions affecting lung and airway function.Dawn Haller12/13/2023Discover strategies for staying healthy during winter festivities. From staying hydrated to conquering stress, you can enjoy the holiday season without compromising your well-being.Winter wellness: 7 tips for staying healthy during the holidays<p>The holidays are a wonderful time for family, friends and celebrations. But winter can take a toll on your physical and mental health, even during the festivities.</p> <h2>So what can you do to stay healthy this winter?</h2> <h3>Drink water.</h3> <p>Winter may be a good time for hot cocoa and cider, but always <a href="/hometown-health/speaking-of-health/water-essential-to-your-body-video" target="_self" title="Opens in same window.">make water your drink of choice</a>. While hot beverages can be great for warmth, remember to keep it balanced with at least 8 cups of water per day. A glass of water with and between each meal can keep you hydrated, healthy and ready to fight off any germs winter may bring.</p> <h3>Stress less.</h3> <p>Over-the-top holiday excursions <a href="/hometown-health/speaking-of-health/coping-with-holiday-stress-keeping-our-expectations-realistic" target="_self" title="Opens in same window.">can be stressful</a>, which isn't how you should feel in this joyful season. Focus on your holiday traditions — don't worry about the rest. Make time for friends, family and good cheer, and embrace relaxation when you can. </p> <h3>Sleep enough.</h3> <p><strong> </strong></p> <p><strong></strong>Don't neglect the value of sleep. Do all that you can to stick to your typical sleep schedule, even around all the celebrations and traveling. Avoid or limit caffeine, alcohol, daytime napping and large meals before bed. These factors can interfere with a <a href="/hometown-health/speaking-of-health/5-ways-to-get-better-sleep" target="_self" title="Opens in same window.">good night's rest</a>.</p> <h3>Dress warmly.</h3> <p>Remember headwear that fully covers your ears, wear mittens rather than gloves and pull on well-insulated socks when dressing for the weather. Instead of wearing one big coat, dress in several layers of loose, warm clothing. This will better protect you against wind, snow and rain. If your clothes become wet, change them as soon as possible.</p> <h3>Limit time in the cold. </h3> <p>Pay attention to weather forecasts and windchill readings. Dress accordingly, but also watch for signs of frostbite, such as red or pale skin, prickling and numbness. Seek emergency help right away if you experience any signs of <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/hypothermia/basics/definition/con-20020453" target="_blank" title="Opens in a new window.">hypothermia</a>, including intense shivering, slurred speech, loss of coordination or fatigue. You can avoid these <a href="/hometown-health/speaking-of-health/watch-out-for-winter-health-mishaps" target="_self" title="Opens in same window.">cold-weather hazards</a> if you take measures to protect yourself against the cold, such as packing an emergency supply kit and warm clothing while traveling.</p> <h3>Exercise.</h3> <p>Cold air sometimes can discourage you from keeping up with your fitness routines. It's easy to let these habits slide for the season, but remember that regular activity can keep you healthy, both mentally and physically. Choose an indoor exercise if the temperature is below zero or the windchill is extreme. Workout apps or online exercise programs are great tools to get you moving in the comfort of your home. If you prefer to <a href="/hometown-health/speaking-of-health/tips-for-cold-weather-training" target="_self" title="Opens in same window.">exercise outside</a>, dress appropriately. Too many layers can make your overheat, so choose layers you can easily remove.</p> <h3>Keep the germs away.</h3> <p>Three words: <a href="/hometown-health/speaking-of-health/5-ws-of-healthy-hands" target="_self" title="Opens in same window.">Wash your hands</a>. This is one of the best ways to avoid getting sick and spreading common winter illnesses, such as colds. Germs accumulate through nearly everything you do or touch, so wash your hands frequently. Wash your hands for at least 20 seconds, scrubbing all surfaces and rinsing well. Also, get <a href="/topics/influenza" target="_self" title="Opens in same window.">flu</a> and <a href="/topics/covid-19-vaccine" target="_self" title="Opens in same window.">COVID-19 vaccines</a> to <a href="/hometown-health/speaking-of-health/steps-to-prevent-norovirus" target="_self" title="Opens in same window.">avoid being sick</a> during the coldest time of year.</p> <p>Following these tips can ensure you have a safe, happy and healthy holiday season.</p> <p><a href="/providers/peter-reisner-md" target="_self" title="Opens in same window."><em>Peter Reisner, M.D.</em></a><em>, is a physician in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/chetek" target="_self" title="Opens in same window.">Chetek</a>, Wisconsin.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>University of Texas Medical Branch</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Family Practice</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Reisner<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/peter-reisner-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=E4299ECA7A6FB83591D4D4F91D0769D6" alt="Peter Reisner, M.D." width="280" height="280" DisableNVelocity="true" />Peter<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13818422Peter Reisner, M.D.1<img src="/-/media/national-files/images/hometown-health/2023/feet-on-sofa-cup-of-coffee.jpg?h=370&iar=0&w=660&sc_lang=en&hash=149A1E81F0F350832B29028D6A2A5E5D" alt="Sitting on sofa with cozy socks and a cup of coffee on table" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Dawn Haller1/3/2024Not only do the sunny colors and flavors of citrus fruits brighten meals, the vitamin C these foods contain is vital to your health. Learn more how easy it is to add to your diet.Boost vitamin C with in-season citrus<p>Do you know how vital vitamin C is for your health? Vitamin C, also known as ascorbic acid, is an essential nutrient and antioxidant.</p> <h2>Here's how vitamin C helps your body:</h2> <ul> <li>Assists in forming blood vessels, cartilage, muscle, collagen in bones and absorbing iron.</li> <li>Helps your cells fight free radicals, which are molecules produced when your body breaks down or is exposed to tobacco smoke or radiation from the sun.</li> <li>Promotes the healing process.</li> <li>Protects against heart disease and cancer.</li> </ul> <p>Vitamin C isn't made in your body, so you need to eat foods that are good sources of this nutrient. A vitamin C deficiency can lead to a disease called scurvy, which can cause anemia, bleeding gums, bruising and poor wound healing.</p> <p>The recommended amount of vitamin C is 90 milligrams a day for adult men and 75 milligrams a day for adult women. Most people can get enough vitamin C from a healthy, balanced diet. If you're taking vitamin C supplements, talk with your healthcare team, since too much vitamin C can have side effects and cause medication interactions.</p> <h2>Citrus and medication interaction</h2> <p>Grapefruit and other citrus fruits, such as Seville oranges, can interfere with several kinds of prescriptions. The severity of the interaction differs depending on the person, medication and amount of grapefruit or grapefruit juice you consume. If you have questions, talk with your healthcare professional or pharmacist. Be sure to read the information provided with your prescription or over-the-counter medication.</p> <h2>How to get your vitamin C</h2> <p>You can find vitamin C in citrus fruits, including oranges, clementines, pineapple, grapefruit, lemons and limes. Berries, potatoes, tomatoes, peppers, cabbage, Brussels sprouts, broccoli and spinach also are good sources.</p> <p>Incorporating foods rich in vitamin C into your daily routine may be easier than you think. Many of these fruits and vegetables can be stored at room temperature for a few days.</p> <p>An orange or a few clementines make an easy grab-and-go snack. Add a lemon or lime to your water to increase flavor as well as vitamin C. Citrus and other vitamin C foods brighten main dishes, salad dressings, desserts and beverages.</p> <h3>Although citrus fruits are typically available throughout the year, some citrus varieties are at their peak during the winter months: </h3> <ul> <li><strong>Oranges</strong><br /> Depending on the variety, they're best from November through April.</li> <li><strong>Clementines</strong><br /> These easy-to-peel fruits are at their sweetest and juiciest from November through January.</li> <li><strong>Grapefruits</strong><br /> The season for ruby reds runs from October through April,. dark red grapefruit is best from November through March. while the season for white grapefruit is from November through February.</li> </ul> <h2>Citrus-centric recipes to boost vitamin C</h2> <h3>These recipes, with their focus on citrus, are high in vitamin C:</h3> <h4>Citrus Salad</h4> <p>By Mayo Clinic<br /> Serves 4</p> <p>2 oranges<br /> 1 red grapefruit<br /> 2 tablespoons orange juice<br /> 2 tablespoons olive oil<br /> 1 tablespoon balsamic vinegar<br /> 4 cups mixed greens<br /> 2 tablespoons pine nuts<br /> 2 tablespoons chopped mint for garnish (optional)</p> <p>Working with one piece of fruit at a time, cut a thin slice off the top and bottom, exposing the flesh. Stand the orange upright and, using a sharp knife, cut off the peel, following the contour of the fruit and removing all of the white pith and membrane. Holding the orange over a small bowl, carefully cut along both sides of each section to free it from the membrane. As you work, discard any seeds and let the sections and any juice fall into the bowl. Repeat with the remaining fruit.</p> <p>In a separate bowl, whisk together the orange juice, olive oil and vinegar. Pour the mixture over the fruit segments and toss gently to coat evenly. To serve, divide the greens on each plate, top with fruit and dressing, and sprinkle each with 1/2 tablespoon of pine nuts. Garnish with chopped mint and serve immediately.</p> <p>Nutritional per serving (1 cup greens and about 1/2 cup fruit): 166 calories, 10 grams fat, 17 grams total carbohydrate, 3 grams fiber.</p> <h4>Roasted red bell pepper pineapple salsa</h4> <p>By Mayo Clinic<br /> Serves 4</p> <p>1/2 cup chopped roasted red bell pepper<br /> 1 cup chopped pineapple<br /> 1/4 cup finely chopped fresh cilantro<br /> 1/4 cup finely chopped red onion<br /> 2 tablespoons diced jalapeño pepper<br /> 2 teaspoons honey<br /> 1/4 teaspoon salt</p> <p>In a medium bowl, combine all ingredients and mix well. Cover and refrigerate until served.</p> <p>Nutritional per serving (1/4 cup): 40 calories, 40 grams total fat, 125 milligrams sodium, 10 grams total carbohydrate, 1 gram fiber, 1 gram protein.</p> <p><a href="/providers/amanda-halls-rd-ld" target="_self" title="Opens in same window."><em>Amanda Halls</em></a><em> is a registered dietitian nutritionist in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition Services</a> in <a href="/locations/lake-city" target="_self" title="Opens in same window.">Lake City</a>, Minnesota.</em></p><ul> <li>Diabetes</li> <li>Overall nutritional changes are lifelong changes for patients and their families</li> <li>Weight Management</li> </ul>RDN, LD<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Dietetics, College of Saint Benedict</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Registered Dietitian</li> <li>Licensed Dietitian</li> </ul>Halls<img src="/-/media/shared-files/images/medical-professionals/full/lake-city/amanda-halls-rdn-ld.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B0FA1017FC839B7CCA36917E15C4BB68" alt="Amanda Halls, R.D.N., L.D." width="280" height="280" DisableNVelocity="true" />Amanda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16305141Amanda Halls, R.D., L.D.1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2024/citrus-and-pomegranate-salad.jpg?h=370&iar=0&w=660&sc_lang=en&hash=41733AE5AC638ACD61D533D05B8FA63D" alt="Citrus and pomegranate salad" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller1/11/2024For parents, the symptoms of a viral illness are worrisome in infants and young children. Learn about a lower respiratory viral infection called bronchiolitis and symptoms to watch for in children.Bronchiolitis in children: Understanding cause, symptoms, concerns<p>As a pediatrician, I see many illnesses, and as a mother, I have had sleepless nights with small children battling illness. The most common culprit? A lower respiratory viral infection called bronchiolitis. </p> <p>Bronchiolitis affects the small airways and commonly causes nasal congestion and discharge, coughing and, sometimes, wheezing in young children. All children are susceptible to bronchiolitis. Many viruses can cause bronchiolitis. The most common is respiratory syncytial virus, or RSV.</p> <p>If your baby was premature, has heart or lung disease or is younger than 4 months old, they are at a higher risk of acquiring this illness. </p> <p>Bronchiolitis affects children in multiple ways.</p> <h2>Fever</h2> <h3>Your child may or may not have a fever with this illness. Call your child's healthcare team if:</h3> <ul> <li>Your child is <a href="/hometown-health/speaking-of-health/dont-ignore-infant-fevers" target="_self" title="Opens in same window.">under 6 months of age</a> and has a temperature greater than 100.4 F.</li> <li>Your child is over 6 months old and has a temperature greater than 102.2 F.</li> <li>Your child has a temperature of 100.4 F or greater for more than five days.</li> <li>Your child has not received <a href="/hometown-health/speaking-of-health/the-facts-about-vaccinations" target="_self" title="Opens in same window.">early childhood vaccinations</a> and is age 2 or under.</li> </ul> <p>The American Academy of Pediatrics recommends obtaining rectal temperatures in children 3 months old or less. Contact your child's healthcare team or seek care immediately if your child is 2 months old or younger and has a rectal temperature of 100.4 F or greater because it could be an emergency. </p> <h2>Changes in breathing</h2> <p>With breathing difficulties, your child may look like they are sucking in their neck and rib muscles, or their breathing may be faster than usual. Infants, especially newborns and those less than 4 months old, can have long pauses in their breathing or stop breathing. </p> <p>Babies normally breathe through their noses. When their nasal cavities are congested, they can't breathe through their nose and often have difficulty eating. This can lead to poor feeding, which can contribute to dehydration and inability to sleep. Although it may be difficult for infants to sleep with nasal congestion and coughing, the ABCs of sleep are still strongly recommended. Always <a href="/hometown-health/speaking-of-health/how-safe-is-your-nursery" target="_self" title="Opens in same window.">put your infant to sleep alone</a> on their back in a crib with a flat, firm surface and away from smoke exposure. </p> <p>If your child is having any of these symptoms, they need to be evaluated by their healthcare team.</p> <h2>Dehydration in babies</h2> <p>Infants and children are especially vulnerable to dehydration. If your child has less than one wet diaper every six hours or has a significant change in the number of wet diapers, it could be an indication of dehydration. Infants up to 12 months should only receive breast milk, formula or a children's electrolyte drink to help with hydration.</p> <h2>Changes in skin color or tone</h2> <p>Especially for newborns, younger infants and preterm infants, viruses can cause changes in skin color or tone. If your child starts to change color or tone, watch them carefully. Contact their healthcare team if they begin looking blue or pale, or appear limp or flaccid.</p> <p>Children of all ages commonly get six to eight colds in a year. This happens even to children with healthy immune systems simply because they are exposed to new illnesses.</p> <h3>Here's what you can do:</h3> <ul> <li>Use a cool mist vaporizer to help decrease nasal congestion. Run it for 30 minutes with the bedroom door shut before nap time, bedtime and throughout the night.</li> <li>Bulb suctioning with nasal saline two to three times a day dramatically helps reduce nasal congestion and allows infants to eat and sleep better. Don't be alarmed if you see a little blood-tinged mucus when doing this. This virus causes irritation that can cause bleeding.</li> <li>For children less than 12 months, have a prepackaged electrolyte drink like Pedialyte on hand. For children older than 12 months, hydrate with water or an electrolyte drink.</li> <li>For infants at high risk of serious illness from RSV, talk to their healthcare team about <a href="/hometown-health/speaking-of-health/rsv-vaccine-for-moms-to-be-and-infants" target="_self" title="Opens in same window.">RSV vaccination</a>. </li> </ul> <p>For some, bronchiolitis will come and go without severe symptoms. For others, that won't be the case. Parents should become familiar with the symptoms so they know the <a href="/hometown-health/featured-topic/when-to-seek-care-for-rsv-and-flu" target="_self" title="Opens in same window.">signs to watch for</a>. If you have any questions, contact your child's healthcare team.</p> <p><em>Christina Andrist, D.O.</em><em>, is a <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">pediatrician</a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2024/parent-helping-child-drink.jpg?h=370&iar=0&w=660&sc_lang=en&hash=27732785A5677EA8A0865F86CA9E0DD6" alt="Parent helping child drink" width="660" height="370" DisableNVelocity="true" />Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Immunizations<p>Disease prevention is crucial to your health. Getting vaccinated is one of the best ways to maintain good health, and protect you and those you care about against infectious diseases. Vaccinations offer protection against serious diseases by stimulating the immune system to create antibodies against certain bacteria or viruses.</p><br/><p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/vaccine-guidance/art-20536857" target="_blank" title="Opens in a new window.">Get vaccine guidance from Mayo Clinic</a>, including benefits, safety, side effects and what to know about recommended vaccines for babies, children, teens, adults and during pregnancy. For recommended vaccines based on age, refer to the <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/adult" target="_blank" title="Opens in a new window.">adult</a> or <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/child" target="_blank" title="Opens in a new window.">child and adolescent</a> schedules.</p><br/><p>Review the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/coronavirus-covid-19/history-disease-outbreaks-vaccine-timeline" target="_blank" title="Opens in a new window.">history of infectious disease outbreaks and vaccines timeline</a> for information about major disease outbreaks, epidemics and pandemics, and the impact of vaccines and research.</p>Dawn Haller1/30/2024Immersing in frigid water may not seem like it would be good for your health. Find out why research is showing that a cold plunge can reduce inflammation and soreness, as well as give your mood a lift.Can taking a cold plunge after your workout be beneficial?<p>From ice bucket challenges to polar plunges, people have embraced being doused with or dunked in icy water to raise money for their favorite causes. But can cold water immersion have benefits beyond fundraising?</p> <p>Research indicates that icy water may have a positive effect on recovery after exercise by reducing inflammation and soreness. It also may help build resiliency, restore balance to the nervous system and improve cognitive function and mood.</p> <h2>What are the basics of cold-water immersion?</h2> <p>A cold plunge or cold-water immersion involves partially or totally submerging yourself in cold water for a few minutes at a time. It can be as simple as sitting in a bathtub filled with cold water and ice cubes or jumping into a cold lake or the ocean. You also can go to a cold-plunge center or create or buy your own cold-plunge tank, which, if it has all the options, can cost up to $20,000.</p> <p>Be sure not to plunge into icy waters that have a current, such as a river, to avoid being swept downstream or trapped under ice.</p> <p>Water should be 50 F or colder. Keep in mind that the water in a frozen lake will be much colder. That's why it's a good idea to measure the temperature before you jump in. The plunge can be done as one continuous session or multiple sessions with breaks between the sessions. Typically, cold-water plungers start with 30 seconds to a minute and work up to five to 10 minutes at a time.</p> <p>Researchers are still determining the optimum process and timing for cold-water immersion sessions.</p> <p>You can do cold plunging every day. However, if you're doing it after training, daily plunges could compromise the potential for long-term performance improvements.</p> <h2>What are the benefits for workout recovery or athletic performance?</h2> <p>Research on cold-water immersion has found evidence that it helps reduce the degree of exercise-induced muscle damage that can occur after physically challenging activities. Less damage leads to less inflammation, which in turn reduces soreness and helps restore physical performance the next day.</p> <p>These benefits may be the result of rapid constriction of the blood vessels due to the cold water. The cold can trigger responses in your body, such as decreased metabolic activity, alterations in hormone production and blood flow, and activation of the immune system.</p> <h2>What are the drawbacks of cold plunges?</h2> <p>The most obvious drawback is the cold and discomfort, although frequent plungers report becoming more comfortable and tolerant of the cold with regular exposure. Depending on the environment, such as plunging into an ice- and snow-covered lake, you also may be at risk for <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/frostbite/symptoms-causes/syc-20372656" target="_blank" title="Opens in a new window.">frostbite</a>. Too-long exposure also can lead to hypothermia, so make sure you have towels and warm clothing close at hand if you're doing cold plunges outdoors.</p> <p>For athletes, cold-water immersion may affect different types of training in different ways. For those engaged in resistance training, cold water may turn down the molecular signaling pathways that are normally activated after exercise. This may hinder long-term improvements in strength, muscle growth and performance. However, cold-water immersion doesn't appear to negatively affect endurance training in the same way.</p> <p>If you want to give cold-water immersion a try, start by consulting an expert, such as a <a href="https://www.mayoclinichealthsystem.org/providers?service=Sports%20Medicine" target="_self" title="Opens in same window.">sports medicine specialist</a>, to ensure you're plunging appropriately and following the right protocol. If you have risk factors associated with <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiovascular disease</a>, such as <a href="/hometown-health/speaking-of-health/know-your-numbers-blood-pressure" target="_self" title="Opens in same window.">high blood pressure</a>, check with your <a href="/services-and-treatments/primary-care" target="_self" title="Opens in same window.">primary care provider</a> or <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiologist</a> so you know it's safe for you to cold plunge.</p> <p><a href="/providers/andrew-jagim-phd" target="_self" title="Opens in same window."><em>Andrew Jagim, Ph.D.</em></a><em>, specializes in <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">sports medicine</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Examining how different nutrition and exercise interventions influence health and performance — this interest applies to both the general population in regards to improve a person’s quality of life and prevent chronic disease in addition to improving the performance ability of elite athletes</li> </ul>Ph.D.<p><strong>Education</strong></p> <ul> <li>Master's degree, Human Performance, University of Wisconsin – La Crosse</li> <li>Ph.D., Kinesiology – Exercise Physiology Texas A&M University, College Station</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>International Society of Sports Nutrition</li> <li>National Strength and Conditioning Association</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Sports Medicine</li> <li>International Society of Sports Nutrition</li> <li>National Strength and Conditioning Association</li> </ul>Jagim<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/andrew-jagim-phd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=AA07F8D241D507CF3C0C9F28FC00E465" alt="Andrew Jagim PhD" width="280" height="280" DisableNVelocity="true" /><p>Dr. Jagim has authored or collaborated on numerous scholarly publications related to sports medicine. His topics have included:</p> <ul> <li>diets and nutrition</li> <li>workouts and training regimens</li> <li>sports injuries and treatment programs</li> <li>use and affects of drugs and supplements in sports</li> </ul> <p>His research has been published in numerous journals including International Journal of Exercise Science, Journal of Sports Science, Journal of Strength and Conditioning Research, Frontiers in Nutrition, International Society of Sports Nutrition, Journal of Neurosurgery and the Clinical Journal of Sports Medicine.</p>Andrew<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20772289Andrew Jagim, Ph.D.1{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2024/person-in-icy-water-wearing-hat.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0ED0852C1C1E790EF66887467163D281" alt="Person in icy water wearing hat" width="660" height="370" DisableNVelocity="true" />Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller1/24/2024Anyone can get glaucoma, but certain families, and particularly African Americans, are most susceptible. Learn more about this sight-stealing disease and how screening can protect your vision.Family history, ethnicity give insights into glaucoma<p>Glaucoma has been called the <a href="/hometown-health/speaking-of-health/dont-be-fooled-by-glaucoma-the-silent-sight-thief" target="_self" title="Opens in same window.">silent thief of sight</a> because its onset can be so gradual that you may not notice changes in your vision until the disease is in its later stages. About 3 million people in the U.S. have <a rel="noopener noreferrer" href="https://www.mayoclinic.org/departments-centers/glaucoma/overview/ovc-20524181" target="_blank" title="Opens in a new window.">glaucoma</a>. Half of those people don't know they have the condition.</p> <h2>How glaucoma affects your vision</h2> <p>Glaucoma is a group of eye conditions that damages the optic nerve, which sends visual information from your eye to your brain and is vital for good vision. Damage to the optic nerve often is related to high pressure in your eye.</p> <p><img alt="Glaucoma illustration" style="width:325px; height:150px;" src="/-/media/national-files/images/hometown-health/2024/glaucoma-illustration.jpg?h=150&w=325&sc_lang=en&hash=FC4F7814E66DC0EFD3107AA904FD0D96" /></p> <h3>There are six common types of glaucoma:</h3> <ol> <li>Open-angle is the most common type. There are no symptoms in the early stages, but patchy blind spots may begin appearing in your side or peripheral vision. In later stages, these blind spots affect your side vision.</li> <li>Acute angle-closure glaucoma can be marked by severe headaches, eye pain, blurred vision, halos or colored rings around lights, eye redness and nausea. </li> <li>Normal-tension glaucoma doesn't have symptoms in the early stages, and there is no indication as to why the optic nerve is damaged despite normal pressure. Peripheral vision decreases and side vision can be lost.</li> <li>Pigmentary glaucoma symptoms include halos around lights, blurred vision with exercise and loss of side vision. It can affect young, healthy people who are nearsighted.</li> <li>Glaucoma also occurs in children, including infants. Babies may have dull or cloudy eyes, increased blinking and tears without crying. Older children may experience blurred vision, nearsightedness that gets worse and headaches. </li> <li>Pseudoexfoliative glaucoma is more common in people from northern Europe. White, powdery deposits can form on the lens and iris of those affected by this type of glaucoma.</li> </ol> <h2>Who is at risk for glaucoma?</h2> <p>Anyone can get glaucoma, but African Americans over age 40, all people over age 60 and those with a family history of glaucoma or diabetes are at higher risk.</p> <p>After cataracts, glaucoma is the leading cause of blindness among African Americans, who are six to eight times more likely to get the disease than white people. African Americans also tend to get glaucoma about 10 years sooner than other ethnic groups. That's why it's crucial for them to get a comprehensive eye exam to check for glaucoma after age 35 or sooner if they have diabetes.</p> <h3>Risk factors for African Americans include those who:</h3> <ul> <li>Are over 40</li> <li>Are extremely nearsighted</li> <li>Have diabetes</li> <li>Have high blood pressure</li> <li>Use steroids, such as those for controlling asthma, for a prolonged time</li> </ul> <p>Other ethnic groups, including Hispanics and Asians, also are at greater risk for the disease.</p> <p>In African Americans, genetic factors may be associated with their higher prevalence of glaucoma, as well as cultural factors such as lower rates of regular eye exams and less access to vision care.</p> <h2>How glaucoma is detected</h2> <p>A regular comprehensive eye exam can detect glaucoma in its early stages before significant damage to the optic nerve occurs. Your age and the presence of symptoms determine the frequency of eye exams.</p> <h3>Here's the recommended timing for having an eye exam:</h3> <ul> <li>Under age 40 — every 5–10 years</li> <li>Ages 40–54 — every 2–4 years</li> <li>Ages 55–64 — every 1–3 years</li> <li>Age 65 and older — every 1–2 years</li> </ul> <p>Diagnosing glaucoma isn't always easy, so your eye care professional will look at many factors before making decisions about your treatment. If your condition is challenging to diagnose or treat, you may be referred to a glaucoma specialist.</p> <h3>A typical comprehensive eye exam includes five tests that determine your eye health by:</h3> <ol> <li>Checking the complete field of vision, including side and central vision.</li> <li>Evaluating the shape and color of the optic nerve by dilating the pupil. </li> <li>Measuring the angle in the eye where the iris meets the cornea.</li> <li>Measuring the inner eye pressure. </li> <li>Measuring the thickness of the cornea.</li> </ol> <h2>Treating and preventing glaucoma</h2> <p>If you have glaucoma, the primary treatment is prescription eye drops or laser treatment that can stop the condition from progressing and preserve your vision. If you've been prescribed eye drops, be sure to take them even if you don't have symptoms.</p> <h3>While there's no cure for glaucoma, you can take steps to prevent this condition, including:</h3> <ul> <li>Know your family history. Since glaucoma tends to run in families, you may need more frequent eye exams.</li> <li>Schedule regular eye exams based on your age and symptoms.</li> <li>Wear eye protection, because glaucoma can be caused by a serious eye injury, especially from sports, such as baseball or boxing.</li> </ul> <p>Consider enrolling in a <a rel="noopener noreferrer" href="https://glaucoma.org/learn-about-glaucoma/patient-resources/clinical-trials/" target="_blank" title="Opens in a new window.">glaucoma clinical trial</a>, especially if you're African American, to help determine its causes and spur the development of new treatments and technologies.</p> <p><a href="/providers/grant-heslep-md" target="_self" title="Opens in same window."><em>Grant Heslep, M.D.</em></a><em>, is an <a href="/services-and-treatments/ophthalmology" target="_self" title="Opens in same window.">ophthalmologist</a> in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em></p><p>Treatment of cataracts and glaucoma<br /> General eye care for adults and children<br /> Plastic, pediatric, reconstructive and glaucoma surgery</p>M.D.<p><strong>Medical School<br /> </strong>University of Florida, Gainesville</p> <p><strong>Residency<br /> </strong>Louisiana State University Medical Center, Shreveport</p> <p><strong>Certification<br /> </strong>Board Certified in Ophthalmology</p>Heslep<img src="/-/media/shared-files/images/medical-professionals/full/owatonna/grant-heslep-md.JPG?h=280&iar=0&w=280&hash=2A22995B297511A110B5D0919EEB9023" alt="Grant Heslep MD" width="280" height="280" DisableNVelocity="true" />Grant<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>10629343Grant Heslep MD1<img src="/-/media/national-files/images/hometown-health/2024/painting-wearing-eyeglasses.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B90BAEAAA9294DFD1BFDD7D5713AC2C2" alt="Painting wearing eyeglasses" width="660" height="370" DisableNVelocity="true" />Eye HealthYour eyes are responsible for providing you with vision, perhaps the most important of the senses. However, the eye is a delicate and complicated structure that needs protection. The ugly truth is that eye injuries can happen at any time and place.Dawn Haller9/16/2025Some fats are healthier for your heart than others. But how can you tell? Learn about each of the main types of fats, which to keep on hand and which ones you should try to avoid.Fast facts on fats and heart health<p>All food sources you may think of as <a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/fat/art-20045550" target="_blank" title="Opens in a new window.">fats</a>, such as butter, shortening and oils, are made up of fatty acids. Fatty acids fall into three categories: monounsaturated, polyunsaturated and saturated. While oils and fats contain a combination of these three types of fatty acids, they're classified by the fatty acid with the highest content percentage. For example, olive oil is made mainly of monounsaturated fatty acids.</p> <p>Fats perform differently in cooking and baking, and how they affect your health. Choose monounsaturated and polyunsaturated fats, such as olive and canola oils, over saturated fats, like butter and lard, to <a href="/locations/la-crosse/services-and-treatments/cardiology/prevention" target="_self" title="Opens in same window.">minimize your risk of heart disease</a>.</p> <h2>Here are some fast facts about each of the main types of fats:</h2> <ul> <li><strong>Monounsaturated fats</strong><br /> Monounsaturated fats are liquid at room temperature but become semi-solid or cloudy in the refrigerator. When substituted for saturated fats, monounsaturated fats can help to improve <a href="/hometown-health/speaking-of-health/know-your-numbers-cholesterol" target="_self" title="Opens in same window.">blood cholesterol levels</a> and reduce the risk of heart disease. Olive oil and peanut oil are examples of monounsaturated fats.</li> <li><strong>Polyunsaturated fats</strong><br /> Polyunsaturated fats are always liquid, even when refrigerated. When used in place of saturated fats, they can help improve blood cholesterol levels and reduce the risk of heart disease. Omega-3 fatty acids are polyunsaturated fats that lower triglyceride levels, improve heart health and provide anti-inflammatory benefits. Canola oil, sunflower oil and walnut oil are examples of polyunsaturated fats.</li> <li><strong>Saturated fats</strong><br /> Saturated fats are solid at room temperature. A diet high in saturated fats has been linked with elevated cholesterol levels and increased risk for heart disease, so it's best to limit your use of them. Butter, lard, palm oil and coconut oil are examples of saturated fats.</li> <li><strong>Hydrogenated fats</strong><br /> Hydrogenated fats are solid at room temperature. Hydrogenation is the chemical process that changes liquid oils into solid fats. Fully hydrogenated oils are primarily saturated fat. A diet high in saturated fats has been linked with elevated cholesterol levels and increased risk of heart disease, so try to reduce your use of them. Shortening, premade pie crusts and refrigerated doughs like biscuits and rolls are examples of hydrogenated fats.</li> <li><strong>Trans fats</strong><br /> Most trans fats are formed through an industrial process that adds hydrogen to vegetable oil, which causes the oil to become solid at room temperature. Trace amounts also occur naturally in some meat and dairy products. Trans fats raise your low-density lipoprotein (bad) cholesterol and lower your high-density lipoprotein (good) cholesterol. High LDL, along with low HDL levels, can increase your risk for heart disease and stroke. These fats are so unhealthy that the Food and Drug Administration has prohibited food manufacturers from adding the major source of artificial trans fats — partially hydrogenated vegetable oils — to foods and beverages.</li> </ul> <h2>Healthy fats to keep on hand</h2> <h3>If you have limited pantry space and are budget-conscious, these three oils will cover your basic cooking and baking needs:</h3> <ul> <li><strong>Olive oil</strong><br /> In addition to being a source of monounsaturated fats, extra-virgin olive oil is also high in antioxidants called polyphenols that have been linked to heart health. Olive oil works well for roasting or sautéing vegetables and making homemade salad dressing.</li> <li><strong>Canola oil</strong><br /> The neutral flavor and high smoke point make canola oil an excellent choice for baking and sautéing. Most canola oil is highly refined and has a relatively long shelf life. It's incredibly versatile and can be used for sautéing, roasting, baking and making salad dressings.</li> <li><strong>Walnut oil</strong><br /> Although this specialty oil is more expensive than olive or canola oil, walnut oil has a rich, nutty flavor and boasts heart-healthy omega-3s. Walnut oil, as with all nut oils, has a short shelf life. Buy a small bottle and store it in your refrigerator for up to three months. Its nutty flavor only works in some dishes. The best uses include salad dressings — try a blend of canola and walnut oils — or to give baked goods a light walnut flavor.</li> </ul> <h2>Using heart-healthy oils</h2> <h3>If you're changing to a healthier oil, here are two recipes to get you started:</h3> <h4>Citrus vinaigrette</h4> <p>By Mayo Clinic<br /> Serves 8</p> <p>Making salad dressings at home lets you control the ingredients. Drizzle this sweet-tangy dressing over mixed fruit or a salad of mixed greens, orange tidbits, cranberries and walnuts. </p> <p>1 cup water<br /> 1/2 cup orange juice concentrate<br /> 1/2 cup canola oil<br /> 1/4 cup rice wine vinegar<br /> 2 tablespoons honey<br /> 1 tablespoon fresh thyme<br /> 1/4 teaspoon salt<br /> Pinch of ground black pepper</p> <p>In a blender, mix all ingredients until smooth. Serve immediately. Place leftovers in a container in the refrigerator for up to two weeks. Shake well before use.</p> <p>Nutrition per 2-tablespoon serving: 143 calories, 14 grams total fat, 1 gram saturated fat, 9 grams monounsaturated fat, 89 milligrams sodium, 7 grams total carbohydrate, 0 grams fiber, 0 grams protein.</p> <h4>Tomato basil pesto sauce</h4> <p>By Mayo Clinic <br /> Serves 15</p> <p>Make the pesto sauce and freeze in containers portioned for your family.</p> <p>1/4 cup olive oil<br /> 4 garlic cloves, minced<br /> 1/4 cup red wine vinegar<br /> 8 cups diced Roma tomatoes<br /> 1/2 cup tomato paste<br /> 12 fresh basil leaves, chopped<br /> 1 tablespoon sugar<br /> 1/2 teaspoon salt<br /> 1/4 teaspoon ground pepper<br /> 1/2 cup grated Parmesan cheese</p> <p>Heat a large saucepan to medium-low heat; add the oil. When the oil is heated, add the garlic and sauté until lightly golden. Add the vinegar and sauté for an additional 2 minutes. Stir in the tomatoes, tomato paste, basil, sugar, salt and pepper. Bring the mixture to a simmer and stir occasionally until the tomatoes break down, about 8 to 10 minutes. Remove the pan from the heat and let it cool slightly. Place the sauce and cheese in a food processor and process until smooth. Taste the sauce and adjust the seasonings as needed.</p> <p>Nutrition per 1/2-cup serving: 85 calories, 4 grams total fat, 1 gram saturated fat, 3 grams monounsaturated fat, 344 milligrams sodium, 8 grams total carbohydrate, 0 grams total sugars, 1 gram fiber, 2 grams protein.</p> <p><em>By Mayo Clinic Health System staff. </em></p><img src="/-/media/national-files/images/hometown-health/2024/veggies-and-rosemary-dish.jpg?h=370&iar=0&w=660&sc_lang=en&hash=14142DAFAECA4618586380263B3014F5" alt="Veggies and rosemary dish" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller9/3/2025From reducing food waste to stretching your food budget, freezing foods at home is an easy, convenient way to preserve freshness and flavors. Check out these tips for best results.Freezing preserves food freshness, flavor<p>Freezing is a quick, convenient way to preserve or extend the storage life of fresh fruits and vegetables, meats and leftovers. It slows down the work of enzymes and growth of bacteria that cause foods to spoil.</p> <h2>When done properly, freezing:</h2> <ul> <li>Doesn't require added salt or sugar to prevent spoiling, unlike many canned items.</li> <li>Helps maintain the quality and nutritional value of foods.</li> <li>Reduces food waste.</li> <li>Saves meal prep time on busy nights.</li> <li>Stretches your food budget by allowing you to buying foods in season or on sale.</li> </ul> <h2>Tips for freezing</h2> <h3>While freezing is easy and doesn't require special equipment, these tips can help you achieve the best results:</h3> <ul> <li>Choose produce that's ripe because the ripening process stops when foods are frozen.</li> <li>Wash, peel, if desired, and cut produce.</li> <li>Blanch produce, which means cooking quickly in boiling water or steaming, before freezing to deactivate enzymes. However, this step isn't necessary. The National Center for Home Food Preservation has more information on <a rel="noopener" href="https://nchfp.uga.edu/how/freeze/blanching.html" target="_blank" title="Opens in a new window.">blanching</a>.</li> <li>Cool all food in the refrigerator before packaging.</li> <li>Package food in airtight containers such as plastic food storage containers or freezer food storage bags.</li> <li>Divide large amounts of food into shallow containers. </li> <li>Pack individual portions of casseroles or soups in small containers for easy meals during the week.</li> <li>Allow enough space between the cover or seal so food can expand as it freezes. </li> <li>Label and date containers.</li> <li>Freeze foods as soon as they are packed and sealed.</li> <li>Freeze and store foods at 0 F or lower for best quality. Learn about <a rel="noopener" href="http://www.foodsafety.gov/" target="_blank" title="Opens in a new window.">recommended storage times</a> for specific foods. Foods should still be safe after these times but may be lower in quality.</li> <li>Don't overload the freezer. </li> </ul> <h2>Tips for thawing</h2> <h3>How you thaw food from the freezer will ensure it retains flavor and texture, and remains safe to eat:</h3> <ul> <li>Thaw food in the refrigerator, under cold running water or in the microwave.</li> <li>Don't thaw foods on the counter at room temperature. </li> <li>Thawed foods should be kept in the refrigerator and used within three to four days. </li> <li>Reheat leftovers to a minimum of 165 F as measured with a food thermometer.</li> </ul> <h2>Recipes</h2> <p>Put those blueberries you bought on sale and froze to delicious use with this oven French toast. Or cook up a hearty pot of split pea soup and freeze it for easy lunches or light dinners.</p> <h3>Baked blueberry French toast</h3> <p>By Mayo Clinic</p> <p>Serves 5</p> <p>12-inch French or sourdough baguette<br /> 4 egg whites<br /> 1 cup fat-free soy milk<br /> 1/4 teaspoon nutmeg<br /> 1 teaspoon vanilla<br /> 4 tablespoons brown sugar, divided<br /> 3/4 cup blueberries, coarsely chopped<br /> 1 tablespoon canola oil<br /> 1/4 cup chopped pecans, toasted (optional; not included in the nutritional analysis)</p> <p>Spray a 9-inch square baking dish with cooking spray. Cut 10 1-inch-thick slices from baguette. Arrange in baking dish. In a large bowl, whisk egg whites until frothy. Then whisk in milk, nutmeg, vanilla and 2 tablespoons brown sugar. Pour evenly over bread, turning slices to coat evenly. Cover pan. Chill at least 8 hours or overnight, until liquid is absorbed by bread.</p> <p>Heat oven to 400 F. Drop blueberries evenly over bread. If desired, stir together remaining brown sugar, oil and pecans in a small bowl, and spoon evenly over bread. Bake, uncovered, about 20 minutes, until liquid from blueberries is bubbling.</p> <p>Nutrition per serving (2 slices): 171 calories, 3 grams total fat, 249 milligrams sodium, 30 grams total carbohydrate, 10 grams added sugars, 0.5 grams fiber, 6 grams protein.</p> <h3>Split pea soup</h3> <p>By Mayo Clinic</p> <p>Serves 4</p> <p>2 tablespoons olive oil<br /> 1 yellow onion, chopped<br /> 1 large carrot, peeled and chopped<br /> 2 cloves garlic, minced<br /> 1 1/2 cups dried yellow or green split peas, picked over, rinsed and drained<br /> 3 cups water<br /> 3 cups low-sodium vegetable stock or broth<br /> 1/4 teaspoon freshly ground black pepper<br /> 1/2 cup chopped lean ham</p> <p>In a large saucepan, heat the olive oil over medium heat. Add the onion and sauté until soft and lightly golden, about 6 minutes. Add the carrot and sauté until the carrot is softened, about 5 minutes. Add the garlic and sauté for 1 minute. Stir in the split peas, water, stock and pepper; bring to a boil. Reduce the heat to low, cover partially, and simmer until the peas are tender, 60 to 65 minutes.</p> <p>In a blender or food processor, puree the soup in batches until smooth and return to the saucepan over medium heat. Reheat gently. Serve with whole-wheat bread and a fresh fruit salad.</p> <p>Nutrition per serving (2 ½ cups): 377 calories, 9 grams total fat, 410 milligrams sodium, 52 grams total carbohydrate, 11 grams added sugars, 19 grams fiber, 22 grams protein.</p> <p><em>By Mayo Clinic Health System staff. </em></p><img src="/-/media/national-files/images/hometown-health/2024/freezer-foods.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E7ABC19CEF65B7C8221139C11DFDEBA1" alt="Freezer foods" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller1/22/2024Isometric exercise focuses on contracting specific groups of muscles. Learn why it's gaining attention for its role in controlling blood pressure and how to do some exercises at home.Isometric exercise: Using body weight to lower blood pressure<p>When you think about exercise, sweating through a cycling class, adding up miles from a brisk walk or pumping iron in the weight room may come to mind. But there's a different form of exercise that uses something besides movement to give you a workout. It's <a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/fitness/expert-answers/isometric-exercises/faq-20058186" target="_blank" title="Opens in a new window.">isometric exercise</a>, which is gaining attention for its role in helping lower and control your blood pressure.</p> <h2>What is isometric exercise?</h2> <p>Isometric exercise focuses on tightening or contracting a specific muscle or group of muscles. The targeted muscles don't noticeably change in length, and the joints involved don't move. The exercise is done in a static position and relies on your body's weight to help maintain strength and stabilize your joints and core.</p> <p>Because isometric exercise doesn't involve movement or full range of motion and targets specific muscles, it can improve strength and stability for people recovering from an injury or those with arthritis.</p> <p>One misconception about isometric exercise is that it involves straining and holding your breath, which can raise your blood pressure. To hold an isometric or static exercise, you need to concentrate on slowly breathing in and out.</p> <p>New research has revealed that isometric exercise can be an effective tool for preventing or lowering high blood pressure.</p> <h2>Why is blood pressure important?</h2> <p>High blood pressure is harmful because it makes the heart work harder and less efficiently. For a quick review of <a rel="noopener" href="https://www.cdc.gov/high-blood-pressure/about/" target="_blank" title="Opens in a new window.">blood pressure</a>, there are two key numbers when <a rel="noopener" href="https://www.cdc.gov/high-blood-pressure/measure/" target="_blank" title="Opens in a new window.">measuring your blood pressure</a>: systolic and diastolic.</p> <h3>The Centers for Disease Control and Prevention define these as:</h3> <ul> <li><strong>Systolic blood pressure</strong><br /> Measures the maximum pressure in the arteries as the heart contracts and relaxes.</li> <li><strong>Diastolic blood pressure</strong><br /> Measures the arterial pressure when the heart rests between beats.</li> </ul> <p><a href="/hometown-health/speaking-of-health/know-your-heart-health-numbers" target="_self" title="Opens in same window.">Healthy blood pressure</a> is less than 120/80 mm Hg.</p> <h2>What are the new research findings about exercise and blood pressure?</h2> <p>In a <a rel="noopener" href="https://bjsm.bmj.com/content/57/20/1317" target="_blank" title="Opens in a new window.">large study</a> published in the British Journal of Sports Medicine, researchers examined the recommendations for exercise to help lower blood pressure, which relied on older research that stressed aerobic or cardio exercises like cycling or running. The study also looked at the effects on blood pressure from high-intensity interval training, or HIIT, and isometric exercise.</p> <p>The authors defined healthy resting blood pressure as below 130/85 mm Hg and high blood pressure as 140/90 mm Hg.</p> <p>The study authors reviewed 270 trials with 15,827 participants between 1990 and 2023, and compared the results for isometric, HIIT, aerobic exercise, dynamic resistance training and a combination of the last two forms of exercise. Their findings were that isometric exercise led to the most significant reductions in systolic and diastolic blood pressure.</p> <h2>How can you build isometric exercise into your workout?</h2> <p>Isometric exercise is an excellent addition to your <a href="/locations/la-crosse/services-and-treatments/cardiology/prevention" target="_self" title="Opens in same window.">cardiovascular and strength training routines</a>.</p> <h3>Wall sits and planks are two of the best isometric exercises for lowering blood pressure. Here's how to do them:</h3> <h4><strong>Wall sit</strong></h4> <p>Stand with your back toward a wall. Step out about 2 feet from the wall. Place your feet firmly on the ground and shoulder-width apart. Slide your back down the wall while keeping your abdominal muscles tight and bending your legs until they're at 90 degrees or a right angle. It's like sitting in a chair without the chair. Check that your knees are straight above your ankles.</p> <p>This exercise focuses on your glutes, or buttock, muscles and quadriceps, or thigh, muscles, as well as your abdominal or core muscles.</p> <h4>Planks</h4> <ul> <li><strong>Wall plank</strong><br /> Stand facing a wall. Place your elbows and forearms on the wall. Take a step back, tuck in your bottom, and tighten your abdominal muscles by pulling your belly button into your spine. Hold for 20 seconds.</li> <li><strong>Floor plank on knees</strong><br /> Lie on your stomach and prop yourself up slightly on your forearms. Using your knees and forearms, lift your hips off the floor to about the same height as your shoulders. Hold this position, focusing on using your core muscles, for 20 seconds. To progress to a harder version, press your toes into the floor, then lift your knees off the floor and squeeze your glutes and core to create a plank that involves full-body tension. Think about pulling your belly button into your spine.</li> </ul> <p>Planks focus on your back, shoulders and abdominal muscles.</p> <h3>With both exercises:</h3> <ul> <li>Remember to breathe slowly and regularly to give your muscles the oxygen they need. </li> <li>Start by holding the position for 20 seconds. Work your way up to holding the position for two minutes. Strive for doing four sets, with a few minutes between each set, three times a week.</li> </ul> <p><a href="/providers/melinda-hahm" target="_self" title="Opens in same window."><em>Melinda Hahm</em></a><em> is a clinical exercise physiologist in <a href="/services-and-treatments/bariatric-surgery" target="_self" title="Opens in same window.">Bariatric Surgery</a> and cardiac rehab tech in <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">Cardiology</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em> </p><ul> <li>Diseased population</li> <li>Helping patients to find ways to become more physically active and incorporate exercise into their lifestyle</li> </ul>ACSM-CEP<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Exercise Physiology, Winona State University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Clinical Exercise Physiologist, American College of Sports Medicine</li> <li>Senior Fitness Training Specialist, American Academy of Health and Fitness</li> </ul>Hahm<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/melinda-hahm.JPG?h=280&iar=0&w=280&sc_lang=en&hash=07CDEFA0A5AA9AA76DB482AC9AF90A59" alt="Melinda Hahm" width="280" height="280" DisableNVelocity="true" />Melinda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13271296Melinda Hahm, ACSM-CEP1{94B2E140-AEF8-44BA-B6A9-4538B77501BC}<img src="/-/media/national-files/images/hometown-health/2024/person-holding-a-plank-pose.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CA02F71A898CE4F51881FA3B4CA19F0B" alt="Person holding a plank pose" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.ArthritisArthritis is inflammation of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Dawn Haller1/17/2024Smart snacking plays a role in your energy level, daily nutrients and weight management. Get expert tips to plan your snacks, evaluate hunger cues and make every nutrient-dense bite count.Are you mindlessly munching or sensibly snacking?<p>When you snack correctly, it can boost your energy between meals, help you meet nutrient needs for the day and keep hunger at bay to prevent you from overeating at the next meal. Managing your appetite can help you maintain a healthy weight and reach <a href="/hometown-health/speaking-of-health/getting-your-weight-loss-back-on-track" target="_self" title="Opens in same window.">weight-loss goals</a>.</p> <h2>Snacking tips</h2> <ul> <li><strong>Plan your snacks.</strong><br /> Keep a variety of nutrient-rich, ready-to-eat foods nearby to snack on when hunger hits. This will help lessen the temptation of less healthy options from vending machines, break rooms or convenience stores. Ideas include fresh fruit, air-popped popcorn, fat-free or low-fat yogurt, and nut mixes.</li> <li><strong>Snack for hunger, not because of stress or boredom.</strong><br /> It's typical to be hungry three to four hours after a meal. When you feel hunger setting in, ask yourself, "Am I physically hungry, or am I bored, stressed or frustrated?" <a href="/hometown-health/speaking-of-health/mindful-snacking-at-home" target="_self" title="Opens in same window.">before you grab a snack</a>. If you're experiencing physical hunger, it's time to grab a satisfying snack. If boredom or stress are prompting you to snack, try doing another activity, such as going for a walk.</li> <li><strong>Make snacks count.</strong><br /> Choose nutrient-dense foods that will help fill the gaps in your eating plan. Focus on <a href="/hometown-health/speaking-of-health/tips-for-eating-more-plant-proteins" target="_self" title="Opens in same window.">incorporating whole foods</a>, such as fruits, vegetables, whole grains and low-fat dairy products. Try to combine carbohydrates, protein and fat for long-lasting, satisfying snacks. Choose these options rather than packaged items high in calories, fat and sodium, such as chips, candy or cookies.</li> <li><strong>Snack on sensible portions.</strong><br /> To keep portion sizes in check, purchase single-serve containers or put small servings of snacks into a bowl rather than eating them directly from the package. Eating out of a package often can lead to mindless eating and result in eating more than intended. Aim for snacks that have less than 200 calories.</li> </ul> <h2>Snacking suggestions</h2> <p>A variety of snacks can fit into your healthy lifestyle choices. With some planning, you can easily choose low-calorie, <a href="/hometown-health/speaking-of-health/make-every-calorie-count-with-nutrient-dense-foods" target="_self" title="Opens in same window.">nutrient-dense options</a>. </p> <h3>Look for snacks in these areas:</h3> <ul> <li><strong>Whole grains</strong><br /> Whole grain snacks include energy from carbohydrates and are a good source of fiber. Choose low-fat, whole-grain crackers; air-popped popcorn without added butter; or whole-grain snack bar without added sugars. One slice of whole-grain bread and one ounce of low-fat protein, like turkey or chicken, is another good choice.</li> <li><strong>Dairy foods</strong><br /> Dairy foods are an excellent source of calcium and protein. Low-fat versions keep the calorie count lower, too. Cheese, yogurt and milk are good options. Limit cheese to a 1-ounce serving and milk and yogurt to a 1-cup portion per snack.</li> <li><strong>Fruits</strong><br /> Fruits are full of vitamins and minerals and don't contain fat. A typical serving of fresh, frozen or canned fruits only has about 60 calories. If you choose canned fruit, look for items packed in 100% fruit juice to eliminate extra calories from syrup.</li> <li><strong>Vegetables</strong><br /> Vegetables contain fiber, which makes them filling. They're packed full of vitamins and minerals and are low in calories. Raw veggies can help you tackle a snack craving when paired with salsa or low-fat dips. </li> <li><strong>Proteins</strong><br /> Nuts and seeds are a <a href="/hometown-health/speaking-of-health/are-you-getting-too-much-protein" target="_self" title="Opens in same window.">good source of protein</a> to help you feel full longer. They also contain heart-healthy fats. Nuts and seeds are high in calories, so pay attention to the serving size.</li> </ul> <h3>Try these snack ideas that incorporate healthy ingredients:</h3> <ul> <li>1 tablespoon peanut butter and slices of medium apple</li> <li>Small banana and 16 almonds</li> <li>1/4 cup mashed avocado and whole-grain toast</li> <li>3/4 cup plain Greek yogurt and 1 cup berries</li> <li>6 whole-wheat crackers and 1 ounce of cheese, typically one slice</li> <li>One 6-inch whole-wheat tortilla, 1/4 cup black beans and 2 tablespoons salsa</li> <li>10 baby carrots and 2 tablespoons hummus</li> <li>3 cups air-popped popcorn sprinkled with 3 tablespoons grated parmesan cheese</li> <li>Pear and string cheese</li> <li>1 cup plain oatmeal and 1/2 cup mixed berries</li> </ul> <h3>Chickpeas are a high-protein, low-fat, high-fiber food perfect for sensible snacking. Give these recipes a try: </h3> <h4>Sweet and spicy snack mix</h4> <p>From Mayo Clinic</p> <p>Swap out traditional peanuts and pretzels for this chickpeas and dried fruit mix to reduce fat and sodium and increase fiber. </p> <p>2 15-ounce cans of chickpeas, rinsed, drained and patted dry<br /> 2 cups unsweetened wheat squares cereal<br /> 1 cup dried pineapple pieces<br /> 1 cup raisins<br /> 2 tablespoons honey<br /> 2 tablespoons Worcestershire sauce<br /> 1 teaspoon garlic powder<br /> 1/2 teaspoon chili powder</p> <p>Heat the oven to 350 degrees F. Lightly coat a large baking sheet with butter-flavored cooking spray.</p> <p>Generously spray a heavy skillet with butter-flavored cooking spray. Add chickpeas to the skillet and cook over medium heat, stirring frequently until they begin to brown, about 10 minutes. Transfer the chickpeas to the prepared baking sheet. Spray the chickpeas lightly with cooking spray. Bake, stirring frequently, until crisp, about 20 minutes.</p> <p>Lightly coat a roasting pan with butter-flavored cooking spray. Measure the cereal, pineapple, raisins and pour them into the pan. Add the roasted chickpeas. Stir to mix.</p> <p>Combine honey, Worcestershire sauce, and spices in a bowl. Stir to mix evenly. Pour the liquid mixture over the ingredients in the roasting pan and toss gently. Coat the mixture again with the cooking spray. Bake for 10 to 15 minutes, stirring occasionally to keep the mixture from burning.</p> <p>Remove from the oven and let cool. Store in an airtight container.</p> <p>Nutrition information per 1/2-cup serving: 172 calories, 1 gram total fat, trace saturated fat, 0 milligrams cholesterol, 197 milligrams sodium, 38 grams carbohydrates, 5 grams fiber, 3 grams sugars, 5 grams protein.</p> <h4>Roasted red pepper hummus</h4> <p>From Mayo Clinic</p> <p>2 cups of canned chickpeas, rinsed and drained<br /> 1 cup roasted red bell pepper, sliced and seeded<br /> 2 tablespoons white sesame seeds<br /> 1 tablespoon lemon juice<br /> 1 tablespoon olive oil<br /> 1 1/4 teaspoons cumin<br /> 1 teaspoon onion powder<br /> 1 teaspoon garlic powder<br /> 1 teaspoon kosher salt<br /> 1/4 teaspoon cayenne pepper</p> <p>In a food processor, blend all ingredients until smooth. Store in an airtight container. Hummus can be kept in the refrigerator for up to one week.</p> <p>Nutrition information per 3 tablespoon serving size: 45 calories, 2 grams total fat, trace saturated fat, 0 milligrams cholesterol, 190 milligrams sodium, 6 grams carbohydrates, 2 grams fiber, 2 grams sugars, 2 grams protein.</p> <p><a href="/providers/allyn-wergin-rdn" target="_self" title="Opens in same window."><em>Allie Wergin</em></a><em> is a registered <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">dietitian nutritionist</a> in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Bariatric surgery</li> <li>Diabetes management</li> <li>Oncology</li> <li>Weight management</li> </ul>RDN<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, St. Catherine University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration </li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul>Mahowald<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/allyn-wergin-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=74F690ED261F537AA65B66929A3356D1" alt="Allie Mahowald, RDN" width="280" height="280" DisableNVelocity="true" />{9209F8EC-1016-41AA-985F-014D9B877417}Allie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15971546Allyn Mahowald, RDN1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2024/healthy-snacks.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2FD64839E96DA6E1BA91E687C60EDACB" alt="Healthy snacks" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller1/15/2024Neal and Claudia Coit volunteer at the same location, but each found an opportunity that fits them best. Read about what they do and why it keeps them coming back.Volunteers polish skills, stay active<p>During the course of his four-hour shift with Speedy Transport Escort Personnel, or STEP, Neal Coit walks four to five miles as he transports patients in wheelchairs or delivers flowers, medications and small packages. During her shift as a family/visitor liaison in the Surgery Department, his wife, Claudia Coit, draws on the customer service and computer skills she acquired before retirement.</p> <p>This active, engaged couple began volunteering at Mayo Clinic Health System in Eau Claire, Wisconsin, in 2021 because both of them wanted to give back to the community where they live.</p> <p>"We chose to volunteer in healthcare, knowing what they'd been through during the height of the pandemic," says Claudia. "A family member was volunteering for Mayo Clinic Health System and spoke highly of the program."</p> <h2>Giving and gratitude</h2> <p>In her role as a liaison, Claudia often sees families on one of their toughest days. "If I can help them through the time their loved one is in surgery, I know I'm making a difference," she says. "The best part is when we reunite the family and patient."</p> <p>As Neal escorts patients in wheelchairs or delivers bouquets, he says the "thank you's" and smiles he receives let him know that what he does is appreciated.</p> <p>Both Claudia and Neal say their volunteer experience has made them grateful that they're healthy and active in retirement. They look forward to interacting regularly with staff, patients, families and other volunteers.</p> <p>"If you're wondering about volunteering for your healthcare system, go for it," says Neal. "You won't regret it."</p> <p>"You'll always walk away with a warm and fuzzy feeling," Claudia adds.</p> <h2>Helping others, benefiting you</h2> <p>Research has shown that volunteering <a href="/hometown-health/speaking-of-health/3-health-benefits-of-volunteering" target="_self" title="Opens in same window.">offers significant health benefits</a>, especially for older adults, including:</p> <h3>Improves physical and mental health.</h3> <p>Volunteering reduces stress and increases positive, relaxed feelings by releasing dopamine. By spending time in service to others, volunteers report feeling a sense of meaning and appreciation, both given and received, which can have a stress-reducing effect.</p> <h3>Provides a sense of purpose and teaches valuable skills.</h3> <p>At Mayo Clinic Health System, volunteers serve as greeters and waiting room attendants, provide patient room information and directions, and help transport patients and patient items. Many volunteers use their craft skills to make prayer shawls, blankets, sweaters and hats for newborn babies and people with cancer. Other services that volunteers provide include working in the hospital gift shop, performing clerical duties for staff and <a href="/hometown-health/speaking-of-health/a-day-in-the-life-of-luna-a-facility-dog" target="_self" title="Opens in same window.">offering pet therapy</a> through the Paws Force team.</p> <h3>Nurture new and existing relationships.</h3> <p>Volunteering increases social interaction and helps build a support system based on common interests. One of the best ways to make new friends and strengthen existing relationships is to participate in a shared activity. Volunteers often have diverse backgrounds, and participating in a volunteer activity helps them expand their social network and allows them to practice social skills with others.</p> <p>People volunteer for different reasons, such as exploring careers, sharpening skills, staying active during retirement, meeting new people and serving others. Yet all volunteers share a common desire to improve the health and welfare of people in their communities.</p> <h2>How you can make a difference</h2> <p>If you'd like to make a difference for our patients and staff, you can find volunteering opportunities in various service areas with flexible schedules and commitments, along with engagement and enrichment options that fit you best. Check out the <a href="/volunteer" target="_self" title="Opens in same window.">volunteering options at your preferred location</a>.</p><img src="/-/media/national-files/images/hometown-health/2024/claudia-and-neal-coit.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F2153EEAA502C937F2058F6B16C9EE24" alt="Claudia and Neal Coit" width="660" height="370" DisableNVelocity="true" />Karen Sperl9/20/2025Stress can increase your blood pressure, but so can what you eat. This eating plan can reduce or control blood pressure while reducing risk of stroke and heart attacks.More than stress: What you eat affects your blood pressure<p>High blood pressure, or <a href="/hometown-health/speaking-of-health/know-your-numbers-blood-pressure">hypertension</a>, is a major risk factor for heart disease and stroke. The condition makes your heart work harder, can harden the walls of arteries and cause organ damage. What you eat affects your blood pressure. One eating plan designed to help prevent or treat high blood pressure is the Dietary Approaches to Stop Hypertension (DASH) diet.</p> <h2>Guidelines, not rules</h2> <p>The DASH diet requires no special foods and has no rigid rules. It emphasizes eating fruits, vegetables, whole grains, low-fat dairy, beans, nuts, lean meats and fish. The eating plan is rich in the minerals potassium, calcium and magnesium, which play a role in regulating blood pressure.</p> <p>What the DASH diet does limit is: </p> <ul> <li>Added sugar. Enjoy sugar-sweetened beverages and sweets sparingly.</li> <li>Food high in saturated fats. Reduce your intake of fatty meats, full-fat dairy products and tropical oils like coconut and palm oils.</li> <li>Salt (sodium). The Food and Drug Administration (FDA) estimates U.S. adults consume about 3,400 milligrams of sodium a day. DASH limits salt to 2,300 milligrams per day. To reduce salt in your diet, dine out less, pare down salt in cooking, flavor foods with salt-free spices or herbs, and choose plain or minimally processed meats.</li> </ul> <h2>Embracing the DASH diet</h2> <p>Reading about an eating plan is one thing, putting it into practice is another. A basic guideline for DASH is to fill half of your plate with fruits and vegetables. The remaining half should be ¼ whole grains or complex carbohydrates and ¼ lean protein.</p> <p>Here's a look at the recommended servings from each food group for a 2,000-calorie-a-day DASH diet:</p> <ul> <li><strong>Vegetables: 4 to 5 servings a day.</strong> One serving is 1 cup raw leafy green vegetables, ½ cup cut-up raw or cooked vegetables, or ½ cup vegetable juice. </li> <li><strong>Fruits: 4 to 5 servings a day.</strong> One serving is one medium piece of fruit, ½ cup fresh, frozen or canned fruit, or ½ cup fruit juice. </li> <li><strong>Grains: 6 to 8 servings a day.</strong> One serving may be ½ cup of cooked cereal, rice or pasta, 1 slice of bread or 1 ounce of dry cereal. </li> <li><strong>Lean meats, poultry and fish: Six 1-ounce servings or fewer a day.</strong> One serving is 1 ounce of cooked meat, poultry or fish, or 1 egg.</li> <li><strong>Fat-free or low-fat dairy products: 2 to 3 servings a day.</strong> One serving is 1 cup milk or yogurt, or 1½ ounces of cheese. </li> <li><strong>Nuts, seeds, or dry beans and peas: 4 to 5 servings a week.</strong> One serving is ⅓ cup nuts, 2 tablespoons peanut butter, 2 tablespoons seeds, or ½ cup cooked dried beans or peas, also called legumes. </li> <li><strong>Fats and oils: 2 to 3 servings a day.</strong> One serving is 1 teaspoon soft margarine or butter, 1 teaspoon vegetable oil, 1 tablespoon mayonnaise or 2 tablespoons salad dressing.</li> <li><strong>Sweets and added sugars: 5 servings or fewer a week.</strong> One serving is 1 tablespoon sugar, jelly or jam, ½ cup sorbet or 1 cup lemonade.</li> </ul> <h2>Eating well for your heart health </h2> <p>No foods are off-limits in the DASH eating plan. You can eat well — and deliciously — without feeling deprived.</p> <h3>Yellow pear and cherry tomato salad</h3> <p>By Mayo Clinic<br /> Serves 6</p> <p>Salad</p> <p>1 ½ cups yellow pear tomatoes, halved<br /> 1 ½ cups orange cherry tomatoes, halved<br /> 1 ½ cups red cherry tomatoes, halved<br /> 4 large fresh basil leaves, cut into slender ribbons</p> <p>Vinaigrette</p> <p>2 tablespoons sherry vinegar or red wine vinegar<br /> 1 tablespoon minced shallot<br /> 1 tablespoon extra-virgin olive oil<br /> ¼ teaspoon salt<br /> ⅛ teaspoon freshly ground black pepper</p> <p>In a small bowl, combine the vinegar and shallot and let stand for 15 minutes. Add the olive oil, salt and pepper and whisk until well blended. In a large serving bowl, toss together all the tomatoes. Pour the vinaigrette over the tomatoes, add the basil ribbons, and toss gently to mix well and coat evenly. Serve immediately.</p> <p>Nutritional per 3/4-cup serving: 45 calories, 3 grams total fat, 0 grams saturated fat, 5 grams carbohydrate, 1.5 grams fiber, 125 milligrams sodium, 1.5 grams protein.</p> <h3>Barbecue chicken pizza</h3> <p>By Mayo Clinic<br /> Serves 4</p> <p>1 cup tomato sauce, no salt added<br /> 1 12-inch thin, whole-grain pizza crust<br /> 1 green pepper, cut into rings<br /> 1 tomato, sliced<br /> 1 cup mushrooms, sliced<br /> 4 ounces cooked chicken breast, sliced about 1-inch thick, with all visible fat removed<br /> 4 tablespoons barbecue sauce<br /> 1 cup shredded, reduced-fat mozzarella cheese (about 4 ounces)</p> <p>Heat the oven to 400 F. Spread the sauce evenly over the pizza crust. Add the pepper, tomato, mushrooms and chicken. Drizzle barbecue sauce over the pizza and top with cheese.</p> <p>Bake about 12 to 14 minutes. Cut the pizza into 8 slices and serve.</p> <p>Nutritional per 2-slice serving: 261 calories, 7 grams total fat, 475 milligrams sodium, 28 grams total carbohydrate, 0 grams total sugars, 5 grams fiber, 21 grams protein.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2024/tossing-salad.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7564222DF9B133943E56CE9FA261F9F7" alt="Tossing salad" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller2/29/2024Did you know calcium is the most abundant mineral in your body? It makes up about 2% of your weight and is necessary for strong bones. Find out if your daily calcium intake hits the recommended level.Calcium intake and absorption: Are you getting enough?<p>Calcium is the most abundant mineral in the body. About 1% of the body's calcium is used for metabolic functions, such as vascular contraction and dilation, muscle function, blood clotting, <a href="/hometown-health/speaking-of-health/racing-heart-beat-heart-arrhythmia-101" target="_self" title="Opens in same window.">heart rhythm</a>, nerve transmission, intracellular signaling and hormone secretion. The remaining 99% is found in structural support for your bones and teeth. When calcium blood levels are low, a hormone signals that calcium be released from bones into the bloodstream.</p> <h2>Recommended calcium intake</h2> <p>Many people don't get enough calcium. But how much do you need?</p> <h3> The National Institutes of Health (NIH) provides this guidance for daily intake in milligrams (mg):</h3> <ul> <li>Younger than 6 months: 200 mg</li> <li>6–12 months: 260 mg</li> <li>1–3 years: 700 mg</li> <li>4–8 years: 1,000 mg</li> <li>9–18 years: 1,300 mg</li> <li>19–50 years: 1,000 mg</li> <li>51–70 years: 1,000 mg for men, 1,200 mg for women</li> <li>71 years and older: 1,200 mg</li> </ul> <p>Inadequate calcium consumption causes osteopenia, or bone loss, which may result in <a href="/hometown-health/speaking-of-health/osteoporosis-silent-disease" target="_self" title="Opens in same window.">osteoporosis</a>, which is weak, brittle bones. In addition, you're more susceptible to bone fractures with poor calcium intake. Signs of inadequate calcium may include muscle cramping and weakness, tingling or <a href="/hometown-health/speaking-of-health/carpal-tunnel-syndrome-culprits" target="_self" title="Opens in same window.">numbness in your fingers</a>, abnormal heart rate or poor appetite.</p> <h2>Calcium absorption</h2> <p>Calcium is a large mineral that can take time to break down and be absorbed into your body. The recommended intake of calcium at one time is 500 mg or less.</p> <h3>Calcium-rich foods include:</h3> <ul> <li>Plain, low-fat yogurt: 415 mg per 8 ounces</li> <li>Cheddar cheese: 307 mg per 1.5 ounces</li> <li>Nonfat milk: 299 mg per 8 ounces</li> <li>Fortified orange juice: 300 mg per 8 ounces</li> <li>Salmon: 181 mg per 3 ounces</li> <li><a href="/hometown-health/speaking-of-health/the-many-types-and-health-benefits-of-kale" target="_self" title="Opens in same window.">Kale</a>: 100 mg per 1 cup</li> <li>Raw broccoli: 21 mg per 1/2 cup</li> </ul> <p>Calcium absorption depends on the total amount of calcium consumed at one time; the higher the amount, the less absorption. However, the presence of vitamin D increases calcium absorption. </p> <p>So the next time you're shopping for high-calcium foods, search for low-fat yogurt, low-fat milk, cheddar cheese, fortified orange juice, leafy greens and other calcium-containing foods. If you're looking for a calcium supplement, remember the importance of 500 mg or less per serving for best absorption.</p> <h2>Try this calcium-rich recipe. Pair it with a side dish of kale salad or broccoli for an extra boost of calcium.</h2> <h3>Citrus seared salmon</h3> <p>By Mayo Clinic<br /> Serves 4</p> <p>4 4-ounce salmon fillets, trimmed<br /> 1 teaspoon cumin<br /> 1 teaspoon orange zest<br /> 1/4 teaspoon kosher salt<br /> 1/4 cup orange juice<br /> 1/4 cup apple juice<br /> 1 tablespoon Dijon mustard<br /> 2 teaspoons honey<br /> 1 teaspoon ground black pepper<br /> 1 tablespoon olive oil<br /> 1 tablespoon water<br /> 1 teaspoon cornstarch</p> <p>Place the salmon fillets skin side down on a plate and season with cumin, orange zest and salt. In a medium bowl, combine the orange juice, apple juice, mustard, honey and black pepper. In a small bowl, combine the water and cornstarch to make a slurry.</p> <p>Heat a nonstick sauté pan over medium-high heat. Add the olive oil to the heated sauté pan. Place the salmon in the pan with the seasoned side down. Cook for approximately 2 minutes. Flip and cook for another 2 minutes until the internal temperature is 145 F.</p> <p>Remove the salmon from the pan, cover and set aside. Add the juice mixture to the sauté pan. Slowly whisk the slurry into the juice mixture, continuing to whisk until the desired thickness is reached. Drizzle the sauce over the salmon and serve.</p> <p>Nutritional per 4-ounce serving: 160 calories, 16 grams total fat, 282 milligrams sodium, 8 grams total carbohydrate, 6 grams total sugars, 0 grams fiber, 22 grams protein.</p> <p><em>Anne Harguth is a registered dietitian in Clinical Nutrition Services in <a href="/locations/waseca" target="_self" title="Opens in same window.">Waseca</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2024/yogurt-and-fresh-fruit.jpg?h=370&iar=0&w=660&sc_lang=en&hash=72A51B4EA2394EA31FB0C3982B988736" alt="Yogurt and fresh fruit" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller2/12/2024An injection of vitamin K is a preventive measure that's recommended for newborns. Get answers to common questions new parents have about why vitamin K is needed and what can happen without it.8 common questions new parents ask about vitamin K<p>Vitamin K is a nutrient that helps blood clot or stop bleeding. Most adults get vitamin K from their food. Bacteria in the large intestines also make some vitamin K that the body can absorb.</p> <p>Healthcare professionals recommend all babies receive a vitamin K injection at birth to help their blood clot effectively. New parents often have questions about these preventive measures for newborns, which also may include <a href="/hometown-health/speaking-of-health/carrier-screening-for-family-planning" target="_self" title="Opens in same window.">screenings for genetic conditions</a> and antibiotic eye ointment to prevent eye infections.</p> <h2>Here are answers to common questions new parents ask regarding vitamin K:</h2> <h3>How is vitamin K administered to infants?</h3> <p>Since 1961, the <a href="#AAP">American Academy of Pediatrics</a> has recommended a single <a href="/locations/la-crosse/services-and-treatments/birthing-centers/labor-and-delivery/immediately-after-delivery" target="_self" title="Opens in same window.">dose of vitamin K injected</a> into the thigh muscle of a newborn infant to prevent bleeding. The recommended dose is based on the infant's weight and given within six hours of birth.</p> <h3>Why does my baby need vitamin K at birth?</h3> <p>A newborn typically has a low level of vitamin K in their blood at birth. Even if the pregnant person has a diet sufficient for vitamin K, only a minimal amount is transferred across the placenta before birth and is not enough to protect the baby after birth.</p> <p>Although breast milk is the best nutrition for all infants, it has a relatively low level of vitamin K. While formula has more vitamin K per fluid ounce than breast milk, a baby is still at risk for a vitamin K deficiency without an injection after birth.</p> <p>According to the American Academy of Pediatrics, recent evidence also shows that a postpartum person taking high doses of vitamin K while <a href="/hometown-health/speaking-of-health/breastfeeding-101-tips-for-new-moms" target="_self" title="Opens in same window.">breastfeeding</a> doesn't increase the level passed to the baby enough to prevent the risk of vitamin K-deficient bleeding.</p> <h3>Is vitamin K safe for infants?</h3> <p>There is no evidence that vitamin K injection causes any harm to the baby<em>.</em> Parents can minimize the short-term discomfort from the injection by holding or feeding the infant while it's administered. </p> <p>Vitamin K is not a vaccine, doesn't contain mercury and has been proven to be safe and beneficial for over 60 years.</p> <h3>How quickly after birth does vitamin K deficiency develop?</h3> <h4>Vitamin K deficiency occurs in male and female infants and can develop during these time frames after birth:</h4> <ul> <li><strong>Early onset</strong> — occurs on the first day of life</li> <li><strong>Classic onset</strong> — occurs between day two and the first week of life</li> <li><strong>Late onset</strong> — occurs between eight days and six months</li> </ul> <h3>What is vitamin K-deficient bleeding?</h3> <p>Vitamin K-deficient bleeding can happen when a baby does not have enough vitamin K. Healthcare professionals have known about the condition, also known as hemorrhagic disease of the newborn, for many decades. New parents may be unaware of vitamin K-deficient bleeding because it's become less common now that most infants receive the injection. </p> <p>There is a risk of bleeding in the body up to 6 months of age in infants who don't receive a vitamin K injection at birth. These babies are 80 times more likely to experience severe bleeding. </p> <h3>What are the signs or symptoms of vitamin K-deficient bleeding in babies?</h3> <p>Infants who don't receive a vitamin K injection at birth may have no warning signs of bleeding for days, weeks or months. Symptoms include bruising easily, paler than usual skin or blood in the stool. Vitamin K-deficient bleeding can occur in various parts of the infant's body, such as the skin, <a href="/hometown-health/speaking-of-health/delayed-umbilical-cord-clamping-benefits" target="_self" title="Opens in same window.">umbilical cord</a>, nose, mouth, gastrointestinal tract and brain. Bleeding in the brain can be life-threatening and cause brain damage or death.</p> <h3>Can my baby receive vitamin K orally instead of as an injection?</h3> <p>Oral vitamin K supplementation isn't recommended because it's less effective and requires multiple doses over several months to achieve the same benefit as the one-time shot. The Food and Drug Administration (FDA) has not approved an oral vitamin K for newborns.</p> <h3>Why is vitamin K essential for male newborns?</h3> <p>Before the recommendation of vitamin K injection at birth in the U.S., infant males had an increased risk of bleeding during circumcision. At that time, one out of every nine baby boys who had an elective newborn male circumcision without vitamin K had bleeding that wouldn't stop.</p> <p>The risk of bleeding during circumcision has significantly decreased since vitamin K supplementation became the standard of care in the U.S. For parents who choose an elective newborn circumcision, administration of vitamin K is required before the procedure.</p> <p>Having your newborn receive vitamin K at birth reduces the risk of severe bleeding. Talk with your baby's healthcare team if you have questions about vitamin K.</p> <p><em><a href="/providers/dennis-costakos-md" target="_self" title="Opens in same window.">Dennis Costakos, M.D.</a>, is a physician in <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window">Pediatric & Adolescent Medicine</a></em><em> in </em><em><a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a></em><em>, Wisconsin.</em></p> <hr /> <p id="AAP"><em>The American Academy of Pediatrics</em> <a rel="noopener" href="https://publications.aap.org/pediatrics/article/149/3/e2021056036/184866/Vitamin-K-and-the-Newborn-Infant?autologincheck=redirected" target="_blank" title="Opens in a new window."><em>policy statement</em></a><em> is dated Feb. 22, 2022. Dr. Costakos is the first author of one of the cited references for the best dosing of vitamin K for premature babies.</em></p><ul> <li>Folic acid to prevent neural tube defects in minority populations as part of equity and inclusion</li> <li>Hyperbilirubinemia</li> <li>Newborn screening for biotinidase deficiency</li> <li>Predictive analytics</li> <li>Pulmonary surfactant and inter-hospital transfer</li> <li>Vitamin K and the newborn</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Dartmouth Medical School </li> </ul> <p><strong>Residency</strong></p> <ul> <li>Pediatrics, Mount Sinai Hospital</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Neonatal/Perinatal Medicine, New York Hospital/Cornell University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Neonatology, American Board of Pediatrics</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Pediatrics, Fellow in Neonatal-Perinatal Medicine and Epidemiology</li> <li>American Federation for Medical Research</li> <li>American Medical Association</li> <li>Society of Neuroscience </li> <li>Wisconsin Association for Perinatal care</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Pediatrics, Mayo Clinic College of Medicine and Science</li> </ul>Costakos<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/dennis-costakos-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=0A58CB05C01B2118F3FD82CC17315366" alt="Dennis Costakos MD" width="280" height="280" DisableNVelocity="true" /><p>See my publications at <a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/?term=costakos+dt" target="_blank" title="Opens in a new window">PubMed</a>.</p>Dennis<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12794287Dennis Costakos, M.D.1<img src="/-/media/national-files/images/hometown-health/2024/infant-being-held-while-sleeping.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0665F4E1D6FFAF0CFF55C3A664F82099" alt="Infant being held while sleeping" width="660" height="370" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller9/10/2025<p>Looking to cook up something delicious and heart-healthy that doesn't break your food budget? You may already have the solution – beans – in your pantry. Learn about these meal-time rock stars.</p>Dried beans: Rock stars of healthy meals<p>Dried beans may not be a glamorous ingredient, but they're rock stars when making healthy meals. Although they're small and mild-tasting, dried beans can take center stage, such as in black bean burgers or a supporting role like chili. Beans can be served hot or cold; added to soups, stews, salads and sides; mashed for dips or spreads; and seasoned with flavors from global cuisines.</p> <p>It's not just their versatility that makes dried beans shine in healthy meals — it's their nutrition benefits. Dried beans are packed with protein, zinc and iron. They're also high in soluble and fermentable fiber. Soluble fiber promotes bowel regularity and gives you a sense of fullness, while fermentable fiber is a source of prebiotics to <a href="/hometown-health/speaking-of-health/good-bacteria-for-your-gut" target="_self" title="Opens in same window">feed your gut biome</a>.</p> <p>Not only do dried beans promote gut health, but they also can improve blood glucose and cholesterol levels, as well as prevent some types of cancer.</p> <h2>Know your dried beans</h2> <p>The family of dried beans, also known as legumes or pulses, includes peas and lentils. Whether you buy them dried or canned, they're widely available and affordable.<strong> </strong>When cooked, 1 pound of dried beans equals about four cans of beans — at a fraction of the cost. There are so many varieties of beans that meal-making possibilities seem endless.</p> <h3>Here are some types of beans you'll find at your supermarket: </h3> <ul> <li><strong>Black<br /> </strong>Also known as turtle beans, black beans are classic in Latin American cooking. They have a velvety-smooth texture and mild flavor. Because of their dense, meaty texture, they make a great addition to vegetarian dishes. </li> <li><strong>Cannellini<br /> </strong>These mild, starchy white beans often are used in soups and stews, particularly in Italian cooking.</li> <li><strong>Chickpeas<br /> </strong>Also known as garbanzo beans, these round, firm, nutty-tasting legumes are a staple in Mediterranean and Middle Eastern cuisines.</li> <li><strong>Great northern</strong><br /> These large, white beans have a firm texture, making them great for stews and soups.</li> <li><strong>Kidney</strong><br /> Named for their shape, kidney beans are often used in salads and chili. They come in a variety of colors and patterns, including white, cream, black, red, purple, spotted, striped and mottled.</li> <li><strong>Lentils<br /> </strong>Available in a rainbow of colors — red, yellow, brown and black — lentils are tiny and tend to break down when cooked. They're the main ingredient in many dishes around the world.</li> <li><strong>Lima</strong><br /> Rounded and slightly curved, these beans have a buttery flavor and creamy texture, which gives them their other name — butter beans. They hold their shape well when cooked.</li> <li><strong>Navy</strong><br /> These small, white beans cook quicker than other white beans and are the traditional choice for baked beans.</li> <li><strong>Pinto</strong><br /> Small and brownish-pink, pinto beans are frequently used in Mexican and other Latin American cooking, particularly for refried beans, stews and chili.</li> </ul> <h2>Stirring beans into your healthy meals</h2> <p>While canned beans are convenient, perfectly cooked dried beans are superior in texture and taste. Each bean is soft on the inside but maintains its shape. Uncooked dried beans contain a natural toxin, but it's destroyed by cooking. </p> <h3>Here's how to cook dried beans:</h3> <p>Spread one pound of beans on a baking sheet and sort through to remove any stones or debris. Transfer the beans to a colander to rinse off any dust. While presoaking isn't necessary, it reduces cooking time and makes the beans more tender.</p> <h4>To presoak beans:</h4> <ul> <li><strong>Overnight<br /> </strong>Place beans in a large pot and cover with water; let stand overnight. Drain and rinse.</li> <li><strong>Quick soak</strong><br /> Put the beans in a pot on the stove, cover with water and bring to a boil. Turn off the heat and let the beans soak for an hour. Drain and rinse.</li> </ul> <h4>To cook beans:</h4> <ul> <li><strong>Stovetop</strong><br /> Put beans in a pot on the stove, cover with water and bring to a boil. Turn down the heat to simmer and cover the pot. Be sure the beans are always covered with water. Start checking the beans for tenderness after an hour. Depending on their age, size and variety, beans may take one to three hours to cook. Drain and rinse.</li> <li><strong>Slow cooker</strong><strong><br /> </strong>Place beans in a slow cooker and add water. Beans that haven't been presoaked will take four to six hours to cook on high. Drain and rinse. </li> </ul> <p>Now your beans are recipe-ready — or you can freeze them. Divide the beans into containers or freezer bags, and label them with the bean type and date before freezing.</p> <h2>Try this recipe using a white bean of your choice, such as cannellini, great northern or navy beans:</h2> <h3>Pasta with grilled chicken, white beans and mushrooms</h3> <p>Serves 6</p> <p>2 boneless, skinless chicken breasts, 4 ounces each<br /> 1 tablespoon olive oil<br /> 1/2 cup chopped white onion<br /> 1 cup sliced mushrooms<br /> 1 cup white beans, canned or cooked (no salt added)<br /> 2 tablespoons chopped garlic<br /> 1/4 cup chopped fresh basil<br /> 12 ounces uncooked rotelle or rotini pasta<br /> 1/4 cup grated Parmesan cheese<br /> Ground black pepper, to taste</p> <p>Prepare a fire in a charcoal grill or heat a gas grill or a broiler. Away from the heat source, lightly coat the grill rack or broiler pan with cooking spray. Position the cooking rack 4 to 6 inches from the heat source. Grill or broil the chicken until browned and cooked to 165 F, about 5 minutes on each side. Transfer the chicken to a cutting board and let rest 5 minutes before slicing into strips. In a large, nonstick frying pan, heat the olive oil over medium heat. Add the onions and mushrooms and saute until tender, about 5 minutes. Stir in the white beans, garlic, basil and grilled chicken strips. Keep warm.</p> <p>Fill a large pot 3/4 full with water and bring to a boil. Add the pasta and cook until tender, about 10 to 12 minutes, or according to the package directions. Drain the pasta, return it to the pot and add the chicken mixture. Toss to mix evenly. Divide the pasta among the plates. Garnish each with 1 tablespoon Parmesan cheese and black pepper. Serve immediately.</p> <p>Nutrition per a 2 ½-cup serving: 341 calories, 5 grams total fat, 74 milligrams sodium, 53 grams total carbohydrate, 2 grams total sugars, 4 grams fiber, 21 grams protein.</p> <p><em>By Mayo Clinic Health System staff. </em></p><img src="/-/media/national-files/images/hometown-health/2024/bowl-of-beans.jpg?h=370&iar=0&w=660&sc_lang=en&hash=70B9110AF8948B2E15583E95B676EA1E" alt="bowl of beans" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller2/2/2024Game day sports parties are associated with food, friends and fun. Get tips to score big at your next party with a winning lineup of nutritious and delicious food options for your guests.Game day grub: Tips for winning with party food choices<p>Ever wonder why big sports parties and other large gatherings are known for food that's notoriously bad for you? Typically, food brings people together and is associated with friends and fun. Sometimes, people are more excited about the food — whether it's healthy or not — than the game itself.</p> <h2>Some of the most popular foods people bring to parties are:</h2> <ul> <li>Fully loaded nachos</li> <li>Fried chicken wings</li> <li>Takeout pizza</li> </ul> <p>These foods also are often fat-laden offenders. Each of these choices can have between 600 and 1,000 calories in a typical, party-sized portion. For example, two pieces of all-meat pizza contain 720–940 calories and 34–56 grams of fat. Add some nachos and you'll likely eat another 600 calories before you even get to dessert.</p> <h2>Negative effects of unhealthy food</h2> <p>On average, partygoers consume a whole day's worth of calories during these events. The high-fat, high-salt load can temporarily increase blood pressure and lipids in the blood. Generally, you should be able to recover from these spikes without much difficulty. However, if you have <a rel="noopener noreferrer" href="http://www.mayoclinic.org/diseases-conditions/heart-disease/basics/definition/con-20034056" target="_blank" title="Opens in new window">heart disease</a> or <a rel="noopener noreferrer" href="http://www.mayoclinic.org/diseases-conditions/diabetes/basics/definition/con-20033091" target="_blank" title="Opens in new window">diabetes</a>, it can be more serious.</p> <p>Overeating also leads to weight gain, especially around your middle, which can increase your risk of heart disease and diabetes. Thankfully, healthier party food alternatives are available that are both nutritious and delicious.</p> <h2>Healthier food options for your next party</h2> <h3>You don't have to sacrifice nutrition for great taste. A few alternative options include:</h3> <ul> <li><a href="/hometown-health/speaking-of-health/not-just-for-the-fair-lunch-on-a-stick" target="_self" title="Opens in same window">Fruit skewers</a> or a fruit plate</li> <li>Infused or sparkling water</li> <li>Homemade trail mix made with whole-grain cereal and low-sodium nuts and seeds</li> <li>Low-fat, yogurt-based dips</li> <li><a href="/hometown-health/speaking-of-health/discover-popcorns-healthy-side" target="_self" title="Opens in same window">Popcorn</a></li> <li>Roasted chickpeas</li> <li>Veggie tray with <a href="/hometown-health/speaking-of-health/sensible-snacking" target="_self" title="Opens in same window">hummus</a></li> </ul> <h3>Try putting a healthy spin on your game-time favorites:</h3> <ul> <li>Bake or <a href="/hometown-health/speaking-of-health/reasons-to-love-your-new-air-fryer" target="_self" title="Opens in same window">air-fry</a> chicken wings instead of frying them in oil.</li> <li>Load a homemade whole-grain or cauliflower crust with veggies instead of serving an all-meat pizza.</li> <li>Swap whole-grain chips with salsa, pico de gallo or black bean and corn dip instead of cheesy nachos.</li> </ul> <h2>Finding balance with your food choices</h2> <p>You still can have fun and enjoy what you eat when cheering for your favorite team. Abstaining from food, however, often leads to overindulgence later. Balance is the key.</p> <h3>Try these other tips at your next party:</h3> <ul> <li><strong>Assess your options.</strong><br /> Decide what you want to eat, and then be mindful about sticking to your choices.</li> <li><strong>Fill up on veggies first.</strong><br /> This helps you feel full and limits how much higher-calorie fare you eat.</li> <li><strong>Find the best seat in the house.</strong><br /> Look for a place to sit that is away from the food table so you're not tempted to go back for more.</li> <li><strong>Reach for the water pitcher.</strong><br /> <a href="/hometown-health/speaking-of-health/tips-for-drinking-more-water" target="_self" title="Opens in same window">Drinking water</a> will help you feel more satisfied while consuming less food. Alcohol lowers your inhibitions and makes you more likely to overeat.</li> <li><strong>Take your time.</strong><br /> The slower you eat, the fuller you'll feel and the more you’ll enjoy the food.</li> <li><strong>Watch your portion size.</strong><br /> Choose a smaller plate to help <a href="/hometown-health/speaking-of-health/strategies-to-control-portions" target="_self" title="Opens in same window">manage portion size</a>. This makes a big difference in the number of calories you consume.</li> </ul> <h2>Watch this video to get healthy eating tips for your next party:</h2> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/j6R7fDenle4" title="Healthy Eating #1: Tips for your next party" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <p>If chicken wings are your favorite party food, try this recipe at your next gathering. You can cut fat and saturated fat in half and reduce calories by more than 100 by using skinless, boneless, chicken breasts instead of chicken wings.</p> <h3>Boneless chicken tenders</h3> <p>Serves 4</p> <p>Strips:</p> <p>4 4-ounce skinless, boneless chicken breasts, cut into 4 strips each<br /> 1 egg<br /> 1 cup panko<br /> 1/2 teaspoon salt<br /> 1 teaspoon garlic powder<br /> 1 teaspoon onion powder<br /> 1/2 teaspoon white pepper<br /> Spray oil</p> <p>Sauce:</p> <p>1 cup buffalo sauce or favorite wing sauce</p> <p>Preheat the oven to 450 F. Grease a baking sheet well with spray oil. Remove all visible fat from the chicken and cut each breast into 4 strips. In a bowl, whisk the egg. In a separate bowl, combine the panko and dry seasonings. Coat the chicken in egg and then coat with the seasoned panko mixture. Shake off excess panko and lay the chicken breasts on the baking sheet. Lightly coat the chicken in spray oil. Bake for 10-15 minutes until the chicken is 165 F and just firm to the touch.</p> <p>In a sauté pan, heat up the buffalo sauce and toss the chicken tenders in the sauce. Serve with a lower-calorie dressing as a dip.</p> <p>Nutritional per serving (3 chicken strips): 362 calories, 10 grams total fat, 254 milligrams sodium, 41 grams total carbohydrates, 27 grams protein.</p> <p><em><a href="/providers/kristi-wempen-rdn" target="_self" title="Opens in same window"><em>Kristi Wempen</em></a> is a </em><em>registered dietitian nutritionist in </em><em><a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window">Nutrition</a> in <a href="/locations/mankato" target="_self" title="Opens in same window">Mankato</a>, Minnesota.</em></p><ul> <li>Chronic kidney disease</li> <li>General health and wellness</li> <li>Weight management</li> </ul>RDN, LD<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Minnesota State University-Mankato</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Iowa State University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration</li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul> <p><strong>Membership</strong></p> <ul> <li>Academy of Nutrition and Dietetics</li> </ul>Wempen<img src="/-/media/shared-files/images/medical-professionals/full/mankato/kristi-wempen-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=BB7EFDC16603EA67B00B7CD0DBD528E1" alt="Kristi Wempen RDN" width="280" height="280" DisableNVelocity="true" />Kristi<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14834341Kristi Wempen, R.D.N.1{2BEE5070-65FF-4406-9E59-103E06C5A535}<img src="/-/media/national-files/images/hometown-health/2024/crackers-with-veggie-topping.jpg?h=370&iar=0&w=660&sc_lang=en&hash=66E5744BEE11EF56194384459132D4C8" alt="Crackers with veggie topping" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Karen Sperl2/6/2024More than a quarter of the world's adult population is affected by the most common form of chronic liver disease. Learn about a shift underway to redefine steatotic liver disease and raise awareness.Redefining liver health: Understanding steatotic liver disease <p>For many years, nonalcoholic fatty liver disease (NAFLD) has referred to a range of liver conditions that develop when too much fat is stored in the liver cells. It's the most common form of chronic liver disease, affecting 25–30% of the world's adult population, and is on the rise globally.</p> <p>A shift is underway to change the name of fatty liver disease to steatotic liver disease (SLD). Why does the name change matter? The "nonalcoholic" reference doesn't accurately capture the cause of the disease, and "fatty" has a negative association.</p> <h2>Categories of SLD include:</h2> <ul> <li>Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease (NAFLD)</li> <li>MASLD and increased alcohol intake (MetALD)</li> <li>Alcohol-related liver disease (ALD)</li> <li>Specific etiology SLD, which includes drug-induced liver injury and liver disease from celiac disease or malnutrition</li> <li>Cryptogenic SLD, which is liver disease with an uncertain origin</li> </ul> <p>Some people can develop an aggressive form of MADLD called metabolic-associated steatohepatitis, or MASH. The primary concern with MASH is that liver inflammation can progress to advanced scarring, called fibrosis. If inflammation is ongoing, the fibrosis can spread and take up more liver tissue.</p> <p><img alt="Illustration of typical liver and steatotic liver" src="/-/media/national-files/images/hometown-health/2024/liver-illustration.jpg?h=259&w=350&sc_lang=en&hash=6DC22E508D6D8FB374CD1BCF118ACEF1" style="height: 259px; width: 350px; margin-left: 0px;" /></p> <h2>Causes of liver disease</h2> <p>Medical professionals have yet to figure out exactly why fat accumulates in the liver of some people.</p> <h3>Certain factors linked to the condition include:</h3> <ul> <li>Genetics</li> <li>Obesity or being overweight</li> <li>High blood sugar, called hyperglycemia, which can indicate <a href="/hometown-health/speaking-of-health/ive-been-diagnosed-with-prediabetes-what-does-that-mean" target="_self" title="Opens in same window.">prediabetes</a> or Type 2 diabetes</li> <li>High levels of fats in the blood, particularly <a href="/hometown-health/speaking-of-health/know-your-numbers-cholesterol" target="_self" title="Opens in same window.">triglycerides</a></li> </ul> <p>These factors may lead to the accumulation of fat in the liver, which can cause chronic liver disease over time.</p> <h2>Symptoms of liver disease</h2> <p>People with early MASLD often have no symptoms of the disease. General symptoms may include fatigue, not feeling well or pain in the right upper belly area.</p> <h3>When liver disease has progressed to advanced fibrosis or severe scarring of the liver, called cirrhosis, possible symptoms include:</h3> <ul> <li>Abdominal swelling from ascites, which is fluid in the belly</li> <li>Enlarged spleen</li> <li>Gastrointestinal bleeding</li> <li>Itchy skin</li> <li>Mental confusion</li> <li>Shortness of breath</li> <li>Swelling in the legs</li> <li>Yellowing of the eyes and skin, or jaundice</li> </ul> <p>Contact your healthcare professional to discuss your risk factors for liver disease and have any symptoms evaluated.</p> <h2>Getting screened for liver disease</h2> <p>Because there are no obvious signs or symptoms of liver disease in its early stages, it can develop and go undiagnosed for many years. Screening and early diagnosis are crucial for identifying and managing the condition.</p> <p>Several noninvasive screening methods are available, including bloodwork and imaging tests like abdominal ultrasound and transient elastography. Your primary care provider, endocrinologist, cardiologist or gastroenterologist can order these screenings.</p> <p>If a member of your care team determines that you are at increased risk of steatotic liver disease or have advanced fibrosis or cirrhosis, they will likely refer you to a gastroenterologist or hepatologist for evaluation and treatment.</p> <h2>Living with liver disease</h2> <p>You can prevent, slow or improve steatotic liver disease by taking actions that help control the disease. If you're overweight or obese, the first step should be weight loss, combined with a healthy diet and exercise.</p> <h3>Actions you can take include: </h3> <ul> <li><strong>Control your diabetes.</strong><br /> If you have prediabetes or diabetes, ask your healthcare team about being screened for steatotic liver disease. Liver disease affects up to 70% of people with Type 2 diabetes, according to the American Diabetes Association. If you have diabetes, monitor your blood sugar and take your medications as directed by your healthcare team to manage your condition.</li> <li><strong>Eat a healthy diet.</strong><br /> Your meal plan should include fruits, vegetables, lean proteins and whole grains. Avoid sugary drinks and pay attention to portion sizes. Interestingly, drinking at least three <a href="/hometown-health/speaking-of-health/what-are-hidden-sources-of-caffeine" target="_self" title="Opens in same window.">cups of coffee</a> daily is associated with less-advanced liver disease. </li> <li><strong>Exercise and look for ways to be active.</strong><br /> Whether or not you're trying to lose weight, being active is good for you. Try to get at least 30 minutes of exercise most days of the week. If you haven't been exercising regularly, talk with your healthcare team first and then slowly start a routine.</li> <li><strong>Go to your medical appointments.</strong><br /> Liver health is crucial. If you have liver disease, you may have a team of healthcare professionals in primary care, gastroenterology, endocrinology and cardiology working together to assess, manage and treat your condition.</li> <li><strong>Lose weight.</strong><br /> A healthy diet and exercise are effective methods to lose weight. Consider working with a registered dietitian to help evaluate your caloric needs to achieve weight loss. If you're overweight or obese, talk with your healthcare team about weight loss programs or <a href="/hometown-health/speaking-of-health/thinking-about-weight-loss-surgery" target="_self" title="Opens in same window.">bariatric surgery</a>.</li> <li><strong>Lower your cholesterol.</strong><br /> If you have high cholesterol or triglycerides, medication, a <a href="/hometown-health/speaking-of-health/plant-power-to-lower-cancer-risk" target="_self" title="Opens in same window.">plant-based diet</a> and exercise can help keep your blood lipid levels at an average level.</li> <li><strong>Protect your liver.</strong><br /> Drinking alcohol can put extra stress on your liver. Limiting or <a href="/hometown-health/speaking-of-health/effects-of-alcohol-on-your-health-and-liver" target="_self" title="Opens in same window.">avoiding alcohol</a> is typically advised for people with liver disease. Those same steps also can prevent liver disease for people who haven't developed the condition. Follow the instructions on prescription medications and over-the-counter medications. Consult with your healthcare professional before taking herbal supplements. There's no approved or safe way to detoxify your liver, so avoid regimens claiming they can do it.</li> </ul> <h2>Next steps:</h2> <ul> <li><a href="/services-and-treatments/gastroenterology-and-hepatology" target="_self" title="Opens in same window.">Find a gastroenterologist near you</a>.</li> <li>Learn more about <a href="/topics/liver-disease" target="_self" title="Opens in same window.">liver disease</a>.</li> <li>Read <a href="/locations/mankato/services-and-treatments/gastroenterology-and-hepatology/digestive-and-liver-disorders/cirrhosis" target="_self" title="Opens in same window.">how cirrhosis affects your liver</a>.</li> <li>Get <a href="/locations/mankato/services-and-treatments/gastroenterology-and-hepatology/prevention-and-self-care" target="_self" title="Opens in same window.">prevention and self-care tips for your digestive system</a>.</li> </ul> <p><a href="/providers/victoria-louwagie-pac" target="_self" title="Opens in same window."><em>Victoria Louwagie</em></a><em> is a physician assistant in <a href="/locations/mankato/services-and-treatments/gastroenterology-and-hepatology" target="_self" title="Opens in same window.">Gastroenterology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Celiac disease</li> <li>Cirrhosis</li> <li>Eosinophilic esophagitis, also called chronic immune system disease</li> <li>Liver disease</li> </ul>P.A.-C., M.S.<p>I have been a practicing physician assistant in the Mankato area for nearly 10 years. I am a grateful clinician, assistant professor and researcher. It brings me joy to care for my patients and provide disease-oriented, evidence-based medical care. I practice shared decision-making with each of my patients and their loved ones. </p> <p>I am an avid reader, and enjoy spending time with my family, camping and being on the water. </p><p><strong>Education</strong></p> <ul> <li>Master's degree, Physician Assistant Studies, Le Moyne College</li> <li>Certificate, Healthcare Administration and Management, University of Lynchburg</li> <li>Advanced Professional Practice degree, University of Lynchburg</li> </ul> <p><strong>Certification</strong></p> <ul> <li>National Commission on Certification of Physician Assistants (NCCPA)</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Academy of Doctoral Physician Assistants</li> <li>American Academy of Physician Assistants</li> <li>American College of Gastroenterology</li> <li>American Gastroenterological Association</li> <li>Minnesota Academy of Physician Assistants</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li><strong></strong>Assistant Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul> <br /> <br />Louwagie<img src="/-/media/shared-files/images/medical-professionals/full/mankato/victoria-louwagie-pac.jpg?h=280&iar=0&w=280&sc_lang=en&hash=79728B1A24856BB2CA6CA11472FCFFCE" alt="Victoria Louwagie PAC" width="280" height="280" DisableNVelocity="true" />{0EA59485-82F3-48D7-8DCC-7F3F87220D3F}Victoria<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15653421Victoria Louwagie, P.A.-C., M.S.1{DC3A2E5F-C54B-4BFA-AE04-95AE79DD4488}|{CDA27FD1-23E5-4D31-BD85-567A48B862F7}<img src="/-/media/national-files/images/hometown-health/2024/adult-stretching-in-outdoors.jpg?h=370&iar=0&w=660&sc_lang=en&hash=16F40B943692C6B40E8BF39BB3112E6E" alt="Adult stretching in outdoor wilderness area." width="660" height="370" DisableNVelocity="true" />Liver DiseaseLiver disease can be genetic or caused by factors such as viruses, alcohol use and obesity.Gastrointestinal HealthGastroenterology at Mayo Clinic Health System specializes in the prevention, diagnosis and treatment of diseases of the digestive tract.Dawn Haller2/22/2024Hearing you need a test on your heart may be scary, but understanding the purpose of the test can help put you at ease. Learn about common heart tests, and get practical tips to help you prepare.Understanding your heart test: What to expect, how to prepare<p>Heart health is an essential part of your overall health and well-being. Your primary care provider will monitor your blood pressure and lab work during an annual physical exam or more frequently. If you have symptoms that indicate your heart may not be functioning properly, such as blood pressure higher than the recommended level, chest pain or swelling in your feet or legs, you may be <a href="/hometown-health/speaking-of-health/when-to-see-a-cardiologist" target="_self" title="Opens in same window.">referred to a cardiologist</a>.</p> <p>A cardiologist uses diagnostic testing to evaluate the heart's ability to pump and move blood and oxygen throughout your body. Hearing you need a test on your heart may be confusing or scary, so understanding the purpose of the tests can help put you at ease.</p> <p>Learn about various tests to help diagnose heart diseases and conditions.</p> <h2>What's a cardiac stress test?</h2> <p>A cardiac stress test shows how your heart works during physical activity. Also known as an exercise stress test, it can detect problems with blood flow when the heart is pumping faster and harder than usual. The test can be done while walking on a treadmill or riding a stationary bike. Or you may be given a drug to mimic the effects of exercise while in a seated, resting position.</p> <p>You may have a stress test to:</p> <ul> <li>Diagnose if coronary artery disease, which is the buildup of cholesterol deposits or plaques, is causing damage or disease in your coronary arteries.</li> <li><a href="/hometown-health/speaking-of-health/racing-heart-beat-heart-arrhythmia-101" target="_self" title="Opens in same window.">Identify arrhythmias</a> that cause your heart to beat too fast, slow, or irregularly.</li> <li>Determine when to proceed with cardiac surgery or valve replacement treatments.</li> </ul> <p>A nuclear stress test may be recommended if an exercise stress test doesn't reveal the cause of your symptoms. During a nuclear stress test, short-lived radioactive medications are injected into the body and taken up by the heart to create an image of the heart's function at rest and with stress. This medication rapidly leaves the body after the test and is safe and painless.</p> <h2>What's a coronary CT angiogram?</h2> <p>During a coronary CT angiogram, advanced CT technology and injected dye are used to take high-resolution 3D images of your heart. The 3D pictures of the beating heart and major blood vessels are used to identify coronary artery blockages. From the 3D images, your healthcare team can see if there are plaque or calcium deposits in the arteries.</p> <h2>What's an echocardiogram?</h2> <p>Sound waves produce images of your heart during an echocardiogram. This is a common test to see your heart beating and pumping blood. The images from an echocardiogram can help identify heart disease, detect congenital heart defects before birth and check for problems with the valves or chambers of your heart.</p> <h3>You may have one of several types of echocardiograms:</h3> <ul> <li><strong>Transthoracic<br /> </strong>The standard type of echocardiogram that converts sound wave echoes into moving images.</li> <li><strong>Transesophageal</strong><br /> Provides more detailed images than the standard echocardiogram.</li> <li><strong>Doppler</strong><br /> Can be used with transthoracic or transesophageal echocardiogram to measure the speed and direction of blood flow in your heart.</li> <li><strong>Stress</strong><br /> Ultrasound images of your heart before and after physical activity can be used to check for coronary artery problems.</li> </ul> <h2>What's an electrocardiogram?</h2> <p>An electrocardiogram (EKG or ECG) is a noninvasive and painless way to quickly detect heart problems and monitor the heart health of people of all ages. You may have an ECG if you have symptoms such as chest pain, dizziness, confusion, heart palpitations or shortness of breath.</p> <p>Small, adhesive electrodes are attached to your chest, arms and legs during an ECG. The electrodes record the electrical activity of your heart, and the ECG machine prints out a chart of your heart's electrical signals.</p> <h3>An ECG can be used to diagnose many common heart problems and may detect:</h3> <ul> <li>Arrhythmias or <a href="/hometown-health/speaking-of-health/is-it-love-or-atrial-fibrillation" target="_self" title="Opens in same window.">abnormal heart rhythm</a></li> <li>Blocked or narrowed arteries in your heart or coronary artery disease</li> <li>If you have had a previous heart attack</li> </ul> <p>Continuous ECG monitoring may be recommended if your symptoms come and go, which causes difficulty with a standard ECG test.</p> <h3>The two types of remote or continuous monitors are: </h3> <ul> <li><strong>Holter<br /> </strong>A small device you can wear records 24 to 48 hours of continuous ECG monitoring.</li> <li><strong>Event</strong><br /> A portable device that records heart electrical signals for a few minutes at a time, typically over the course of 30 days.</li> </ul> <h2>What you can do to prepare for a heart test</h2> <p>Preparing for diagnostic heart tests helps ensure the results are accurate. Talk with your healthcare team about your questions when preparing for the test recommended specifically for your symptoms.</p> <h3>Here are a few general steps you can take before a heart test:</h3> <ul> <li>Notify your care team of prescription medications, over-the-counter drugs, <a href="/hometown-health/speaking-of-health/do-supplements-help-or-hurt-gut-health" target="_self" title="Opens in same window.">supplements or herbal products</a> you are taking. Your heart can be affected by some medicines. Your healthcare team will tell you if adjustments are needed to your medications for the test.</li> <li>You may need to fast before specific tests. This means you may have to avoid food or beverages before the test. Your healthcare team will give you detailed fasting instructions if necessary.</li> <li>Wear loose, comfortable clothing that allows access to your chest, arms and legs. You may need to wear a hospital gown during the test. Avoid applying lotion, oil or powder to your skin before specific tests, like an ECG.</li> <li>Limit strenuous activity that may elevate your heart rate for a few hours before the test. <a href="/hometown-health/speaking-of-health/what-are-hidden-sources-of-caffeine" target="_self" title="Opens in same window.">Consuming caffeine</a> or nicotine before some tests can affect your heart rate and interfere with the results.</li> <li>Some tests require sedation or other medicine to help you relax. This can affect your ability to drive after the test, so you need to arrange a ride to and from the healthcare facility.</li> <li>Follow specific instructions from your healthcare team.</li> </ul> <h2>Next steps:</h2> <ul> <li>Find a <a href="https://www.mayoclinichealthsystem.org/providers?service=Cardiology" target="_self" title="Opens in same window.">cardiologist near you</a>.</li> <li>Learn about <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiology services</a>.</li> <li><a href="/classes-and-events" target="_self" title="Opens in same window.">Find classes or events</a> to improve your heart health. </li> <li>Read more <a href="/topics/heart-health" target="_self" title="Opens in same window.">heart health articles</a>. </li> </ul> <a href="/providers/michael-meyers-md" target="_self" title="Opens in same window."><em>Michael Meyers, M.D.</em></a><em>, is a <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/sparta" target="_self" title="Opens in same window.">Sparta</a>, Wisconsin.</em> <ul> <li>Cardiac CT angiography</li> <li>Diagnostic angioplasty and invasive hemodynamic assessment</li> <li>Echocardiography</li> </ul> M.D. <p><strong>Education</strong></p> <ul> <li>Medical College of Wisconsin</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Mayo Clinic College of Medicine and Science</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Cardiovascular Disease, Mayo Clinic College of Medicine and Science</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Board of Cardiology</li> <li>American Board of Internal Medicine</li> <li>American College of Cardiology</li> <li>American Heart Association</li> <li>American Medical Association</li> <li>American Society of Echocardiography</li> <li>National Board of Echocardiography</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Medicine, Mayo Clinic College of Medicine and Science</li> </ul> Meyers<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/michael-meyers-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=F4FBD5430D9465FF8CD6B2CD95E99049" alt="Michael Meyers MD" width="280" height="280" DisableNVelocity="true" /> {EF81A87C-A3C8-40D3-AECC-E9803E3AFD04}Michael<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>11197871Michael Meyers, M.D. 1{676428F6-179A-4C9B-9B23-5F1E40032A38}<img src="/-/media/national-files/images/hometown-health/2024/two-people-in-jackets-outdoors.jpg?h=370&iar=0&w=660&sc_lang=en&hash=16CB1505B61A7772BCC086B21023FDD0" alt="Two people in jackets outdoors" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller3/19/2024Bariatric surgery can help you lose weight, but it may offer another benefit: reduced risk of certain cancers. Read more about the link between obesity and cancer, and what the research is revealing. Beyond weight loss: Bariatric surgery may reduce cancer risk<p>When you think about <a href="/locations/mankato/services-and-treatments/bariatric-surgery/about-obesity" target="_self" title="Opens in same window.">obesity</a>, you may not connect it to <a href="/topics/cancer" target="_self" title="Opens in same window.">cancer</a>. However, researchers long have suspected a link between certain cancers and weight. Among those are endometrial, ovarian, colon, liver, pancreatic and postmenopausal breast cancers, which together contribute to 15 to 20% of all cancer deaths in the U.S.</p> <h2>Cancer risk increases with obesity</h2> <p>More than one-third of adults in the U.S. are considered obese with a <a rel="noopener" href="https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-bmi-is-not-the-only-indicator-of-your-overall-health/" target="_blank" title="Opens in a new window.">body mass index (BMI)</a> of 30 or higher. BMI is the <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/obesity/in-depth/bmi-calculator/itt-20084938" target="_blank" title="Opens in a new window.">measure of body fat of body fat based on weight and height</a>. The number of people with severe obesity, which is a BMI of 40 or higher, has increased significantly. According to one study in the New England Journal of Medicine, if a person's BMI goes up by even five points, their cancer risk increases by 10%.</p> <p>Those who are obese are two times more likely to develop cancer than those of optimal weight. For example, the risk for endometrial cancer increases sevenfold with a BMI of more than 40.</p> <p>The greater risk of cancer appears to be due to excess body weight in the form of fat. Obesity causes fat cells in the body to increase. As the number of these fat cells goes up, the body's release of hormones changes. These changes tend to increase pro-inflammatory hormones and estrogen. This chronic inflammatory state can lead to damage in cells and the DNA in them, increasing the risk of certain types of cancers.</p> <p>Researchers are studying the role body fat plays in <a href="/hometown-health/speaking-of-health/want-to-ease-chronic-inflammation" target="_self" title="Opens in same window.">chronic inflammation</a>. In addition, hormones like estrogen and insulin resistance can lead to <a href="/services-and-treatments/endocrinology" target="_self" title="Opens in same window.">chronic metabolic diseases</a>, including diabetes. By 2050, the Centers for Disease Control estimates that 1 in 3 adults <a rel="noopener" href="https://www.cdc.gov/diabetes/about/" target="_blank" title="Opens in a new window.">will have diabetes</a> with its associated health complications.</p> <h2>Bariatric surgery and reduction of cancer risk link</h2> <p>Researchers believe a decrease in inflammatory fat cells could reduce cancer risks, but more research is needed. And it's still unknown to what extent cancer risk is reversed with nonsurgical, also called intentional, weight loss.</p> <p>But for anyone who has lost weight with lifestyle changes, the challenge is keeping it off. The body has many complex neurohormonal systems in place to avoid starvation, making it difficult to maintain weight loss.</p> <p>At this time, <a href="/hometown-health/speaking-of-health/thinking-about-weight-loss-surgery" target="_self" title="Opens in same window.">bariatric or metabolic surgery</a> is the most effective treatment for obesity available, even when compared with medications and intensive lifestyle therapy. After surgery, people typically lose 50 to 70% of their excess weight or 25 to 35% of their total body weight, which often is sustained for many years.</p> <h2>Continuing research</h2> <p>Several large studies have been conducted to explore the link between weight loss through bariatric surgery and the reduction of cancer risk.</p> <p>In a <a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/28938270/" target="_blank" title="Opens in a new window.">2019 article in the Annals of Surgery</a>, more than 22,000 people who had bariatric surgery were compared with 66,000 who didn't. The study participants were matched by sex, age, study site, BMI and other factors. Statistical models were used to look at the incidence of cancer up to 10 years after bariatric surgery compared to nonsurgical participants.</p> <p>Those who had undergone bariatric surgery had a 33% lower risk of developing any type of cancer during the follow-up period compared to those who didn't have bariatric surgery. The results were even stronger when the outcome was restricted to obesity-associated cancers.</p> <p>A <a rel="noopener" href="https://jamanetwork.com/journals/jama/fullarticle/2793220" target="_blank" title="Opens in a new window.">2022 study in the Journal of the American Medical Association</a> followed 30,000 people, all with a BMI greater than 35. The participants were divided into two groups and matched by factors including age and sex. One group of about 5,000 patients had undergone bariatric surgery; the other group of just over 25,000 patients didn't have surgery. The median follow-up period was about six years.</p> <p>The follow-up showed that bariatric surgery was associated with a significant reduction in the risk of obesity-related and other cancers. It also showed that patients who had undergone bariatric surgery had a decrease in cancer-related deaths compared with those who didn't have the surgery.</p> <p>Researchers continue to delve into why and how bariatric surgery is reducing the risk of cancer and diabetes, and more studies are needed to confirm these results. However, there is promise for patients struggling with obesity that bariatric surgery can decrease metabolic diseases like diabetes and possibly the risk of cancer.</p> <p>If you're considering bariatric surgery, this new evidence about its effectiveness and benefits may help you decide. It's another topic to discuss with your primary care provider or <a href="/services-and-treatments/bariatric-surgery" target="_self" title="Opens in same window.">bariatric surgery team</a>.</p> <p><a href="/providers/maria-linnaus-md" target="_self" title="Opens in same window."><em>Maria Linnaus, M.D.</em></a><em>, is a <a href="/services-and-treatments/bariatric-surgery" target="_self" title="Opens in same window.">bariatric surgeon</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p> <ul> <li>Bariatric surgery</li> <li>Complex foregut pathology</li> <li>Endocrine surgery, such as adrenal tumors, thyroid and parathyroid disease</li> <li>Hiatal hernia repair</li> <li>Minimally invasive surgery for gastroesophageal reflux</li> <li>Robotic surgery</li> <li>Surgical research</li> </ul> M.D.<p>I enjoy getting to know my patients on a personal level and taking time to listen to their thoughts and concerns.</p> <p>Outside of the hospital, I enjoy spending time with my husband and children. I also enjoy playing piano, watching baseball and softball, spending time outdoors, and baking and cooking.</p> <p><strong>Education</strong></p> <ul> <li>Creighton University School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>General Surgery, Mayo Clinic Graduate School of Medicine</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Minimally Invasive and Bariatric Surgery, Medical School of Wisconsin</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Certificate of Fellowship Training, Society of American Gastrointestinal and Endoscopic Surgeons</li> <li>General Surgery, American Board of Surgery</li> <li>Satisfactory Training: Metabolic and Bariatric Surgery for Fellows, American Society for Metabolic and Bariatric Surgery</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Medical Association</li> <li>American Society of Metabolic and Bariatric Surgery</li> <li>Society of American Gastrointestinal and Endoscopic Surgeons</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Surgery, Mayo Clinic College of Medicine and Science</li> </ul> Linnaus<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/maria-linnaus-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A9B1D6F1A43E52F2AA5EC35173EC2A1D" alt="Maria Linnaus, M.D." width="280" height="280" DisableNVelocity="true" /> <ul> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/38413304/ " target="_blank" title="Opens in a new window.">Optimizing antibiotic management for patients with acute appendicitis: A quality improvement study</a>, May 2024.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/37031042" target="_blank" title="Opens in a new window.">Implications of routine cholangiography during laparoscopic cholecystectomy on postoperative testing: Review of more than 2,300 cases in a community-based practice</a>, August 2023.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/36912029/" target="_blank" title="Opens in a new window.">The elephant in the residency room</a>, July 2023.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/34845542/" target="_blank" title="Opens in a new window.">Anatomic location and mechanism of hiatal hernia recurrence: A video-based assessment</a>, July 2022.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/33522273/" target="_blank" title="Opens in a new window.">Postoperative opioid utilization and patient satisfaction in general surgery procedures: A prospective observational study</a>, February 2022.</li> </ul> {A16ED5B9-BA90-44AA-BBBD-09A4DC844818}Maria<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15934691Maria Linnaus, M.D. 1{CE631A85-B409-4C11-907C-39868E49E636}<img src="/-/media/national-files/images/hometown-health/2024/couple-smiling-together.jpg?h=370&iar=0&w=660&sc_lang=en&hash=276CF0693CBBD98D12ED080485C27D45" alt="Couple smiling together" width="660" height="370" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Dawn Haller3/4/2024Are you breathing from your belly or chest? Most people chest breathe, but belly breathing is more efficient and offers a wealth of body and mind benefits. Learn how to breathe from your belly.How belly breathing benefits your body, mind<p>From the day you're born, you know how to breathe correctly. That means letting the diaphragm — the large, thin muscle just below the rib cage — do the work of drawing air into the lungs and letting it out. It's known as diaphragmatic or belly breathing, and it's the most efficient and effective way to breathe.</p> <p>But over time, almost everyone needs to remember how. Rather than belly breathing, people begin chest breathing. With chest breathing, the muscles between the ribs and the neck do the harder work of raising and lowering the rib cage to pull air into the lungs and push it out. Chest breathing requires a lot of effort and moves less air.</p> <p>When it comes to the correct way to breathe, it doesn't matter whether you breathe through your nose or your mouth. Where you breathe from matters: your belly and not your chest.</p> <h2>Chest breathing vs. belly breathing</h2> <p>Relaxed breathing should originate primarily from the diaphragm, with little movement of the chest and shoulders. Chest breathing activates accessory respiratory muscles that tighten the neck, chest and vocal cords, and can trigger a fight-or-flight stress reflex.</p> <p>A chest-breathing pattern is useful in short bursts when running from danger. However, prolonged chest breathing can contribute to coughing, hoarseness, tension headaches, chest tightness, shortness of breath and anxiety.</p> <p>Belly breathing promotes a sense of calm relaxation. That's why it's typically part of mindfulness practices and yoga.</p> <h2>Benefits of belly breathing</h2> <p>About 80% of people with <a href="/hometown-health/speaking-of-health/why-are-you-coughing-so-much" target="_self" title="Opens in same window.">chronic cough</a> have more than one factor contributing to symptoms. These can include postnasal drip, <a href="/hometown-health/speaking-of-health/take-the-burn-out-of-gerd" target="_self" title="Opens in same window.">gastroesophageal reflux disease, or GERD,</a> asthma, respiratory infections, throat dryness and inefficient chest breathing, which often is an overlooked <a href="/hometown-health/speaking-of-health/why-are-you-coughing-so-much" target="_self" title="Opens in same window.">cough trigger</a>. People with chronic coughs tend to adopt inefficient breathing habits.</p> <p>Each of these conditions can aggravate the other, and the cough may persist unless the person addresses all contributing factors at the same time.</p> <p>Research has indicated that people with GERD who practice belly breathing after eating reduce how often they experience acid reflux. People with <a href="/hometown-health/speaking-of-health/do-i-have-sleep-apnea" target="_self" title="Opens in same window.">sleep apnea</a> and <a href="/hometown-health/speaking-of-health/6-tips-for-living-with-copd" target="_self" title="Opens in same window.">chronic obstructive pulmonary disease, or COPD</a>, can find some relief with belly breathing to help feel less shortness of breath and anxiety. Belly breathing also can slow your heartbeat and lower or stabilize blood pressure.</p> <p>Mayo Clinic <a rel="noopener noreferrer" href="https://www.mayoclinic.org/departments-centers/pain-rehabilitation-center/sections/overview/ovc-20481691" target="_blank" title="Opens in a new window.">Pain Rehabilitation Centers</a> in Arizona, Florida and Minnesota help people experiencing chronic pain find ways to alleviate or control it. One way is by using <a rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/biofeedback/about/pac-20384664" target="_blank" title="Opens in a new window.">biofeedback</a> to train patients to relax and breathe with their belly, not their chest.</p> <p>Medications can't correct chest breathing. The only solution is practice and patience. Most people can improve their breathing patterns with enough time and attention. As a bonus, you may end up with fewer headaches and less anxiety.</p> <h2>Test your breathing technique</h2> <h3>You can determine how you tend to breathe with a simple test:</h3> <ul> <li>Stand up straight or lie flat on a bed or the floor.</li> <li>Put one hand flat on your chest, the other one flat on your belly. </li> <li>Watch your hands when you inhale and exhale.</li> </ul> <p>If you're chest breathing, the hand on your chest will go up and down. If you're belly breathing, that hand will go up and down. Other signs that you're chest breathing include frequent sighing and yawning, which indicate you're not getting enough air into your lungs.</p> <p>Relearning how to belly breathe takes practice. If you've ever taken a yoga class or done a mindfulness exercise, you likely started with belly breathing practice.</p> <p>Begin your training by repeating the test throughout the day while lying down, standing or sitting with your back straight. As you get more comfortable breathing from your belly, you can try it when you're more active, such as walking. Then build your way up to practicing belly breathing while engaging in more vigorous activities, such as working out, running, mowing the grass or dancing.</p> <h2>Practice reaps results</h2> <p>Don't worry if you revert to chest breathing. Think about it this way: Chest breathing will get you there, just like crawling does. But neither is efficient. As a toddler, you spend countless hours, with plenty of falls and tumbles, learning how to walk so you can get from point A to point B most efficiently. Like walking, belly breathing will become normal to you. Be patient with yourself.</p> <p>Not only is diaphragmatic or belly breathing efficient and powerful, it's also free and has no side effects. Embrace belly breathing, and your body and mind will thank you.</p> <p><em>Richard Crockett, M.D.</em><em>, is an <a href="/services-and-treatments/immunology" target="_self" title="Opens in same window.">allergist</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a> and <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2024/person-in-woods-looking-up.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CD3A77FFFA80040B50D5D9277BA1567C" alt="Person in woods looking up" width="660" height="370" DisableNVelocity="true" />BreathingMost cases of shortness of breath are due to heart or lung conditions. Your heart and lungs are involved in transporting oxygen to your tissues and removing carbon dioxide, and problems with either of these processes affect your breathing.Dawn Haller9/19/2025Social media is awash with images of intricately arranged platters of party tidbits also known as charcuterie boards. When creating one, be sure you're serving up safety along with the snacks.Charcuterie boards: Popular and pretty for party food ― but are they safe?<p>A meat-and-cheese platter paired with a basket of crackers is a go-to appetizer for many parties. Now, these basic platters have been elevated to the next level with the addition of pates, spreads, breads, fresh or dried fruits, and vegetables — both raw and pickled. Served on a wooden board or stone slab, they're a feast for the eye and the taste buds.</p> <h2>As you assemble your picture-perfect charcuterie board, remember to pay attention to food safety and health concerns.</h2> <h3>Keep it clean</h3> <h4>Prepping and assembling a charcuterie board requires a lot of handling of each item, so don't forget the basics: </h4> <ul> <li>Start by <a rel="noopener" href="https://www.cdc.gov/clean-hands/prevention/about-handwashing-a-healthy-habit-in-the-kitchen.html" target="_blank" title="Opens in a new window.">washing your hands</a> for at least 20 seconds with soap and warm water before, during and after preparing food. </li> <li>Always wash your hands after handling uncooked meat, chicken and other poultry, seafood, flour or eggs. </li> <li>Wash your utensils, cutting boards and countertops with hot, soapy water after preparing each food.</li> <li>Wash fresh fruits and vegetables before cutting.</li> <li>Choose a slab or board for serving that you don't use for cutting or other food preparation. Wash it thoroughly.</li> </ul> <h3>Beware of bacteria</h3> <p>No party host wants their guests to take home a nasty bout of food poisoning. Selecting and handling your board's ingredients are key to preventing foodborne illnesses and protecting people at higher risk, which includes those who are younger than 5, older than 65, have a weakened immune system or are pregnant.</p> <p>Pregnant people are more likely to get bacterial illnesses and 10 times more susceptible to a listeria infection. Deli meats, cold cuts and dry sausages can be contaminated with listeria when they're made or packaged. Although cooking, fermenting or drying kills germs, these meats can get contaminated afterward if they touch surfaces carrying listeria.</p> <p>Listeria isn't the only concern. Salmonella also can contaminate foods and has been found in charcuterie meats, as well as raw and frozen, precooked shrimp.</p> <h3>Watch the clock</h3> <p>Bacteria that cause food poisoning multiply quickly at room temperature. Harmful germs can grow in perishable foods, including meat and cut fruit, if they're left out for more than two hours.</p> <p>Pay attention to how long your charcuterie board has been sitting out. To avoid tossing the tidbits after two hours, consider making more than one board. Set out one and refrigerate the others until needed.</p> <h3>Check the cheese</h3> <p>Cheeses made with raw cow's, sheep or goat's milk can make you sick. These can include soft cheeses, such as brie and blue cheese. It's a good idea to check the labels of soft cheeses to ensure they're made from pasteurized milk. In the U.S., cheeses made with raw milk must be aged for at least 60 days. Aging, along with pasteurization, kills bacteria.</p> <h3>Scale back on the sodium</h3> <p>Many ingredients used in charcuterie boards are high in sodium, including deli meats, dry sausages, cheeses, salted nuts, pretzels and crackers. The recommendation for daily sodium intake for adults is 2,300 milligrams or less. To reduce the sodium load on your board, add more fresh or dried fruits and raw veggies. Choose unsalted nuts and low-sodium crackers and pretzels.</p> <h3>Serve it safely</h3> <p>Charcuterie boards are the epitome of finger food. That means lots of fingers touching the food throughout your party. No host wants to play hand-washing police, so give your guests multiple options for picking up their food selections. Have plenty of picks, tongs, spoons and forks at hand. Some foods can be threaded onto skewers or picks before being arranged on the board for easier handling.</p> <p>For a creative option that's great for gatherings with more mingling than sitting, put together charcuterie cups. You can find recyclable and compostable cups in stores or online. Fill each cup with nuts and assorted mini skewers, such as one with a deli meat rosette and a cube of cheese; another with fresh and dried fruit; and one with a variety of olives. Add a couple of crackers, and you have an easy-to-hold, portable appetizer.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2024/charcuterie-boards.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E528714D83AA9656DB64A114986EA7A5" alt="Charcuterie boards" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller3/18/2024In every chapter of your life, you can become overwhelmed by the day-to-day realities and wonder where the joy went. Joy is there, even during difficult times. Learn ways to help you find it.Finding joy in every phase of your life<p>Launching into the adult world, welcoming a child, transitioning to an empty nest or starting retirement — each phase of your life brings a range of emotions. Your initial feelings of excitement often are followed by being overwhelmed with all the unknowns and the demands of everyday life.</p> <p>You may be questioning your job or career choice, longing for one night when the baby doesn't wake you up, missing your kids, or wondering what you'll do with your time when you have nothing but time. This is reality. So where's the joy in that?</p> <h2>Is it joy, or is it happiness?</h2> <p>Joy is there, even during transitional or challenging times, but you have to look for it. First, you need to know what joy isn't and what it is.</p> <p>Joy isn't happiness. <a href="/hometown-health/speaking-of-health/how-to-create-happiness" target="_self" title="Opens in same window.">Happiness</a> is a reaction to things happening around you, like having a fun outing with a friend. When you're struggling, it's harder to be happy, but you can still have joy.</p> <p>Joy is a state of mind. While happiness and joy can be entwined with each other, joy is more profound and longer lasting. Joy can be big, like meeting your soulmate or holding your baby for the first time, or it can be the small things that soothe your spirit. You need to be open to experiencing joy.</p> <p>For example, after a tough day at work, the last thing you want to do is take your dog for a walk on a gray, drizzly spring evening. But as you walk, you begin to notice little green shoots growing in a neighbor's garden, the mild breeze on your face, a cardinal calling from its perch, your dog snuffling along the path. And maybe, when you look up at the sky, the clouds part and you spot a rainbow.</p> <p>By noticing, acknowledging and savoring these moments, you're sparking joy. These sparks accumulate in your brain and support your mental health.</p> <h2>How to find and cultivate joy</h2> <p>How you find and cultivate joy is personal — one size does not fit all. To start, reflect on a time when you did feel joy. What were you doing? Who were you with? Evaluating these times of joy can help you home in on what matters to you.</p> <p>Finding joy is about paying attention to the moment — not looking ahead or ruminating on the past, but experiencing the now.</p> <p>It's easy to jump to the negatives of your life automatically. That's because the brain is hardwired for survival and safety, and anticipating what can go wrong protects you.</p> <p>Have you ever noticed that you fret about hitting all the red lights when driving but don't celebrate the green ones? Finding joy is about carving out an opening for the positives.</p> <h3>By cultivating the pathway for positives, you start seeing them everywhere. Here are some techniques you can practice:</h3> <ul> <li>Appreciate seeing joy in others. When someone else experiences joy, it boosts your own.</li> <li>Count your blessings more. Pay attention when things in your life go smoothly. </li> <li>Do something that will remind you of moments of joy at those times when you don't feel joyful. For example, take photos of joy-filled moments and look through them later.</li> <li>Name three things that happened in the past 24 hours that you're grateful for. <a href="/wellness/gratitude" target="_self" title="Opens in same window.">Gratitude</a> plays into joy.</li> </ul> <h2>Open yourself to joy</h2> <p>When you're struggling, it's hard to be open to positive experiences. It takes practice, but if you feel yourself going down the rabbit hole of negative thoughts and feelings, take a deep breath, pull yourself back and allow joy in.</p> <h3>Explore these other resources for supporting a positive, joyful outlook:</h3> <ul> <li><a href="/hometown-health/speaking-of-health/the-art-of-kindness" target="_self" title="Opens in same window.">Practice the art of kindness.</a></li> <li><a href="/hometown-health/speaking-of-health/use-mindfulness-to-improve-well-being" target="_self" title="Opens in same window.">Use mindfulness to improve well-being.</a></li> <li><a href="/hometown-health/speaking-of-health/purpose-and-mental-health" target="_self" title="Opens in same window.">Find your sense of purpose.</a></li> <li><a href="/hometown-health/speaking-of-health/discovering-calm-in-the-chaos" target="_self" title="Opens in same window.">Discover calm in the chaos.</a></li> <li><a href="/hometown-health/featured-topic/brushing-off-the-social-rust" target="_self" title="Opens in same window.">Ease loneliness through connection.</a></li> </ul> <p><a href="/providers/rosean-bishop-lp" target="_self" title="Opens in same window."><em>Rosean Bishop, Ph.D.</em></a><em>, is a psychologist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Family medicine resident education</li> <li>Integrated behavioral medicine</li> <li>Resilience training</li> </ul>Ph.D., L.P.<p><strong>Education</strong></p> <ul> <li>Doctor of Philosophy, Counseling Psychology, Pennsylvania State University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Counseling Center, University of Rochester, New York</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Counseling Center, Vanderbilt University, Nashville, Tennessee</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Licensed Psychologist, Minnesota Board of Psychology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Psychological Association</li> <li>Minnesota Psychological Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine and Psychology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota</li> </ul>Bishop<img src="/-/media/shared-files/images/medical-professionals/full/mankato/rosean-bishop-phd-lp.jpg?h=200&iar=0&w=200&sc_lang=en&hash=D37783EF34004E64C8CDA884C074F5C1" alt="Rosean Bishop LP" width="200" height="200" DisableNVelocity="true" />Rosean<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15429687Rosean Bishop LP1<img src="/-/media/national-files/images/hometown-health/2024/hand-touching-plants-in-field.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C610EF5C92143BE7F61EBF2A0EFCA417" alt="Hand touching plants in field" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller3/12/2024Decoding "Midwest Nice" can be confusing for newcomers to the region. Learn what lies behind this form of social interaction and how to practice its underlying kindness.Good for you, good for others: Practicing the kindness behind 'Midwest Nice'<p>In the Midwest, and particularly Minnesota, many people have a distinctive way of communicating and relating to others that has earned the region a reputation around the globe for being welcoming and helpful.</p> <p>Visitors and newcomers to the region may experience "Midwest Nice" or "Minnesota Nice" as polite, nonconfrontational and guarded. Residents may be perceived as avoiding challenging topics or giving strong opinions to be seen as open and friendly.</p> <p>Midwest Nice is sometimes described as being passive-aggressive — speaking politely to someone's face while voicing displeasure behind the person's back or through subtle, unkind actions.</p> <h2>The backstory of Midwest and Minnesota Nice</h2> <p>It's thought that Minnesota Nice originated with the first settlers in the area who migrated from Scandinavian countries and Germany. In these cultures, people tend to be socially guarded and slow to warm to others but develop deep, lasting friendships once they open up.</p> <p>People in Scandinavian and German cultures also are known for presenting an appearance of niceness and community mindedness. The present style of social interaction in this region evolved as immigrants to the U.S. slowly began to merge into new communities.</p> <p>This form of communication can feel like second nature for people who are longtime Midwesterners and Minnesotans. It involves learning to adjust your own behavior and responses based on subtle cues that indicate others are becoming upset. People who have developed a lifelong habit of avoiding conflict can feel relief when others do the same.</p> <p>However, conversations can feel like a strange game with secret rules for people who are transplants from other states or countries. People new to the region often speak about how difficult it can be to form friendships and make connections, even though they know they can lean on neighbors and co-workers if they need something in a pinch. It can be frustrating if they feel others are unhappy with them, but can't find someone willing to explain why.</p> <h2>Decoding Midwest and Minnesota Nice social interaction</h2> <p>Like any game, the social interactions associated with Midwest and Minnesota Nice can be decoded. If you're new to the region, try these tips. If you're a resident, they can be used to adjust your own Midwest or Minnesota Nice tendencies and those of other people.</p> <p>One example of being welcoming and helpful is people asking newcomers to meet at a coffee shop or restaurant. However, the reserved side is demonstrated by not inviting the newcomers to visit their more personal spaces, such as their home or a cabin.</p> <p>Overcoming such social reservations may require being a little more assertive on the part of the newcomer. If invitations never escalate, try offering an invitation of your own. Provide clear feedback, such as, "I enjoy spending time with you and would love to get together more often." Then, make a solid plan to do so.</p> <p>To deepen a connection, try to find common ground, whether it's through similar experiences, opinions, values or shared interests. Offer some self-disclosure and see if it's reciprocated. Be patient. Being more aggressive about relationships than people expect might lead them to draw back and hamper your efforts. Meaningful friendships can be formed — it just may take time and effort.</p> <h3>Overcoming passive-aggressive behavior and conflict avoidance can be more difficult. Some strategies include:</h3> <ul> <li>Asking permission before broaching a challenging topic. </li> <li>Speaking in a firm, but kind, manner. </li> <li>Setting an expectation that the topic might need to be addressed in a few short conversations to give people time to cope with any discomfort.</li> </ul> <p>Keep in mind that inaction is still a form of action. Inaction means choosing to maintain the status quo. Making change requires stepping outside your comfort zone.</p> <h2>Being nice and being kind — two halves of a whole</h2> <p>The Oxford Dictionary defines niceness as "the quality of being nice; pleasantness," while its definition of kindness is "the quality of being friendly, generous and considerate." In other words:</p> <ul> <li>Niceness involves not ruffling feathers, making waves or drawing too much attention to yourself. But it can be the first step to kindness.</li> <li>Kindness involves investing more fully in the happiness and well-being of others. Moving from niceness to kindness can be a behavioral goal.</li> </ul> <h3>The benefits of expressing kindness include: </h3> <ul> <li>Encouraging reflection on what you feel grateful for</li> <li>Improving relationships</li> <li>Lifting your mood, increasing your optimism and giving you a spark of happiness </li> <li>Lowering anxiety and stress </li> <li>Promoting overall health and longer life</li> <li>Protecting your mental health and that of others </li> <li>Reducing isolation by creating a stronger sense of belonging </li> <li>Spreading positivity in the world</li> </ul> <h2>Practicing kindness and instilling it in kids</h2> <p>One of the best ways to incorporate kindness into your life is to practice it daily. It starts with having a mindset of looking for ways to brighten the lives of others. You might be surprised by the opportunities to practice kindness when you look for them. Kindness can take the form of small or large acts.</p> <h3>Here are some simple ways to practice kindness:</h3> <ul> <li>Hold a door for the person behind you.</li> <li>Mail a "thinking of you" card to a friend going through a tough time.</li> <li>Notice when someone has dropped something.</li> <li>Offer compliments as well as thank-you's.</li> <li>Send a surprise "good morning" or "good night" text to a loved one.</li> <li>Share or teach your skills with a mentee.</li> <li>Volunteer, whether a one-time experience or a long-term commitment.</li> </ul> <p>To instill kindness in children, teach by example. Involve kids in small acts of kindness, then talk about it afterward to help them understand the effect of their kind acts. Activities like donating a book to a friend or a free neighborhood library, writing a "get well soon" note, speaking kindly and thankfully to people in customer service jobs, and giving genuine compliments to peers are all things children can take part in and continue to practice on their own.</p> <p><a href="/providers/kimberly-haala-phd" target="_self" title="Opens in same window."><em>Kimberly Haala, Ph.D.</em></a><em>, is a clinical health psychologist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Comorbid medical and behavioral health conditions</li> <li>Integrated behavioral health</li> <li>Psychosocial impact of chronic health conditions</li> </ul>Ph.D., L.P.<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Psychology, Minnesota State University-Mankato</li> <li>Master's degree, Clinical Psychology, Oklahoma State University</li> <li>Doctorate of Philosophy, Clinical Psychology, Oklahoma State University</li> </ul> <p><strong>Internship:</strong></p> <ul> <li>Clinical Psychology, Veterans Administration Black Hills Health System</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Minnesota Consortium for Advanced Rural Psychology Training</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Clinical Health Psychology, American Board of Professional Psychology (ABPP)</li> <li>Certificate in Primary Care Behavioral Health</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Psychological Association</li> <li>Association for Behavioral and Cognitive Therapies</li> <li>Society for Health Psychology</li> </ul>Haala<img src="/-/media/shared-files/images/medical-professionals/full/mankato/kimberly-haala-phd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=93F45A61A9FF744E43E1D46CE4A59A2B" alt="Kimberly Haala, Ph.D." width="280" height="280" title="Kimberly Haala, Ph.D." DisableNVelocity="true" />Kimberly<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14884798Kimberly Haala, Ph.D., L.P.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2024/two-people-hugging.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9E172366167047B4AAAEE985B4D99384" alt="Two people hugging" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller3/21/2024Getting children to fall asleep can seem like an elusive goal when they are young. Here's what you need to know about melatonin use in children and how to improve sleep hygiene without a sleep aid.Melatonin use in children: Is a sleep aid supplement safe?<p>Melatonin is a hormone naturally produced in the brain that's linked to your body's sleep and wake cycle. The natural release of melatonin is stimulated by darkness and suppressed by daylight. It's also available as a supplement that you can take as a pill or chewable gummy.</p> <p>As a supplement, a small dose can trigger your body to produce melatonin that makes you feel sleepy and helps you fall asleep.</p> <p>More people are asking their healthcare team about melatonin and report using it, including parents giving it to children. Here's what you need to know about melatonin use in children and how to <a href="/hometown-health/speaking-of-health/sleep-an-essential-element-of-success-for-children" target="_self" title="Opens in same window.">improve sleep hygiene</a> without a sleep aid.</p> <h2>Research on melatonin</h2> <p>In the U.S., melatonin is available over the counter as a dietary supplement. This differs from other countries, such as the United Kingdom, Japan and Australia, where melatonin is regulated as a prescription medication.</p> <p>Research has shown that melatonin generally is safe for short-term use in adults and adolescents. Fewer studies have been done to evaluate the effects of its long-term use and safety. It's also unclear whether melatonin supplements are safe for children.</p> <h2>Melatonin use and side effects</h2> <p>While melatonin can help children fall asleep, it doesn't keep them asleep.</p> <h3>Difficulty falling or staying asleep can be a sign of an issue in the body, including:</h3> <ul> <li>Iron deficiency can cause restlessness during sleep.</li> <li><a href="/hometown-health/speaking-of-health/tonsils-tiny-but-pack-a-big-punch" target="_self" title="Opens in same window.">Enlarged tonsils</a> or adenoids can lead to snoring or obstructive sleep apnea.</li> <li>For children who have nightmares, melatonin may make dreams more vivid, which can worsen sleep.</li> </ul> <p>That's why it's crucial to consult with your child's healthcare team to find and treat issues causing sleep disturbances.</p> <p>Melatonin may be recommended for children with neurological conditions like autism spectrum disorder or <a href="/hometown-health/speaking-of-health/5-tips-to-manage-adhd-in-children" target="_self" title="Opens in same window.">attention-deficit/hyperactivity disorder</a>, or ADHD, and managed with routine evaluation and follow-up by their healthcare team.</p> <p>In gummy form, melatonin supplements can be enticing for children, leading to a risk of overconsumption. Taking a large dose of melatonin can cause gastrointestinal issues or irritability. A large dose also can keep your child's body from naturally producing melatonin to make them sleepy.</p> <h2>Evaluate sleep hygiene</h2> <p>Melatonin use is intended as a short-term aid. When sleep issues are a long-term problem for children, evaluating <a href="/hometown-health/speaking-of-health/5-ways-to-get-better-sleep" target="_self" title="Opens in same window.">sleep habits</a> and the environment can identify the causes of those issues. Many sleep-related disturbances in children can be addressed with a consistent nighttime and sleep routine.</p> <h3>Here are some things to consider when striving for good sleep hygiene:</h3> <ul> <li><strong>Limit screen use.</strong><br /> Looking at a backlight screen tells the brain it's time to be awake and engaged. Watching TV, using a phone or tablet, or playing a video game before bed does not allow your child's brain to relax and prepare for sleep. Stop any <a href="/hometown-health/speaking-of-health/children-and-screen-time" target="_self" title="Opens in same window.">screen use</a> 30 minutes to an hour before bedtime.</li> <li><strong>Have a routine.</strong><br /> A consistent nighttime routine with an age-appropriate bedtime can help with the natural release of melatonin. Taking a bath or shower, reading and quietly relaxing can help set the tone for sleep.</li> <li><strong>Create a sleep-friendly space.</strong><br /> A dark, quiet room is ideal for sleep. Lights should be kept low or dim. Place phones or devices that could make noise and disrupt sleep in another room.</li> <li><strong>Aim for eight to 10 hours of sleep.</strong><br /> Busy schedules and commitments can easily affect sleep schedules for children. Try to keep your child's <a href="/hometown-health/speaking-of-health/is-your-child-getting-enough-sleep" target="_self" title="Opens in same window.">sleep schedule</a> consistent throughout the week for a regular wake/sleep rhythm.</li> </ul> <p><a href="/providers/sarah-scherger-md" target="_self" title="Opens in same window."><em>Sarah Scherger, M.D.</em></a><em>, is a <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">pediatrician</a> in <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>Johns Hopkins Bloomberg School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Department of Pediatric and Adolescent Medicine, Mayo Clinic</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Pediatrics, Mayo Clinic College of Medicine and Science</li> </ul>Scherger<img src="/-/media/shared-files/images/medical-professionals/full/austin/sarah-scherger-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=6AC1E8D2F4C9C1DBE14B11A7201385A8" alt="Sarah Scherger MD" width="280" height="280" DisableNVelocity="true" />Sarah<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15261310Sarah Scherger, M.D.1<img src="/-/media/national-files/images/hometown-health/2024/child-lying-on-floor-reading.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4409941469404B6AD73ED4DF35F63C35" alt="Child lying on floor reading" width="660" height="370" DisableNVelocity="true" />SleepSleep is essential to good health. It's one of the body's basic needs. But, what do you do when you have troubles sleeping, or getting enough hours of sleep? Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller4/22/2024Strokes can happen to anyone at any time. You can go from feeling as usual to feeling sick within a matter of seconds. Be prepared to spot the signs of stroke using these five things to know.5 things to know about stroke<p>A stroke can happen at any time and to anyone. You might be talking to your loved one and notice they're suddenly slurring their words. Or, while grocery shopping, you realize you can't move your hand to pick up a jar from the shelf. You can go from feeling as usual to feeling sick within a matter of seconds to minutes.</p> <h2>Here are five key things to know about stroke:</h2> <h3>1. Strokes affect the oxygen and nutrients supplied to your brain.</h3> <p>Strokes occur when nutrients and oxygen are not delivered to the brain through blood vessels, leading to the death of brain cells. This lack of delivery can be caused by a clot in a blood vessel obstructing the blood flow to the brain, known as an <a href="/hometown-health/speaking-of-health/stroke-what-it-is-and-the-different-types" target="_self" title="Opens in same window.">ischemic stroke</a>, or when a blood vessel ruptures and prevents blood flow to the brain, known as a hemorrhagic stroke.</p> <p>Sometimes, the obstruction to the blood flow and the resulting symptoms are caused by a temporary clot and are transient, resulting in a mini-stroke or transient ischemic attack, or TIA.</p> <h3>2. Strokes can happen to anyone.</h3> <p>Strokes can happen to anyone regardless of age, gender or race. Certain risk factors can put you at a <a href="/hometown-health/speaking-of-health/who-is-most-at-risk-for-a-stroke" target="_self" title="Opens in same window.">higher risk of stroke</a>.</p> <h4>Risk factors are divided into two categories:</h4> <ul> <li><strong>Controllable</strong> — the ones you can control or improve</li> <li><strong>Uncontrollable</strong> — those that are not within your control</li> </ul> <h4>Common controllable risk factors include:</h4> <ul> <li>Atrial fibrillation, which increases stroke risk by five times</li> <li><a href="/hometown-health/speaking-of-health/diabetes-what-you-need-to-know-and-do" target="_self" title="Opens in same window.">Diabetes</a></li> <li>Excessive alcohol intake — an average of more than one drink per day for women or more than two drinks a day for men</li> <li>High blood pressure</li> <li>High cholesterol</li> <li>Illicit drug use</li> <li>Obesity </li> <li>Obstructive sleep apnea</li> <li>Physical inactivity</li> <li>Sickle cell anemia</li> <li>Smoking or <a href="/hometown-health/speaking-of-health/a-doctors-warning-about-the-dangers-of-vaping" target="_self" title="Opens in same window.">vaping</a></li> </ul> <h4>Uncontrollable risk factors include:</h4> <ul> <li>Gender</li> <li>Heredity</li> <li>Increasing age</li> <li>Race</li> </ul> <h3>3. Be prepared to spot the signs of a stroke.</h3> <p>Learn to recognize the <a href="/hometown-health/speaking-of-health/is-it-a-stroke-how-to-know-and-help" target="_self" title="Opens in same window.">signs of stroke</a> quickly.</p> <h4>The American Stroke Association lists these symptoms to help you know when to seek medical care:</h4> <ul> <li><strong>F = Face drooping:</strong> Ask the person to smile and see if the smile is uneven.</li> <li><strong>A = Arm weakness:</strong> Ask the person to raise both arms and see if one arm drifts down.</li> <li><strong>S = Speech difficulty:</strong> Ask the person to speak and see if the speech is slurred.</li> <li><strong>T = Time to call 911:</strong> Stroke is an emergency. Call <a href="tel:911">911</a> at once. Note the time when any of the symptoms first appear.</li> </ul> <h4>Other stroke symptoms to watch for include:</h4> <ul> <li>Numbness of the face, arm or leg, especially on one side of the body</li> <li>Sudden confusion, trouble speaking or difficulty understanding speech</li> <li>Sudden onset severe headache with no known cause</li> <li>Sudden vision issues, such as trouble seeing in one or both eyes</li> <li>Trouble walking, loss of balance, dizziness or coordination</li> </ul> <p>If you or someone you are with have any stroke-like symptoms, seek immediate medical care.</p> <h3>4. A stroke is a medical emergency.</h3> <p><a href="/hometown-health/speaking-of-health/with-stroke-time-is-survival" target="_self" title="Opens in same window.">Every second counts</a> when someone is experiencing a stroke. Once a stroke starts, the brain loses around 1.9 million neurons each minute. For every hour without treatment, the brain loses as many neurons as it typically does in nearly 3.6 years of regular aging.</p> <h4>While waiting for paramedics, do these things if possible:</h4> <ul> <li>If the person is conscious, lay them down on their side with their head slightly raised and supported to prevent falls.</li> <li>Loosen any restrictive clothing that could cause breathing difficulties.</li> <li>If weakness is obvious in any limb, support it and avoid pulling on it when moving the person.</li> <li>If the person is unconscious, check their breathing and pulse, and put them on their side.</li> <li>If they do not have a pulse or are not breathing, start CPR straight away.</li> <li>Do not give them anything to eat or drink if you feel they may have trouble swallowing.</li> </ul> <h3>5. Women have an increased risk of stroke.</h3> <p>According to the American Stroke Association, stroke is the third most common cause of death in women. Over 90,000 women die from a stroke in the U.S. each year. Every 1 in 5 <a href="/hometown-health/speaking-of-health/women-and-stroke-what-you-need-to-know" target="_self" title="Opens in same window.">women will have a stroke</a>, and about 55,000 more women than men have a stroke each year, with Black women having the highest prevalence of stroke.</p> <p>The risk of stroke increases in women who have atrial fibrillation, migraines with aura, smoke, take birth control pills, use hormonal replacement therapy, are pregnant or have preeclampsia.</p> <p>Talk to your healthcare team about your stroke risk and ways to lower your risk by addressing controllable factors.</p> <a href="/providers/prashant-natteru-mbbs-md" target="_self" title="Opens in same window."><em>Prashant Natteru, M.B.B.S., M.D.</em></a><em>, is a <a href="/services-and-treatments/neurology" target="_self" title="Opens in same window.">neurologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em><ul> <li>Botox injection</li> <li>Cervical dystonia</li> <li>Chorea</li> <li>Deep brain stimulation</li> <li>Parkinsonism</li> <li>Seizures</li> <li>Tremors</li> </ul>M.B.B.S, M.D.<p>I am a strong proponent of patient education. It is my firm belief that informed patients make better decisions about their health. In today's world, where information can sometimes be overwhelming or confusing, having an aide or a point of contact for information would be beneficial. I can't promise I will know the answer to all the questions, but we can search for answers together!</p> <p>The other aspect I love is how much I learn from my patients. My patients have taught me things as simple as the best food in town or as complicated as how to negotiate with a car dealer.</p> <p>I provide outreach services in Neurology in Prairie du Chien.</p> <p>I was born and raised in India where I completed my medical school in the beautiful coastal town of Mangalore. I moved to the United States in 2017 to further my medical education.</p> <p>I have received the Robert Currier Award for Excellence in Neurology, Arnold P. Gold Foundation's Humanism and Excellence in Teaching Award and the University of Iowa Graduate Medical Education's Excellence in Teaching Award.</p> <p>In my spare time, I enjoy spending time with family and traveling.</p><p><strong>Education</strong></p> <ul> <li>K.S. Hegde Medical Academy</li> </ul> <p><strong>Internship</strong></p> <ul> <li> Internal Medicine, University of Mississippi Medical Center</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Neurology, University of Mississippi Medical Center</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Epilepsy, Cleveland Clinic Foundation</li> <li>Movement Disorders, University of Iowa</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Epilepsy, American Board of Psychiatry and Neurology</li> <li>Neurology, American Board of Psychiatry and Neurology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Neurology</li> <li>American Epilepsy Society</li> <li>American Neurological Association</li> <li>Gold Humanism Honor Society</li> <li>International League Against Epilepsy – Young Epilepsy Section</li> <li>International Parkinson and Movement Disorder Society</li> <li>Iowa Medical Society</li> <li>National Ataxia Foundation</li> <li>Parkinson and Movement Disorder Alliance</li> </ul>Natteru<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/prashant-natteru-mbbs-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=8363234B53D040A5B6637E9F27E3A649" alt="Prashant Natteru, M.B.B.S, M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/37539415/" target="_blank" title="Opens in new window">New-onset chorea post-COVID-19 infection: A case report</a>, July 2023.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/36285375/" target="_blank" title="Opens in new window">Abdominal compartment syndrome with Super-K (Ketamine) for Super-R(efractory) status epilepticus: A case report</a>, October 2022.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/34327089/" target="_blank" title="Opens in new window">Meningeal hemangiopericytoma presenting as pure Gerstmann syndrome: A double rarity</a>, June 2021.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/33791064/" target="_blank" title="Opens in new window">Primary central nervous system lymphoma mimicking longitudinally extensive transverse myelitis</a>, April 2021.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/33480216/" target="_blank" title="Opens in new window">Paraplegia due to aortic occlusion from a fungal ball</a>, January 2021.</li> </ul>{A264E9F3-76FC-49A7-BE15-075D7AADE94C}Prashant<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30225914Prashant Natteru, M.B.B.S., M.D.1{96029A9E-A1FE-46A4-87D8-46E6ECB9FB56}<img src="/-/media/national-files/images/hometown-health/2024/couple-sitting-on-steps-outside.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1DA2A85B44A7C39A3F74AFDCEED2C2FB" alt="Couple sitting on steps outside" width="660" height="370" DisableNVelocity="true" />StrokeAs one of the leading causes of death in the U.S., stroke will affect 80% of families during their lifetimes, according to the National Stroke Association. And the faster care you receive for stroke, the better. Learn more about stroke prevention, symptoms and treatments here.Stroke AwarenessA stroke occurs when the blood supply to part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and food. A stroke is a medical emergency. Prompt treatment is crucial. Early action can minimize brain damage and potential complications.<br/>Dawn Haller4/11/2024Breakthroughs in hip and knee replacements are reshaping orthopedic care and providing patients with pain-free movement and faster recovery. Learn about these new approaches.Advanced technologies, techniques redefine hip and knee replacements<p>Not so long ago, undergoing a total hip or knee replacement and recovery was a grueling and often painful ordeal. While these are still major surgeries, new techniques and technologies are redefining them — and people's outcomes.</p> <p>Robotic-assisted joint replacement technology has revolutionized hip and knee surgeries. This technology allows the surgeon to:</p> <ul> <li>Perform enhanced, <a rel="noopener" href="https://www.mayoclinic.org/departments-centers/anatomic-modeling-laboratories/overview/ovc-20473121" target="_blank" title="Opens in a new window.">3D preoperative planning and modeling</a> to ensure there's no impingement or pinching of nerves or tissues and to refine implant sizing and positioning for a high degree of accuracy.</li> <li>Prepare the bone and insert the implants with an unprecedented level of precision.</li> <li>Produce outcomes for patients that are more predictable and able to be reproduced in other patients.</li> </ul> <p>In addition, major advances have been made in anesthesia used for total joint replacement surgery in the past five to 10 years. With these advances, patients recover more quickly, and get up and move sooner after surgery with less pain, nausea and vomiting.</p> <p>Another rapidly advancing technology in orthopedic surgery is 3D printing, which allows the designing and creation of custom implants to address challenging problems, including deformities, bone loss and unusual hip or knee anatomy. This promising technology needs more long-term data before it becomes widely used. Mayo Clinic is at the forefront of 3D printing and has been integral in advancing its clinical applications.</p> <p>If a total hip or knee replacement is in your future, here's what you can expect.</p> <h2>Hip replacements</h2> <p>Any patient who is a candidate for a conventional total hip replacement is a candidate for a robotic-assisted total hip replacement.</p> <p>Hip replacements no longer are a one-technique-fits-all approach. With a 360-degree approach, your surgeon can tailor the surgery to you, choosing from direct <a href="/locations/eau-claire/services-and-treatments/orthopedic-surgery/joint" target="_self" title="Opens in same window.">anterior, posterior or anterolateral</a> approaches. The surgeon will discuss these options and the entire surgical experience in detail with you during your pre-op consultation.</p> <p>You'll also have a standardized patient education session with a specialty nurse and pre-op evaluation by a <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapist</a>. These sessions will set you up for success beginning immediately after surgery.</p> <h3>When it comes to recovery and rehabilitation:</h3> <ul> <li>For most patients, total hip replacement surgery is either a <a href="/hometown-health/speaking-of-health/same-day-joint-replacement-surgery-possible" target="_self" title="Opens in same window.">same-day surgery</a> or a one-night hospital stay.</li> <li>Patients can walk and navigate stairs right after surgery.</li> <li>The majority of patients will follow a self-directed physical therapy plan at home, with no need to go to an outpatient physical therapy facility.</li> </ul> <h2>Knee replacements</h2> <p>As with hip replacements, any patient who is a <a href="/hometown-health/speaking-of-health/is-it-time-for-a-total-knee-replacement" target="_self" title="Opens in same window.">candidate for a conventional total knee replacement</a> is a candidate for robotic-assisted total knee replacement. You'll also take part in a comprehensive education experience and physical therapy assessment to review the technique your surgeon will use during surgery.</p> <p>Like hip replacements, total knee replacements typically are same-day surgeries or may involve a one-night hospital stay.</p> <p>Once you've awakened from the anesthesia, you can walk and navigate stairs. About one week after surgery, you'll begin meeting with a physical therapist who specializes in working with knee-replacement patients. For best results with strength and range of motion, you'll also be assigned daily exercises to do at home to supplement your physical therapy sessions at an outpatient facility.</p> <p>The excellent news for total knee and hip replacement patients is that the techniques and technologies for these surgeries continue to evolve. The primary goals are to reduce pain, enhance function, and get patients back to their day-to-day activities and those they love to do.</p> <h2>Next steps:</h2> <ul> <li>Learn about the <a href="/hometown-health/speaking-of-health/top-5-reasons-for-joint-replacement" target="_self" title="Opens in same window.">top five reasons a joint replacement may be in your future</a>.</li> <li>Watch this video as I explain robotic-assisted joint replacement surgery: <div> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/cKdzHuQlcdg" title="Robotic-assisted orthopedic surgery" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> </div> </li> <li>Read more about <a href="/hometown-health/speaking-of-health/robotic-orthopedic-surgery-accuracy" target="_self" title="Opens in same window.">robotic-assisted joint replacements</a>.</li> <li>Watch and listen to Mark Greatens, M.D., explain what you can expect after joint replacement surgery: <div> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/FaBAoY-ATHg" title="What to expect after joint replacement surgery" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> </div> </li> </ul> <p><a href="/providers/brandon-bukowski-md" target="_self" title="Opens in same window."><em>Brandon Bukowski, M.D.</em></a><em>, is an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgeon</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p> M.D. <p>It is an honor to return to Mayo Clinic and join the practice in Mankato. I look forward to using my foundational training in orthopedic surgery in combination with my subspecialty training in adult reconstruction and joint replacement surgery. I want to provide the most innovative and highest quality of care to our community.</p> <p>In my free time, I enjoy spending time outdoors with family, watching hockey (Go Mavs!) and biking.</p> <p><strong>Education</strong></p> <ul> <li>University of Wisconsin School of Medicine and Public Health</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Orthopedic Surgery-Adult Reconstruction, New York-Presbyterian Hospital</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Minnesota State Medical License</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Orthopedic Surgeons</li> <li>American Association of Hip and Knee Surgeons</li> <li>American Medical Association </li> <li>Mid-America Orthopedic Association </li> <li>Minnesota Medical Society</li> <li>Wisconsin Medical Society</li> </ul>Bukowski<img src="/-/media/shared-files/images/medical-professionals/full/mankato/brandon-bukowski-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=88F8A1E6631E587712A8C1745E6F232F" alt="Brandon Bukowski, M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/35307528/" target="_blank" title="Opens in new window">Extended oral antibiotic prophylaxis after aseptic revision TKA: Does it decrease infection risk?</a>, August 2022.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/35256235/" target="_blank" title="Opens in new window">Pairing 40-mm femoral heads with the smallest compatible acetabular components in THA: Mid-term outcomes in 177 cases</a>, July 2022.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/33622530/" target="_blank" title="Opens in new window">The Lawrence D. Dorr Surgical Techniques & Technologies Award: Using big heads and small acetabular components with highly cross-linked polyethylene in total hip arthroplasty: Is it safe?</a>, July, 2021.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/33602587/" target="_blank" title="Opens in new window">Primary total hip arthroplasty in patients with ankylosing spondylitis</a>, July 2021.</li> <li><a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/32418748/" target="_blank" title="Opens in new window">Revision total hip arthroplasty in patients with ankylosing spondylitis: Long-term results</a>, September 2020.</li> </ul>{DA7E6471-164C-43A5-A43F-0AAF8E8FE25D}Brandon<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20196547Brandon Bukowski, M.D. 1{DEF55970-853F-4E96-9A4D-3413874FF059}<img src="/-/media/national-files/images/hometown-health/2024/two-people-talking-by-fire-ring.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0701DDF306711180B0155E88D4DD0624" alt="Two people talking by fire ring" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller4/15/2024The exchange of information is critical for patients and healthcare professionals. Read how two patients who are deaf connect with healthcare through their in-person interpreter.Beyond words: ASL interpreter creates bridge between deaf patients, healthcare<p>Even the most routine medical appointment can be stressful for patients. Now imagine that you can't hear what healthcare professionals are saying while you're giving birth, learning that you have a serious health problem, accompanying your children or elderly parents to their appointments, or coping with unfamiliar medical terms.</p> <p>While some deaf people can lip-read, there are still barriers. For example: </p> <ul> <li>Being ill or groggy from anesthesia can complicate visual communication.</li> <li>If a healthcare professional is wearing a mask, lip reading isn't possible, and essential aspects of the message, like facial expressions, aren't available.</li> <li>Medical terms may be hard to understand.</li> <li>Some words or letters can be difficult to distinguish, such as meet and met, or the letters T, D and K.</li> <li>The healthcare staff may turn away while talking.</li> <li>There may be a side conversation concerning your issue.</li> </ul> <p>"Lip reading takes a lot of brain power because it's so intense, and it can be exhausting," says Theresa Lewis of West Salem, Wisconsin. "You can miss a lot of what's being communicated."</p> <p>Theresa and her husband both are deaf, and Theresa often accompanies him and her 93-year-old mother-in-law to medical appointments. So she also needs to know about any follow-up care, prescriptions and updates on her mother-in-law's health.</p> <p><img alt="ASL Theresa and Colleen" style="width:350px; height:267px;" src="/-/media/national-files/images/hometown-health/2024/asl-theresa-and-colleen.jpg?h=267&w=350&sc_lang=en&hash=5903213DDB44FB3D49397031C2316027" /></p> <p>"Having an in-person interpreter with us makes sure that we're getting the whole picture and 100% of what we need to know," says Theresa.</p> <p>Evie Seifert of Sparta, Wisconsin, has three daughters ages 17, 15 and 7. Evie is deaf, but her children can hear. Like any parent, she accompanies them to their healthcare appointments, whether for routine care and immunizations or something more serious like a broken arm.</p> <p>"I want to make sure that I can follow up on what their providers say," Evie says. "When reading lips, you can never take your eyes off the person speaking, and I worry about missing something. I want to have the same access to information as my daughters."</p> <h2>Enhancing healthcare communication, understanding</h2> <p>Enter Colleen Cudo, supervisor for <a href="/locations/la-crosse/patients-and-visitors/accessibility-to-services" target="_self" title="Opens in same window.">Language Services</a> for Mayo Clinic Health System in La Crosse, Wisconsin, who works with Theresa and Evie. Fluent in <a rel="noopener" href="https://www.nidcd.nih.gov/health/american-sign-language" target="_blank" title="Opens in a new window.">American Sign Language</a>, or ASL, Colleen has more than 30 years of experience as an interpreter. She explains that ASL is a combination of letters, words, body language and facial expressions to enhance communication.</p> <p>"English and ASL are like two different languages," Colleen says. "As interpreters, we consider ourselves word nerds. We work hard to know what we're scheduled for and do our homework about medical terminology that may come up during an appointment, so we're prepared. During an office visit, we also get clarification from our client's healthcare professionals and present it in terms our client will understand."</p> <p>For instance, a healthcare professional may ask, "When was the first day of your last period?" But, Colleen says, that doesn't make sense in sign language, so the most common way to pose the question is, "When did your most recent period start?"</p> <p>Colleen and the other in-person interpreters consider themselves just that: interpreters. They're the third person in the room and are careful not to add an opinion or insert themselves in any other way between the patient and healthcare professional. They also strictly uphold patient privacy.</p> <p>But they're still compassionate with the message. "We do more than interpret," Colleen says. "Sometimes we're communicating bad news, such as a serious condition or even life-ending diagnosis. Through our signing and body language, we can convey not only the words but also our empathy."</p> <p>While there are tools for helping with interpretation, such as tablets and smartphones, those tools aren't always effective in certain healthcare settings. They also can experience delays or freeze, leaving the patient without access to vital information or instructions. It's also not appropriate for the healthcare team to rely on a family member, such as a child, to interpret for a patient.</p> <p>Theresa says, "I've been asked why my son can't interpret, but he's not a certified medical interpreter, and I want to keep my conversations private. Having my son at a mammogram? No way."</p> <h2>Being there for patients</h2> <p>Whether in the Emergency Department or Birthing Center, Colleen and other interpreters are there for their clients, often providing their services any time of the day and night.</p> <p>Colleen was at Evie's side when her youngest daughter was born.</p> <p>"It was wonderful, and my labor was fast," Evie says, "but there were so many people in the room and so much going on. Colleen was my support system, providing interpretation for words I didn't understand. She was so impressive. I can't imagine what it would have been like if she hadn't been there."</p> <p><img alt="ASL Evie and Colleen" style="width:351px; height:263px;" src="/-/media/national-files/images/hometown-health/2024/asl-evie-and-colleen.jpg?h=263&w=351&sc_lang=en&hash=CA0F861F4F46A3A1EA269A893AAC0405" /></p> <p>Evie confesses that when she first started seeing healthcare staff at the clinic, she didn't use an in-person interpreter because she didn't feel comfortable having a stranger at her office visits. Instead, she and her care team communicated by writing, which had its own drawbacks, leading to some miscommunication.</p> <p>"It was a lot of writing, mostly with our smartphones," she says. Then she met Colleen. </p> <p>"We became close, and I totally trust her," Evie says. "I trust her confidentiality and medical knowledge, and appreciate her accessibility. I also know that having her interpret reduces confusion and increases understanding."</p> <p>Theresa feels the same way.</p> <p>"Having an in-person interpreter helps me communicate better with my providers. I trust Colleen to make sure we all understand each other," she says.</p> <p>That's one of the satisfactions Colleen gets from interpreting for her clients.</p> <p>"It's so amazing and rewarding when someone's face lights up because they understand what's being said," she says.</p> <p>Gaining that understanding is something Evie appreciates. "I never take accessibility for granted," she says. "Mayo Clinic is world-class, and offering in-person interpretation makes it world-class for all patients."</p><img src="/-/media/national-files/images/hometown-health/2024/person-using-sign-language.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CA4B66B6C91BB7CD0027FB22978BE1D8" alt="Person using sign language" width="660" height="370" DisableNVelocity="true" />Ear HealthAn audiologist specializes in evaluating and treating people of all ages with hearing loss, dizziness and balance disorders. Specialty audiology consultation is available for assessment and treatment of hearing loss, tinnitus, dizziness and balance disorders.Speech-LanguageThe evaluation and treatment of communication disorders and swallowing disorders.Dawn Haller4/10/2024Almost half of Americans report using their smartphones four to five hours daily. Your posture and the time spent using a screened device can increase your chances of having a "tech neck."'Tech neck': Technology's effect on your neck<p>Are you looking at your phone right now? Stop and evaluate your posture. Is your head down to look at your device? You're not alone.</p> <p>On average, people spend <a rel="noopener" href="https://explodingtopics.com/blog/smartphone-usage-stats#top-smartphone-stats" target="_blank" title="Opens in a new window.">three hours and 15 minutes </a>on their phones daily, checking them an average of 58 times each day. Almost half of Americans say they spend an average of four to five hours on their smartphones daily. </p> <p>Some people spend eight or more hours using a computer during the workday. After work, you may spend another two to four hours on a home computer or your phone. The combined time spent <a href="/hometown-health/speaking-of-health/whats-your-familys-digital-diet-plan-for-2018" target="_self" title="Opens in same window.">using a screened device</a> is highly fatiguing for your neck and body.</p> <h2>The problem of pressure</h2> <p>Bending your head forward at a 45-degree angle to look at a cellphone or tablet can dramatically increase your chances of having a "tech neck."</p> <p>You can use an analogy with a gallon of milk to help understand the pressure of supporting your head on the neck, shoulders and back. The average adult's head weighs approximately 10-12 pounds, while a gallon of milk weighs roughly eight pounds. You can likely hold a gallon of milk next to your body for an extended length of time. But if you extend your arm to hold the gallon of milk out to your side, you're creating 72 pounds of pressure at your elbow and 96 pounds at your shoulder. Holding the gallon of milk outstretched for an extended period would be more difficult due to the pressure from the weight. </p> <p>Your neck and <a href="/hometown-health/speaking-of-health/exercises-for-a-happy-back" target="_self" title="Opens in same window.">upper back muscles</a> feel the same pressure from the weight of your head when spending extended time looking down at electronic devices. As a result, "tech neck" is becoming a more common issue for people in businesses, schools and industry.</p> <p>Neck pain is the fourth leading cause of disability, with an annual prevalence rate exceeding 30%. Most episodes of acute neck pain will resolve with or without treatment, but nearly 50% of those people will continue to experience some degree of fatigue or discomfort from frequent recurrences.</p> <h2>What is tech neck?</h2> <p>Tech neck is any form of chronic neck or <a href="/hometown-health/speaking-of-health/why-does-my-shoulder-ache" target="_self" title="Opens in same window.">shoulder pain</a>, soreness or stiffness caused by poor posture while using technology, such as phones or computers. </p> <p>Looking down at electronic devices causes the neck muscles to strain and the shoulders to slump forward. Musculoskeletal fatigue and pressure on the nerve supply in the neck can cause pain in the neck, which also can cause referred pain in the arms and hands. Over time, staying in this position can increase the force and effort on your shoulders, neck and upper back muscles and put uneven pressure on your spine. </p> <p>Your <a href="/hometown-health/speaking-of-health/proper-posture-is-important-for-good-health">posture</a> also can contribute to these issues. While using a cellphone, you're likely to bring it closer to your body to maintain visual comfort and see the screen more clearly. People looking at their phones often stay in a static or same position for extremely long periods of time. This actually requires more work and effort from your body than dynamic movement. </p> <p>Your body wants to have visual comfort over postural comfort. This means you will tend to change your posture to accommodate vision with your screen and can cause musculoskeletal fatigue. </p> <p>Tech neck also can cause issues beyond your neck and shoulders. Extra spinal pressure in your neck can lead to mid and lower-back pain as well as <a href="/hometown-health/speaking-of-health/common-questions-about-headaches" target="_self" title="Opens in same window.">headaches</a>.</p> <p>As you age, the discs of your spine become narrowed, and you lose some of the support they provide. This leads to more pressure on the nerve roots that emerge from the spine at the base of the neck. Some people may notice an increased level of fatigue and discomfort.</p> <p>While children may be less affected by poor posture and lack of ergonomics, the effects of those issues can take a toll on their bodies as they grow. As early as your 20s, muscle fatigue can set in and cause more strain and sprain. It's critical to ensure young people consistently stretch, change positions and <a href="/hometown-health/featured-topic/the-importance-of-movement" target="_self" title="Opens in same window.">move throughout the day</a> to avoid neck and back strain.</p> <h2>Ways to decrease the strain of tech neck</h2> <p>You can decrease the pressure caused by tech neck by placing pillows on your lap to support your forearms. Try to hold the phone in a more upright, angled position to improve visual comfort. </p> <h3>Ways to improve your computer posture include:</h3> <ul> <li>Place your screen 20–30 inches away from your eyes, which is about an arm's length.</li> <li>Use a computer monitor or laptop stand to help raise your screen to the right level. Your eye height should be about 1/2 inch to 1½ inches higher than the top characters on your screen to allow for a 15-degree eye gaze.</li> <li>Sit with your head, hips and spine stacked.</li> <li>Keep your wrists straight and your elbows bent at about 90-degree angles.</li> <li>Keep your knees aligned with your hips and your feet flat on the floor.</li> </ul> <p>When you are looking straight ahead, your neck, back and upper shoulder muscles get a chance to relax. This prevents uneven pressure on the nerve supply of these muscle groups.</p> <p>The goal is to stay in a <a rel="noopener" href="https://www.osha.gov/etools/computer-workstations" target="_blank" title="Opens in a new window.">neutral, supported, upright posture</a> while using screened devices. Focus on keeping your head upright with your ears over your shoulders and your shoulders over your hips.</p> <p>Also, look for ways to build movement into your day after being in a static position like sitting. Remember, your next posture is your best posture.</p> <em>Brian Langenhorst is an industrial and ergonomics specialist in <a href="/services-and-treatments/occupational-health" target="_self" title="Opens in same window.">Occupational Medicine</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em><img src="/-/media/national-files/images/hometown-health/2024/sitting-typing-on-laptop.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6EB58BBB5D551A3BF72E0D288FF377F2" alt="Sitting typing on laptop" width="660" height="370" DisableNVelocity="true" />HeadacheHeadache is pain in any region of the head that feels like a sharp pain, throbbing sensation or dull ache. It may develop gradually or suddenly, and last for minutes or days.Occupational MedicineBusiness success depends upon the productivity of the workforce. Occupational medicine helps businesses and organizations prevent and manage occupational and environmental injuries, illnesses and disabilities.Dawn Haller4/17/2024Tammy LeDoux wasn't sure what to expect when she volunteered for a genetic testing study. The results revealed a surprising condition that led her to take preventive action for her health.Genetic screening reveals surprising condition<p>When Tammy LeDoux heard about a DNA sequencing research study, she opted to participate out of curiosity to learn more about her ancestry. She never imagined the outcome would lead to finding a tumor the size of a pineapple growing on her left ovary. Or that precancerous polyps were lurking in her stomach and colon.</p> <p>The surprising discoveries came after Tammy underwent genetic screening through the <a rel="noopener" href="https://www.mayo.edu/research/centers-programs/center-individualized-medicine" target="_blank" title="Opens in a new window.">Mayo Clinic Center for Individualized Medicine</a>.</p> <p>"The results came back that I have <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/lynch-syndrome/symptoms-causes/syc-20374714" target="_blank" title="Opens in a new window.">Lynch syndrome</a>, which I'd never heard of," says Tammy.</p> <p>The disorder is associated with an 80% risk of <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/colon-cancer/symptoms-causes/syc-20353669" target="_blank" title="Opens in a new window.">colorectal cancer</a>, and a 50% risk of uterine and endometrial cancer.</p> <p>"I couldn't believe it. I'm beyond grateful. I feel like I've been given this look inside to things that could have happened to me in the future," says Tammy, an information technology analyst from Menomonie, Wisconsin.</p> <p>Tammy's experience mirrors that of many other patients who were unaware of their disease risk before participating in the center's DNA sequencing research study called Tapestry.</p> <p>Along with roughly 100,000 people who chose to participate in the Tapestry study, Tammy was screened for three hereditary conditions: familial hypercholesterolemia (hereditary high cholesterol), hereditary breast and <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/ovarian-cancer/symptoms-causes/syc-20375941" target="_blank" title="Opens in a new window.">ovarian cancer</a> (BRCA1 and BRCA2), and Lynch syndrome.</p> <h2>Tammy's journey with Lynch syndrome</h2> <p>Upon receiving her genetic screening results, Tammy met with <a href="/services-and-treatments/medical-genetics" target="_self" title="Opens in same window.">genetic counselor</a>s twice to learn about her risks of different types of cancers.</p> <p>During follow-up appointments, Tammy's care team educated her on Lynch syndrome and helped schedule various screenings. </p> <p>She had a uterine biopsy at <a href="/locations/menomonie" target="_self" title="Opens in same window.">Mayo Clinic Health System in Menomonie</a>, in addition to an upper endoscopy, colonoscopy and ultrasound. These screenings uncovered eight polyps in her stomach and two colon polyps, some with precancerous characteristics.</p> <p>Three concerning moles on her skin were removed by Tammy's dermatologist, <a href="/providers/patrice-hicks-md" target="_self" title="Opens in same window.">Patrice Hicks, M.D.</a>, at <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Mayo Clinic Health System in Eau Claire</a>.</p> <p>After speaking with her care team and learning that the risk of having endometrial cancer was 80% to 90%, she decided to undergo a hysterectomy to reduce her cancer risk.</p> <p>"The immediate recommendation from my doctors was to have a preventive hysterectomy," explains Tammy. "The care between Mayo Clinic Health System and Rochester providers was seamless. Everybody was on the same page, and everything was just like clockwork."</p> <p>It was during this procedure at <a rel="noopener" href="https://www.mayoclinic.org/" target="_blank" title="Opens in a new window.">Mayo Clinic</a> in Rochester, Minnesota, that surgeons discovered and removed the sizable benign tumor on her left ovary.</p> <p>"I never had any cramping. I never had any pain. I never felt anything hard or lumpy in my abdomen or down in my pelvic area. I never knew anything was there," says Tammy.</p> <h2>Seeing the value of genetic screening</h2> <p>While Tammy didn't know what to expect when she volunteered, researchers leading the Tapestry study anticipated that nearly 2% of participants would receive a positive result from the screenings based on existing literature.</p> <p>"We need to do a better job of educating people about the value of genetic screening for rare, but preventable, conditions," says <a rel="noopener" href="https://www.mayo.edu/research/centers-programs/center-individualized-medicine/about/director-insights" target="_blank" title="Opens in a new window.">Konstantinos Lazaridis, M.D.,</a> the Carlson and Nelson Endowed Executive Director for Mayo Clinic's Center for Individualized Medicine.</p> <p>Dr. Lazaridis says Mayo Clinic is advancing the idea of bringing genetic screening to routine patient care to help identify patients at high risk for cancer and other diseases, enabling earlier screening and mitigating the risk of cancer, the need to use expensive and limited therapies for advanced disease, and reducing premature deaths.</p> <p>The goal is to coordinate care with earlier diagnosis and treatment from genetic testing and counseling to benefit more patients, as it did for Tammy.</p> <h2>Tammy's positive outlook</h2> <p>One year later, Tammy looks back on the steps she's taken to be proactive about her health and keep a positive outlook during that time.</p> <p>"I've been through the wringer, but now I have peace of mind knowing I've reduced my risks for cancer," she says.</p> <p>When people ask her about her experience, Tammy is open about sharing the benefits of routine screenings and preventive care.</p> <p>"It's good to know because you can be proactive about your care, and you're going to have a much better result than waiting until symptoms show up," she says.</p> <p>Tammy recently met with her primary care provider, <a href="/providers/jessica-winterfeldt-md" target="_self" title="Opens in same window.">Jessica Winterfeldt, M.D.</a>, at Mayo Clinic Health System in Menomonie for a follow-up appointment. </p> <p>"She said, 'Well, it's good to see you. You've been through a lot this last year.'" recalls Tammy.</p> <p>Going forward, Tammy will continue to have a colonoscopy and endoscopy every two years and see her dermatologist every six months.</p> <p>"There's so much preventive care I can do now versus what I didn't know," says Tammy. "I honestly feel like knowing these genetic results has saved my life."</p><img src="/-/media/national-files/images/hometown-health/2024/tammy-ledoux.jpg?h=370&iar=0&w=660&sc_lang=en&hash=38D882E2AE562C4370E376F9C78B2633" alt="Tammy LeDoux" width="660" height="370" DisableNVelocity="true" />Genetic TestingGenetic testing examines your DNA — the chemical database that carries instructions for your body's functions — to reveal changes or alterations in your genes that may cause illness or disease. <br/><br/>CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Colorectal HealthGet screening and treatment for colorectal cancer symptoms, and learn about risk factors and prevention strategies.Pelvic Health<p>Pelvic health disorders are common for women and men, and can be physically and emotionally disruptive to daily life. Our multidisciplinary specialists can evaluate pelvic health problems and design personalized treatment plans to relieve your symptoms.</p><br/><h2>Specialties that provide pelvic health care include:</h2><br/><ul><li><strong><a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a></strong><br />Provides annual pap smears, STI checks and referrals to additional services from Physical Therapy, OB-GYN and Urology.</li><br/><li><strong><a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">Physical Therapy</a></strong><br />Provides treatment for pelvic floor dysfunction, urinary and fecal incontinence, postural changes, weakened core, back pain and more.</li><br/><li><strong><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></strong><br />Provides treatment for incontinence, frequent and urgent urination, pelvic pressure or heaviness, pelvic pain, sexual problems and more with various options, including lifestyle changes, medication, physical therapy and advanced minimally invasive surgery.</li><br/><li><strong><a href="/services-and-treatments/urology" target="_self" title="Opens in same window.">Urology</a></strong><br />Provides treatment for testicular and prostate cancer, enlarged prostate, erectile dysfunction and bladder issues, such as incontinence, frequent and urgent urination, inability to stop urination flow, inability to empty the bladder.</li></ul><br/><h2>Learn more about pelvic health:</h2><br/>Skin CancerSkin cancer — the abnormal growth of skin cells — most often develops on skin exposed to the sun. But this common form of cancer can also occur on areas of your skin not ordinarily exposed to sunlight.Dawn Haller4/18/2024Minutes count when someone overdoses on opioids. That's why it's important to administer the over-the-counter, overdose-reversal medication naloxone. Read what you can do to save a life.Naloxone overdose intervention: When minutes count<p>News coverage and headlines document an epidemic in the U.S.: the <a href="/hometown-health/speaking-of-health/do-you-have-addictive-personality-traits-video" target="_self" title="Opens in same window.">surge of opioid addiction</a> and deaths affecting every community in the country. Since 1999, more than 1 million Americans have died from drug overdoses. In 2023, more than 112,000 people lost their lives to overdoses, with 88% due primarily to synthetic opioids like <a rel="noopener" href="https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-minute-benefits-dangers-of-fentanyl/" target="_blank" title="Opens in a new window.">fentanyl</a>.</p> <h2>The drugs behind the epidemic</h2> <p>Opioids are one of the most commonly prescribed medications to treat acute pain. This class of drugs includes medications such as fentanyl, <a rel="noopener" href="https://www.mayoclinic.org/drugs-supplements/morphine-oral-route/description/drg-20074216" target="_blank" title="Opens in a new window.">morphine</a> and <a rel="noopener" href="https://www.mayoclinic.org/drugs-supplements/oxycodone-oral-route/description/drg-20074193" target="_blank" title="Opens in a new window.">oxycodone</a>. They work by blocking pain receptors in the central nervous system.</p> <p>What makes opioids effective is also what makes them dangerous due to the risks associated with addiction and overdoses.</p> <p>Fentanyl is the drug most responsible for the high rates of addiction and overdose. The market for illicitly manufactured fentanyl continues to change, and the drug can be found in combination with heroin, counterfeit pills and cocaine.</p> <h2>Signs of an overdose</h2> <h3>Recognizing the signs of opioid overdose can save a life. Things to look for include:</h3> <ul> <li>Choking or gurgling sounds</li> <li>Cold and clammy skin</li> <li>Discolored skin, especially lips and nails</li> <li>Falling asleep or losing consciousness</li> <li>Limp body</li> <li>Slow, weak or no breathing</li> <li>Slurred speech or confusion</li> <li>Small, constricted pinpoint pupils</li> </ul> <p>Death from a fentanyl overdose can happen quickly. That's why it's crucial to <a rel="noopener" href="https://newsnetwork.mayoclinic.org/discussion/three-things-to-know-when-using-narcan-during-an-opioid-overdose/" target="_blank" title="Opens in a new window.">intervene</a> if you suspect someone is overdosing.</p> <h2>Reversing an overdose with naloxone</h2> <p>The <a rel="noopener" href="https://www.fda.gov/" target="_blank" title="Opens in a new window.">Food and Drug Administration</a> has approved a rescue medicine called <a rel="noopener" href="https://www.mayoclinic.org/drugs-supplements/naloxone-nasal-route/description/drg-20165181" target="_blank" title="Opens in a new window.">naloxone</a>, or Narcan. It quickly <a rel="noopener" href="https://www.cdc.gov/stop-overdose/caring/naloxone.html" target="_blank" title="Opens in a new window.">reverses an overdose</a> by blocking the effects of opioids. Naloxone can restore normal breathing within two to three minutes in a person whose breath has slowed or recently stopped. While giving naloxone to someone who doesn't have opioids in their system won't hurt them, be aware that it can't reverse an overdose of every drug.</p> <p>This lifesaving medication is now <a rel="noopener" href="https://newsnetwork.mayoclinic.org/discussion/what-is-naloxone-and-should-everyone-have-access-to-it/" target="_blank" title="Opens in a new window.">available over the counter</a> as a 4-milligram nasal spray. It's being sold in pharmacies without a prescription, but also is becoming available at grocery stores, convenience stores, vending machines and other retail locations. The cost typically is less than $50 for a two-spray pack.</p> <p>Due to naloxone's effectiveness in reviving people experiencing an overdose, many organizations and government entities offer it for free. People also are beginning to carry a naloxone pack in their vehicle or first aid kit.</p> <h3>If you suspect someone is overdosing:</h3> <ul> <li>Call 911 immediately.</li> <li>Administer naloxone. Due to the strength of some opioids like fentanyl, more than one dose may be needed.</li> <li>Try to keep the person awake and breathing.</li> <li>Lay them on their side to prevent choking.</li> <li>Stay with them until emergency assistance arrives.</li> </ul> <p>If you're concerned about being liable for administering naloxone, the <a rel="noopener" href="https://www.gao.gov/products/gao-21-248" target="_blank" title="Opens in a new window.">majority of states</a> have passed good Samaritan and naloxone access laws, which protects people without medical training who administer the medication.</p> <h2>Seeking help for addictions</h2> <p>Medications and other <a href="/locations/faribault/services-and-treatments/addiction-treatment" target="_self" title="Opens in same window.">recovery strategies</a> are available for people struggling with <a href="/services-and-treatments/addiction-treatment" target="_self" title="Opens in same window.">addiction</a>. Contact your primary care provider or other healthcare professional to discuss available options.</p> <em><a href="/providers/glenn-kauppila-do" target="_self" title="Opens in same window.">Glenn Kauppila, D.O.</a></em><em>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in Eau Claire, Wisconsin, with special interest in </em><em>addiction.</em> <ul> <li>Addiction treatment (alcohol and other substances)</li> <li>Chronic disease management (diabetes, hypertension, etc.)</li> <li>Exercise and healthy eating</li> <li>Health and Wellness promotion</li> </ul> D.O.<p>My practice philosophy is to see you as a whole person and address all of those aspects to promote health and wellness through the ages. As a physician, my role is to advise and partner with you as you travel along the journey of your life. Taking the time to listen to you is most important. I use an evidence-based approach to utilize the best and most current science to diagnose and treat. </p> <p>I have additional training in the care of those with alcohol and other substance addictions.</p> <p>Outside of the practice of medicine, I enjoy spending time with my family, travel and running ultra-marathons.</p><p><strong>Education</strong></p> <ul> <li>A.T. Still University – Kirksville College of Osteopathic Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Family Medicine, Horizon Health System</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Practice, Henry Ford Health System/Michigan State University</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Addiction Medicine, University of Wisconsin-Madison</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Family Medicine, American College of Osteopathic Family Practitioners</li> <li>Department of Transportation (DOT) Exams</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Society of Addiction Medicine</li> <li>Wisconsin Medical Society</li> <li>Wisconsin Society of Addiction Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Kauppila<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/glenn-kauppila-do.JPG?h=280&iar=0&w=280&sc_lang=en&hash=3FF4643FE207A1FCEE384E7F78F88C0C" alt="Glenn Kauppila, D.O." width="280" height="280" DisableNVelocity="true" /> <ul> <li><a rel="noopener noreferrer" href="https://www.aafp.org/afp/2021/0301/p272.html" target="_blank" title="Opens in a new window.">Alcoholics Anonymous and other 12-step Facilitation Programs for Alcohol Use Disorder</a>, March 2021</li> </ul> {B8C019FF-98BC-40C6-BAF8-0ADE2A7503A0}Glenn<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16129652Glenn Kauppila, D.O. 1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{67744200-E25F-439A-8B70-572A5A091172}<img src="/-/media/national-files/images/hometown-health/2024/interlaced-fingers-multiple-hands.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6013CF5B26BE1763DAD35DE14EA222A8" alt="Interlaced fingers of multiple hands" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Substance AbuseInformation for helping those with alcohol and other drug abuse concerns.Dawn Haller9/18/2025Medical conditions, weight-loss goals, athletic performance and more can have you puzzled about what eating plan best fits you. A registered dietitian nutritionist can help you solve the puzzle.Deciphering your eating plan FAQ: How a registered dietitian nutritionist can help<p>Do you want to <a href="/hometown-health/speaking-of-health/organizing-and-executing-weight-loss-goals" target="_self" title="Opens in same window.">lose or gain weight</a>? Are you <a href="/hometown-health/speaking-of-health/5-ways-to-prepare-before-starting-a-family" target="_self" title="Opens in same window.">pregnant</a>, looking to become pregnant or just had a child? Are you looking for ways to maintain your health in your older years? Are you an athlete looking to <a href="/hometown-health/speaking-of-health/5-nutrition-tips-to-maximize-your-workouts" target="_self" title="Opens in same window.">boost performance</a>?</p> <h2>Check out this FAQ on how a registered dietitian nutritionist, or RDN, can help you decipher the eating plan that works best for you.</h2> <h3>When does it make sense to work with an RDN and what are the benefits?</h3> <p>Lifestyle changes, such as following a <a href="/hometown-health/speaking-of-health/use-95210-to-refresh-healthy-habits" target="_self" title="Opens in same window.">healthy eating plan</a>, achieving a healthy weight and regularly engaging in <a href="/hometown-health/doctors-orders/need-to-exercise-start-slowly" target="_self" title="Opens in same window.">physical activity</a>, can significantly improve your health, reduce your risk of developing <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">chronic illnesses</a> and help you <a href="/hometown-health/speaking-of-health/3-tips-for-living-well-with-chronic-conditions" target="_self" title="Opens in same window.">manage symptoms</a> or slow the progression of current chronic illnesses.</p> <p>Working with an RDN who can provide expert, science-based advice as you make these changes can improve your long-term success.</p> <h3>What kind of training does an RDN have?</h3> <p>RDNs are food and nutrition experts who have graduated with at least a bachelor's degree in nutrition, completed an accredited supervised dietetic internship and passed a national examination. They also must meet ongoing continuing professional education requirements to maintain their registration.</p> <h3>Where do RDNs work?</h3> <p>RDNs can work in various environments including healthcare, food service, private practice and community settings. They also can attain additional certifications in specialized areas, such as pediatrics, renal nutrition, oncology and diabetes education.</p> <h3>Why do I need an RDN? Can't I just figure this out myself?</h3> <p>An RDN will partner with you to develop a safe and realistic eating plan that you can stick with for the long haul. To guide and motivate you, an RDN will use creative and out-of-the-box strategies to help with meal planning, grocery shopping and mindful eating.</p> <h3>What can I expect when I meet with an RDN?</h3> <p>Your RDN will thoroughly review with you your medical history, current diet and eating habits.</p> <h4>Then, with your input, the RDN will develop a nutrition plan that takes into consideration your:</h4> <ul> <li>Food preferences, allergies and intolerances </li> <li>Lifestyle </li> <li>Finances </li> <li>Ability to shop for and prepare food </li> <li>Multiple or conflicting dietary needs</li> </ul> <p>The focus will be on foods to include, not just what to avoid. The RDN also will help you identify barriers to success, provide strategies for overcoming them and provide additional guidance as you set goals for yourself.</p> <h3>How do I start working with an RDN?</h3> <p>Most often you'll need a referral from your healthcare professional to work with an RDN. The cost of these visits varies depending on insurance type and coverage. Ask your healthcare professional for a referral to a registered dietitian nutritionist and get started <a href="/topics/eat-well" target="_self" title="Opens in same window.">maximizing your nutrition</a> for a better quality of life.</p> <h4>Try one of these dietitian-approved recipes:</h4> <p><strong>Parmesan roasted cauliflower</strong></p> <p>By Mayo Clinic staff<br /> Serves 6</p> <p>1/2 cup panko breadcrumbs<br /> 1/4 cup finely grated Parmesan cheese<br /> 2 tablespoons olive oil<br /> 1 teaspoon fresh lemon zest<br /> 1 teaspoon finely chopped fresh basil<br /> 1/4 teaspoon paprika<br /> 1/4 teaspoon kosher salt<br /> 3 cups small cauliflower florets</p> <p>Fill a medium pot with water and bring to a boil. Heat oven to 375 F. Lightly coat an 8-by-8-inch baking dish with cooking spray. In a small bowl, combine the breadcrumbs, cheese, oil, lemon zest, basil, paprika and salt. Use your hands to evenly combine the mixture. Place the cauliflower in boiling water for 3 minutes, then drain in a colander. Place the cauliflower in the baking dish and sprinkle the breadcrumb mixture evenly over the top. Bake for about 15 minutes or until crust is lightly brown.</p> <p>Nutritional per 1/2-cup serving: 84 calories, 6 grams fat, 1 gram saturated fat, 163 milligrams sodium, 6 grams carbohydrates, 1 gram fiber, 3 grams protein.</p> <p><strong>Whole-wheat blueberry pancakes </strong></p> <p>By Mayo Clinic staff<br /> Serves 6</p> <p>1 1/3 cup white whole-wheat flour<br /> 2 teaspoons baking powder<br /> 1 tablespoon sugar<br /> 1/2 teaspoon cinnamon<br /> 1 1/3 cups skim milk<br /> 1 egg, lightly beaten<br /> 1 tablespoon canola oil<br /> 1 cup fresh or frozen blueberries</p> <p>In a large bowl, mix flour, baking powder, sugar and cinnamon. In another bowl, beat together milk, egg and oil. Add the liquid mixture to the flour mixture and stir until the flour is moistened. Add blueberries and stir gently. Coat a griddle or skillet with cooking spray and heat to medium-high heat. Pour about 1/4 cup of batter onto the hot griddle and cook until browned. Flip and brown the other side.</p> <p>Nutritional per 2-pancake serving: 163 calories, 4 grams fat, 1 gram saturated fat, 29 grams carbohydrates, 4 grams fiber, 203 milligrams sodium, 7 grams protein.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2024/meal-prepping-in-jars.jpg?h=370&iar=0&w=660&sc_lang=en&hash=862F4D4717724DC473E06FE6327C5B25" alt="Meal prepping in jars" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller4/24/2024Diagnosing autism spectrum disorder can be challenging because of the distinctive pattern of symptoms. Learn about evolving awareness and treatments for neurodivergent conditions.Understanding autism: The path to diagnosis, awareness and support<p>Diagnosing a person with autism spectrum disorder can be challenging. It's a medical condition that no blood test, brain scan or objective test can pinpoint. And because of each person's distinctive pattern of symptoms, it can be hard to determine its severity.</p> <p>As people gain familiarity with autism, however, they are becoming more open to discussing the diagnosis and seeking treatment. Society is also becoming more motivated to learn about neurodivergent conditions, including autism.</p> <h2>What is autism spectrum disorder?</h2> <p><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/symptoms-causes/syc-20352928" target="_blank" title="Opens in a new window.">Autism spectrum disorder</a> is a condition related to brain development that affects how a person perceives and socializes with others, causing problems in social interaction and communication. It includes conditions that previously were considered separate, including autism, Asperger's syndrome, childhood disintegrative disorder and an unspecified form of pervasive developmental disorder.</p> <p>Autism affects children and adults in three areas: communication, social interaction and behaviors. <a href="/hometown-health/speaking-of-health/could-my-child-have-autism-spectrum-disorder" target="_self" title="Opens in same window.">Children with autism spectrum disorder</a> may struggle with recognizing their emotions and may feel them more intensely. Regulating their anger and frustration can be difficult and lead to intense bursts of emotions. Children with autism also have higher rates of anxiety and depression.</p> <p>Each child with autism spectrum disorder is likely to have a distinctive pattern of behavior and level of severity. A healthcare professional will generally describe the severity of the condition based on the person's level of impairments and how those affect their ability to function.</p> <h3>A child or adult with autism spectrum disorder may have problems with social interaction and communication skills, including any of these signs:</h3> <ul> <li>Can't start a conversation, keep one going or can only start one to make requests or label items.</li> <li>Doesn't appear to understand simple questions or directions.</li> <li>Doesn't express emotions or feelings and appears unaware of others' feelings.</li> <li>Doesn't speak or has delayed speech.</li> <li>Fails to respond to their name or appears not to hear you sometimes.</li> <li>Has difficulty recognizing nonverbal cues, such as interpreting other people's facial expressions, body postures or tone of voice.</li> <li>Has poor eye contact and lacks facial expression.</li> <li>Inappropriately approaches a social interaction by being passive, aggressive or disruptive.</li> <li>Prefers playing alone.</li> <li>Repeats words or phrases verbatim but doesn't understand how to use them.</li> </ul> <h2>Awareness of autism behaviors</h2> <p>According to the <a rel="noopener" href="https://publications.aap.org/aapnews/news/23904/CDC-Autism-rate-rises-to-1-in-36-children" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention (CDC)</a>, the latest research from 2023 shows that 1 in 36 children was diagnosed with autism. This is an increase from 1 in 44 children just <a rel="noopener" href="https://www.cdc.gov/mmwr/volumes/72/ss/ss7202a1.htm?s_cid=ss7202a1_e&ACSTrackingID=USCDC_921-DM101985&ACSTrackingLabel=This%20Week%20in%20MMWR%20-%20Vol.%2072%2C%20March%2024%2C%202023&deliveryName=USCDC_921-DM101985" target="_blank" title="Opens in a new window.">two years ago</a>.</p> <p>Children tend to become more aware of their diagnosis around puberty. Kids recognize their differences from their peers and notice their struggle to fit in. They might notice they're not being invited to participate in certain activities or being accepted in the same way as many of their peers. Social interactions become more crucial for young people in middle and high school, which can be stressful for someone on the autism spectrum. </p> <p>Parents may notice symptoms early on when they see how their child's behaviors, communication and social interactions differ from their peer group. It can be challenging for parents to accept that their child is different from other children. Parents may feel guilty and responsible, even though this developmental condition has no known cause.</p> <h2>Living with autism spectrum disorder</h2> <p>As the number of people living with autism spectrum disorder increases, it's critical to seek out educational opportunities that can help with understanding autism spectrum disorder. What are the strengths and disadvantages of the child? How can that knowledge be used to strengthen the skills of a child with autism? Answering these questions can help identify specific interventions to teach skills relevant to the child. </p> <p>For example, if a child struggles with regulating emotions, this can be addressed through <a href="/hometown-health/speaking-of-health/autism-treatments-and-therapies" target="_self" title="Opens in same window.">treatment</a> to help them gain more control over their emotions and behaviors.</p> <p>No cure exists for autism spectrum disorder, and there's no one-size-fits-all treatment. The goal of treatment is to maximize your child's ability to function by reducing their autism spectrum disorder symptoms and <a href="/hometown-health/speaking-of-health/helping-your-childs-education-through-an-iep-or-504-plan" target="_self" title="Opens in same window.">supporting their development and learning</a>. Early intervention during the preschool years is key.</p> <h3>Treatment options may include:</h3> <ul> <li>Behavior and communication therapies</li> <li>Educational therapies</li> <li>Family therapies</li> <li>Medications</li> </ul> <p>When you have a child or loved one with autism, the chance of them having anxiety or depression is increased. Evaluating and treating these symptoms can improve their level of functioning and their overall mental health. </p> <p>One of the most critical things parents, friends or classmates of someone diagnosed with autism spectrum disorder can do is educate yourself about it while recognizing their strengths.</p> <p>You can develop increased compassion for your loved ones, classmates, friends and colleagues by recognizing and understanding more about the condition. While you can't eliminate a child's autism or wait for them to outgrow it, you can minimize some of its symptoms and improve quality of life.</p> <p><a href="/providers/janice-schreier-lcsw" target="_self" title="Opens in same window."><em>Janice Schreier</em></a><em> is a child and adolescent clinical therapist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Anxiety</li> <li>Attention deficit hyperactivity disorder</li> <li>Bipolar disorders</li> <li>Chemical dependency</li> <li>Depression</li> <li>Eating disorders</li> <li>Facilitates social skills groups for adolescents with autism spectrum disorders</li> <li>Individual, family and group therapy</li> <li>Obsessive-compulsive disorders</li> <li>Post-traumatic stress disorder</li> <li>Reactive attachment disorder</li> <li>Trauma</li> <li>Treatment for children 7–17 and young adults</li> </ul>L.C.S.W.<p><strong>Education</strong></p> <ul> <li>Addiction Counseling, Viterbo University</li> <li>Bachelor's degree, Social Work, University of Wisconsin-La Crosse</li> <li>Master's degree, Social Work, University of Wisconsin-Milwaukee</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Autism Spectrum Disorders</li> <li>Licensed Clinical Social Worker, Substance Abuse Specialty</li> </ul>Schreier<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/janice-schreier-msw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=42215A8A31EDEE2903AC5F89E6D23B11" alt="Janice Schreier MSW" width="280" height="280" DisableNVelocity="true" />Janice<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15449963Janice Schreier, L.C.S.W.1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2024/kids-crafting-outdoors.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D15FC8BB6B9B4FD64DFC6FCB52F01E4B" alt="Kids crafting outdoors" width="660" height="370" DisableNVelocity="true" />AutismAutism is one of a group of serious developmental problems called autism spectrum disorders that appear in early childhood — usually before age 3. Though symptoms and severity vary, all autism spectrum disorders affect a child's ability to communicate and interact with others.<br /><br /><br/><br/>While there is no cure for autism, intensive, early treatment can make a big difference in the lives of many children with the disorder.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller5/14/2024High blood pressure can be dangerous when there aren't symptoms indicating a problem. Learn why your blood pressure matters and the risk factors you can change in your lifestyle.6 ways to manage high blood pressure<p>One of the most dangerous health conditions is also one of the sneakiest.</p> <p><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410" target="_blank" title="Opens in a new window.">High blood pressure</a>, also known as hypertension, often is called the "silent killer" because most people who have it don't have any symptoms. That silence can be deadly. </p> <p>High blood pressure can lead to a host of serious problems, including <a href="/hometown-health/speaking-of-health/what-should-i-do-if-i-might-be-having-a-heart-attack" target="_self" title="Opens in same window.">heart attack</a>, heart failure and <a href="/hometown-health/speaking-of-health/5-things-to-know-about-stroke" target="_self" title="Opens in same window.">stroke</a>. That's why it's crucial to know your risk factors for developing high blood pressure — and take steps to lower your risks.</p> <h2>Why your blood pressure matters</h2> <p>High blood pressure can cause significant damage to your heart, eyes, <a href="/hometown-health/speaking-of-health/5-nutrition-tips-for-chronic-kidney-disease" target="_self" title="Opens in same window.">kidneys</a>, brain and blood vessels. Left untreated, this can lead to kidney failure or vision loss.</p> <p>High blood pressure can also affect your ability to think, remember and learn. There's even a type of dementia — <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/vascular-dementia/symptoms-causes/syc-20378793" target="_blank" title="Opens in a new window.">vascular dementia</a> — caused by high blood pressure.</p> <h2>What you can do about high blood pressure</h2> <p><a href="/hometown-health/speaking-of-health/know-your-heart-health-numbers" target="_self" title="Opens in same window.">Know your numbers</a> — and act on them.</p> <p>People 40 and older, or anyone younger with risk factors, should have their blood pressure checked by a healthcare professional once a year. Younger people without risk factors should be checked at least every two years.</p> <p>Blood pressure should be less than 120/80. If it's consistently above the recommended level, lifestyle changes, medication or a combination of the two can usually bring it down to a healthy level.</p> <p>If your blood pressure is elevated, discuss lifestyle changes or medications to lower it with your healthcare team.</p> <h2>Risk factors you can't change</h2> <p>Unless you can turn back time, your risk of developing blood pressure is going up. That's because risk increases as you age.</p> <p>High blood pressure tends to run in families, so if one of your parents or a sibling has the condition, you're also more likely to have it. Your race may also increase your risk. High blood pressure is more common — and often more severe — among African Americans.</p> <h2>Risk factors you can change</h2> <p>Lifestyle changes play a role in controlling high blood pressure. Making changes to your habits and daily activities might prevent, delay or reduce the need to take medication to manage high blood pressure. </p> <h3>Consider these six lifestyle changes to help control blood pressure:</h3> <ul> <li><strong>Manage your stress.</strong><br /> Long-term stress may also play a role in developing the condition, either by temporarily increasing your blood pressure or by leading you toward unhealthy coping strategies, such as smoking or drinking too much alcohol. <a href="/hometown-health/speaking-of-health/setting-boundaries-for-well-being" target="_self" title="Opens in same window.">Set boundaries</a> to help you learn to say no. Make time for your hobbies and activities with friends and family that bring you joy.</li> <li><strong>Monitor your blood pressure.</strong><br /> Keep tabs on your blood pressure numbers to make sure any lifestyle modifications and medications are working as intended. Talk to your healthcare team about using a home blood pressure monitor to track your numbers. Attending your regular visits with your healthcare team is crucial to making sure your blood pressure is well-controlled.</li> <li><strong>Quit smoking.</strong><br /> If you smoke, vape or use chewing tobacco, it's time to quit. Tobacco temporarily raises blood pressure in the short term and can damage artery walls over time. <a href="/hometown-health/speaking-of-health/a-smokers-guide-to-quitting" target="_self" title="Opens in same window.">Breaking the habit</a> is one of the best things you can do for your health. Several effective medications are available to help people quit.</li> <li><strong>Skip the sodium.</strong><br /> Too much salt can cause you to retain fluid, which increases blood pressure. Limit salt to 2,300 milligrams a day or less. A lower sodium intake of 1,500 milligrams a day or less is ideal for most adults, especially those with high blood pressure. Salt hides in all processed foods, like hot dogs, lunch meats, pickles and all canned foods. Read food labels and look for low-sodium versions of foods. Use herbs and spices for added flavor in foods rather than reaching for the salt.</li> <li><strong>Track your exercise.</strong><br /> Aim for 150 minutes of physical activity a week. That's only 30 minutes five times throughout the week. Regular exercise can lower your blood pressure, help strengthen your heart muscle and also may help you lose weight. Walking, jogging and swimming are popular aerobic exercises. Consider adding interval training or strength training after consulting with your healthcare team.</li> <li><strong>Watch your waistline.</strong><br /> Blood pressure may increase as body weight increases, so weight loss is one of the most effective lifestyle changes for blood pressure control. Particularly, carrying too much weight around your waist can increase hypertension risk.</li> </ul> <h2>Next steps:</h2> <ul> <li><a href="https://www.mayoclinichealthsystem.org/providers?service=Primary%20Care&populateTracking=True" target="_self" title="Opens in same window.">Find a primary care provider</a> near you.</li> <li>Get the <a href="/-/media/national-files/documents/hometown-health/2019/get-the-facts-high-blood-pressure.pdf?sc_lang=en&hash=938229F6EA80675E1B647E093FB1D162" target="_blank" title="Opens in a new window.">facts on high blood pressure</a> (PDF).</li> <li>Watch a video to learn more about high blood pressure:<br /> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/dWYMAK2lsvw" title="Know your numbers: Blood pressure" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> </li> </ul> <p><a href="/providers/philip-van-huigenbos-do" target="_self" title="Opens in same window."><em>Philip van Huigenbos, D.O.</em></a><em>, is a <a href="/services-and-treatments/family-medicine">Family Medicine</a> physician in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin. </em></p><ul> <li>High blood pressure</li> <li>Osteopathic manipulative treatment</li> </ul>D.O.<p>I am a resident in the Mayo Clinic Family Medicine Residency Program in Eau Claire.</p> <p>I am a big believer in preventive medicine to help prolong my patients' lifespan and quality of life while simultaneously reducing the cost of their healthcare. I do my best to collaborate with my patients to identify their healthcare goals and values and provide the best care that aligns with these goals and values.</p> <p>I enjoy participating in outdoor recreation with my wife and our dog. During my residency training, I do not have as much time for outdoor recreation as I would like, but I love to hike, camp, bike, kayak, canoe, sail, swim and fish.</p><p><strong>Education</strong></p> <ul> <li>Michigan State University College of Osteopathic Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Academy of Osteopathy</li> <li>American College of Osteopathic Family Physicians</li> <li>American Medical Association</li> <li>American Osteopathic Association</li> <li>Wisconsin Academy of Family Physicians</li> <li>Wisconsin Association of Osteopathic Physicians & Surgeons</li> </ul>van Huigenbos<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/philip-van-huigenbos-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=BAFF62A2202E36F3A27DFD9B1752CE4F" alt="Philip van Huigenbos, D.O." width="280" height="280" DisableNVelocity="true" />Philip<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30242609 Philip van Huigenbos DO1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}<img src="/-/media/national-files/images/hometown-health/2024/parent-lifting-young-child.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4ED204C9A7D85C25F9B958DF349D3929" alt="Parent lifting young child" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller5/20/2024You may not notice your tonsils in the back of your throat until they're inflamed or develop tonsil stones. Discover why the small pebbles in the tonsil tissue can be more than just a nuisance.All about tonsil stones<p>Your tonsils are oval-shaped pads of tissue in the back of your throat, one on each side. They work as part of your body's immune system to filter bacteria and viruses. <a href="/hometown-health/speaking-of-health/tonsils-tiny-but-pack-a-big-punch" target="_self" title="Opens in same window.">Tonsils</a> also make white blood cells and antibodies to help fight infections.</p> <h2>What are tonsil stones?</h2> <p>Tonsil stones form from substances like food particles that become lodged in the crevices of your tonsils. People with large tonsils usually have irregularities on the surface, called crypts. When swallowing, food particles, saliva or mucus can get caught in the holes and become calcified and hard.</p> <p><img alt="Tonsil stone illustration" style="width:350px; height:373px;" src="/-/media/national-files/images/hometown-health/2024/tonsil-stone-illustration.jpg?h=373&w=350&sc_lang=en&hash=01E7A1D95CDE0F01B6BDAB062E2E1EA7" /></p> <h2>How are tonsil stones identified?</h2> <p>Tonsil stones become evident when small pebbles appear on the surface of the tonsils. The stones may look white or yellow. If they form deep in the tissue of the tonsils, the stones may not be visible.</p> <p>Tonsil redness and irritation are common symptoms of tonsil stones. In some instances, tonsil stones can cause chronic tonsil inflammation or infection of the tonsils, called tonsillitis.</p> <p>People with a history of tonsillitis may be more susceptible to tonsil stones. Each time the tonsils are enlarged from infection, small holes tend to develop from the swelling.</p> <p>People with large tonsils also are more at risk of developing tonsil stones. Large tonsils have a large surface area that develops holes on the surface where food particles can collect and turn into tonsil stones.</p> <h2>Can tonsil stones be prevented?</h2> <p>It's difficult to prevent tonsil stones because they are created by food and other substances passing through the mouth to the stomach. While you can't prevent them, you can minimize the development of tonsil stones with good oral hygiene.</p> <p><a href="/hometown-health/speaking-of-health/keeping-childrens-teeth-healthy" target="_self" title="Opens in same window.">Brush your teeth</a> after meals, in the morning and before bed. While brushing your teeth, also gently brush your tongue, followed by flossing. Regularly use a mouthwash that does not have an alcohol base. Good oral hygiene reduces the bacteria in your mouth that can lead to the formation of tonsil stones.</p> <p>Tonsil stones are not harmful to your health and are more of a nuisance than an issue. A frequent complaint about tonsil stones is that they tend to cause bad breath due to the bacteria that collect on the tonsils.</p> <h2>How are tonsil stones treated?</h2> <p>For people with a history of tonsil stones, removing the tonsils is a permanent way to prevent future bouts. The tonsils are removed in a surgery called tonsillectomy.</p> <p>If tonsillectomy surgery is not an option due to your medical history, age or personal preference, you can manage tonsil stones in other ways.</p> <p>Talk with your healthcare team about removing tonsil stones on your own. You can remove them by gently pressing on them with a cotton swab. You may also consider using a low-pressure water irrigator to rinse out the crypts in the tonsils. Gargling with salt water after eating can help remove bacteria from the mouth and throat.</p> <p>You should <a href="/hometown-health/speaking-of-health/8-reasons-to-visit-an-ent-specialist" target="_self" title="Opens in same window.">see an ENT healthcare professional</a> for tonsil stones if your tonsils look red, bleed easily, or experience sore throat or ear pain. These symptoms can develop after trying to remove or manipulate tonsil stones.</p> <h3>Watch this video to learn more about tonsil stones and when you should seek medical attention from an ENT professional:</h3> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/6VIsYgH0qrU" title="All About Tonsil Stones: Ask Mayo Clinic Health System" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <p><em><a href="/providers/pao-vang-md" target="_self" title="Opens in same window.">Pao Vang, M.D.</a>, is an <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">otolaryngologist</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/rice-lake" target="_self" title="Opens in same window.">Rice Lake</a>, Wisconsin.</em></p> <ul> <li>Airway surgery</li> <li>Chronic sinusitis</li> <li>Ear surgery</li> <li>Endocrine surgery</li> <li>General otolaryngology</li> <li>Head and neck cancer</li> <li>Nasal polyps</li> <li>Nose and sinus disease</li> <li>Pediatric otolaryngology</li> <li>Sinus surgery</li> <li>Tonsillectomy and adenoidectomy</li> <li>Voice disorders</li> </ul> M.D. <p> I am a firm believer that listening to the patient is the best form of medicine. Often, patients know what is wrong with them or they know that something is not right. They just need someone to listen to them and help treat their illness. It is this principle that has guided me as a physician and propelled me to pursue a career in medicine.</p> <p>I was attracted to the practice of ear, nose and throat (ENT) medicine because of a personal experience. In junior high school, my younger brother needed ear surgery, and since my parents didn't speak English, I had to do a lot of reading on it so I could interpret for them. I was absolutely amazed when his hearing improved dramatically after the surgery.</p> <p>After medical school, I started in general surgery to be a transplant surgeon. The idea of taking a human organ from one person and putting it into another fascinated me (and it still does). I changed course and went into ENT instead.</p> <p>Today, I am the first and only Hmong ENT surgeon in this country, and I am proud to be a part of Mayo Clinic Health System.</p> <p>In my free time, I enjoy biking and hiking. My favorite pastime is to go out into the countryside, pick a road and bike on it to see where it goes. It’s amazing the people I come across and the things I see when I take the time to look around. I once biked from Providence, Rhode Island, to Denver, Colorado. It was breathtaking to see the things I saw on that trip. I would do it again in a heartbeat.</p> <p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Internship</strong></p> <ul> <li>University of Nebraska Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Ear, Nose and Throat, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Otolaryngology – Head and Neck Surgery</li> <li>American Board of Otolaryngology</li> </ul> Vang<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/pao-vang-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=033E415DACE1C36268AC812E8C2D5272" alt="Pao Vang, M.D." width="280" height="280" DisableNVelocity="true" /> {6E33A01E-3D8E-4CFB-A7D2-440C4D160777}Pao<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13562746Pao Vang, M.D. 1<img src="/-/media/national-files/images/hometown-health/2024/holding-pizza-slice-outdoors.jpg?h=370&iar=0&w=660&sc_lang=en&hash=485105DA2AF5F0186796BF812A2408CE" alt="Holding pizza slice outdoors" width="660" height="370" DisableNVelocity="true" />Ear, Nose and Throat (ENT)Get information about symptoms, disorders and diseases affecting the ear, nose and throat, and related head and neck structures.Dawn Haller5/17/2024Measles was declared eliminated from the U.S., but cases are returning. Get answers to common questions about measles, and read why vaccination is the best defense against the spread of the virus.Answers to 3 common questions about measles<p><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/measles/symptoms-causes/syc-20374857" target="_blank" title="Opens in a new window.">Measles</a> is a serious illness that can lead to significant health complications. According to the <a rel="noopener" href="https://www.cdc.gov/measles/index.html" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention (CDC)</a>, measles was declared eliminated from the U.S. in 2000. But measles cases are returning at a <a rel="noopener" href="https://www.cdc.gov/measles/data-research/" target="_blank" title="Opens in a new window.">record pace</a> in 2024.</p> <p>While many viruses are not contagious or moderately contagious, measles is aerosolized and highly infectious. Measles spreads when an infected person coughs, sneezes or talks, which produces infected droplets. These droplets are either inhaled by others or live on surfaces for up to two hours after first contact.</p> <p>People with measles are contagious for about eight days — four before a rash appears and four while a rash is present.</p> <h2>What are the symptoms of measles?</h2> <p>Measles symptoms appear seven to 14 days after contact with the virus. Measles occurs in stages and progresses over a two- to three-week period. Symptoms are different throughout each stage.</p> <h3>Stage one: Infection and incubation</h3> <p>The incubation period for measles is 10–14 days, during which time there aren't any signs or symptoms.</p> <h3>Stage two: Nonspecific signs and symptoms</h3> <h4>Common first signs of measles include these symptoms:</h4> <ul> <li><a href="/hometown-health/speaking-of-health/why-are-you-coughing-so-much" target="_self" title="Opens in same window.">Dry cough</a></li> <li>Fever</li> <li>Red, watery eyes, known as conjunctivitis</li> <li>Runny nose</li> <li>Sore throat</li> </ul> <h3>Stage three: Acute illness and rash</h3> <p>In the third stage, you'll start to see a rash, which typically begins on the face. Tiny, white spots known as Koplik spots may appear inside the mouth two to three days after symptoms start. A measles rash appears three to five days after the first symptoms.</p> <p>Over the next few days, the rash will spread to the arms, torso and legs. Accompanying the rash will be a quickly rising fever that may reach more than 105 degrees Fahrenheit. Eventually, the fever dips, and the rash clears up from bottom to top.</p> <h2>Who is at risk for measles?</h2> <p>Measles is most dangerous for children up to age 5 and immunocompromised adults over 65.</p> <p>Measles complications can range from uncomfortable to life-threatening. Possible complications include <a href="/hometown-health/speaking-of-health/questions-about-earaches-and-ear-infections" target="_self" title="Opens in same window.">ear infection</a>, bronchitis, laryngitis or pneumonia. Approximately 1 in 1,000 people can get encephalitis, which is swelling in the brain that can lead to death.</p> <p>Also called rubeola, measles may be serious or even fatal for young children. <a rel="noopener" href="https://www.cdc.gov/measles/hcp/clinical-overview/" target="_blank" title="Opens in a new window.">Statistics</a> show that 1–3 in 1,000 children who become infected with measles will die from respiratory or neurologic complications.</p> <p>Measles can be challenging to diagnose for physicians and nonmedical people in the U.S. due to the limited number of cases. If there are pockets where people are not vaccinated, or vaccine rates continue to fall across the country, more outbreaks could occur.</p> <h2>How is measles prevented?</h2> <p>The most effective way to prevent measles is by vaccination. The vaccine is primarily administered as the combination measles-mumps-rubella (MMR) or the measles-mumps-rubella-varicella (MMRV) vaccine. </p> <p>The CDC recommends routine <a href="/hometown-health/speaking-of-health/the-facts-about-vaccinations" target="_self" title="Opens in same window.">childhood immunization</a> for the MMR vaccine, starting with the first dose at 12–15 months and the second dose at ages 4–6, or at least 28 days following the first dose.</p> <p>The MMRV vaccine also is available to children ages 1–12. People born during or after 1957 who do not have evidence of immunity against measles should get at least one dose of the MMR vaccine.</p> <p>It's crucial to ensure you and your children are vaccinated. The potential of becoming infected increases to 90% if not vaccinated.</p> <p>One dose of MMR vaccine is approximately 93% effective at preventing measles; two doses are approximately 97% effective. Almost everyone who does not respond to the measles component of the first dose of MMR vaccine at age 1 or older will respond to the second dose.</p> <p>Talk with your primary care clinician if you have any questions about measles or <a href="/hometown-health/speaking-of-health/the-facts-about-vaccinations" target="_self" title="Opens in same window.">vaccinations</a>.</p> <p><a href="/providers/sarah-scherger-md" target="_self" title="Opens in same window."><em>Sarah Scherger, M.D.</em></a><em>, is a <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">pediatrician</a> in <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</em></p>M.D.<p><strong>Education</strong></p> <ul> <li>Johns Hopkins Bloomberg School of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Department of Pediatric and Adolescent Medicine, Mayo Clinic</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Pediatrics, Mayo Clinic College of Medicine and Science</li> </ul>Scherger<img src="/-/media/shared-files/images/medical-professionals/full/austin/sarah-scherger-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=6AC1E8D2F4C9C1DBE14B11A7201385A8" alt="Sarah Scherger MD" width="280" height="280" DisableNVelocity="true" />Sarah<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15261310Sarah Scherger, M.D.1<img src="/-/media/national-files/images/hometown-health/2024/child-smelling-basil-leaf.jpg?h=370&iar=0&w=660&sc_lang=en&hash=83A4C4183755FF81E0DE03DE9943F5F4" alt="Child smelling basil leaf" width="660" height="370" DisableNVelocity="true" />Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Immunizations<p>Disease prevention is crucial to your health. Getting vaccinated is one of the best ways to maintain good health, and protect you and those you care about against infectious diseases. Vaccinations offer protection against serious diseases by stimulating the immune system to create antibodies against certain bacteria or viruses.</p><br/><p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/vaccine-guidance/art-20536857" target="_blank" title="Opens in a new window.">Get vaccine guidance from Mayo Clinic</a>, including benefits, safety, side effects and what to know about recommended vaccines for babies, children, teens, adults and during pregnancy. For recommended vaccines based on age, refer to the <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/adult" target="_blank" title="Opens in a new window.">adult</a> or <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/child" target="_blank" title="Opens in a new window.">child and adolescent</a> schedules.</p><br/><p>Review the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/coronavirus-covid-19/history-disease-outbreaks-vaccine-timeline" target="_blank" title="Opens in a new window.">history of infectious disease outbreaks and vaccines timeline</a> for information about major disease outbreaks, epidemics and pandemics, and the impact of vaccines and research.</p>Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller5/3/2024Noise-induced hearing loss, even from earbuds and headphones, can be permanent. That's why it's important to teach young people safe listening habits and how to protect their hearing.Young people wearing earbuds or headphones? Listen up<p>From tweens to early adults, young people tune in to their playlists, podcasts and phone conversations with in-the-ear devices, such as earbuds. While these devices are a convenient, private way to listen, they're also potentially <a rel="noopener" href="https://www.cdc.gov/ncbddd/hearingloss/index.html" target="_blank" title="Opens in a new window.">damaging to hearing</a>.</p> <p>Global studies released in 2020 revealed that 24% of those ages 12–35 listened to sound at unsafe levels. And it's not just devices that are a hearing risk but also the noisy places young people tend to go, including music venues and other spaces like busy cafes, school cafeterias or sporting events.</p> <h2>How loud is too loud?</h2> <p>The <a rel="noopener" href="https://www.cdc.gov/hearing-loss/causes/" target="_blank" title="Opens in a new window.">louder the sound</a>, the more damage it can cause to your hearing, and the faster that damage will occur. Sound is measured in decibels (dB). Any sound at or above 85 dB is more likely to damage your hearing over time. How loud is 85 dB? It's equivalent to a food blender or a soundtrack in a movie theater.</p> <p>Many young people use devices with sound levels much higher than 85 dB. For example, music played through headphones at the highest volume often is 94–110 dB. The upper level of 110 dB is more than 100 times as intense as 85 dB. If a young person is wearing over-ear headphones and you can hear the lyrics, the volume is too high.</p> <p>In 2022, the World Health Organization <a rel="noopener" href="https://www.who.int/news/item/02-03-2022-who-releases-new-standard-to-tackle-rising-threat-of-hearing-loss" target="_blank" title="Opens in a new window.">issued standards for tackling hearing loss</a> in this age group. One of those standards is for devices to be set at a default output level to protect hearing, typically 70–85 decibels (dB).</p> <p>However, that default isn't activated in devices bought in the U.S. So it's up to parents, caregivers and users to turn on this default setting. To do this, review the settings on the young person's device.</p> <h2>Why listening at safe levels is crucial at any age</h2> <p>According to the Centers for Disease Control and Prevention, even a small amount of <a rel="noopener" href="https://www.cdc.gov/hearing-loss-children/about/" target="_blank" title="Opens in a new window.">hearing loss in children</a> can profoundly affect their speech, language comprehension, communication, classroom learning and social development.</p> <p>A <a rel="noopener" href="https://www.cdc.gov/hearing-loss-children/data/" target="_blank" title="Opens in a new window.">national study</a> of children and adolescents ages 6–19 revealed that 12%, or about 5.2 million, have suffered permanent hearing damage from exposure to excessive noise. This type of hearing loss, also known as noise-induced hearing loss, can be caused by one loud blast or by listening at loud levels over time. It usually can't be medically or surgically corrected.</p> <h2>Developing safe listening habits</h2> <p>As the tweens in your life are beginning to be more independent when it comes to making decisions about their listening habits, it's a great time to help them develop safe practices that will protect their hearing for a lifetime.</p> <p>Three factors apply to safe listening: decibels, time and distance. The higher the decibels, the less time you can listen safely at that level. You can reduce the effect of high sound levels by moving farther away from the source, such as an amp at a concert, which allows you to listen longer.</p> <h3>Here are some tips for safe listening:</h3> <ul> <li>Activate volume control limits on devices.</li> <li>Teach tweens to lower the volume.</li> <li>Listen with the volume set to 80% for no more than 90 minutes.</li> <li>Move away from loud sound sources.</li> <li>Wear ear protection such as earplugs or earmuffs in noisy environments or during noisy activities.</li> </ul> <p>Also, consider giving your ears a break. Rather than wearing earbuds for eight hours, switch to over-ear headphones. Or wear an earbud in only one ear, then switch to the other. Consider opting for devices with noise-cancellation features and improved sound quality. This may limit the impulse to increase the volume to hear over the noise around you.</p> <p>Another tip: Keep your in-ear devices clean. An earbud contaminated with bacteria can introduce it into your ear and cause conditions such as <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/swimmers-ear/symptoms-causes/syc-20351682" target="_blank" title="Opens in a new window.">swimmer's ear</a>, a painful, itchy infection.</p> <p>If you suspect the young people in your family may have hearing loss, consult with a healthcare professional or audiologist.</p> <a href="/providers/katie-dease-aud"><em>Katie Dease</em></a><em> is an <a href="/services-and-treatments/audiology" target="_self" title="Opens in same window.">audiologist</a> in <a href="/locations/owatonna" target="_self" title="Opens in same window.">Owatonna</a>, Minnesota.</em><ul> <li>Amplification/hearing aids</li> <li>Audiometry</li> <li>Pediatrics</li> <li>Tinnitus</li> </ul>Au.D.<p><strong>Education</strong></p> <ul> <li>Doctor of Audiology, University of Wisconsin-Stevens Point</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Audiology</li> <li>Certificate of Clinical Competence, American Speech-Language-Hearing Association</li> <li>Hearing Instrument Dispenser</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Speech-Language-Hearing Association</li> </ul>Dease<img src="/-/media/shared-files/images/medical-professionals/full/mankato/katie-dease-aud.jpg?h=280&iar=0&w=280&hash=2A9E758AE48ADAA463D9362B7EE868C8" alt="Katie Dease, Au.D." width="280" height="280" DisableNVelocity="true" />{A4D89010-062B-42B7-830A-2F6D0A2BD079}Katie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15263924Katie Dease, Au.D.1{18E5E65E-45C8-4C48-BD32-A914794E2AA4}<img src="/-/media/national-files/images/hometown-health/2024/person-wearing-earbuds.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2979156458D39E15654DCED5EEBD9D27" alt="Person wearing earbuds" width="660" height="370" DisableNVelocity="true" />Ear HealthAn audiologist specializes in evaluating and treating people of all ages with hearing loss, dizziness and balance disorders. Specialty audiology consultation is available for assessment and treatment of hearing loss, tinnitus, dizziness and balance disorders.Dawn Haller5/31/2024<p>A Mayo Clinic expert shares what you need to know about the H5N1 avian influenza outbreak and why the public health risk remains low. Find out the steps to take to ensure food remains safe.</p>Monitoring the H5N1 avian influenza, bird flu, outbreak<p>The <a rel="noopener" href="https://www.cdc.gov/bird-flu/situation-summary/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fbird-flu%2Fphp%2Favian-flu-summary%2Findex.html" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention</a> (CDC) continues to actively monitor the ongoing outbreak of <a rel="noopener" href="https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-virologist-offers-perspective-on-avian-influenza-bird-flu-outbreak/" target="_blank" title="Opens in a new window.">H5N1 avian influenza</a>, also known as bird flu, and says that the public health risk remains low.</p> <p><a rel="noopener" href="https://www.mayoclinic.org/biographies/binnicker-matthew-j-ph-d/bio-20513862" target="_blank" title="Opens in a new window.">Matthew Binnicker, Ph.D.</a>, director of the <a rel="noopener" href="https://www.mayoclinic.org/departments-centers/laboratory-medicine-pathology/overview/specialty-groups/clinical-microbiology" target="_blank" title="Opens in a new window.">Clinical Virology Laboratory</a> at Mayo Clinic, says scientists and public health officials have known about avian influenza for decades.</p> <p> "What's different today is that since 2020, we're seeing the largest outbreak of avian influenza among wild birds, poultry and backyard bird flocks," he states.</p> <p>"The virus has also been found in certain mammalian species, most recently in dairy cattle, which is a little bit unprecedented and unique. And every time we see the virus go from birds into mammals, we worry about the virus adapting closer and closer to being able to infect and be transmitted efficiently between humans," Dr. Binnicker commented.</p> <p>Bird flu has been detected in the milk of dairy cattle, raising concerns about potential transmission to humans. However, the <a rel="noopener" href="https://www.fda.gov/food/alerts-advisories-safety-information/updates-highly-pathogenic-avian-influenza-hpai" target="_blank" title="Opens in a new window.">Food and Drug Administration</a> (FDA) found no traces of live virus in dairy products available to the public.</p> <p>"The good news is that the pasteurization process used in the United States and many countries inactivates avian influenza. The milk that we drink, if it's been pasteurized, is safe. Any animal products, such as eggs, beef or chicken, that you would cook to the recommended internal temperature renders that product safe to eat," says Dr. Binnicker.</p> <p>Watch Dr. Matthew Binnicker discuss avian influenza:</p> <p><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/hMHwOx3aH70" title="Monitoring the H5N1 avian influenza, bird flu, outbreak" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <h2>Food preparation tips</h2> <p>People can take steps to ensure their food remains safe from any viral or bacterial pathogen.</p> <p>"As with any potential infectious disease associated with food, cooking to the recommended internal temperature that the CDC lists on their <a rel="noopener" href="https://www.cdc.gov/food-safety/prevention/index.html" target="_blank" title="Opens in a new window.">website</a> is really important. And if you do that, you inactivate viruses like influenza, you inactivate bacteria and parasites that could cause a human infection," says Dr. Binnicker.</p> <p>The CDC recommends using a food thermometer to ensure foods are cooked to a safe minimum internal temperature. </p> <p>The minimum internal temperature varies by the type of meat:</p> <ul> <li>Beef, bison, veal, lamb steaks, roasts, chops to 145 F</li> <li>Ground meat and sausage to 160 F</li> <li>Poultry to 165 F</li> </ul> <p>Always wash your hands with soap and water, and disinfect cooking surfaces when handling raw or uncooked meat and poultry.</p> <h2>Precautions around birds</h2> <p>Dr. Binnicker says millions of birds have been infected with avian influenza, and the risk to humans remains low because the virus hasn't adapted to humans at this time. He recommends precautions for those who spend time outdoors or work with birds.</p> <p>"If you're interacting with birds, either through a backyard bird flock or a poultry farm, and there are birds that are either sick or have died, you need to wear an N95 mask. You need to wear eye protection and gloves," says Dr. Binnicker. "Most importantly, you need to contact your state or local public health officials so that they're aware of what's going on in your poultry facility or backyard bird flock."</p> <h2>Testing for avian influenza</h2> <p>The bird flu usually doesn't infect people, but some rare cases have happened. According to the CDC, the infection can range from no symptoms to mild illness, such as <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/pink-eye/symptoms-causes/syc-20376355" target="_blank" title="Opens in a new window.">pink eye</a>, to very serious and even deadly.</p> <p>"If you come down with symptoms, especially after interacting with a sick or dead bird, get tested for influenza and let your doctor and local public health officials know," he says. "The good news is that influenza tests that we currently use for human strains of influenza should be positive if an individual is infected with avian influenza. The current tests just won't tell us specifically that an individual has avian influenza."</p> <p>The CDC is working with diagnostic test manufacturers and clinical laboratories to develop tests to specifically determine if it's avian flu. Dr. Binnicker says those tools should be available in the months ahead.</p> <p><em><a rel="noopener" href="https://www.mayoclinic.org/biographies/binnicker-matthew-j-ph-d/bio-20513862" target="_blank" title="Opens in a new window.">Matthew Binnicker, Ph.D.</a>, is a microbiologist in <a rel="noopener" href="https://www.mayoclinic.org/departments-centers/laboratory-medicine-pathology/overview/specialty-groups/clinical-microbiology" target="_blank" title="Opens in a new window.">Clinical Virology Laboratory</a> at <a rel="noopener" href="https://www.mayoclinic.org/" target="_blank" title="Opens in a new window.">Mayo Clin</a><a rel="noopener" href="https://www.mayoclinic.org/" target="_blank" title="Opens in a new window.">ic</a> in Rochester</em><em>, Minnesota.</em></p> <p><em>This article was originally published on the Mayo Clinic </em><a rel="noopener" href="https://newsnetwork.mayoclinic.org/discussion/monitoring-the-h5n1-avian-influenza-bird-flu-outbreak/" target="_blank" title="Opens in a new window."><em>News Network</em></a>.</p><img src="/-/media/national-files/images/hometown-health/2024/airfrying-chicken-with-thermometer.jpg?h=370&iar=0&w=660&sc_lang=en&hash=19022E0840ECB93E4648BEF4FA518C4B" alt="Airfrying chicken with thermometer" width="660" height="370" DisableNVelocity="true" />InfluenzaInfluenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza, commonly called the flu, is not the same as the stomach "flu" viruses that cause diarrhea and vomiting.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Dawn Haller6/12/2024Morning, midday or evening — which time of day will give the biggest boost to your workout? Learn about the benefits of each and which is best for you.Exercise conundrum: When's the best time to work out?<p>When is the best time to exercise? It's a question people ask when striving to reach the <a rel="noopener" href="https://www.cdc.gov/healthy-weight-growth/physical-activity/index.html" target="_blank" title="Opens in a new window.">recommended physical activity level</a>. Whether you exercise in the morning, midday or evening, are there any physiological advantages to these times?</p> <p>Supporters of either morning or evening workouts cite various benefits, including increased energy levels, enhanced performance and greater <a href="/hometown-health/speaking-of-health/organizing-and-executing-weight-loss-goals" target="_self" title="Opens in same window.">weight loss</a>. Given the ongoing <a rel="noopener" href="https://www.heart.org/en/healthy-living/fitness/fitness-basics/when-is-the-best-time-of-day-to-work-out" target="_blank" title="Opens in a new window.">"When is the best time of day?"</a> question, health experts have delved into the science behind exercise timing to shed light on the optimal approach for achieving fitness goals.</p> <h2>The case for morning workouts</h2> <p>For morning exercisers, the allure of starting the day with a workout is undeniable. Completing your workout before you begin your day can provide a sense of accomplishment. Add to that the post-workout release of endorphins, and your morning workout can serve as a powerful ego boost to set a positive tone for the rest of the day.</p> <p>Morning workouts also eliminate the worry about finding time for exercise later in the day since it's often the only time of day that hasn't been committed yet to work, social events or family activities. This sense of freedom and flexibility can alleviate stress and help establish a consistent daily routine.</p> <p>Strategically timed <a href="/hometown-health/speaking-of-health/5-nutrition-tips-to-maximize-your-workouts" target="_self" title="Opens in same window.">pre-exercise nutrition</a> can significantly improve energy levels and performance for people embarking on morning workouts.</p> <p>Starting the day with a balanced breakfast containing carbohydrates, protein and healthy fats can provide the necessary energy to power through a morning workout. Opt for whole-grain cereals and Greek yogurt with fruit, then allow sufficient time for digestion to prevent discomfort and maximize nutrient absorption.</p> <p>If you're not hungry in the morning, try something simple like an energy bar or have a bedtime snack the night before your morning workout.</p> <h2>The case for evening workouts</h2> <p>Waking up early to exercise is the last thing you may feel like doing, so the case for evening workouts may be more appealing.</p> <p>The body's ability to perform peaks in the afternoon and early evening for some people, with optimal muscle function, strength and endurance often occurring later in the day. That's because your body has had time to wake up by moving around throughout the day, you've eaten a meal or two to ensure adequate energy for your workout, and you may be more mentally alert.</p> <p>In addition, oxygen uptake kinetics — your body's ability to take in oxygen and deliver it to the working tissues and the tissues' ability to use the oxygen — are more favorable in the evening, allowing for more efficient fuel use during exercise. That means your body is primed for performance in the late afternoon and early evening, making it an ideal window for high-intensity activities like interval training, strength workouts or speed work.</p> <p>However, if you opt for evening workouts, you may face more challenges balancing your commitments, and physical and mental energy.</p> <p>After a long day at work or shuttling around the kids all day, it can be hard to muster the motivation to go to the gym and exert a lot of physical effort. Intense physical activity in the evening also may trigger a stress response which can lead to difficulty falling asleep or cause you to wake up in the middle of the night if you experience cortisol disruption and release. If you're going to exercise right before sleep, consider a lower-intensity activity, such as a walk or lighter lifting session.</p> <p>If you choose later-in-the-day workouts, ensure that you're getting adequate nutrients throughout the day so you have enough fuel available to support your workout. Eating a nutrient-rich meal within two hours after your workout can aid muscle recovery and help you better adapt to training. Consider options like grilled chicken with quinoa and vegetables or a protein-packed stir-fry to refuel and replenish after an evening workout.</p> <h2>What about a midday workout?</h2> <p>Whether working or at home, most people hit the dreaded <a href="/hometown-health/speaking-of-health/dont-just-sit-there-exercises-for-the-office" target="_self" title="Opens in same window.">afternoon slump</a> around 3 p.m. A <a rel="noopener" href="https://www.nature.com/articles/s41467-023-36546-5" target="_blank" title="Opens in a new window.">recent study of more than 90,000 people </a> found that working out in the afternoon reduces the risk of heart disease or early death more than physical activity in either the morning or afternoon. The benefits of afternoon exercise for longevity were most pronounced for men and seniors.</p> <p>Morning workouts may not be ideal for shift workers, those who work late or stay up late in the evening. A midday or early afternoon workout may allow for more sleep in the morning and extra time before your next evening shift or late night. </p> <p>According to a OnePoll survey, the most effective activity for people for an afternoon workout is <a href="/hometown-health/speaking-of-health/5-tips-for-walking-your-way-to-better-health" target="_self" title="Opens in same window.">going for a walk</a>, which is a great way to improve both physical and mental energy.</p> <h2>The bottom line: Avoid the couch</h2> <h3>For those who say, "I don't have any time to work out," here are tips for finding time:</h3> <ul> <li><strong>Schedule a "snack competing" activity.</strong> It's an excellent way to flip the script if you know you're apt to sit on the couch and snack in the evenings. Instead, use that time for a workout. You consume fewer calories by snacking less and also burn more calories with the workout. </li> <li><strong>Split a workout into six, 10-minute sessions throughout the day.</strong> By day's end, you'll have exercised for 60 minutes.</li> </ul> <h2>Finding the right balance</h2> <p>No matter when you work out, if you're doing prolonged or intense exercise for more than 90 minutes, mid-workout nutrition can play a pivotal role in sustaining energy levels and preventing fatigue. Incorporate carbohydrate-rich snacks during extended workouts to maintain endurance and performance.</p> <p>Ultimately, the best time to exercise is the time that fits into your schedule and aligns with your energy levels and preferences. Consistency and sticking to a regular exercise routine are far more critical than the time of day you choose to work out.</p> <p>Experimenting with timing and being aware of how your body responds are essential in determining the best time to optimize your exercise performance, recovery and overall well-being.</p> <p>Any time of day is better than no exercise in reducing the risk of death from any cause, including <a href="/hometown-health/speaking-of-health/qa-its-never-too-early-to-develop-heart-healthy-habits" target="_self" title="Opens in same window.">heart disease</a> and <a href="/hometown-health/speaking-of-health/keep-moving-the-importance-of-exercise-in-cancer-survivorship" target="_self" title="Opens in same window.">cancer</a>.</p> <h2>Next steps:</h2> <ul> <li>Check out the <a href="/hometown-health/featured-topic/the-importance-of-movement" target="_self" title="Opens in same window.">ideas to get you moving</a> any time of day.</li> <li>Find <a href="/hometown-health/speaking-of-health/fit-a-workout-into-any-schedule" target="_self" title="Opens in same window.">ways to fit a workout into your day</a>.</li> <li>Learn <a href="/-/media/national-files/images/hometown-health/2021/know-your-numbers-heart-rate.jpg" target="_self" title="Opens in same window.">how to calculate your target heart rate</a> for exercise.</li> <li>Watch a video on heart health and wearable fitness device: <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/1OnQHdN4m_Q" title="heart health and wearable fitness device" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> </li> </ul> <p><a href="/providers/andrew-jagim-phd" target="_self" title="Opens in same window."><em>Andrew Jagim, Ph.D.</em></a><em>, is a <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">sports medicine</a> professional in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and Onalaska, Wisconsin. <a href="/providers/jacob-erickson-do" target="_self" title="Opens in same window.">Jacob Erickson, D.O.</a>, practices sports medicine, and <a href="/providers/alecia-gende-do" target="_self" title="Opens in same window.">Alecia Gende, D.O.</a>, is a sports medicine and <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">emergency medicine</a> physician, both in Onalaska.</em></p><ul> <li>Examining how different nutrition and exercise interventions influence health and performance — this interest applies to both the general population in regards to improve a person’s quality of life and prevent chronic disease in addition to improving the performance ability of elite athletes</li> </ul>Ph.D.<p><strong>Education</strong></p> <ul> <li>Master's degree, Human Performance, University of Wisconsin – La Crosse</li> <li>Ph.D., Kinesiology – Exercise Physiology Texas A&M University, College Station</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>International Society of Sports Nutrition</li> <li>National Strength and Conditioning Association</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Sports Medicine</li> <li>International Society of Sports Nutrition</li> <li>National Strength and Conditioning Association</li> </ul>Jagim<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/andrew-jagim-phd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=AA07F8D241D507CF3C0C9F28FC00E465" alt="Andrew Jagim PhD" width="280" height="280" DisableNVelocity="true" /><p>Dr. Jagim has authored or collaborated on numerous scholarly publications related to sports medicine. His topics have included:</p> <ul> <li>diets and nutrition</li> <li>workouts and training regimens</li> <li>sports injuries and treatment programs</li> <li>use and affects of drugs and supplements in sports</li> </ul> <p>His research has been published in numerous journals including International Journal of Exercise Science, Journal of Sports Science, Journal of Strength and Conditioning Research, Frontiers in Nutrition, International Society of Sports Nutrition, Journal of Neurosurgery and the Clinical Journal of Sports Medicine.</p>Andrew<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20772289Andrew Jagim, Ph.D.1{7746ADF8-715B-4593-8AAB-55D7F0467848}<ul> <li>Minor trauma</li> <li>Musculoskeletal/sports ultrasound</li> <li>Office procedures</li> <li>Preventive medicine</li> <li>Sports/musculoskeletal medicine</li> </ul>D.O.<p><strong>Medical Degree</strong></p> <ul> <li>Kirksville College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo College of Medicine and Science</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Sports Medicine, University of Iowa</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Medical Association</li> <li>American Osteopathic Association</li> <li>American Society of Sports Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor, Family Medicine, Mayo Clinic Alix School of Medicine</li> </ul>Erickson<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/jacob-erickson-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=E94E476103713CA50775C5FD045B05EB" alt="Jacob Erickson DO" width="280" height="280" DisableNVelocity="true" />{C6B5FA43-E21E-423A-A349-342C8DCCBC31}Jacob<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15534570Sports Medicine - Jacob Erickson DO1{7746ADF8-715B-4593-8AAB-55D7F0467848}<ul> <li>Exercise and movement</li> <li>Female athletes</li> <li>Sports injuries</li> <li>Teaching</li> <li>Ultrasound-guided procedures</li> <li>Women's musculoskeletal health</li> </ul>D.O.<p>I practice collaboratively with my patients, offering an explanation of their situation and a few options for workup and management. I try to empower my patients to make informed decisions regarding their care. </p> <p>My goals are to optimize overall well-being and to see more than just a sports injury or musculoskeletal complaint. I will treat the whole person, working to get them back to their goals, whether that is playing organized sports, golfing, recreational running, weightlifting or being able to play with their kids or grandkids.</p> <p>I enjoy time outdoors, working on our farm and with my family. For my own fun and fitness, I enjoy CrossFit, running, weightlifting, walking, hiking, hunting and anything outdoors.</p><p><strong>Education</strong></p> <ul> <li>Midwestern University Chicago College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Emergency Medicine, University of Iowa Hospitals & Clinics</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Primary Care Sports Medicine, University of Iowa Hospitals & Clinics</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Emergency Medicine</li> <li>American Association Women Emergency Physicians</li> <li>American College of Emergency Physicians</li> <li>American College of Sports Medicine</li> <li>American Institute of Ultrasound in Medicine</li> <li>American Medical Society for Sports Medicine</li> <li>Emergency Medicine Residents Association (EMRA)</li> <li>Veterans of Foreign Wars</li> </ul> <p><strong>Academic Appointments</strong></p> <ul> <li>Assistant Professor of Emergency Medicine, Mayo Clinic College of Medicine and Science</li> <li>Assistant Professor of Orthopedics (Orthopedic Surgery), Mayo Clinic College of Medicine and Science</li> </ul>Gende<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/alecia-gende-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=5BCB6FFA652C592FF31686030603223C" alt="Alecia Gende DO" width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/37208055/" target="_blank" title="Opens in a new window.">Acute hemorrhage on the playing field</a>, July 2023.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/33585801/#:~:text=Conclusion%3A%20Preliminary%20findings%20indicate%20a,requiring%20referral%20to%20a%20cardiologist." target="_blank" title="Opens in a new window.">Use of electrocardiographic screening to clear athletes for return to sports following COVID-19 infection</a>, April 2021.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/33306518/" target="_blank" title="Opens in new window. ">Ultrasound in trauma and other acute conditions in sports, Part II</a>, December 2020.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/30908326/" target="_blank" title="Opens in a new window.">Delayed-union of acetabular stress fracture in female gymnast: Use of teriparatide to augment healing</a>, September 2020.</li> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/29560061/" target="_blank" title="Opens in a new window.">Educator toolkits on Second Victim Syndrome, mindfulness and meditation, and positive psychology: The 2017 Resident Wellness Consensus Summit</a>, March 2018.</li> </ul>{D57FF1AB-3266-4374-BBD1-D222CFB57AA6}Alecia<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21428671Alecia Gende, D.O.1{7746ADF8-715B-4593-8AAB-55D7F0467848}|{FB3BB67A-14FA-4DDE-B183-F85C42E0B255}<img src="/-/media/national-files/images/hometown-health/2024/people-doing-pool-fitness.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E053E0EDAECB1B9B11BF501AD1EC6D66" alt="People doing pool fitness" width="660" height="370" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Dawn Haller6/6/2024Although skin cancer is the most common form of cancer, it's also the most curable type when treated early. Learn why Mohs surgery is an effective treatment for removing skin cancer.Removing skin cancer with Mohs surgery<p>Skin cancer is the most common form of cancer. When treated early, it's also the most curable type of cancer. <a href="/services-and-treatments/mohs-surgery" target="_self" title="Opens in same window.">Mohs surgery</a> is one of the most successful surgical treatments for removing skin cancer.</p> <p>The abnormal growth of skin cells that leads to skin cancer develops most often on skin exposed to the sun, such as your scalp, face, lips, ears, neck, arms and hands. However, it can also occur on areas of your skin not directly exposed to sunlight, including your palms and beneath your fingernails or toenails. </p> <h2>Types of skin cancer</h2> <p>Basal cell carcinoma, squamous cell carcinoma and melanoma are three of the most common types of skin cancer. Of those three types, basal cell and squamous cell skin cancers are diagnosed most often and are the most curable. </p> <h3>Basal cell carcinoma</h3> <p>This type of skin cancer often starts as a small, flesh-colored or pearly-looking bump on the skin. It may bleed or have no symptoms. It may look like a pimple that doesn't entirely heal. <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/basal-cell-carcinoma/basics/definition/con-20028996" target="_blank" title="Opens in a new window.">Basal cell carcinoma</a> may extend deep into the tissue under the skin. </p> <h3>Squamous cell carcinoma</h3> <p>This type of skin cancer often starts as a rough or scaly patch or growth on the skin. It can develop rapidly and hurt a bit if touched. <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/squamous-cell-carcinoma/basics/definition/con-20037813" target="_blank" title="Opens in a new window.">Squamous cell carcinoma</a> usually appears in one place on the skin and rarely spreads to other parts of the body. However, if left untreated, this cancer may grow within the skin and destroy surrounding tissues and structures, such as nerves and muscles. The cancerous cells can then spread to nearby lymph nodes and other areas. </p> <h3>Melanoma</h3> <p>While <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/melanoma/basics/definition/con-20026009" target="_blank" title="Opens in a new window.">melanoma</a> occurs less commonly, it's more serious. It often begins as a dark spot or odd-looking mole. It can grow deep into the tissue under the skin. If left untreated, melanoma can spread to other parts of the body. Early detection and treatment of this cancer are critical.</p> <h2>Treating skin cancer with Mohs surgery</h2> <p>Mohs surgery is intended to remove all the cancerous tissue, called a tumor, and leave as much healthy neighboring skin and tissue as possible. </p> <p>To diagnose skin cancer, a healthcare professional removes a biopsy, or small tissue sample, to be examined. While you can see the top of the tumor growing on the skin's surface, deeper roots may be out of sight under the skin. The method used during Mohs surgery looks closely at the affected area and surrounding skin to find and remove all of the tumor. </p> <img alt="Mohs surgery illustration" style="height:800px; width:318px;" src="/-/media/local-files/eau-claire/images/medical-services/dermatology/mohs-surgery-illustration.jpg?sc_lang=en&hash=1DE25FB0B711E73DBAA8B1DFC452D32B" />  <h3>A Mohs surgeon may recommend this procedure for skin cancer that:</h3> <ul> <li>Has come back after previous treatment or has a high risk of recurring.</li> <li>Has developed rapidly and deeply.</li> <li>Is located around the face, scalp or neck.</li> </ul> <h2>What to expect with Mohs surgery</h2> <p>Mohs surgery is an outpatient surgery, meaning you won't stay in the hospital overnight. The length of the surgery depends on the size and number of tumors to be removed. While surgery can last between one to 10 hours, most surgeries take two to five hours. </p> <p>During Mohs surgery, the area of your skin is numbed first. Then, the surgeon removes the tumor and a thin layer of skin around it. After any bleeding is stopped, a temporary bandage is applied. These steps typically take about 10 minutes. </p> <p>While you wait in the surgical waiting room, the surgeon maps each section of tissue from the tumor that was removed and uses a microscope to examine it for cancer cells. If the surgeon finds cancer cells, the map helps to locate the position in the skin. </p> <p>You'll return to the surgical room for the surgeon to remove more tissue from the area where the cancer cells are found. These steps are repeated until the surgeon no longer sees cancer cells under the microscope. </p> <h3>After the tumor is completely removed, the surgeon determines the best option for closing the wound area, including:</h3> <ul> <li><strong>Side-to-side stitches</strong><br /> Most surgeries are closed this way with a row of sutures if enough loose skin is available next to the wound.</li> <li><strong>Skin graft</strong><br /> The surgeon may remove a piece of skin from another part of your body to place over the wound. </li> <li><strong>No stitches</strong><br /> The wound may be left open to heal on its own, depending on the area of the body. </li> <li><strong>Cartilage harvest</strong><br /> Cartilage is a connective tissue found in the nose and ear. Your surgeon may take cartilage from one of these areas to repair and support the wound. </li> <li><strong>Skin flap</strong><br /> If your wound is too large to close with side-to-side stitches, a skin flap is used to move nearby skin to cover it. </li> </ul> <p>After surgery, your surgeon may prescribe an antibiotic to lower the risk of infection in the wound. Follow instructions from your care team for managing pain. Depending on the location and size of the wound, each person may have a different level and time frame for pain. </p> <p>Healing time also depends on the size of the wound and the way it was closed. The procedure can cause scarring, which will typically soften naturally over time. </p> <p>After having skin cancer once, you are at a higher risk of having a recurrence of the same type of cancer or another type of skin cancer. Talk with your healthcare team about how frequently you need full-body skin examinations. </p> <h2>Watch this video to see how Mohs surgery is used to treat skin cancer:</h2> <p><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/mr4lxrCCAu8" title="Mayo Clinic Minute: How Mohs surgery is used to fight skin cancer" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <p><a href="/providers/john-kohorst-md" target="_self" title="Opens in same window."><em>John Kohorst, M.D.</em></a><em>, is a <a href="/services-and-treatments/dermatology" target="_self" title="Opens in same window.">dermatologist</a> and <a href="/services-and-treatments/mohs-surgery" target="_self" title="Opens in same window.">Mohs surgeon</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em> </p><ul> <li>Community health and wellness</li> <li>Mohs surgery</li> <li>Skin cancer prevention, education and treatment</li> </ul>M.D.<p>I chose to become a Mohs surgeon because I wanted to be able to provide the highest cure rate for skin cancers to my patients. Every day, our team has the opportunity to get to know our patients and treat their skin cancer. I truly believe in Mohs surgery and the benefit it brings to patients. The cure rates of Mohs surgery are higher than any other skin cancer removal. After skin cancer is removed, there is another truly rewarding part of our practice: We are able to reconstruct the surgical defect using a variety of primary closures, grafts and flaps. I am very fortunate to work at Mayo Clinic with a top-notch team of other specialists in plastic surgery; ear, nose and throat (ENT); and radiation oncology. The amazing patients we have in La Crosse and the wonderful colleagues I have make coming to work rewarding every day.</p> <p>The practice philosophy of our surgical team is that we want to deliver the best outcome to each patient every day. To do this, we focus on each step of the procedure. We don't rush. I want to assure my patients that they received the finest care we are able to provide. We are proud of our process — knowing we gave our best to each patient we have the opportunity to care for.</p> <p>I have an amazing wife and two beautiful children. My wife, Mira, is a physician in Pediatric Hematology-Oncology at Mayo Clinic in Rochester. She is originally from a small town in Illinois, and we met in medical school at Mayo Clinic.</p> <p>In my spare time, I love to spend time with family and friends. We feel so lucky to live in such a beautiful area of the country. We very much like to be outdoors. In the summer we like to swim, hike, bike and garden. In the winter, I enjoy winter sports and do woodworking projects in our basement.</p><p><strong>Medical School</strong></p> <ul> <li>Mayo Clinic Alix School of Medicine</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Internal Medicine, Mayo Clinic</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Dermatology, Mayo Clinic</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Dermatologic Surgery and Oncology, Baylor College of Medicine</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Dermatology</li> <li>American College of Mohs Surgery</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Dermatology</li> <li>American College of Mohs Surgery</li> <li>American Society for Dermatologic Surgery</li> <li>Mayo Clinic Fellows Association</li> <li>Wisconsin Dermatological Society</li> </ul>Kohorst<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/john-kohorst-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=78D80C9999057857455999A287A995E6" alt="John Kohorst MD" width="280" height="280" DisableNVelocity="true" />{9BAFC6CB-1F29-4142-8927-AA1D08038E3E}John<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15598730John Kohorst, M.D.1{276FDCB2-F341-4C45-B04B-F71FB963B8CB}|{20D94572-B26A-4FB7-8C9D-7555CE785162}<img src="/-/media/national-files/images/hometown-health/2024/sitting-in-chairs-near-rv.jpg?h=370&iar=0&w=660&sc_lang=en&hash=025DBAF43D83A153579C71A4891B2DE9" alt="Sitting in chairs near RV" width="660" height="370" DisableNVelocity="true" />Skin CancerSkin cancer — the abnormal growth of skin cells — most often develops on skin exposed to the sun. But this common form of cancer can also occur on areas of your skin not ordinarily exposed to sunlight.Dawn Haller10/7/2025Wildfire smoke can affect air quality in areas thousands of miles away from active wildfires. Learn how to monitor air quality indexes to be aware of the air pollution in your area.Understanding the complex health risks of wildfire smoke<p>Wildfires are continuing to become increasingly common throughout the U.S. and neighboring Canadian provinces. Air quality may be affected in those regions and even trigger <a href="/hometown-health/speaking-of-health/breathing-issues-from-wildfires-smoke" target="_self" title="Opens in same window.">respiratory health issues</a> thousands of miles away. </p> <h2>The dangers of wildfire smoke</h2> <p>The composition of wildfire smoke includes various pollutants. Those with ultrafine particles pose the most significant threat because they can infiltrate deep into the lungs. This can trigger inflammation and exacerbate preexisting respiratory conditions. The array of respiratory irritants in smoke, including hydrocarbons and other organic chemicals, can cause symptoms from coughing and wheezing to chest tightness and shortness of breath.</p> <p>Wildfire smoke also can affect your cardiovascular health. Fine particulate matter can potentially enter the bloodstream, where it can bring on systemic inflammation and worsen cardiovascular conditions. </p> <h3>The health effects of breathing in wildfire smoke may include:</h3> <ul> <li><a href="/hometown-health/speaking-of-health/create-an-asthma-action-plan-for-your-child" target="_self" title="Opens in same window.">Asthma attack</a></li> <li>Chest pains</li> <li>Coughing</li> <li>Fast heartbeat</li> <li>Headaches</li> <li>Runny nose</li> <li>Scratchy throat</li> <li><a href="/hometown-health/speaking-of-health/chronic-sinusitis-more-than-a-stuffy-nose" target="_self" title="Opens in same window.">Sinus irritation</a></li> <li>Stinging eyes</li> <li>Tiredness</li> <li>Trouble breathing comfortably, wheezing and shortness of breath</li> </ul> <p>People with preexisting heart disease or hypertension may experience symptoms from elevated levels of wildfire smoke, including chest pain, palpitations and fatigue.</p> <p>Children are particularly susceptible to environmental pollutants because their respiratory systems are still developing.</p> <p>While it can be challenging to keep children indoors, especially when the weather appears otherwise pleasant, it's crucial to be aware of the weather conditions and the air quality. If the air quality is marginal, it's OK for children to spend limited time outside. If the air quality is bad, find an alternative activity indoors until the air quality has improved.</p> <p>Older adults with compromised lung function and reduced tolerance to respiratory stressors should pay particular attention to air quality during wildfire events and adjust their activities accordingly. </p> <h2>Managing chronic conditions</h2> <p>People with preexisting respiratory conditions such as asthma, <a href="/hometown-health/speaking-of-health/6-tips-for-living-with-copd" target="_self" title="Opens in same window.">chronic pulmonary obstructive disease (COPD)</a> and bronchitis are at elevated risk of worsening symptoms and respiratory distress during times of poor air quality.</p> <p>People who need relief from pervasive smoke can seek sanctuary in indoor environments with filtered air conditioning systems.</p> <p>People managing chronic respiratory conditions should talk to their healthcare team about how to handle times when there is poor outdoor air quality. Ensure you have a sufficient supply of medications, including rescue inhalers and controller medications. Establish an action plan that outlines steps to manage any symptoms and when to seek care, if needed, for any wildfire smoke exposure.</p> <h2>Be aware of air quality in your area</h2> <p>Monitoring air quality indexes and advisories are crucial to minimizing exposure to harmful pollutants.</p> <p>Just as you check the weather forecast each day, check the air quality index for your area. And just as you'd carry an umbrella to be prepared for rain, think about carrying personal protective equipment like an N95 respirator mask, which does a great job filtering out small particles from wildfire smoke, should you need it.</p> <p>The <a rel="noopener" href="https://www.airnow.gov/aqi/aqi-basics/" target="_blank" title="Opens in a new window.">U.S. Air Quality Index (AQI)</a> measures air pollution according to the Clean Air Act of the Environmental Protection Agency (EPA).</p> <h3>The AQI has six color-coded categories to help you quickly determine the air quality in your community:</h3> <ul> <li><strong>Green</strong> — Air pollution poses little to no risk, and the air quality is satisfactory.</li> <li><strong>Yellow</strong> — Air quality is acceptable, but there may be a risk for people sensitive to air pollution.</li> <li><strong>Orange</strong> — While most people are unlikely to be affected, people sensitive to air pollution may experience health effects. </li> <li><strong>Purple</strong> — The risk of health effects is increased for everyone. </li> <li><strong>Maroon</strong> — Everyone is likely to be affected by the hazardous conditions.</li> </ul> <p>Visit <a rel="noopener" href="https://fire.airnow.gov/" target="_blank" title="Opens in a new window.">AirNow</a> for real-time updates and guidance on whether your area is affected by smoke and fire. It's a valuable resource for monitoring air quality indexes and accessing needed information during wildfire events.</p> <em>Mark Norton, M.D.</em><em>, is a <a rel="noopener" href="https://www.mayoclinic.org/departments-centers/pulmonary-medicine/home/orc-20397844" target="_blank" title="Opens in new window.">pulmonologist</a> and <a rel="noopener" href="https://www.mayoclinic.org/departments-centers/critical-care/sections/overview/ovc-20399554" target="_blank" title="Opens in a new window.">critical care specialist</a> at <a rel="noopener" href="https://www.mayoclinic.org/" target="_blank" title="Opens in a new window.">Mayo Clinic </a>in Rochester.</em><img src="/-/media/national-files/images/hometown-health/2024/parent-and-child-with-fishing-pole.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0EA76B95C5F4E058DDDD2485AC87763A" alt="Parent and child with fishing pole" width="660" height="370" DisableNVelocity="true" />BreathingMost cases of shortness of breath are due to heart or lung conditions. Your heart and lungs are involved in transporting oxygen to your tissues and removing carbon dioxide, and problems with either of these processes affect your breathing.Dawn Haller7/9/2024The body works harder to stay cool during pregnancy, which makes pregnant people more susceptible to heat exhaustion and heat stroke. When temperatures soar, staying hydrated and cool is crucial.Staying safe in the heat during pregnancy<p>With summer temperatures soaring, pregnant people must be extra cautious to avoid heat-related health issues. During pregnancy, your body has to work harder to stay cool because you're cooling yourself and your baby. </p> <p>The body's natural cooling mechanisms already are working overtime during pregnancy, making it more challenging to regulate temperature. This means that pregnant people are more susceptible to heat exhaustion and heat stroke compared to other people.</p> <p>Heat can be particularly dangerous during pregnancy because an elevated core body temperature can lead to serious complications. You don't want your core body temperature to exceed 102 degrees. <a href="/hometown-health/speaking-of-health/effects-of-high-temperatures-on-blood-pressure-heart" target="_self" title="Opens in same window.">Excessive heat</a> can lead to heat stroke or heat exhaustion, which are dangerous for both the pregnant person and the baby.</p> <h2>Hydration is essential</h2> <p>Staying hydrated is one of the most critical steps pregnant people can take to protect themselves in the heat. </p> <p>Water is always the <a href="/hometown-health/speaking-of-health/water-essential-to-your-body-video" target="_self" title="Opens in same window.">preferred choice for hydration</a>. Fluids with electrolytes also are beneficial because the body loses sodium and potassium through sweat. It's essential to replace these minerals, especially on hot summer days.</p> <p>However, not all drinks are created equal. Avoid <a href="/hometown-health/speaking-of-health/what-are-hidden-sources-of-caffeine" target="_self" title="Opens in same window.">caffeinated beverages</a> like coffee, soda and certain teas, as they don't provide sufficient hydration. Sports drinks and other sugary drinks shouldn't replace water. Pure water is the best and healthiest option.</p> <p>Your hydration needs increase during pregnancy, especially in the heat. Pregnant people should drink at least 64 ounces of water daily. Increase that amount if you are spending time in hot weather. It's crucial to <a href="/hometown-health/speaking-of-health/tips-for-drinking-more-water" target="_self" title="Opens in same window.">stay ahead of your thirst</a>. If you're thirsty, you're likely already lacking necessary hydration.</p> <h2>Understanding heat exhaustion and heat stroke</h2> <p>Understanding the symptoms and risks of heat exhaustion and heat stroke is crucial. <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/heat-exhaustion/symptoms-causes/syc-20373250" target="_blank" title="Opens in a new window.">Heat exhaustion</a> symptoms include headache, dizziness, confusion, loss of appetite, nausea, extreme thirst and muscle cramps.</p> <p>If you experience these symptoms, move to a cool area, drink water and place cool towels on your head, neck, armpits and groin. You should start feeling better within 30 minutes.</p> <p><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/heat-stroke/symptoms-causes/syc-20353581" target="_blank" title="Opens in a new window.">Heat stroke</a>, a more severe condition, includes symptoms such as high body temperature, not sweating despite feeling hot, shortness of breath, confusion, rapid breathing and seizures. </p> <p>These symptoms require immediate medical attention. Heat stroke can be life-threatening for both the pregnant person and the baby.</p> <h3>Use these practical tips for staying cool:</h3> <ul> <li><strong>Dress for the heat.</strong><br /> Wear loose, breathable fabrics, such as cotton or moisture-wicking clothes, to stay cool. Avoid tight items that can trap heat and cause discomfort.</li> <li><strong>Seek shade.</strong><br /> When planning outdoor activities, look for shaded areas or bring an umbrella. Stay under shade trees or use a splash pad to keep cool. If you're near water, submerging your feet can help lower your body temperature.</li> <li><strong>Recognize the signs of overheating.</strong><br /> Pregnant people should be vigilant about the <a href="/hometown-health/speaking-of-health/when-temps-rise-remember-these-heatstroke-prevention-tips" target="_self" title="Opens in same window.">signs of overheating</a>, which include increased sweating, dizziness, fatigue, unquenchable thirst and muscle cramps. If you experience these symptoms, get out of the sun, hydrate and use cool cloths to lower your body temperature.</li> </ul> <h3>Additional precautions include:</h3> <ul> <li><strong>Planning ahead.</strong><br /> Always have an action plan for outdoor activities. Pack extra water and ice packs, and have current medications available. Be aware of the heat index and air quality, especially if traveling. Be prepared to find air conditioning or a shady tree if you feel overheated.</li> <li><strong>Using technology.</strong><br /> The Centers for Disease Control and Prevention offers a <a rel="noopener" href="https://ephtracking.cdc.gov/Applications/heatTracker/" target="_blank" title="Opens in a new window.">Heat & Health Tracker app</a>, which provides information on heat risk and air quality. This can be a valuable tool for planning your day. You can input your ZIP code and get real-time updates on the heat index and air quality.</li> </ul> <p>Recognize the signs that professional medical help is needed. If you haven't urinated in over 24 hours or if you're experiencing frequent uterine cramps, contact your healthcare team. </p> <p> Pregnancy is a time of great care and precaution. Summer heat adds a layer of complexity, but pregnant people can enjoy the season safely with the proper planning and awareness. Always prioritize hydration, wear appropriate clothing, seek shade and be vigilant about the signs of overheating.</p> <p><a href="/providers/abbey-rose-cnm-apnp" target="_self" title="Opens in same window."><em>Abbey Rose</em></a><em> is a certified nurse midwife in <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/tomah" target="_self" title="Opens in same window.">Tomah</a>, Wisconsin.</em></p><ul> <li>Lactation support</li> <li>Postpartum depression management and support</li> </ul>CNM, A.P.N.P.<p>I pursued by master's in midwifery to give women a different option of care. I strive to educate and empower women to take ownership of their health care experience. It is important for me to ask each woman I care for to share with me her story. I want women to be heard in their own voice.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Nursing, Viterbo University</li> <li>Master's degree, Nursing, Frontier Nursing University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Internation Board Certified Lactation Consultants</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Nurse Midwives (ACNM)</li> <li>American Collete of Obstetricians and Gynecologists (ACOG)</li> <li>Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN)</li> </ul>Rose<img src="/-/media/shared-files/images/medical-professionals/full/tomah/abbey-rose-cnm-apnp.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A10B8590322E2098992335DE530EC543" alt="Abbey Rose, CNM, A.P.N.P." width="280" height="280" DisableNVelocity="true" />Abbey<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21231567Abbey Rose, CNM, A.P.N.P.1{54693F31-87AF-4B21-91DB-1DEC1E21F878}<img src="/-/media/national-files/images/hometown-health/2024/pregnant-person-drinking-water.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6942BA058384C32876AFA327E5F0AAFC" alt="Pregnant person drinking water" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller7/16/2024Do you ever feel weighed down by negativity? Learn how to thrive through resiliency. Just as you train your muscles with exercise, use these seven strategies to strengthen your resiliency muscle.Learn how to strengthen your resiliency muscle<p>Resilient people are made, not born. There isn't a gene or a personality trait for resiliency. It's a skill you can practice and strengthen, just as you would a muscle. Becoming more resilient is something you can develop at any age or phase of life.</p> <h2>This, not that: Recognizing resiliency</h2> <p>Resilience is the ability to adapt to difficulties and challenges and manage their impact on your life. Resilience is how you withstand adversity, bounce back and even prevent or pre-empt adversity.</p> <p>Think of a rumble strip on the highway. When your tires hit the strip, there's a rumble signaling you to take action to get back on the road. The rumble strip is an example of resilience. It alerts you to a stressor so you can correct course and recover.</p> <p>Resilience is not keeping your head down, powering through and stuffing away your emotions. It's not ignoring or pretending not to be affected by the messiness of life.</p> <p>Instead, resilience is responding positively to help you move forward.</p> <h2>Overcoming negativity</h2> <p>Part of resiliency is finding the positive in the negative. For example, someone may have suffered a terrible accident and been told they will never walk again. That could be an overwhelming negative. Resilience can help them find that little kernel of positivity and act on it, such as joining a wheelchair basketball team or advocating for people with disabilities.</p> <p>This isn't easy. The human brain is hardwired toward negativity. Throughout our evolution, humans have needed to pay attention to threats to ensure survival. Fast-forward to today. People no longer have to worry about being eaten by saber-toothed tigers; but now, there are everyday life stresses that they fear. The fight-or-flight switch is stuck in the on position, which makes negativity the default mode.</p> <h2>Training your brain toward positivity</h2> <p>Increasing awareness of when you're stuck in negativity can be incredibly powerful. Awareness allows you to stop, intervene and focus on a more positive path. That's how you develop and <a href="/hometown-health/speaking-of-health/9-ways-to-tame-anxiety-during-the-covid-19-pandemic" target="_self" title="Opens in same window.">strengthen your resiliency</a>.</p> <h2>Seven strategies to cultivate and focus on the positive are to:</h2> <h3>1. Identify three good things at the beginning or end of your day. </h3> <p>These don't have to be huge. For most people, positive events are in the low- to moderate-size range, like running into a friend at the store, finding a forgotten dollar in a pocket or learning that the weird noise in your car only required a quick and inexpensive fix.</p> <p>What matters isn't the intensity of positive experiences; it's the frequency of recognizing them. This exercise helps train our brains to <a href="/hometown-health/speaking-of-health/finding-joy-throughout-life" target="_self" title="Opens in same window.">pay more attention to the positive</a>. Try identifying three good things every day for two weeks, and you'll automatically begin recognizing those positive kernels.</p> <h3>2. Practice gratitude.</h3> <p>Ask yourself, "Who or what am I grateful for?" Once again, this is more than just big things because it's easy to forget all the <a href="/hometown-health/speaking-of-health/can-expressing-gratitude-improve-health" target="_self" title="Opens in same window.">small things you appreciate</a>.</p> <p>A study conducted among nuns asked them to count their blessings rather than burdens. They were divided into two groups. One kept a daily journal of their blessings; the other was the control group. Researchers found that the nuns who expressed more gratitude lived up to a decade longer than those in the control group.</p> <p>To practice this resiliency skill, regularly jot down what you're grateful for or send someone a gratitude letter, email or text.</p> <h3>3. Try something different.</h3> <p>Your brain loves novelty and the new. Notice the new playground equipment at the park or take a different route to the store. At the store, pick up an item <a href="/hometown-health/speaking-of-health/looking-to-try-something-new-start-with-what-you-eat" target="_self" title="Opens in same window.">you've never tried before</a>.</p> <h3><strong>4. Spend time in nature.</strong></h3> <p>Nature is full of novelty. Notice the beauty around you: what's in the sky above, the bark patterns on a tree and how light streams through clouds after a storm. Try spending five minutes outdoors and mentally noting what you see, smell, hear and feel.</p> <h3>5. Focus on what you can control.</h3> <p>You're stuck in traffic. There's nothing you can do about the fender bender that just happened ahead of you. Do you get all worked up? Or do you take deep breaths to tamp down the stress and evaluate the situation? Are you in danger? No. Are you going to miss a flight? Probably not. Is there an exit ahead you can take? Yes. Is this a tragedy or an inconvenience? Inconvenience. Will this matter 10 days from now? No.</p> <p>Focus on what <a href="/hometown-health/speaking-of-health/tips-to-help-ease-anxiety" target="_self" title="Opens in same window.">you can control</a>: your reaction to the situation.</p> <h3>6. Foster relationships.</h3> <p>Relationships are essential to resiliency. You can connect with different people for different reasons. You choose who is in your tribe and why. It's these people who you value and who value you. They're the ones who will be there for you when faced with the challenges of life, both large and small.</p> <h3>7. Be mindful.</h3> <p><a href="/hometown-health/speaking-of-health/use-mindfulness-to-improve-well-being" target="_self" title="Opens in same window.">Mindfulness</a> is focusing on the moment and paying attention. But being mindful is tough. The brain is easily hijacked from the now by thoughts of the past and future and judgmental thoughts about ourselves and others.</p> <p>The next time you're in a conversation and your mind starts wandering off to what you'll say in response, pull your attention back to the speaker. <span>   </span></p> <h2>Passing along the resiliency 'gene'</h2> <p>You don't need to tackle all these strategies at once. Pick one and play around with it.</p> <p>Strengthening your resiliency muscle is a journey. Working on this skill throughout your life can help you grow. It's also a skill you can <a href="/hometown-health/speaking-of-health/fostering-resiliency-in-kids" target="_self" title="Opens in same window.">teach children</a> and set them up to be more resilient as they face the ups and downs of life.</p> <p><a href="/providers/rosean-bishop-lp" target="_self" title="Opens in same window."><em>Rosean Bishop, Ph.D.</em></a><em>, is a psychologist in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Family medicine resident education</li> <li>Integrated behavioral medicine</li> <li>Resilience training</li> </ul>Ph.D., L.P.<p><strong>Education</strong></p> <ul> <li>Doctor of Philosophy, Counseling Psychology, Pennsylvania State University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Counseling Center, University of Rochester, New York</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Counseling Center, Vanderbilt University, Nashville, Tennessee</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Licensed Psychologist, Minnesota Board of Psychology</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Psychological Association</li> <li>Minnesota Psychological Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine and Psychology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota</li> </ul>Bishop<img src="/-/media/shared-files/images/medical-professionals/full/mankato/rosean-bishop-phd-lp.jpg?h=200&iar=0&w=200&sc_lang=en&hash=D37783EF34004E64C8CDA884C074F5C1" alt="Rosean Bishop LP" width="200" height="200" DisableNVelocity="true" />Rosean<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15429687Rosean Bishop LP1<img src="/-/media/national-files/images/hometown-health/2024/person-feeding-horse.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6B480466E4ECFF5275B12EDEC87D244A" alt="Person feeding horse" width="660" height="370" DisableNVelocity="true" />ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller7/3/2024Are you hosting a summer party or an outdoor event? Making food safety a top priority can ensure your guests have a fun and safe experience. Follow these four simple food safety tips.4 essential food safety tips for summertime gatherings<p>Summer is a season of outdoor gatherings, <a href="/hometown-health/speaking-of-health/8-healthy-tips-for-summer-dining" target="_self" title="Opens in same window.">barbecues and picnics</a>, where food is often at the center of the festivities. However, the warm weather also creates ideal conditions for the growth of harmful bacteria, increasing the risk of foodborne illnesses. It's critical that you follow food safety recommendations so you can enjoy hosting and attending these events without worrying about getting sick.</p> <h2>Follow these four simple tips to prevent foodborne illness:</h2> <h3>1. Wash your hands and surfaces often.</h3> <p><a href="/hometown-health/speaking-of-health/5-ws-of-healthy-hands" target="_self" title="Opens in same window.">Wash your hands frequently</a>, especially when handling food. Always wash your hands after using the bathroom, changing a diaper or touching pets. Also clean your hands before eating and after sneezing or coughing. If you can't use soap and hot, running water, clean your hands with disposable hand wipes before and after working with food. Confirm that all surfaces are clean before preparing food. Regularly sanitize countertops, cutting boards and utensils.</p> <h3>2. Avoid cross-contamination.</h3> <p>When packing a cooler, securely package raw meats and store them separately from other foods to prevent their juices from leaking onto ready-to-eat items. Thoroughly wash any plates, containers and utensils that have come into contact with raw meats or poultry before using them for cooked food. Use separate cutting boards for raw meat and other foods, and always wash your hands after handling raw meat to prevent the spread of harmful bacteria. Keep utensils and food covered until serving time. Flies, other insects and pets can carry germs or salmonella and spread them to your food and serveware if they touch them.</p> <h3>3. Cook food to safe temperatures.</h3> <p>Bring a food thermometer to ensure meat and poultry are fully cooked. Be aware of the <a rel="noopener" href="https://www.fsis.usda.gov/food-safety/safe-food-handling-and-preparation/food-safety-basics/safe-temperature-chart" target="_blank" title="Opens in a new window.">recommended internal temperatures</a> for each type of meat. Make sure the thermometer rests in the thickest part of the meat for an accurate reading. Do not partially cook food in advance, as this can allow bacteria to survive and multiply, potentially reaching levels that later cooking won't eliminate.</p> <h3>4. Refrigerate food promptly.</h3> <p>Ensure perishable items, like luncheon and cooked meats, chicken and salads, are always chilled. To avoid temperature fluctuations, consider using a separate cooler for beverages since people will open a drink cooler frequently. Package and put leftovers in a cooler or fridge within two hours after eating. When in doubt about the safety of any food item, throw it out.</p> <p>If you develop what you suspect is a foodborne illness, keep a careful watch on your symptoms. While many illnesses can be treated by increasing fluid intake to replace lost fluids or electrolytes, severe cases may require further treatment. Seek medical attention right away if you are experiencing symptoms such as diarrhea, high fever, blood in your stools, prolonged vomiting, severe dehydration or signs of shock or confusion.</p> <h2>Next steps:</h2> <ul> <li><a href="https://www.mayoclinichealthsystem.org/providers?service=Family%20Medicine&populateTracking=True" target="_self" title="Opens in same window.">Find a family medicine professional</a> near you.</li> <li><a href="/request-appointment" target="_self" title="Opens in same window.">Request an appointment</a> today.</li> <li>Find out <a href="/hometown-health/speaking-of-health/be-sun-savvy-and-protect-yourself-from-skin-cancer" target="_self" title="Opens in same window.">how to be sun savvy</a> to protect from skin cancer.</li> <li>Get more <a href="/hometown-health/speaking-of-health/summer-fun-safety-tips" target="_self" title="Opens in same window.">summer safety tips</a>.</li> <li>Learn <a href="/hometown-health/speaking-of-health/boating-this-summer-make-safety-your-top-priority" target="_self" title="Opens in same window.">safety rules when boating</a>.</li> </ul> <p><a href="/providers/michael-ulrich-md" target="_self" title="Opens in same window."><em>Michael Ulrich, M.D.</em></a><em>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a>, Minnesota.</em></p><ul> <li>Emergency medicine</li> <li>Sports medicine</li> <li>Wound care</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of British Columbia</li> </ul> <p> <strong>Residency</strong></p> <ul> <li>University of British Columbia</li> </ul> <p> <strong>Certifications</strong></p> <ul> <li>American Board of Family Medicine (ABFM)</li> <li>Canadian College of Family Practice (CCFP)</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Ulrich<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/michael-ulrich-md.jpg?h=280&iar=0&w=280&hash=718CEE70AD1B55B597625993B64ACDF0" alt="Michael Ulrich MD" width="280" height="280" DisableNVelocity="true" />Michael<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13567055Michael Ulrich, M.D.1<img src="/-/media/national-files/images/hometown-health/2024/table-of-summer-food.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1CE3840CF326A4D17F0DDF6EFD82E80B" alt="Table of summer food" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller8/7/2024Is your child ready for the new school year? Before packing your child's backpack with new school supplies, prepare them for a successful school year with these back-to-school basics.Back-to-school essentials: Parent's guide for a healthy start to the school year<p>As the back-to-school season approaches, parents and guardians have much to consider for their children to have a healthy and successful start to the new academic year. From scheduling well-child examinations to planning for proper nutrition and adequate sleep, the list of tasks may feel daunting.</p> <p>Here are back-to-school tips to help you and your children prepare.</p> <h2>Well-child examinations</h2> <p><a href="/hometown-health/speaking-of-health/schedule-your-childs-back-to-school-physical" target="_self" title="Opens in same window.">Well-child examinations</a> are a cornerstone of healthcare for children of all ages. These check-ups are essential for monitoring your child's growth and development, catching potential health issues early and ensuring they are physically and mentally prepared for school.</p> <h3>During a well-child examination, the healthcare team will:</h3> <ul> <li>Create a comprehensive medical history, which is crucial for future healthcare needs.</li> <li>Identify and manage potential health problems before they become more serious.</li> <li>Monitor and track your child's growth patterns and development.</li> <li>Update your child's medical history and verify that vaccinations are current.</li> </ul> <h2>Vaccinations</h2> <p><a href="/hometown-health/speaking-of-health/the-facts-about-vaccinations" target="_self" title="Opens in same window.">Vaccinations play a critical role</a> in protecting children from various infectious diseases. Illnesses can quickly spread, so ensuring your child is current on vaccinations is vital.</p> <h3>The Centers for Disease Control and Prevention and healthcare professionals recommend these vaccinations:</h3> <ul> <li>Diptheria/tetanus/pertussis</li> <li>Haemophilus influenza B</li> <li>Hepatitis A</li> <li>Hepatitis B</li> <li><a href="/hometown-health/speaking-of-health/hpv-immunization-who-can-benefit" target="_self" title="Opens in same window.">Human papilloma virus</a></li> <li>Influenza</li> <li>Meningococcal</li> <li>MMR</li> <li>Pneumococcal</li> <li>Polio</li> <li>Rotavirus</li> <li>Varicella (chickenpox)</li> </ul> <p>Talk with your healthcare team about vaccines your state requires to attend school.</p> <h2>Nutrition</h2> <p>A balanced diet is fundamental to a child's physical and cognitive development. Proper nutrition helps children maintain energy levels, concentrate better in school and support overall growth and development. Children require different amounts of nutrients based on their age. </p> <h3>Follow these nutrition tips for your family:</h3> <ul> <li>Encourage your child to drink plenty of water to stay hydrated, especially during the warmer months.</li> <li>Minimize sugary snacks and <a href="/hometown-health/speaking-of-health/the-buzz-on-energy-drinks" target="_self" title="Opens in same window.">sweetened beverages</a> to help prevent obesity and dental problems.</li> <li>Offer meals made from fresh foods, including dairy, fruits, protein, vegetables and whole grains.</li> <li>Provide nutritious snacks like fruits, nuts and yogurt to energize your child throughout the day.</li> <li>Start every day with breakfast.</li> <li>Visit <a rel="noopener" href="https://www.healthychildren.org/English/healthy-living/nutrition/Pages/Healthy-Active-Living-for-Families.aspx" target="_blank" title="Opens in a new window.">Healthy Active Living for Families</a> to learn about the 5-2-1-0 rule.</li> </ul> <p>Talk with your child's healthcare team if you have questions about your child's nutritional needs.</p> <h2>Sleep</h2> <p>Adequate sleep is crucial for a child's overall well-being, affecting everything from their mood to their ability to learn and retain information. Children who do not get enough sleep are more likely to experience attention problems, behavioral issues and poor academic performance.</p> <h3>Tips for ensuring adequate sleep include:</h3> <ul> <li>Create a consistent bedtime routine to help your child wind down and prepare for sleep.</li> <li>Encourage your child to get the <a href="/hometown-health/speaking-of-health/sleep-an-essential-element-of-success-for-children" target="_self" title="Opens in same window.">recommended amount of sleep</a> each night, typically eight to 10 hours for school-aged children.</li> <li>Ensure your child's bedroom is quiet, dark and cool to facilitate restful sleep.</li> <li>Reduce exposure to screens at least an hour before bedtime to promote better sleep quality and remove screens from the room at bedtime.</li> <li>Try a red light in the bedroom, which may help release melatonin naturally. Avoid using a blue light.</li> </ul> <h2>Bullying</h2> <p>Bullying is a serious issue that can significantly affect a child's mental and emotional health. It occurs far too often nationwide in elementary, junior high and high schools. Parents and guardians must <a href="/hometown-health/speaking-of-health/cyberbullying-tips-to-protect-kids" target="_self" title="Opens in same window.">take bullying seriously</a> and teach your children a few tactics to address bullies productively.</p> <h3>Steps to take if bullying occurs:</h3> <ul> <li>Ask a teacher or other school officials for help.</li> <li>Don't fight back and maintain composure.</li> <li>Say "stop" confidently.</li> <li>Walk away.</li> </ul> <p>It's crucial to offer emotional support and reassurance to your child. If needed, consider professional counseling to help them cope with the effects of bullying.</p> <h2>Creating a positive start to the school year</h2> <p>Preparing for the new school year involves more than buying school supplies and updating the calendar with activities. It's also about prioritizing your child's health and well-being to ensure their success and happiness. </p> <p> By scheduling well-child examinations, keeping vaccinations up to date, providing balanced nutrition, ensuring adequate sleep, addressing bullying and modeling these healthy habits yourself, you can help your child have a healthy, productive and successful school year.</p> <p><em>Christina Andrist, D.O., is a <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">pediatrician</a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2024/two-kids-by-school-lockers.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D4D8FE7531753C4D26821D5A1CD24532" alt="Two kids by school lockers" width="660" height="370" DisableNVelocity="true" />Back to SchoolPediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller8/2/2024Discover the power of your diet and nutrition habits in lowering your cancer risk. Learn which foods and beverages to consider removing from your pantry and what to add to your next grocery list.Nourishing your health: Diet and nutrition factors for cancer prevention<p>Compelling evidence shows that generous amounts of fruits and veggies as part of a healthy diet may lower the risk of chronic diseases like diabetes, heart disease and certain types of cancer. Eating a nutritious diet and adopting beneficial behaviors have the power to decrease the possibility of developing cancer.</p> <h2>Risks from foods and beverages</h2> <h3>Alcohol use</h3> <p><a href="/hometown-health/speaking-of-health/does-drinking-alcohol-kill-brain-cells" target="_self" title="Opens in same window.">Alcohol use</a> is linked to an increased risk of cancer as the third most modifiable lifestyle factor. Research shows that less than one drink of any type of alcohol per day increases the risk of common cancers like breast, head and neck and esophageal cancers.</p> <p>Decreasing <a href="/hometown-health/speaking-of-health/balancing-the-risks-benefits-of-alcohol" target="_self" title="Opens in same window.">alcohol consumption</a> lowers your cancer risk.</p> <h3>Processed and red meat</h3> <p>Research shows diets with more than 18 ounces of red meat weekly can increase your cancer risk. <a href="/hometown-health/speaking-of-health/processed-foods-what-you-should-know" target="_self" title="Opens in same window.">Processed meats</a> like hot dogs and deli meat should be limited or avoided entirely.</p> <p>Consuming moderate amounts of red meat provides a good protein, iron, zinc and vitamin B12 source. The recommended intake should be limited to 12–18 ounces of red meat per week, divided into three or more portions.</p> <p>Also, cooking meats at high temperatures or charring them can create harmful chemicals that may raise cancer risk.</p> <h3>Sugars and sweeteners</h3> <p>Although research hasn't shown a direct link between eating sugar and cancer risk, eating too much sugar over time can lead to obesity, which is a known risk factor for cancer. Also, research suggests that higher amounts of <a href="/hometown-health/speaking-of-health/the-not-so-sweet-truth-of-added-sugars" target="_self" title="Opens in same window.">added sugars</a> can lead to insulin resistance, as well as elevated insulin levels and insulin-like growth factor-I (IGF-I). These factors may all increase the risk of cancer.</p> <h2>Diet and nutrition</h2> <p>Focus on eating a diet rich in fruits and veggies, legumes, nuts and seeds, lean meats, low-fat dairy products and whole grains. Most foods have functional components, such as antioxidants,, omega-3 fatty acids and polyphenols. <a href="/hometown-health/speaking-of-health/maximize-memory-function-with-a-nutrient-rich-diet" target="_self" title="Opens in same window.">Functional foods</a>, also known as superfoods, work to decrease damage caused by inflammation and oxidation. Oxidation is a natural process that leads to cell and tissue damage and may contribute to some diseases.</p> <p>Over the years, research has revealed the true power of plant-based nutrition to decrease the risk of certain types of cancer. As research continues to reveal, there isn't a single food that protects you from cancer. It's a cumulative approach of overall diet choices, exercise and other lifestyle factors.</p> <p>Aim to eat a variety of fruits, veggies, whole grains, legumes, nuts and seeds to maximize the benefits of a cancer-preventive diet. The more variety and color you add to your plate meals, the more you improve your overall health.</p> <h2>Next steps:</h2> <ul> <li>Find a <a href="https://www.mayoclinichealthsystem.org/providers?service=Nutrition" target="_self" title="Opens in same window.">registered dietitian nutritionist near you</a>.</li> <li>Learn about managing chronic conditions with <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">nutrition counseling</a>.</li> <li>Read more about <a href="/hometown-health/speaking-of-health/plant-power-to-lower-cancer-risk" target="_self" title="Opens in same window.">using diet to lower cancer risk</a>.</li> <li>Get <a href="/hometown-health/speaking-of-health/diet-tips-during-cancer-treatment" target="_self" title="Opens in same window.">diet tips to reduce side effects during cancer treatment</a>.</li> <li>Find out why <a href="/hometown-health/speaking-of-health/bariatric-surgery-and-cancer-risk" target="_self" title="Opens in same window.">bariatric surgery may reduce cancer risk</a>.</li> </ul> <em><a href="/providers/grace-fjeldberg-rd" target="_self" title="Opens in same window."><em>Grace Fjeldberg</em></a> is a registered dietitian nutritionist in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window.">Nutrition</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em><ul> <li>Bariatric surgery</li> <li>General nutrition</li> <li>Oncology</li> <li>Pediatric nutrition</li> </ul>RDN, LD <p><strong>Education</strong></p> <ul> <li>Minnesota State University, Mankato</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Mayo Clinic College of Medicine, Minnesota</li> </ul> <p><strong>Certifications</strong> </p> <ul> <li>Commission on Dietetic Registration</li> <li>Minnesota Board of Dietetics and Nutrition Practice</li> </ul> Fjeldberg<img src="/-/media/shared-files/images/medical-professionals/full/mankato/grace-fjeldberg-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=FB99EC499314FA86AE8202C30AB740A2" alt="Grace Fjeldberg RDN" width="280" height="280" DisableNVelocity="true" /> Grace<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15268781Grace Fjeldberg R.D.N. 1<img src="/-/media/national-files/images/hometown-health/2024/healthy-food-dish.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1D5820D659634665266C376CC1182121" alt="Healthy food dish" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Dawn Haller8/14/2024Developing a lifelong exercise habit is key to bariatric surgery success. To stick with exercising, find what you like to do, but switch it up to add variety and challenge your body. Learn how.Why exercise is essential after bariatric surgery<p><a href="/hometown-health/speaking-of-health/thinking-about-weight-loss-surgery" target="_self" title="Opens in same window.">Bariatric surgery</a> is more than just surgery. It's a lifestyle change that includes a lifelong <a href="/hometown-health/speaking-of-health/establishing-healthy-behaviors-that-stick" target="_self" title="Opens in same window.">commitment to eating healthy</a> with your dietitian's guidance and incorporating <a href="/hometown-health/speaking-of-health/the-5-elements-of-fitness" target="_self" title="Opens in same window.">regular exercise</a> into your routine.</p> <p>After bariatric surgery, patients who regularly exercise for 60 minutes six days a week lose weight more quickly and dramatically improve their capacity for exercise.</p> <h2>Take advantage of peak weight-loss period</h2> <p>The time to <a href="/hometown-health/doctors-orders/need-to-exercise-start-slowly" target="_self" title="Opens in same window.">establish your exercise habits</a> is before you have the surgery. Then solidify that routine during the first year after surgery, which is when people typically find it easiest to lose weight.</p> <p>After bariatric surgery, your body may try to hold onto its fat stores until its other energy sources are depleted. This can lead to the loss of muscle mass after surgery. To minimize or prevent the body from using muscle mass for energy, it's crucial to work your muscles regularly.</p> <h3>Some of the benefits of cardio, strength and endurance training are:</h3> <ul> <li>Improved heart condition, balance, stability and mood</li> <li>Increased energy, lean muscle mass and bone density</li> <li>Reduced body fat, risk of injury and stress</li> </ul> <h2>Amp up, change your exercise routine</h2> <p>When people lose weight, their energy expenditure — the number of calories the body burns — is reduced both at rest and during exercise. This means that when you lose weight, but continue the same exercise routine, you burn fewer calories than before you lost weight.</p> <p>In addition, regular exercise increases your capacity and ability to work harder. As you become better conditioned, your workout will feel easier than when you first began. This is an indication that it's time to increase the exercise intensity.</p> <p>You want to aim for a level of cardiorespiratory exercise that's somewhat difficult for you. One test of intensity is if you can talk in breathy sentences as you exercise. If you can't speak, scale back until you can.</p> <p>Consider changing your exercise routine by <a href="/hometown-health/speaking-of-health/prevent-boredom-and-injury-during-physical-activity" target="_self" title="Opens in same window.">trying something new</a>. If you feel comfortable with your treadmill workout, try switching to another piece of equipment, such as an elliptical or cycle. Or take a class such as low-impact aerobics, spinning, <a href="/hometown-health/speaking-of-health/aquatic-exercise-healthy-easy-on-the-body" target="_self" title="Opens in same window.">water fitness</a> or aerobic dance.</p> <p>These tweaks to your routine can challenge your body in new ways and help maintain your interest in exercising. Workout variety also plays a significant role five to six months after bariatric surgery, when many patients experience a <a href="/hometown-health/speaking-of-health/why-has-my-weight-plateaued-when-i-have-50-more-pounds-to-lose" target="_self" title="Opens in same window.">weight-loss plateau</a>. Changing your exercise routine can minimize or even eliminate a plateau.</p> <h2>Increase exercise intensity, time, frequency</h2> <p>As your fitness improves, you'll be able to increase the intensity, time or frequency of your exercise routine. One way to do that is through <a href="/hometown-health/speaking-of-health/interval-training-for-heart-health" target="_self" title="Opens in same window.">high-intensity interval training (HIIT)</a>. As with any new form of exercise, check with your healthcare team to make sure HIIT is a good fit for you.</p> <p>A HIIT workout alternates between short intense bursts of exercise and active recovery, which is like a "breather" with less intense exercise. Research shows that HIIT workouts are more effective for heart health, fat loss and strength gain than traditional cardio and strength training. HIIT can be incorporated into nearly any exercise from running to water fitness.</p> <h2>Pay attention to strength training</h2> <p>As you plan your routine, focus on <a href="/hometown-health/speaking-of-health/no-matter-your-age-or-skill-level-its-never-too-late-to-start-weight-training" target="_self" title="Opens in same window.">muscle-strengthening exercises</a> at least three days a week, which will also improve your bone density and metabolism. Muscle burns calories even at rest, so if you increase your muscle mass, you will burn more calories throughout the day.</p> <p>You can build muscle strength using weight machines, resistance bands, free weights and <a href="/hometown-health/speaking-of-health/isometric-exercise-and-blood-pressure" target="_self" title="Opens in same window.">your own body weight</a>.</p> <h2>A new lifestyle, not a chore</h2> <p>You've undergone bariatric surgery not only to lose weight but also to improve your health. Reaching your goals requires changing your lifestyle, and exercise is essential to that success. Becoming a regular exerciser can be empowering, fun and open doors to meeting new people and broadening your interests.</p> <p>To keep exercise from becoming a chore, find what you like to do, but switch it up to add variety and challenge your body in different ways. Cardio and strength training are both key to a successful exercise and weight-loss routine.</p> <h2>Next steps:</h2> <ul> <li>Find <a href="/services-and-treatments/bariatric-surgery" target="_self" title="Opens in same window.">bariatric surgery</a> resources.</li> <li>Explore the option of a <a href="/hometown-health/speaking-of-health/athletic-or-personal-trainer-best-fit" target="_self" title="Opens in same window.">personal or athletic trainer</a>. </li> <li>Watch a video on heart health and wearable fitness devices:<br /> <div> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/1OnQHdN4m_Q" title="Heart Health: Best Exercise & Wearable Fitness Trackers" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> </div> </li> </ul> <p><a href="/providers/melinda-hahm" target="_self" title="Opens in same window."><em>Melinda Hahm</em></a><em> is a clinical exercise physiologist in <a href="/services-and-treatments/bariatric-surgery" target="_self" title="Opens in same window.">Bariatric Surgery</a> and a cardiac rehab tech in <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">Cardiology</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Diseased population</li> <li>Helping patients to find ways to become more physically active and incorporate exercise into their lifestyle</li> </ul>ACSM-CEP<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Exercise Physiology, Winona State University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Clinical Exercise Physiologist, American College of Sports Medicine</li> <li>Senior Fitness Training Specialist, American Academy of Health and Fitness</li> </ul>Hahm<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/melinda-hahm.JPG?h=280&iar=0&w=280&sc_lang=en&hash=07CDEFA0A5AA9AA76DB482AC9AF90A59" alt="Melinda Hahm" width="280" height="280" DisableNVelocity="true" />Melinda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13271296Melinda Hahm, ACSM-CEP1{94B2E140-AEF8-44BA-B6A9-4538B77501BC}<img src="/-/media/national-files/images/hometown-health/2024/person-in-gym-in-plank-position.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B8CDAB9CD3638D3A5382D7E182D2DE46" alt="Person in gym in plank position" width="660" height="370" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Dawn Haller8/28/2024Supporting someone who is grieving a loved one's death by suicide can be uncomfortable. Learn how to start and continue compassionate conversations.How to talk with someone grieving a suicide loss<p>In 2021, suicide was the 11th leading cause of death in the U.S., claiming the lives of more than 48,000 people — nearly double the number of homicides. People of all ages, ethnicities and backgrounds choose to end their own lives. That means that people of all ages, ethnicities and backgrounds may be affected by suicide.</p> <p>When learning that a loved one, friend, neighbor, work colleague or <a href="/hometown-health/speaking-of-health/do-children-grieve" target="_self" title="Opens in same window.">child</a> has lost someone to suicide, you want to support them. Your first thought might be, "What do I say?"</p> <p>Supporting someone <a href="/hometown-health/speaking-of-health/offering-support-to-the-grieving" target="_self" title="Opens in same window.">grieving</a> a suicide loss can be uncomfortable and even a bit scary. The support you provide is crucial to helping them navigate this tragedy, and it's essential to their mental health. Be aware that those who have lost someone to suicide are at a higher risk of dying from suicide, as well.</p> <h2>How to start the conversation about suicide</h2> <p>People who have lost a loved one to suicide may consider themselves a survivor. They may be experiencing a complex range of feelings from grief to anger, shame and fear. Being present and showing you care — without judgment — plays a vital role in supporting them.</p> <p>When talking with the survivor, show you still remember their loved one. Use the person's name, share memories and maybe even photos of time spent together. Talking openly about the person can help remove the stigma of their death. Sometimes, all you need to do is listen.</p> <p>The survivor may ask unanswerable questions, such as, "I don’t understand how this happened," or "How could they do this to me?" Validate those thoughts and acknowledge that neither of you has the answers. Provide support with statements such as, "This is very hard for you, and I'm sorry that I don't have any answers."</p> <h2>Maintaining connection after loss</h2> <p>Often, a survivor hears most from their circles of family and friends shortly after the death, but then the connections taper off. The survivor's emotions and feelings haven't tapered off. That's why keeping in touch is so important.</p> <p><a href="/hometown-health/speaking-of-health/grief-and-loss-throughout-the-holiday-season" target="_self" title="Opens in same window.">Holidays</a>, anniversaries, birthdays and other milestone events can be particularly difficult for survivors because they conjure up intense memories and emotions about their loved ones. Check in with survivors around these times. A "thinking of you" card, email or text may be all they need to know you're there for them. They may also ask for space, and that's OK too.</p> <p>Also, remember to include the survivor in activities. If you've frequently met for coffee, extend the invitation again. If they enjoy the theater, ask if they'd like to go to a show with you. If the answer is "no," accept it and don't push, but don't give up on them. The time will come when they say, "Yes."</p> <h2>Be aware of suicide warning signs</h2> <p>Because survivors are at greater risk of dying from suicide, pay attention to them. Listen to what they're saying and what they're not saying.  And although it's uncomfortable for you — without judging them or minimizing their feelings — gently ask if they're having thoughts of suicide themselves.</p> <h3>Here are some questions to consider:</h3> <ul> <li>Do you feel you have no hope for the future?</li> <li>Do you feel you'd be better off dead?</li> <li>Do you feel your loved ones would be better off without you?</li> <li>Do you think you might try to hurt yourself today?</li> <li>Have you had thoughts of suicide?</li> <li>Have you been thinking of killing yourself?</li> <li>Have you thought of ways you might hurt yourself?</li> <li>What would you do to end your life?</li> </ul> <p>Setting aside your discomfort to ask a few questions can help the survivor feel supported and less alone, isolated and hopeless.</p> <h3>If you're concerned for the survivor, here are some warning signs to watch for:</h3> <ul> <li>Acting anxious, agitated or behaving recklessly</li> <li>Experiencing extreme mood swings </li> <li>Increasing use of alcohol or drugs</li> <li>Looking for a way to kill themselves like searching online or buying a gun</li> <li>Showing rage or talking about seeking revenge</li> <li>Sleeping too little or too much</li> <li>Talking about being a burden to others</li> <li>Talking about feeling hopeless or having no reason to live</li> <li>Talking about feeling trapped or in unbearable pain</li> <li>Talking about wanting to die or to kill themselves</li> <li>Withdrawing or isolating themselves</li> </ul> <p>If you see these signs and are with the survivor, call 988, the national suicide and crisis line, a local crisis center or take them to the nearest emergency department.</p> <p>Everyone plays a <a href="/hometown-health/speaking-of-health/awareness-and-intervention-help-with-suicide-prevention" target="_self" title="Opens in same window.">role in suicide prevention</a>. Stay connected with a survivor, listen to them, be aware of risks and warning signs, and don't hesitate to offer help when needed.</p> <h2>Resources</h2> <h3>Note these crisis phone resources:</h3> <ul> <li><strong>988 Suicide and Crisis Lifeline</strong><br /> Call or text 988 or chat at <a rel="noopener" href="https://988lifeline.org/" target="_blank" title="Opens in a new window.">988lifeline.org</a>.</li> <li><strong>Crisis text line</strong><br /> Text "HOME" to 741-741.</li> <li><strong>For veterans</strong><br /> Call 988, then press 1.<br /> Text 838255.<br /> Chat at <a rel="noopener" href="https://www.veteranscrisisline.net/get-help-now/chat/" target="_blank" title="Opens in a new window.">Veterans Crisis Line</a>.</li> </ul> <h2>Read more about suicide: </h2> <ul> <li><a href="/hometown-health/speaking-of-health/8-common-myths-about-suicide" target="_self" title="Opens in same window.">Eight common myths about suicide</a> </li> <li><a href="/hometown-health/speaking-of-health/suicide-isnt-about-dying-its-about-perceived-relief" target="_self" title="Opens in same window.">Suicide isn't always about dying, it may be about perceived relief</a></li> <li><a href="/hometown-health/speaking-of-health/support-kids-who-identify-as-lgbtq" target="_self" title="Opens in same window.">Why it's important to support kids who identify as LBGTQ and may be struggling</a></li> <li><a href="/hometown-health/speaking-of-health/5-ways-to-help-teens-overcome-suicidal-thoughts" target="_self" title="Opens in same window.">Five ways to help teens overcome suicidal thoughts</a> </li> <li><a href="/hometown-health/speaking-of-health/how-to-support-a-loved-one-with-depression" target="_self" title="Opens in same window.">Supporting a loved one experiencing depression</a>.</li> </ul> <p><a href="/providers/jessie-wolf-licsw" target="_self" title="Opens in same window."><em>Jessie Wolf</em></a><em> is a clinical social worker in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> in <a href="/locations/new-prague" target="_self" title="Opens in same window.">New Prague</a>, Minnesota.</em></p><ul> <li>Adjustment disorders</li> <li>Adolescent and children’s behavioral health (ages 6-17)</li> <li>Anxiety disorders</li> <li>Attention-deficit/hyperactivity disorder (ADHD) assessment and treatment with adults and children (ages 6-17)</li> <li>Depressive disorders</li> <li>Grief and loss</li> </ul>L.I.C.S.W.<p>I see children six years of age through adulthood.</p><p><strong>Education </strong></p> <ul> <li>Master's degree, Social Work, Minnesota State University-Mankato</li> </ul> <p><strong>Internships</strong></p> <ul> <li>Hospice and Palliative Care, Mayo Clinic Health System-Mankato</li> <li>Nursing Home and Rehab Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>ADHD, Certified Clinical Services Provider </li> <li>Art of Traumatic Grief Counseling, Compassionate Bereavement Care</li> <li>Licensed Independent Clinical Social Worker</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Professional Society of ADHD and Related Disorders</li> <li>National Social Work Association</li> </ul> <p><strong>Academic Rank</strong></p> <ul> <li>Instructor in Social Work, Mayo Clinic College of Medicine and Science</li> </ul>Wolf<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jessie-wolf-licsw.jpg?h=280&iar=0&w=280&sc_lang=en&hash=B680201D1A0D763676AD889806D46E00" alt="Jessie Wolf LICSW" width="280" height="280" DisableNVelocity="true" />Jessie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14640821Jessie Wolf LICSW1{2B88C934-922C-4130-B661-197B59D83899}|{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2024/comforting-person-with-hug.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D5BF038A17C2D68DB8C891DFA157CEDE" alt="Comforting person with hug" width="660" height="370" DisableNVelocity="true" />Suicide PreventionSuicide is a major concern in the U.S. According to the Centers for Disease Control and Prevention, suicide was among the top nine leading causes of death for people ages 10–64 and the second leading cause of death for people ages 10–14 and 25–34. The positive news is that with the right information and willingness to reach out to someone in need, we all can help prevent suicide.<br /><br /><strong>If you are having suicidal thoughts, call the 988 Suicide and Crisis Lifeline at <a href="tel:988">988</a>, or chat at <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://988lifeline.org/" target="_blank" title="Opens in a new window.">988lifeline.org</a>.</strong>GriefGrief is the natural reaction to loss. It will be unique to you, depending on your own personality and circumstances.Dawn Haller9/23/2024ACL tears are one of the most common noncontact knee injuries. Learn how they happen, how they're treated and when you can expect to be back to your regular activities.Feel a pop, then pain in your knee? It could be an ACL tear<p>You're playing tag with your kids, hitting a fast tennis return shot, landing after a gymnastics vault, evading a football tackle or jumping off a rock onto the beach. Suddenly, you feel a pop in your knee, then immediate pain followed by swelling. You may have just injured or torn your anterior cruciate ligament, or ACL.</p> <h2>How an ACL tear can happen</h2> <p>The ACL is a tough band of tissue that lies within your knee and provides front-to-back and rotational stability. When there's too much force through the ligament — especially from a noncontact action — it can burst. This type of force happens during movements such as:</p> <ul> <li>Landing awkwardly from a jump.</li> <li>Making a quick change of direction.</li> <li>Pivoting with your foot planted.</li> <li>Receiving a blow to the knee, like when being tackled.</li> <li>Stopping suddenly.</li> </ul> <h3>The factors that can lead to an ACL injury include:</h3> <ul> <li><strong>Athletic activity</strong> — Participating in sports, such as soccer, football, basketball, gymnastics or downhill skiing.</li> <li><strong>Conditioning</strong> — Poor conditioning increases the risk of injury.</li> <li><strong>Field surface</strong> — Playing on artificial turf compared to other surfaces like grass since your foot can become more securely planted.</li> <li><strong>Gender</strong> — Women are more susceptible to ACL tears due to knee anatomy, muscle strength and hormonal influence.</li> <li><strong>Sports gear</strong> — Wearing footwear that doesn't fit properly or using poorly maintained sports equipment increases the risk of injury.</li> </ul> <h2>What to do after an ACL injury</h2> <p>As soon as possible after the injury, you can reduce pain and swelling by following the R.I.C.E. method at home.</p> <h3>The R.I.C.E. method includes:</h3> <ul> <li><strong>Rest</strong> — Promote healing and pain by limiting weight bearing on your knee.</li> <li><strong>Ice</strong> — Try to ice your knee for 20 minutes at least every two hours when you're awake.</li> <li><strong>Compression</strong> — Wrap your knee with an elastic bandage or compression wrap.</li> <li><strong>Elevation</strong> — Use pillows to prop up your knee.</li> </ul> <p>If you're concerned about the extent of the injury, consult with an orthopedic specialist, who may order an MRI, which is the gold standard for diagnosing ACL issues. Surgery is often necessary, especially if you want to return to higher-impact activities.</p> <h2>Treatment for an ACL injury</h2> <p>If the orthopedic specialist recommends surgery, you'll work with an orthopedic surgeon to reconstruct your ACL. During surgery, your surgeon strives to recreate your anatomy as closely as possible. Typically, you'll go home the same day as the surgery even if the meniscus, a shock-absorbing pad of cartilage, also has been damaged. Your surgeon will repair both at the same time.</p> <img alt="ACL graft illustration" style="width: 375px; height: 310px;" src="/-/media/national-files/images/hometown-health/2024/acl-graft-illustration.jpg?h=310&w=375&sc_lang=en&hash=5774EBFDE3072B6F07B08A1B6D7CF5EF" /> <p>Following an ACL reconstruction, you'll begin walking and undergo physical therapy right away to regain range of motion and strength. The goal is for you to return to regular activity as soon as possible.</p> <p>If you need more complex surgery, such as both ACL and meniscus repair, you typically won't be able to put full weight on the injured leg for four to six weeks. However, you'll still undergo physical therapy that focuses on range of motion and strength.</p> <h3>Watch a video on what to expect during and after surgery:</h3> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/sqz4GMnZ280" title="Guide to ACL Surgery" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <p>At about three months, your physical therapy team may start you on activity- or sports-specific exercises such as jogging or dribbling a ball. Part of your postoperative care may include working out on an <a rel="noopener" href="https://newsnetwork.mayoclinic.org/discussion/crossing-the-finish-line-with-help-from-sports-medicine/" target="_blank" title="Opens in a new window.">anti-gravity treadmill</a> that lets you practice running while putting no weight on your legs. Physical therapists also may conduct functional testing, including the hop test, to ensure that both legs have the same strength and range of motion. They also will gradually increase the impact on your healing leg.</p> <p>By about nine months, you should be able to return to unrestricted competition or higher-impact activity.</p> <h2>Take action to avoid an ACL tear</h2> <p>Researchers are still determining who may be predisposed to ACL tears. However, you can take action to help prevent an ACL injury. Lower your risk of injury by taking steps to:</p> <ul> <li>Increase stability by strengthening your core. </li> <li>Learn and practice good form and mechanics for your sport.</li> <li>Work on overall leg strength, including your quadriceps, hamstrings and glutes.</li> </ul> <h2>Next steps:</h2> <ul> <li>Find an <a href="https://www.mayoclinichealthsystem.org/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic</a> or <a href="https://www.mayoclinichealthsystem.org/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">sports medicine</a> specialist near you.</li> <li>Learn more about <a rel="noopener" href="https://www.mayoclinic.org/medical-professionals/orthopedic-surgery/news/achieving-optimal-outcomes-for-teen-athletes-with-acl-injury/mac-20562450" target="_blank" title="Opens in a new window.">ACL injuries in teen athletes</a>.</li> <li>Read more about <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/acl-injury/symptoms-causes/syc-20350738" target="_blank" title="Opens in a new window.">ACL injuries and treatment</a>.</li> <li>Watch a video on ACL tear treatment and risk reduction:<br /> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/gKjK0yav9uk" title="Navigating ACL Tears" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> </li> </ul> <p><em><a href="/providers/doug-bartels-md" target="_self" title="Opens in same window.">Douglas Bartels, M.D.</a></em><em>, is an orthopedic surgeon in </em><em><a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">Orthopedics</a></em><em> and </em><em><a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">Sports Medicine</a></em><em> in </em><em><a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a></em><em>, Wisconsin.</em></p><ul> <li>ACL injuries</li> <li>Cartilage restoration and transplantation</li> <li>Hip arthroscopy</li> <li>Knee arthroscopy</li> <li>Meniscus tears</li> <li>Multi-ligament knee injuries</li> <li>Open surgery of the knee </li> <li>Open surgery of the shoulder</li> <li>Patellar instability</li> <li>Rotator cuff injury</li> <li>Shoulder arthroscopy</li> <li>Shoulder instability</li> <li>Shoulder replacement surgery</li> <li>Sports medicine</li> <li>Tendon tears (Achilles, pec, tricep, bicep)</li> </ul>M.D.<p>I chose a career in sports medicine to help patients of all ages and activity levels regain function and get back to doing the things they love. In my practice, I enjoy taking care of acute and chronic shoulder, hip and knee injuries and issues. I take pride in providing individualized care and making sure you are a part of the decision-making process. As a lifelong athlete, my main goal is to get patients back to work, school, hobbies, and sports feeling better than they did before their injury.</p> <p>I grew up in the Midwest and am thrilled to be providing orthopedic care in Northwest Wisconsin. As a college athlete I was exposed to sports-related injuries, which sparked my interest in orthopedics and sports medicine. During my residency and fellowship, I was able to be a team doctor for athletes at the high school level all the way to the professional level with the San Francisco 49ers.</p> <p>In my spare time, I enjoy spending time with my family and dogs along with traveling and fishing.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Biological Anthropology, Northwestern University</li> <li>Master's degree, Liberal Studies, Northwestern University</li> <li>Doctor of Medicine, Rush Medical College</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Sports Medicine and Shoulder Surgery, Stanford Health Care</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Alpha Omega Alpha Honor Medical Society</li> <li>American Academy of Orthopedic Surgeons (AAOS)</li> <li>American Medical Association (AMA)</li> <li>American Orthopedic Society for Sports Medicine (AOSSM)</li> <li>Football Team Physician, San Francisco 49ers</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Orthopedics, Mayo Clinic College of Medicine and Science</li> </ul>Bartels<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/douglas-bartels-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A5E506A9AEFC8F3CA64AF69A13885600" alt="Douglas (Doug) Bartels M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/35188900/" target="_blank" title="Opens in new window">Antibiotic prophylaxis with cefazolin is associated with lower shoulder periprosthetic joint infection rates than non-cefazolin alternatives</a>; May 2022</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/33764935/" target="_blank" title="Opens in new window">Revision reverse shoulder arthroplasty for anatomical glenoid component loosening was not universally successful: A detailed analysis of 127 consecutive shoulders</a> May 2021</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/31039055/" target="_blank" title="Opens in new window">Mid-term radiological results of a cementless short humeral component in anatomical and reverse shoulder arthroplasty</a>; May 2019</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/30968051/" target="_blank" title="Opens in new window">Epidemiology of hand and wrist injuries in NCAA men's football: 2009-2010 to 2013-2014</a>; April 2019</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/30393556/" target="_blank" title="Opens in new window">Arthroscopy and arthrotomy to address intra-articular pathology during PAO for hip dysplasia demonstrates similar short-term outcomes</a>; June 2018</li> </ul>{C36F83B1-9C26-4B21-BA7B-739F5EB4C565}Douglas (Doug)<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20090200Douglas (Doug) Bartels, M.D.1{DEF55970-853F-4E96-9A4D-3413874FF059}|{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2024/pickleball-player-on-court.jpg?h=370&iar=0&w=660&sc_lang=en&hash=6FDB0B6D73B2C4393C9E825814370ADB" alt="Pickleball player on court" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller9/6/2024Narrow, pointy-toed, high-heeled shoes may be perfect for your outfit, but not so great for your feet. Pressure on your big toes can lead to bunions. Take steps to relieve this painful condition.How to step up to manage bunions<p>Stylish shoes can add the finishing touch to an outfit and help you feel like you're putting your best foot forward. But those dressy shoes might not be the best for your feet — especially your toes.</p> <p>Shoes that are narrow, tight, pointed or high-heeled can push the tip of your big toes toward and over your smaller toes, causing bunions.</p> <p>Bunions are bulging, bony bumps at the base of your big toes. As the angle of your big toe worsens, the joint may become red, swollen and ache. Pain can occur in the joint and under the ball of your foot.</p> <img alt="Bunion" style="width:325px; height:334px;" src="/-/media/shared-files/images/service-lines/orthopedics/bunion.jpg?h=334&w=325&sc_lang=en&hash=D31604B543269B85F37319AAE9885AE2" /> <p>Smaller bunions, called bunionettes or tailor's bunions, can form on the outer part of your foot at the base of your fifth toe.</p> <p>While your choice of shoes can contribute to bunions, other factors include:</p> <ul> <li>Arthritis</li> <li>Deformity at birth</li> <li>Inherited foot anatomy</li> <li>Injury</li> </ul> <p>Learn the steps to take to manage the pain of bunions or bunionettes.</p> <h2>First step: Relief without surgery</h2> <p>Typically, experiencing pain and not being able to wear stylish shoes or walk long distances lead people to seek care, usually with a podiatrist or orthopedic specialist.</p> <p>The first line of treatment is nonsurgical:</p> <ul> <li>Evaluate your shoe choices and select bunion-friendly options. Choose shoes with a wider toe box — no pointy toes — that give your toes room to spread out and relieve the pressure on the bunion.</li> <li>Give your shoes the "press" test to ensure there's a space between the tip of your big toe and the end of the shoe.</li> <li>Take over-the-counter medications like acetaminophen, ibuprofen or naproxen or apply ice to relieve pain and swelling.</li> <li>Try toe spacers that separate your toes and bunion guards that provide padding between the shoe and your aching joint.</li> </ul> <h2>Second step: Consider surgery</h2> <p>Keep in mind that bunion surgery isn't cosmetic surgery. The angle of your bunion may be severe, but surgery is not typically recommended unless it's giving you consistent pain that interferes with your daily activities.</p> <p>If your orthopedic specialist determines that surgery is your best option for pain relief, you'll undergo imaging that helps your surgeon choose the best surgical procedure and technique.</p> <p>The surgery may involve one or more procedures. These might be:</p> <ul> <li>Joining the bones of your big toe joint permanently.</li> <li>Realigning one or more bones in your forefoot to a more normal position to correct the abnormal angle of your big toe joint.</li> <li>Removing swollen tissue from around the big toe joint.</li> <li>Straightening your big toe by removing part of the bone.</li> </ul> <h2>Third step: Recovery</h2> <p>Each person's bunion surgery is different and so is their recovery. Be sure to talk with your surgeon about what to expect during the healing process. You may be able to walk on your foot right after the procedure, or you may need to avoid bearing weight on it while it heals. You may not be fully recovered for weeks or months.</p> <p>After surgery, the best way to prevent a bunion from reforming is to wear properly fitted shoes that conform to the shape of your feet without squeezing or pressing on any part of your foot.</p> <h2>Next steps:</h2> <ul> <li>Check out an <a href="/locations/la-crosse/services-and-treatments/podiatry/questions" target="_self" title="Opens in same window.">FAQ on foot care and health</a>.</li> <li>Learn more about <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/bunions/symptoms-causes/syc-20354799" target="_blank" title="Opens in a new window.">bunions and bunionettes</a>.</li> <li>Read <a href="/hometown-health/speaking-of-health/how-to-determine-foot-arch-type" target="_self" title="Opens in same window.">how to determine your foot arch type</a>.</li> <li>If you're a runner, check out <a href="/hometown-health/speaking-of-health/expert-advice-on-finding-the-best-shoe-fit" target="_self" title="Opens in same window.">how to get the best fit in your running shoes</a>.</li> </ul> <p><em><a href="/providers/taylor-beahrs-md" target="_self" title="Opens in same window.">Taylor Beahrs, M.D.</a></em><em>, specializes in </em><em><a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgery</a></em><em> and <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">sports medicine</a>, including foot and ankle surgery,</em><em> in </em><em><a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a></em><em>, Minnesota.</em></p><ul> <li>Ankle and hindfoot reconstructive surgery</li> <li>Ankle arthroscopy (minimally invasive surgery)</li> <li>Ankle joint replacement</li> <li>Lower extremity fracture care</li> <li>Minimally invasive foot and ankle surgery</li> <li>Robotic assisted hip and knee arthroplasty</li> <li>Sports injuries of the foot and ankle</li> </ul>M.D.<p>Orthopedic surgery is about relieving pain, restoring function and treating the whole patient. It is a great privilege to help patients with difficulties related to lower extremity arthritis, other bone and tendon degenerative conditions, trauma, deformity and more. In my clinic, you will learn about your orthopedic diagnosis and treatment options. Whenever possible, we start with safe nonoperative treatment plans, and we will discuss if or when surgery is an option.</p> <p>In addition to practicing orthopedic surgery, I serve as Chair of Quality and Value for Mayo Clinic Health System in Minnesota. In this role, I work with multidisciplinary teams to improve patient experience, patient safety and overall quality of care for Mayo Clinic Health System patients.</p> <p>Outside of work, I enjoy spending time with my wife and three children. I enjoy outdoor activities on the lakes, rivers and beautiful farmlands in southern Minnesota. My personal interests and hobbies include walleye fishing, canoeing, golfing and downhill skiing.</p><p><strong>Education</strong></p> <ul> <li>University of Illinois at Chicago College of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Foot and Ankle Surgery, University of Tennessee Campbell Clinic</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Orthopaedic Surgery, American Board of Orthopaedic Surgery</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Orthopaedic Surgeons</li> <li>American Orthopaedic Foot and Ankle Society</li> <li>Mid-America Orthopaedic Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Orthopedics, Mayo Clinic College of Medicine and Science</li> </ul>Beahrs<img src="/-/media/shared-files/images/medical-professionals/full/mankato/taylor-beahrs-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=C2623E1C3B3AA3CCC3069D68C37B8740" alt="Taylor Beahrs, M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/31423824/" target="_blank" title="Opens in new window. ">Smoking Effects in Foot and Ankle Surgery: An Evidence-Based Review</a>, August 2019</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/?term=What+Factors+Are+Predictive+of+Outcome+in+the+Treatment+of+Soft+Tissue+Sarcomas+of+the+Foot+and+Ankle" target="_blank" title="Opens in new window.">What Factors Are Predictive of Outcome in the Treatment of Soft Tissue Sarcomas of the Foot and Ankle</a>, February 2017</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/27605690" target="_blank" title="Opens in new window.">Complex Primary Total Knee Arthroplasty: Long-Term Outcomes</a>, September 2016</li> <li><a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/27815014" target="_blank" title="Opens in new window.">Rotating platform versus fixed bearing total knee arthroplasty at mid-term follow-up</a>, December 2016</li> </ul>{3B7AEE26-7FB1-48F3-A835-0A05DDDD39A7}Taylor<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15701328Taylor Beahrs, M.D.{DEF55970-853F-4E96-9A4D-3413874FF059}|{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2024/touching-foot-with-hands.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1F27FF3431D088D1EAD125E3F8659031" alt="Touching foot with hands" width="660" height="370" DisableNVelocity="true" />Foot HealthPodiatry is a branch of medicine devoted to the study of diagnosis, medical and surgical treatment of disorders of the foot, ankle and lower extremity.Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller9/27/2024A Mayo Clinic Health System high-risk breast consultant and breast cancer awareness advocate shares the top 10 questions commonly asked about breast cancer, screening and risk factors.Top 10 questions about breast cancer answered<p>Breast cancer receives much attention during October's awareness month. Although sightings of pink ribbons and breast cancer-related information increase during the month, it's crucial to keep screenings and clinical breast exams at the forefront of preventive care year-round.</p> <p>A Mayo Clinic Health System high-risk breast consultant and breast cancer awareness advocate shares the top 10 questions about breast cancer asked by people of all ages and backgrounds.</p> <ol> <li><strong>Why do I need to worry about breast cancer and having routine mammograms?</strong><br /> This is the most common question shared during breast clinic consultations. Many people mention that they don't have any family history of breast cancer. However, approximately just 20% of breast cancer is related to family history and genetic links. People are considered at the highest risk after a breast cancer diagnosis in a first-degree relative, such as a mom or sister.</li> <p> </p> <li><strong>What can I do to prevent breast cancer from developing?</strong><br /> For most people, the answer is to live a healthy lifestyle, including not smoking, minimizing alcohol consumption and maintaining an ideal body weight through diet and exercise. The majority of the risk for breast cancer comes from being female, having breasts and aging.</li> <p> </p> <li><strong>What steps can I take to be informed of my risk of breast cancer?</strong><br /> This answer has two parts. The first part is to learn about your family's medical history. The second part is to follow your healthcare team's recommended preventive screening plan, including a mammogram if necessary.</li> <p> </p> <li><strong>Should I continue doing self-checks of my breasts and have an annual clinical breast exam?</strong><br /> The American College of Obstetricians and Gynecologists and the U.S. Preventive Services Taskforce update breast screening recommendations annually, but more research studies need to be done. Your health history and conversations with your healthcare team will help inform the best approach for you. Although not all healthcare professionals perform a yearly clinical breast exam as part of an annual physical, you may choose to perform monthly or quarterly self-checks to increase your breast awareness. Both a yearly breast exam by a medical professional and regular self-checks are recommended if you have a higher risk of breast cancer.</li> <p> </p> <li><strong>What does it mean to have dense breasts, and how does that affect mammograms?</strong><br /> Approximately 30% of people have moderately dense breasts and up to 10% have extremely dense breasts. While dense breast tissue does affect the detection of breast cancer through mammography, a mammogram is still a recommended annual screening starting at age 40 for people with average breast cancer risk.</li> <p> </p> <li><strong>Does taking a birth control pill increase my risk of developing breast cancer? <br /> </strong>No strong connection has been identified to suggest any such connection in average-risk patients during childbearing years. However, studies suggest that continuing hormone therapy after age 60 can increase the risk of breast and endometrial cancer.</li> <p> </p> <li><strong>Does pregnancy and breastfeeding increase my risk of breast cancer?</strong> <br /> No, it's quite the opposite. The risk of developing breast cancer decreases based on the duration of time spent pregnant and breastfeeding.</li> <p> </p> <li><strong>How do environmental toxin exposure and radiation affect breast cancer? <br /> </strong>Certain factors, such as radiation exposure from previous cancer treatment, working in an environment with toxins, or other radiation exposure can increase your risk of many cancer types, including breast cancer.</li> <p> </p> <li><strong>Should I have genetic testing to determine if I have a family-related risk of breast cancer?</strong><br /> The short answer is, for some people, yes. However, genetic testing is recommended only after a discussion with your healthcare team or breast specialist about your cancer risks. You may be asked to meet with a genetics counselor to ensure that there is a strong indication for testing.</li> <p> </p> <li><strong>Does my race affect my risk of breast cancer?</strong><br /> The answer to this question is complex. According to the Centers for Disease Control and Prevention, African Americans, American Indians, Pacific Islanders and Alaskan Native Americans have a much higher rate of breast cancer and breast cancer-related mortality. However, there are many nuances to this concerning medical equity, racial disparity and other considerations that need to be explored and addressed.</li> </ol> <p> </p> <p>If you have been identified as having a higher risk of breast cancer and referred to a high-risk breast clinic, you can expect a comprehensive meeting with a healthcare professional who is skilled and passionate about breast cancer prevention and survivorship.</p> <p paraid="1295089260" paraeid="{e05c4a8f-1395-455f-ba45-6ebd5d909165}{194}"><em><a href="/providers/graham-king-md" target="_self" title="Opens in same window">Graham King, M.D.</a></em><em>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window">Family Medicine</a> physician who performs high-risk breast assessments at the <a href="/locations/mankato/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window">Breast Clinic</a> in <a href="/locations/mankato" target="_self" title="Opens in same window">Mankato</a>, Minnesota.</em></p><ul> <li>Community fitness outreach programs</li> </ul>M.D.<p>I enjoy caring for the health needs of families from prenatal care and pediatrics to adult medicine, and specialize in women's health and reproductive health. I focus on listening and hearing my patients, and forming partnerships with them in delivering their care.</p> <p>I am married to an elementary school teacher with four energetic boys who are active in community, school and sports. I enjoy playing guitar and piano, writing educational blogs and practicing healthful living. </p> <p>I am an 80s rock superfan and love going to concerts with my family and friends. I also enjoy Vikings, Twins, Wild and Maverick sports.</p><p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Mercy Hospital</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Sutter Health Family Medicine Residency Program</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Family Medicine</li> <li>Mayo Clinic Quality Fellow, Bronze Level</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Medical Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>King<img src="/-/media/shared-files/images/medical-professionals/full/mankato/graham-king-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=78048D61A3A60EF1DF00C06F2F6CCBEE" alt="Graham King MD" width="280" height="280" DisableNVelocity="true" />{46521252-3F34-48F2-80D2-338AA6DD4C22}Graham<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14899019Graham King, M.D.1<img src="/-/media/national-files/images/hometown-health/2024/2-smiling-ladies-in-fall-outdoor-setting.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5BA00BF34B9A95F1DC51943A664AC4FA" alt="2 smiling ladies in fall outdoor setting" width="660" height="370" DisableNVelocity="true" />Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller10/25/2024 Can't squeeze a long workout into your day? At-home workouts of 10-15 minutes can effectively boost your health and fitness. Learn about the benefits and how to design your own routine. Can a quick workout boost your health and fitness?<p>When life happens, don't automatically scrap the long workout you had planned for the day. You can still get an effective, full-body workout at home in just 10-15 minutes. Moving more frequently throughout the day is actually better than focusing only on your time at the gym. This type of movement is especially important if you sit for most of the day, since that can cancel out spending an hour at the gym.</p> <p>Any time you sit for extended periods, blood vessels stiffen and fluids pool in your feet and legs.</p> <h3>Moving your body:</h3> <ul> <li>Boosts your metabolism.</li> <li>Enhances the absorption of nutrients.</li> <li>Helps control your <a href="/hometown-health/speaking-of-health/know-your-heart-health-numbers" target="_self" title="Opens in same window">blood pressure</a>. </li> <li>Increases blood flow to the brain for mental health benefits.</li> <li>Lubricates joints.</li> <li>Makes muscles and ligaments do the work they're designed for.</li> </ul> <p>While exercise is essential for everyone, it's especially crucial as you age.</p> <h3>Moving and exercising:</h3> <ul> <li>Help maintain your strength.</li> <li>Improve your coordination and balance.</li> <li>Increase musculoskeletal health (<a href="/hometown-health/speaking-of-health/osteoporosis-silent-disease" target="_self" title="Opens in same window">strong bones</a>).</li> <li>Lessen the chance of falling.</li> <li>Promote your range of motion.</li> </ul> <h3>What should a 10- to 15-minute workout look like?</h3> <p>It doesn't matter where you exercise. A gym typically offers access to weight and cardio machines and equipment, but you can create similar movements using a space at home. Home equipment may include hand weights, resistance bands and your body weight.</p> <p>To get the biggest return for your time, target the large muscle groups and select exercises that move more than one joint at a time.</p> <p>For example, when you do a squat, you work the muscles and joints that help you sit and stand, including:</p> <ul> <li>Glutes, which make up your buttocks. </li> <li>Quadriceps and hamstrings, which run along the front and back of your upper legs.</li> <li>Your ankle, knee and hip joints.</li> </ul> <p>Design your workout by choosing exercises that fit into four movement types. This ensures that you target different muscle groups and joints to improve strength across your entire body, not just a single body part.</p> <p>Click on the link for how-to tips and to view a video:</p> <ul> <li><a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/fitness/multimedia/modified-pushup/vid-20084674" target="_blank" title="Opens in a new window.">Upper body push</a> (push-ups) </li> <li><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/osteoporosis/in-depth/osteoporosis/art-20044989" target="_blank" title="Opens in a new window.">Upper body pull</a> (rowing using hand weights or resistance band)</li> <li><a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/fitness/multimedia/squat/vid-20084663" target="_blank" title="Opens in a new window.">Lower body push</a> (squat)</li> <li><a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/fitness/multimedia/lunge/vid-20084662" target="_blank" title="Opens in a new window.">Lower body pull</a> (lunge)</li> </ul> <p>Start with 5-10 repetitions of each exercise. You can repeat the circuit for 10 or 15 minutes. Consider doing one set in the morning and repeating it later in the day.</p> <p>Here are more examples for each movement category:</p> <h4>Upper body push</h4> <p><strong>Shoulder press. </strong>Hold hand weights between your collarbone and shoulder height with the elbows beneath the wrists. Bracing your core, keep your chest up, and drive the weight upward until your arms are straight and the weights are overhead.</p> <p><strong>Triceps extension. </strong>Bend at the knees and hips and lean forward so that your torso is at a low angle to the floor. With the weights in your hand, pull your elbows back to the side of your torso. While keeping the upper arm and elbows stationary, extend at the elbow to straighten your arm. Slowly return elbows to the bent position.</p> <h4>Upper body pull</h4> <p><strong>Dumbbell shrug. </strong>Standing upright, grip a weight in each hand and hold them at your side. Elevate your shoulders in a shrugging motion, then lower them back to the starting position.</p> <p><strong>Reverse flys.</strong> Bend at your hips with a slight bend in your knees so that your torso is almost parallel to the floor. Hold hand weights or a resistance band below your chest, keeping your arms straight down. Lift weights or pull the band to the side so they're perpendicular to your torso by squeezing your shoulders together in the back. With control, lower your arms to the starting position.</p> <h4><strong>Lower body pull</strong></h4> <p><strong>Glute bridge</strong>. Lie on the floor with your feet on the ground or low bench and your knees bent. Place your arms out to your side, brace your core to keep your back flat, and drive your feet into the ground or bench. Focus on squeezing the glutes and hamstrings, extending at the hips until your torso and upper body are in a straight line.</p> <p><strong>Step ups. </strong>Stand in front of a sturdy, elevated stepping surface, such as the bottom step of stairs. Step up with one foot, shifting your body weight onto that foot to lift the rest of your body into a standing position on the step. Step off carefully and step up again using the same foot or alternate feet.</p> <h4>Lower body push</h4> <p><strong>Forward lunge.</strong> Keeping your torso upright with a slight forward lean, step with one leg forward. Bend the front leg and bring the knee of the back leg to the ground. Contract the front leg to drive your feet into the ground and return to standing. Use hand weights, if desired.</p> <p><strong>Sumo squats. </strong>Stand with feet more than shoulder width apart. Point toes out at a 45-60-degree angle. Lower your body by bending your knees and hips at the same time. Keep your body weight over the middle of your feet and knees in line with your toes. As you stand, keep your knees out and in line with your feet.</p> <h4>Core and full-body</h4> <p><strong>Farmer's carry.</strong> Standing up straight, hold a hand weight in each hand. Keeping your arms still, walk forward with controlled, medium-long, heel-toe strides.</p> <p><strong>Bird dogs. </strong>Get down on your hands and knees with your knees positioned below your hips and hands below your shoulders. Reach out one arm overhead; on the opposite side, stretch your leg out behind you. Bring the outstretched arm and leg together beneath your torso, touching the elbow to the knee. Repeat on both sides.</p> <h4>Work your heart and lungs, too</h4> <p>Pair the strength exercises with longer workouts that make your heart and lungs work harder, such as running, walking, cross-country or downhill skiing, snowboarding, ice skating or inline skating, racquet and ball sports, swimming and water fitness, canoeing or kayaking — even climbing stairs or playing a game of tag with the kids.</p> <p>Make sure to vary the intensity level of your exercise.</p> <p>On some days:</p> <ul> <li>Exercise at an intensity that's easy to sustain for more than 30 minutes, and allow you to carry on a conversation. </li> <li>Exercise at a higher intensity that you may only be able to sustain for 10-20 minutes and having a conversation is challenging.</li> </ul> <p>The key is to move, have fun with friends and family being active — spending some of that time outdoors — most days of the week.</p> <h3>Workouts that work</h3> <p>Workouts work best when they fit into your routine. You can do a 10-15 minute workout every day or a couple of times a week to supplement longer workouts.</p> <p>If finding 10 minutes to work out is a challenge, treat your body to an "exercise snack" for 30 seconds. Stand up and sit down, wave your arms above your head, march in place or do a couple of lunges or squats. Both your body and mind will feel more energized.</p> <h4>Next Steps:</h4> <ul> <li>Check out ways to start a <a href="/hometown-health/speaking-of-health/no-matter-your-age-or-skill-level-its-never-too-late-to-start-weight-training" target="_self" title="Opens in same window">weight-training program</a>.</li> <li>Consider consulting with a <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window">sports medicine specialist</a>.</li> <li>Don't forget that <a href="/hometown-health/speaking-of-health/5-tips-for-walking-your-way-to-better-health" target="_self" title="Opens in same window">walking</a> is good exercise.</li> <li>Follow <a rel="noopener" href="https://www.mayoclinichealthsystem.org/wellness/journey" target="_blank" title="Opens in a new window.">Journey to Wellness</a> for physical and mental health tips.</li> <li>Get tips for <a href="/hometown-health/speaking-of-health/fit-a-workout-into-any-schedule" target="_self" title="Opens in same window">fitting a workout into your busy day</a>.</li> <li>How <a href="/hometown-health/speaking-of-health/isometric-exercise-and-blood-pressure" target="_self" title="Opens in same window">isometric exercises</a> can control blood pressure.</li> <li>Learn why a <a href="/hometown-health/speaking-of-health/how-to-strengthen-your-core" target="_self" title="Opens in same window">strong core</a> is important.</li> <li>Stuck at your desk? <a href="/hometown-health/speaking-of-health/dont-just-sit-there-exercises-for-the-office" target="_self" title="Opens in same window">Try these exercises</a>.</li> </ul> <p><em><a href="/-/media/shared-files/images/medical-professionals/full/onalaska/andrew-jagim-phd.jpg" target="_self" title="Opens in same window"><em>Andrew Jagim, Ph.D.</em></a>, is a physician in <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window">Sports Medicine</a> in <a href="/locations/onalaska">Onalaska</a>, Wisconsin</em></p><ul> <li>Examining how different nutrition and exercise interventions influence health and performance — this interest applies to both the general population in regards to improve a person’s quality of life and prevent chronic disease in addition to improving the performance ability of elite athletes</li> </ul>Ph.D.<p><strong>Education</strong></p> <ul> <li>Master's degree, Human Performance, University of Wisconsin – La Crosse</li> <li>Ph.D., Kinesiology – Exercise Physiology Texas A&M University, College Station</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>International Society of Sports Nutrition</li> <li>National Strength and Conditioning Association</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Sports Medicine</li> <li>International Society of Sports Nutrition</li> <li>National Strength and Conditioning Association</li> </ul>Jagim<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/andrew-jagim-phd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=AA07F8D241D507CF3C0C9F28FC00E465" alt="Andrew Jagim PhD" width="280" height="280" DisableNVelocity="true" /><p>Dr. Jagim has authored or collaborated on numerous scholarly publications related to sports medicine. His topics have included:</p> <ul> <li>diets and nutrition</li> <li>workouts and training regimens</li> <li>sports injuries and treatment programs</li> <li>use and affects of drugs and supplements in sports</li> </ul> <p>His research has been published in numerous journals including International Journal of Exercise Science, Journal of Sports Science, Journal of Strength and Conditioning Research, Frontiers in Nutrition, International Society of Sports Nutrition, Journal of Neurosurgery and the Clinical Journal of Sports Medicine.</p>Andrew<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20772289Andrew Jagim, Ph.D.1{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2024/woman-squat-exercising.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EBC6B72FC0A0EAA58CD0829AFCF292D2" alt="Woman squat exercising" width="660" height="370" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller10/23/2024Dense breast tissue can make detecting breast cancer with screening mammography more challenging. Molecular breast imaging is a different approach to breast imaging for women with dense breast tissue.A closer look at molecular breast imaging: The benefits for dense breast tissue<p>Women with dense breast tissue have access to a reliable new breast cancer screening called <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/molecular-breast-imaging/about/pac-20394710" target="_blank" title="Opens in a new window.">molecular breast imaging</a> (MBI).</p> <p>This breakthrough technology was developed at Mayo Clinic and is available at Mayo Clinic locations and Mayo Clinic Health System locations in La Crosse and Eau Claire, Wisconsin.</p> <h3>Here are answers to common questions about molecular breast imaging:</h3> <h4>How is molecular breast imaging different from a mammogram?</h4> <p>MBI is a fundamentally different approach to breast imaging than mammography.</p> <p>3D mammography detects slightly more cancers than standard 2D mammography. MBI is significantly better than either <a href="/services-and-treatments/mammography" target="_self" title="Opens in same window">type of mammography</a> at detecting breast cancer in women with dense breast tissue.</p> <p>During a <a href="/hometown-health/speaking-of-health/3d-technology-provides-enhanced-breast-cancer-detection" target="_self" title="Opens in same window">3D mammogram</a>, individual images are captured by X-ray and combined to simulate "slices" of breast tissue. </p> <p>MBI, on the other hand, is a type of functional imaging that uses a special gamma camera to create an image of the breast based on cell activity in the tissue. The images created show differences in the activity of the breast tissue. </p> <p>During MBI, a small amount of a radioactive tracer is injected into a vein in your arm. The tracer attaches to breast cancer cells that the gamma camera can then detect. MBI identifies tumors based on molecular activity, and areas that absorb more tracer appear as bright spots on the images.</p> <h4>Who should consider molecular breast imaging?</h4> <p>MBI provides the most significant benefit for women with <a href="/hometown-health/speaking-of-health/what-is-dense-breast-tissue-what-do-you-need-to-know" target="_self" title="Opens in same window">dense breasts</a>. Breast tissue is made up of milk glands, milk ducts, fatty tissue and supportive, or dense, breast tissue. Women with dense breasts have more supportive breast tissue than fatty tissue.</p> <p>As the density of breast tissue increases, the ability to detect breast cancer with screening mammography becomes more challenging. Both dense breast tissue and cancer appear white on a mammogram, which can make it more challenging to detect whether there is breast cancer in the images.</p> <p>However, breast density has minimal effect on the detection of breast cancer with MBI screening.</p> <p>Healthcare professionals may request MBI to help evaluate a <a href="/locations/eau-claire/services-and-treatments/breast-care/breast-lumps" target="_self" title="Opens in same window">breast lump</a>, review an unusual area detected on a mammogram or recommend if other imaging tests produce inconclusive results. </p> <h4>How effective is MBI screening?</h4> <p>Studies show that combining molecular breast imaging and a mammogram leads to finding three times more breast cancers than a mammogram alone. </p> <p>MBI imaging does a better job of distinguishing between dense tissue, benign tumors and cancerous tissue. MBI also has fewer false positives for breast cancer. </p> <h4>Is molecular breast imaging safe?</h4> <p>Molecular breast imaging is a safe procedure and received Food and Drug Administration clearance over two decades ago in 1999. </p> <p>The level of radiation exposure during an MBI is comparable to that from a mammogram. It's also less than the natural radiation the body absorbs from the environment annually. </p> <h4>Will molecular breast imaging replace my annual mammogram?</h4> <p>MBI does not replace, but is supplementary to, screening mammography for early breast cancer detection.</p> <p>For women with dense breasts, the current recommendation is to use 3D mammography and MBI screening together.</p> <h4>What can I expect during a molecular breast image test? <img alt="Molecular breast imaging - illustration" style="height: 282px; width: 450px; float: right; margin-left: 3px;" src="/-/media/national-files/images/hometown-health/2024/molecular-breast-imaging-illustration.jpg?h=282&w=450&sc_lang=en&hash=30A2DD0EDB8E507750D127B38FE562DB" /></h4> <p>At the start of the MBI test, you'll receive an injection of the radioactive tracer into a vein in your arm. Fast-growing cells, such as cancer cells, will quickly absorb the tracer. </p> <p>Two small gamma cameras in the molecular breast imaging system detect gamma rays that the tracer emits. </p> <p>The breast is placed on top of one gamma camera, and the second gamma camera is lowered on top of it just enough to hold it in place during the test. </p> <p>The gamma cameras record the tracer's activity for 10 minutes, and then the breast is repositioned for a second image. If you are having both breasts imaged, the process is repeated. Two images are created of each breast, and each image takes about 10 minutes. </p> <p>If you are told you have dense breasts, as 50% of women do, talk with your healthcare team about breast cancer screening options, including 3D mammography and molecular breast imaging.</p> <p><strong>Next steps:</strong></p> <ul> <li>Find <a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window">breast cancer care</a> near you.</li> <li>Explore advanced breast cancer <a href="/hometown-health/speaking-of-health/advanced-breast-cancer-screening" target="_self" title="Opens in same window">screening options</a>.</li> <li>Get answers to the top 10 <a href="/hometown-health/speaking-of-health/top-10-breast-cancer-questions" target="_self" title="Opens in same window">questions about breast cancer</a>.</li> <li>Learn when a lump is <a href="/hometown-health/speaking-of-health/when-a-lump-is-more-than-a-lump" target="_self" title="Opens in same window">more than a lump</a>. </li> </ul> <p><em><a href="/providers/cameron-leitch-md" target="_self" title="Opens in same window">Cameron Leitch, M.D.</a></em><em>, is a <a href="/services-and-treatments/radiology-and-imaging" target="_self" title="Opens in same window">radiologist</a> in </em><em><a href="/locations/eau-claire" target="_self" title="Opens in same window">Eau Claire</a></em><em>, Wisconsin.</em></p><ul> <li>Breast</li> <li>Body</li> <li>Pulmonary</li> <li>Thoracic imaging</li> </ul>M.D.<p>It is an honor to be able to continue my involvement with world-class medical treatment and diagnosis, which is provided by Mayo Clinic. I also look forward to helping to continue innovation at the forefront of technology.</p> <p>I enjoy spending time with my family, fishing, and hockey.</p><p><strong>Medical School</strong></p> <ul> <li>University of North Dakota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Diagnostic Radiology, Mayo Clinic, Rochester, MN</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Breast Imaging, Mayo Clinic, Rochester, MN</li> </ul>Leitch<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/cameron-leitch-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=957902D01CDDDEB8CCCD4881017588FC" alt="Cameron Leitch, M.D." width="280" height="280" DisableNVelocity="true" />Cameron<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15735940Cameron Leitch, M.D.1<img src="/-/media/national-files/images/hometown-health/2024/2-ladies-walking-outdoors.jpg?h=370&iar=0&w=660&sc_lang=en&hash=FA031E1F39502D567E07227CDD5EC5D4" alt="2 ladies walking outdoors" width="660" height="370" DisableNVelocity="true" />Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller10/8/2024Once the common symptoms of a concussion have subsided, people may notice other often-missed symptoms such as ringing in their ears. It's important for hearing health not to brush off these symptoms.Don't miss a quiet symptom of concussion<p>Dizziness, headaches, confusion, fatigue, blurry vision and sensitivity to light are among the most common symptoms of a <a rel="noopener" href="https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/what-is-a-concussion" target="_blank" title="Opens in a new window.">concussion</a>. Once these symptoms have subsided and patients begin to resume their regular activities, they also may experience often-overlooked, underlying effects of concussion — persistent <a href="/hometown-health/speaking-of-health/are-you-hearing-crickets" target="_self" title="Opens in same window">ringing in their ears</a>, sensitivity to noise and hearing difficulties.</p> <p>A concussion is a mild form of <a href="/hometown-health/speaking-of-health/team-approach-to-treating-traumatic-brain-injuries" target="_self" title="Opens in same window">traumatic brain injury</a> caused by an impact to the head. It can change brain cells, including those associated with hearing. Some of these changes will heal, while others are permanent.</p> <p>Hearing can be affected in adults and children who have been diagnosed with concussions following common incidents such as a head injury from a fall, vehicle accident or <a href="/hometown-health/speaking-of-health/get-ready-to-wheel-into-spring" target="_self" title="Opens in same window">riding a bike without a helmet</a>. Other people, like athletes or military service members, can be affected due to their sports activities or professions.</p> <h2>How a concussion can affect your ears</h2> <p>Tiny hair cells line your inner ears. These hair cells are crucial for changing the energy from the vibrations of your eardrum and middle ear bones into electrical energy that can move through the nerves to the brain for processing.</p> <p style="text-align: center;"><img alt="Inner ear anatomy-Illustration" style="height:414px; width:500px;" src="/-/media/national-files/images/hometown-health/2024/inner-ear-anatomy-illustration.jpg?sc_lang=en&hash=195633631254313D10E6566019D2AC0E" /></p> <p>Think of these tiny hair cells as blades of grass. When you step on the grass, some blades spring back up, while others stay flattened or broken. The hairs in your ears are the same. Those that are damaged by a concussion can't be regrown or repaired, and they can no longer send signals to the brain.</p> <p>This damage to the hair cells can cause ringing in the ears — known as tinnitus — <a href="/hometown-health/speaking-of-health/is-it-time-to-get-your-hearing-checked" target="_self" title="Opens in same window">hearing loss</a>, noise sensitivity and the inability to correctly process sounds, such as speech.</p> <h2>How a concussion can affect sound processing</h2> <p>Tiny nerve cells in the ears detect sounds and pass the signals to the brain, where the sounds are processed. Any injury to the nerve cells can disrupt this process. Those who have experienced a concussion may have difficulty distinguishing words in noisy environments, although their overall hearing may be fine.</p> <p>Researchers have tested athletes who have had concussions, using a tool called Speech-in-Noise exams. The athlete listened to a simple sentence such as "Sugar is sweet." The phrase was repeated with increasingly loud background noise. Researchers found that the louder the background noise, the less able the athlete was to distinguish the words.</p> <p>Other tests have revealed that athletes who have had concussions also may be hypersensitive to sounds or have difficulty processing rapidly spoken words.</p> <h2>Don't ignore hearing issues</h2> <p>People of all ages can experience concussions from various activities or as the result of an accident, including:</p> <ul> <li>Accidental falls</li> <li>Basketball</li> <li>Bicycling</li> <li>Car accidents</li> <li>Football</li> <li>Hockey</li> <li>Inline skating</li> <li>Skateboarding</li> <li>Soccer</li> <li>Volleyball</li> <li>Winter sports like skiing and sledding</li> </ul> <p>If your child has experienced a concussion, once their major concussion symptoms have eased it's essential to take note if they comment about dizziness, ringing in their ears or having trouble hearing. Some of these symptoms may improve, while others may be permanent.</p> <p>Hearing or sound processing issues may also show up as difficulty concentrating or new challenges with schoolwork.</p> <h2>Where to seek help</h2> <p>When seeking help for suspected hearing issues from a concussion, consider consulting an <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window">ear, nose and throat (ENT)</a> specialist who can assess ear health and determine if any previous underlying conditions could be contributing to the symptoms.</p> <p>An audiologist can assist with dizziness and balance issues, test hearing and provide tools and strategies for managing symptoms. In more severe cases, an audiologist may determine if hearing aids are needed and discuss options to address hearing issues.</p> <p><em><a href="/providers/katie-dease-aud" target="_self" title="Opens in same window"><em>Katie Dease, Au.D.</em></a>, is an audiologist in <a href="/locations/owatonna/services-and-treatments/audiology" target="_self" title="Opens in same window">Audiology</a> in <a href="/locations/owatonna">Owatonna</a></em>, Minnesota.</p><ul> <li>Amplification/hearing aids</li> <li>Audiometry</li> <li>Pediatrics</li> <li>Tinnitus</li> </ul>Au.D.<p><strong>Education</strong></p> <ul> <li>Doctor of Audiology, University of Wisconsin-Stevens Point</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Audiology</li> <li>Certificate of Clinical Competence, American Speech-Language-Hearing Association</li> <li>Hearing Instrument Dispenser</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Speech-Language-Hearing Association</li> </ul>Dease<img src="/-/media/shared-files/images/medical-professionals/full/mankato/katie-dease-aud.jpg?h=280&iar=0&w=280&hash=2A9E758AE48ADAA463D9362B7EE868C8" alt="Katie Dease, Au.D." width="280" height="280" DisableNVelocity="true" />{A4D89010-062B-42B7-830A-2F6D0A2BD079}Katie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15263924Katie Dease, Au.D.1{18E5E65E-45C8-4C48-BD32-A914794E2AA4}<img src="/-/media/national-files/images/hometown-health/2024/closeup-rollerblades-on-feet.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A5B01692130D497C3A157BD916DEC87C" alt="Closeup of rollerblades on a person's feet" width="660" height="370" DisableNVelocity="true" />Ear HealthAn audiologist specializes in evaluating and treating people of all ages with hearing loss, dizziness and balance disorders. Specialty audiology consultation is available for assessment and treatment of hearing loss, tinnitus, dizziness and balance disorders.ConcussionA concussion is a traumatic brain injury that alters the way your brain functions. Although concussions usually are caused by a blow to the head, even a “ding,” “getting your bell rung,” or what seems to be a mild bump or blow to the head can be serious. As many as 3.8 million sports- and recreation-related concussions occur in the U.S. each year.Dawn Haller10/15/2024A healthy breakfast sets up students for a day of learning and school success. Think outside the cereal box to create easy breakfasts that tempt kids and fuel their day.Fuel the school day with an A+ breakfast<p>When you send kids off to school, a healthy breakfast fuels their school day, prepares them to learn and sets the tone for the rest of the day. Adults can enjoy the same benefits from a good breakfast.</p> <p>Even so, studies show breakfast is the most-skipped meal of the day. On average, 13% of school-aged kids and 27% of 12- to 19-year-olds skip breakfast, which means going up to 12 hours without eating.</p> <p>When you eat breakfast, you're breaking the fast since your last meal, and your body is ready to power up for the day.</p> <h2>What makes breakfast so important for kids?</h2> <p>Study after study shows that breakfast provides many benefits for children and their learning experience.</p> <p>Those who eat breakfast:</p> <ul> <li>Can score significantly higher on standardized math, spelling and reading tests.</li> <li>Develop a healthy breakfast habit that can carry over into adulthood.</li> <li>Have better brain function, memory, attention and energy.</li> <li>Perform better on vocabulary tests, math problems and challenging mental tasks.</li> <li>Show increased focus, alertness, improved moods and ability to deal with frustration. </li> <li>Tend to have lower body weight and struggle less with weight-related challenges in life since they may not be eating unhealthy foods or overeating later in the day. </li> </ul> <p>Kids of all ages have plenty of reasons why they skip the morning meal. Some are picky eaters or don't like traditional breakfast foods. Teens may skip breakfast because they think they'll gain weight. Faced with hectic schedules of homework, extracurricular activities and part-time jobs, students may not prioritize time for breakfast.</p> <h2>Building blocks of a balanced breakfast</h2> <p>A balanced breakfast has three key building blocks: protein, healthy fat and carbohydrates. These nutrients provide calories for energy, support growth and contain essential vitamins and minerals.</p> <p>Longer-lasting energy comes from lean proteins and fats, while grains, starches and fruits give you a quick energy surge. Both types are necessary for your health and performance.</p> <p>The fun part about breakfast is that you can eat any type of food — it doesn't need to be traditional breakfast foods like toast or bacon and eggs.</p> <p>Think outside the cereal box and consider:</p> <ul> <li>Leftover veggie pizza or lasagna, cold chicken or meatloaf from last night's dinner on a whole grain bun with a piece of fruit.</li> <li>Roll up a breakfast burrito with scrambled eggs and cheese in a whole-grain tortilla with a side of fruit.</li> <li>Stuff a whole-wheat pita with peanut butter, banana slices and raisins.</li> </ul> <h3>Breakfast bowls are trending and can be savory or sweet, warm or cold, and are a great way to use leftovers.</h3> <p>Try these breakfast bowl ideas:</p> <ul> <li>Arrange quinoa, slices of hard-boiled egg or tofu chunks, avocado, chopped onions and grape tomatoes on a bed of kale and drizzle with low-fat ranch dressing. </li> <li>Spoon seasoned black beans into a bowl, add chopped tomatoes and green onions, and sprinkle with shredded cheese. Serve with a whole-wheat tortilla.</li> <li>Top leftover roasted sweet potatoes with chopped tomatoes, a poached egg and a pinch of red pepper flakes or splash of hot sauce.</li> </ul> <p>More traditional breakfast choices may be:</p> <ul> <li>Granola with fresh or frozen berries, topped off with Greek yogurt.</li> <li>Old-fashioned oats with some cinnamon, nuts and apples. A make-ahead option for oatmeal is overnight oats. </li> <li>Whirl up a smoothie with milk, Greek yogurt, fresh or frozen fruit, and flaxseed or chunks of avocado. For a nutritious bonus, add some cauliflower to make it extra creamy </li> <li>Whole wheat toast spread with peanut butter and a banana on the side.</li> </ul> <p>Whether you're getting your kids ready for a successful day at school, preparing to start another busy workday or tackling your to-do list, eating a healthy breakfast fuels your body and energizes your mind.</p> <p>Try this recipe for your next breakfast:</p> <h2>Overnight Orange Cinnamon French Toast</h2> <p>Makes 10 slices</p> <p>8 slices whole-wheat bread<br /> 8 eggs<br /> 1 cup orange juice<br /> 1 cup skim milk<br /> 2 tablespoons brown sugar<br /> 2 teaspoons vanilla extract<br /> 1 teaspoon ground cinnamon</p> <p>Lightly coat a loaf pan with cooking spray. Tear the bread into chunks and place in the pan. In a medium bowl, combine the eggs, juice, milk, brown sugar, vanilla and cinnamon. Whisk until well-mixed. Pour the egg mixture over the bread, cover with plastic wrap and refrigerate overnight. </p> <p>Heat oven to 350 F. Remove plastic wrap from pan and cover with foil. Bake for 30 minutes. Remove the foil and bake for another 10 to 15 minutes or until the top is lightly browned.</p> <p>Nutritional per slice: 182 calories, 6 grams total fat, 303 milligrams sodium, 24 grams total carbohydrates, 2 grams fiber, 8 grams sugar, 9 grams protein.</p> <p><em><a href="/providers/caitlin-terpstra-rdld" target="_self" title="Opens in same window">Caitlin Terpstra</a> is a dietitian in</em><em> <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window">Nutrition</a></em><em> in <a href="/locations/owatonna" target="_self" title="Opens in same window">Owatonna</a>, Minnesota.</em></p>RDN, LD<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, St. Catherine University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>University of Wisconsin Hospital and Clinics</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Licensed Dietician</li> <li>Registered Dietitian</li> </ul>Terpstra<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/caitlin-terpstra-rd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=D56D6F5A2B6A4866353C6D74A8883157" alt="Caitlin Terpstra RD" width="280" height="280" DisableNVelocity="true" />Caitlin<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>19992149Caitlin Terpstra, RDN, LD1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2024/child-handing-food-to-a-person.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E71E058E45FD885D1C38E84C7A0702E7" alt="child in kitchen handing food to another" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller11/4/2024 Pumpkin perks range from essential nutrients to health benefits including reducing inflammation and helping maintain normal blood pressure. Pumpkin's also delicious in both sweet and savory recipes. From inflammation to heart health: The perks of pumpkin in your diet<p>Besides being ideal for jack-o'-lanterns and harvest-themed decorations, pumpkin is great for eating. During the fall, you can find pumpkin-inspired foods everywhere — cereal, yogurt, coffee, lattes, ravioli, pie, cookies, candies, cheesecake and even baking chips.</p> <p>But when the season changes, don't say farewell to pumpkin. It contains essential nutrients and boasts health benefits ranging from <a href="/hometown-health/speaking-of-health/want-to-ease-chronic-inflammation" target="_self" title="Opens in same window">reducing inflammation</a> to helping maintain normal <a href="/-/media/national-files/images/hometown-health/2021/know-your-numbers-blood-pressure.jpg" target="_self" title="Opens in same window">blood pressure</a>.</p> <h3>Reaping the nutritional power of pumpkin</h3> <p>Although pumpkin-flavored items may tempt your taste buds, many are high in sugar, fat and carbohydrates. But did you know that one-half cup of canned, 100% pumpkin provides 4 grams of fiber, virtually no fat and only 40 calories?</p> <p>Thanks to its deep orange color, pumpkin contains a large amount of beta carotene, which the body converts to vitamin A. Pumpkin also is an excellent direct source of vitamin A — one cup of pumpkin puree provides 238% of the recommended daily intake.</p> <p>Vitamin A helps preserve vision, <a href="/hometown-health/speaking-of-health/support-your-immune-function-with-good-nutrition" target="_self" title="Opens in same window">fight infections</a>, maintain healthy skin and bones, and regulate cell growth and division. It also may protect against heart disease and some cancers.</p> <p>Pumpkins also are packed with potassium, which helps muscles contract, regulates body fluids, helps maintain normal blood pressure and balances minerals in the body's cells.</p> <h3>How to make fresh pumpkin recipe ready</h3> <p>Small sugar pumpkins, also known as pie pumpkins, are best for recipes. You can also use larger pumpkins, but don't eat ones that have been carved, since they may contain bacteria and other contaminants.</p> <p>Pumpkins should be stored in a cool, dark, dry place. With proper storage, they can remain fresh for several months. Pumpkin, when cut into chunks or pureed, also freezes well.</p> <p>Here's how to prepare pumpkin for cooking and baking throughout the fall and year-round.</p> <p>To peel a pumpkin, use a sharp knife to:</p> <ul> <li>Cut off the top, then cut a slice off the bottom so it sits flat. </li> <li>Remove slices of the skin from top to bottom in vertical strips.</li> <li>Slice the pumpkin in half and remove the seeds and stringy pulp with a large spoon. </li> <li>Cut the pumpkin into chunks.</li> </ul> <p>Pumpkin puree can be frozen for up to six months. </p> <p>To make the puree: </p> <ul> <li>Steam pumpkin chunks until soft and drain well. </li> <li>Use a masher or electric food processor or blender to puree the pumpkin until smooth. </li> <li>Drain to remove excess moisture.</li> </ul> <p>You also can use canned, unsweetened 100% pumpkin with no added pumpkin pie spice in your recipes. </p> <h3>Ways to use pumpkin in recipes</h3> <p>Pumpkin can be substituted for winter squash in most recipes. Try these:</p> <ul> <li>Add canned or mashed cooked pumpkin to pancakes or quick breads.</li> <li>Drizzle fresh pumpkin wedges with olive oil, season with salt and pepper, and roast for about 25 minutes at 400 F.</li> <li>Fold 1/2 cup pumpkin puree, 2 tablespoons of sugar and 1/2 teaspoon of pumpkin spice into a softened pint of nonfat vanilla ice cream. Refreeze before serving.</li> <li>Layer low-fat vanilla yogurt with pumpkin puree and low-fat granola. Top with a pinch of cinnamon and nutmeg.</li> <li>Make a special serving bowl for soup, stews, grains and other side dishes. Scoop out a pumpkin, remove the seeds and bake at 350 F until tender. Let cool before filling.</li> <li>Stir pumpkin puree into soups, chilies and stews.</li> </ul> <h3>How to roast pumpkin seeds</h3> <p>Pumpkin seeds are packed with protein, fiber and minerals such as iron, copper, magnesium, manganese, phosphorous, zinc, potassium, folate, niacin and selenium. They also contain <a href="/hometown-health/speaking-of-health/fast-facts-on-fats-and-heart-health" target="_self" title="Opens in same window">healthy poly- and mono-unsaturated fats</a>. Plus, they make a <a href="/hometown-health/speaking-of-health/sensible-snacking" target="_self" title="Opens in same window">tasty snack</a>.</p> <p>Roast and eat them as you would other heart-healthy seeds. Here's how:</p> <ul> <li>After scooping the pulp and seeds from a pumpkin, separate the seeds from the pulp.</li> <li>Place the seeds in a colander and rinse well to remove any pumpkin flesh. Drain and pat dry with a cloth dish towel (they'll stick to paper towels).</li> <li>Spread the clean, dry seeds on a baking sheet and bake at 250 F until dry, about 1 hour.</li> <li>Toss with olive oil, season with salt, pepper or other flavors and roast at 350 F, tossing occasionally, until golden brown and crisp, about 20 minutes.</li> </ul> <h3>Warm up a chilly day with this hearty, flavorful pumpkin soup. Serve it with whole-grain bread, a green salad and sliced, fresh pears for an easy dinner:</h3> <h4>Pumpkin soup</h4> <p>By Mayo Clinic<br /> Serves 4</p> <p>3/4 cup water, divided<br /> 1 small onion, chopped<br /> 1 can (15 ounces) pumpkin puree<br /> 2 cups unsalted vegetable broth<br /> 1/2 teaspoon ground cinnamon<br /> 1/4 teaspoon ground nutmeg<br /> 1 cup fat-free milk<br /> 1/8 teaspoon black pepper<br /> 1 green onion top, chopped</p> <p>In a large saucepan, heat 1/4 cup water over medium heat. Add the onion and cook until tender, about 3 minutes. Don't let all the liquid cook off. Add the remaining water, pumpkin, broth, cinnamon and nutmeg. Bring to a boil, reduce heat and simmer for 5 minutes. Stir in the milk and cook until hot. Don't boil. Ladle soup into warmed bowls and garnish with black pepper and green onion tops. Serve immediately.</p> <p>Nutritional per 1-cup serving: 77 calories, 1 gram total fat, 57 milligrams sodium, 14 grams carbohydrates, 4 grams fiber, 3 grams protein, 0 grams added sugar.</p> <em><a href="/providers/allyn-wergin-rdn" target="_self" title="Opens in same window"><em>Allie Wergin</em></a> is a dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window"><em>Nutrition</em></a> in <a href="/locations/new-prague" target="_self" title="Opens in same window"><em>New Prague</em></a>, Minnesota.</em><ul> <li>Bariatric surgery</li> <li>Diabetes management</li> <li>Oncology</li> <li>Weight management</li> </ul>RDN<p><strong>Education</strong></p> <ul> <li>Bachelor's degree, St. Catherine University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Viterbo University</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetic Registration </li> <li>Minnesota Board of Dietetics and Nutrition Practice </li> </ul>Mahowald<img src="/-/media/shared-files/images/medical-professionals/full/new-prague/allyn-wergin-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=74F690ED261F537AA65B66929A3356D1" alt="Allie Mahowald, RDN" width="280" height="280" DisableNVelocity="true" />{9209F8EC-1016-41AA-985F-014D9B877417}Allie<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15971546Allyn Mahowald, RDN1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2024/woman-with-pumpkins.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1C730E1F25EAFEBFD3D648A1D8724F79" alt="Woman with pumpkins" width="660" height="370" DisableNVelocity="true" />NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.Dawn Haller11/26/2024Alcohol consumption peaks during the holidays and can lead to a serious issue with binge drinking. Learn what's considered binge drinking and get four tips for enjoying holiday gatherings responsibly.4 tips for enjoying holiday gatherings while drinking responsibly<p>People may use the festive time around the holidays as a reason to consume alcohol. But they might not realize how much they drink and its effect on their life.</p> <p>According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), alcohol consumption peaks during holidays like Christmas and New Year's Eve. The 2023 National Survey on Drug Use and Health (NSDUH) revealed that nearly 1 in 4 adults aged 18 and over, or 60.4 million people, reported <a href="/hometown-health/speaking-of-health/does-drinking-alcohol-kill-brain-cells" target="_self" title="Opens in same window">binge drinking</a> within the previous month.</p> <h3>What's considered binge drinking?</h3> <p>The NIAAA defines one standard drink as:</p> <ul> <li>1.5 ounces of hard liquor distilled spirits (about 40% alcohol)</li> <li>5 ounces of wine (about 12% alcohol)</li> <li>8 to 9 ounces of malt liquor (about 7% alcohol)</li> <li>12 ounces of regular beer (about 5% alcohol)</li> </ul> <p>Binge drinking is a pattern that can cause significant <a href="/hometown-health/speaking-of-health/effects-of-alcohol-on-your-health-and-liver" target="_self" title="Opens in same window">health and safety risks</a>. For men, this means consuming five or more drinks within two hours. For women, it's at least four drinks within two hours.</p> <p>During the holidays, binge drinking can be a serious issue due to people drinking too much alcohol in a short amount of time.</p> <p>Excessive drinking is linked to a higher risk of injury, including:</p> <ul> <li>Accidents</li> <li>Alcohol poisoning</li> <li>Falls</li> <li>Blackouts</li> <li>Overdoses</li> </ul> <p>Binge drinking may lead to alcohol dependence or <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/symptoms-causes/syc-20369243" target="_blank" title="Opens in a new window.">alcohol use disorder</a>, so it's critical to learn how to manage alcohol consumption.</p> <h3>Here are four tips for enjoying holiday gatherings while drinking responsibly:</h3> <p><strong>Eat well.</strong><br /> Consuming alcohol before you've eaten can make you feel intoxicated more quickly. Eating beforehand helps slow alcohol absorption, which can delay the effects of intoxication. Choose dishes made of foods high in carbohydrates and protein, such as bread, pasta, meat and cheese.</p> <p><strong>Look for alcohol-free options.</strong><br /> Alcohol-free beverages provide options for guests to enjoy the gathering and have fun together without excessive drinking. Fill your glass with non-alcoholic drinks, such as water, soda, sparkling water and mocktails. Alcohol is a diuretic, which increases fluid loss and suppresses vasopressin, a hormone that helps the kidneys retain fluids. Drinking a balance of <a href="/hometown-health/speaking-of-health/6-tips-for-a-healthy-holiday-makeover" target="_self" title="Opens in same window">non-alcoholic beverages</a> can help prevent alcohol-induced dehydration.</p> <p><strong>Make transportation plans in advance.</strong><br /> Alcohol can impair cognitive ability and decision-making, so it's a good idea to create a plan before you start drinking. Determine the length of time you'll spend at a holiday gathering and arrange your transportation to and from the event. Many options are available, including a designated sober driver, taxi or ride-share service. If needed, arrange a safe place to stay.</p> <p><strong>Set a limit.</strong><br /> <a href="/hometown-health/speaking-of-health/balancing-the-risks-benefits-of-alcohol" target="_self" title="Opens in same window">Determine a limit</a> on how many drinks you'll have before you get to the holiday gathering or event. Keep in mind that a standard drink may be much smaller than you think. One standard drink is approximately equal to 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 40% alcohol-based hard liquor. Remember that binge drinking is consuming four or more standard drinks within two hours for women and five or more standard drinks for men.</p> <p style="text-align: center;"><img alt="drawing of alcohol glasses" src="/-/media/national-files/images/hometown-health/2024/drawing-of-alcohol-glasses.jpg?h=288&w=500&sc_lang=en&hash=76EC3A9E01B326B0D3EE74060939A759" /></p> <p>If you feel that drinking alcohol is causing problems in your life, or if your family is concerned about your drinking, talk with your healthcare team. You also can seek help from an <a href="/services-and-treatments/addiction-treatment" target="_self" title="Opens in same window">addiction treatment counselor</a> or a support group.</p> <p><em><a href="/providers/yilin-gui-ladc" target="_self" title="Opens in same window"><em>Yilin Gui</em></a> is a counselor in <a href="/services-and-treatments/addiction-treatment" target="_self" title="Opens in same window">Addiction Treatment</a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window">Albert Lea</a>,</em><em> Minnesota.</em></p> <ul> <li>Addiction treatment</li> </ul> L.A.D.C. <p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Psychology, University of Minnesota</li> <li>Master's degree, Integrated Behavioral Health, University of Minnesota</li> </ul>Gui<img src="/-/media/shared-files/images/medical-professionals/full/albert-lea/yilin-gui-ladc.jpg?h=280&iar=0&w=280&sc_lang=en&hash=76B6836EF56E84D040FBDBA0B6B5A5F3" alt="Yilin Gui, L.A.D.C." width="280" height="280" DisableNVelocity="true" /> Yilin<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30208598Yilin Gui, L.A.D.C. 1{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2024/holiday-punch-drinks.jpg?h=370&iar=0&w=660&sc_lang=en&hash=085213361A9069DBD21307AF8ABB89CD" alt="Holiday punch drinks" width="660" height="370" DisableNVelocity="true" />Substance AbuseInformation for helping those with alcohol and other drug abuse concerns.Dawn Haller11/20/2024When noninvasive approaches don't relieve your shoulder pain, it's time to consult an orthopedic surgeon to discuss if shoulder replacement may be needed to relieve the pain.What are your options for shoulder replacement surgery?<p>For some people, noninvasive approaches for shoulder pain, such as over-the-counter pain relievers, <a href="/hometown-health/speaking-of-health/injection-therapy-for-nonoperative-joint-pain-relief" target="_self" title="Opens in same window">injections</a> and physical therapy, no longer bring relief. </p> <p>When shoulder pain begins to infringe on your ability to do your work, day-to-day tasks and activities you love to do, it's time to consult an orthopedic surgeon.</p> <h2>Causes of shoulder pain</h2> <p>Shoulder pain is typically caused by damage to the shoulder joint, including:</p> <ul> <li><a href="/hometown-health/speaking-of-health/shoulder-pain-it-could-be-your-rotator-cuff" target="_self" title="Opens in same window">Chronic rotator cuff injuries</a>. Damage to this group of muscles and tendons surrounding the shoulder joint can lead to injury of the cartilage and bones in the joint.</li> <li>Fractures of the humerus, the bone in the upper arm.</li> <li><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/osteoarthritis/symptoms-causes/syc-20351925" target="_blank" title="Opens in a new window.">Osteoarthritis</a>, also known as wear-and-tear arthritis. This condition damages the cartilage that covers the ends of bones and helps the joint move smoothly.</li> <li><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/symptoms-causes/syc-20353648" target="_blank" title="Opens in a new window.">Rheumatoid arthritis</a> or other <a href="/services-and-treatments/rheumatology" target="_self" title="Opens in same window">inflammatory diseases</a>. Inflammation caused by an overactive immune system can damage the cartilage in the shoulder.</li> </ul> <p>None of these conditions is reversible, so in many cases, you'll need a surgical approach — shoulder replacement — to relieve pain and restore the range of motion and strength to your shoulder and arm.</p> <h2>Surgical options</h2> <p>Your surgeon will order X-rays and possibly a CT scan to determine the type of damage to your shoulder. This imaging allows your surgeon to determine the shoulder replacement technique best suited to the condition of your shoulder joint. There are three types of shoulder replacement.<img alt="Illustration of Shoulder Replacement Options" style="height: 417px; width: 292px; float: right; margin-left: 5px;" src="/-/media/national-files/images/hometown-health/2024/shoulder-replacement-options-2.jpg?h=417&w=292&sc_lang=en&hash=AC72F16F3CBE2E7A844037C89E5E1BEC" /></p> <h3><strong>Options for shoulder replacement and when they're used</strong></h3> <h4>Anatomical.</h4> <p>This technique replaces both the ball at the end of the humerus and the socket in your shoulder and matches your existing anatomy. It's used typically when the rotator cuff isn't damaged and most closely duplicates your natural range of motion.</p> <br /> <h4>Reverse.</h4> <p>With this technique, the socket is attached to the humerus and the ball to the shoulder, which is the opposite of your anatomy. A reverse replacement is used when the rotator cuff is damaged. Following a reverse replacement, you may experience changes in your range of motion, such as how far you can reach behind your back or over your head. That means that some workers may need to modify their movements. Lifting should be done with both hands to avoid stressing the surgical arm.  </p> <h4>Partial.</h4> <p>If the ball in your shoulder joint is damaged, it can be replaced, leaving the rest of the joint intact. The replacement ball is attached to the humerus, replicating your anatomy.</p> <h2>What to expect during and after surgery</h2> <p><img alt="Illustration of Shoulder Replacement Options" src="/-/media/national-files/images/hometown-health/2024/shoulder-replacement-options.jpg?h=417&w=292&sc_lang=en&hash=CE323AE68CDE1AE2646FB3D0E7E46FBF" style="color: #333333; height: 417px; width: 292px; margin-left: 5px; float: right;" />The majority of shoulder replacements are <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/hip-replacement/expert-answers/outpatient-joint-replacement/faq-20515416" target="_blank" title="Opens in a new window.">outpatient surgeries</a> which typically take 1-2 hours. After resting in the recovery area, most patients return home the same day. Your surgeon and <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window">physical therapist</a> will develop a plan to allow for healing and regaining range of motion and strength.</p> <p>When you go home, you'll be wearing an immobilizer, which is a sling with a pad in it to hold your arm still and at the correct angle. Depending on the progress of your healing, you may wear the immobilizer for up to six weeks. Starting at six weeks and continuing for up to three months, you'll work with a physical therapist to improve your range of motion and strength.</p> <p>As with any surgery, some complications could occur. These include:</p> <ul> <li>Dislocation, with the new ball coming out of the socket.</li> <li>Failure of the rotator cuff due to wear after a partial or anatomical replacement.</li> <li>Formation of blood clots in the leg or arm following surgery.</li> <li>Fracture of the humerus or other shoulder bones after surgery.</li> <li>Infection at the incision site or deeper in the tissues.</li> <li>Loosening of the implants over time, which may require additional surgery.</li> <li>Numbness, weakness and pain due to nerve damage.</li> </ul> <h2>Goals for shoulder replacement</h2> <p>The primary goal for shoulder replacement surgery is pain relief and overall improved function of your shoulder joint. That means being able to do everyday tasks at home and work, as well as the activities you take pleasure in and contribute to your physical and mental health and wellness.</p> <h3>Next steps:</h3> <ul> <li>Find out what <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window">orthopedic services</a> are available in Mayo Clinic Health System.</li> <li>Learn about what to expect from shoulder <a rel="noopener" href="https://www.youtube.com/watch?v=GRlcQ3vNSBM&list=PLggupBM2Bzuc8NEsmfE1hw4GUJA7DW8mK&index=23" target="_blank" title="Opens in a new window.">surgery and recovery</a>.</li> <li>Read more about <a href="/hometown-health/speaking-of-health/shoulder-pain-it-could-be-your-rotator-cuff" target="_self" title="Opens in same window">rotator cuff injuries</a>.</li> </ul> <p><strong>Watch a video about shoulder pain and when to seek care.</strong></p> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/7y3DKzzpbqk" title="Shoulder Pain – When to seek help and available treatment options - Mayo Clinic Health System" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <p><em><a href="/-/media/shared-files/images/medical-professionals/full/eau-claire/douglas-bartels-md.jpg" target="_self" title="Opens in same window">Douglas Bartels, M.D.</a>, is an orthopedic surgeon in <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window">Orthopedics</a> and <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window">Sports Medicine</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window">Eau Claire</a>, Wisconsin.</em></p><ul> <li>ACL injuries</li> <li>Cartilage restoration and transplantation</li> <li>Hip arthroscopy</li> <li>Knee arthroscopy</li> <li>Meniscus tears</li> <li>Multi-ligament knee injuries</li> <li>Open surgery of the knee </li> <li>Open surgery of the shoulder</li> <li>Patellar instability</li> <li>Rotator cuff injury</li> <li>Shoulder arthroscopy</li> <li>Shoulder instability</li> <li>Shoulder replacement surgery</li> <li>Sports medicine</li> <li>Tendon tears (Achilles, pec, tricep, bicep)</li> </ul>M.D.<p>I chose a career in sports medicine to help patients of all ages and activity levels regain function and get back to doing the things they love. In my practice, I enjoy taking care of acute and chronic shoulder, hip and knee injuries and issues. I take pride in providing individualized care and making sure you are a part of the decision-making process. As a lifelong athlete, my main goal is to get patients back to work, school, hobbies, and sports feeling better than they did before their injury.</p> <p>I grew up in the Midwest and am thrilled to be providing orthopedic care in Northwest Wisconsin. As a college athlete I was exposed to sports-related injuries, which sparked my interest in orthopedics and sports medicine. During my residency and fellowship, I was able to be a team doctor for athletes at the high school level all the way to the professional level with the San Francisco 49ers.</p> <p>In my spare time, I enjoy spending time with my family and dogs along with traveling and fishing.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Biological Anthropology, Northwestern University</li> <li>Master's degree, Liberal Studies, Northwestern University</li> <li>Doctor of Medicine, Rush Medical College</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Sports Medicine and Shoulder Surgery, Stanford Health Care</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>Alpha Omega Alpha Honor Medical Society</li> <li>American Academy of Orthopedic Surgeons (AAOS)</li> <li>American Medical Association (AMA)</li> <li>American Orthopedic Society for Sports Medicine (AOSSM)</li> <li>Football Team Physician, San Francisco 49ers</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Orthopedics, Mayo Clinic College of Medicine and Science</li> </ul>Bartels<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/douglas-bartels-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=A5E506A9AEFC8F3CA64AF69A13885600" alt="Douglas (Doug) Bartels M.D." width="280" height="280" DisableNVelocity="true" /><ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/35188900/" target="_blank" title="Opens in new window">Antibiotic prophylaxis with cefazolin is associated with lower shoulder periprosthetic joint infection rates than non-cefazolin alternatives</a>; May 2022</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/33764935/" target="_blank" title="Opens in new window">Revision reverse shoulder arthroplasty for anatomical glenoid component loosening was not universally successful: A detailed analysis of 127 consecutive shoulders</a> May 2021</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/31039055/" target="_blank" title="Opens in new window">Mid-term radiological results of a cementless short humeral component in anatomical and reverse shoulder arthroplasty</a>; May 2019</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/30968051/" target="_blank" title="Opens in new window">Epidemiology of hand and wrist injuries in NCAA men's football: 2009-2010 to 2013-2014</a>; April 2019</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/30393556/" target="_blank" title="Opens in new window">Arthroscopy and arthrotomy to address intra-articular pathology during PAO for hip dysplasia demonstrates similar short-term outcomes</a>; June 2018</li> </ul>{C36F83B1-9C26-4B21-BA7B-739F5EB4C565}Douglas (Doug)<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20090200Douglas (Doug) Bartels, M.D.1{DEF55970-853F-4E96-9A4D-3413874FF059}|{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2024/lady-reaching-for-upper-kitchen-shelf.jpg?h=370&iar=0&w=660&sc_lang=en&hash=56F62D99EB591FBC40B4FFF1AAF1101C" alt="Lady reaching for upper kitchen shelf" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller12/23/2024From on-the-go snack to the star of a beloved pie, an apple also offers an amazing array of health benefits. Learn why and how to make apples part of your daily diet.Pick apples for a bushel of health benefits<p>Did you know apples are the most widely consumed fruit in the world? In the U.S., we eat nearly 18 pounds per person each year. And we've got plenty of apples to choose from: the U.S. grows close to 2,500 varieties.</p> <p>Apples are readily available, easy to eat on the go and versatile in cooking and baking, and they offer a bushel of health benefits. To gather the most benefits, choose whole fruit over juice.</p> <h3>How apples support overall health</h3> <p>There's truth behind the old saying, "An apple a day keeps the doctor away." Here's how a daily apple supports overall health:</p> <p><strong>Antioxidants</strong>. <br /> These substances reduce <a href="/hometown-health/speaking-of-health/want-to-ease-chronic-inflammation" target="_self" title="Opens in same window">inflammation</a>, aid in digestion and provide protection against cancers such as colorectal, lung and some forms of breast cancer. Antioxidants also help lower the risk of asthma, improve lung function and regulate blood sugar levels.</p> <p><strong>Fiber</strong>.<br /> Fiber aids in weight loss by slowing digestion, reduces constipation by providing bulk and promotes gut health. It reduces the risk for heart disease by lowering <a href="/hometown-health/speaking-of-health/know-your-numbers-cholesterol" target="_self" title="Opens in same window">cholesterol</a> levels and <a href="/hometown-health/speaking-of-health/6-ways-to-manage-high-blood-pressure" target="_self" title="Opens in same window">blood pressure</a>. It also helps lower <a href="/hometown-health/speaking-of-health/ive-been-diagnosed-with-prediabetes-what-does-that-mean" target="_self" title="Opens in same window">blood sugar</a>.</p> <p><strong>Hydration</strong>.<br /> An apple contains 85% water, so it can help quench your thirst.</p> <p><strong>Phytochemicals</strong>.<br /> Apples contain:</p> <ul> <li>Fisetin, which may protect against memory loss and boost brain health.</li> <li>Pectin, which acts as a <a href="/hometown-health/speaking-of-health/good-bacteria-for-your-gut" target="_self" title="Opens in same window">prebiotic</a> "food" for growing good bacteria. </li> <li><a rel="noopener" href="https://newsnetwork.mayoclinic.org/discussion/drugs-that-kill-zombie-cells-may-benefit-some-older-women-but-not-all-mayo-clinic-study-finds/" target="_blank" title="Opens in a new window.">Quercetin</a>, which protects your brain from oxidative stress, stops harmful bacteria from growing in your gut and strengthens your immune system. </li> </ul> <h3>How to choose and store apples</h3> <p>Sweet to tart, tender to crisp, apples are available year-round and won't break your budget , particularly in the fall and winter. Typically, there are 2-4 apples per pound. </p> <p>Buy firm, well-colored apples with smooth skin free from bruises and gouges. Dry, tan-brown spots on the skin are called scald and don't affect the flavor. </p> <p>Store apples in a plastic bag in the refrigerator for up to six weeks after purchase.</p> <h3>How to add apples to your daily diet</h3> <p>The serving size for fresh apples is one cup or one small apple. Try these simple ways to harvest the benefits of apples throughout the day:</p> <ul> <li>Arrange apple slices over pork chops to add moisture and flavor during cooking.</li> <li>Dip apples into peanut butter for a protein-packed snack.</li> <li>Mix apple chunks into tuna salad for a sandwich or main dish salad.</li> <li>Punch up your morning <a href="/hometown-health/speaking-of-health/start-your-day-with-healthy-oatmeal" target="_self" title="Opens in same window">oatmeal</a> by stirring in chopped apples and walnuts. </li> <li>Sprinkle cinnamon, apple pie spice or nutmeg on sliced apples and top with a dollop of nonfat plain <a href="/hometown-health/speaking-of-health/an-introduction-to-probiotics" target="_self" title="Opens in same window">yogurt</a> for an easy "apple pie" dessert.</li> </ul> <h3>Apple recipes showcase their versatility</h3> <p>Apples add color and crunch to this whole-grain pilaf, which can be served warm or cold for a hearty lunch or as a side dish with grilled or roasted meat or fish.</p> <h4>Wild rice pilaf with cranberries and apples</h4> <p>By Mayo Clinic Staff<br /> Serves 8</p> <p>1/4 cup slivered almonds<br /> 3 cups water<br /> 1 1/2 cups wild rice, rinsed and drained<br /> 1/2 cup dried cranberries, no sugar added<br /> 2 tablespoons olive oil<br /> 1 tablespoon red wine vinegar<br /> 1 tablespoon sugar<br /> 2 Granny Smith apples, cored and diced</p> <p>Preheat the oven to 325 F. Lightly coat a baking sheet with cooking spray.</p> <p>Spread the almonds on the baking sheet and bake, stirring occasionally, until golden, about 10 minutes. Put on a plate to cool.</p> <p>In a medium saucepan, bring 3 cups of water to a boil. Add the rice. Reduce heat and cover. Keep adding water as needed to keep the rice from drying out. Simmer until the rice is tender, about 45 to 60 minutes. Pour through a fine-mesh strainer to drain. Return the rice to the saucepan and stir in the dried cranberries. Cover and set aside.</p> <p>In a small bowl, whisk together the oil, vinegar and sugar. Dice the apples. In a large bowl, combine the rice and apples. Add the oil mixture and toss to coat evenly. Serve warm or cold. Top with toasted almonds.</p> <p>Nutritional per 1-cup serving: 289 calories, 5.5 grams total fat, 0 milligrams cholesterol, 3 milligrams sodium, 32 grams carbohydrates, 4 grams fiber, 5 grams protein.</p> <p><em><a href="/providers/corrinna-lenort-rdn" target="_self" title="Opens in same window">Corrinna Lenort</a> is a registered dietitian in <a href="/services-and-treatments/nutrition" target="_self" title="Opens in same window">Nutrition Counseling & Education</a> in <a href="/locations/fairmont" target="_self" title="Opens in same window">Fairmont</a>, Minnesota.</em></p> <p> </p><ul> <li>Diabetes</li> <li>Weight management</li> </ul>RDN, LD<p>Patients can expect feeling seen and heard during appointments. I strongly believe in individualized nutrition care based on a patient's main concerns and health goals they want to focus on. My nutrition philosophy is small, sustainable changes for long-term success.</p> <p>I enjoy spending time with my family and friends. My hobbies include nice evening walks, being outside and squeezing in short exercises when a busy life schedule allows the opportunity. I aim to meet needs of people I encounter in my day. I enjoy cooking and trying new recipes; quick and easy are most realistic for me.</p><p><strong>Education</strong></p> <ul> <li>Bachelor's degree, Dietetics, South Dakota State University</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Dietetic Program, University of South Dakota Center for Disabilities</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Commission on Dietetics Registration</li> <li>Minnesota Board of Dietetics and Nutrition Practice</li> </ul>Lenort<img src="/-/media/shared-files/images/medical-professionals/full/fairmont/corrinna-lenort-rdn.jpg?h=280&iar=0&w=280&sc_lang=en&hash=19F275E4907F391664940C0314CB187E" alt="Corrinna Lenort, R.D.N." width="280" height="280" DisableNVelocity="true" />Corrinna<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30259811Corrinna Lenort RDN1{2BEE5070-65FF-4406-9E59-103E06C5A535}|{137191DF-266C-47EA-897F-817D98AEA7BC}|{65CCD51B-4359-4987-BEAD-351431E58203}<img src="/-/media/national-files/images/hometown-health/2024/person-holding-bitten-apple.jpg?h=370&iar=0&w=660&sc_lang=en&hash=17A98EA9CAAE3BB15F0B25BC09ECF0D5" alt="person holding bitten apple" width="660" height="370" DisableNVelocity="true" />Get healthy recipes and tipsWhen life gets hectic, remember that eating well can give you more energy, reduce stress and improve your immune system. Eating well can also decrease your chance of developing heart attack, stroke, Type 2 diabetes and other chronic diseases, as well as lower your blood pressure and help prevent some types of cancer. Make healthy choices for you and your family — one meal at time.NutritionMastering nutrition basics comes down to understanding the roles that specific nutrients play in a healthy diet. Want to go beyond the nutrition basics? Talk to your doctor or a dietitian for personalized dietary advice that takes into account your health status, lifestyle, and food likes and dislikes.Dawn Haller12/9/2025<p>Jaundice is common and often harmless, but some babies require treatment to prevent complications. Understanding jaundice and how it's managed can help parents feel prepared.</p>Newborn jaundice and light therapy<h2>Newborn jaundice and light therapy: What parents need to know</h2> <p>Many newborns develop <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/infant-jaundice/symptoms-causes/syc-20373865" target="_blank" title="Opens in a new window.">jaundice</a> within the first few days of life. For parents, seeing a yellow tint in their baby's skin or eyes can be concerning. Jaundice is common and often harmless, but some babies require treatment to prevent complications. Understanding what jaundice is and how it's managed can help parents feel prepared and reassured.</p> <h3>Understanding newborn jaundice</h3> <p>Jaundice occurs when a baby has elevated levels of bilirubin, a yellow pigment produced as the body breaks down red blood cells. Newborns have immature livers that may not remove bilirubin efficiently, causing it to build up in the bloodstream and settle in the skin and eyes.</p> <p>The condition affects 50%–80% of newborns in the United States. While most full-term babies experience mild jaundice that resolves on its own, higher levels of bilirubin can be dangerous. If untreated, severe jaundice in babies can lead to permanent brain damage, so early recognition and monitoring are essential.</p> <p>Other symptoms of jaundice in infants include difficulty waking, seeming listless or sick, not gaining weight, feeding poorly and making high-pitched cries.</p> <h3>When treatment is needed</h3> <p>Not all cases of jaundice require medical intervention. Babies born between 35 weeks and full term frequently improve without treatment. However, if a baby's bilirubin levels rise too quickly or reach a level that is considered unsafe, intervention is necessary to prevent complications.</p> <p>Clinicians determine treatment needs based on bilirubin levels, the baby's age, gestational age, feeding patterns and other risk factors.</p> <h3>How light therapy works</h3> <p>Phototherapy, or light therapy, is one of the most common treatments for newborn jaundice. </p> <p>Phototherapy uses a specific range of blue-green visible light. When this light reaches the baby's skin, it changes bilirubin into a water-soluble form that the body can eliminate through stool and urine. The treatment is safe, effective and noninvasive.</p> <p>During therapy, babies typically wear only a diaper and protective eye patches. Maximizing skin exposure helps improve treatment efficiency.</p> <h2>Ensuring safe and effective treatment</h2> <p>In 2024, the American Academy of Pediatrics updated its recommendations on phototherapy to specify the most effective light intensity. Increasing the brightness beyond these guidelines does not improve outcomes and may decrease safety. </p> <p>In the <a rel="noopener" href="https://publications.aap.org/hospitalpediatrics/article-abstract/15/11/e526/204527/Newborn-Phototherapy-Irradiance-Levels-With-and" target="_blank" title="Opens in a new window.">November 2025 issue of Hospital Pediatrics,</a> new insights were published on how factors such as covers or swaddles can influence phototherapy effectiveness in newborns.</p> <p>Short-term side effects can include skin rashes, dehydration and overheating. The most important safety measure is protecting the baby's eyes, as direct exposure to the light could harm their retinas.</p> <p>Clinicians follow clear, individualized guidelines for when to begin and discontinue phototherapy.</p> <h3>Why sunlight isn't a substitute</h3> <p>Sunlight contains ultraviolet and infrared radiation. These can cause sunburn, overheating and dehydration. For this reason, sunlight is not recommended as a treatment for jaundice.</p> <p>Phototherapy provides a safe and controlled exposure without these risks. </p> <h2>Supporting your baby at home</h2> <p>The best way for you to prevent your baby from developing jaundice after birth is to make sure the baby is getting fed on a regular schedule. Infants typically need 8–12 feedings each day in the first several days of life. </p> <p>Parents should monitor their newborn for changes in skin color, feeding patterns, alertness and weight. If you have concerns, it is important to contact your baby's healthcare provider promptly.</p> <h2>Promoting healthy beginnings</h2> <p>Jaundice is a common part of newborn life, and most cases resolve with simple monitoring and supportive care. When treatment is needed, phototherapy offers a gentle and reliable way to prevent the serious complications of high bilirubin. With early recognition and proper care, parents can feel confident that their baby is off to a healthy start.</p> <p><a href="/providers/dennis-costakos-md" target="_self" title="Opens in same window"><em>Dennis Costakos, M.D.</em></a>,<em> is a <a href="/sitecore/service/notfound.aspx?item=web%3a%7b4EB435AB-067A-42EB-B3D7-B38B2A5BCB6E%7d%40en" target="_self" title="Opens in same window">neonatal</a> physician for the Mayo Clinic Health System in <a href="/locations/la-crosse" target="_self" title="Opens in same window">La Crosse, Wisconsin</a>.</em></p><ul> <li>Folic acid to prevent neural tube defects in minority populations as part of equity and inclusion</li> <li>Hyperbilirubinemia</li> <li>Newborn screening for biotinidase deficiency</li> <li>Predictive analytics</li> <li>Pulmonary surfactant and inter-hospital transfer</li> <li>Vitamin K and the newborn</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Dartmouth Medical School </li> </ul> <p><strong>Residency</strong></p> <ul> <li>Pediatrics, Mount Sinai Hospital</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Neonatal/Perinatal Medicine, New York Hospital/Cornell University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Neonatology, American Board of Pediatrics</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Pediatrics, Fellow in Neonatal-Perinatal Medicine and Epidemiology</li> <li>American Federation for Medical Research</li> <li>American Medical Association</li> <li>Society of Neuroscience </li> <li>Wisconsin Association for Perinatal care</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Pediatrics, Mayo Clinic College of Medicine and Science</li> </ul>Costakos<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/dennis-costakos-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=0A58CB05C01B2118F3FD82CC17315366" alt="Dennis Costakos MD" width="280" height="280" DisableNVelocity="true" /><p>See my publications at <a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/?term=costakos+dt" target="_blank" title="Opens in a new window">PubMed</a>.</p>Dennis<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12794287Dennis Costakos, M.D.1<img src="/-/media/national-files/images/hometown-health/jaundice-newborn-being-held.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C5FAA31D65F0A34AF83C608E75FA8230" alt="TreatingNewbornJaundice_Blog_660x370" width="660" height="370" DisableNVelocity="true" />Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller1/28/2026<span>Learn how a lingering cough may be caused by acute bronchitis.</span>Is your cough acute bronchitis?<p>A lingering cough can be frustrating — especially when it starts interfering with sleep, work, or everyday activities. While many coughs improve on their own, some may be caused by acute bronchitis, a common condition that often develops after a cold or other respiratory infection.</p> <p>Want fast, convenient care from home? The <a href="/services-and-treatments/virtual-care" target="_self" title="Opens in same window">Mayo Clinic Primary Care On Demand app</a> makes it easy to connect with a provider to evaluate your symptoms and recommend next steps.</p> <h2>What is acute bronchitis?</h2> <p>Acute bronchitis occurs when the lining of the bronchial tubes — the airways that carry air to your lungs — becomes inflamed. In most cases, it’s caused by respiratory viruses, but bacterial infections or exposure to irritants such as dust, pollution, fumes or tobacco smoke can also play a role.</p> <h3>Common symptoms</h3> <p>Acute bronchitis often brings symptoms such as:</p> <ul> <li>Cough, often with clear, white, yellow or green mucus</li> <li>Fatigue or feeling unwell</li> <li>Chest discomfort or soreness</li> <li>Wheezing or a whistling sound when breathing</li> <li>Low-grade fever</li> <li>Shortness of breath, especially with activity</li> <li>Sore throat, often before the cough begins</li> </ul> <p>If you’re noticing symptoms like these and want guidance sooner rather than later, <a href="/services-and-treatments/virtual-care" target="_self" title="Opens in same window">Primary Care On Demand</a> offers quick virtual visits with trusted Mayo Clinic providers.</p> <h3>When should you seek care?</h3> <p> Consider contacting a healthcare provider if:</p> <ul> <li>Your cough lasts more than three weeks</li> <li>You have a fever over 100.4°F</li> <li>You’re coughing up blood</li> <li>Your symptoms worsen or do not improve </li> </ul> <p>Prompt evaluation can help rule out pneumonia or other conditions that may require treatment.</p> <p>Tips to lower your risk:</p> <ul> <li>Avoid smoking and secondhand smoke</li> <li>Wash your hands often</li> <li>Wear a mask in dusty or polluted areas</li> <li>Avoid close contact with people who are sick </li> </ul> <p><strong>Ready to feel better, faster?</strong></p> <p>Don’t wait for symptoms to disrupt your life. Get expert guidance for coughs, colds, and hundreds of other conditions without leaving home. Connect with providers anytime, anywhere with Primary Care On Demand — often in 30 minutes or less.</p> <p>Download the app through your phone’s app store today.</p> <p><a rel="noopener" href="https://apps.apple.com/us/app/primary-care-on-demand/id6462700069" target="_blank" title="Opens in new window. "><img alt="AppleAppStore334x100" src="/-/media/national-files/images/khealth-pcod-page-assets/appleappstore334x100px.png?h=45&w=150&sc_lang=en&hash=5BBAC460B729CBF11916234AA87A1A87" /></a>      <a rel="noopener" href="https://play.google.com/store/apps/details?id=org.mayoclinic.primarycareondemand" target="_blank" title="Opens in a new window."><img alt="GooglePlay300px" src="/-/media/national-files/images/khealth-pcod-page-assets/googleplay300px.png?h=45&w=150&sc_lang=en&hash=67DBFF492EABC87AAA187B13233DC057" style="width: 150px; height: 45px;" /></a></p> <p><a rel="noopener" href="https://apps.apple.com/us/app/primary-care-on-demand/id6462700069" target="_blank" title="Opens in a new window."><img alt="AppleAppQRCodes300px" src="/-/media/national-files/images/khealth-pcod-page-assets/appleappqrcodes300px.jpg?h=150&w=150&sc_lang=en&hash=5E4DBC1308E7389656B3ED8BB8483A1C" /></a>      <a rel="noopener" href="https://play.google.com/store/apps/details?id=org.mayoclinic.primarycareondemand" target="_blank" title="Opens in a new window."><img alt="GoogleAppQRCodes300px" src="/-/media/national-files/images/khealth-pcod-page-assets/googleappqrcodes300px.jpg?h=150&w=150&sc_lang=en&hash=E5E5210BC5D05C275C38DB608DBC80DC" style="width: 150px; height: 150px;" /></a></p><img src="/-/media/national-files/images/hometown-health/2026/pcodbronchitis_blog_660x370.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2A26480A151EDEE3D5A8C55889BF88F1" alt="PCODBronchitis_Blog_660x370" width="660" height="370" DisableNVelocity="true" />BreathingMost cases of shortness of breath are due to heart or lung conditions. Your heart and lungs are involved in transporting oxygen to your tissues and removing carbon dioxide, and problems with either of these processes affect your breathing.Respiratory CareRespiratory care helps people with serious health problems associated with their lungs and ability to breathe. The Respiratory Care team is always ready to respond to a variety of emergency situations, such as an asthma attack. Additional services may include pulmonary rehabilitation and educational programs.Dawn Haller2/9/2026<span style="line-height: 115%;">Sinus infections (acute sinusitis) occur when the air‑filled spaces around your nose become inflamed and swollen.</span>Is your sinus pressure a sinus infection?<p>Stuffy nose. Pressure around your eyes and cheeks. A headache that just won’t quit. When sinus symptoms drag on, it’s hard to know if you’re dealing with a simple cold or a sinus infection that needs more attention.</p> <p>Sinus infections, also known as acute sinusitis, occur when the air‑filled spaces around your nose become inflamed and swollen. They’re most often caused by common cold viruses and usually last three to seven days. They can also be caused by bacterial infections, allergies, nasal polyps, or structural issues in the nose, such as a deviated septum.</p> <p>Most cases clear up on their own, but when symptoms linger or get worse, it may be time to connect with a healthcare provider.</p> <p>Mayo Clinic Health System offers patients in Wisconsin, Minnesota and Iowa convenient virtual care for sinus infections and hundreds of other common conditions through the <a href="/services-and-treatments/virtual-care" target="_self" title="Opens in same window">Mayo Clinic Primary Care On Demand app.</a></p> <h2>What are sinus infection symptoms?</h2> <p>Common sinus infection symptoms can make everyday life uncomfortable.</p> <p>These symptoms often include:</p> <ul> <li>Nasal congestion or a runny nose</li> <li>Facial pressure or pain around the eyes, cheeks, nose or forehead</li> <li>Yellow or green nasal discharge</li> <li>Pain in the face or upper teeth</li> <li>Fever</li> <li>Bad breath</li> <li>Fatigue or feeling unwell</li> <li>Cough, sometimes worse at night</li> <li>Sore throat</li> </ul> <p>If you’re noticing several of these symptoms together — especially facial pressure and thick nasal drainage — you may be dealing with a sinus infection rather than a simple stuffy nose.</p> <h2>When should you seek medical attention?</h2> <p>Many sinus infections improve without treatment. </p> <p>However, it’s important to contact a healthcare provider if:</p> <ul> <li>Symptoms last more than 10 days</li> <li>Symptoms worsen after initially improving</li> <li>You have a fever over 102°F, or 38.9°C</li> <li>You develop severe headaches or vision changes</li> <li>You notice swelling around the eyes</li> <li>You have a stiff neck or feel confused</li> </ul> <p>These signs can point to a more serious infection that needs prompt medical evaluation.</p> <h2>Tips to help lower your risk of sinus infections</h2> <p>While not all sinus infections can be prevented, you can help lower your risk by:</p> <ul> <li>Washing your hands often</li> <li>Avoiding cigarette smoke and other irritants</li> <li>Working with your provider to manage allergies</li> <li>Using a humidifier if the air in your home is dry</li> </ul> <p>If you do develop symptoms, getting guidance early can help you feel better faster and rule out more serious problems.</p> <h3>Ready to feel better, faster?</h3> <p>Don’t wait for symptoms to disrupt your life. Get expert guidance for coughs, colds, and hundreds of other conditions without leaving home. Connect with providers anytime, anywhere with <a href="/services-and-treatments/virtual-care" target="_self" title="Opens in same window">Primary Care On Demand</a> — often in 30 minutes or less.</p> <p><strong>Download the app through your phone’s app store today.</strong></p> <p><a rel="noopener" href="https://apps.apple.com/us/app/primary-care-on-demand/id6462700069" target="_blank" title="Opens in new window. "><img alt="AppleAppStore334x100" src="/-/media/national-files/images/khealth-pcod-page-assets/appleappstore334x100px.png?h=45&w=150&sc_lang=en&hash=5BBAC460B729CBF11916234AA87A1A87" /></a>      <a rel="noopener" href="https://play.google.com/store/apps/details?id=org.mayoclinic.primarycareondemand" target="_blank" title="Opens in a new window."><img alt="GooglePlay300px" src="/-/media/national-files/images/khealth-pcod-page-assets/googleplay300px.png?h=45&w=150&sc_lang=en&hash=67DBFF492EABC87AAA187B13233DC057" style="width: 150px; height: 45px;" /></a></p> <p><a rel="noopener" href="https://apps.apple.com/us/app/primary-care-on-demand/id6462700069" target="_blank" title="Opens in a new window."><img alt="AppleAppQRCodes300px" src="/-/media/national-files/images/khealth-pcod-page-assets/appleappqrcodes300px.jpg?h=150&w=150&sc_lang=en&hash=5E4DBC1308E7389656B3ED8BB8483A1C" /></a>      <a rel="noopener" href="https://play.google.com/store/apps/details?id=org.mayoclinic.primarycareondemand" target="_blank" title="Opens in a new window."><img alt="GoogleAppQRCodes300px" src="/-/media/national-files/images/khealth-pcod-page-assets/googleappqrcodes300px.jpg?h=150&w=150&sc_lang=en&hash=E5E5210BC5D05C275C38DB608DBC80DC" style="width: 150px; height: 150px;" /></a></p><img src="/-/media/national-files/images/hometown-health/2026/winter-outdoor-lady-and-girl.jpg?h=370&iar=0&w=660&sc_lang=en&hash=26103686F65F6879C7C63BF5AF6C312C" alt="winter outdoor lady and girl 660x370" width="660" height="370" DisableNVelocity="true" />HeadacheHeadache is pain in any region of the head that feels like a sharp pain, throbbing sensation or dull ache. It may develop gradually or suddenly, and last for minutes or days.Ear, Nose and Throat (ENT)Get information about symptoms, disorders and diseases affecting the ear, nose and throat, and related head and neck structures.Dawn Haller3/10/2026<p>If you are dealing with coughs, fevers or congestion, know when to seek medical care and when symptoms can be managed at home.</p>When to seek care for cold, flu and RSV<p>Cold, flu and respiratory syncytial virus (RSV) are most common in winter, but respiratory illnesses can occur year‑round and spread quickly. If you or your family are dealing with coughs, fevers or congestion, knowing when to seek medical care — and when symptoms can be managed at home — can help you make confident, timely decisions.</p> <p>Not every illness requires a visit to the emergency department or urgent care. But some symptoms should never be ignored. Understanding warning signs can help protect your health and prevent complications.</p> <p>RSV is a highly contagious virus that affects the lungs and airways. While RSV often causes mild, cold‑like symptoms in healthy adults, it can lead to serious breathing problems in infants, older adults and people with certain medical conditions.</p> <p>Mayo Clinic Health System offers patients ages three and older in Wisconsin, Minnesota and Iowa convenient virtual care for cold, flu and hundreds of other common conditions through the <a href="/services-and-treatments/virtual-care" target="_self" title="Opens in same window">Mayo Clinic Primary Care On Demand app</a>.</p> <h2>When you can recover at home</h2> <p>Many mild cold and flu symptoms can be treated at home with rest, fluids and over‑the‑counter medications.</p> <p>These symptoms may include:</p> <ul> <li>Runny or stuffy nose</li> <li>Mild cough</li> <li>Sore throat</li> <li>Low‑grade fever</li> <li>Fatigue or body aches</li> </ul> <p>RSV symptoms often begin gradually and may look like a common cold at first. In some cases, symptoms can worsen after several days, especially in young children and older adults.</p> <p>If symptoms remain mild and gradually improve over several days, home care is often enough. Continue to monitor how you feel, stay hydrated and limit contact with others to reduce the spread of illness. If symptoms worsen, last longer than expected or begin to interfere with breathing or daily activities, it may be time to seek medical guidance.</p> <h2>When to seek emergency care</h2> <p>Some symptoms may signal a more serious illness and require immediate evaluation.</p> <p>Go to the emergency department or call 911 if you experience:</p> <ul> <li>Difficulty breathing or shortness of breath</li> <li>Wheezing, rapid breathing or signs of increased effort to breathe</li> <li>Pain or pressure in the chest or abdomen</li> <li>Dizziness or confusion</li> <li>Severe or persistent vomiting</li> <li>Flu‑like symptoms that improve and then return with fever and a worsening cough</li> </ul> <p>If you are unsure whether symptoms are serious, connecting with a health care professional can help you determine the safest next step.</p> <h2>Who should take extra precautions?</h2> <p>Certain people face a higher risk of complications from flu, RSV and other respiratory infections. If you or someone you care for is in one of these groups, do not delay seeking medical advice if symptoms appear in:</p> <ul> <li>Adults age 65 and older</li> <li>Children younger than 5, especially those under age 2</li> <li>Pregnant women</li> <li>People with chronic conditions such as asthma, diabetes or heart disease</li> <li>Individuals with weakened immune systems</li> <li>People who smoke or vape</li> </ul> <p>RSV is a leading cause of hospitalization in infants and can also cause serious lung infections, such as pneumonia or bronchiolitis, in older adults and people with chronic heart or lung disease. Early evaluation and treatment can reduce the risk of severe illness.</p> <h2>Warning signs to watch for in children</h2> <p>Children can become sicker more quickly than adults. </p> <p>Seek medical care if a child has:</p> <ul> <li>Fast or labored breathing</li> <li>Bluish lips or face</li> <li>Extreme irritability or difficulty waking</li> <li>Refusal to drink fluids</li> <li>Fever accompanied by a rash</li> </ul> <p>In infants, RSV may also cause pauses in breathing, flaring of the nostrils or visible pulling in of the chest muscles with each breath. Parents and caregivers know their children best. If something does not seem right, trust your instincts and seek care.</p> <h2>Ready to feel better, faster?</h2> <p>Don’t wait for symptoms to disrupt your life. Get expert guidance for coughs, colds and hundreds of other conditions for you and your family members ages 3 and older — without leaving home.</p> <p><a href="/services-and-treatments/virtual-care" target="_self" title="Opens in same window">Download the Primary Care On Demand app</a> now to connect with providers anytime, anywhere — often in 30 minutes or less.</p><img src="/-/media/national-files/images/hometown-health/2026/coldflursv-blog-photo.jpg?h=370&iar=0&w=660&sc_lang=en&hash=95BF169DC54B83024315A4788749BFDC" alt="ColdfluRSV blog photo" width="660" height="370" DisableNVelocity="true" />InfluenzaInfluenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza, commonly called the flu, is not the same as the stomach "flu" viruses that cause diarrhea and vomiting.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller4/6/2026Pink eye is a common eye condition that affects people of all ages and can be uncomfortable and, in some cases, contagious.Pink eye: Symptoms, causes and when to seek care<p>Pink eye, also called conjunctivitis, is a common eye condition that affects people of all ages. While it often starts as mild irritation, pink eye can be uncomfortable and, in some cases, contagious. Knowing the symptoms, understanding what causes pink eye and recognizing when to seek care can help protect your eye health and reduce the risk of spreading infection to others.</p> <p>Mayo Clinic Health System offers patients ages three and older in Wisconsin, Minnesota and Iowa convenient virtual care for cold, flu and hundreds of other common conditions through the <a href="/services-and-treatments/virtual-care" target="_self" title="Opens in same window">Mayo Clinic Primary Care On Demand app</a>.</p> <h2>What is pink eye?</h2> <p>Pink eye occurs when the thin, clear membrane lining the eyelid and covering the white part of the eye becomes inflamed. When this happens, small blood vessels become more visible, giving the eye a pink or reddish appearance.</p> <p>Pink eye can have several causes. The most common cause is a viral infection, but it can also result from bacteria or allergies. In babies, blocked tear ducts may lead to similar symptoms. Because some forms of pink eye are contagious, early diagnosis and simple precautions can help limit its spread at home, school or work.</p> <p>Common pink eye symptoms</p> <p>Symptoms of pink eye can vary depending on the cause, but many people experience one or more of the following:</p> <ul> <li>Redness in one or both eyes</li> <li>Itching, burning or a gritty feeling</li> <li>Discharge that may cause the eyelids to stick together, especially overnight</li> <li>Excess tearing</li> <li>Sensitivity to light</li> </ul> <p>Symptoms may start in one eye and spread to the other, particularly with viral or bacterial conjunctivitis. Allergic pink eye often affects both eyes at the same time and may occur along with sneezing or nasal congestion.</p> <p>If you are unsure what is causing your symptoms, a healthcare professional can help determine whether treatment is needed.</p> <h2>When to seek urgent care for pink eye</h2> <p>Most cases of pink eye are mild and improve with basic care or time. However, some symptoms may signal a more serious eye condition and should be evaluated promptly.</p> <h3>Seek urgent care if you experience:</h3> <ul> <li>Eye redness with pain</li> <li>A sensation that something is in the eye</li> <li>Blurred or reduced vision</li> <li>Increased sensitivity to light</li> <li>Symptoms that worsen or do not improve within 12 to 24 hours</li> </ul> <p>People who wear contact lenses should stop wearing them as soon as symptoms begin. Continuing to wear contacts may increase the risk of complications.</p> <h2>How pink eye spreads and how to prevent it</h2> <p>Viral and bacterial pink eye can spread easily through direct contact. Good hygiene plays an important role in prevention.</p> <h3>Steps that can help reduce the risk of spreading pink eye include:</h3> <ul> <li>Avoid touching or rubbing the eyes</li> <li>Wash hands often with soap and water</li> <li>Use clean towels and washcloths</li> <li>Avoid sharing personal items such as towels, washcloths or eye makeup</li> <li>Replace old eye cosmetics, including mascara</li> <li>Change pillowcases regularly</li> </ul> <p>These steps are especially important in households with children, shared living spaces and workplaces where close contact is common.</p> <h2>Getting care for pink eye</h2> <p>Pink eye is common, but it should not be ignored. Understanding the symptoms, knowing when to seek care and taking steps to prevent spread can help protect your vision and the health of those around you.</p> <p>If you think you may have pink eye, talking with a healthcare provider can help you understand what is causing your symptoms and what treatment, if any, is appropriate. In many cases, pink eye can be evaluated through a virtual visit.</p> <h2>Ready to feel better, faster?</h2> <p>Don’t wait for symptoms to disrupt your life. Get expert guidance for coughs, colds and hundreds of other conditions for you and your family members ages three and older — without leaving home.</p> <p><a href="/services-and-treatments/virtual-care" target="_self" title="Opens in same window">Download the Primary Care On Demand app</a> now to connect with providers anytime, anywhere — often in 30 minutes or less.</p><img src="/-/media/national-files/images/hometown-health/2026/pinkeyepcod_blog_660x370.jpg?h=370&iar=0&w=660&sc_lang=en&hash=019AF1617A9014A8E488DB894D78BDC4" alt="PinkEyePCOD_Blog_660x370" width="660" height="370" DisableNVelocity="true" />Eye HealthYour eyes are responsible for providing you with vision, perhaps the most important of the senses. However, the eye is a delicate and complicated structure that needs protection. The ugly truth is that eye injuries can happen at any time and place.Dawn Haller6/26/2018<p>In sobriety, Al Smith rediscovered his passion for drawing, and it's in giving that brings peace and contentment.</p>Dramatic changes, dedication reconnect patient with passion for drawing<img height="370" alt="Pencil drawing of a soldier" width="660" src="/-/media/national-files/images/hometown-health/2018/pencil-drawing-of-a-soldier.jpg?sc_lang=en&hash=6FCC9F3EFC61558732FB167AFCF3EA70" class="img-responsive"> <p><em><strong>Editor's Note:</strong> Al Smith, profiled in this blog post, is a dedicated speaker at Fountain Centers, and has served as a facilitator for the Recovery Support Group in Faribault.</em></p> <p>Married with four children, and having lost everything but his home and his family, Al Smith’s life was saved at a Minneapolis hospital on a cold November night in 1973.</p> <p>With a suffering marriage and no income or insurance, Al set out to make dramatic changes to regain his health. He embarked on a new, restricted diet to lose weight, eliminated nicotine and, above all else, quit alcohol. Al was introduced to Alcoholics Anonymous and started on his path to recovery.</p> <p>Little by little, he began to experience small successes along the way. He found faith and the importance of God in his recovery. “Staying sober was my choice, and God gave me the strength, direction and conviction to stay sober,” says Al. “He helped me maintain it, bringing people, places and situations into my life so I can learn from them.”</p> <p>With successes, there also were failures, but Al was able to see that he had significantly more successes than failures and continued to maintain his sobriety. “Life is not easy, and we all have difficult things to contend with, but there is absolutely nothing in the world that would make a person take a drink or drugs except themselves,” says Al. "It’s a choice."</p> <p>In his 44 years of sobriety, he has attended over 3,000 meetings, always maintained a sponsor and keeps an open mind to learning. Enriching his daily life with connections, he reflects on sobriety at roundups, hospitals, churches, high schools, colleges, treatment centers and Alano societies. Al also learned how to be a friend. He takes the time to visit them in the hospital, convalescent homes or makes a special trip if they’re confined to their own home. If they’re far away, he calls, mails a card or sends an e-mail.</p> <p>In sobriety, he also had the opportunity to reconnect with his passion for drawing. He started drawing as a young boy, spending most of his time drawing pictures of what most boys do: cartoons, boxers, wrestlers, airplanes, hot rods and wild animals. Recently, his sponsor and friend — a Vietnam War veteran — asked him to draw a portrait of him. As he created it, Al rediscovered his love for drawing with a pencil once again. He couldn’t stop. He vividly captured aspects of soldiers' experiences in the face of war. Each of his pencil strokes shaded and accentuated the emotions — the fear, anxiety, doubt and dread.</p> <p>In the beginning, he was just drawing pictures. Now it’s an emotional connection and a way to honor brave veterans. “Life is about giving and not taking," Al says. "It’s in giving to others that brings peace and contentment. Celebrate what you do and who you are.”</p><img src="/-/media/national-files/images/hometown-health/2018/pencil-drawing-of-a-soldier.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0E22DFD417CF91453151DA714E8DFCDB" alt="Pencil drawing of a soldier" width="660" height="370" DisableNVelocity="true" />Dawn Haller1/28/2022Jill and Dan McElroy discovered they had a special connection with Jill's neurologist. Read about the career junction of two sailors, plus the added connection with Jill's father.All hands on deck for Jill McElroy: Second opinion leads to former U.S. Navy shipmate<p><em>Editor’s note: Donn Dexter, M.D., retired from Mayo Clinic Health System in December 2022 after 30 years of service. We thank Dr. Dexter for caring for this patient, and thousands of others, during his career.</em></p> <p>For 29 years, a U.S. Navy plaque has hung in an exam room of Donn Dexter, M.D. It commemorates his military service as a hospital corpsman on the USS Ranger aircraft carrier from 1972 to 1976. It may be small, but it represents the biggest decisions that shaped his life: to join the U.S. Navy at 18 and pursue a career in medicine.</p> <p>Occasionally, patients would comment about the plaque or thank Dr. Dexter for his service, but overall, it garnered little attention by the thousands of patients he cared for over the decades. That is until one day in November 2021, when Dan and Jill McElroy sat in the exam room. When Dr. Dexter walked through the door, Dan greeted him with an enthusiastic "Good afternoon, shipmate."</p> <p>The McElroys of Cedarburg, Wisconsin, noticed the plaque right away. Dan and Jill's father, Larry R. Fout, also served on the USS Ranger in the 1970s. Upon closer inspection, they realized Dan and Larry were shipmates with Dr. Dexter.</p> <p>"I was floored. In 29 years, this has never happened before," says Dr. Dexter. "I understand that it's a small world, but that was a pretty limited period of time and it was a long time ago. I just didn't think that I would ever meet a fellow Ranger sailor in my office."</p> <h2>Different paths, same destination</h2> <p>In 1968, Dan McElroy enrolled in the U.S. Naval Academy in Annapolis, Maryland. Originally, he planned to attend Cornell University, but he changed his mind when he learned he could play football and learn to fly at the college.</p> <p>A few years later, Dan met Jill in Florida, and he proposed at the top of the Matterhorn Bobsleds attraction in Disneyland Park in California. Weeks after their wedding in 1972, Dan left for a seven-month deployment as an ensign on the USS Ranger. He was stationed in the Philippines for a temporary assignment prior to flight training.</p> <p>At this time, Dr. Dexter was fresh out of hospital corpsmen training in San Diego and assigned to the USS Ranger. While on the ship, he reported up to the senior medical officer, Commander Larry Fout ― Dan McElroy's father-in-law. During his tour, he received additional training in podiatry and served as an operating room technician and cast technician.</p> <p>Dr. Dexter completed his military commitment on the USS Ranger in 1976. With encouragement from a mentor, he attended the University of Minnesota using the GI Bill and medical school at Mayo Clinic Alix School of Medicine in Rochester, Minnesota. He started practicing neurology at Mayo Clinic Health System in Eau Claire, Wisconsin ― what was then Luther Midelfort ― in 1993.</p> <p>Dan's tour on the USS Ranger ended in 1973, and he trained to be a pilot. In 2000, he retired as a captain in the U.S. Navy after serving 32½ years. The couple and their two daughters love colder climates, so they moved to Wisconsin in 2002. Jill worked as a school counselor and Dan as a golf course and school administrator until they retired in 2017 and 2016, respectively.</p> <h2>Searching for memories</h2> <img alt="McElroy and Dr. Dexter" src="/-/media/national-files/images/hometown-health/2022/mcelroy-and-dexter.jpg?h=270&w=350&sc_lang=en&hash=7D96D0F42C7E9A20A6B32674CC187124" style="height: 270px; width: 350px; float: right; margin-bottom: 5px; margin-left: 5px;" /> <p>During the appointment, Dan and Dr. Dexter realized they had many shared memories aboard the USS Ranger, including a rescue mission of a fallen aircraft. It's possible they were in the same rescue boat 40 years ago and 8,000 miles away in the Gulf of Tonkin off the coast of Vietnam.</p> <p>The search for memories is the primary reason they were in Dr. Dexter's office that day. Starting about five years ago, Jill began to struggle with her memory. She was tested at a local clinic and told it was stress-related. The test was repeated 2½ years later with the same result and diagnosis. The McElroys' daughters urged the couple to seek a second opinion.</p> <p>"A neighbor gets a physical at Mayo Clinic every year and told us how wonderful it was," says Dan. "We researched around and figured out that Mayo was the best for this."</p> <h2>Difficult diagnosis</h2> <p>The McElroys traveled to <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Mayo Clinic Health System in Eau Claire</a> for a neuropsychological assessment with <a href="/providers/michele-ries-phd" target="_self" title="Opens in same window.">Michele Ries, Ph.D.</a>, a neuropsychologist. This assessment measured the integrity of Jill's cognitive functions like memory, language and problem-solving.</p> <p>"Results of the assessment showed marked decline in memory concerning for Alzheimer’s disease," says Dr. Ries. "I recommended that Jill complete a brain MRI for further diagnostic clarification."</p> <p>After an MRI, Jill and Dan met with Dr. Dexter in Mayo Clinic Health System's <a href="/locations/eau-claire/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Memory Care Clinic</a>, which is affiliated with the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://wai.wisc.edu/" target="_blank" title="Opens in a new window.">Wisconsin Alzheimer's Institute</a>. During this appointment, Dr. Dexter reviewed her neuropsychological assessment and MRI results.</p> <p>"Her MRI pays attention to things like hippocampal volume loss. This, along with her memory struggles, are consistent with Alzheimer's disease," says Dr. Dexter. "Jill is a delight. She's one of those people where friends and family are often surprised with a diagnosis because she's has good verbal skills and pays attention to things. But when you dive into it, you realize she has really poor memory."</p> <p>Alzheimer's disease is a progressive neurologic disorder that causes the brain to shrink and brain cells to die. Approximately 5.8 million people in the U.S. 65 and older live with the disease. There is no cure for Alzheimer's disease.</p> <p>The couple was shocked and saddened by her diagnosis.</p> <p>"I am so frightened, but I know I'm in good hands. I never thought I would have to experience this, and we have no family history," says Jill. "But when we realized the connection between Dr. Dexter and my dad, I felt like my dad was in the room with us and we found the right doctor."</p> <p>Dr. Dexter reassured the couple that their team would do all they could do to guide them through the diagnosis and available treatment options. "I told them that I have two brothers, but I will treat Jill as if she were my sister," he says.</p> <h2>Looking ahead</h2> <p>Jill is taking medications with the hope that it slows the disease progression, and she is spending as much time as possible with their daughters and four grandchildren. After decades of experience as primary caregiver, Jill has transitioned this role to Dan.</p> <p>"They are one of those couples where you think, 'Gosh, I hope I'm lucky enough to have a spouse who is so involved and willing to go the extra mile as they are,'" says Dr. Dexter. "Jill is in really good hands with him."</p> <p>Dan admits to having moments of fear and worry, but as a self-proclaimed optimist, he is trying to focus on the positive.</p> <p>"I think that everything happens for a reason, and I've decided that this is happening because Jill is going to be the first survivor of Alzheimer's."</p> <p>Dr. Dexter has cared for thousands of patients over his career, but the opportunity to help a fellow shipmate has made a lasting impression on him.</p> <p>"Meeting them reminded me of how lucky I was to join the Navy and have the assignments that I had," says Dr. Dexter. "It changed my life in such a positive way. It's neat that we were on the same ship together and able to reconnect and help Jill. These personal connections are what medicine is all about."</p><img src="/-/media/national-files/images/hometown-health/2022/jill-and-dan-mcelroy.jpg?h=370&iar=0&w=660&sc_lang=en&hash=79287D10ECDFE9AFD756F18F4D2A0BBE" alt="Jill and Dan McElroy" width="660" height="370" DisableNVelocity="true" />Dementia/Alzheimer's DiseaseDementia isn't a specific disease. Instead, dementia describes a group of symptoms affecting thinking and social abilities severely enough to interfere with daily functioning. Many causes of dementia symptoms exist. Alzheimer's disease is the most common cause of a progressive dementia. Dawn Haller1/11/2022Gregg's life has been full of heart-pounding moments, including a big shock when he learned that not only did he have a rare disease, but that he would need a heart transplant.New heart, new start for Gregg Bohlig <p>Heart-pounding moments have been ever-present in Gregg Bohlig's life. He is a gifted athlete and was a three-sport star in high school, earning state player of the year in football and second team all-state guard in basketball. And he was offered a contract with a major league baseball team.</p> <p>While in college, the Eau Claire, Wisconsin, native was the quarterback on the University of Wisconsin Badger football team and led the team to victory over fourth-ranked University of Nebraska in 1974.</p> <p>After college, Gregg's heart-pounding moments continued. He ran 10 marathons and was fast enough to qualify for the Boston Marathon. When not running, he was golfing and playing tennis.</p> <p>He brought this competitive spirit and passion to growing his insurance business and raising his three daughters with wife, Barb Bohlig. Overall, Gregg gave his heart quite a workout in his 69 years.</p> <h4>Surprising diagnosis</h4> <p>As an avid golfer, Gregg could be found on local courses with friends. It was there that he had his first indication that something might be wrong. He was used to walking the course, but he found himself out of breath after walking a short incline on the fairway.</p> <p>"I thought: 'What the heck is this? I'm not that old,'" Gregg said in an interview with the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.leadertelegram.com/news/front-page/giving-thanks-heart-transplant-gives-former-badgers-qb-bohlig-a-fresh-start/article_b81b0cba-f98d-5871-83a6-e5e7bb8654e2.html" target="_blank" title="Opens in a new window.">Eau Claire Leader Telegram</a>.</p> <p>Gregg made an appointment with <a href="/providers/daniel-kincaid-md" target="_self" title="Opens in same window.">Daniel Kincaid, M.D.</a>, a <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiologist</a> at <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Mayo Clinic Health System in Eau Claire</a>. After a series of tests, Dr. Kincaid diagnosed Gregg with <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/amyloidosis/symptoms-causes/syc-20353178" target="_blank" title="Opens in a new window.">amyloidosis</a>, which is a rare disease that occurs when an abnormal protein, called amyloid, builds up in the organs. The protein reduces the heart's ability to fill with blood between heartbeats. Gregg was experiencing shortness of breath because less blood was being pumped with each beat of his heart.</p> <p>Over the next few years, Gregg's condition continued to worsen, with him becoming increasingly fatigued and having trouble catching his breath.</p> <p>"Anyone who did anything with him, whether it was hunting, going for walks or playing golf, was extremely aware that he had no stamina," Barb told the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.leadertelegram.com/news/front-page/giving-thanks-heart-transplant-gives-former-badgers-qb-bohlig-a-fresh-start/article_b81b0cba-f98d-5871-83a6-e5e7bb8654e2.html" target="_blank" title="Opens in a new window.">Eau Claire Leader Telegram</a>.</p> <p>After trying other treatments, Gregg learned that a heart transplant was the only option left to save his life. While understandably nervous, his family also remained hopeful that a new heart would give Gregg a new lease on life.</p> <p>Gregg was placed on the heart transplant list in the Midwest, and he waited. During this time, his condition continued to deteriorate, and Gregg was worried a heart would not arrive in time. Following the advice of his health care team, Gregg also got on the waitlist through Mayo Clinic in Arizona, where the chances of a heart becoming available would be greater.</p> <p>A study of patients on the waitlist for heart transplants at Mayo Clinic in Arizona from 2015 through 2017 showed that 76% received a transplant within three years, 65% within a year and 19% within 30 days. Gregg and Barb temporarily relocated to Arizona with the hope of returning home with a new heart.</p> <h4>Early surprise</h4> <p>Gregg didn't have to wait long. Just six days after arriving in Arizona, he received the call he had been hoping for: A heart was waiting for him.</p> <p>"I kept thinking that moment was way off in the distance," says Gregg. "It was just so surreal."</p> <p>Gregg told Barb the good news, and they quickly drove to Mayo Clinic in Arizona for surgery. Gregg recalls being wheeled into the operating room in the morning and being mesmerized by all the machines and activity. The next thing he remembers is waking up 13 hours later and thinking, "Oh, my God, I wonder if I have my new heart."</p> <p>During his surgery, the transplant team removed Gregg's diseased heart and sewed the donor heart into place. After that, the surgeon attached the major blood vessels to the donor heart.</p> <p>"The diagnosis of amyloid carries a stigma that there may be little hope or options with regard to care," says <a rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/rosenthal-julie-l-m-d/bio-20270072" target="_blank" title="Opens in a new window.">Julie Rosenthal, M.D.</a>, a Mayo Clinic cardiologist and heart transplant surgeon. "Thankfully, the paradigm is changing with increased awareness, advancement of amyloid targeted interventions, and the ability to proceed with advanced therapies like heart transplant."</p> <p>Since the launch of <a rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/heart-transplant/care-at-mayo-clinic/pcc-20384753" target="_blank" title="Opens in a new window.">Mayo Clinic's heart transplant program</a> in 1988, surgeons across Mayo Clinic have performed more than 1,600 heart transplant procedures. Gregg is one of 500 patients to receive a new heart at Mayo Clinic in Arizona.</p> <h4>Excelling during recovery</h4> <p>In typical Gregg fashion, he approached his rehabilitation with passion. In the hospital, Gregg was up walking the day after his transplant.</p> <p>"I think it was his third day postop when he asked the staff if he could try the stairs," says Barb. "For him to be able to do two or three flights of stairs while still in the hospital was a good validator that his heart was doing better."</p> <p>After being discharged from the hospital, Barb and Gregg incorporated walking into his recovery. Barb is a retired cardiac rehabilitation nurse, so Gregg was under her watchful eye and in good hands. Thanks to his excellent presurgery fitness and zeal during rehabilitation, the Mayo Clinic Transplant team allowed him to return to Wisconsin one month earlier than originally planned.</p> <p>"We typically ask heart transplant recipients to plan on staying in the Phoenix area for approximately three months after receiving their transplant. This allows us to closely monitor their recovery, and make appropriate recommendations and medical adjustments," says <a rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/devaleria-patrick-a-m-d/bio-20053338" target="_blank" title="Opens in a new window.">Patrick DeValeria, M.D.</a>, a Mayo Clinic heart transplant surgeon. "Mr. Bohlig was extremely motivated and driven to have a successful recovery. His personal dedication to rehabilitation after his surgery, combined with the excellent, coordinated medical follow-up that could be provided in Eau Claire and Rochester, allowed us to feel confident that he could return home earlier than our typical plan."</p> <p>As directed, Gregg continued his follow-up care at Mayo Clinic in Rochester, Minnesota, and Mayo Clinic Health System in Eau Claire. Dr. Kincaid recalls that "one of my problems in taking care of him was to keep him for overexerting." Two months after his transplant, Gregg was back out on the putting green and itching to begin golfing again.</p> <h4>Feelings of gratitude</h4> <p>Gregg and Barb are excited about his future, but they are also in awe of the gift he received. They are interested in learning more about the donor, but ultimately that decision rests with the donor family.</p> <p>"We are hopeful to have an opportunity to thank that family," says Gregg. "It's a weird thing to have a medical miracle for you be the result of a tragedy for someone else. I went from feeling like I didn't have long to live to now knowing some people have lived with a heart transplant for 20 years or more."</p> <p>In the meantime, Gregg is living life the only way he knows how: full of heart-pounding moments ― whether they be on the golf course, pheasant hunting with friends or as the family celebrated the birth of a grandchild. And the common thread through it all is gratitude for his new start.</p> <p>"Between here (Eau Claire), and Rochester and Arizona, Mayo definitely saved my life," says Gregg. "It's hard to wrap your head around the idea that they can take out your old heart and give you a new one. I'm really thankful to be alive in this day and age when medical technology has advanced as far as it has. It makes you feel really blessed. God is good and gracious."</p><img src="/-/media/national-files/images/hometown-health/2022/gregg-bohlig.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BC441F4E13077685B6777FEAC9955BCF" alt="Gregg Bohlig" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller2/28/2022Lying in the ICU, Jon Bratsch thought he was past the point of no return. Everything changed when a cross-disciplinary team found the source of his dire symptoms.Cross-disciplinary teamwork leads to remarkable recovery<p>Jon Bratsch had accepted that he was going to die. He was barely conscious, breathing through a ventilator and paralyzed in the ICU. He could not see a way through the destructive illness that had taken so much from him.</p> <p>Just three weeks earlier, Jon had felt fine. He was a happily married father of two grown girls, known throughout his hometown as a hardworking mechanic. He spent weekends riding his motorcycle with his wife, Kris Bratsch, seated behind him.</p> <p>To Kris and their daughters, it seemed impossible that Jon could have fallen so gravely ill. He was a powerhouse whose strength was as much a tool of his trade as the equipment in his garage.</p> <p>"I was taking care of my parents, taking care of this shop and my family, and then all of the sudden I couldn't take care of myself," Jon says. "That was kind of a rude awakening, you know?"</p> <p>What knocked Jon down in late summer 2015 was his own immune system. Testing at <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayocliniclabs.com/" target="_blank" title="Opens in a new window.">Mayo Clinic Laboratories</a> revealed that Jon's immune cells, triggered by a cause not well-understood, laid siege to a particular protein, called <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://news.mayocliniclabs.com/neurology/demyelinating-disease/" target="_blank" title="Opens in a new window.">myelin oligodendrocyte glycoprotein</a> (MOG). This type of brain cell, found on the surface of oligodendrocytes, helps make the myelin coating of nerve cells.</p> <p>"When those cells get damaged, then the insulation is removed and patients have neurologic symptoms," explains <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/flanagan-eoin-p-m-b-b-ch/bio-20149754" target="_blank" title="Opens in a new window.">Eoin Flanagan, M.B., B.Ch.</a>, a Mayo Clinic neurologist who specializes in autoimmune neurologic conditions. Dr. Flanagan was a member of Jon's care team.</p> <p>In Jon's case, the damage was acute. "It's as sick as a neurology patient can get," says Dr. Flanagan.</p> <p>And while Jon's return to health was slow, the road forward was just as remarkable as his decline.</p> <h2>Falling hard and fast</h2> <p>While Jon might never remember some parts of his medical journey — he fell into an eight-day coma just after arriving at Mayo Clinic Hospital — Rochester — the events leading up to his decline remain vivid in both his and Kris' memories.</p> <p>It was a Sunday morning at the end of the summer when Jon awoke with a painful headache. It was unusual for Jon to develop headaches, and even more unusual, the pain progressively worsened over the course of a week. Eventually, the pain became so intense it forced Jon to leave work early and seek care at a medical center close to his home in Gaylord, Minnesota. There, he received pain medication, but it was largely ineffective.</p> <p>A few days later, he returned to the small hospital, where he was admitted and diagnosed with viral <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/meningitis/symptoms-causes/syc-20350508" target="_blank" title="Opens in a new window.">meningitis</a>. He received antiviral treatment and more pain medication, but he became weak and confused. During the stay, Jon began losing feeling in his legs. Realizing Jon's condition was worsening, Kris insisted his care be transferred to the larger medical center in nearby Mankato, Minnesota.</p> <p>At <a href="/locations/mankato" target="_self" title="Opens in same window.">Mayo Clinic Health System in Mankato</a>, Jon deteriorated further. He lost all feeling in his legs and lower torso. Moving his arms became a challenge. He grew more confused. He underwent an <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/mri/about/pac-20384768" target="_blank" title="Opens in a new window.">MRI</a>, but the results were inconclusive. Jon's physicians reached out to their colleagues at Mayo Clinic in Rochester to arrange a transfer.</p> <p>During the 90-minute ambulance ride, Jon experienced breathing difficulties. When he was admitted to the Neurosciences ICU, he was placed on a ventilator. The device made breathing easier. However, it did nothing to improve Jon's worsening symptoms.</p> <p>Within two days, he slipped into a coma.</p> <h2>Working together to find answers</h2> <p>While comatose and unresponsive, Jon underwent several more MRIs. These scans showed spinal cord abnormalities and changes in the white matter of his brain that prompted the leader of Jon's ICU team to consult with Dr. Flanagan.</p> <p>"When I came to see him in the ICU, he was very sick," Dr. Flanagan says. "He was weak in his arms and legs and severely confused, unable to follow commands."</p> <p>Based on the MRI results, and an analysis of Jon's spinal fluid, which showed an overabundance of inflammatory cells, the Neurology team believed Jon's illness could be demyelinating with an autoimmune cause.</p> <p>Dr. Flanagan requested Jon's blood be evaluated for MOG antibodies with a test that had been developed at Mayo Clinic Laboratories.</p> <p>"This MOG antibody came back extremely high and confirmed the diagnosis of MOG antibody-associated disease," Dr. Flanagan says. "We knew what Mr. Bratsch had, and we knew how to treat it."</p> <h2>Enjoying a remarkable recovery</h2> <p>The first treatment Jon received was high-dose IV steroids, which reigned in the inflammatory process in his brain. Next, several rounds of plasmapheresis, or plasma exchange, were administered. During this process, Jon's blood was removed from his body and spun in a centrifuge. That caused all his antibodies, including the MOG antibodies, to separate from the blood cells.</p> <p>Once clear of the antibodies, the blood was returned to his body. Jon underwent seven rounds of plasmapheresis before his care team was satisfied that enough antibodies had been removed from his blood to have an effect.</p> <p>"He began to improve with this combination of treatments," Dr. Flanagan says. "He was able to come off the breathing machine. He started to regain some strength in his arms and legs, and he started to come back to us. He began to follow some commands."</p> <p>Jon's improvement prompted his Neurology team to move him to inpatient rehabilitation, where he stayed for 30 days. During that time, he slowly built back his strength and regained the ability to walk and move independently. In early October 2015, Jon was released from the hospital, and Kris brought him home.</p> <p>"The really great thing was the next time I saw Mr. Bratsch in the clinic three months later, he was almost completely back to normal. He walked into the office and was able to engage fluidly in conversation," Dr. Flanagan says. "It was just amazing to see him recover so well. This shows the potential to reverse these autoimmune neurological conditions."</p> <p>In the years since his life-threatening event, Jon has watched his daughters marry, welcomed grandchildren into his fold, and taken many motorcycle rides. He's become more accepting of his circumstance and approaches life with an optimistic outlook.</p> <p>"I'm still not 100% ― maybe 90%, 85%. I don't think I ever will be 100% because I'm too old; 'm 52 now," Jon says. "I was 47 when this happened. I never thought I would see 48, so it's all good. I got another chance."</p> <p><em>This article was originally published on the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://news.mayocliniclabs.com/homepage/stories/" target="_blank" title="Opens in a new window.">Mayo Clinic Laboratories website</a>.</em></p><img src="/-/media/national-files/images/hometown-health/2022/jon-bratsch.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3F715EE0843A1CF050796B3DFAE150E7" alt="Jon Bratsch" width="660" height="370" DisableNVelocity="true" />Dawn Haller2/16/2022Eye contact is an important nonverbal communication skill. But for George Frank, this wasn't possible. Read about a surgery that changed the muscles around his eye to align his crossed eyes to improve his sight.George Frank seeing straight thanks to surgery for crossed eyes<p>Sight is the most dominant sense. It affects people's ability to perceive and move through the world, but it also affects how people are perceived by others.</p> <p>Eye contact during a conversation shows attentiveness, respect, confidence and understanding. Each person has a different comfort level with sustained eye contact, but this part of nonverbal communication may be difficult for people who have crossed eyes, or strabismus, because one or both eyes point in a different or unexpected direction.</p> <p>George Frank can relate. The 57-year-old Menomonie, Wisconsin, resident has struggled with strabismus for 42 years.</p> <p>Like many others, George needed glasses to correct his vision, beginning in elementary school. But his eyes were otherwise healthy and functioning properly. When he was 15, he suffered a head injury during a motorcycle accident. This accident reduced his vision and caused his right eye to drift out of alignment.</p> <p>Strabismus, also called crossed eyes or eye misalignment, is common. This condition affects approximately 4% of people. It can be caused by problems with the eye muscles or the nerves that control eye movements. It also can develop after a stroke or head injury, such as in George's case.</p> <p>Esotropia strabismus is an inward drift of the eyeball. George had exotropia strabismus, which is an outward drift of the eyeball. Strabismus in children often requires patching of one eye to prevent vision loss from not using the misaligned eye. New strabismus in adults usually requires immediate attention to address the cause.</p> <p>As he got older, George's vision worsened as his eyes became increasingly misaligned. He eventually lost depth perception and had occasional episodes of double vision. This made reading difficult and driving impossible. He also was self-conscious that his eyes were pointing in different directions and how this affected communicating with others.</p> <p>"When I would talk with people, my right eye would drift off to the side. It was lazy," says George. "They probably didn't think I was paying attention. That was hard."</p> <h4>Hope for clearer vision</h4> <p>George wasn't sure what could be done to correct his strabismus. But he received good news during an appointment with <a href="/providers/dany-najjar-md" target="_self" title="Opens in same window.">Dany Najjar, M.D.</a>, an <a href="/services-and-treatments/ophthalmology" target="_self" title="Opens in same window.">ophthalmologist</a> at Mayo Clinic Health System who sees patients in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a> and <a href="/locations/menomonie" target="_self" title="Opens in same window.">Menomonie</a>. A surgical treatment option could be completed in Eau Claire, about 30 minutes from his home.</p> <p>Dr. Najjar referred George to <a href="/providers/sasha-mansukhani-mbbs" target="_self" title="Opens in same window.">Sasha Mansukhani, M.B.B.S.</a>, who also is an ophthalmologist at Mayo Clinic Health System.</p> <p>"Over time, Mr. Frank's strabismus got worse to the point that it was constant when I met him for the first time," says Dr. Mansukhani, who specializes in correcting eye misalignment. "He had a moderate to severe exotropia."</p> <p>Dr. Mansukhani explained to George that a surgery could correct his eye misalignment and other symptoms he was experiencing.</p> <p>"Strabismus surgery either tightens a muscle or loosens the effect of the eye muscles to allow the brain to use the eyes together," says Dr. Mansukhani. "During the surgery, we detach the eye muscles from the eyeball and reattach them with the eye in a better position to allow the eyes to be aligned better with one another."</p> <p>Many adults with strabismus are unaware that a surgical treatment option is available, explains Dr. Mansukhani. "I hear too often from my adult patients that they thought they couldn't have strabismus surgery, it could not be fixed as an adult, or that strabismus surgery is a cosmetic procedure. Nothing could be further from the truth," she says.</p> <p>There are many functional benefits of strabismus surgery, including improvement of depth perception, improving double vision and relieving eye strain. In addition, it improves social interactions and confidence.</p> <p>"I can't emphasize enough the functional and psychosocial benefits of strabismus surgery and that it is not a cosmetic procedure," says Dr. Mansukhani. "Strabismus is often a source of embarrassment and a source of poor confidence. Patients report not being taken seriously or that they're not trusted as much. The psychosocial improvement of strabismus surgery can be equally important to the functional benefits. In these situations, one plus one equals three when your eyes are well-aligned."</p> <h4>Surgical option</h4> <p>George approached the surgery with his normal positive attitude. "I told her, 'Let's do it,'" he says. "I was really excited to hop on and get it done."</p> <p>Strabismus surgery is a same-day surgery, which means patients are not admitted into the hospital and can recover safely at home. Most patients can expect a full recovery in about six weeks. George's surgery took place in early November 2021.</p> <p>"I had no pain or discomfort after surgery. Dr. Mansukhani tightened all the nuts and bolts in my eye when she was in there," George says with a laugh. "I'm so glad that I found her and her team."</p> <p>Dr. Mansukhani explains that while George's surgery was the standard procedure, some patients' conditions qualify them for an adjustable suture strabismus surgery.</p> <p>"This surgery allows us to tweak or to fine-tune the muscle position after the patient wakes up from general anesthesia," she says. "We can further pull up the muscle or let the muscle back a little before we secure it. This gives us the chance to customize the eye position to the individual patient. It's one more tool in our toolbox that we can offer to our patients."</p> <p>While healing from either standard or adjustable suture strabismus surgery, patients gradually notice improvement in the eye position and reduction in symptoms they were previously experiencing.</p> <p>"It does take a while for the brain to adjust to the new eye position. But after the process of healing and readjustment, it is very rewarding for a lot of our patients to have their eyes better aligned," says Dr. Mansukhani.</p> <h4>Seeing bright future ahead</h4> <p>George's recovery is right on track, and he is seeing the difference.</p> <p>"I can read now, and my eye doesn't drift. It's easier to watch TV. When I look forward, I can see the stuff next to me without looking at it. My peripheral vision is much better," he says. "My eye is 200% better. I appreciate it very much. Now I can finally see straight again."</p> <p>Throughout his journey, George's optimistic attitude has had a positive effect on Dr. Mansukhani and the care team.</p> <p>"Mr. Frank has a lot of positive energy, and he's one of those patients who touches the lives of everyone he encounters," she says. "He has this unique way of channeling any negative situation or circumstance into a positive, lighthearted experience. He's one patient that I won't forget."</p><img src="/-/media/national-files/images/hometown-health/2022/george-frank.jpg?h=370&iar=0&w=660&sc_lang=en&hash=94C90870A4096C5F5F3A71409209B2E9" alt="George Frank" width="660" height="370" DisableNVelocity="true" />Eye HealthYour eyes are responsible for providing you with vision, perhaps the most important of the senses. However, the eye is a delicate and complicated structure that needs protection. The ugly truth is that eye injuries can happen at any time and place.Dawn Haller5/31/2022After a shoulder injury, avid drummer John DiTulio searched for a less-invasive treatment option and found ultrasonic tenotomy. He hardly skipped a beat after undergoing this nonsurgical procedure.Beat goes on for drummer with calcific tendonitis<p>In his day job, John DiTulio is the go-to guy for clients needing high-level tech troubleshooting. But after-hours, he trades his computer for drumsticks, playing in rock and new country bands. </p> <p>In 2020, this avid musician battled the effects of COVID-19, eventually gaining 35 pounds. Determined to regain his health in 2021, John lost weight, quit drinking and began working out with a trainer. When his left shoulder began twinging, he wondered if doing bench presses was the culprit, so he modified his routine.</p> <p>Then the twinge became pain so bad he couldn't raise his arm to the side and parallel with the ground. John was diagnosed with calcific tendonitis, a condition in which calcium deposits build up on the tendons in the shoulder.</p> <p>Despite physical therapy, nothing improved his range of motion or relieved the pain. The only solution offered was rotator cuff surgery.</p> <p>Twenty years earlier, John had undergone rotator cuff surgery on his right shoulder, and he dreaded the long recovery. Most of all, he dreaded not being able to perform, ride his motorcycle or keep up his healthier lifestyle quest.</p> <p>"So I researched the internet to see if there were any other treatments and came across the <a href="/hometown-health" target="_self" title="Opens in same window.">Hometown Health</a> blog on the <a href="/hometown-health/speaking-of-health/6-benefits-of-ultrasonic-energy-shoulder-procedure" target="_self" title="Opens in same window.">ultrasonic energy procedure</a>," says John. "I thought, 'Huzzah! This could be it!'"</p> <p>Also known as ultrasonic tenotomy, this minimally invasive procedure uses a needle-like device with an oscillating tip. The device is inserted through a 5-millimeter incision and acts like a jackhammer to target and remove calcifications and damaged tendon tissue.</p> <p>The author of the blog was <a href="/providers/jacob-erickson-do" target="_self" title="Opens in same window.">Jacob Erickson, D.O.</a>, a <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">sports medicine</a> specialist practicing at <a href="/locations/onalaska" target="_self" title="Opens in same window.">Mayo Clinic Health System in Onalaska</a>, Wisconsin, three hours from John's home in Monroe, Wisconsin. "But I would have flown across the country to give this a try," he says.</p> <p>John didn't need to book a flight. Instead, his first appointment was a virtual visit. Dr. Erickson explained the procedure, evaluated John's MRI with him and determined he was a candidate.</p> <p>John liked all the benefits of the procedure, including no invasive surgery, only local anesthesia, a small incision, quick treatment time, short recovery period, and no sling or brace needed. So on Valentine's Day 2022, he underwent the procedure and three calcifications were removed.</p> <p>"By the time I reached the parking lot, the chronic pain I'd been dealing with for months was gone. I kind of felt like I'd been hit in the shoulder with a 2-by-4, but over-the-counter medications helped relieved that," John says.</p> <p>For three days, John babied his arm and began moving it a bit. At two weeks, he was given the go-ahead for greater movement, including gradually and slowly lifting his arm higher, simple weights and light physical therapy. His last follow-up was four weeks after the procedure.</p> <p>John continues to work out, is down 30 pounds, and, best of all, about three months after the procedure, he performed with his band again. "Dr. Erickson is dynamite, and thanks to him and this procedure, I'm on the road to full recovery, pursuing a healthier lifestyle and doing what makes me happy."</p><ul> <li>Minor trauma</li> <li>Musculoskeletal/sports ultrasound</li> <li>Office procedures</li> <li>Preventive medicine</li> <li>Sports/musculoskeletal medicine</li> </ul>D.O.<p><strong>Medical Degree</strong></p> <ul> <li>Kirksville College of Osteopathic Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo College of Medicine and Science</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Sports Medicine, University of Iowa</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Medical Association</li> <li>American Osteopathic Association</li> <li>American Society of Sports Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor, Family Medicine, Mayo Clinic Alix School of Medicine</li> </ul>Erickson<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/jacob-erickson-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=E94E476103713CA50775C5FD045B05EB" alt="Jacob Erickson DO" width="280" height="280" DisableNVelocity="true" />{C6B5FA43-E21E-423A-A349-342C8DCCBC31}Jacob<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15534570Sports Medicine - Jacob Erickson DO1{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2022/john-ditulio.jpg?h=370&iar=0&w=660&sc_lang=en&hash=1ECFF1562E5177E392120173DF8EA9BB" alt="John DiTulio" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Dawn Haller5/5/2022Rae Reekie and Amy White share the twists and turns of their multiple breast cancer diagnoses and treatments. And they offer advice for others facing similar health challenges.Mother, daughter share cancer journey twists, survivors' advice<p>Some personality traits are inherited. A child may be introverted, agreeable or meticulous like a parent. Other traits are learned, such as mannerisms, speech patterns and resilience during adversity.</p> <p>Resilience and strength are traits that Rae Reekie and Amy White have in common. This mother and daughter duo also live on the same street in Tomah, Wisconsin, and are professionals, mothers, wives, daughters and friends. Rae and Amy are each two-time breast cancer survivors, as well.</p> <h2>First diagnoses</h2> <p>Rae was 52 when she was first diagnosed with breast cancer in 1997. It was detected during a routine mammogram. Rae had a family member diagnosed with breast cancer years earlier, so she was diligent about annual mammograms. She soon found herself juggling cancer treatments with her busy home and work life as a certified nursing assistant. She had a lumpectomy to remove the cancer and underwent a series of radiation treatments.</p> <p>"I worked my morning shift at the hospital," says the retired 75-year-old. "Amy would leave school to pick me up and bring me home. Then my husband or a friend would drive me to radiation."</p> <p>The treatments were challenging. Rae was relieved when it was over and her cancer gone. She made it a priority to talk with her daughters, Amy and Christine Rox, about her experience. She also stressed the importance of being diligent with screenings and knowing your body.</p> <p>This advice served Amy well when she discovered a lump on her right breast six years later in 2003.</p> <p>"I was just 37 at the time. I went to scratch an itch and felt something that seemed like a tiny bump," says Amy, the 55-year-old high school teacher. "It wasn't big, but it was worrisome to me that it wasn't normal. My intuition was telling me what I needed to do."</p> <p>Amy talked with her mom about what she discovered, and Rae encouraged her to get it checked out. The biopsy results confirmed what Amy's intuition feared – she had breast cancer.</p> <p>"Emotionally, it was brutal," recalls Amy. "I had watched my mom go through her experience, and it felt surreal that I was facing the same thing."</p> <p>Amy met with <a href="/providers/m-kathleen-christian-md" target="_self" title="Opens in same window.">M. Kathleen Christian, M.D.</a>, a <a href="/services-and-treatments/surgery" target="_self" title="Opens in same window.">surgeon</a> at Mayo Clinic Health System in <a href="/locations" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin, to discuss her options. Her cancer was classified as stage 1 invasive ductule cancer. Like Rae's treatment a few years earlier, Amy would need a lumpectomy to remove the tumor and radiation. She also had chemotherapy.</p> <p>Amy leaned on the support of Rae and the rest of her family to get through the treatments. Amy's cancer responded to treatment. After a while, she was back to work and the family pressed on.</p> <h2>Second diagnoses</h2> <p>Amy and Rae had put cancer behind them, at least for a short time. In 2005, a routine mammogram showed some concerning spots on both of Amy's breasts. A biopsy confirmed that she had breast cancer for a second time. She was just 39.</p> <p>"I thought, 'Here I go again,'" Amy says. "Only this time, the stakes were higher because there were concerning spots on both breasts."</p> <p>Dr. Christian and team developed an aggressive treatment plan for Amy.</p> <p>"Dr. Christian sat down with us and went through the pros and cons of everything," she says. "That helped me make the best decisions for myself and my family."</p> <p>Amy began chemotherapy and radiation treatments. After much discussion, she decided to have a bilateral mastectomy and reconstruction as well.</p> <p>After Amy's second diagnosis, the family had genetic testing completed to determine if their cancers were caused by BRCA1 and BRCA2 genes. About 5% to 10% of breast cancers and 10% to 15% of ovarian cancers are hereditary. The test results showed that the family does not carry any genes known to be associated with an increased risk of breast cancer. Their cancer may not be hereditary, but their strength is.</p> <p>Twelve years passed cancer-free for the family, and Rae and Amy continued with annual screenings. In 2017, an annual mammogram showed a concerning spot in Rae's breast. It was 20 years after her first breast cancer diagnosis.</p> <p>"It was kind of a shocker because it had been so long," Rae says. "Many people think that if you make it past five years in recovery, you are OK. But that's a false sense of security."</p> <p>Rae's treatment included chemotherapy and radiation. She found herself in a unique community of cancer survivors, occasionally seeing friends and neighbors in the Center for Breast Care waiting room. Friends and family brought her meals and offered support.</p> <h2>Survivors' advice</h2> <p>It's been five years since the mother and daughter duo's last breast cancer diagnosis and treatment. They have had a few "twists and turns" with their health during that time, but feel well today.</p> <h3>They remain diligent about their overall health and wish to share advice for people whose lives have been affected by cancer:</h3> <h4>Know your body.</h4> <p>Women should become familiar with their breasts to detect abnormalities or changes. Amy was young when she discovered a spot on her breast that was different and unexpected. Her cancer was detected early because she knew what was normal and abnormal for her body.</p> <p>"It's important that people watch for unusual changes to their bodies and be advocates for their own health," agrees Dena Brion, a nurse practitioner in the <a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Center for Breast Care</a>. "Amy was concerned about the change she noticed and sought care when something didn't seem right. We want everyone to be empowered to manage their own health just like Amy."</p> <p>Other breast changes that are warning signs of cancer include a new lump, breast thickening, shift in breast shape or size, and changes in the nipple.</p> <h4>Be diligent about screenings</h4> <p>A mammogram is a proven method of determining if you have any breast abnormalities. In Rae and Amy's cases, an annual mammogram discovered their cancers early.</p> <p>"Be persistent and get tested every year," says Rae. "You can't get too comfortable. It's not a one and done type of thing. You need to have one every year."</p> <p>"Annual mammograms starting at age 40 are recommended for women of average risk," says Dr. Christian. "If you have family history of breast cancer, start your exams 10 years prior to your family member's age at diagnosis. For example, begin yearly mammograms at 36 if your mother was diagnosed at 46."</p> <p>Amy has discussed this screening recommendation with her daughter. She will need to begin annual screenings at a younger age because of Amy's diagnosis at age 37.</p> <h4>Find the right health care team for you</h4> <p>Compassion, expertise and listening are essential skills for a health care team, according to Rae and Amy. They recommend survivors find the right team to lead them through their cancer journeys.</p> <p>"Find a doctor that you are comfortable with and who listens to you and answers your questions," says Amy. "Take an active role in your health care. Don't be afraid to ask questions. Be a part of the process."</p> <p>Both women have developed strong bonds with their health care team in the Center for Breast Care, including Dr. Christian and Dena.</p> <p>"It has been a joy to care for and get to known Rae, Amy and their family members," says Dr. Christian. "They are a lovely family and an inspiration."</p> <p>Amy remembers fondly the time she spent with James Novotny, M.D., a Mayo Clinic Health System oncologist who retired in 2014 after 29 years of practice.</p> <h4>Seek support</h4> <p>Leaning on the support of family and friends helped Rae and Amy during their cancer journeys. They helped with rides, meals, housework and babysitting. They also offered a shoulder to cry on and an ear to listen.</p> <p>"Cancer affects the entire family, especially if you have younger kids," says Amy. "Don't be afraid to ask for help. It's OK to let the people in our lives help us."</p> <p>The family created a special tradition during annual mammograms. Rae, Amy and Christine schedule their appointments on the same day, so they have a built-in support network. They celebrate together as well.</p> <p>"All of these emotions come back once a year when we go back in, but we are all there for each other," says Rae. "After our appointments, we enjoy a mother/daughter lunch and take a picture of the three of us in Christine's backyard."</p> <p>Rae and Amy have been given the gift of time together and new perspectives after their cancer journeys. And they pass along their traits of resiliency and strength to future generations in their family.</p><img src="/-/media/national-files/images/hometown-health/2022/white-and-reekie.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8E38090E60CA67A3D7B00F457EF19E66" alt="White and Reekie" width="660" height="370" DisableNVelocity="true" />Dawn Haller6/10/2022Cal Sharpsteen was stillborn at 38 weeks, but he lives on through "Cal's Corner," a cart filled with books donated by his parents for other grieving families who have lost a child.Cal lives on through books for grieving parents, families<p>Like all couples who learn they're going to be parents, Rebecca and Dan Sharpsteen, of Mankato, Minnesota, experienced immense joy and anticipation for their first child. That joy turned to heartbreak when Cal was stillborn at 38 weeks at <a href="/locations/mankato" target="_self" title="Opens in same window.">Mayo Clinic Health System in Mankato</a>.</p> <p>"As a mother-to-be, you have so many hopes and dreams you create during the nine months you carry a baby," says Rebecca. "When we lost Cal, we felt we were losing our future."</p> <p>As Rebecca and Dan began processing Cal's death, they talked with <a href="/providers/amanda-bassett-swanson-licsw" target="_self" title="Opens in same window.">Amanda Bassett Swanson</a>, a social worker in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a>. Amanda told them to look at every part of Cal: to unwrap his blanket and look at his feet and all of his features. It helped the couple realize that, as Rebecca says, "Cal was still born, even though it was a stillborn birth."</p> <p>So the couple held Cal, sang to him, took pictures and, of course, cried. They say they're thankful for the compassion and suggestions that Amanda and other care team members offered them. And they cherish the pictures and memories of their brief time with Cal.</p> <p>It's now been more than a year since Cal died. Rebecca admits there have been a lot of ups and downs, saying, "We've been trying to heal and navigate the grief of losing our child."</p> <p>Part of that healing has been to share their story and reach out to other parents of stillborn babies.</p> <p>"For parents whose baby is stillborn, the time they have in the hospital is the only time they'll have with their baby," says Rebecca. "And they're in such shock at the loss they often don't know what to do next."</p> <p>When the couple started thinking about having another baby, Rebecca began looking at books to read to Cal's future siblings about his death. As a school social worker, Rebecca says, "Working with little ones, I see how important reading is and how books can help them understand things."</p> <p>Part of her job is to find resources to help explain hard topics to kids. She discovered wonderful books for many different situations involving the death of a child.</p> <p>Reading about grief and how to get children through it can guide adults, as well. "While there are great resources for adults, in the moment, when they first lose their baby, parents are still processing," says Rebecca. "Something simple like a children's story can help."</p> <img alt="Cal's Corner book cart" src="/-/media/national-files/images/hometown-health/2022/cals-corner-book-cart.jpg?h=325&w=280&sc_lang=en&hash=2C370189D11A477D44AE00FED6FB1134" style="width: 280px; height: 325px; float: right; margin-bottom: 5px; margin-left: 5px;" /> <p>It was that knowledge that gave birth to an idea to help heal not only other parents and families who lost a baby, but also themselves. In February, the Sharpsteens donated a book cart, named Cal's Corner, to the hospital in Mankato. The couple reached out to their network of friends and family to stock Cal's Corner with books for parents to read to their stillborn baby, and books for the baby's siblings. The cart is in the <a href="/locations/mankato/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Labor and Delivery</a> unit.</p> <p>"All the memories parents have of the child they lost is that eight to 12 hours in the hospital," says Bassett Swanson, whose work includes bereavement support for parents. That's why the hospital offers physical reminders like casts of hands and feet, handprints, blankets, stuffed animals and pictures. That's also where Cal's Corner fits in.</p> <p>"Cal's Corner is a wonderful addition to the Labor and Delivery Unit for patients and family who experience a stillbirth, miscarriage or newborn death," Angela says. "We ask families if they'd like to participate, and all have said yes. The books are door-openers and conversation-starters. The book they read to their baby and take home is another keepsake, and so are the books they take home for the siblings."</p> <p>Angela adds they also roll the cart to the <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">Emergency Department</a> because parents lose children there, too.</p> <p>Among the books on the cart are "My Sibling Still," by Megan Lacourrege and "Someone Came Before You," by Pat Schwiebert.</p> <p>"They're beautifully written, illustrated and so simple they can help parents and children through their grief," says Rebecca.</p> <p>Not all the books in Cal's Corner are about loss. "Some are just favorites, like 'Love You Forever,' by Robert Munsch," says Rebecca. There also are other familiar childhood books in the cart, but the Sharpsteens were careful not to select ones about kids growing up.</p> <p>Rebecca and Dan aren't seeking donations for Cal's Corner, but they encourage people who are moved by their story to find ways to create their own book cart or donate to another cause that touches the hearts and minds of others.</p> <p>"The sadness is always there. The loss is always there. But the load becomes a little lighter by doing things to remember Cal and help other families," says Rebecca. "Through the book cart, Cal lives on to help others."</p><img src="/-/media/national-files/images/hometown-health/2022/dan-and-rebecca-sharpsteen.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5C2B7F3CC3F56F50339B1525EF33BB83" alt="Dan and Rebecca Sharpsteen" width="660" height="370" DisableNVelocity="true" />GriefGrief is the natural reaction to loss. It will be unique to you, depending on your own personality and circumstances.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller6/1/2022Two total knee replacements later — one traditional, one robot-assisted — Betty Hayden-Tauscher is digging into her garden again. Learn why she gives the robotic procedure two green thumbs up.Digging into garden after robotic total knee replacement<p>Forty-two years as a radiology technologist for Mayo Clinic Health System in La Crosse — with countless hours on her feet and often wearing a 15-pound protective lead apron — took its toll on Betty Hayden-Tauscher's knees. So in 2014, she had a total knee replacement on the left. This knee replacement was performed with traditional techniques.</p> <p>All went well with her left knee recovery, although the arthritis in her right knee grew worse despite noninvasive injections. "I could squat to garden, but kneeling was bad, and I had a heck of a time getting up," Betty says.</p> <p>Eventually, the injections' effectiveness wore off. That's when Betty turned to <a href="/providers/kariline-bringe-md" target="_self" title="Opens in same window.">Kariline Bringe, M.D.</a>, an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgeon</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>. Dr. Bringe offered her the option of <a href="/hometown-health/speaking-of-health/robotic-orthopedic-surgery-accuracy" target="_self" title="Opens in same window.">robot-assisted surgery</a>, and after listening to Dr. Bringe's explanation, Betty agreed.</p> <p>"What is really exciting about robotic-assisted orthopedic surgery is the ability to use this technology to recreate the patient's natural anatomy and to make subtle adjustments when placing the implants to better balance the knee, protect soft tissue and make precise cuts," says Dr. Bringe.</p> <p>"Even during surgery, I'm collecting information about alignment and ligament balancing that help me determine exactly how to place the implants. Making these real-time changes leads to better knee motion and balance. That's just not the kind of feedback you get when you do a joint replacement manually."</p> <p>"I was fine with what the robotic process would be because it lets surgeons fine-tune the new joint more precisely than they can by eye or feel," says Betty.</p> <p>She feels recovery from the second surgery went better than the first, in part because she knew what to expect. During her first surgery, Betty was in the hospital two nights, was in a lot of pain, had a catheter and was on a machine to mechanically flex her new knee.</p> <p>"I remember thinking, 'What have I done?'" she says.</p> <p>Her second surgery was a different story. "I went home after one night. They no longer use that flexing machine. And although there was pain, the medications managed it," Betty says. "I went to physical therapy about six times and felt like the flexion came back faster. I didn't push it, but I think in general my knee healed faster."</p> <p>During physical therapy, her therapist said it would be six weeks before she could drive. "But I was getting antsy, and at four weeks, I got behind the wheel and practiced moving my foot from the gas to the brake and back. I drove around the block, and it was OK."</p> <p>Eight months postsurgery, Betty's now retired, volunteering through her church and anxious to dig into her garden again. For friends who are considering total knee replacement, Betty says: "Go for it! I'm so happy with the results, and I made a good choice going with Dr. Bringe and the robotic surgery."</p><img src="/-/media/national-files/images/hometown-health/2022/betty-tauscher.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A2B3D07ECB1F9442111C5148014CE0EB" alt="Betty Tauscher" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller7/15/2022Lisa Luskey-Lestrud had her first total knee replacement at age 47 because pain was curtailing her active life. Five years later with two new knees, she's gained years of pain-free activity.Patient resumes active life after knee surgeries<p>Always active, Lisa Luskey-Lestrud of Kensett, Iowa, played volleyball and softball in high school and worked physical jobs requiring hours of standing and heavy lifting. By the time she was 47, her aching knees reminded her daily of the toll that wear, injuries and having rheumatoid arthritis were taking on her ability to remain active.</p> <p>After going through noninvasive treatments — physical therapy and injections — Lisa was walking with a stiff leg and more than ready to undergo total knee replacement to relieve the pain. That's when she connected with <a href="/providers/michael-eckstrom-md" target="_self" title="Opens in same window.">Michael Eckstrom, M.D.</a>, an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgeon</a> in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a> and <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</p> <p>"Knee replacements are typically performed due to sever arthritic pain that doesn't respond to more conservative treatment. But we're seeing these surgeries being performed in an increasingly younger population," says Dr. Eckstrom. "In these patients, severe arthritis is frequently brought on by trauma to the joint.</p> <p>"At some point, it comes down to pain versus quality of life. The pain affects their quality of life and keeps them from doing what they want to do, whether it's just daily activities, playing golf or riding a bike."</p> <p>One drawback is that younger patients will more than likely need another joint replacement in 15–20 years. "It's a mechanical piece of equipment that can and does wear out," Dr. Eckstrom says. "How fast that happens depends on patients' weight, if they participate in a lot of sports or engage in high-impact activities, like running."</p> <p>Dr. Eckstrom says when a patient has reached the point of needing a total joint replacement, he explains the potential outcomes, then leaves the decision to his patients. "Most opt for reducing pain and improving the quality of lives," he adds.</p> <p>That's the decision Lisa came to, as well, despite her young age. Her first total knee replacement was performed traditionally on the knee she had injured playing softball. The surgery provided the pain relief, stability and greater mobility she was seeking.</p> <p>Five years later, orthopedic surgery technology had advanced considerably. Dr. Eckstrom performed surgery on her other knee assisted by a robotic arm.</p> <p>"The precision of robot-assisted surgery provides better alignment and balance because the weight of the body is more accurately centered through the middle of the knee. It may even prolong the life of the device," says Dr. Eckstrom. "It takes out the guesswork, and I think it makes me a better, more consistent surgeon. Robot-assisted surgery definitely takes total joint replacement to the next level."</p> <p>Lisa agrees. In January, at age 52, she underwent her second total knee replacement. "I definitely noticed a difference, even right after surgery," she says. "I was moving around better and went home the same day."</p> <p>Her husband, Scott, and son, Ryder, took care of her, but as Lisa says, "They didn't baby me. After the first couple of days, I was managing pretty much on my own. But I firmly believe in using the ice machine to keep down swelling and pain."</p> <p>A bout of COVID-19 slowed her recovery, but she's back doing her physical therapy exercises to regain strength and flexibility. One result is that, with the arrival of warmer weather, Lisa began walking more, along with her miniature schnauzers, Mylo and Axel.</p> <p>Scott also bought a new motorcycle, and she practiced getting on and off.</p> <p>"My goal was to be able to swing my leg over the seat. It was hard at first, but now I can do it. We're really enjoying riding again," she says.</p> <p>Once again, Lisa's life is active, with motorcycle riding, serving on Kensett's 150th anniversary celebration, camping and even exploring a new job. She loves creating crafts made from found objects like driftwood, china plates and colorful beads. A circle of crafting friends is saving up money from sales to vacation together. She's busy, but that's just how she likes it. And now she can enjoy life pain-free.</p><img src="/-/media/national-files/images/hometown-health/2022/lisa-luskey-lestrud.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B62F6D495A1E6890E382BA0DB99BA59B" alt="Lisa Luskey-Lestrud" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Dawn Haller8/19/2022Arlene’s retirement was far from stress-free. Thanks to private and group yoga classes, she learned how to manage her pain and bring balance to her body and life.Arlene Wellemeyer finds pain relief, balance through yoga<p>Arlene Wellemeyer was looking to relax and de-stress after decades at a demanding job.</p> <p>"When I retired, I thought I could finally move around and do everything I want to do," says the Hastings, Minnesota, resident who retired in 2013. "But retirement ended up being more stressful than my working years."</p> <p>Soon after retirement, Arlene transitioned into the role of caregiver, first for a family member with a disability and then for her husband after a surgery. During this time, Arlene's body began to break down. She began experiencing severe pain in her low back, and she was diagnosed with a pinched nerve in her lumbar spine. Her primary care provider at <a href="/locations/red-wing" target="_self" title="Opens in same window.">Mayo Clinic Health System in Red Wing</a>, Minnesota, recommended physical therapy.</p> <p>Arlene completed 12 sessions of physical therapy and found it to be helpful. However, she still had some pain in her low back after treatment ended, so she began looking for a solution that could help her physically and emotionally during this stressful time.</p> <p>"My doctor told me that yoga works well for people looking to reduce anxiety and stress," she says. "So I looked on the Mayo Clinic Health System website and I read about private yoga therapy sessions."</p> <h2>Yoga therapy</h2> <p>Although all yoga is potentially healing, most yoga in the U.S. is exercise-focused, says <a href="/providers/michele-hoffman-ciayt" target="_self" title="Opens in same window.">Michele Hoffman</a>, a yoga therapist at Mayo Clinic Health System in Red Wing.<br /> <br /> "Yoga therapy is the specific application of yoga practices and teachings to address people's physical, mental and emotional needs," says Michele. "We study chronic health conditions and learn what yoga practices can help or harm."</p> <p>Yoga therapists have training in anatomy, physiology and psychology, and they have observation and assessment skills.</p> <p>"Yoga therapy is not a substitute for Western medicine, but it is an effective complementary therapy to treat and manage many health conditions, including chronic pain," says Michele. "Breathing practices, meditation and other yoga practices work on the autonomic nervous system. These practices can change a person's relationship to pain and the way they experience it."</p> <h3>Other health conditions that may benefit from yoga therapy include:</h3> <ul style="list-style-type: disc;"> <li>Arthritis</li> <li>Asthma</li> <li>Cancer — during and after treatment</li> <li>Depression</li> <li>Diabetes</li> <li>Fibromyalgia</li> <li>High blood pressure and other cardiac conditions</li> <li>Multiple sclerosis</li> <li>Parkinson's disease</li> <li>Post-traumatic stress disorder</li> </ul> <p>"In yoga therapy, our goals are to strengthen what's weak, release what is tight and bring balance to the body and balance to an individual's life," Michele says. "A patient's main goal may be to reduce back pain, but if they are also suffering from anxiety or chronic obstructive pulmonary disease, I can design a yoga practice to address those issues, as well."</p> <p>During a private yoga therapy session, the yoga therapist observes a person's structure, posture, movement patterns, breathing, attitudes and behaviors. Over several sessions, the therapist can design a yoga therapy practice to address goals and needs while respecting their limitations.</p> <p>Arlene, who describes herself as a perfectionist, says that Michele was excellent at diffusing any feelings of awkwardness or apprehension during her individual yoga therapy sessions.</p> <p>"Michele talked with me for quite a long time to find out who I was and what my issues were, and we then started with really simple poses and breathing practices that she demonstrated by getting right down on the mat with me," says Arlene. "She was patient and went slowly."</p> <p>After starting yoga, Arlene found relief from her pain quickly.</p> <p>"Physical therapy was necessary in the beginning because it gave me most of my functionality back, but I am convinced that yoga is what helped me get it all the way back to health and maintain it," Arlene says. "I felt some improvement within a week."</p> <h2>Promising self-care practice</h2> <p>Arlene had eight individual yoga therapy sessions and then felt comfortable enough to join a weekly therapeutic group yoga class and continue home practice.</p> <p>"Yoga takes long-term practice," she says. "It's a physical skill as well as mental intention. You gradually learn it, and it just becomes a habit."</p> <p>And it is a habit that stuck.</p> <p>Several years later, Arlene regularly attends a weekly yoga class. She also continues to practice at home, usually two to three times per week, with routines that Michele created specifically for her.</p> <p>"Besides helping with my pain, yoga has improved my focus and concentration. I'm a believer in yoga. I really like it."</p> <p>Check the <a href="/classes-and-events" target="_self" title="Opens in same window.">Classes and Events page</a> for information about upcoming yoga opportunities. </p><img src="/-/media/national-files/images/hometown-health/2022/arlene-wallemeyer.jpg?h=370&iar=0&w=660&sc_lang=en&hash=DB34F16259B00669D2E90DEE273D5280" alt="Arlene Wallemeyer" width="660" height="370" DisableNVelocity="true" />Back PainBack pain is one of the most common health complaints in the U.S. In fact, eight out of 10 Americans will experience back pain at some point in their lives. Symptoms include muscle ache, shooting or stabbing pain, pain that radiates down your leg and limited flexibility or range of motion of the back.<br/><br/>Get tips to manage your pain, and know when to see your healthcare provider.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Integrative MedicineUnderstanding total health, not just of the body, but of the mind and the spirit, enhances the natural healing process allowing you to feel more empowered, have more energy and experience tranquility.Dawn Haller8/8/2022Thresa Pattee thought she simply was walking into her regular chemotherapy appointment. Instead, she walked into a surprise wedding shower put together by her care team.Surprise wedding shower 1,000 miles from home<p>Every day, people receive cancer care in the <a href="/locations/eau-claire/services-and-treatments/oncology/cancer-center" target="_self" title="Opens in same window.">Albert J. and Judith A. Dunlap Cancer Center</a> at <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Mayo Clinic Health System in Eau Claire</a>, Wisconsin. While administering chemo, radiation or preparing a patient for surgery, the care team is quick to provide a listening ear, warm hugs, blankets and caring smiles for patients. In July, the care team happily took on another task: a surprise wedding shower for a special patient, Thresa Pattee.</p> <p>Thresa traveled over 1,000 miles from her home in Bozeman, Montana, to receive care at Mayo Clinic Health System. In 2021, a tumor on her back was discovered, and she was diagnosed with <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/osteosarcoma/symptoms-causes/syc-20351052" target="_blank" title="Opens in a new window.">osteosarcoma</a>, a type of bone cancer that begins in the cells that form bones. Her local health care team recommended that she seek specialized care for her rare cancer. Thresa knew where she wanted to go.</p> <p>"We chose Mayo because they are at the forefront of cancer care in general, and my type of cancer in particular," she says. "My family decided to relocate to Wisconsin for as long as necessary for my treatment."</p> <p>Thresa settled into the summer home of her mother and stepfather in Mosinee, Wisconsin, and began treatments under the guidance of <a href="/providers/scott-okuno-md" target="_self" title="Opens in same window.">Scott Okuno, M.D.</a>, an <a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">oncologist</a> and osteosarcoma specialist. She was accompanied by her mother, stepfather and fiancé, Aron Gliko. She had surgery to remove the tumor in her back, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/proton-therapy/about/pac-20384758" target="_blank" title="Opens in a new window.">proton beam radiation therapy at Mayo Clinic</a> in Rochester, Minnesota, and chemotherapy in Eau Claire.</p> <p>Because she spent so much time within the hospital walls — by her count 160 days over 15 months — Thresa forged special connections with members of her care team.</p> <p>"Everyone has been so wonderful. The nurses in the hospital and Cancer Center were my angels," she says. "They treated me like a person, not just a patient. When I walked in, it felt like I was going to hang out with friends. Their humanity is exceptional."</p> <p>The feeling, as they say, is mutual.</p> <p>"Thresa's personality is out-of-this-world amazing," says Karen Schreiter, a Cancer Center nurse. "She has a such a bubbly personality, and it was fun to see her face when she walked into the treatment room."</p> <p>Which is why it was only natural for the care team, with help from Thresa's mother, to plan a surprise wedding shower at the Cancer Center during one of her last treatments in Eau Claire, says Karen. Thresa is returning to her hometown to continue chemotherapy therapy under the guidance of her Mayo Clinic Health System team.</p> <p>"This move is our attempt to have as much normalcy as possible," she says. "My circumstances are unusual before a wedding. I am returning home only one month before our wedding in September. I couldn't go on a wild, or non-wild, bachelorette party with girlfriends. A shower wasn't something that I was thinking about."</p> <p>The morning of the shower, the Cancer Center team decorated a treatment room with balloons and flowers and brought in chocolates and treats for Thresa and her mother to enjoy. When she arrived, they pulled the curtain back to reveal the surprise. The entire staff circled through to wish her well and share a hug and smile.</p> <p><img height="300" alt="Bridal shower" width="400" src="/-/media/national-files/images/hometown-health/2022/bridal-shower.jpg?h=300&w=400&sc_lang=en&hash=A2E62D736550C084376E404F7137AB6B" /></p> <p>"I was so surprised and shocked," she says. "It was so thoughtful and kind. There hasn't been a lot of random fun in my life lately. So, to have a group of people to care for me in this way was very, very special."</p> <p>"There is no one more deserving to be celebrated than Thresa. She is part of our family here at the Cancer Center," says Karen. "The meaningful relationships that we get to forge with our patients are beautiful. It was such a wonderful and fun time that we had during her bridal shower. The team thoroughly enjoyed being a part of this very special event for her."</p> <p>Thresa and Aron are looking forward to their small, backyard wedding ceremony in September and will be thinking of the friends they met while in Wisconsin.</p> <p>"I've had a lovely time, and the state has been good to me," Thresa says. "So many of the nurses and other staff have treated us exceptionally. I've spent a lot of time with them, and this journey has been as easy as something this hard could be."</p><img src="/-/media/national-files/images/hometown-health/2022/thresa-patte.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D617D90A327CCC182F5D96A2467EFE6A" alt="Thresa Patte" width="660" height="370" DisableNVelocity="true" />CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Dawn Haller10/6/2022While preparing for a ride, Becky Brooks had stabbing chest pain. The cause was an aortic dissection, which can be fatal if not treated right away. Read how her heart team got her back on the road.Cyclist changing gears after heart health scare<p>It's a relatively uncommon and serious cardiovascular condition with symptoms that often mimic a heart attack or stroke. It's called aortic dissection. And if not detected early or treated immediately when symptoms occur, it can be fatal.</p> <p>Aortic dissection is an equal opportunity disease — affecting men and women — even those who lead an active, healthy lifestyle, like cyclist Becky Brooks.</p> <p>"I do feel like I'm flying. And the hum of the tires on the pavement is just like music and meditation," says Becky, who has a passion for pedaling. "It's freedom. It's joy. It's exertion."</p> <img alt="Rebecca Brooks" src="/-/media/national-files/images/hometown-health/2022/rebecca-brooks.jpg?h=250&w=203&sc_lang=en&hash=5971AF2451CC090888EB403929A05008" style="height: 250px; width: 203px; float: right; margin-bottom: 5px; margin-left: 5px;" /> <p>The 66-year-old from Mankato, Minnesota, has won national titles in long-distance cycling.</p> <p>"I don't think of biking as a workout. I think of it as a ride. And I don't do it because I want exercise. I do it because I want to ride," she says. "After all I went through, I thought I could never ride the way I used to ride. It was the 24th of April 2021."</p> <p>As Becky prepared at home for a bike ride, she felt a horrific pain in her chest.</p> <p>"Stabbing — I mean, it felt like a knife inside," Becky says. "So I said to my husband, 'Shall I call the cardiologist?' And he goes, 'No, we should call 911.' And thankfully, we did."</p> <p>It wasn't a heart attack.</p> <p>"My aorta dissected," she says.</p> <p>Becky was transported by ambulance to the <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">Emergency Department</a> at <a href="/locations/mankato" target="_self" title="Opens in same window.">Mayo Clinic Health System in Mankato</a> and then quickly flown to <a rel="noopener" href="https://www.mayoclinic.org" target="_blank" title="Opens in a new window.">Mayo Clinic </a>in Rochester. During this time, Becky was unconscious and in dire need of emergency surgery.</p> <p>"Certainly, when I met Becky, it was a very dramatic scene," says John Stulak, M.D., a Mayo Clinic cardiovascular surgeon. "If there's one analogy you can make to the diagnosis of an aortic dissection, it is a ticking time bomb."</p> <p>The cardiovascular surgery team at Mayo, led by surgeons Dr. Stulak and <a rel="noopener" href="https://www.mayoclinic.org/biographies/pochettino-alberto-m-d/bio-20055563" target="_blank" title="Opens in a new window.">Alberto Pochettino, M.D.</a>, rapidly prepared for what would be an eight-hour procedure to repair the <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/aortic-dissection/symptoms-causes/syc-20369496" target="_blank" title="Opens in a new window.">dissected aorta</a>.</p> <p>"The aorta is the main blood vessel that leaves the heart. It carries blood to all of our tissues and organs," says Dr. Stulak. "Blood now instead of being in the middle of that tube, gets into the wall of the aorta, and then kind of does exactly what the term says. It dissects along in through the wall of the aorta. And as time goes on, it could pop and the patient can bleed to death."</p> <p>The surgical team removed the damaged aorta and replaced it.</p> <p>"It's a woven, artificial tube that the patient has. And it's just like if a pipe were damaged in your house, you would splice that out and put in a new piece of pipe. And that's basically what we did," says Dr. Stulak.</p> <p>Now, more than a year later, Becky, a retired English professor and accomplished author, is working on her newest novel and feels blessed to have this next chapter in life.</p> <p>"I feel great!" she says.</p> <p>Her racing days are done, but she is back on a bike — an e-bike.</p> <p>"It's a bike that gives assist when you're pedaling," Becky says. "I took it out on the road, and I started to cry. Like, oh my gosh, I can do this again! I can go hard without putting all that stress on my body."</p> <p>"There's not an hour goes by that I don't appreciate being alive. I mean, I could have been dead," she says. "I'm here. I'm so grateful."</p><img src="/-/media/national-files/images/hometown-health/2022/cyclist-on-road-near-mountains.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9E44B27EE6E173998990F90F8CA87EBB" alt="Cyclist on road near mountains" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Dawn Haller10/18/2022Time is of the essence with breast cancer, and Gail Raddatz didn’t want to wait. This avid traveler had no issue with a journey across town to get the care she needed right away.Short journey for quicker breast cancer care<p>Gail Raddatz likes a good road trip and embracing the journey. She and husband, Keith Raddatz, like to hit the open road with their motorcycle and RV. They have visited all 50 U.S. states and are working on getting to every U.S. national park.</p> <p>"We worked our whole lives for this, and love to go to places we haven't been before," says the 71-year-old Sparta, Wisconsin, resident.</p> <p>In 2021, Gail found herself in an all-too-familiar place and one that she wasn't excited about revisiting. A routine <a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">mammogram</a> detected three suspicious spots in her breast tissue. It was a reminder of her previous diagnosis with aggressive <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/endometrial-cancer/symptoms-causes/syc-20352461" target="_blank" title="Opens in a new window.">endometrial cancer</a> and subsequent <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/endometrial-cancer/symptoms-causes/syc-20352461" target="_blank" title="Opens in a new window.">hysterectomy</a>. A second cancer journey was not on Gail's plan.</p> <p>A mammogram confirmed that she had a mass deep in her breast. Two biopsies showed the Gail had stage 1 breast cancer at one site and intraductal carcinoma at the other site. After doing genetic testing to determine that the cancer would likely return, her health care team in La Crosse recommended a lumpectomy to remove the breast tissue. Unfortunately, this surgery could not be scheduled for two months. Gail knew that traveling across town for care was the best option for her.</p> <p>"I thought, 'I don't think I can live like this,'" Gail says. "The waiting was going to be too hard, so I decided to see if Mayo could get me in any sooner."</p> <p>She called <a href="/locations/la-crosse" target="_self" title="Opens in same window.">Mayo Clinic Health System in La Crosse</a> and was able to get an appointment a week later at the <a href="/locations/la-crosse/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Center for Breast Care</a> with surgeon <a href="/providers/m-kathleen-christian-md" target="_self" title="Opens in same window.">M. Kathleen Christian, M.D.</a> Keith and a friend who had been through a previous breast cancer diagnosis went with her to gather information.</p> <p>"Dr. Christian answered all of our questions, and we had a lot of questions," says Gail. "She spent as much time with us as we needed and talked with us like she had known us forever."</p> <p>It's all part of her role as a surgeon, explains Dr. Christian.</p> <p>"Building a relationship and trust with patients is our priority," says Dr. Christian. "Facing a cancer diagnosis is a scary time. Patients need to feel confident that all their questions are answered, their needs are addressed, and they are in the right hands."</p> <p>Two weeks later, Gail underwent breast conserving surgery with two site lumpectomies at Mayo Clinic Health System. Dr. Christian and the surgical team removed the areas of cancer in her breast with a small amount of normal tissue to ensure they got all the cancer.</p> <p>"Gail did great during surgery and recovery," says Dr. Christian. "We were able to excise both cancer sites with clear margins. Because the cancer sites were small with a good prognosis, she was able to undergo a radiation regimen with only five treatments, and chemotherapy was not recommended."</p> <p>Gail talked with her primary care professional about where to get her radiation.</p> <p>"They said, 'Stay with your surgeon and with Mayo.' So I did."</p> <p>Shortly after her surgery, Gail semiretired from her career as an accountant.</p> <p>"They wouldn't let me quit completely," she says laughing.</p> <p>She completed five rounds of radiation in February, and a follow-up mammogram showed she was cancer-free. Soon, she and Keith began making travel plans for the coming year, including a road trip to multiple national parks.</p> <p>"We are able to do everything that we want, but I do feel tired sometimes," she says, now 10 months after surgery. "Overall, I'm feeling really good."</p> <p>Dr. Christian says that Gail's story is a good example of how health care teams work together across organizations to do what is best for each patient.</p> <p>"We were happy to care for Gail and get her the care she needed quickly. Time is of the essence with breast cancer," says Dr. Christian. "Sometimes that means taking a journey across the state or, in this case, just across town, to get care as soon as possible."</p><img src="/-/media/national-files/images/hometown-health/2022/gail-raddatz.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D5A7E5468059CA7FB777CA1D8D9B13C4" alt="Gail Raddatz" width="660" height="370" DisableNVelocity="true" />Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.SurgeryHaving surgery is a major event in your life. We know this and make every effort to keep you as comfortable as possible, focusing on you as an individual. Our surgeons and staff work as a coordinated team treating a wide variety of illnesses ranging from simple to complex. We offer comprehensive, advanced care and service to every patient.Genetic TestingGenetic testing examines your DNA — the chemical database that carries instructions for your body's functions — to reveal changes or alterations in your genes that may cause illness or disease. <br/><br/>Dawn Haller10/27/2022A life-threatening motorcycle accident landed Tom Lansing in post-acute care. The collaborative services of the rehab team and Tom's hard work helped restore him to his active life.Wrap-around rehab reaps results<p>It was May 25, 2021. After Tom Lansing of Stewartville, Minnesota, mowed his mom's yard, the then 59-year-old decided it was a perfect late afternoon for a motorcycle ride. So he revved up his Harley Davidson Ultra Classic and pulled onto the country road in front of his house.</p> <p>A little more than a mile later, going highway speed, Tom collided with a car that crossed into his path at an intersection. A nearby resident and former EMT was first on the scene and cared for Tom until the ambulance arrived. His long journey from repair to recovery was about to start.</p> <p>It wasn't until about three weeks later that Tom was able to ask his sister what had happened. He learned the list of his injuries was impressive: 30 broken bones, including skull and facial fractures; a dislocated left hip; broken ribs; broken right femur; and a severely fractured left wrist and ankle, along with a traumatic head injury and injuries to his internal organs. He had a total of 10 surgeries.</p> <img alt="Tom Lansing in hospital" src="/-/media/national-files/images/hometown-health/2022/tom-lansing-in-hospital.jpg?h=186&w=250&sc_lang=en&hash=4478621890411F4363FA5F44A0F7CC00" style="height: 186px; width: 250px; float: right; margin-bottom: 5px; margin-left: 5px;" /> <p>"I was in <a href="/services-and-treatments/intensive-and-critical-care" target="_self" title="Opens in same window.">intensive care</a> for 16 days, then three weeks in a regular hospital room," Tom says. "About a month after the accident, I asked where I was going to go to get better."</p> <p> That "where" was the <a href="/services-and-treatments/transitional-care" target="_self" title="Opens in same window.">Mayo Post Acute Care</a> unit at <a href="/locations/new-prague" target="_self" title="Opens in same window.">Mayo Clinic Health System in New Prague</a>, Minnesota. Tom's needs were so extensive, they exceeded the capabilities of nursing homes closer to home. So although New Prague was nearly 100 miles away, it was the best option. He arrived at the post-acute care unit on July 2, 2021.</p> <p>What came next was a lot of grit, hard work and determination on Tom's part and skilled, focused rehabilitation from his care team. The team provided <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapy</a> to help with healing and movement; <a href="/services-and-treatments/occupational-therapy" target="_self" title="Opens in same window.">occupational therapy</a> for regaining daily living skills; <a href="/services-and-treatments/speech-language-therapy" target="_self" title="Opens in same window.">speech therapy</a>; <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">mental health support</a> to deal with mild depression, anxiety and PTSD; and chaplain services.</p> <p>"He had some memory loss from the accident, multiple fractures, wasn't able to bear weight on his legs and was in a neck brace," says <a href="/providers/kayla-wojciechowski-licsw" target="_self" title="Opens in same window.">Kayla Wojciechowski</a>, a <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">licensed social worker</a> in New Prague. "We took a collaborative approach to his care because his needs far exceeded one area of expertise. Mayo has a great model for working as a team. Without one team member, we're not as successful as we could be. It really is the best way to care for our patients and play a role in their recovery."</p> <p>Once Tom got settled in, what he really wanted to do was put his feet on the ground after lying in bed for so long. After intensive physical therapy, two physical therapists helped him swing his legs off the bed, grab onto the walker and stand — while they stood right next to him.</p> <p>"I almost crumpled to the ground. It felt like I weighed 800 pounds; I couldn't support my weight," he says. "That was the biggest eye opener for me, and I thought, 'I have some work to do.'"</p> <p>And so his rehab began. Each day he worked on standing, regaining movement throughout his body and jump-starting his foggy brain and memory with games, pictures and other techniques. Toward the end of his stay, he and his therapist even visited a store where he bought 10 items — and then was quizzed about an hour later on what he bought. "I remembered all 10," he says. "I aced it!"</p> <p>During the weeks of rehab, Tom also returned to Mayo Clinic for follow-up exams and surgeries. By Aug. 21, he was ready to be discharged. "I was still on crutches and doing physical therapy twice a week when I left," Tom says. "After just a couple of days at home, I got on the lawn mower on my own, and that's when I knew I could take care of myself."</p> <p>Tom supplemented his formal physical therapy by dancing to his favorite music in his living room and working around the house and his hobby farm. A year to the date of his accident, he retired from his job as a detention deputy at the Olmsted County Work Release Facility.</p> <p>But Tom still wasn't done with New Prague. In July 2022, he made a surprise visit to the Mayo Post Acute Care unit to thank everyone, including the desk staff, doctors, therapists, nurses and support staff who brought him meals and helped him shower. He admits it was an emotional day.</p> <p>"Tom's rehab was extraordinary," Kayla says. "He came here totally dependent on staff and left using a just a walker."</p> <p>"The things we take for granted mean more when you can't do them," Tom says.</p> <p>Thanks to the wrap-around rehabilitation he received in New Prague, Tom is back doing ordinary things, like mowing the yard, working around his farm and playing golf, as well as the special things like getting back up on water skis. He says, "When I yelled, 'Hit it!' and lifted out of the water, I thought, 'A lot has changed from a year ago.'"</p><img src="/-/media/national-files/images/hometown-health/2022/tom-lansing.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F0ABCCD630FC372AE019E074C3766EDD" alt="Tom Lansing" width="660" height="370" DisableNVelocity="true" />Rehabilitation TherapyRestoring movement and function to people injured or impaired by disease or injury.Dawn Haller11/14/2022Sarah Wittrock found care, kindness and professionalism in her local Emergency Department following a domestic assault. She urges others in similar situations to seek the help they need.Neighborly compassion in Sarah's time of need<p>Sarah Wittrock has lived in Bloomer, Wisconsin, her entire life. She works as a substitute teacher in the local school district, knows most residents in town and is raising her two children in the community.</p> <p>The friendly town is known for a long list of pies at the café and for hosting the annual rope jump contests, earning the nickname the "Jump Rope Capital of the World."</p> <p>It's the type of place where neighbors know and help each other in their times of need. And that's exactly what Sarah needed in January 2021.</p> <p>Her now ex-husband was upset while driving, and it escalated quickly.</p> <p>"He was driving with one hand and started hitting and punching me with the other," she recalls. "I couldn't believe it was happening."</p> <p>Sarah remembers being dropped off at the <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">Emergency Department</a> at <a href="/locations/bloomer" target="_self" title="Opens in same window.">Mayo Clinic Health System in Bloomer</a>. She was bleeding and needed immediate care. The health care team quickly escorted her into a treatment room, secured the department and called the police.</p> <p>"They were so caring and sensitive with what was going on," says Sarah. "Even though they were busy, a nurse sat with me and held my hand the entire time. They were kind and sympathetic. I was scared out of my mind that he would come back and get me. But they kept reassuring me that I was safe there."</p> <p>That's precisely why the team is there, explains Mary Stencil, registered nurse and Emergency Department manager in Bloomer.</p> <p>"Our team is ready 24/7 to care for the most critically injured and ill patients, such as Sarah," she says. "In a traumatic situation, we understand that care is more than just fixing the physical injuries, but caring for the patient's emotional health, as well."</p> <p>Sarah suffered multiple injuries. Her <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/broken-nose/symptoms-causes/syc-20370439" target="_blank" title="Opens in a new window.">nose</a> and teeth were broken. She had a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/concussion/symptoms-causes/syc-20355594" target="_blank" title="Opens in a new window.">concussion</a> and a large cut between her eyes. A CT scan later revealed bleeding on her brain, so she was admitted to the <a href="/services-and-treatments/intensive-and-critical-care" target="_self" title="Opens in same window.">Critical Care Unit</a> at <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Mayo Clinic Health System in Eau Claire</a>, where she spent three days.</p> <p>Sarah says she is grateful for the compassionate care she received and the "neighbors-helping-neighbors" mentality she experienced.</p> <p>"They were very gentle and treated me professionally," she says. "I've known some of the staff for years, and whenever they see me now, they ask how I'm doing. It means a lot to me."</p> <p>This is what makes Mayo Clinic Health System special, says Mary.</p> <p>"The Bloomer hospital and clinic bring Mayo Clinic knowledge and expertise close to home for Sarah and thousands of patients like her," she says. "Our team lives and works in the community. We take great pride in, and feel great responsibility for, meeting the needs of our friends, family and neighbors."</p> <p>Today, Sarah is divorced and loves to spend time with her kids and dad. She also works occasionally and is active in her church, serving on the church council and preschool board.</p> <p>Her ongoing health care needs are managed by <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a>. Sarah feels well but continues to struggle with the lasting effects of her attack. Yet she wants to offer hope and advice for others who have found themselves in similar situations.</p> <p>"It's not easy, but it's worth it to get out of your situation. And the Emergency Department team is nice and can help," Sarah says.</p> <h2>Learn more about domestic violence:</h2> <ul> <li>Contact the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.thehotline.org/" target="_blank" title="Opens in a new window.">National Domestic Violence Hotline</a> by calling <a href="tel:1-800-799-7233">1-800-799-SAFE (7233)</a>, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.thehotline.org/" target="_blank" title="Opens in a new window.">live chat</a> or text "START" to 88788. </li> <li>Read <a href="/hometown-health/speaking-of-health/abuse-at-home-safety-planning-during-covid-19" target="_self" title="Opens in same window.">"Abuse at home: Safety planning during the COVID-19 pandemic."</a></li> <li>Contact a local domestic abuse and sexual assault program, such as <a href="/locations/la-crosse/patients-and-visitors/social-work" target="_self" title="Opens in same window.">Safe Path in La Crosse</a>, Wisconsin, or <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://crimevictimsresourcecenter.org/" target="_blank" title="Opens in a new window.">Crime Victims Resource Center</a> in Austin, Minnesota.</li> </ul><img src="/-/media/national-files/images/hometown-health/2022/sarah-wittrock.jpg?h=370&iar=0&w=660&sc_lang=en&hash=02E33805365CBDC183754AA1F9251F3C" alt="Sarah Wittrock" width="660" height="370" DisableNVelocity="true" />Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Dawn Haller11/16/2022After Taylor Suhr had a stroke, he needed to relearn how to do many things, including eating. Speech pathology helped him regain those abilities and rewarded him with the cheeseburger he'd been craving.Say cheeseburger: Patient smiling thanks to special treat<p>Taylor Suhr thought he was dying.</p> <p>"I was terrified," Taylor says. "I woke up and there were a bunch of tubes coming out of me. I couldn't talk. I panicked."</p> <p>Taylor wasn't dying. But he'd come close. The 27-year-old La Crosse, Wisconsin, resident had a major <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/stroke/symptoms-causes/syc-20350113" target="_blank" title="Opens in a new window.">stroke</a> and had been brought to <a rel="noopener noreferrer" href="https://www.mayoclinic.org/" target="_blank" title="Opens in a new window.">Mayo Clinic</a> in Rochester, Minnesota, for treatment. He'd had surgery to relieve swelling in his brain and was in a coma for close to a week.</p> <p>In the days after Taylor woke up, he had to adjust to a new reality. He would need to relearn how to do things he had previously given little thought to — things like walking, talking and eating.</p> <p>"When I first met Taylor, he was having significant difficulties even swallowing his own saliva," says Jordan Alvarez, a Mayo Clinic speech pathologist. Communication also was a challenge. "At first, we used a communication board that had letters and items he could point to."</p> <p>Alvarez was honest with Taylor. She told him recovery would take time. She also assured him that he'd get better.</p> <p>"When you're scared and facing a challenge like Taylor's, it's powerful to hear someone say, 'I've seen this before, and it will get better,'" Jordan says.</p> <p>For Taylor, getting better started with small steps. He began by swallowing ice chips to start exercising the muscles in his throat.</p> <p>"We spent about two weeks on ice chips and swallowing exercises," Jordan says.</p> <p>But Taylor was eager to move on. He dreamed of eating something real. A cheeseburger topped his list.</p> <p>"Taylor loves to cook, so eating is very motivating for him," Jordan says.</p> <p>About three weeks after Taylor's stroke, a swallow study brought the good news that he was ready to try pureed foods. But the real joy came a week later, after a second swallow study showed that Taylor could eat solid foods chopped into small pieces.</p> <p>"He was so excited that he cried," Jordan says.</p> <p>Soon Taylor was ready to try foods that were more solid. And Jordan knew just what his first meal should be.</p> <p>"I walked over to McDonald's and got him a cheeseburger," she says.</p> <p>It was a simple meal Taylor will never forget. "I loved that burger," he says. "I can still taste it."</p> <p>He also has a love for Alvarez and the other staff who cared for him during his recovery.</p> <p>"Mayo saved my life," he says. "I shouldn't be here. This experience made me believe in miracles."</p> <p>It's made his mother, a door attendant at <a href="/locations/onalaska" target="_self" title="Opens in same window.">Mayo Clinic Health System in Onalaska</a>, a believer too.</p> <p>"I've worked here for 17 years and have always thought Mayo is the best," Cynthia Thorne says. "They proved my faith. They saved my son's life."</p> <p>For Jordan, getting to develop relationships with people like Taylor is why she loves her job.</p> <p>"Taylor had such a great attitude and worked so hard," she says. "People come in at the most challenging time of their lives, and we get to help them get better. It's incredibly rewarding."</p><img src="/-/media/national-files/images/hometown-health/2022/taylor-suhr.jpg?h=370&iar=0&w=660&sc_lang=en&hash=72B7B955BD080DFFC8821DABF95745DC" alt="Taylor Suhr" width="660" height="370" DisableNVelocity="true" />Speech-LanguageThe evaluation and treatment of communication disorders and swallowing disorders.StrokeAs one of the leading causes of death in the U.S., stroke will affect 80% of families during their lifetimes, according to the National Stroke Association. And the faster care you receive for stroke, the better. Learn more about stroke prevention, symptoms and treatments here.Dawn Haller12/22/2022George Hite is happy and engaged in life. But that wasn't always the case. He battled addictions to opiates and food. But thanks to lots of hard work and bariatric surgery, he is a changed man.George Hite's journey through addictions, weight loss<p>Many adjectives could be used to describe George Hite. Healthy, happy, energetic, motivated, honest and transformed are just a few.</p> <p>But eight years ago, he probably wouldn't have used any of those words to describe his life. He had a good job, bought a house, was married to the love of his life and had two great children. From the outside, life looked good. But he was hiding a secret — an all-consuming addiction to opiates. It started when he got morphine from a friend to treat migraines.</p> <p>"It snowballed from there. I was able to get fentanyl, and soon I was using all the time," says the 45-year-old Cadott, Wisconsin, resident. "I was spending more and more money to get it. I lied to many people and even myself. I told myself it was safe because they were pharmaceutical drugs."</p> <p>Over five years, his addiction spiraled out of control. George lost his job, was behind on his bills and his marriage to his wife of 21 years, Sarah Hite, was in trouble. He knew it could not go on any longer.</p> <p>"My addiction brought the walls tight around me. I stopped hanging out with friends and going to events," he recalls. "That wasn't me. I was always a happy person before. I had goals and was a better person than this."</p> <p>With the support of Sarah, George enrolled in a 28-day inpatient addiction treatment program at Hazelden Betty Ford Foundation in 2015. He was able to kick the addiction and emerged a new man.</p> <p>"I almost lost everything, and I'm so glad I got a second chance," he says.</p> <p>Now, clean and sober, George focused on rebuilding relationships with the important people in his life and getting back to work. Life was looking up, but he noticed the scale was creeping in the same direction.</p> <p>"I had replaced a pharmaceutical addiction with a food addiction," he recalls. "I knew I had a problem, but I lied to myself and thought, 'At least it's better than drugs.'"</p> <img alt="George Hite Before" src="/-/media/national-files/images/hometown-health/2022/george-hite-before.jpg?h=225&w=225&sc_lang=en&hash=476E887AD3D3F0D0A954BA9153149BC2" style="height: 225px; width: 225px; float: right; margin-bottom: 5px; margin-left: 5px;" /> <p>He binged on food, constantly snacking on empty-calorie foods and eating out multiple times per day. Within three years, George gained about 100 pounds. At 5 feet 10 inches tall, he weighed about 335 pounds and had a body mass index of nearly 48.</p> <p>The extra weight was affecting George's physical and mental health. He had prediabetes, sleep apnea and low back pain. His migraines returned, and he had low energy. He was isolating himself again and staying home instead of seeing friends and family.</p> <p>"Sarah loves me for me and never made me feel bad about it," says George. "But I didn't tell her about everything I was eating. When I realized I was keeping secrets again, I knew it was a problem."</p> <p>It was time for George to make a change again. He enrolled in the <a href="/services-and-treatments/bariatric-surgery" target="_self" title="Opens in same window.">Bariatric Surgery</a> program at <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Mayo Clinic Health System in Eau Claire</a>.</p> <p>Bariatric surgery is a procedure that changes the structure of the digestive system by either limiting the size of the stomach, reducing the nutrients absorbed by the stomach, or both. It can be an effective tool to help people lose significant weight.</p> <p>Wendy Payson, a registered nurse and bariatric surgery coordinator, stresses that bariatric surgery at Mayo Clinic Health System isn't just a surgical procedure.</p> <p>"It's a multidisciplinary program, and the team focuses on supporting each patient's emotional, physical, nutritional and educational needs," she says. "Every prospective surgical patient must complete presurgical education and nutrition and lifestyle counseling. This comprehensive care improves patient outcomes and ensures long-term success."</p> <p>During the seven-month program, George met with a surgeon, registered dietitians, counselors, exercise specialists and other medical experts to determine if he was prepared for the lifestyle changes necessary to ensure long-term weight loss success. The team evaluated whether surgery was right for him and helped him set up routines and support systems at home and work.</p> <p>An essential part of the program is a 10-week Healthy Eating and Active Lifestyle with Thoughtful Habits (HEALTH) group, which creates an environment where members help each other achieve or maintain weight loss.</p> <p>"I was really inspired by hearing or reading other people's stories about overcoming addiction or weight loss," says George. "I wanted to know peoples' mindset before or after surgery, what they did when they felt tempted, and how they prepared themselves to come home after surgery.</p> <p>That's precisely the point, says <a href="/providers/jackilyn-andrew-lcsw" target="_self" title="Opens in same window.">Jackilyn Andrew</a>, a clinical social worker in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry & Psychology</a> and HEALTH group facilitator.</p> <p>"When group members are willing to share openly, it is relatable and inspiring. Many people share that they find it helpful to be a part of the group for the support and interaction," says Andrew. "Even those that are shy and more reluctant to share, often report a lot of benefit from just listening and taking it all in."</p> <p>At the end of the program, George was ready for surgery.</p> <p>"Mr. Hite was a good candidate for bariatric surgery because he met the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.niddk.nih.gov/health-information/weight-management/bariatric-surgery/potential-candidates" target="_blank" title="Opens in a new window.">National Institutes of Health</a> requirements of having a body mass index of 40 or greater with obesity-related medical conditions, such as sleep apnea," explains <a href="/providers/maria-linnaus-md" target="_self" title="Opens in same window.">Maria Linnaus, M.D.</a>, general and bariatric surgeon. "Also, he expressed great motivation throughout the program to make changes to his lifestyle to ensure long-term success."</p> <p>Dr. Linnaus explained the two surgical options to George: sleeve gastrectomy and Roux-en-Y gastric bypass. </p> <p>"Mr. Hite had a history of gastroesophageal reflux, which can potentially be made worse with a sleeve gastrectomy. This is why we ultimately decided together on Roux-en-Y gastric bypass.", </p> <p>Roux-en-Y is a minimally invasive laparoscopic procedure that creates a small pouch in the stomach and reconnects it directly to the small intestine. This causes patients to get full quicker and absorb fewer calories because food bypasses part of the small intestine. </p> <p>In September 2021, George had a Roux-en-Y gastric bypass and remained in the hospital for one day. Most patients receive acetaminophen and nonsteroidal anti-inflammatory medications to control pain after surgery. George was leery of any postsurgical pain control medications due to his previous addiction, so the team worked with him to use other nonmedication methods of pain control, including aromatherapy and music therapy. </p> <img alt="George and Sarah Hite" src="/-/media/national-files/images/hometown-health/2022/george-and-sarah-hite.jpg?h=225&w=225&sc_lang=en&hash=4ACC7449090D678CE109493CB82C936B" style="height: 225px; width: 225px; float: right; margin-bottom: 5px; margin-left: 5px;" /> <p>While not wholly pain-free at first, he could walk the same day and returned to light-duty work about one week later. Within a month, George gradually started exercising and resuming his regular activities. In addition to exercising on an elliptical and walking his dogs, George modified his diet. </p> <p>"I'm very picky about what I eat and how much. I cut out carbonated beverages, caffeine, bread and processed sugar," he says. "I eat protein and vegetables first, then carbs and other calories if I'm still hungry." </p> <p>Quickly he noticed his weight dropping. About 14 months after his surgery, George weighs 165 pounds, and his body mass index is 24. He no longer struggles with migraines, sleep apnea or low back pain. He recently added weight training to his exercise routine.</p> <p>"I've never been muscular before," he says, laughing. "I'm actually getting veins in my biceps now." </p> <p>His weight loss is typical of people who have completed the bariatric surgery program. </p> <p>"Most patients can lose an estimated 60% to 70% excess weight for a gastric bypass and about 50% to 60% excess weight for a sleeve gastrectomy," explains Dr. Linnaus. "Mr. Hite is an example of how one can achieve even greater weight loss when following the program."</p> <p>Following the program is precisely what George recommends. </p> <p>"The program does work if you follow it. For me, it wasn't just a physical transformation. The surgery helped me emotionally and mentally, too. It changed me," he says. "I'm doing all that stuff that I was missing before. My confidence is through the roof now. One of the nurses said, 'You did all the work.' But that team gave me the tools to get the work done. It really does work."</p> <p>Dr. Linnaus gives credit to George for his success.</p> <p>"Our program provides the building blocks for patients to get on the right track, and our surgeries can help reset their physiology. But at the end of the day, he did the hard work to follow the program, and it has paid off greatly."</p><img src="/-/media/national-files/images/hometown-health/2022/george-hite.jpg?h=370&iar=0&w=660&sc_lang=en&hash=011E7E0392E521BA1CACF9898665C984" alt="George Hite" width="660" height="370" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller1/19/2023Lewey Christopherson's heart condition kept him from doing his favorite things. Learn how the care he received from his cardiologists has him doing the two-step again.From davenport to dance floor: New life for patient with heart condition<p>Betty Christopherson is grateful for the special Christmas present she received in 2022: the gift of twirling around the dance floor once again with her husband, Llewellyn (Lewey) Christopherson.</p> <p>It's a gift Betty won't take for granted. In early 2022, Lewey, an 85-year-old farmer from Melrose, Wisconsin, found that he didn't have the energy to do routine daily tasks, let alone go dancing.</p> <p>"I wasn't able to work around the farm," he says. "I went from the recliner to the davenport to the bed. That was my day. I had terrible color. I had to hang on to gates and rails to walk."</p> <p>Lewey also was on several medications to treat other conditions. The inability to participate in daily life and the side effects from the medications made him depressed and even suicidal.</p> <p>"I wasn't a very good husband and was crabby all the time," he says.</p> <p>Lewey and Betty decided it was time to see <a href="/providers/michael-meyers-md" target="_self" title="Opens in same window.">Michael S. Meyers, M.D.</a>, Lewey's <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiologist</a> at <a href="/locations/la-crosse" target="_self" title="Opens in same window.">Mayo Clinic Health System in La Crosse</a>, Wisconsin. Dr. Meyers enlisted the help of <a href="/providers/xiaoke-ken-liu-md-phd" target="_self" title="Opens in same window.">Xiaoke (Ken) Liu, M.D., Ph.D.</a>, a heart rhythm specialist, to get to the root of Lewey's health troubles.</p> <h2>Irregular heart rhythm in an unusual place</h2> <p>Lewey was asked to wear a portable ECG monitor for a week to analyze his heart rhythms. The ECG readings revealed that Lewey had heart arrhythmia, or an irregular heartbeat. </p> <p>Heart arrhythmias occur when the electrical signals that coordinate heartbeats don't work properly. The faulty signaling causes the heart to beat too fast (tachycardia), too slow (bradycardia) or irregularly.</p> <p>According to Dr. Liu, heart arrhythmias may feel like a fluttering or racing heart and may be harmless. However, some <a href="/hometown-health/speaking-of-health/racing-heart-beat-heart-arrhythmia-101" target="_self" title="Opens in same window.">heart arrhythmias</a> may cause bothersome and sometimes even life-threatening signs and symptoms.</p> <p>"Lewey had an abnormal spot firing erratically and very frequently from the bottom part of the heart called the left ventricle, near a heart valve," Dr. Liu says. "This caused the irregular rhythm and compromised the pumping efficiency of the heart. If left untreated, this may weaken the heart muscle and cause symptoms and signs of heart failure."</p> <p>In late September, Dr. Liu performed an <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/heart-arrhythmia/diagnosis-treatment/drc-20350674" target="_blank" title="Opens in a new window.">ablation procedure</a> without X-rays and other radiation.</p> <p>"Radiation exposure has been well-known to be harmful to the human body, and we have been able to eliminate radiation exposure for ablation procedures in recent years," Dr. Liu notes. "In Lewey's case, we used a special wire connected to a sophisticated mapping system together with an ultrasound machine to locate the exact spot where the abnormal rhythm comes from."</p> <p>"Once we pinpoint the target, we were able to use radiofrequency energy to cauterize that abnormal spot and make it unable to generate abnormal electric signals," Dr. Liu says.</p> <h2>Two-stepping to recovery</h2> <p>Lewey's age was of some concern to his care team, but he handled the procedure well, Dr. Liu says.</p> <p>"It brings me tremendous happiness and joy to see my patients, like Lewey, feel better or completely recover from frequently debilitating heart rhythm conditions through treatment," Dr. Liu says.</p> <p>"I was on the table for just about two hours," Lewey recalls. "I thanked Dr. Liu and the staff up and down for what they were doing."</p> <p>Lewey was monitored closely for a week after the surgery and has had no issues.</p> <p>"I have a lot more energy now," Lewey says. "I've gotten rid of most of my depression. The best part is, I'm able to do things with my wife again without being so tired."</p> <p>Lewey and Betty can now do things they enjoy, such as crossword puzzles. And they were hitting the dance floor, of course.</p> <p>"We enjoy doing the waltz, polka and two-step. The hop waltz is our favorite," Lewey says.</p> <p>For her part, Betty is thrilled to have an active Lewey by her side.</p> <p>"You gave me a new husband," she tells his Mayo care team.</p><img src="/-/media/national-files/images/hometown-health/2023/lewey-christopherson.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4679BC66D9910C49667B6629587C5FF0" alt="Lewey Christopherson" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller1/11/2023Durable medical equipment helps people recover from injury or manage chronic conditions. Mayo Clinic Store offers personalized expertise that sets it apart from other vendors. Just ask Elna Johnson.Mayo Clinic Store offers medical supplies, personalized care<p>Every day, thousands of patients receive care at Mayo Clinic Health System. Some experiences are routine or even simple. Others are life-changing and dramatic.</p> <p>A common thread is a personal connection and support between the patient and health care team. A listening ear or a comforting hug could help turn around a person's day. But others need more tangible support, like a walker or brace. That's where the durable medical equipment experts at <a href="/services-and-treatments/home-medical-equipment" target="_self" title="Opens in same window.">Mayo Clinic Store</a> shine brightly.</p> <h2>Supporting patient needs</h2> <p>Mayo Clinic Store is a convenient supplier of durable medical equipment, also called DME, for patients recovering at home from an illness or accident or managing a chronic health condition. Many vendors offer DME, but Mayo Clinic Store staff offer personal connection and expertise that sets the experience apart for patients.</p> <h3>A wide variety of products are available at most Mayo Clinic Stores* to help patients live safely and fully at home, including:</h3> <ul> <li>Braces</li> <li>Breast pumps</li> <li>Compression garments</li> <li>Continuous positive airway pressure (CPAP) products</li> <li>Daily living aids</li> <li>Enteral nutrients</li> <li>Exercise aids and adaptive equipment</li> <li>Hospital beds</li> <li>Lifts and lift chairs</li> <li>Mastectomy products</li> <li>Mobility aids, including canes, crutches, walkers and wheelchairs</li> <li>Ostomy supplies</li> <li>Oxygen</li> <li>Personal care and convenience items</li> <li>Respiratory devices</li> <li>Urology supplies</li> <li>Wound care supplies</li> </ul> <p><em>*Not all equipment and services are available at all Mayo Clinic Store locations. Check with your preferred location in advance.</em></p> <p>Mayo Clinic Store staff work with patients' health care teams to ensure access to the safest and most effective solutions for at-home care.</p> <h2>Personalized care</h2> <p>It's not just the equipment that's special, it's the personalized and compassionate care each patient receives. Just ask Elna Johnson of Menomonie, Wisconsin.</p> <p>When she was diagnosed with sleep apnea, she turned to Mayo Clinic Store experts to determine the right CPAP equipment to help her get a restful night's sleep.</p> <p>"It took me a little time to find the right mask, but I think a lot of people struggle with that at first," says the 83-year-old retired nurse. "Now, I use it every single night. I'm compulsive about it."</p> <p>Elna can get new supplies for her CPAP machine every three months. This maintains a good mask seal, prevents bacteria growth and keeps her equipment working properly. During this ongoing interaction with Mayo Clinic Store staff, Elna developed a close bond with Lisa Oldenberg, a durable medical equipment expert in Menomonie.</p> <p>"She is personable, knowledgeable and very easy to talk with," says Elna. "She makes me feel like I am being personally known and heard."</p> <p>And that's exactly the point, explains Lisa.</p> <p>"That's how I was taught to help patients," she says. "It's important to connect with people, so I call each patient to ask if they need equipment or have questions. Over the years, I built a good rapport with Elna."</p> <p>This personal connection and compassion extend beyond the telephone. Lisa knew Elna was going to visit the clinic but had knee pain.</p> <p>"She saw I was walking down the hall, and she came running to meet me with my equipment," says Elna. "You can really tell when someone is interested in helping you versus just doing their job. Lisa is one of those people." </p> <p>This personal connection is mutual.</p> <p>"We get the chance to get to know our patients and their needs," says Lisa. "Elna's bubbly and friendly. I feel like I know her on a professional and personal level. I like talking with her and helping her."</p> <p>Mayo Clinic Store offers the same expertise and personalized care at 16 locations across Arizona, Minnesota and Wisconsin. Talk with your local health care team about your needs and questions regarding DME, postsurgical supplies and health care aids.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/mayo-clinic-store.jpg?h=493&iar=0&w=880&sc_lang=en&hash=E6F5DD3AE9EDA5BF3C3F6E7FDA2BB1F2" alt="Mayo Clinic Store" width="880" height="493" DisableNVelocity="true" />SleepSleep is essential to good health. It's one of the body's basic needs. But, what do you do when you have troubles sleeping, or getting enough hours of sleep? Dawn Haller2/9/2023Julie Wesson's atrial fibrillation diagnosis was an unexpected component of her retirement plans. Her determination and research led to a procedure to address her elevated stroke risk.Heart procedure provides solution to worry<p>After a rewarding career and entrepreneurial endeavors, Julie Wesson was looking forward to retirement. Julie and her husband had built their dream home, a log cabin in a secluded area of Wisconsin near Tomah. They had settled into a quiet, peaceful life running a cat sanctuary.</p> <p>But a presurgery exam for cataract surgery in July 2021 revealed an unexpected diagnosis for Julie — atrial fibrillation.</p> <h2>Motivation for a solution</h2> <p>With <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/atrial-fibrillation/symptoms-causes/syc-20350624" target="_blank" title="Opens in a new window.">atrial fibrillation</a>, Julie's heart was pumping out of sync, or irregularly, between the upper and lower chambers. When the heart does not squeeze properly, blood can move slower in the top chambers, creating clots. If these clots travel through the body, they can cause strokes or other issues.</p> <p>Julie was prescribed anticoagulant medication, which thins the blood and helps prevent clots. However, side effects from the medication led Julie to the decision that she needed an alternative treatment method.</p> <p>"My motivation was not to have to take medication for the rest of my life," says Julie.</p> <p>Determination and research led Julie to a procedure called left atrial appendage occlusion performed at Mayo Clinic Health System in Eau Claire, Wisconsin.</p> <p>She was thrilled to learn the procedure was performed close to home.</p> <p>"It was an easy decision to stay in Wisconsin," says Julie.</p> <p>Julie's research had prepared her for the steps needed prior to the procedure, including a preliminary review, bloodwork and angiogram, before meeting <a href="/providers/gurpreet-singh-md" target="_self" title="Opens in same window.">Gurpreet Singh. M.D.</a>, an <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">interventional cardiologist</a> at Mayo Clinic Health System.</p> <p>"Julie was knowledgeable about her diagnosis and was a good candidate for the procedure," explains Dr. Singh. "She was very encouraged and excited at the prospect of not having to take medication to reduce the risk of stroke."</p> <h2>Excitement about the procedure</h2> <p>On Dec. 19, 2022, Julie and her husband traveled to Eau Claire to meet with the team performing the left atrial appendage occlusion. From admission to anesthesia, Julie felt reassured by her decision to have the procedure.</p> <p>"Not for a moment was I worried or frightened," recalls Julie. "The atmosphere in the room was of excitement, and it felt like a happy experience."</p> <p>Julie expressed her concerns to the care team about previous experiences with side effects from anesthesia and worries about sleep apnea and leg cramps during post-procedure recovery.</p> <p>"Patients need to voice their worries or concerns so they can be addressed," shares Julie. </p> <p>During the procedure, Dr. Singh and <a href="/providers/vaibhav-vaidya-mbbs" target="_self" title="Opens in same window.">Vaibhav Vaidya, M.B.B.S.</a>, placed the device in the left atrial appendage through a catheter in the femoral vein of Julie's leg. The heart's complex anatomy and appendage shape can make it more challenging to place the device. Julie's left atrial appendage had what is known as a "chicken wing."</p> <p>"I gave Dr. Singh a challenge with my chicken wing," laughs Julie.</p> <p>Dr. Singh confirmed that it indeed was a complex anatomy.</p> <h2>A restful recovery</h2> <p>"When I woke up, I felt comfortable and didn't hurt anywhere," explains Julie.</p> <p>She was released from the hospital the same day and was happy to be able to recover at home.</p> <p>"I had to behave, with no reaching, stretching or lifting over 5 pounds for a couple of weeks," says Julie.</p> <p>Her planning and preparation before the procedure made resting during the short recovery easier. Julie and her husband had prepared and frozen healthy meals created with produce from their garden to eat during her recovery period.</p> <p>Upon returning home, Julie wrote a letter to her support group of friends and family to update them on the successful procedure. Her second note was a thank you to Dr. Singh for his life-giving work. </p> <p>"The <a href="/hometown-health/transforming-healthcare/transforming-heart-care" target="_self" title="Opens in same window.">left atrial appendage occlusion</a> procedure allows Mayo Clinic Health System to meet the needs of patients like Julie, who are predisposed to stroke due to atrial fibrillation," shares Dr. Singh.</p> <p>Since the launch of the procedure in Eau Claire in September 2021, 45 patients have undergone left atrial appendage occlusion.</p> <p>"My worry about having a stroke is gone," says Julie. "The dark cloud of fear hanging over my head has lifted away."</p><img src="/-/media/national-files/images/hometown-health/2023/julie-wesson.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C1F3F496DD7EA224EB3B31B38DB7EC33" alt="Julie Wesson" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller3/2/2023A life-threatening case of COVID-19 put April Alden-O'Connor in the hospital for more than two months. Learn how it also brought insights about caring for others and her future career path.COVID-19 care generates gratitude, new career<p>It was Thanksgiving week in 2021 when April Alden-O'Connor's life took an unimaginable turn. She'd spent a crisp November day deer hunting with her brother. While she was away, her boyfriend, Joe Houske, told her he'd tested positive for COVID-19.</p> <p>Joe and April isolated at their home in Hastings, Minnesota. But by Friday, Nov. 26, April, who was 30 at the time, developed symptoms. On Sunday, she tested positive for COVID-19.</p> <p>Unlike Joe, April's symptoms were worse — way worse. "I felt like death warmed over and was having trouble breathing," April says.</p> <p>As her symptoms worsened, including her blood oxygen dropping to 70%, April sought care in the Emergency Department at <a href="/locations/cannon-falls" target="_self" title="Opens in same window.">Mayo Clinic Health System in Cannon Falls</a>, followed by being admitted to the hospital on Dec. 2 at <a href="/locations/red-wing" target="_self" title="Opens in same window.">Mayo Clinic Health System in Red Wing.</a></p> <h2>From ICU to ECMO</h2> <p>April's condition continued to deteriorate. On Dec. 8, she was transferred to the ICU at <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/patient-visitor-guide/minnesota/campus-buildings-maps/mayo-clinic-hospital-methodist-campus" target="_blank" title="Opens in a new window.">Mayo Clinic Hospital — Rochester, Methodist Campus</a>, where she was told she needed to be intubated.</p> <p>"I texted my mom that there must be a misunderstanding. Then I asked to call my family so I could say goodbye, knowing that I might not wake up on this side of the living," she says.</p> <p>By Dec. 15, April had developed severe COVID-19 pneumonia. To accelerate her care and take the pressure off her heart and lungs, April's care team approved her for <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/ecmo/about/pac-20484615" target="_blank" title="Opens in a new window.">extracorporeal membrane oxygenation</a>, or ECMO, the highest form of life support, which required another transfer, this time to <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/patient-visitor-guide/minnesota/campus-buildings-maps/mayo-clinic-hospital-saint-marys-campus" target="_blank" title="Opens in a new window.">Mayo Clinic Hospital — Rochester, Saint Marys Campus.</a></p> <p>"The next thing I remember was slowly waking up around Christmas," she says. "I was heavily medicated and experiencing weird hallucinations, like thinking I had six babies. When I asked for them, my care team thought I meant our dogs."</p> <img alt="April Alden in the hospital" src="/-/media/national-files/images/hometown-health/2023/april-alden-hospital.jpg?h=275&w=224&sc_lang=en&hash=59A569700266BACEB0EE35C67E0C1015" style="height: 275px; width: 224px; float: right; margin-bottom: 5px; margin-left: 5px;" /> <p>The coming weeks were rough. April was treated for <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/pneumonia/symptoms-causes/syc-20354204" target="_blank" title="Opens in a new window.">COVID-19 pneumonia and bacterial pneumonia</a>, a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/staph-infections/symptoms-causes/syc-20356221" target="_blank" title="Opens in a new window.">staph infection</a> and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/sepsis/symptoms-causes/syc-20351214" target="_blank" title="Opens in a new window.">sepsis</a>. But then her condition began improving and the infections were brought under control. On Jan. 21, 2022, April was taken off ECMO. However, she first had to prove she could walk around the unit with assistance.</p> <p>"My favorite physical therapist cheered me on, but it still took about eight people to help me walk," April says.</p> <p>On Jan. 24, she'd passed the next test: the ability to swallow.</p> <p>"I'm a big water drinker, and I drank nine glasses of water. It felt wonderful," she says. That same day, she was moved from the ICU to the respiratory unit, then to the general floor.</p> <h2>Deep gratitude for care</h2> <p>On Feb. 3, April was discharged home on oxygen. By the end of June, her lungs were recovered enough to stop the supplemental oxygen.</p> <p>April's COVID-19, 63-day journey by the numbers was: 48 days in the ICU, 38 days on ECMO and 50 days being unable to speak.</p> <h3>Looking back, she feels deep, lasting gratitude for the care she received, including the: </h3> <ul> <li>Nurse who braided her hair across the top of her head so it was out of the way.</li> <li>Therapists and nurses who helped her cope with the hallucinations, anxiety and post-ICU post-traumatic stress disorder.</li> <li>Nurses who sat with her and held her hand so she knew she wasn't alone.</li> <li>Physical therapists who helped her rebuild strength.</li> <li>Respiratory therapists who monitored and coached her while her lungs healed.</li> <li>Scores of health care professionals and aides who oversaw her care and made her as comfortable as possible.</li> </ul> <h2>Finding a new path</h2> <p>April still doesn't feel completely recovered. She continues to experience hair loss and undergo pulmonary rehabilitation. The smell of hand sanitizer and beeping machines trigger memories of her hospital stay. But she knows she's made gigantic strides, including returning to the dance studio where she studied tap and jazz for nearly 15 years.<span></span></p> <p>Before COVID-19, April was a personal care assistant, but dreamed of becoming a nurse like her mom, who retired in December 2022 after 40 years at Mayo Clinic. But April suffered from such severe migraines that college seemed impossible.</p> <p>"Maybe God thought I'd been through enough, but for the past seven or eight months, the severity and frequency of my migraines has decreased significantly," she says.</p> <p>In November 2022, she took a first step toward a new career. She applied and was hired for a scheduling desk position at Mayo Clinic Health System in Cannon Falls.</p> <p>"It's a big job, but I love interacting with people, especially the elderly," April says. "Nursing may still be in my future, but I want to regulate my life a bit first. But becoming a nurse seems more possible now than ever."</p> <h2>Moving forward</h2> <p>From her COVID-19 experience, April admits it may be a cliché, but she now realizes life is precious and no one is promised unlimited time.</p> <p>"I learned not to suffer in silence, but to seek help when I need it. I strive to breathe deeply, practice mindfulness and, most importantly, reach out to others. Tell people you love them, spend time with them doing things you love and spend less time on what doesn't serve you."</p> <p>And one more insight she offers: If someone you know is in a similar life-threatening situation, keep a journal for them detailing their care.</p> <p>"It's helpful to know the details and clarify what happened. It's part of the healing," April says.</p><img src="/-/media/national-files/images/hometown-health/2023/april-alden.jpg?h=370&iar=0&w=660&sc_lang=en&hash=745B6C9CA9628204C4FA89EFFA1209BB" alt="April Alden" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Dawn Haller3/14/2023Though Asiya Awad and Larry Jerome come from different worlds, they formed a friendship during Larry's hospital stay. And when an exceptional filly was born on his farm, Larry honored Asiya's care.Patient names prize Arabian filly in honor of staff member<p>When a colleague told Asiya Awad that a patient had asked her to stop by his room, she expected it was just to visit.</p> <p>Despite their differences in age and culture, Asiya and the patient, Larry Jerome, had developed a close friendship and often chatted about their lives and families.</p> <p>"I call him Mr. Fantastic," says Asiya, who is a patient care assistant at <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/" target="_blank" title="Opens in a new window.">Mayo Clinic</a> in Rochester, Minnesota. "He's really special to me."</p> <p>When Asiya got to the room, Larry — who breeds prize-winning <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://arabians.jerland.com/" target="_blank" title="Opens in a new window.">Arabian horses</a> and other animals at <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://www.jerland.com/" target="_blank" title="Opens in a new window.">Jerland Farms</a> in Barron, Wisconsin — showed Asiya a video of an Arabian filly that had been born the night before.</p> <img alt="Jerland Farms filly" src="/-/media/national-files/images/hometown-health/2023/asiya-jerome-filly.jpg?h=278&w=225&sc_lang=en&hash=4B9E88A628980C938070281A1725DFAF" style="width: 225px; height: 278px; float: right; margin-bottom: 5px; margin-left: 5px;" /> <p>"Oh, she's so cute!" Asiya said.</p> <p>Larry smiled. He knew the filly was more than cute. She was exceptional. And he'd chosen to give her a special name to match her potential.</p> <p>"I'm naming her after you," he told Asiya.</p> <p>The news made Asiya emotional. But she tried not to let it show.</p> <p>After hugging Larry, she went to the bathroom and cried.</p> <p>"In my head, I was just doing my job," Asiya says. "I was not thinking of me. I was thinking of him and how the patient comes first. The patient deserves everything. But he thought I deserved something, too."</p> <h2>A long journey to Rochester</h2> <p>Asiya's journey to Mayo Clinic began when her family fled their home in Somalia and moved to a refugee camp in Ethiopia.</p> <p>"Because of the civil war, Somalia was not safe," she says. "We'd hear shots and bombs in the middle of the day. My mom said anywhere is better than hearing shots fired every day."</p> <p>In Ethiopia, the family lived in a structure made of cardboard, tree branches and clothing.</p> <p>"I just bought a TV, and the box it came in reminded me of my home in the refugee camp," Asiya says.</p> <p>Once a month, an aid organization would distribute food: grain, beans and oil. Water came from a well, and milk from goats.</p> <p>"When we got to the U.S., we wondered why there were nine different kinds of milk," Asiya says. "There were so many choices. Why so many milks?"</p> <p>After 10 years in the camp, the Awads learned they would be able to immigrate to the U.S.</p> <p>"My brother has muscular dystrophy, and that's why we were able to come to the U.S.," Asiya says. The family — Asiya, her parents and six siblings — arrived in San Diego in 2014.</p> <p>Two hours after their plane landed, Asiya was rushed to the hospital by ambulance and diagnosed with tuberculosis. She spent her first two weeks in the U.S. in isolation in a hospital.</p> <p>"The doctors, nurses and PCAs were all so nice," she says. "They all wanted to help me."</p> <p>She'd remember their kindness when choosing her own career path.</p> <h2>From California to Minnesota</h2> <p>In San Diego, Asiya began working as a housekeeper and taking English lessons. After two years, the family moved to Rochester so her brother could receive care at Mayo Clinic.</p> <p>Asiya resumed English classes and also learned about career opportunities. Two options stood out: becoming a paraprofessional educator or a certified nursing assistant.</p> <p>"When I was younger, I wanted to be a teacher," she says. "But when I thought about everything people had done for me in the hospital, I decided, 'I want to do that for someone.'"</p> <p>After earning a certified nursing assistant certificate from Hawthorne Education Center, Asiya began working at a nursing home. She loved the work, but after three years was ready for a new challenge. She returned to school, earned an advanced certificate, and became a patient care assistant at Mayo Clinic in March 2021.</p> <p>I want the patients to feel happy. I don't want them to feel like a patient. I want them to feel human and to feel they are home when they are in their room.</p> <p>"I help patients with daily life activities," Asiya says. "I take their vital signs, help them in the bathroom, and help with feeding if needed."</p> <p>But she does much more than that.</p> <p>"I want the patients to feel happy," Asiya says. "I don't want them to feel like a patient. I want them to feel human and to feel they are home when they are in their room. And I want them to know that they're not alone, that I am here for them."</p> <p>She now asks patients the question that her care team in San Diego asked her: "What can I do for you?"</p> <h2>Honoring a new friend</h2> <p>For Larry, the answer to that question was often to share a conversation.</p> <p>"I've traveled and worked internationally, and I'm very interested in other cultures," Larry says. "I like to learn. I asked lots of questions about Asiya and her family, and she asked me about mine."</p> <p>The two also shared a sense of humor.</p> <p>"I joked around with her, and she gave it right back," Larry says. "She is a charming, charming individual. She impressed me. She made me happy."</p> <p>When it came time to name that new filly, Larry wanted to choose a name connected to his stay in Rochester.</p> <p>"I try to make the names of my animals meaningful," he says. "I have a line of horses all named after Nat King Cole songs and a line of blues — Blue Moon, Blue Jay, Forever in Blue Jeans."</p> <p>He didn't have to think long about the right name for the "extremely exceptional filly" he believes may one day grace the cover of a magazine.</p> <p>"I wanted to honor Asiya," Larry says. "She is a phenomenal person and pretty special to me. Now, when people ask me about the horse's name, I'll be able to tell them Asiya's story."</p> <p>"It's mind-blowing that Larry did that for me," Asiya says. "I'm very grateful and happy that he thought of me. "</p> <p>Asiya is also grateful to be at Mayo Clinic.</p> <p>"I could not do my job and do my best work without the support of my colleagues," she says. "I am grateful to them every day."</p> <p>Asiya is once again ready for a challenge. She's begun working toward her nursing degree, which will give her new opportunities to care for patients.</p> <p>And while she still believes she would have enjoyed teaching, her name suggests she's living her destiny.</p> <p>The meaning of Asiya? "One who tends to the weak and comforts them."</p> <em>This article was originally published on the Mayo Clinic </em><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://intheloop.mayoclinic.org/" target="_blank" title="Opens in a new window."><em>In the Loop</em></a><em> blog.</em><img src="/-/media/national-files/images/hometown-health/2023/asiya-jerome.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D665D0B6C8A4F81F208E080982DC60AA" alt="Asiya Awad and Larry Jerome" width="660" height="370" DisableNVelocity="true" />Dawn Haller2/5/2026After a family vacation, Izzy Iverson started having significant pain. Her family soon learned she would need surgery to remove a rare tumor in her chest called a teratoma.Unexpected vacation ending leads to rare tumor discovery<p>Kelly and Jered Iverson of Grand Meadow, Minnesota, had planned a perfect Hawaiian vacation for themselves and their daughters, Isabelle (Izzy) and Emmy. They enjoyed seven days on Maui, where they went whale watching, attended a luau, drove the Road to Hana and spent hours on the beach.</p> <p>"Izzy is a great traveler," says Jered of his 11-year-old daughter, who was born with a developmental delay. "She likes to see all the sights and loves the beach."</p> <p>Blood tests showed her white blood count was elevated, so there was concern the pain was caused by appendicitis.</p> <p>Izzy underwent a CT scan of her abdomen, which ruled out appendicitis but revealed a shocking surprise. She had a significant mass near her left lung. Its presence was staggering, but so was its composition. While additional tests would be necessary, the care team believed the mass was a teratoma.</p> <p>Teratomas are rare, germ-cell tumors that are usually benign and form during gestation. They’re made up of tissue from all different parts of the body. A classic teratoma will contain hair, skin, bone, and muscle and organ tissues.</p> <p>Izzy needed surgical evaluation, so she was transferred to <a rel="noopener" href="https://www.mayoclinic.org/patient-visitor-guide/minnesota" target="_blank" title="Opens in a new window.">Mayo Clinic in Rochester</a>.</p> <h2>Transfer to Mayo Clinic</h2> <p>While shaken, Jered and Kelly tried to remain optimistic for their daughter.</p> <p>"We tried, but we were puddles — just a mess," says Kelly. "You want to remain strong for your children, but I remember sobbing in the hall."</p> <p>Kelly's parents met them in Cannon Falls to provide comfort and support. They also took Emmy home so Jered and Kelly could focus on Izzy. She was transported to <a rel="noopener" href="https://www.mayoclinic.org/patient-visitor-guide/minnesota/campus-buildings-maps/mayo-clinic-hospital-saint-marys-campus" target="_blank" title="Opens in a new window.">St. Marys Hospital</a> by ambulance. Kelly rode along and Jered followed behind in the family's car.</p> <p>The following day, Izzy had additional tests and another CT scan to confirm the location of the mass. She would need surgery the next day to remove it. Only after it was removed and examined under a microscope would her care team know 100% if it was benign or cancerous.</p> <p><img height="330" alt="Izzy and Dr Ishitani" width="330" src="/-/media/national-files/images/hometown-health/2023/izzy-and-dr-ishitani.jpg?sc_lang=en&hash=49B2FEF236FE93B699771E7404A38968" /></p> <h2>Surgery</h2> <p>Child life specialists kept Izzy busy with painting and other activities that afternoon and evening. The following day, Izzy was wheeled into an operating room. The surgeon performed the three-hour surgery to remove the fist-sized mass, which occupied about one-third of her chest. He confirmed it was a teratoma due to its composition.</p> <p>Teratomas in the chest are exceedingly rare. Most of the time, they develop in the ovaries, testes or tailbone. In Izzy’s case, the teratoma was slightly attached to the pericardium sack in the middle of the chest, but most of it was sitting right in the center of the chest and pushing the lungs to the side. It was in the thoracic cavity adjacent to the lungs but not invading the lungs.</p> <p>Kelly and Jered got to see a photo of the teratoma after surgery, and the family nicknamed it "Izzy's Demogorgon" after a creature on the TV show "Stranger Things." Izzy remained in the hospital for two days after surgery. During this time, a pediatric ICU nurse, Marlee, made a lasting impression on Izzy.</p> <p><img alt="Izzy in hospital" style="height:330px; width:330px;" src="/-/media/national-files/images/hometown-health/2023/izzy-in-hospital.jpg?sc_lang=en&hash=DDFA986BF6868C4DAFC6EDBC892259CB" /></p> <p>"All of the staff was phenomenal. They came down to her level and made sure she was comfortable," says Kelly. "Now Izzy plays with this little doctor kit after school every day. She pretends to be Marlee and takes care of patients."</p> <p>A few days after surgery, the pathology reports showed that Izzy's teratoma was benign and no additional care would be necessary. The family got more good news when they were told it shouldn't cause any lasting effects on Izzy's health or her lung capacity going into the future.</p> <p>And recover she did. Izzy returned to school about a week after her surgery.</p> <p>"We are just overwhelmed with the staff and how they treated her, but also how they treated us. We were really scared at first, but they had so much compassion," says Kelly. "I was just so impressed with how the teams work together. It was a really easy transition from Cannon Falls to Rochester. Everybody knew what was going on when they came into the room. They were all so great with her and us."</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2023/izzy-iverson.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A86F83536697E24C91C938B4BF582EF9" alt="Izzy Iverson" width="660" height="370" DisableNVelocity="true" />Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.SurgeryHaving surgery is a major event in your life. We know this and make every effort to keep you as comfortable as possible, focusing on you as an individual. Our surgeons and staff work as a coordinated team treating a wide variety of illnesses ranging from simple to complex. We offer comprehensive, advanced care and service to every patient.Dawn Haller5/12/2023After discovering an odd lump on his arm, Jerry Haines was diagnosed with non-Hodgkin's lymphoma. Now he's cancer-free thanks to the work of his hometown team.Team approach helps farmer beat lymphoma<p>Shortly before Thanksgiving 2021, Jerry Haines, a part-time farmer and retired butter and cheesemaker, was helping another farmer with fall chores. He felt good but noticed an odd lump on his upper arm.</p> <p>"It wasn't too big — only about the size of a hickory nut. I thought that something bit me," says the 81-year-old Arcadia, Wisconsin, resident. "Over the next few days, it got bigger. Then I found a lump in my armpit too."</p> <h2>Getting a diagnosis</h2> <p>Jerry talked with his wife, Sherry Haines, and they decided to get the lumps examined. Jerry scheduled an appointment with his primary care provider, <a href="/providers/paul-winey-pac" target="_self" title="Opens in same window.">Paul Winey</a>, a physician assistant at <a href="/locations/arcadia" target="_self" title="Opens in same window.">Mayo Clinic Health System in Arcadia</a>.</p> <p>"Jerry has always been mindful of his health, and his wife makes sure he doesn't dismiss anything," says Paul. "Given the location and characteristics of his lesions, an ultrasound was ordered as it is available quickly and conveniently at the Arcadia clinic."</p> <p>Winey reviewed the scanned images with his <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> colleagues, <a href="/providers/jodi-breska-md" target="_self" title="Opens in same window.">Jodi Breska, M.D.</a>, and <a href="/providers/timothy-cox-md" target="_self" title="Opens in same window.">Timothy Cox, M.D.</a> The evening before Thanksgiving, Dr. Breska called the couple to explain that the team was concerned and recommended a CT scan of Jerry's chest and arm.</p> <p>Soon after, Jerry and Sherry made the 44-mile trip to <a href="/locations/la-crosse" target="_self" title="Opens in same window.">Mayo Clinic Health System in La Crosse</a> for the scan. Oncologist <a href="/providers/jonathan-ticku-md" target="_self" title="Opens in same window.">Jonathan Ticku, M.D.</a>, reviewed the results and explained to the couple that Jerry would need a biopsy and a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/pet-scan/about/pac-20385078" target="_blank" title="Opens in a new window.">PET scan</a> to confirm a diagnosis.</p> <p>With the results in hand, Dr. Ticku confirmed that Jerry had diffuse large B-cell lymphoma, a type of <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/non-hodgkins-lymphoma/symptoms-causes/syc-20375680" target="_blank" title="Opens in a new window.">non-Hodgkin's lymphoma</a>. This type of cancer begins in the lymphatic system when the body produces too many abnormal white blood cells, which can form tumors throughout the body.</p> <h2>Team approach to cancer care</h2> <p>Treating cancer is a team approach at Mayo Clinic Health System, explains oncologist <a href="/providers/scott-okuno-md" target="_self" title="Opens in same window.">Scott Okuno, M.D.</a> The <a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">Oncology</a> team collaborates with a multidisciplinary group, including Pathology, Surgery, Radiology, nursing, Pharmacy, Social Work, financial counselors, schedulers and primary care providers, to determine the best treatment approach for each patient.</p> <p>"Each team has daily huddles to review the patients we will see and go over each other's plans. We provide additional experience and expertise to each patient's case. Each patient is essentially getting multiple second opinions during the treatment journey," says Dr. Okuno.</p> <p>In Jerry's case, the team recommended six cycles of chemotherapy followed by radiation.</p> <h2>Managing health conditions during treatment</h2> <p>In January 2022, Jerry began chemotherapy and all went well. Except Sherry was concerned about one medication — a steroid.</p> <p>"He had been given a high dose of prednisone before chemo. I was surprised because it seemed so high," says Sherry, a retired nurse of 52 years. "But they explained that it would help him tolerate the chemo, and then I felt fine. I asked a lot of questions, and we always had someone to go to and never waited for answers."</p> <p>Sherry was right to ask, as Jerry has <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193" target="_blank" title="Opens in a new window.">Type 2 diabetes</a>, and prednisone can increase blood sugar levels. While Jerry completed chemotherapy treatments, she monitored his blood sugar and used the <a href="/patient-online-services" target="_self" title="Opens in same window.">Mayo Clinic patient portal</a> to communicate the results with Paul.</p> <p>"As was expected, his blood sugars did fluctuate quite a bit," says Paul. "He was reluctant to use insulin to manage his blood sugars. Through extensive use of our patient portal, his wife was able to provide me with frequent updates on his sugar levels. This allowed us to adjust his oral medications almost daily to keep his sugars within range."</p> <h2>Treated like family</h2> <p>The couple says they have always felt close to their hometown health care team in Arcadia, but their experiences extended that to encompass their new team in La Crosse.</p> <p>"It's like we became one big happy family. Everyone treated him like he was the most important person. It made the long days go by faster," says Sherry.</p> <p>In celebration of Jerry's birthday, the couple delivered treats and hosted a chemo birthday party in the Oncology unit during his third round of chemotherapy. And the good news continued.</p> <p>Dr. Okuno explained that Jerry's cancer was responding so well to treatment that he would only need four rounds of chemotherapy instead of the expected six.</p> <h2>Driving away cancer-free</h2> <p>After 15 radiation treatments and 44 round trips to La Crosse, Jerry was declared cancer-free in April 2022. He decided to do something big to celebrate. On the way home from his last appointment, he stopped at a Ford dealership and bought a new pickup truck.</p> <p>Jerry now is in a cancer surveillance program for the next five years, which includes a physical examination and blood tests every three to six months. He also will have CT scans at regular intervals. Coordinating this care is <a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">Oncology</a> physician assistant <a href="/providers/allison-humes-pac" target="_self" title="Opens in same window.">Allison Humes</a>, who has built a rapport with the couple.</p> <p>"She's something else. We joke together," says Jerry.</p> <p>Sherry has been impressed with Allison's thoroughness and reassuring nature.</p> <p>"She doesn't let him leave until she's fully examined him and answered every question," Sherry says.</p> <p>Allison explains that connections like this help to personalize health care for patients and the care team.</p> <p>"We all have unique life experiences, but there are always pieces of our story that connect with other people's experiences," she says. "My goal is for patients to know that they are being heard during each of our visits."</p> <h2>Hometown care continues</h2> <p><strong> </strong></p> <p>Today, Jerry remains cancer-free and is feeling well.</p> <p>"I'm still kicking but not as high. Chemo did slow me down a lot, but I'm one of the lucky people," he says.</p> <p>He and Sherry are spending time with their 13 grandchildren and 13 great-grandchildren and feeling appreciation for the care they received in their hometown and down the road in La Crosse.</p> <p>"We live in a rural area and only have a clinic in town. Some might say 'it's just a clinic,'" says Sherry. "We are lucky we have the clinic. We had no delays from Day One until where we are today. Everyone has looked out for Jerry."</p> <p>The admiration is mutual, and the care team praises the couple for having a positive attitude.</p> <p>"Jerry has been an exceptional patient," says Allison. "He has maintained an inspiringly positive attitude throughout his cancer journey despite undergoing intensive chemotherapy."</p> <p>Paul stresses that teamwork begins with the couple.</p> <p>"I have known Jerry since 2006, and he's an 'OK' patient. He begrudgingly listens and follows instructions. However, his wife ensured he was a 'great' patient and provided a balanced optimism in a rough situation. While there were ups and downs, both remained positive," says Paul. "His experience is evidence of the team approach culture at Mayo Clinic Health System. Multiple teams and departments came together for a positive outcome. Central to this was a man and his wife believing in us and trusting us with his care. That is the true reward."</p><img src="/-/media/national-files/images/hometown-health/2023/jerry-haines.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0E434B9B19AD23B8751AE90A511C7FDB" alt="Jerry Haines" width="660" height="370" DisableNVelocity="true" />CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller5/1/2025Charlie Pierce was ready to make a career change, but hearing loss was an obstacle to being accepted for the new position. Learn how his Audiology team gave him a fresh start with a small pair of hearing aids.The sound of success: How improved hearing aids career change<p>When does a trickle sound like a waterfall? After you get hearing aids, according to Charlie Pierce.</p> <p>"I spent so many years not hearing the things that I can hear now. I can hear the smallest noise in the next room," he says. "It's incredible."</p> <p>Charlie's improved hearing has done more than amplify the sounds he hears ― it helped the 55-year-old start a new career.</p> <h2>Construction work and overcoming addiction</h2> <p>For over 40 years, Charlie worked in construction. But his career was beginning to take a toll on his body, and he felt drawn to a different path — working with the Transportation Security Administration (TSA).</p> <p>"I started the application process to work for the TSA, but I talked myself out of it," Charlie recalls, feeling that the timing wasn't right.</p> <p>Charlie continued his job as a construction superintendent in Tennessee. He also overcame a 38-year addiction to drugs and alcohol, thanks to attending two addiction recovery programs in 2019. He and wife, Amy Pierce, were married the following year.</p> <img height="325" alt="Pierces" width="325" src="/-/media/national-files/images/hometown-health/2023/pierces.jpg?sc_lang=en&hash=33CEFD47C5F6B1C0613FD3AD1B91AA79" />" <p>Amy and I agreed that we wouldn't make any other major life changes until I was a year sober," he says.</p> <h2>Making a change</h2> <p>In September 2022, the Pierces decided to relocate to Faribault, Minnesota, to be closer to family. When Charlie saw an advertisement for TSA positions at the Minneapolis-St. Paul International Airport, he knew just what to do.</p> <p>"It seemed like a God moment that I was seeing it again, so I applied," he says.</p> <p>During the application screening and medical exam process, Charlie learned that years of construction and power tools had taken more than just a toll on his muscles and joints. He had hearing loss that could potentially exclude him from a TSA career.</p> <p>Time was of the essence for Charlie to address his hearing issue. He knew that his application would be denied for medical reasons if he failed the hearing test.</p> <p>"I knew I needed to see someone right away," he says. "I wasn't just going to give up at that point."</p> <h2>Audiology, hearing aids to the rescue</h2> <p>A week later, Charlie's hearing was evaluated by an audiologist at <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Mayo Clinic Health System in Albert Lea</a>, Minnesota.</p> <p>Charlie's hearing was thoroughly tested, which revealed that the damage was different in each ear. Typically, when hearing changes, it happens equally in both ears.  </p> <p>The audiology team recommended hearing aids to improve it. Hearing aids digitally process incoming sounds. They make soft sounds more audible while keeping a limit on the overall output so that the volume isn't too loud.  </p> <p>Charlie was fitted with hearing aids that have a small instrument behind the ear connected to a domed earpiece in each canal. This style is comfortable for people like Charlie who wear glasses. They're also well-suited for the field he wanted to enter, which requires him to hear as clearly as possible in difficult environments with a lot of background noise. Each hearing aid was programmed to best correct his hearing loss.</p> <p><img alt="Hearing aids" src="/-/media/national-files/images/hometown-health/2023/hearing-aids.jpg?h=225&w=325&sc_lang=en&hash=D4EA18D32A1402B35484D9481A7EA9D7" style="color: #131313; font-family: 'Open Sans', Arial, sans-serif; height: 225px; width: 325px;" /></p> <p>Some professions — including construction — increase the risk of hearing loss due to loud noises from equipment or instruments used. Other examples include mechanics, truck drivers, farmers, factory workers, surgeons and dentists. If your employer requires hearing protection on the job, use it.  </p> <p>Noisy hobbies, like woodworking, hunting and engine repairs, should also include hearing protection when sound levels are high.</p> <p style="margin-bottom: 12px;">Hearing loss has an additive effect over a lifetime so preserving hearing early makes a difference.  </p> <h3>Moving forward</h3> <p>Two weeks after his initial appointment, Charlie got his new hearing aids and received the necessary paperwork and testing so he would clear the employment medical evaluation. He was hired by the TSA and began training.</p> <p>Charlie says he is enjoying his new career at the airport and is grateful for the expertise of the Mayo Clinic Health System Audiology team.</p> <p>"They really went above and beyond to help make all this stuff come to fruition for me," he says. "They're masters of their craft and knew exactly what needed to be done."</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2023/charlie-pierce.jpg?h=370&iar=0&w=660&sc_lang=en&hash=233BFD08758600CD988F380F7A403B6A" alt="Charlie Pierce" width="660" height="370" DisableNVelocity="true" />Ear HealthAn audiologist specializes in evaluating and treating people of all ages with hearing loss, dizziness and balance disorders. Specialty audiology consultation is available for assessment and treatment of hearing loss, tinnitus, dizziness and balance disorders.Dawn Haller9/19/2023A slippery stone brought Tom's epic trek of the Appalachian Trail to a halt. Read how repair of his ruptured Achilles tendon and a total knee replacement got him back on the trail.Orthopedic expertise powers Tom Brown's epic trek<p>When people retire, they often plan to spend more time with their grandkids, or on activities like volunteering, gardening, traveling and hobbies. Christine Brown came up with something far more epic.</p> <p>After thinking about what she and her husband, Tom, enjoyed doing together, she proposed that they spend the next five years hiking the 2,190 miles of the Appalachian Trail (AT). Stretching from Springer Mountain, Georgia, to Katahdin, Maine, it's the longest hiking-only trail in the world.</p> <p>Tom's response was, "Absolutely!"</p> <h2>Retirement challenge: Tackling the Appalachian Trail</h2> <p>So in 2018, the La Crosse, Wisconsin, couple laced up their boots, hoisted their backpacks, grabbed their hiking sticks and headed north from the trail's southernmost point. Their five-year plan called for hiking the Appalachian Trail in 400- to 550-mile segments. That schedule meant 12 to 18 miles per day over rough terrain, up and down mountains through all kinds of weather, from sweltering heat to snow and sleet. According to the Browns, that breaks down to 30,000 to 40,000 steps a day.</p> <p>"It's a physical challenge, but it's also a mental challenge," says Tom. "Some days, you see quite a few hikers; on other days, you're completely alone. Some days, the hiking is challenging, and some days you're walking down a small town's Main Street. You meet people of all backgrounds and ages on the AT. The hikers become a community and are always willing to help each other."</p> <p>Even before the start of their epic trek, Tom, 63, had been experiencing pain in his right knee brought on by years of work at his excavating and snowplowing business. He'd undergone hyaluronate injections to relieve the pain and help the joint move more smoothly. Those treatments meant the pain wasn't enough to delay or trim back their plan.</p> <p>Then came May 2022.</p> <h2>A slippery stone leads to surgery</h2> <p>Christine, whose trail name is Beanbuster, and Tom, whose trail name is Traverse, were hiking the Appalachian Trail as it wove through the Green Mountains of Vermont. It was a drizzly day. They were climbing up a mountain, and the stones underfoot were slippery. A stone shifted, and Tom felt something stretch and pop: the Achilles tendon in his right leg.</p> <p>The couple worked their way to a hotel, began icing the tendon and contacted primary care provider in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, for advice on caring for the injury. The Browns decided to head home and a few days later, Tom's Achilles tendon ruptured. Repairing the tendon now took precedence over his aching, arthritic knee.</p> <p>To address this critical injury, which turned out to be particularly complicated, Tom reached out to <a href="/providers/charles-nolte-do" target="_self" title="Opens in same window.">Charles Nolte, D.O.</a>, his long-time <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedics specialist</a>, who practices at Mayo Clinic Health System in La Crosse and <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</p> <p>"This wasn't just an Achilles rupture," Dr. Nolte says. "Tom had a completely calcified tendon, probably due to an earlier injury. We had to perform a complex reconstruction of the tendon, which involved cutting out much of it, then reconnecting it."</p> <p>Dr. Nolte says they weren't sure if the tendon would heal, much less heal well enough for Tom to return to the trail. Dr. Nolte told Tom it would be a slow recovery. But Tom tackled his rehabilitation and recovery with the same can-do spirit as he tackled the trail with Christine.</p> <p>"At one point, there was no guarantee if the surgery would hold, if I'd have a drop foot or get my range of motion back," he says. "The physical therapists knew I wanted to be back on the AT by May 2023, so they set up a program that focused on strength, range of motion and stretching the tendon. They kept me on track and didn't let me get ahead of my healing."</p> <h2>Time to address chronic pain</h2> <p>After six months of recovery from the Achilles rupture, it was time to start phase two of Tom's plan to get back to the trail: a total replacement of his right knee.</p> <p>"Tom had dealt with his arthritic right knee for years and undergone nonoperative treatments to relieve the pain," says Dr. Nolte. "We planned to do a total knee replacement during his off-season from the trail, but then the Achilles rupture happened."</p> <p>In February, Dr. Nolte performed a robotic-assisted total knee replacement of Tom's right knee.</p> <p>"The robot takes a really good, successful procedure and makes it better," says Dr. Nolte. "The accuracy of cuts and component alignment are close to perfect, which reduces pain and speeds recovery."</p> <p>Dr. Nolte adds that after completing about 300 robotic-assisted total knee replacements, he's seen a considerable difference in the postoperative recovery phase, with patients getting back more quickly to what they love to do.</p> <p>Once again after surgery, Tom went into aggressive rehabilitation mode, following the plan of his <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapists</a>, and buying an exercise bike to continue building strength and range of motion at home. His goal was to be back on the Appalachian Trail by early May.</p> <p>"I want to thank Dr. Nolte and my physical therapists, <a href="/providers/katherine-crowley-dpt" target="_self" title="Opens in same window.">Katie [Crowley]</a> and <a href="/providers/roy-eggart-pta" target="_self" title="Opens in same window.">Roy [Eggart]</a> in Onalaska, for all they did to help me reach my goals," Tom says. "They were amazing."</p> <p>Dr. Nolte also credits Tom with doing the hard work to get better.</p> <p>"Tom's a highly motivated patient. He did physical therapy before and after both surgeries, and followed his recovery plans," says Dr. Nolte. "Christine is a real go-getter, and he wanted to make sure he could keep up with her."</p> <h2>Postcards to the hometown care team</h2> <p>On May 5, almost one year to the day since his Achilles injury and less than three months since his knee replacement, Tom and Christine were back hiking a grueling 400-mile segment of the Appalachian Trail, including summiting 6,288-foot-high Mount Washington in New Hampshire's White Mountains during a snow and sleet storm.</p> <p>"We had two weeks of nice weather," says Christine, "followed by five-and-a-half weeks of rain."</p> <img height="225" alt="Tom and Christine Brown" width="325" src="/-/media/national-files/images/hometown-health/2023/tom-and-christine-brown.jpg?sc_lang=en&hash=C8FF3F73C6AA554C0DD5D2DBBDB696D6" /> <p>Despite the weather and continual up-and-down mountain climbing, Christine noticed a difference in Tom.</p> <p>"He had been in pain for a long time with that knee. Pain is insidious, and affects you physically and mentally," she says. "It was great having my cheerful, good-humored husband back."</p> <p>Throughout their 2023 trek of the trail, Christine sent postcards to Dr. Nolte. He shared the cards with his team members, who took pride and satisfaction in Tom's accomplishments. While the scenes on the cards varied, the message was always the same: "Dear Dr. Frankenstein-Nolte. Your surgery was such a success that you've created a monster. My husband sees a mountain, wants to climb it and makes me go with him. I'm cold and tired. Make him stop. Christine."</p> <p>Christine will get her wish in June 2024 when she and Tom reach Katahdin, Maine, and officially complete the last 170-mile segment of their epic trek. To mark making it to the trail's end, they're planning to fly family members to Bar Harbor, Maine, for a grand finale celebration of their great adventure on the Appalachian Trail.</p><img src="/-/media/national-files/images/hometown-health/2023/tom-brown.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8C3FBC84D107A84394C45EF7CC8DBFC4" alt="Tom Brown" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Rehabilitation TherapyRestoring movement and function to people injured or impaired by disease or injury.Dawn Haller9/7/2023Breathing is an automatic function that most people don't think about until it becomes difficult. Read how the Mayo Clinic Store supports Marie's journey with COPD.Personalized care gives Marie Hammes oxygen and answers<p>Every day, people take more than 23,000 breaths that fill their lungs with 2,000 gallons of air. It's an automatic and essential function that most people don't think about — until that breathing becomes difficult.</p> <p>Marie Hammes knows this feeling well. The 70-year-old West Salem, Wisconsin, resident was diagnosed with chronic obstructive pulmonary disease, or COPD, in 1996. This chronic inflammatory lung disease causes obstructed airflow from the lungs. She handled her condition without extra oxygen until 2008, when <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/pneumonia/symptoms-causes/syc-20354204" target="_blank" title="Opens in a new window.">pneumonia</a> made breathing harder.</p> <p>For the next 10 years, Marie used a stationary oxygen concentrator overnight at home and portable oxygen tanks when away from home. In 2018, a health insurance plan change led her to seek a new oxygen supplier. That's when she met Jaclyn Dunnum, a respiratory therapist and <a href="/services-and-treatments/home-medical-equipment" target="_self" title="Opens in same window.">Mayo Clinic Store</a> assistant manager in <a href="/locations/la-crosse/services-and-treatments/home-medical-equipment" target="_self" title="Opens in same window.">La Crosse</a>.</p> <h2>Supporting patient needs</h2> <p>Mayo Clinic Store is a convenient supplier of durable medical equipment for patients recovering at home from an illness or accident or managing a chronic health condition like COPD.</p> <p>Jaclyn explains that getting necessary medical equipment can feel overwhelming and complicated. Usually, the need is triggered by a medical condition that can feel scary and affect daily activities.</p> <p>"Nobody wakes up in the morning and thinks, 'I am going to go get oxygen' or 'I want a bed and a walker,'" she says. "It is our job to make life easier by providing patients some normalcy in needing medical equipment."</p> <p>Mayo Clinic Store staff accomplish this by educating patients and their families about their options and helping them select the least intrusive, but most beneficial, equipment for daily living needs.</p> <h2>Helping Marie breathe easier</h2> <p>After discussing the options with Jaclyn, Marie decided to continue using a stationary concentrator at night and switched to a portable oxygen concentrator for times away from home. She was happy with how the portable concentrator made it easier to navigate when away from home.</p> <p>"A portable oxygen concentrator is a small device that she can carry in a shoulder bag or backpack that pulls atmospheric air into the unit and creates medical-grade oxygen," says Jaclyn. "This allows Marie to be safe outside her home and keep her blood oxygen levels at the appropriate level."</p> <p>Marie primarily uses supplemental oxygen while venturing outside and each night during sleep.</p> <p>"I would never be able to walk through an entire store without the portable. It has made my ability to move where I want to much easier," she says. "It keeps my brain working well too. The portable is so much nicer to take places because I used to run into everything with the tanks."</p> <h2>No unimportant questions</h2> <p>The support Marie feels extends beyond the equipment she has received. Over the years, she has learned that she can depend on Jaclyn to answer her questions quickly and compassionately, whether they are big or small.</p> <p>"I never feel like I ask a stupid question. She takes it in and answers it — no problem."</p> <p>That's an important part of the job says Jaclyn.</p> <p>"Durable medical equipment can be hard to navigate if you don't know the questions to ask or who to ask. I would not be doing my job as a healthcare worker if I did not make sure she was safe and getting what she needed to be safe in her home."</p> <p>Marie is grateful for this personalized attention.</p> <p>"They have been wonderful with me. Ask any question, and they are more than willing to try to answer it. It truly helps to know that I have them to rely on if or when needed."</p> <h2>Other equipment</h2> <h3>In addition to oxygen, Mayo Clinic Stores offer a wide variety of equipment to help patients live safely and fully at home, including:</h3> <ul> <li>Braces</li> <li>Breast pumps</li> <li>Compression garments</li> <li>Continuous positive airway pressure (CPAP) products</li> <li>Daily living aids</li> <li>Enteral nutrients</li> <li>Exercise aids and adaptive equipment</li> <li>Hospital beds</li> <li>Lifts and lift chairs</li> <li>Mastectomy products</li> <li>Mobility aids, including canes, crutches and walkers</li> <li>Ostomy supplies</li> <li>Oxygen</li> <li>Personal care and convenience items</li> <li>Respiratory devices</li> <li>Urology supplies</li> <li>Wound care supplies</li> </ul> <p>Not all equipment and services are available at all Mayo Clinic Store locations. Check with your preferred location in advance.</p> <h2>Celebrating every milestone</h2> <p>There's little slowing down for Marie. Recently, she marked her 70th birthday with her typical month-long celebration.</p> <p>"I think every year is a milestone and worth a party," she laughs. "Age doesn't bother me, and having my oxygen helps me to celebrate."</p> <p>Her attitude inspires Jaclyn and the Mayo Clinic Store staff.</p> <p>"Marie is so fun to work with. She's a busy lady, and I'm glad the equipment keeps her that way," says Jaclyn. "She advocates for herself, and our team will always support whatever she needs."</p><img src="/-/media/national-files/images/hometown-health/2023/marie-hammes.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2B4CE9526C46C6513F9AB0CB37FDD583" alt="Marie Hammes" width="660" height="370" DisableNVelocity="true" />BreathingMost cases of shortness of breath are due to heart or lung conditions. Your heart and lungs are involved in transporting oxygen to your tissues and removing carbon dioxide, and problems with either of these processes affect your breathing.Dawn Haller10/9/2023An avid hunter, Gregory Jones, M.D., found traditional hearing protection unsatisfactory. Then his audiologist recommended next-generation devices. Learn about this option.Hunter gives next-generation hearing protection two thumbs up<p>As an <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">ear, nose and throat (ENT)</a> specialist, <a href="/providers/gregory-jones-md" target="_self" title="Opens in same window.">Gregory Jones, M.D.</a>, knows firsthand the importance of ear protection. As a lifelong hunter, he also knows the damage the sound of gunshots can have on hearing and that even one shot can cause permanent injury.</p> <p>But like many other hunters, Dr. Jones found foam earplugs and earmuffs uncomfortable and inconvenient.</p> <p>"Earplugs can be a real nuisance. I'd usually take them out every chance I got," says Dr. Jones, who practices at <a href="/locations/owatonna" target="_self" title="Opens in same window.">Mayo Clinic Health System in Owatonna</a>, Minnesota. "Some of my hunting partners tried noncustom-fitted earplugs that were impact-noise canceling, but they didn't like the inconsistent functioning of the earplugs and fussing with the hearing aid-type batteries."</p> <h2>Finding a solution</h2> <p>Aside from the discomfort and inconvenience, many hunters wearing traditional ear protection can't hear conversations, their dogs, the game or even the wind through grasses and trees. So Dr. Jones asked his colleague, audiologist <a href="/providers/katie-dease-aud" target="_self" title="Opens in same window.">Katie Dease</a>, if there were other options for protecting his hearing while hunting. Katie recommended next-generation electronic hearing protection devices.</p> <p>"These devices provide hearing protection without restricting the ability to hear environmental sounds," Katie says.</p> <p>The devices she recommended for Dr. Jones are custom-molded earplugs that include a microphone that allows the user to hear normally. But when a gun is fired, the microphone shuts off and the earplugs provide maximum sound protection.</p> <p>The devices don't require regular battery replacement. They're recharged in the same way you'd recharge a cellphone.</p> <p>Dr. Jones made sure he was fitted for and ordered his new hearing protection in time for the beginning of this fall's pheasant and quail hunting season.</p> <h2>Testing new devices in the field</h2> <p>On a recent pheasant-hunting trip to South Dakota, Dr. Jones was able to try out the new devices.</p> <p>"I put them in when we headed to the field and didn't take them out until we were done hunting," he says. "It makes a big difference when you can hear as you hunt. We're often hunting in cornfields and the stalks are higher than our heads, which limits our ability to see. That makes hearing even more important."</p> <p>Plus, his new hearing protection allowed him to talk with his hunting partners and the guides.</p> <p>Katie says the electronic hearing protection devices are available with custom and noncustom options, as well as three levels of technology and three price points.</p> <p>"Reach out to your local <a href="/services-and-treatments/audiology" target="_self" title="Opens in same window.">audiology expert</a> to ask about these new devices and if they may be the right choice for you," she says.</p> <p>After hunting with his new hearing protection devices, Dr. Jones says, "They're very good and very reliable.</p> <p>"Bottom line, they're worth every penny. And if you can afford to hunt, you can afford this protection for your hearing."</p><img src="/-/media/national-files/images/hometown-health/2023/gregory-jones-md.jpg?h=370&iar=0&w=660&sc_lang=en&hash=16FD0A8BBE6AC610AED7393603D90BB7" alt="Gregory Jones, M.D." width="660" height="370" DisableNVelocity="true" />Ear HealthAn audiologist specializes in evaluating and treating people of all ages with hearing loss, dizziness and balance disorders. Specialty audiology consultation is available for assessment and treatment of hearing loss, tinnitus, dizziness and balance disorders.Ear, Nose and Throat (ENT)Get information about symptoms, disorders and diseases affecting the ear, nose and throat, and related head and neck structures.Dawn Haller10/24/2023An unexpected cardiac diagnosis led Steve Bernstein, M.D., to research minimally invasive surgery for aortic valve replacement. He found an expert team in Eau Claire.Remarkable recovery after minimally invasive heart surgery<p>In Steve Bernstein, M.D.'s neighborhood, Halloween is a fun time for children and families. Dressed in their costumes, they visit neighbors' homes; the chorus of "Trick or Treat" rings out as goodies are dropped in their bags.</p> <p>Halloween 2022 was particularly remarkable for Dr. Bernstein, however. He'd undergone a minimally invasive aortic valve replacement surgery just four days earlier but now felt well enough to join the trick-or-treaters.</p> <p>Dr. Bernstein's path to this remarkable recovery started many years earlier.</p> <h2>An unlikely diagnosis</h2> <p>The 65-year-old is a urologist in Minneapolis, seeing patients with prostate, bladder or kidney conditions. Dr. Bernstein also has a passion for action, from sailboat racing to vigorous bicycling, which at times has led to an injury.</p> <p>During an emergency department visit in 2015 for a broken foot, he was diagnosed with a heart murmur. Dr. Berstein was surprised. With no heart murmur symptoms, like shortness of breath, chest pain or dizziness, he had been unaware of the condition affecting his heart. The emergency department team recommended a follow-up appointment with a cardiologist. </p> <p>The exam and testing by a cardiologist determined that Dr. Bernstein had aortic regurgitation and <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/left-ventricular-hypertrophy/diagnosis-treatment/drc-20374319" target="_blank" title="Opens in a new window.">left ventricular hypertrophy</a>. Aortic valve regurgitation causes the valve between the lower left chamber and the body's main artery to not close tightly. As a result, blood can lead backward out of the left ventricle, the heart's main pumping chamber.</p> <p>Left ventricular hypertrophy develops gradually, and some people, like Dr. Bernstein, don't have symptoms. Symptoms can develop, however, as the thickening in the heart walls makes it harder for the heart to pump blood to the body effectively.</p> <h2>A holding pattern</h2> <p>After the diagnosis of left ventricular hypertrophy, Dr. Bernstein continued with his medical practice and enthusiasm for sailing and biking. His cardiologist monitored his condition for the next seven years. </p> <p>During that time, he knew he eventually would need a procedure to address the aortic stenosis. When the valve narrows, the heart must work harder to pump blood into the aorta. </p> <p>In 2022, Dr. Bernstein and his cardiologist decided it was time to take action with an aortic valve replacement. </p> <h2>Researching the best treatment</h2> <p>During aortic valve replacement, a surgeon removes the damaged valve and replaces it with a mechanical valve, or one made from cow, pig or human heart tissue. The valve replacement may be done through traditional open-heart surgery, also called a midline sternotomy, which involves an incision in the middle of the chest and dividing the sternum or breastbone. A more minimally invasive method uses a smaller incision in the chest or a catheter inserted in the leg. </p> <p>Bernstein began extensive research on aortic valve replacement surgery and called on his colleagues for recommendations for a cardiovascular surgeon. </p> <p>"Anyone who has kidney or prostate surgery is going to have trepidation about it; there's no denying that," says Dr. Bernstein. "The trepidation before open-heart surgery is even greater, and I had some of that." </p> <p>His research led him to <a href="/providers/robert-wiechmann-md" target="_self" title="Opens in same window.">Robert Wiechmann, M.D.</a>, at Mayo Clinic Health System in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin. Dr. Wiechmann and the surgery team perform a minimally invasive procedure to insert a mechanical valve through a small incision in the right chest, providing the same result as traditional open-heart surgery. </p> <p>"It wasn't just that I got a thumbs up on Dr. Wiechmann, it was the credentials of the people who gave him a thumbs up," says Dr. Bernstein. "It's one thing to ask friends on Facebook, but when you talk to senior cardiac surgeons around the country, and they give a thumbs up — to me, that gives it a lot of clout." </p> <p>The reputation that Dr. Wiechmann and the Mayo Clinic Health System <a href="/locations/eau-claire/services-and-treatments/cardiac-surgery" target="_self" title="Opens in same window.">cardiac surgery</a> team have established around the country led Dr. Bernstein to determine he would have his surgery in Eau Claire. </p> <p>"I made the decision to drive a few hundred miles to get the best possible treatment for my particular condition. I left a big city — with a big academic, highly regarded medical center — to go to the relatively small city of Eau Claire because I thought it was that important of an investment to make," he says.</p> <h2>Care like clockwork</h2> <p>After deciding to have Dr. Wiechmann perform the aortic valve replacement, Dr. Bernstein was scheduled for a pre-op physical exam and bloodwork. </p> <p>"I drove to Eau Claire, and everything went like a Swiss watch. And that's very reassuring for someone who's going to have surgery," he says. "The trepidation balanced with my confidence in the surgeon, his team and the health system." </p> <p>Several weeks later, Dr. Bernstein returned to Eau Claire for the surgery.</p> <p>"The cardiothoracic surgery team at Mayo Clinic Health System is leading the field in bringing the latest advances in cardiac surgery to patients," says Dr. Wiechmann. "The team specializes in performing minimally invasive surgical procedures, which provide a quicker, less painful recovery to help people, like Dr. Bernstein, get back to doing the activities they enjoy sooner."</p> <h2>A remarkable recovery</h2> <p>Following the successful surgery, Dr. Bernstein was moved to the ICU.</p> <p>"The pain was well-controlled; it was uncomfortable, but not horrible. I was less uncomfortable than I expected," he says.</p> <p>Dr. Bernstein had been told to expect to be in the hospital for four to six days to regain strength and monitor his heart. By Sunday, just two days after surgery, he felt pretty good.</p> <p>On Monday morning, Dr. Wiechmann checked on his patient and, after the exam, didn't find a reason to keep him in the hospital any longer.</p> <p>"Dr. Bernstein's active lifestyle and good physical health before his surgery played a role in his rapid recovery in the hospital," says Dr. Wiechmann.</p> <p>Although his inpatient stay was short, Dr. Bernstein appreciated his interactions with the care team.</p> <p>"All of the touchpoints that I had when I was there were outstanding, from the nurses at the bedside managing all the tubes and fluids, the X-ray people who took my picture every morning, Dr. Wiechmann's nurse practitioner, physician assistant and the housekeeping and dietary people. All the people, without fail — everyone was professional and compassionate," says Dr. Bernstein.</p> <p>The at-home preparations done in advance for his recovery, including obtaining a shower chair, turned out to be unnecessary. Showering, dressing and moving around the house proved to be easier than he had expected.</p> <h2>Getting back on the bike</h2> <p>For the next two weeks, Dr. Bernstein stayed active by walking in the local mall. Three weeks after the surgery, he was anxious to get back on his exercise bike. </p> <p>Dr. Wiechmann agreed he could start slowly with a low-resistance, 20-minute ride. With no issues from the initial biking exercise, Dr. Bernstein continued to increase his activity level and duration. </p> <p>By Thanksgiving weekend, just four weeks after surgery, he was ready to ride his snow bike with studded tires outside in the crisp fall weather. </p> <p>Although Dr. Bernstein felt well enough to return to work after just six weeks, he took the recommended 12 weeks off. By then, he was back to 100% health with no deficiencies after the surgery and ready to rejoin his busy medical practice.</p> <p>While the routine post-op follow-up visit is typically done in person at the hospital, Dr. Bernstein was able to do his post-op appointment using telehealth with Dr. Wiechmann's nurse practitioner. </p> <p>"The incision is basically invisible. It looks like a plastic surgeon closed it," says Dr. Bernstein.</p> <h2>Going forward</h2> <p>Dr. Bernstein continued his heart care with his cardiologist after the surgery and recovery. A postoperative echocardiogram was performed to look at his heart and establish a new baseline. The echocardiogram showed a typical result for heart function.</p> <p>"So the beginning of hypertrophy of the left ventricle has resolved, as Dr. Wiechmann suspected it would, and my heart is normal after the aortic valve replacement," says Dr. Bernstein. </p> <p>"Treating complex cardiac conditions with a minimally invasive approach provides the best outcome possible for candidates of the surgery," explains Dr. Wiechmann. "The goal is to provide the highest-quality heart care for our patients."</p> <p>With his background in healthcare leadership, Dr. Bernstein is experienced in evaluating care to look for opportunities to increase efficiency, decrease cost or improve patient experience.</p> <p>"As I look back on my experience with heart surgery, I can't find anything to improve. I couldn't recommend Dr. Wiechmann and his team more strongly for patients with surgical heart valve disease."</p><img src="/-/media/national-files/images/hometown-health/2023/bernstein.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E953D64B03047746D34C5523D288724E" alt="Bernstein" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller10/4/2023A seemingly innocent fall led to a race against time, an emergency craniotomy and an incredible road to recovery for young Livia. Here's how the care team came together in her moment of need.Unforeseen danger of a child's fall: Livia's remarkable recovery<p>Livia Mayberry and her sister were playing basketball with their dad at a neighbor's house in August 2022 when then-4-year-old Livia took a hard fall and hit her head on the pavement.</p> <p>Her family wasn't too concerned because she seemed OK. She was talking, didn't lose consciousness and didn't have a bump. However, a short time later, she threw up.</p> <h2>Quick medical attention</h2> <p>Her parents decided to get her checked at the Emergency Department at <a href="/locations/mankato" target="_self" title="Opens in same window.">Mayo Clinic Health System in Mankato</a>, Minnesota, to be safe.</p> <p>"She seemed fine," says John Mayberry, Livia's dad, of their initial reaction to her fall. "Now, of course, we're so glad we brought her in."</p> <p>Manish Sharma, M.B.B.S., a neurosurgeon, commends the family for bringing Livia in for evaluation because it can be difficult for parents and family members to determine if a head injury is serious.</p> <p>"Many patients with head trauma will talk afterward and may seem OK," says Dr. Sharma. "Unfortunately, about 1% will die within 24 hours from their injuries. These unfortunate patients can develop internal bleeding deep in the skull that can increase in volume rapidly and compress the underlying brain tissue. That's why it's critical to get all head injuries checked  right away."</p> <p>Dr. Sharma says that all head injuries need careful monitoring, and emergency medical attention is necessary if the person also experiences a headache, vomiting, nausea, seizure or weakness.</p> <h2>Race against time</h2> <p>While in the Emergency Department, the family learned that Livia's bump on the head was more severe than they initially thought. A CT scan showed a fractured skull bone in her temple, which was causing blood to pool over her brain and compressing her brain in the process.</p> <p>Dr. Sharma immediately reviewed the images and discussed the need for a lifesaving operation with anesthesiologist <a href="/providers/david-stinson-md" target="_self" title="Opens in same window.">David Stinson, M.D.,</a> and emergency medicine physician <a href="/providers/jason-planas-md" target="_self" title="Opens in same window.">Jason Planas, M.D.</a></p> <p>"We were concerned by the size of the bleeding and the degree of brain compression. An emergency craniotomy would be needed to save life and function," says Dr. Sharma.</p> <p>A craniotomy is a surgery to open a section of the skull to relieve pressure, remove blood and, occasionally, repair part of the brain.</p> <p>Time was of the essence in Livia's case. Usually, neurosurgery procedures for pediatric patients are performed at Mayo Clinic in Rochester. However, Livia couldn't be safely transported there because Mayo Clinic Ambulance Service helicopters were grounded due to weather. Fortunately, specialists who could handle her case were on scene.</p> <p>"Our Emergency Department team had a bad feeling about her injuries and contacted us immediately, even before they knew the helicopters weren't flying," Dr. Sharma says.</p> <p>While some patients could be transported by ground in those situations, Livia needed to get to an operating room sooner. "She wouldn't survive an ambulance ride to Rochester," says Dr. Sharma. "Although we were in our civilian clothes, we decided to rush this child to the OR and operate immediately."</p> <p>Dr. Sharma performed a two-hour craniotomy surgery. He made a 6-inch incision along Livia's temple, drilling holes around the skull fracture to evacuate the blood and relieve pressure on the brain. The skull segment was replaced and secured with titanium plates.</p> <img height="225" alt="Livia Mayberry post-surgery" width="325" src="/-/media/national-files/images/hometown-health/2023/livia-mayberry-2.jpg?sc_lang=en&hash=E5B4DD65AAC8CD452B70BB3CE32B0F4B"> <p>Once that procedure was done, Livia was transferred on a ventilator in an induced coma to Radiology, where another CT scan confirmed that the bleeding on her brain had stopped, and her brain compression had been relieved. She was then transferred by ambulance to <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/patient-visitor-guide/minnesota/campus-buildings-maps/mayo-clinic-hospital-saint-marys-campus" target="_blank" title="Opens in a new window.">Mayo Clinic Hospital — Rochester, Saint Marys Campus.</a></p> <img height="225" alt="Livia Mayberry recovery" width="325" src="/-/media/national-files/images/hometown-health/2023/livia-mayberry-3.jpg?sc_lang=en&hash=6E36B65B480058E99232743694A92D61"> <p>After an overnight stay in the hospital, Livia was cleared to go home with her family the next day. Her brain was safe, and she didn't need any further surgery.</p> <h2>One year later</h2> <p>About 12 months after her accident, Livia and her dad visited the Mankato team that swung into action to help her. They said the operating team, nurses and Emergency Department staff did a great job.</p> <img height="325" alt="Livia Mayberry with craniotomy scar" width="325" src="/-/media/national-files/images/hometown-health/2023/livia-mayberry-4.jpg?sc_lang=en&hash=CE02865BED17C7061AA5849DF78C5D7B"> <p>John says Livia is doing well and has fully recovered from her fall. She recently started a second year of preschool and is learning to ride a bike. Her family says she has no lasting effects of her injury.</p> <p>"Right, pumpkin?" says John while holding Livia, who has grown back a full head of blond hair.</p> <p>"Right," Livia says.</p> <p>Her dad says Livia has been completely herself since the injury. She's full of energy and thriving. He and Livia's mother are grateful for the care she received.</p> <p>"Everyone was amazing," says John. "It was all a little bit of a blur, but everyone was so nice and took great care of her."</p><img src="/-/media/national-files/images/hometown-health/2023/livia-mayberry.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EECDDAB53D4641C4594A92E9883BDA93" alt="Livia Mayberry" width="660" height="370" DisableNVelocity="true" />Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.NeurosurgeryNeurosurgery treats disorders that impact any part of the nervous system, which may include the brain, spine or peripheral nerves. Conditions treated range from life-threatening brain tumors, to disorders impacting quality of life, such as back pain and carpel tunnel syndrome.Dawn Haller11/6/2023Patsy Weber was told she might spend the rest of her life in a care facility, unable to walk, speak or swallow. Read how she and her rehab team were determined to defy that prognosis.To sip a cola: Patsy Weber's goal for rehab from rare disease<p>Patsy Weber's condition had healthcare professionals at her local clinic and a regional medical center stumped. In June 2021, she went from being so healthy that she had only taken a handful of sick days during her 40 years working at a bank in Sheldon, Iowa, to not being able to get out of bed.</p> <p>For about two weeks, Patsy had been coping with mysterious symptoms that included morning headaches that would disappear by the time she arrived at work and exhaustion that had her dragging throughout the day.</p> <h2>A week of uncertainty</h2> <p>On a morning in early June 2021, she told her husband, Doug, she didn't think she could get up. But the couple managed to make it to the local clinic, where her symptoms perplexed the staff. Patsy went home, only to feel worse by morning. Back at the clinic, the staff checked her blood oxygen level, which had fallen to 68.</p> <p>Admitted to the hospital that day, Patsy's condition worsened. She was intubated and transported by helicopter to the medical center in Sioux Falls, South Dakota. The healthcare team suspected she might have <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/guillain-barre-syndrome/symptoms-causes/syc-20362793" target="_blank" title="Opens in a new window.">Guillain-Barre syndrome</a>, a rare disorder in which the body's immune system attacks the nerves. They removed a nerve sample from her ankle and a muscle sample from her arm and sent them for analysis to the medical center at the University of Iowa in Iowa City.</p> <p>At one point, the healthcare team thought she was improving enough to have her breathing tube removed; three hours later, it was reinserted. After nine days in the ICU in Sioux Falls, Patsy's team was considering moving her to a care center in Lincoln, Nebraska. That's when Patsy wrote Doug a note on her tablet: "I want to go to Mayo Clinic."</p> <h2>Seeking answers at Mayo Clinic</h2> <p>On July 2, 2021, Patsy was transported to Minnesota by plane and admitted to <a rel="noopener noreferrer" href="https://www.mayoclinic.org/" target="_blank" title="Opens in new window.">Mayo Clinic</a> in Rochester. Within a day, the eight specialists assigned to Patsy's care had identified her mysterious condition: nemaline myopathy. This genetic, neurological disease causes muscle weakness and reduces reflexes throughout the body, including those responsible for movement, breathing and swallowing. There is no cure; treatment includes exercise, therapy, and respiratory and feeding support.</p> <p>"This was only the 20th case my neurologist had seen at Mayo," Patsy says.</p> <p>One of the first steps in her care was to give her a tracheostomy to help with breathing. She also had a feeding tube inserted. Patsy was transported to Saint Marys Campus, Rochester, where she was put under the care of the pulmonologists in the respiratory care unit.</p> <p>Once she was able to get off the ventilator helping her breathe, <a rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/yin-linda-x-m-d/bio-20551079" target="_blank" title="Opens in a new window.">Linda Yin, M.D.</a>, an ear, nose and throat (ENT) specialist, tried to provide her with a speaking valve for her tracheostomy so she could communicate with those around her. When Patsy had a hard time forming a voice, a scope exam by Dr. Yin found that Patsy's vocal cords also were paralyzed. Dr. Yin and her colleague, <a rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/bayan-semirra-l-m-d/bio-20455756" target="_blank" title="Opens in a new window.">Semirra Bayan, M.D.</a>, treated the paralysis with Restylane injections to help with speaking and swallowing. Despite the treatment, Patsy still couldn't talk; that would be another step.</p> <p>Another thing that her healthcare team found: both of Patsy's eardrums were punctured, which was why she kept writing to Doug that she couldn't hear. The ENT team treated the injury so that she wouldn't develop an infection.</p> <p>Once she was more stable, Patsy was ready to enter a rehabilitation facility to help her try to regain the functions she had lost. The facility best suited to her needs was <a href="/services-and-treatments/transitional-care" target="_self" title="Opens in same window.">Mayo Post Acute Care</a> at <a href="/locations/osseo" target="_self" title="Opens in same window.">Mayo Clinic Health System in Osseo</a>, Wisconsin.</p> <p>But Patsy was still seriously ill. Her healthcare team in Rochester was frank with her: she might never eat, walk or talk on her own again. She also might spend the rest of her life in a care facility.</p> <p>Her sister, Missy Gruis, is a home healthcare nurse. When she visited Patsy and Doug in Rochester, she gave her sister a piece of advice that Patsy took to heart: "Do whatever they tell you. If you don't, you'll never go home."</p> <h2>Regaining her life in Osseo</h2> <p>"Osseo was the best option because I needed to be on a respirator," Patsy says. "I wasn't happy about it because it was so far away from my home and family. But it's the best thing that ever happened to me."</p> <p>When she arrived in Osseo, Patsy was transferred to the care of <a href="/services-and-treatments/pulmonology" target="_self" title="Opens in same window.">pulmonologist</a> Mark Lindsay, M.D. That's also where Patsy and Doug met her "super support team." Over the next two months, <a href="/services-and-treatments/respiratory-therapy" target="_self" title="Opens in same window.">respiratory therapists</a> David Beck-Leisz and Jesse Myers; <a href="/services-and-treatments/speech-language-therapy" target="_self" title="Opens in same window.">speech therapists</a> <a href="/providers/amy-hilbert-cccslp" target="_self" title="Opens in same window.">Amy Hilbert</a> and <a href="/providers/briana-kenyon-cccslp" target="_self" title="Opens in same window.">Briana Kenyon</a>; and the nurses and staff would help her gain strength, wean off the respirator and relearn how to speak and swallow.</p> <p>At first, Patsy was on a ventilator 24/7. The goal was to wean her off it for at least part of the day. Because her disease affects the strength of the muscles that help her breathe, she wasn't getting enough oxygen at night and carbon dioxide would build up in her body. That's what had been causing the morning headaches that led to her diagnosis.</p> <p>Patsy's respiratory and <a href="/services-and-treatments/physical-therapy" target="_self" title="Opens in same window.">physical therapists</a> worked to strengthen her chest muscles. Once she had more strength, she only needed the ventilator at night to ensure she was taking deep breaths while asleep.</p> <img alt="Patsy Weber in Transitional Care" style="height:400px; width:325px;" src="/-/media/national-files/images/hometown-health/2023/patsy-weber-transitional-care.jpg?sc_lang=en&hash=F128B29C577DBB085A6A7E7D8C20CE6B" /> <p>The tracheostomy is permanent because the muscles around her trachea and throat also are weak. But with the speaking valve, she can talk. That's where the speech therapists came in, training her how to use it so she can carry on a conversation.</p> <p>"We trained every day in Osseo," Doug says. "Eventually, the team had me doing everything — managing the ventilator and even the feeding tube — so I could handle it when we got home."</p> <p>One of Patsy's biggest milestones was relearning how to swallow — and passing a swallow test.</p> <p>She traveled to Eau Claire, Wisconsin, with Jesse and Doug for the test. "I hadn't even had an ice chip in my mouth for two months. I was terrified," Patsy says. "But Jesse told me he wouldn't let me choke and was right there if I needed suctioning.</p> <p>"That's what I needed to hear — and I passed," she says. When asked what she wanted to eat or drink with her newfound ability, there was no question: an ice-cold cola.</p> <p>Noting how happy it made her, Jesse called ahead to the rehabilitation center and asked them to stock some of her preferred brand, and it was waiting for her when she returned. One of her other therapists knew she liked iced coffee and would bring her one when she came to work.</p> <p>"I can't say enough about the care I received from the therapists and Dr. Lindsay. Some of the nurses would take their breaks and come sit with me," Patsy says. "It's like I have a whole new family."</p> <p>That caring support extended to helping Patsy through the death of her mother, which happened two weeks before Patsy was discharged. They arranged for her to watch the service online and comforted her in her loss. "A day doesn't go by that we don't think of them," Patsy says.</p> <h2>Rehab rock stars</h2> <p>Throughout all her transfers across four states, Doug was with her. He had retired in January 2021, and once she fell ill, he stayed by her side. Since Osseo was a nearly six-hour drive from their home, he settled into a nearby motel with the help of Mayo Clinic Health System staff.</p> <p>"Patsy and Doug are rock stars," says Dr. Lindsay. "Osseo was the perfect fit for her, and she really knocked her recovery out of the park. She was very determined, but she was also very fortunate to have such a good partner in Doug."</p> <p>Not many patients can go home on a ventilator, but because of Doug, Patsy could since she has the support she needs.</p> <p>Dr. Lindsay also commends <a href="/services-and-treatments/hospital-medicine" target="_self" title="Opens in same window.">hospitalist</a> <a href="/providers/olawale-onibile-md" target="_self" title="Opens in same window.">Olawale Onibile, M.D.,</a> and the entire rehabilitation team in Osseo for how well they meet the needs of their patients.</p> <p>"The strength of our program is our transitional care team," he says. "Our experienced nursing and therapy teams know how to care for patients with complex needs. Their communication, collaboration and attention to patient safety create a healing environment so patients can reach their highest level of independence. It also helped lower Patsy's stress and ensured that she and Doug felt confident to manage her care at home."</p> <h2>Learning more about a rare disease</h2> <p>Throughout her journey, Patsy and Doug learned more about nemaline myopathy, including that the muscle weakness it causes may have been a factor in the scoliosis she had dealt with all her life. The nerve and muscle samples tested in Iowa City revealed that she was born with the disorder and that one of her parents had carried the gene. Although the Webers don't have children, Patsy has alerted her siblings and their children about the need for them to consider genetic testing.</p> <p>"Every test will lead to more knowledge about this disease," she says.</p> <p>Two years after her health crisis, Patsy says, "They gave me my life back. I don't breathe like I did before, but I can live like this. I can go out with friends, have coffee, garden and enjoy my hobbies.</p> <p>"Mayo Clinic and the rehabilitation center were a major part of my life. Of course it was scary, but they treated me like a whole person, watching out not just for my physical issues but also for my mental well-being. Their care doesn't compare to anything else."</p><img src="/-/media/national-files/images/hometown-health/2023/patsy-weber.jpg?h=370&iar=0&w=660&sc_lang=en&hash=ACB18F1F5E2CF790FF45746092102D7E" alt="Patsy Weber" width="660" height="370" DisableNVelocity="true" />Rehabilitation TherapyRestoring movement and function to people injured or impaired by disease or injury.Speech-LanguageThe evaluation and treatment of communication disorders and swallowing disorders.Respiratory CareRespiratory care helps people with serious health problems associated with their lungs and ability to breathe. The Respiratory Care team is always ready to respond to a variety of emergency situations, such as an asthma attack. Additional services may include pulmonary rehabilitation and educational programs.Dawn Haller3/29/2024Carole Reisinger tells people not to put off colonoscopy screening and to pay attention to symptoms. After being diagnosed with two types of cancer, she knows the importance of cancer screenings.A tale of cancer worth hearing<p>Telling a tale sometimes is used as an expression to spread rumors or lies. Unfortunately for Carole Reisinger, her body told a true tale that most people wouldn't want to hear. </p> <p>"It started last February when I was diagnosed with <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/kidney-cancer/symptoms-causes/syc-20352664" target="_blank" title="Opens in a new window.">kidney cancer</a>. Thanks to the medical staff at Mayo Clinic in Rochester, five days later, I had a 9-by-5-centimeter tumor removed," says Carole.</p> <p>But it was during that surgery that a second story began to unfold.</p> <p>"In the process of that surgery, the surgeons noticed my colon was inflamed and had a thickening of the wall. After speaking with the physicians a few days later, they proposed that I should get a colonoscopy," says the Warrens, Wisconsin, native.</p> <p>After recovering, she took her physicians' words to heart and had a colonoscopy. It's something she says she should have done sooner.</p> <p>In April 2023, she was diagnosed with <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/rectal-cancer/symptoms-causes/syc-20352884" target="_blank" title="Opens in a new window.">rectal cancer</a>.</p> <p>"I had been having some signs of something wrong. My stomach had been crampy, and I did have blood in my stool at times," Carole says.</p> <p>Carole's symptoms fit the common <a rel="noopener noreferrer" href="https://www.mayoclinic.org/symptoms/rectal-bleeding/basics/causes/sym-20050740" target="_blank" title="Opens in a new window.">signs and symptoms of rectal cancer</a>, including:</p> <ul> <li>Abdominal pain</li> <li>Change in bowel habits, such as diarrhea, constipation or more frequent bowel movements</li> <li>Dark maroon or bright red blood in stool</li> <li>Feeling that your bowel doesn't empty completely</li> <li>Narrow stool</li> <li>Unexplained weight loss</li> <li>Weakness or fatigue</li> </ul> <h2>Treating colorectal cancer</h2> <p>"Rectal cancer is a subset of colon cancer that is located at the final segment of your colon. Symptoms of bleeding and irregular bowel habits are common. Cancer inside the rectum (rectal cancer) and cancer inside the colon (colon cancer) are often referred to together as colorectal cancer," says <a href="/providers/andrew-morris-md" target="_self" title="Opens in same window.">Andrew Morris, M.D</a>., colorectal and rectal surgeon at <a href="/locations/la-crosse/services-and-treatments/colon-and-rectal-surgery" target="_self" title="Opens in same window.">Mayo Clinic Health System in La Crosse</a>.</p> <p>"Colon cancer begins when healthy cells develop changes, or mutations, in their DNA," he explains. "These cancers and their DNA changes, unfortunately, also can be hereditary."</p> <p>According to the <a rel="noopener noreferrer" href="https://www.cancer.org/cancer/types/colon-rectal-cancer.html" target="_blank" title="Opens in a new window.">American Cancer Society</a>, <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/colon-cancer/symptoms-causes/syc-20353669" target="_blank" title="Opens in a new window.">colorectal cancer</a> is the third-leading cause of cancer-related deaths in men and the fourth-leading cause in women. The lifetime risk of developing colorectal cancer is about 1 in 23 for men and 1 in 25 for women.</p> <p>At 64 years old, Carole now had to battle a second type of cancer in a matter of months. For the next six months, she would go through <a rel="noopener noreferrer" href="https://www.mayoclinic.org/tests-procedures/chemotherapy/about/pac-20385033" target="_blank" title="Opens in a new window.">chemotherapy</a> and then <a href="/locations/la-crosse/services-and-treatments/oncology/cancer-treatment-options" target="_blank" title="Opens in a new window.">radiation treatments</a> at Mayo Clinic Health System in La Crosse. In January of this year, Dr. Morris and the surgical team removed the cancer.</p> <p>"Advances in surgery have allowed colon and rectal cancers to be removed in a minimally invasive fashion, often using the da Vinci robotic surgical system. Mrs. Reisinger was able to have the cancer completely removed, including the lymph nodes, and her colon reattached. Her recovery was generally quick due to the minimal pain related to the small incisions," says Dr. Morris.</p> <h2>Risk factors for colorectal cancer</h2> <p>In some families, gene mutations passed from parents to children increase the risk of colorectal cancer. One in 3 people who develop colorectal cancer have other family members who have had it. Carole wasn't one of them.</p> <p>"I know of no family history of colon cancer," she says. "After I was diagnosed, we did genetic testing, and that also came up with nothing. I guess I'm one of the lucky ones."</p> <h3>Besides family history, other factors can lead to colon cancer:</h3> <ul> <li><strong>African American descent</strong><br /> People of African ancestry born in the U.S. have a greater risk of colorectal cancer than people of European ancestry.</li> <li><strong>Diabetes</strong><br /> People with poorly controlled <a href="/hometown-health/speaking-of-health/diabetes-what-you-need-to-know-and-do" target="_self" title="Opens in same window.">Type 2 diabetes</a> may have an increased risk of colorectal cancer.</li> <li><strong>Alcohol consumption</strong><br /> Regularly drinking more than three alcoholic beverages a week may increase your risk of colorectal cancer.</li> <li><strong>Diet low in vegetables</strong><br /> Colorectal cancer may be associated with a diet low in vegetables and high in red meat, particularly when the meat is charred or well-done.</li> <li><strong>Inflammatory bowel disease</strong><br /> <a href="/hometown-health/speaking-of-health/lifestyle-and-diet-in-inflammatory-bowel-disease" target="_self" title="Opens in same window.">Chronic inflammatory diseases</a> of the colon and rectum, such as ulcerative colitis and Crohn's disease, increase your risk of colorectal cancer.</li> <li><strong>Obesity</strong><br /> Obese people have an increased risk of colorectal cancer when compared with people considered to be at a healthy weight.</li> <li><strong>Older age</strong><br /> Colorectal cancer can be diagnosed at any age, but most people with this type of cancer are older than 50. The rates of colorectal cancer in people younger than 50 have been increasing, but doctors aren't sure why.</li> <li><strong>Smoking</strong><br /> People who smoke may have an increased risk of colorectal cancer.</li> <li><strong>Too little exercise</strong><br /> If you're inactive, you're more likely to develop colorectal cancer. Getting regular physical activity may reduce your risk of cancer.</li> </ul> <h2>Be proactive about cancer screening</h2> <p><a rel="noopener noreferrer" href="https://www.cancer.net/cancer-types/colorectal-cancer/statistics#:~:text=For%20rectal%20cancer%2C%20the%20overall,relative%20survival%20rate%20is%2074%25." target="_blank" title="Opens in a new window.">Recent research</a> shows that the overall five-year relative survival rate for people diagnosed with rectal cancer is 68%. If the cancer is diagnosed at a localized stage, the survival rate is 90%. If the cancer has spread to surrounding tissues, organs and the regional lymph nodes, the five-year relative survival rate is 74%.</p> <p>"The advances in chemotherapy, immunotherapy and surgical techniques are improving these survival rates in both rectal and colon cancer. Thankfully, the multiteam approach provided at Mayo for these cancers ensures that all treatment options and even study protocols are being used. Early detection is key, though, because it gives the best chances for a cure," says Dr. Morris.</p> <p>Carole's outlook is good. She can't thank the surgeons, physicians and medical staff at Mayo Clinic in Rochester and Mayo Clinic Health System in La Crosse enough for helping her through both medical situations.</p> <p>She points out that all women — and men — should take responsibility for their healthcare now and not wait until it's too late.</p> <p>"My advice is not to put off a colonoscopy," says Carole. "Start at the age of 45 and begin paying attention to your body. Pay attention to your own bowel movements. They're a tattletale on your health."</p><img src="/-/media/national-files/images/hometown-health/2024/carole-reisinger.jpg?h=370&iar=0&w=660&sc_lang=en&hash=764E8A1DC39D9344CD372027231CF4B5" alt="Carole Reisinger" width="660" height="370" DisableNVelocity="true" />Colorectal HealthGet screening and treatment for colorectal cancer symptoms, and learn about risk factors and prevention strategies.Dawn Haller5/8/2024While waiting for her husband at their clinic, Colleen Lundequam had no warning before she went into cardiac arrest. Quick action by the clinic's team made all the difference in her good-news recovery.Clinic staff's response gives waiting room crisis a happy ending<p>It's not unusual for Colleen Lundequam to accompany her husband to the Clairemont Campus clinic in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin, for his routine tests. Sometimes, she waits in the car. But on Oct. 18, 2023, she decided to sit in the waiting room. That decision ultimately saved her life.</p> <p>Karrie Brantner, a patient appointment services specialist, first knew there might be a problem in the Radiology, Diabetes Education and Occupational Medicine waiting room when she heard a person shout, "Ma'am, are you OK?" She looked out from her desk and saw a woman slumping in her chair. Karrie dashed out to check on her, and found the woman was unconscious and not breathing. Karrie told the lead scheduler, Derrick Samuelson, to call 911 and issue an emergency Code Blue.</p> <p>"There weren't a lot of staff around, so Derrick went to find a nurse while a diabetic educator and I lowered the woman to the floor. By then, she didn't have a pulse, so the educator started doing chest compressions," says Karrie, who stayed by Colleen's side.</p> <p>Melissa Berlin, nurse manager, was in a meeting nearby and rushed into the waiting room when she heard the commotion. She found a hectic scene, but one that revealed everyone doing what they'd been trained to do.</p> <h2>First-rate response</h2> <p>"The staff response was tremendous," says Melissa. "The clinic isn't like a hospital. We don't have an Emergency Department, and we're not equipped for a full-blown emergency like this. But we do have a defibrillator in the waiting room, and staff located other necessary equipment from around the clinic."</p> <p>With emergency care underway, Melissa assessed what else needed to be done, including directing patients in the waiting room to another area and holding up blankets to give the woman some privacy. They also had to figure out who she was since she hadn't checked in as a patient.</p> <p>They determined by process of elimination that she was Colleen Lundequam, 69, and her husband, John, was in an exam room.</p> <p>"I came into the waiting room and there was Colleen with a crowd of medical people around her," says John, 70. "It was very shocking, and I was worried she wouldn't make it."</p> <p>By the time EMTs arrived, Colleen had a weak pulse. They transported her to the <a href="/locations/eau-claire/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">Emergency Department</a> at the Luther Campus in Eau Claire. Once again, clinic staff stepped forward, calling the Lundequams' daughter on John's phone and driving him to the hospital.</p> <p>"I was in the middle of something at work, and my phone kept ringing, so I decided to pick up," says Lindsey Lundequam. "That's when I learned that Mom was in <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/sudden-cardiac-arrest/symptoms-causes/syc-20350634" target="_blank" title="Opens in a new window.">cardiac arrest</a> and being taken to the hospital.</p> <p>"Just the weekend before, we had a family visit. Mom was fine, and we had such a good time. She has health issues, but we never suspected she had an underlying heart condition."</p> <p>Even though Lindsey was driving from Chippewa Falls, about 20 minutes away, she beat the ambulance to the hospital and was able to connect with her dad there.</p> <h2>Expert help for an ailing heart</h2> <p>Hospital staff determined that Colleen had experienced a <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/heart-attack/symptoms-causes/syc-20373106" target="_blank" title="Opens in a new window.">heart attack</a>. They stabilized her in the Emergency Department and transferred her to the <a href="/locations/eau-claire/services-and-treatments/intensive-and-critical-care" target="_self" title="Opens in same window.">Critical Care Unit</a>.</p> <p>"Just when we thought she was stable on Wednesday, Mom had another heart attack on Saturday," says Lindsey.</p> <p>That second heart attack prompted doctors to insert two <a rel="noopener" href="https://www.mayoclinic.org/tests-procedures/coronary-angioplasty/about/pac-20384761" target="_blank" title="Opens in a new window.">stents</a> in Colleen's blocked arteries. She spent time on a ventilator and more than two weeks in the hospital before she was able to return home to Barron, Wisconsin.</p> <p>"I didn't know about any of this until I came around. I had no warning whatsoever in the waiting room. When I asked why I was in the hospital, I was told what had happened; it was scary. But they told me I was going to be OK, and I was happy to hear that," says Colleen.</p> <p>"I'm amazed they were able to do all the wonderful things they did to keep me alive and that I'm still alive."</p> <h2>Gratefully living a "new normal" life</h2> <p>Since that eventful October, Colleen has graduated from <a href="/services-and-treatments/cardiovascular-rehabilitation-and-services" target="_self" title="Opens in same window.">cardiac rehabilitation</a>. She can continue using the facility's exercise equipment, and now John has joined her in a regular workout schedule. As she settles into her "new normal" life, she's enjoying time with her grandchildren and great-grandchild and has welcomed a new rescue dog into their home.</p> <p>Lindsey is pleased that her mother has had support from <a href="https://www.mayoclinichealthsystem.org/providers?service=Cardiology" target="_self" title="Opens in same window.">cardiologists</a> and <a href="https://www.mayoclinichealthsystem.org/providers?service=Nutrition&populateTracking=True" target="_self" title="Opens in same window.">dietitians</a>, that they have adjusted Colleen's medications and her mother's buckling down to take better care of her heart health.</p> <p>"Mom and Dad are so appreciative of how everyone went into action to help her, and they both recognize that if something like this was going to happen, she was in the best place," says Lindsey.</p> <p>"You never think it's going to happen to you until it does. And we've asked ourselves 1,000 times, 'What if she'd stayed in the car?' There are no words to express the appreciation we have for the great team who has seen Mom all the way through cardiac rehab."</p> <p>Reflecting on the clinic team's efforts, Melissa, the nurse manager that day, says, "We're so glad Colleen has had a complete recovery. When the staff was called on to help that day, they knew just what to do. I don't think they recognize how fabulous their teamwork was."</p><img src="/-/media/national-files/images/hometown-health/2024/lundequams.jpg?h=370&iar=0&w=660&sc_lang=en&hash=26F30372D1CC41B9F05C6F3732A9186E" alt="Lundequams" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Dawn Haller6/28/2024Without changes in breast screening options, Melissa Neuman would have gone longer before a tumor was detected. Learn about those changes and the effects on her breast cancer journey.How a different mammogram experience led to lifesaving cancer diagnosis<p>Melissa Neuman dreaded getting mammograms. Her small, dense breasts made the screening exceptionally uncomfortable and painful. So Melissa put off getting an <a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">annual mammogram</a> until she felt she couldn't delay any longer.</p> <p>For about five years, Melissa had been plagued with a nagging pain just under her left breast. In February 2023, a recommendation from a friend led her to seek care from <a href="/providers/jessica-johnson-np" target="_self" title="Opens in same window.">Jessica Johnson</a>, an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> nurse practitioner with <a href="/locations/owatonna" target="_self" title="Opens in same window.">Mayo Clinic Health System in Owatonna</a>, Minnesota.</p> <p>"She took me seriously, was curious and determined to find out what was causing the pain," says Melissa, who lives in Owatonna and works as an activities assistant at a local assisted living and memory care facility.</p> <p>During their appointment, Jessica noticed that Melissa hadn't had a mammogram for several years. When Melissa explained why she was reluctant to be screened, Johnson suggested she have a breast MRI.</p> <p>"I'd still be getting screened, but with less pain," says Melissa. "So I said, 'Let's do it.'"</p> <p>The MRI revealed an area of concern. Jessica recommended that Melissa have a <a href="/hometown-health/speaking-of-health/preparing-for-your-breast-biopsy" target="_self" title="Opens in same window.">biopsy</a>, but it would require a mammogram first. That's when Melissa met Amanda Steinberg, a radiology technologist in Owatonna. She was just the person Melissa needed.</p> <h2>Overcoming mammogram fears, pain</h2> <p>"Mammograms aren't a favorite activity for women," says Amanda. "While it's a preventive screening, we have mammograms to make sure we don't have breast cancer. It's scary."</p> <p>At 35, Amanda had her own scare with a mammogram that showed an area of concern, so she understands her patients' fears and reluctance. She strives to set them at ease, explain simply and clearly what she's doing, take their mind off the compression and be as quick and effective as possible.</p> <p>That understanding and empathy resonated with Melissa. So did Amanda's technique. Amanda had learned that mammograms can be less painful if the patient doesn't reach forward to grip the handles on the machine.</p> <p>"When you grip or make a fist, your pectoral muscles tense up. Squeezing a muscle that is already tight makes the pinching feeling of compression feel worse," she says.</p> <p>That clenching also can create an undesirable "C" shape on the image. So instead, she tells patients not to raise their arms and grip but to let them hang relaxed by their sides.</p> <p>"Women have told me how much better it is," says Amanda.</p> <p>Melissa agrees. "She was amazing, and I will never forget her, and I wish I'd found her sooner," she says.</p> <h2>A closer look reveals a tumor</h2> <p>The mammogram and a subsequent ultrasound were inconclusive, so Johnson ordered a biopsy that was performed on Dec. 6, 2023. Two days later, Melissa learned that the biopsy had confirmed an invasive ductal carcinoma tumor positioned right up against her chest wall.</p> <p>"Suddenly, everything was insane," says Melissa.</p> <p>The whirlwind of preoperative tests and appointments began, and she was informed of her options: a lumpectomy, radiation or a single or double mastectomy.</p> <p>After talking through the options with her husband, Rick, she opted for a double mastectomy.</p> <p>"I didn't want to undergo MRIs every six months or worry for the rest of my life," says Melissa.</p> <p>Melissa met with Mayo Clinic Health System surgeons and had a double mastectomy on Jan. 30. After one night in the hospital, she was home and recovering with help from Rick and their children, Sarah and Joshua.</p> <p>Before starting her on hormone-blocking cancer medication, Melissa's oncologist, <a href="/providers/mina-hanna-md" target="_self" title="Opens in same window.">Mina Hanna, M.D.</a>, ordered a bone density scan. Melissa was delighted to learn that Amanda would conduct it since she had such a positive experience with the mammograms.</p> <p>"After I've done mammograms for a patient, I usually don't know their results or even see them again," says Amanda. "Doing Melissa's bone density scan felt like it was meant to be that we'd be on this journey together."</p> <h2>Genetics, recovery and a night at the ballpark</h2> <p>At the start of her breast cancer journey, Melissa was surprised to learn her diagnosis because she didn't know of any women in her family who had breast cancer. Tests revealed the cancer was both estrogen and progesterone-positive but negative for BRCA 1 and 2 markers. Melissa wanted to learn more, so she underwent in-depth <a href="/services-and-treatments/medical-genetics" target="_self" title="Opens in same window.">genetics testing</a>, none of which indicated a genetic predisposition for breast cancer.</p> <p>"I wanted to do extra testing so my daughter and son would have that information," says Melissa. She's now taking the hormone-blocking cancer medication and continuing her recovery.</p> <p>"Everyone on my care team — Jessica, Amanda, Dr. Hanna, my surgeons and everyone else — has been so great," she says.</p> <p>To celebrate her progress, Melissa threw out the first pitch at Cancer Survivors Night, sponsored by Mayo Clinic Health System, at a recent Mankato MoonDogs baseball game.</p> <img alt="Melissa Neuman pitching" style="height:400px; width:325px;" src="/-/media/national-files/images/hometown-health/2024/melissa-neuman-pitching.jpg?sc_lang=en&hash=6D1F22704717DE5E0296A95094466C7C" /> <p>"This was my first outing since my surgery, and it was so fun and inspiring. I just hoped I'd throw a good pitch," says Melissa.</p> <h2>Continuing to advance, refine mammograms</h2> <p>Amanda is proud of her role in helping detect Melissa's breast cancer — and that of her other patients.</p> <p>"I've always wanted to learn and do new things with mammography," she says.</p> <p>She is particularly excited about new 3T MRI equipment in Owatonna, which will allow for MRI biopsies and more advanced imaging.</p> <p>"This equipment will provide more support for breast procedures," she says. "And more patients will be able to stay close to home for first-rate care without traveling to Mayo Clinic in Rochester."</p> <p>Melissa adds that her experience is a good example of why it's important for doctors and others working in healthcare to take women's health concerns seriously and provide them with options for preventive health scans and healthcare.</p> <p>"If I didn't have a provider who listened and came up with a breast MRI to screen for breast cancer, we wouldn't have found it this early," she says.</p><img src="/-/media/national-files/images/hometown-health/2024/melissa-neuman-and-family.jpg?h=370&iar=0&w=660&sc_lang=en&hash=04F90355919FC7CE00D1D809D578F675" alt="Melissa Neuman and family" width="660" height="370" DisableNVelocity="true" />Breast CancerBreast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. It can occur in men and women, but it's far more common in women.Dawn Haller6/24/2024Multiple health issues and not being able to keep up with her kids were the turning point for Katie Crow. That's when she sought out weight-loss surgery. Read how it's changed her life.Thriving, not just surviving, after bariatric surgery<p>A trip to Disney World in 2023 was an eye-opener for Katie Crow. It wasn't the rides, parades or immersive activities that caught her attention but that she struggled to have the energy to go to the amusement park every day.</p> <p>"It wasn't the experience I wanted it to be. That's when I knew I finally needed to do something about my weight," says Katie, an endoscopy nurse with Mayo Clinic Health System in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</p> <p>That summer, the 36-year-old saw her weight reach 296 pounds. Katie suffered from leg and back pain, had been diagnosed with severe <a href="/hometown-health/speaking-of-health/do-i-have-sleep-apnea" target="_self" title="Opens in same window.">sleep apnea</a>, and her energy was at an all-time low. She also worried about developing diabetes and heart disease, which run in her family. Since 2019, she also had been coping with anxiety and depression.</p> <p>"The worst part was I couldn't keep up with my kids," says Katie, the mother of three children, now ages 15, 13 and 3. "I was just surviving."</p> <h2>Exploring the options</h2> <p>No stranger to battling her weight, Katie had tried a slew of diets, but none were successful. In the spring of 2023, her primary care provider referred her to the <a href="/locations/la-crosse/services-and-treatments/bariatric-surgery" target="_self" title="Opens in same window.">Bariatric Surgery Department</a> at Mayo Clinic Health System in La Crosse. There she learned about her options, which included <a href="/hometown-health/speaking-of-health/whats-the-skinny-on-weight-loss-drugs" target="_self" title="Opens in same window.">weight-loss drugs</a> and <a href="/hometown-health/speaking-of-health/thinking-about-weight-loss-surgery" target="_self" title="Opens in same window.">bariatric surgery</a>.</p> <p>"I considered the weight-loss drugs, but at the time, some hadn't been approved yet, and given the side effects, they didn't seem like an option for me," says Katie. "But the statistics showing the success of bariatric surgery sounded promising."</p> <p>Katie hadn't decided on her next steps, and then came the Disney World trip. The trip turned out to be the push she needed to finalize her decision to proceed with surgery, even though she was nervous about the permanent nature of the procedure.</p> <h2>Choosing weight-loss surgery</h2> <p>With the decision made, Katie started her bariatric surgery journey, which included various consultations, a psychological examination and a two-week pre-op diet to prepare her body for the surgery. She also met with Kathriena Greenwell, M.D., who would perform the surgery.</p> <p>"Dr. Greenwell took the time to answer all my questions and thoroughly explain the risks and benefits," says Katie.</p> <p>"Katie was an excellent candidate for surgery. Since the surgery, she's been very motivated in her weight-loss goals, dedicated to the weight-management program and is taking her lifestyle changes seriously," says Dr. Greenwell.</p> <p>In December 2023, Katie underwent surgery. While her body healed, she was on a restricted diet for six weeks.</p> <p>"I thought I'd never eat real food again," says Katie. "But I'd made the commitment and was determined to make it work."</p> <h2>Making lifestyle changes</h2> <p>When she made her choice, Katie knew that this was a lifelong commitment. She decided to track her experience on social media, posting about the ups and downs of her weight loss and the changes she was making. The most noticeable was the pounds she was shedding. In five months, Katie lost 109 pounds and 84 inches off her body. She'd dropped from size 3X to large.</p> <img alt="Katie Crow before and after bariatric surgery" style="height:400px; width:325px;" src="/-/media/national-files/images/hometown-health/2024/katie-crow-before-and-after.jpg?sc_lang=en&hash=006E44E23155211D91D46F65E15A3029"> <p>There were other changes, as well. Dr. Greenwell says Katie's <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/obesity/symptoms-causes/syc-20375742" target="_blank" title="Opens in a new window.">body mass index, or BMI</a>, has decreased from 49.26 to 31, and she no longer is considered morbidly obese. Dr. Greenwell also noted that Katie has stopped experiencing gastric reflux and anticipates that as she loses more weight, she won't require a continuous positive airway pressure, or CPAP, machine to treat her sleep apnea.</p> <p>"Hopefully, by losing weight now while she's young, it will prevent her from developing the complications of obesity, including diabetes, heart disease and hypertension," says Dr. Greenwell.</p> <p>Katie also has seen other personal victories beyond the numbers on the scale. Her leg and back pain are gone, she doesn't worry if a chair will hold her when she sits down, and she delights in shopping for clothes wherever she wants. Her anxiety and depression also have subsided.</p> <p>"I have more energy than before," says Katie. "My goal is to get down to 150 pounds, but based on the way I feel now, I'd be happy staying at this weight. Bariatric surgery is a tool, but you still have to do the work every day. It requires mental toughness and dedication; I didn't realize how challenging it would be mentally."</p> <p>For those considering weight-loss surgery, Katie advises researching the process and understanding the commitment you'll be making.</p> <p>"Going in, you know that you're going to be on vitamins and supplements forever, you won't be able to tolerate certain foods, you need to monitor your protein and hydration, and you have to become a regular exerciser," says Katie. "But ultimately, you have to look at the bigger picture.</p> <p>"I'm no longer just surviving; I'm thriving. I've become the mom I always dreamt of being," she says. "My only regret is that I didn't do this sooner."</p><img src="/-/media/national-files/images/hometown-health/2024/katie-crow.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3B51F7EF1EDEC772FD8B61ADE1138AD2" alt="Katie Crow" width="660" height="370" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller8/20/2024New technology allows for remote monitoring of a patient's recovery after total knee replacement surgery. For those recovering well, like Ronald Gary Woods, the smart knee technology has benefits.Smart knee technology allows care team to remotely monitor patient's recovery<p>For more than 15 years, Ronald Gary Woods ended most days with aching knees.</p> <p>"It was hard walking around. My knees would get sore and were popping and cracking," says Ronald, 63, of Eagle Lake, Minnesota. "It's like everything else, they just wore out."</p> <p>Ronald tried various treatments, including cortisone shots and nerve ablation, to interrupt pain signals sent to the brain. He planned to wait until retirement for surgical intervention. </p> <p>"But I was tired of hurting," he says.</p> <p>Ronald and <a href="/providers/jacob-ziegler-md" target="_self" title="Opens in same window.">Jacob Ziegler, M.D.</a>, his orthopedic surgeon at <a href="/locations/mankato" target="_self" title="Opens in same window.">Mayo Clinic Health System in Mankato</a>, recommended bilateral <a href="/locations/mankato/services-and-treatments/orthopedic-surgery/joint" target="_self" title="Opens in same window.">knee replacement</a>, a surgery to replace both of his knees at the same time. </p> <p>Dr. Ziegler had recently become the first surgeon at Mayo Clinic Health System to utilize new sensor technology licensed by Zimmer Biomet through a partnership with Canary Medical. The smart orthopedic implants function just like standard knee replacements, but they include a sensor in the stem anchored in the shin bone that remotely monitors and tracks a patient's recovery by measuring range of motion, steps, stride and other data associated with gait.</p> <p>Dr. Ziegler explained to Ronald that he could use an app to see his gait and mobility information as he recovered from surgery. The data would be uploaded once daily to Dr. Ziegler's team, helping them monitor how well Ronald was progressing. </p> <p>"It sounded pretty good," he says. "The doctor said it was for research, too. I thought, 'Why not?'"</p> <p>According to Zimmer Biomet, Ronald was one of the first known patients in the world to receive single-surgery bilateral smart knee replacements on March 26.</p> <p>Dr. Ziegler and <a rel="noopener" href="https://www.mayoclinic.org/biographies/couch-cory-g-m-d/bio-20493331" target="_blank" title="Opens in a new window.">Cory Couch, M.D.</a>, orthopedic surgeon at <a rel="noopener" href="https://www.mayoclinic.org/" target="_blank" title="Opens in a new window.">Mayo Clinic</a> in Rochester, Minnesota, are the only two Mayo Clinic surgeons who have implanted smart knee replacements in patients, but they will become widely available after Mayo Clinic's trial period of the technology. </p> <p>Remote monitoring is a major benefit in the rural healthcare setting, Dr. Ziegler says. Patients who live a longer distance from the hospital may not have to return for some in-person follow-up appointments during recovery if the smart knee data shows positive recovery metrics. </p> <p>"The biggest benefit to patients is our ability to monitor their progress with objective data," Dr. Ziegler says. "Historically, we had to do it very, very subjectively. We could see their range of motion, and beyond that, it was just asking, 'How do you feel? Do you feel like you're moving well? Do you feel like you're progressing?' And patients didn't have any way of knowing what normal should be or what to compare it to. We're able to pull up these recovery curves and show them how their data compares to other patients in a cohort and what they can do to progress."</p> <p>The battery is guaranteed to last 10 years, although many will likely last longer, Dr. Ziegler says. When the battery dies, the knee replacement continues to function like a traditional knee replacement.</p> <p>Dr. Ziegler is quick to point out that patient privacy is always at the forefront. Real-time data is not collected, and there is no GPS component showing the care team where the patient is located at any time. Patients also can choose to stop uploading data if they no longer want their metrics shared with the care team. </p> <p>The only criteria for patients who want to receive a smart knee is that they must be comfortable enough with the technology to engage with the app.</p> <p>The future of the technology is exciting to think about, Dr. Ziegler says. Future versions could have the potential to detect micro motions and subtle temperature changes to identify infection early on or loosening of the implant.</p> <p>Dr. Ziegler and Ronald agree he's doing well in his recovery, and the data from the smart knee has helped his care team ensure he's been on the right trajectory. </p> <p>"It's getting better every day," says Ronald, who just several months after surgery was able to get back on his motorcycle. "I won't make it to Sturgis this year, but next year for sure."</p> <h2>Next steps:</h2> <p><strong> </strong></p> <ul> <li>Read the <a href="/hometown-health/speaking-of-health/top-5-reasons-for-joint-replacement" target="_self" title="Opens in same window.">top five reasons for joint replacement</a>. </li> <li>Learn more about <a href="/locations/mankato/services-and-treatments/orthopedic-surgery/robotic" target="_self" title="Opens in same window.">robotic surgery for joint replacement</a>. </li> <li>Find an <a href="https://www.mayoclinichealthsystem.org/providers?service=Orthopedic%20Surgery&populateTracking=True" target="_self" title="Opens in same window.">orthopedic surgeon near you</a>. </li> <li>Watch this video learn more about Dr. Ziegler:<br /> <br /> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/RdklY0VdIzo" title="Jacob Ziegler provider video" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> </li> </ul> <ul> <li>Direct anterior hip replacement</li> <li>Minimally invasive hip and knee replacement</li> <li>Partial knee replacements</li> <li>Robotic assisted hip and knee arthroplasty</li> </ul> M.D. <p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Orthopedic Surgery, University of Minnesota</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Adult Reconstruction, Insall-Scott-Kelly Institute for Orthopaedics and Sports Medicine</li> <li>Adult Reconstruction, NYU Langone Orthopedic Hospital-Hospital for Joint Diseases</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Orthopaedic Surgery</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Association of Hip and Knee Surgeons</li> <li>Minnesota Orthopaedic Society</li> <li>Orthopaedic Trauma Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Orthopedics, Mayo Clinic College of Medicine and Science</li> </ul>Ziegler<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jacob-ziegler-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=EE50DD78035502A319D080295D6E695E" alt="Jacob Ziegler MD" width="280" height="280" DisableNVelocity="true" /> {9D2EDEA0-8D4B-411F-A2A2-06E925C765CC}Jacob <a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20570325Jacob Ziegler, M.D. 1{DEF55970-853F-4E96-9A4D-3413874FF059}<img src="/-/media/national-files/images/hometown-health/2024/ronald-woods.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E5EEB1FFBA3C7F17D19D7D8614E9AD7A" alt="Ronald Woods" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Karen Sperl10/18/2024After suffering a spinal cord injury in an accident at home, Laurie Reese had big questions about what lay ahead. Read how her rehabilitation team helped her adapt and live a full life.Adapting to life after spinal cord injury with rehab and determination<p>What began as a creative backyard project changed Laurie Reese's life forever. </p> <p>An avid gardener, Laurie envisioned turning an unused outhouse on their property into an ideal garden shed. So on a November day in 2007, Laurie's husband, Pete, used their skid loader to move the structure. While Laurie was guiding Pete, she noticed the outhouse was wobbling, so she put her hands out to steady it. That’s when the structure fell over, trapping Laurie beneath it. </p> <p>Pete was able to lift the outhouse just enough so that Laurie could pull herself most of the way out from under it, and Pete pulled her the rest of the way to safety. Paramedics took Laurie from her home in Oronoco, Minnesota, to <a rel="noopener" href="https://www.mayoclinic.org/patient-visitor-guide/minnesota/campus-buildings-maps/mayo-clinic-hospital-saint-marys-campus" target="_blank" title="Opens in a new window.">Mayo Clinic Hospital, Saint Marys Campus</a> in Rochester, Minnesota. </p> <h2>A sobering prognosis </h2> <p>Laurie and Pete learned that two vertebrae in her thoracic (middle) spine were damaged. She had a fracture of the T12 vertebrae and a fracture dislocation of the T11 and T12 vertebrae. </p> <p>The next day, she underwent nearly six hours of surgery. Her prognosis following the operation was dire: Laurie would have a 0-3% chance of walking again. </p> <p>"I was in shock and not really thinking clearly. So many things were running through my head," Laurie says. "I was just 39 and wondered if this injury would shorten my life. Our daughter was pregnant with our first grandchild, and I thought, 'Well, I've still got use of my arms, so at least I can hold the baby.'" </p> <p>Thoughts of her future grandchild spurred her to work especially hard in therapy to gain as much strength, movement and ability to do everyday tasks as possible. Laurie also knew two people who had quadriplegia, so she understood the reality of her situation. </p> <h2>Preparing for her new life </h2> <p>Laurie began rehabilitation while still in the hospital, then transferred to the Mary Brigh Building on the Saint Marys Campus for intensive, inpatient rehabilitation to adapt to her new life. <img alt="Reese walking in therapy" style="height: 300px; width: 244px; float: right; margin-left: 4px;" src="/-/media/national-files/images/hometown-health/2024/reese-walking-in-therapy.jpg?h=300&w=244&sc_lang=en&hash=6F9B5F3FBEA29CEBDBBB13445DF0125C" /></p> <p>In rehab, Laurie worked with physical and occupational therapists to practice and learn a wide range of skills and activities, including: </p> <ul> <li>Stretching her legs. </li> <li>Rolling over and sitting up. </li> <li>Inserting a catheter. </li> <li>Using a wheelchair. </li> <li>Transferring in and out of vehicles. </li> <li>Showering and dressing. </li> <li>Using a machine that supported her, braced her legs and simulated walking. </li> <li>Performing daily chores like cooking, doing the dishes and opening cupboards. </li> </ul> <p>"Before they let you leave rehabilitation, you go home for a day," Laurie says. "That's when the reality hits you that this is your life going forward."</p> <h2>Adapting, learning and doing what she wants <img alt="Reese with therapist" style="height: 300px; width: 244px; float: right; margin-left: 4px;" src="/-/media/national-files/images/hometown-health/2024/reese-with-therapist.jpg?h=300&w=244&sc_lang=en&hash=8E1BDD13E969CA39ACA9391AE91B52C7" /></h2> <p>By December 20, Laurie was ready to return home. Once home, outpatient therapy and occupational therapists make suggestions for adapting the house to meet her needs. To accommodate her wheelchair, the Reeses added a ramp to the house and eventually remodeled the kitchen. </p> <p>Once the basics were manageable, Laurie focused on resuming the things she loved to do, such as gardening, horseback riding and snowmobiling. </p> <p>Pete made modifications so she could indulge in her love of flowers. He revamped the garden beds to make them smaller and more manageable, built raised beds that Laurie could reach and added a fountain.</p> <p> Another goal of Laurie's was to try horseback riding again. She was able to sit on her horse a couple of times but realized it wasn't feasible to safely ride. </p> <p>Snowmobiling was a different story. After testing her comfort and ability on an older machine, she opted to get a new one with upgrades like an electric start, reverse gear, heated hand warmers and more. With a strap anchoring her legs, she's taken several trips — and even some spills — and continues to tinker with the design of her seat. </p> <p>Since the accident, Laurie has been determined to live life on her own terms. With help from her therapists and plenty of practice, she stood for pictures at a daughter's wedding. </p> <p>She holds, cares for and plays with her eight grandchildren. When she wants to see them, she loads her wheelchair onto the lift bed, gets into her pickup and drives to their homes. </p> <p>Laurie also returned to work in cardiovascular education for Mayo Clinic in Rochester, a position she's held for 19 years. She provides digital education for medical staff needing board certification or recertification. </p> <h2>Nearly 20 years of success </h2> <p>Although it's been 17 years since her accident, Laurie still battles issues like pressure sores that landed her in the hospital for three months this year. That hospitalization set her back, and she spent nearly three months in rehabilitation at <a href="/locations/cannon-falls">Mayo Clinic Health System in Cannon Falls</a>, Minnesota.</p> <p>"It still can be rough. Some days are better than others, and I get jealous of those who can easily do something like picking up a baby," she says. "And nothing is as easy as you think it will be, but you make it work. You have to have the mindset and the drive to constantly adapt."</p> <p>What helped Laurie develop that mindset and drive was a journal her rehab team encouraged her to write in the hospital after her initial injury. The journal evolved into a book, "My Life Beyond the Outhouse: The First Two Years." Laurie focused on the first two years because she was most likely to regain any mobility during that time.</p> <p>"Publishing the book helped me talk about my injury, and my family and friends got a better understanding of what I was going through," Laurie says. "People who read it say they had no idea how much of your life is affected by being paralyzed."</p> <p>While her life changed on that November day, it didn't end. Laurie attributes her success to her rehabilitation team and their ongoing care.</p> <p>"I couldn't have asked for better people on my side. When I cried, they gave me a shoulder to cry on," she says. "I can't imagine not having the training they gave me. Because of them, I was able to start out in a new capacity, and today, I'm able to do almost whatever I want."</p> <p>"Even now, when I go in for appointments, they remember me and know my story. It's so neat that out of the thousands of patients they've seen, we still have that connection."</p><img src="/-/media/national-files/images/hometown-health/2024/reese-posed-on-snowmobile.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7D5AF2E0F3B28262965956E84B9F74D5" alt="Reese posed on snowmobile" width="660" height="370" DisableNVelocity="true" />Rehabilitation TherapyRestoring movement and function to people injured or impaired by disease or injury.Dawn Haller11/14/2024Dan Knapp prioritizes his health through annual visits with his care team, medications for chronic conditions and regular home blood pressure monitoring. Read about the benefits of at-home monitoring.Home blood pressure monitoring benefits Dan Knapp<p>At 77, Dan Knapp prioritizes his health. "For the past twelve years, I've scheduled annual visits to monitor my conditions," says Knapp, a longtime patient at <a href="/" target="_self" title="Opens in same window">Mayo Clinic Health System</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window">Eau Claire</a>, Wisconsin. "It gives me peace of mind, knowing I'm doing everything I can to stay ahead of any potential issues."</p> <p>During these visits, Dan meets with his primary care team to discuss medication and lifestyle changes that may affect his well-being. The team also monitors his chronic conditions, which include diabetes and high blood pressure.</p> <h3>Why your blood pressure matters</h3> <p>Having high blood pressure increases the risk of heart disease and <a href="/hometown-health/speaking-of-health/who-is-most-at-risk-for-a-stroke" target="_self" title="Opens in same window">stroke</a>, which are the leading causes of death in the U.S.</p> <p><a href="/hometown-health/speaking-of-health/know-your-numbers-blood-pressure" target="_self" title="Opens in same window">Blood pressure</a> measures how hard blood pushes against arteries as it moves through the body. Over time, elevated or high blood pressure makes the heart work harder and less efficiently. It can also damage the eyes, kidneys and blood vessels. </p> <p>Blood pressure readings fall into four categories: Normal, elevated, hypertension stage 1 and hypertension stage 2. Knowing your blood pressure numbers is critical for maintaining or improving your health. </p> <h3>Increasing convenience with at-home monitoring</h3> <p><a href="/hometown-health/speaking-of-health/6-ways-to-manage-high-blood-pressure" target="_self" title="Opens in same window">Controlling high blood pressure</a> requires consistent effort from both patients and healthcare teams. Historically, this has involved in-person visits for regular monitoring.</p> <p>However, for many people, especially those in rural areas, the inconvenience of these visits can be a barrier to effective care.</p> <h4>A home blood pressure monitoring program offers people more control and convenience when tracking their readings.</h4> <p>Based on recommendations from the American Medical Association and American Heart Association, people are educated on proper techniques for using their own blood pressure monitors at home.</p> <h4>Monitors that allow upper arm blood pressure and ensure proper cuff size have the most accurate readings.</h4> <p>Readings can then be manually entered into the patient portal or through Bluetooth-enabled devices.</p> <p>"Home blood pressure monitoring is a terrific option for our patients," says <a href="/providers/christopher-roberts-md" target="_self" title="Opens in same window">Christopher Roberts, M.D.</a>, a <a href="/services-and-treatments/primary-care" target="_self" title="Opens in same window">Primary Care</a> physician in <a href="/locations/eau-claire" target="_self" title="Opens in same window">Eau Claire</a>. "Mr. Knapp was motivated to get his blood pressure under control, which made him an excellent candidate for this program. It has saved him the cost and inconvenience of driving 80 miles to our clinic."</p> <p>"The whole process is incredibly user-friendly — even for a non-tech savvy guy like me," Dan says. "Not all my readings are perfect, but when they're not, I know my care team will be on top of it."</p> <p>If the blood pressure readings show concerning trends over time, your healthcare team can recommend lifestyle or <a href="/hometown-health/speaking-of-health/blood-pressure" target="_self" title="Opens in same window">dietary changes</a> and make medication adjustments.</p> <p>For Dan, this enhanced access has paid off. His most recent blood pressure was 125/69, a dramatic improvement from his starting point.</p> <p>"Overall, I’m a healthier person because of this process," says Dan. "As I've gotten older, my health has become more important — you can't wait until things go wrong to fix them. I want to live a long time, and this is a way I can do that."</p><img src="/-/media/national-files/images/hometown-health/2024/home-bp-monitor.jpg?h=370&iar=0&w=660&sc_lang=en&hash=ED0B264723507ECD5AC37A9DCA5B3364" alt="Home BP monitor" width="660" height="370" DisableNVelocity="true" />Dawn Haller11/14/2025 <p>After dedicating 43 years to Emergency Medical Services (EMS), Don Hauge suddenly found himself on the receiving end of the very care he once provided.</p> A lifesaver saved: An EMS veteran’s journey from rescue to recovery <p>For Don <span class="RadEWrongWord" id="RadESpellError_0">Hauge</span>, the irony was unmistakable. After dedicating 43 years to Emergency Medical Services (<span class="RadEWrongWord" id="RadESpellError_1">EMS</span>) — a career spent helping others in their most critical moments — he suddenly found himself on the receiving end of the very care he once provided. In a dramatic twist of fate, the system he had long served was now called upon to save his life.</p> <h2>A sudden emergency</h2> <p>In 2024, Don was participating in a clinical trial at Mayo Clinic, Rochester, Minnesota, for acute necrotic myositis — a condition where the immune system mistakenly attacks the muscles, causing weakness, decreased mobility and the inability to walk. Shortly after being discharged home, Don developed a saddle pulmonary embolism, a blockage of blood flow in his lungs, which triggered a cardiac arrest.</p> <p><span class="RadEWrongWord" id="RadESpellError_2">EMS</span> responded to his home, performing <span class="RadEWrongWord" id="RadESpellError_3">CPR</span> for an astonishing hour and 20 minutes between his home and the Emergency Department at Mayo Clinic Health System in Albert <span class="RadEWrongWord" id="RadESpellError_4">Lea</span>. From there, Don was flown to Mayo Clinic Hospital, Saint <span class="RadEWrongWord" id="RadESpellError_5">Marys</span> Campus in Rochester, where he was placed on extracorporeal membrane oxygenation (<span class="RadEWrongWord" id="RadESpellError_6">ECMO</span>), a life support treatment that temporarily takes over the work of the heart and/or lungs. For someone who had spent decades witnessing the urgency and precision of emergency response, the experience was surreal.</p> <p>“I was relying on the medical expertise and skills of my colleagues to keep me alive,” says Don.</p> <h2>The long road to recovery</h2> <p>Don spent two months at Saint <span class="RadEWrongWord" id="RadESpellError_7">Marys</span> Hospital, beginning the slow process of recovery. His acute necrotic myositis left him unable to walk or stand on his own. To continue his recovery and rebuild strength and mobility, he was transferred to Mayo Post Acute Care (<span class="RadEWrongWord" id="RadESpellError_8">MPAC</span>) at Mayo Clinic Health System in Cannon Falls, Minnesota, where he began his two-month rehabilitation journey. </p> <p>At <span class="RadEWrongWord" id="RadESpellError_9">MPAC</span>, Don began a rigorous schedule of physical and occupational therapy five days a week. Physical therapy focused on rebuilding muscle strength, starting with standing exercises using supportive devices and gradually progressing to targeted exercises for his legs, core and lower body. Eventually, he graduated from using an <span class="RadEWrongWord" id="RadESpellError_10">assistive</span> standing device to managing a walker on his own.</p> <p>“It was hard, and I always broke out in a sweat,” Don says. “But with every effort, I knew I was working toward regaining my strength.”</p> <p>As his lower body grew stronger, Don also focused on strengthening his upper body, using <span class="RadEWrongWord" id="RadESpellError_11">Therabands</span> and light weights. Every movement, no matter how small, was an accomplishment and was met with encouragement and praise from his therapists. </p> <p>“Don’s perseverance was truly unmatched,” says <span class="RadEWrongWord" id="RadESpellError_12">Samantha</span> <span class="RadEWrongWord" id="RadESpellError_13">Lencioni</span>, physical therapist at Mayo Clinic Health System in Cannon Falls. “He never said no to a challenge, even when he was exhausted. We celebrated any progress toward his goals, no matter how small.”</p> <p>Occupational therapy helped Don relearn everyday skills and tasks. He practiced moving around in his room and the kitchen, reaching for dishes and clothing and grooming items. These tasks, once considered routine, were meaningful markers of progress.</p> <p>“Don made significant progress with this ability to care for himself, and it was exciting to see him meet each challenge to further his independence,” says <span class="RadEWrongWord" id="RadESpellError_14">Lori</span> <span class="RadEWrongWord" id="RadESpellError_15">Copeman</span>, occupational therapist at Mayo Clinic Health System in Cannon Falls.</p> <h2>Healing beyond the physical</h2> <p>Recovery <span class="RadEWrongWord" id="RadESpellError_16">wasn</span>’t just physical for Don; it was emotional, too. The slow, often frustrating pace tested his resilience. On difficult days, it was the <span class="RadEWrongWord" id="RadESpellError_17">MPAC</span> staff who helped carry him through. From the nurses and aides to food service workers, housekeeping staff and the hospital chaplain, everyone played a role in lifting his spirits.</p> <p>“They were my cheerleaders,” says Don. “Even the simplest ‘hello, how are you today,’ made a world of difference. It was hard to be grumpy and frustrated around such happiness and encouragement.”</p> <p>That support extended beyond kind words. The staff helped Don navigate insurance challenges to ensure his therapy could continue uninterrupted. As his discharge date approached, they coordinated every detail — providing him with a walker and installing handrails for his bed and bathroom to ensure a safe and smooth transition home.</p> <h2>A new chapter begins</h2> <p>In March 2025, Don was finally discharged home — an emotional milestone in his long journey.</p> <p>“I felt like I was leaving my family,” says Don. “I formed so many close relationships with the <span class="RadEWrongWord" id="RadESpellError_18">MPAC</span> staff, and everyone provided such wonderful care and support. It was very difficult to leave.”</p> <p>But those bonds <span class="RadEWrongWord" id="RadESpellError_19">didn</span>’t end at discharge. Don keeps in touch with some of his care team through texts, maintaining the connection that played such an important role in his recovery.</p> <p>Don continues outpatient physical and occupational therapy three times a week at Mayo Clinic Health System in Albert <span class="RadEWrongWord" id="RadESpellError_20">Lea</span>, Minnesota, closer to home. His progress is steady, though he admits it’s not going as fast as he would like.</p> <p>“Recovery is going slower than I want, but I’m determined to keep working toward some normalcy again, like being able to drive and go to the store on my own,” says Don. </p> <h2>Full circle</h2> <p>Don’s recovery <span class="RadEWrongWord" id="RadESpellError_21">isn</span>’t over yet, but he remains optimistic and extremely grateful for the care he received at <span class="RadEWrongWord" id="RadESpellError_22">MPAC</span> in Cannon Falls. His story is a powerful testament to strength, perseverance and the life-saving impact of compassionate care. For a man who spent his life rushing to save others, the outpouring of care and support he received in return speaks volumes. </p> <p>“I’ll never forget the care I received,” Don says. “And I will be forever grateful.”</p> <img src="/-/media/national-files/images/hometown-health/2025/don-hauge.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D165222588CA0879BCC05CD07CCD5F9B" alt="Don H patient blog image" width="660" height="370" DisableNVelocity="true" />Dawn Haller12/24/2015<p>Susi and Luc Boe were ready to start their family. But after a year of trying, Susi still wasn't pregnant.</p>And baby makes 3<p><img alt="Boe_lg" src="/-/media/national-files/images/hometown-health/2015/fall-2015/boe_lg.jpg?h=260&w=300&sc_lang=en&hash=72191C1BB7920065BA0E4F2979B65CC3" style="height: 260px; width: 300px; float: right; margin-bottom: 10px; margin-left: 10px;" />Susi and Luc Boe were ready to start their family. But after a year of trying, Susi still wasn’t pregnant.</p> <p>“I went to see a doctor and she told me to lose weight,” says Susi. She did, but still did not become pregnant. Then, Susi scheduled an appointment with an obstetrician-gynecologist at Mayo Clinic Health System in Red Wing, Minnesota.</p> <p>A number of tests and treatments can be done to try to determine the cause of infertility in men and women including medication, sperm washing and intrauterine insemination.</p> <p>Susi's physician prescribed a medication called metformin, which helps some women ovulate. It’s just one option for fertility treatment. A few months after she began taking metformin, Susi was overjoyed to become pregnant.</p> <p>“It was a really good pregnancy,” she says.</p> <p>It must have been good from the baby’s perspective, too, because at 41 weeks — a typical pregnancy is 40 weeks — Susi still hadn’t delivered. Susi was scheduled for an induction, which means she would be given medication to start labor. It worked, and Rowan Thomas Boe arrived at 3:19 a.m. on June 2, weighing in at 9 pounds, 6 ounces.</p> <p>“In our family, that makes him a tiny baby,” says Susi with a laugh. “My sister and I both weighed over 11 pounds when we were born.”</p> <p>After Rowan’s birth, Susi attended a discharge class and postnatal classes in Red Wing. The classes include baby weight, jaundice, cord and circumcision checks, and give new parents an opportunity to receive education and support from childbirth education instructors, nurses and lactation consultants. Parents can also share their experiences with other new parents, and ask any questions they have.</p> <p>“Every time I went to one of the classes, I learned something new,” says Susi. “I don’t know what I would have done without the classes. They kept me sane.”</p> <p>When she looks back on her pregnancy experience, Susi says what stands out most is the care she and her family received in the hospital.</p> <p>“I was surprised by how well they took care of all of us,” she says. “I was expecting them to look after my health and the baby’s health, and they did. The nurses were so attentive to me and did everything they could to make sure I was comfortable. But, they also took care of Luc and my mom and sister, who came to be with me. They really went above what I was expecting.”</p><img src="/-/media/national-files/images/hometown-health/2015/fall-2015/boe_sm.jpg?h=76&iar=0&w=76&sc_lang=en&hash=55F728DA48E39269B0373603805EFC27" alt="Boe_sm" width="76" height="76" DisableNVelocity="true" />FertilityFertility issues may be due to a single cause with you or your partner or a combination of factors that may prevent a pregnancy from occurring or continuing. There are multiple safe, effective fertility therapies available.Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller9/10/2015<p>Michelle Cowgill has discovered a way to keep her family healthier, and it doesn’t involve taking pills or changing their diets.</p>Patient portal helps busy mom keep her family healthier<img alt="POS_SP15_MichelleCowgillFamily_web" src="/-/media/national-files/images/hometown-health/2015/spring-2015/pos_sp15_michellecowgillfamily_web.jpg?h=146&w=400&sc_lang=en&hash=2C5A47549C5C20F05FAFCA63525EC699" style="height: 146px; width: 400px;" /> <p>Michelle Cowgill has discovered a way to keep her family healthier, and it doesn't involve taking pills or changing their diets.</p> <p>"It's a wonderful tool," says Michelle, who uses the Mayo Clinic patient portal to manage her healthcare, as well as the care of her three children, including son Jonah, who has autism and growth hormone deficiency. "It's so helpful, especially when you have kids with complicated medical issues."</p> <p>She has used the service to ask questions, view lab results and review provider's notes from appointments.</p> <p>"It's very time-efficient," says Michelle, who has logged on from a beach in Mexico, on an airplane and in the parking lot of the medical center. "No matter where I am when I have a question or concern, I can check in."</p> <p>Michelle says her questions usually are answered the same day. </p> <p>"Before I used the portal, I'd call, leave a message, and then wind up playing phone tag with someone before getting an answer," she says. "This is much more convenient."</p> <p>Health records from Mayo Clinic appointments also can be viewed through the portal — an important benefit to families like the Cowgills, who see providers in Rochester, Minnesota.</p> <p>"Jonah sees an endocrinologist and neurologist at Mayo Clinic, and all of the records from those appointments are there too" she says. "I can also ask those providers questions. It's a great way to communicate and helps build solid relationships with your providers."</p> <p>Michelle also appreciates having an online record with immunization dates, medication information and notes from providers.</p> <p>"I recently had surgery, and it was great to be able to log in and read my surgeon's notes," she says. "I also reviewed the post-surgery instructions. It's easy to forget some of what you hear at an appointment. The portal is a great backup. And it's there anytime you need it, in one neat little package."</p> <h2>Health information access 24/7/365</h2> <p>The portal is a secure, convenient way to access your health information.</p> <p>On the password-protected portal, you can view portions of your health records, including lab results and clinical notes, as well as pay your clinic bill using a secure interface.</p> <p><a href="/patient-online-services" target="_self" title="Opens in same window.">Register today.</a>. You'll need your Mayo Clinic patient number, which is located on your billing statements and any previsit questionnaires, and an email address to create an account.</p> <p>For assistance setting up an account or using the portal, call the support line at <a href="tel:1-877-858-0398">877-858-0398</a>.</p><img src="/-/media/national-files/images/hometown-health/2015/spring-2015/pos_sp15_michellecowgill_sm.jpg?h=76&iar=0&w=76&sc_lang=en&hash=49E36BBB9A21CC41AEC34B1CCE1BC9AD" alt="POS_SP15_MichelleCowgill_sm" width="76" height="76" DisableNVelocity="true" />Patient PortalStaying engaged in your healthcare is important. The patient portal is a free, secure and convenient online resource that connects you to your healthcare team and helps you manage your health from the comfort of your home or anywhere else.Dawn Haller11/10/2014<p>Marilyn Streif says Mayo Clinic Health System's Weight Management Services saved her life.</p>'I believe the program saved my life'<img alt="marilyn" src="/-/media/national-files/images/hometown-health/2014/marilyn.jpg?h=270&w=350&sc_lang=en&hash=757027C8551E26A3672088127B368428" style="height: 270px; width: 350px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p><strong><em>by Marilyn Streif</em></strong></p> <p>After having stents put in for my heart problems, I visited my cardiologist for a follow-up appointment where he told me that the medication costing me $300–$500 a month was still not making me better.</p> <p>He told me, “Marilyn, you know what you need to do. You need to lose the weight. I can’t tell you you’re getting better, because you’re not.”</p> <p>After that visit, I was worried about my health even more. I tried to lose the weight on my own for three years, but I just wasn’t ready to commit. My grandchildren would often comment that I couldn’t get down on the floor to play with them or keep up with them as they played games around the house, and it started to push me more to lose the weight. However, it wasn’t until my son told me that he was worried he wouldn’t have his mom around much longer, that I finally found the motivation to take action.</p> <p>My cardiologist recommended I work with Mayo Clinic Health System’s Weight Management Services, which I had briefly tried before. With determination this time, I tried again in May 2011 and started the HMR at Home weight-loss program that was complete with a diet plan and a weekly meeting. Weight Management Services dietitians and a nurse, coached and helped me to stay on track, and slowly, I lost the weight pound by pound. </p> <p>I had my good days and my bad days. The staff taught me to understand food triggers and gave me the drive to keep going. </p> <p>I weighed 265.2 pounds before I started the program. Now, thanks to dedication and Mayo’s wonderful team, I stand much happier at 111 pounds. My medication costs have dramatically dropped to $30 a month, and I went from a size XXXL to a petite small.</p> <p>I used to be worried about fitting in the chairs at my beauty salon and couldn't stand to go shopping. Now, I slide into chairs with ease and clothes shopping is one of my favorite things to do. Though, sometimes I still find myself shopping for sizes too big for me.</p> <p>I feel confident in my new body but am ultimately so grateful that I can now fully live in it. I can finally keep up with my grandchildren and am happy to know I can watch them grow.</p> <p>I believe the program saved my life. To anyone struggling on their own journey: It’s never too late to change your life. That decision and the dedication that comes with it, is completely up to you, but you’ve always got people there to support you, and for me, that support was my loving family and the dedicated staff at Mayo Clinic Health System.</p><img src="/-/media/national-files/images/hometown-health/2014/margaret_small.jpg?h=85&iar=0&w=85&sc_lang=en&hash=74BC4FEBCA1812A218A90A0A5737D022" alt="margaret_small" width="85" height="85" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller6/16/2014<p>Dan Rinehart of Le Center, Minn., had been overweight his whole life. And it was making him sick and tired. </p>Little changes, big results: Couple sheds pounds — and health problems — together<p><img alt="P_Rinehart_SP14_01" src="/-/media/national-files/images/hometown-health/2014/spring-2014/p_rinehart_sp14_01.jpg?sc_lang=en&hash=723110CDA9CF5D122DD2ED61B669AE0C" style="float: right; margin-bottom: 10px; margin-left: 10px;" />Dan Rinehart of Le Center, Minn., had been overweight his whole life. And it was making him sick and tired.</p> <p>“I had high blood pressure, high cholesterol and type 2 diabetes,” says Dan, who took medication to control all three. “And I was tired all the time.”</p> <p>In the fall of 2012, Dan’s doctor, Daniel Stahl, M.D., a family physician at Mayo Clinic Health System in Waseca, advised that he’d soon need to use insulin to control his blood sugar. </p> <p>“I didn’t want to be giving myself shots every day,” says Dan. He knew losing weight could improve his diabetes control, and decided to look into bariatric surgery. His wife, Kelli, who’d also struggled with her weight, decided to join him. </p> <p>A little more than a year later, they’ve lost nearly 250 pounds combined. But they never had surgery. Instead, they changed their diet and exercise habits. </p> <p>“Before you can be approved for bariatric surgery, you have to meet with a dietitian,” says Dan. He and Kelli met with Grace Fjeldberg, a registered dietitian at Mayo Clinic Health System in Mankato.</p> <p>“I’d met with dietitians before, but Grace was different,” says Dan. “We were successful because she made it so easy.”</p> <p>At their first meeting, Fjeldberg encouraged the couple to focus on just two things — the calories and serving sizes of the foods they ate. </p> <p>The couple began reading food labels and tracking what they ate on a smartphone app. Within a month, Dan lost 20 pounds. The next month, he lost another 15. </p> <p>Kelli was losing weight, too. </p> <p><img alt="P_Rinehart_SP14_02" src="/-/media/national-files/images/hometown-health/2014/spring-2014/p_rinehart_sp14_02.jpg?sc_lang=en&hash=F05CF330CB77DECBA199C82DC6ABB7E7" style="float: right; margin-bottom: 10px; margin-left: 10px;" />“To actually see the weight come off felt great,” she says. </p> <p>The couple agrees that they didn’t change what they ate — just how much they ate. </p> <p>“The key has been portion control,” says Kelli. “We eat more veggies now and smaller portions of meat. We still treat ourselves. We go out one night a week and have whatever we want without worrying about calories.”</p> <p>Fjeldberg says that’s a healthy approach.</p> <p>“The key to long-term health and well-being is to continually improve eating and exercise patterns in a realistic manner,” she says. “Dan and Kelli have figured out patterns that work for them.”</p> <p>That includes regular trips to the gym for cardio and weightlifting sessions. </p> <p>“I used to hate to work out, but now I get mad if I don’t go,” says Dan. </p> <p>The new habits have led to big changes for the Rineharts. Dan is sleeping well again. Kelli, formerly a dedicated napper, hasn’t taken a nap in almost a year. They’ve both lowered their cholesterol, and Dan no longer takes diabetes or blood pressure medication. Both say they feel better than they have in years. </p> <p>“I can do things so much easier and have so much more energy,” says Kelli. “But the best part is knowing that we’re healthy.</p><img src="/-/media/national-files/images/hometown-health/2014/spring-2014/p_rinehart_sp14_sm.jpg?h=75&iar=0&w=75&sc_lang=en&hash=115BEA16827DF147E8EAFA7A46A26E21" alt="P_Rinehart_SP14_sm" width="75" height="75" DisableNVelocity="true" />Weight-loss (Bariatric) SurgeryWeight-loss surgery, or bariatric surgery, helps you lose weight and lowers your risk of medical problems associated with obesity.Dawn Haller3/14/2014<p>While breastfeeding comes naturally to many women, that’s not always the case. Some women — and their babies — struggle with it. Maria Salas Quintero was one of them. </p>Teamwork helps ensure newborn gets strong start in life<p><img src="/-/media/national-files/images/hometown-health/2014/winter-2014/p_quintero_wi14_01.jpg?sc_lang=en&hash=90B77869716AF38E60B33CC0FEE27B40" alt="P_Quintero_WI14_01" style="float: right; margin-bottom: 10px; margin-left: 10px;" class="img-responsive">Breast milk is the meal of choice for newborns. It’s easier for babies to digest than formula and contains the perfect balance of nutrients for babies’ growing bodies. It also provides antibodies that boost a child’s immunity. </p> <p>And while breastfeeding comes naturally to many women, that’s not always the case. Some women — and their babies — struggle with it. Maria Salas Quintero was one of them.</p> <p>Maria knew the benefits of breastfeeding. The Cannon Falls, Minnesota, mother of three had breastfed her two older children, daughter Daniela (17) and son Joel (10). When her son, Joshua, was born on June 18, 2013, she began breastfeeding him, as well. </p> <p>But after Maria brought Joshua home, mother’s intuition told her something was wrong. </p> <p>“I knew something was wrong the day after I left the hospital because Joshua would not stop crying,” Maria says through a translator. </p> <p>A public health nurse visited Maria’s home and discovered that Joshua had lost a concerning amount of weight. While all babies lose a small amount of weight immediately after birth, Joshua’s weight loss and lack of soiled diapers suggested that he was not getting enough food. The nurse suspected that Joshua was having difficulty getting enough milk from Salas Quintero’s breasts.</p> <p>After consulting with Anne Beckman and Ann Warrington, the international board certified lactation consultants at Mayo Clinic Health System, Maria was taught a combination of techniques, including use of an electric breast pump, to ensure Joshua had an ample supply of breast milk. Maria followed the instructions. </p> <p>Each day for a week, Joshua was weighed and his diapers were reviewed at Mayo Clinic Health System, the Goodhue County WIC office or at his home by a nurse who visited. With the extra breast milk and some additional formula, he steadily gained weight, which confirmed he was getting enough to eat. But his mother had another way of knowing her son was full.</p> <p>“I knew he was getting what he needed because he was quiet and content,” says Maria. “I am so grateful for the teaching I received and for the people who came to my house to weigh Joshua. I don’t know what would have happened if they hadn’t come to my house, because it is difficult for me to find a ride to the clinic.”</p> <p>Today, Joshua is doing well thanks to the efforts of his mother and the team of caregivers who helped her give him what he needed for a strong start in life.</p> <p>“I’m very grateful for the concern and kindness I received,” says Maria.</p><img src="/-/media/national-files/images/hometown-health/2014/winter-2014/p_quintero_wi14_02.jpg?h=175&iar=0&w=236&sc_lang=en&hash=FB0E6A0264BE596EB7D932F6DED57C9F" alt="P_Quintero_WI14_02" width="236" height="175" DisableNVelocity="true" />Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller1/25/2021Pregnant women are at an increased risk for serious illness from COVID-19. An OB-GYN answers questions about the vaccine for pregnant and breastfeeding women.What pregnant and breastfeeding women should know about the COVID-19 vaccine<p>Pregnant women are at an increased risk for serious illness from <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/coronavirus/symptoms-causes/syc-20479963" target="_blank" title="Opens in a new window.">COVID-19</a>.</p> <p>"Compared to nonpregnant women who have the same health and age, a COVID-infected woman is about 1.3 to 1.4 times more likely to end up in the hospital when she's pregnant," says <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/theiler-regan-n-m-d-ph-d/bio-20402742?mc_id=us&utm_source=newsnetwork&utm_medium=l&utm_content=content&utm_campaign=mayoclinic&geo=national&placementsite=enterprise&cauid=100721" target="_blank" title="Opens in a new window.">Dr. Regan Theiler</a>, a Mayo Clinic obstetrician.</p> <p>Should pregnant and breastfeeding women <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-vaccine/art-20484859" target="_blank" title="Opens in a new window.">be vaccinated for COVID-19</a>? While there are limited data about current COVID-19 vaccines in pregnant and breastfeeding patients, there are many questions.</p> <h3>In this Q&A, Dr. Theiler answers questions about COVID-19 vaccines for pregnant and breastfeeding women, and women who plan on becoming pregnant:</h3> <h4>Should pregnant women be vaccinated for COVID-19?</h4> <p>Since the emergency use authorization was granted, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.acog.org/" target="_blank" title="Opens in a new window.">The American College of Obstetricians and Gynecologists</a> and the Society for Maternal-Fetal Medicine have been firm in recommending that pregnant women have access to COVID-19 vaccines. That is, if women so choose, they should be able to be vaccinated for COVID-19.</p> <h4>Can a fetus get COVID-19 if the mother is vaccinated for COVID-19? </h4> <p>Through vaccination for COVID-19, the baby should not be exposed to the virus. It is known that the COVID-19 vaccines are the genetic code for a single protein. It doesn't replicate in a person. It doesn't cause an infection with COVID-19. There's no virus floating around in a woman. Any vaccine that has a live virus that's replicating is not used in pregnant women because of any theoretical risk. It is thought that there is no risk that this would cause an infection in a pregnant woman and cause an infection that goes to the baby.</p> <h4>Are COVID-19 vaccines safe for pregnant women?</h4> <p>Because this is an emergency use authorization and any medication or vaccine during its first iteration of trials is never tested in pregnant women, there is no direct evidence of safety in pregnancy. What is known is that there is a lack of theoretical evidence of harm.</p> <p>There is no conceivable reason why COVID-19 vaccines should be harmful to pregnant women. None of the components of the vaccines ― the nanoparticles ― are known to be harmful in pregnancy. The best evidence for pregnant women suggests that being vaccinated for COVID-19 is a lot safer than getting COVID-19.</p> <h4>Are COVID-19 vaccines safe for women who are breastfeeding?</h4> <p>There is no indication that COVID-19 vaccines are harmful or damaging to women who are breastfeeding or their infants.</p> <h4>Do COVID-19 vaccines cause infertility?</h4> <p>There's no evidence of COVID-19 vaccines causing infertility.</p> <p>There's been a sophisticated anti-vaccine campaign that originated online. The New York Times had a great article about it, going through the levels of disinformation and where it came from. It sounds scientific, and it goes something like this: There's a protein in the placenta that has similarities to viruses. And if you have antibodies to viruses that are induced by this vaccine, it will cause you to have a miscarriage and the pregnancy did not implant in your uterus. <strong>This is completely made up.</strong> It sounds smart. It's based in molecular biology. It's written by a scientist. But it's fundamentally not true.</p> <p>If that were true, then women who had COVID-19 ― millions of women now ― would be more likely to have miscarriages and not get pregnant. That's because they would have those same antibodies because it's the identical gene producing the identical kinds of antibodies in the virus infection and in the COVID-19 vaccines.</p> <p>OK, so you have the same antibodies; yet, in women who have had COVID-19, there have been other viral infections with even more homology to this protein. No signals are being seen for increased miscarriages or decreased fertility.</p> <p>Again, this is a sophisticated scientific-sounding campaign that was purposefully put out on the internet to prevent women especially from getting this vaccine. It's not based in truth, and it's doing significant harm.</p> <h4>Do you have recommendations for women who are pregnant, breastfeeding or are planning a pregnancy to avoid getting infected with COVID-19?</h4> <p>Everyone should continue social distancing. Everyone should continue masking. All of those safety measures apply to pregnant women, lactating women and women who are contemplating a pregnancy.</p> <p>There are no formal recommendations yet. Knowing how good these COVID-19 vaccines are at preventing infection and how dangerous the infection is in pregnancy, the recommendation is that women stay on their contraception, go through the COVID-19 vaccination series, and then contemplate conception. COVID-19 vaccines are known to be effective.</p> <p><em>Mayo Clinic follows the guidelines of the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.acog.org/" target="_blank" title="Opens in a new window.">American College of Obstetricians and Gynecologists</a> and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.smfm.org/" target="_blank" title="Opens in a new window.">Society for Maternal-Fetal Medicine</a>, as well as independent data.</em></p><img src="/-/media/national-files/images/hometown-health/2021/pregnant-woman-holding-belly.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0070F29CAC1024DC9B64FFF5A0A7FDEE" alt="Pregnant woman holding belly" width="660" height="370" DisableNVelocity="true" />Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller2/3/2021Bringing home a newborn may feel overwhelming at any time, but how do you do manage it during a pandemic? Here's a Q&A to help parents navigate the ever-changing safety concerns.Caring for newborns during the COVID-19 pandemic<p>You have waited nine months for your newborn to arrive. You ate well, took <a href="/hometown-health/speaking-of-health/should-women-take-supplements-while-pregnant" target="_self" title="Opens in same window.">prenatal vitamins</a>, attended appointments and did your best to keep yourself healthy. Now that your baby has arrived, how do you keep him or her healthy during the COVID-19 pandemic?</p> <h2>This Q&A will help parents navigate ever-changing safety concerns:</h2> <h3>Q. How can parents protect newborns once they go home?</h3> <p>A. While many new mothers are excited to introduce their new baby to family members, physical distancing remains the best strategy for limiting the risk of infection for their new babies. This means that people who do not live with you should not come see your baby until the COVID-19 pandemic has resolved. Use social media or video applications, such as FaceTime, Skype and Zoom, to connect with friends and family members who do not live with you to introduce your baby. All caretakers and siblings should wash their hands frequently and take special care to wash hands before touching newborns. They also should wear a mask when holding the baby. The baby should only be around people who live in the house and are asymptomatic. If someone has COVID-19 symptoms, isolate that person from the baby and family as much as possible. Overall, avoid taking the baby out of the house to prevent exposing the baby to the virus. Take advantage of online shopping and grocery pickup.</p> <h3>Q. Is the COVID-19 vaccine safe for breastfeeding women?</h3> <p>A. On Dec. 12, 2020, the Pfizer BioNTech vaccine received emergency use authorization from the Food and Drug Administration, including authorization to vaccinate pregnant and breastfeeding women. The U.S. Advisory Committee on Immunization Practices recommends with the Pfizer BioNTech vaccine that these patients discuss vaccination with their health care providers. They should discuss the benefits and risks, and consider what is known and what is not known to make an informed decision with the expectation that many would proceed with vaccination. Get more information about <a href="/hometown-health/featured-topic/common-questions-about-covid-19-vaccinations-answered" target="_self" title="Opens in same window.">COVID-19 vaccines</a>.</p> <h3>Q. If mom gets COVID-19 and she's breastfeeding, will it transfer to the baby?</h3> <p>A. Breastfeeding has not been linked to transmission of COVID-19. However, there have been limited studies. At this time, the virus has been not been detected in breast milk. This does not mean that it isn't possible. There just isn't sufficient evidence available at this time to be certain.</p> <h3>Q. If mom has COVID-19, what can she do to keep the baby safe while breastfeeding?</h3> <p>A. There is no way to avoid how close mom and her baby must be to breastfeed. However, COVID-19 is spread through respiratory droplets that can easily be transmitted from a mother to her baby during breastfeeding. Moms who have confirmed COVID-19 respiratory symptoms, are suspicious for COVID-19 or are awaiting COVID-19 test results should take precautions to prevent spreading it to the baby through respiratory droplets. This includes washing hands prior to touching the baby and wearing a face mask while breastfeeding. If mom is pumping or hand-expressing milk, she should wash her hands prior to touching any bottles or pump parts. Someone who is not sick can then feed the baby.</p> <p>There may be instances in which mom and her baby must be separated, such as when babies require neonatal intensive care or special care services. In this event, it is recommended that moms continue to pump or hand-express milk.</p> <p>Get tips about <a href="/hometown-health/speaking-of-health/returning-to-work-after-maternity-leave" target="_self" title="Opens in same window.">returning to work after maternity leave</a>.</p> <p><em><a href="/providers/laura-ambler-do" target="_self" title="Opens in same window.">Laura Ambler, D.O.</a>, is an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p> <hr /> <p><em>This post was updated on Feb. 3, 2021, to reflect new recommendations. The information is accurate at the time of its posting. Due to the fluid nature of the COVID-19 pandemic, scientific understanding, along with guidelines and recommendations, may have changed since the original publication date in May 2020.</em></p><ul> <li>Robotic surgery</li> </ul>D.O.<p>I chose to come to Mayo Clinic Health System because I believe in patient-centered, humanistic care that is relationship-driven. Mayo Clinic Health System is in line with my personal beliefs of what medicine should be.</p> <p>My personal interests include reading, traveling and taking road trips with my family.</p><p><strong>Education</strong></p> <ul> <li>Western University of Health Sciences College of Osteopathic Medicine of the Pacific</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Obstetrics and Gynecology, University of Florida–Sacred Heart Health System in Pensacola</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Obstetrics and Gynecology, Mayo Clinic College of Medicine and Science</li> </ul>Ambler<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/laura-ambler-do.JPG?h=280&iar=0&w=280&sc_lang=en&hash=FE0201A72EBD0F82CF8F73889DFB1D15" alt="Laura Ambler, D.O." width="280" height="280" DisableNVelocity="true" />Laura<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21276579Laura Ambler, D.O.1{54693F31-87AF-4B21-91DB-1DEC1E21F878}<img src="/-/media/national-files/images/hometown-health/2020/new-mom-cuddling-newborn-baby.jpg?h=370&iar=0&w=660&sc_lang=en&hash=47E638F6AAA28308CF44DAB7C3C7443F" alt="New mom cuddling newborn baby" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Dawn Haller2/12/2021This time can feel especially frightening for some pregnant women. Here's a Q&A to help expecting families feel informed and prepared for pregnancy and delivery during this unprecedented time.COVID-19 and pregnancy: Q&A<p>It's often said that pregnant women are eating for two. But during this COVID-19 pandemic, they also may be worrying for two. This time can feel especially frightening for some pregnant women who are considering the safety of their newborns.</p> <h2>This Q&A can help expecting families feel informed and prepared for pregnancy and delivery during this uncertain time:</h2> <h3>Q. Are pregnant women at a great risk of getting COVID-19?</h3> <p>A. COVID-19 is a newer viral infection, which means there is limited data about its effects on pregnant women who become infected. At this point, pregnant women seem to have the same level of infection risk as women who are not pregnant.</p> <h3>Q. Is COVID-19 more dangerous for pregnant women?</h3> <p>A. According to the Centers for Disease Control and Prevention, pregnant women are at an increased risk for severe illness from COVID-19 and death, compared to nonpregnant women. Also, pregnant women with COVID-19 may have an increased risk for other adverse outcomes, such as preterm labor.</p> <h3>Q. What can pregnant women do to reduce their risk of getting COVID-19?</h3> <p>A. The best way to reduce the risk of infection is the same for all people. Prevent the virus from infecting your body by washing your hands frequently with soap and water or alcohol-based hand sanitizer, and disinfect surfaces in your house that are frequently touched, such as countertops and doorknobs. Also, you should maintain physical distancing, stay home if possible and wear a mask.</p> <h3>Q. If a woman gets COVID-19 while pregnant, will it harm her baby?</h3> <p>A. At this time, current evidence suggests that transmitting the virus from mother to baby during pregnancy is unlikely. COVID-19 has not yet been found in breast milk, amniotic fluid or other maternal body fluid samples. However, while the virus may not transfer to baby, a mother's infection can affect her baby. Any severe infection that compromises a mother's ability to breathe can significantly affect the baby, as the baby relies on the oxygen in a mother's blood. Severe illness in pregnant women can increase the risk of preterm birth, either due to preterm labor, or the medical need to deliver early for the health of the mother or baby. Pregnant women who become ill with symptoms consistent with COVID-19 should call their health care providers.</p> <h3>Q. With social gatherings being canceled, what should pregnant women do about attending a childbirth education class?</h3> <p>A. <a href="/services-and-treatments/prenatal-care">Childbirth education</a> is an important part of preparing for birth. However, in-person classes are not available at this time due to physical distancing. The best option is to pursue online options that can help women prepare for birth while minimizing their risk of becoming sick with COVID-19. While women are encouraged to take birthing classes, they are optional. Many women who have not attended birthing classes have still had successful vaginal births. Finally, women will still have prenatal appointments with their providers. If they have specific questions, they should speak up, and ask their nurse or provider.</p> <h3>Q. Are there any other care options during COVID-19?</h3> <p>A. Mayo Clinic Health System offers more virtual care options so patients do not need to come in to receive routine prenatal care. Virtual care options allow women to maintain social distancing, which helps minimize risk of exposure. Ultrasounds will be scheduled as needed. Locations in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a> and <a href="/locations/menomonie" target="_self" title="Opens in same window.">Menomonie</a> also offer the Mayo Clinic OB Nest program. This program, which was in place before the COVID-19 pandemic, allows women to have fewer in-person visits. Through this innovative program, women are provided a fetal Doppler — the instrument used to listen to baby's heartbeat, and a blood pressure cuff. Women can use these tools to monitor their own health and the well-being of their babies. Nurses provide care via phone calls and online through Patient Online Services.</p> <h3>Q. Is the birth experience different during this pandemic?</h3> <p>A. Yes, the experience is a bit different right now. While there are a few small differences, women do not need to bring anything special to the hospital or prepare differently. At this time, women can have one support person join them during labor and delivery. In the past, women were allowed multiple visitors. However, limiting visitors to a single support person helps to limit the risk of spreading COVID-19 in the Birth Center. Due to visitor limitations, women should plan to use social media or other methods of virtual communication to <a href="/hometown-health/featured-topic/caring-for-newborns-during-the-covid-19-pandemic" target="_self" title="Opens in same window.">introduce newborns to their family and friends</a>. You and your support person will be required to wear a mask while in the hospital. It is important to note that women who are ill with COVID-19 will not be able to have a support person during labor due to the increased risk of spreading the virus.</p> <h3>Q. Is the COVID-19 vaccine safe for pregnant and breastfeeding women?</h3> <p>A. On Dec. 12, 2020, the Pfizer BioNTech vaccine received emergency use authorization from the Food and Drug Administration, including authorization to vaccinate pregnant and breastfeeding women. The U.S. Advisory Committee on Immunization Practices recommends with the Pfizer BioNTech vaccine that these patients discuss vaccination with their health care providers. They should discuss the benefits and risks, and consider what is known and what is not known to make an informed decision with the expectation that many would proceed with vaccination.</p> <p><em><a href="/providers/laura-ambler-do" target="_self" title="Opens in same window.">Laura Ambler, D.O.</a>, is an <a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p> <hr /> <p><em style="color: #131313; font-family: 'Open Sans', Arial, sans-serif;">This post was updated on Feb. 12, 2021, to reflect new recommendations. The information is accurate at the time of its posting. Due to the fluid nature of the COVID-19 pandemic, scientific understanding, along with guidelines and recommendations, may have changed since the original publication date in April 2020.</em></p> <p> </p><ul> <li>Robotic surgery</li> </ul>D.O.<p>I chose to come to Mayo Clinic Health System because I believe in patient-centered, humanistic care that is relationship-driven. Mayo Clinic Health System is in line with my personal beliefs of what medicine should be.</p> <p>My personal interests include reading, traveling and taking road trips with my family.</p><p><strong>Education</strong></p> <ul> <li>Western University of Health Sciences College of Osteopathic Medicine of the Pacific</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Obstetrics and Gynecology, University of Florida–Sacred Heart Health System in Pensacola</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Obstetrics and Gynecology, Mayo Clinic College of Medicine and Science</li> </ul>Ambler<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/laura-ambler-do.JPG?h=280&iar=0&w=280&sc_lang=en&hash=FE0201A72EBD0F82CF8F73889DFB1D15" alt="Laura Ambler, D.O." width="280" height="280" DisableNVelocity="true" />Laura<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>21276579Laura Ambler, D.O.1{54693F31-87AF-4B21-91DB-1DEC1E21F878}<img src="/-/media/national-files/images/hometown-health/2020/pregnant-woman-holding-baby-bump.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7018D243C030FA60ED1828E07421DE28" alt="Pregnant woman holding baby bump" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Dawn Haller2/4/2021As experts continue to learn more, strep throat assessment and testing has been combined with COVID-19 when needed. Find out what's new and what to do.Strep throat included in COVID-19 testing<p>The COVID-19 testing process at Mayo Clinic locations across the Midwest will now include group A streptococcus — strep throat — assessment and testing when indicated for all patients 3 to 75. Based on the number of strep throat cases seen, combining assessment and testing with COVID-19 is expected to improve the patient experience and expedite care.</p> <p>At the testing site, Mayo Clinic staff will collect specimens using appropriate precautions. If you require more than one test, staff may need to collect more than one specimen.</p> <h2>Get results</h2> <p>Specimens will be sent to a Mayo Clinic lab for analysis, with results expected in 24 to 72 hours. If you are positive for any of the illnesses, you will be contacted and advised of next steps.</p> <p>Your results will all be available in the patient portal or by calling the Test Result Phone Line at 877-838-2050. Have your Mayo Clinic number available when you call.</p> <h2>Influenza and respiratory syncytial testing</h2> <p><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/flu/symptoms-causes/syc-20351719?_ga=2.45863204.1239574754.1610976048-957305950.1522067713" target="_blank" title="Opens in a new window.">Influenza</a> and <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/respiratory-syncytial-virus/symptoms-causes/syc-20353098?_ga=2.37468448.1239574754.1610976048-957305950.1522067713" target="_blank" title="Opens in a new window.">respiratory syncytial virus</a> was previously included in the combined testing process. However, due to the incredibly low rates of influenza across the nation and Mayo Clinic Health System, testing was removed in late January. These tests are still available through your primary care provider when symptoms indicate it is necessary.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2021/hand-on-throat-glass-of-water.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3D517B791418EE745C82D6FD60EE5E5E" alt="Hand on throat, glass of water nearby" width="660" height="370" DisableNVelocity="true" />Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller3/31/2021Over 30,000 women who are pregnant have been vaccinated for COVID-19, including thousands in a CDC monitoring program which closely follows them for long-term adverse effects. Here's what the studies have found.What studies show about pregnancy, COVID-19 vaccines<p>A recent data review by the Advisory Committee on Immunization Practices shows that over 30,000 women who are pregnant have been safely vaccinated for COVID-19. The preliminary safety study, which took place between December 2020 and January 2021, compared women who were pregnant and not pregnant, and who received the Pfizer or Moderna COVID-19 vaccines.</p> <p>The advisory committee found that one day after vaccination, local reactions in both study groups were similar. In nearly all cases, no significant differences in reactions were experienced, such as localized pain, redness, fatigue, headache or fever.</p> <p>Women who are pregnant and participate in v-Safe ― a Centers for Disease Control and Prevention safety monitoring program following COVID-19 vaccination ― are being followed at these intervals to monitor for longer-term adverse effects:</p> <ul> <li>Once per trimester</li> <li>After delivery</li> <li>When the infant is 3 months old</li> </ul> <p>"Now we have some data that shows they haven't had any increased risk of bad outcomes from their pregnancies. Their babies have been just as healthy as their counterparts who weren't vaccinated," says <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/swift-melanie-d-m-d-m-p-h/bio-20441907?mc_id=us&utm_source=newsnetwork&utm_medium=l&utm_content=content&utm_campaign=mayoclinic&geo=national&placementsite=enterprise&cauid=100721" target="_blank" title="Opens in a new window.">Melanie Swift, M.D.</a>, co-chair of Mayo Clinic's COVID-19 Vaccine Allocation and Distribution Work Group.</p> <p>Approximately 2,000 pregnant patients have been enrolled in the V-Safe monitoring program and nearly 300 of those patients have completed pregnancies to date. Pregnancy outcomes, such as miscarriage, stillbirth, pregnancy complications and infant outcomes, among participants are no different than general rates in women who are pregnant and have not been vaccinated for COVID-19.</p> <p>"Pregnant women are at increased risk for bad outcomes when they get COVID-19. And even if they're healthy, the pregnancy itself makes them susceptible to some of the complications of COVID-19. So pregnant women are more likely to have severe COVID-19 and more likely to be hospitalized," says Dr. Swift. "And any severe illness in pregnancy increases the risk to the outcome of the pregnancy. So that's one reason — despite the lack of controlled trials in pregnant women — why experts who take care of pregnant women do encourage them to be vaccinated because they really want to protect pregnant women from having these severe outcomes from COVID-19."</p> <p>Researchers are determining if pregnant women who are vaccinated for COVID-19 can transfer immunity to their unborn babies.</p> <p>"There are some early signs from studies that have been conducted that are small, that show those antibodies do get transferred across the placenta to the baby," says Dr. Swift. "Pfizer is enrolling about 4,000 women in a large study, looking at the immunity that babies get when they're too young to be vaccinated. Could they still get enough benefit from their mother being vaccinated to protect them from COVID-19 in infancy? It's still a question that's being answered, and there's some very promising early results."</p> <p>Dr. Swift recommends that pregnant women talk to their OB-GYN or other health care provider to discuss the pros and cons of being vaccinated for COVID-19. Mayo Clinic continues to follow the guidelines of <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.acog.org/" target="_blank" title="Opens in a new window.">The American College of Obstetricians and Gynecologists</a>, and the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.smfm.org/" target="_blank" title="Opens in a new window.">Society for Maternal-Fetal Medicine</a>, when caring for patients who are pregnant.</p> <p><em>Information in this post was accurate at the time of its posting. Due to the fluid nature of the COVID-19 pandemic, scientific understanding, along with guidelines and recommendations, may have changed since the original publication date.</em></p><img src="/-/media/national-files/images/hometown-health/2021/daughter-touching-mothers-pregnant-belly.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5300F2A395399FB5D41E5E7CF530E798" alt="Daughter touching mother's pregnant belly" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Dawn Haller4/2/2024Over 100,000 people in the U.S. are waiting for an organ transplant. Being an organ donor is a generous, worthwhile decision that can be lifesaving. Get answers to 10 common organ donation myths.Organ donation: Don't let these myths confuse you<p>Over 100,000 people in the U.S. are waiting for an organ transplant. Unfortunately, many may never get the call saying that a suitable donor organ — and a second chance at life — has been found. It's estimated that more than 15 people die every day in the U.S. because of the lack of donor organs.</p> <p>It can be hard to think about what's going to happen to your body after you die, let alone donating your organs and tissue. But being an organ donor is a generous, worthwhile decision that can be lifesaving.</p> <p>If you've never considered organ donation or delayed becoming a donor because of something you've heard, here are answers to some common organ donation myths and concerns.</p> <h2>Myth: If I agree to donate my organs, the hospital staff won't work as hard to save my life.</h2> <p>Fact: When you go to the hospital for treatment, healthcare professionals focus on saving your life — not somebody else's. You'll receive care from healthcare professionals whose expertise most closely matches your condition and who can give you the best care possible.</p> <h2>Myth: Maybe I won't really be dead when they sign my death certificate.</h2> <p>Fact: Although it's a popular topic in the tabloids, in reality, people don't start to wiggle their toes after they're declared dead. People who have agreed to organ donation are given more tests to determine that they're truly dead than those who haven't agreed to organ donation. These extra tests are done at no charge to their families.</p> <h2>Myth: Organ donation is against my religion.</h2> <p>Fact: Organ donation is consistent with the beliefs of most major religions. These religions include Roman Catholicism, Islam, most branches of Judaism and most Protestant faiths. If you're unsure of or uncomfortable with your faiths position on organ donation, ask your clergy member.</p> <h2>Myth: I'm under 18. I'm too young to make this decision.</h2> <p>Fact: Many states allow people younger than 18 to register as organ donors, but the final decision will remain the responsibility of your parents or legal guardian. Discuss your wish to become an organ donor with your family, and ask for their consent. Keep in mind that children need organ transplants, and they usually need organs smaller than those an adult can provide.</p> <h2>Myth: An open-casket funeral isn't an option for people who have donated organs or tissues.</h2> <p>Fact: Organ and tissue donation doesn't interfere with having an open-casket funeral. The donor's body is clothed for burial and treated with care and respect, and there are no visible signs of organ or tissue donation.</p> <h2>Myth: I'm too old to donate. Nobody would want my organs.</h2> <p>Fact: There's no defined cutoff age for donating organs. The decision to use your organs is based on strict medical criteria, not age. Don't prematurely disqualify yourself. Let the doctors decide at the time of your death whether your organs and tissues are suitable for transplantation.</p> <h2>Myth: I'm not in the best of health. Nobody would want my organs or tissues.</h2> <p>Fact: Few medical conditions automatically disqualify you from donating organs. Again, the decision to use an organ is based on strict medical criteria. It may turn out that certain organs aren't able to be transplanted, but other organs and tissues may be fine. Don't prematurely disqualify yourself. Only medical professionals at the time of your death can determine whether your organs can be transplanted.</p> <h2>Myth: I'd like to donate one of my kidneys now, but I wouldn't be allowed to do that unless one of my family members is in need.</h2> <p>Fact: While that used to be the case, it isn't any longer. Whether it's a distant family member, friend or stranger you want to help, you can donate a kidney through certain transplant centers as what is known as a living donor.</p> <p>If you decide to become a living donor, you will undergo extensive questioning to ensure that you know the risks and that your decision to donate isn't based on financial gain. You also will undergo testing to determine if your kidneys are in good shape and whether you can live a healthy life with just one kidney.</p> <h2>Myth: Rich and famous people go to the top of the list when they need a donor organ.</h2> <p>Fact: The rich and famous aren't given priority when it comes to allocating organs. It may seem that way because of the amount of publicity generated when a celebrity receives a transplant, but they are treated no differently than anyone else. In reality, celebrity and financial status are not considered in organ allocation.</p> <h2>Myth: My family will be charged if I donate my organs.</h2> <p>Fact: The organ donor's family is never charged for donation. The family is charged for the costs of all final efforts to save your life, and those are sometimes misinterpreted as costs related to organ donation. Costs for organ recovery go to the transplant recipient.</p> <h3>Becoming an organ donor is easy. You can indicate that you want to be a donor in these ways:</h3> <ul> <li><strong>Register with your state's donor registry.</strong><br /> Most states have registries. Check the list at <a rel="noopener noreferrer" href="https://www.organdonor.gov/" target="_blank" title="Opens in a new window.">organdonor.gov</a>.</li> <li><strong>Designate your choice on your driver's license.</strong><br /> Do this when you obtain or renew your license.</li> <li><strong>Tell your family.</strong><br /> Make sure your family knows your wishes regarding donation.</li> </ul> <p>The best way to ensure that your wishes are carried out is to register with your state's organ donation registry and include donor designation on your driver's license or state ID. Taking these steps legally authorizes your organ donation upon death.</p> <p>If you have designated someone to make healthcare decisions for you if you become unable to do so, make sure that person knows that you want to be an organ donor. You also may include your wishes in your living will if you have one, but that paperwork might not be immediately available at the time of your death.</p> <p>It's also important to tell your family you want to be a donor. Hospitals seek consent from the next of kin before removing organs, although this isn't required if you're registered with your state's donor registry or have donor designation on your driver's license or state ID card.</p> <h2>Learn more about organ donation:</h2> <ul> <li>Visit the <a rel="noopener noreferrer" href="https://www.donatelife.net/" target="_blank" title="Opens in a new window.">Donate Life America website</a>.</li> <li>Watch an organ donation <a rel="noopener noreferrer" href="https://www.youtube.com/watch?v=XafcAezg5JI" target="_blank" title="Opens in a new window.">Honor Walk video</a>.</li> <li>Read Jim Halbach's story to learn <a href="/hometown-health" target="_self" title="Opens in same window.">why it's important to be a kidney donor</a>.</li> <li>Read Debbie Pollino's story about <a href="/hometown-health" target="_self" title="Opens in same window.">meeting the man who received her son's heart</a>.</li> </ul> <p><a href="/providers/jason-beckermann-md" target="_self" title="Opens in same window.">Jason Beckermann, M.D.</a>, is a <a href="/services-and-treatments/surgery" target="_self" title="Opens in same window.">surgeon</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin. Anja Grogseth is the donor liaison in <a href="/locations/red-wing" target="_self" title="Opens in same window.">Red Wing</a>, Minnesota, and Angi Grimm is the donor liaison in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</p>M.D.<p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>General Surgery, Hennepin County Medical Center</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Critical Care, Hennepin County Medical Center</li> </ul> <p><strong>Certification</strong></p> <p> </p> <ul> <li>General Surgery</li> <li>Surgical Critical Care</li> </ul> <p><strong>Membership</strong></p> <ul> <li>Fellow, American College of Surgeons</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Surgery, Mayo Clinic College of Medicine and Science</li> </ul>Beckermann<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/jason-beckermann-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=9876BD2CCE873C4E71DCD4D119F27DFA" alt="Jason Beckermann, M.D." width="280" height="280" DisableNVelocity="true" />Jason<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13687743Jason Beckermann, M.D.1<img src="/-/media/national-files/images/hometown-health/2024/weeds-in-sunny-field.jpg?h=370&iar=0&w=660&sc_lang=en&hash=AB16C10C82DD8F3C7E3EDDC58F975951" alt="Weeds in sunny field" width="660" height="370" DisableNVelocity="true" />Organ DonationOver 100,000 people in the U.S. are waiting for organ transplant, and every 10 minutes another person is added to the national waiting list.</p><br/><br/>Unfortunately, many never get the call saying that a suitable donor organ — and a second chance at life — has been found. It's estimated that 15 people die each day in U.S. because the organ they need is not donated in time.</p><br/><br/>By donating your organs after you die, you can save or heal more than 75 lives. Many families say that knowing their loved one helped save other lives helped them cope with their loss.</p><br/><br/><strong>Becoming an organ donor is easy. You can indicate you want to be a donor by:</strong><br/><ul><br/><li>Registering with your state's donor registry. Check the list at <a href =" https://www.organdonor.gov/" target=blank>organdonor.gov.</a><br/><li>Designating your choice on your driver's license when you get or renew your license.<br/><li>Making sure your family knows your wishes regarding donation.</li><br/></ul><br/>Visit the <a href= " https://www.donatelife.net/" target=blank>Donate Life America website</a> for more information about organ donation.</p>Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller5/29/2024<p>How much time do you and your family members spend using screens? Reducing screen time allows you to be present in the moment. Learn about the many benefits of cutting down on screen time.</p>5 ways slimming screen time is good for your health<p>Smartphones, <a href="/hometown-health/speaking-of-health/are-video-games-and-screens-another-addiction" target="_self" title="Opens in same window">gaming systems and screens</a> are everywhere. They are in our homes, bedrooms, offices, vehicles, pockets and purses. Have you ever considered how much time you or your family members spend on a screen? While these electronics can be helpful and entertaining, the amount of time we spend on them also can become a problem.</p> <p>Consider this: When using a device, you disengage with something else. Is that something else important to you? Perhaps it's a child, a significant other, exercise, your job, chores or hobbies.</p> <p>Many people feel like something is missing in life. Perhaps it's an unidentified desire to live life more fully. Reducing screen time frees up more time to connect with family and friends. <a href="/hometown-health/featured-topic/brushing-off-the-social-rust" target="_self" title="Opens in same window">Feeling connections with others</a> can help ward off symptoms of stress, depression and anxiety. We often miss out on the fun and beauty happening around us because of screens. By being present and in the moment — perhaps by setting aside a device — you may find what you need to fill that void.</p> <h2>There are many wellness benefits to cutting down on screen time, including these five:</h2> <h3>1. Improve your physical health.</h3> <p>You know that physical activity is good for your health, but devices use could reduce your exercise time. Maintaining healthy habits can be hard when you spend lots of time using screens.</p> <h4>Benefits include:</h4> <ul> <li><strong>Preventing obesity and conditions related to excess weight.</strong><br /> Such conditions include Type 2 diabetes and heart disease. <a href="/hometown-health/speaking-of-health/children-and-screen-time" target="_self" title="Opens in same window.">Children who watch more TV</a> have a greater risk of becoming overweight.</li> <li><strong>Freeing more time for exercise and play.</strong><br /> You can add physical activity to fill the new gaps in your schedule.</li> <li><strong>Increasing your amount of sleep.</strong><br /> Children who watch more TV tend to have more difficulty falling or staying asleep. They can feel tired and snack more often to make up for lost hours of sleep.</li> <li><strong>Reducing mindless snacking which can lead to weight gain.</strong><br /> Snacking or eating meals in front of the TV can lead to <a href="/hometown-health/speaking-of-health/sensible-snacking" target="_self" title="Opens in same window">mindless eating</a>, which can result in consuming larger portions. Eliminating distractions allows you to pay more attention to your body and its signals when you're full.</li> </ul> <h3>2. Free up time to have fun playing and exploring.</h3> <p>Exploring and learning about the world is an integral part of life. Children are naturally curious, but adults can explore, too. Instead of spending time on devices, you and your family can try new activities. Go for a bike ride, take a walk, visit a park, check out the museum or explore a local nature trail. Activities that don't involve screens can be as exciting as what is on them. Try <a href="/hometown-health/speaking-of-health/coloring-is-good-for-your-health" target="_self" title="Opens in same window.">coloring</a>, reading, crafting or other activities that use your imagination. Decreasing screen time allows more time for play and creative activities.</p> <h3>3. Make social connections.</h3> <p>Connecting with others is crucial for us to feel cared for. Children look to their caregivers for this sense of belonging; adults may find it within their families and friends. Devices can damage these relationships.</p> <p>When parents engage with a screen, children may feel they need to compete for attention. When you set down your device, you are more emotionally available and can help <a href="/hometown-health/speaking-of-health/whats-your-familys-digital-diet-plan-for-2018" target="_self" title="Opens in same window">strengthen the family bond</a>.</p> <p>One study found that children who went without electronic devices for five days were better at recognizing facial emotions and reading nonverbal cues than those who lived life as usual. Less screen time can result in better face-to-face social skills. Having a TV on, even as background noise, will direct your focus to it rather than what is happening around you.</p> <h3>4. Boost your mood.</h3> <p>Putting down your phone and going outside or doing an enjoyable activity can be a mood booster. It can make you feel more accomplished and improve your well-being. Depression and anxiety can cause a person to withdraw and isolate themselves from others. <a href="/hometown-health/speaking-of-health/maintaining-healthy-relationships-is-important-as-we-age">Engaging in social activities</a> helps you connect with others and reduce symptoms of these conditions. Children who spend more time looking at a screen are more likely to have behavioral problems and divided attention; decreasing screen time can improve their focus. Violence in media may cause kids to feel anxious and depressed and lead them to think that violence is an acceptable way to deal with problems.</p> <h3>5. Build community.</h3> <p>Being part of the community around you and feeling connected to others benefits your overall health.</p> <h4>Consider these ways to get connected:</h4> <ul> <li>Families who eat meals together tend to be healthier. Turning off electronics during meals or family time eliminates distractions. Children from families who eat together also show better academic scores.</li> <li>Find events in your community. Use time previously spent on devices for volunteering, joining a sports team or connecting with a spiritual group.</li> <li>Feeling a <a href="/hometown-health/speaking-of-health/is-having-a-sense-of-belonging-important" target="_self" title="Opens in same window">sense of belonging</a> and being social is an excellent way to manage stress. Having support and feeling that you are not alone can help you cope with difficult times.</li> </ul> <p>While technology is a great tool, it also can hinder your wellness and make you feel disconnected from those around you. Taking a break from devices frees up more time to be active and enjoy time with loved ones. Why not give it a try?</p> <p>Register for <a href="/wellness/slim-your-screen-time" target="_self" title="Opens in same window."><strong>Slim Your Screen Time</strong></a><strong> — a free, at-home, self-guided program that is designed to help you improve your health by reducing screen time. Join the program at any time.</strong></p> <p><em><a href="/providers/mysoon-ayuob-md" target="_self" title="Opens in same window.">Mysoon Ayuob, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/faribault" target="_self" title="Opens in same window.">Faribault</a>, Minnesota.</em></p><ul> <li>Chronic disease</li> <li>Community education</li> <li>Community health and wellness</li> <li>Pediatrics</li> <li>Public safety regarding COVID-19</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Khartoum College of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, New York Medical College at St. Joseph's Medical Center</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Family Medicine</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Family Physicians</li> <li>American Medical Association</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Ayuob<img src="/-/media/shared-files/images/medical-professionals/full/faribault/mysoon-ayuob-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=CFE58C08C0B03A51DD513CAC27D3A307" alt="Mysoon Ayuob MD" width="280" height="280" DisableNVelocity="true" />Mysoon<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16315847Mysoon Ayuob MD1{B3F96F77-F93E-41A4-AE4E-603045CDB443}<img src="/-/media/national-files/images/hometown-health/2024/kids-pulling-rope-exercise-station.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5FD0B57D829B51B9E638A9B350E2F866" alt="Kids pulling rope exercise station" width="660" height="370" DisableNVelocity="true" />Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.ParentingAs a parent, you quickly realize that your bundle of joy also is a bundle of responsibility. Suddenly, you’re looking for reliable information on everything from diapers to driver’s education. Parenting covers a lot of ground, and our experts in many fields offer information and perspectives on raising great kids.Child DevelopmentWe all want our children to grow up happy and healthy. The reality is most all of them do — but at vastly different rates. Experts across Mayo Clinic Health System see thousands of children each year, and have the experience and resources to know what is normal and what may be cause for closer observation. This includes not only physical and motor skills development, but psychological and social skill advancement.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller6/6/2023Loneliness, a by-product of COVID-19 pandemic isolation, now is considered an epidemic in the U.S. The prescription for easing loneliness? More human connection. These tips can help you reconnect.Four tips for easing loneliness through connection<p>By nature, humans aren't solitary creatures. They thrive through connecting with others, which typically happens without much thought or effort. But the COVID-19 pandemic, which led to isolation and hefty doses of anxiety and uncertainty, has led many to question their ability to make these essential connections.</p> <p>In a recent advisory, the U.S. surgeon general recognized that people are struggling to connect and declared loneliness in the U.S. an epidemic.</p> <p>There's a difference between being alone and loneliness. When you're alone, there's no one with you. When you're lonely, you feel disconnected from others, even if they're right beside you.</p> <p>The prescription for addressing loneliness? More human connection.</p> <h2>Brush off the social rust</h2> <p>To ease your loneliness and make connections, you may need to brush off the rust that's built up on your social skills and regain your confidence in social settings.</p> <h3>These four tips can help you get started reconnecting with others.</h3> <h4>Begin with self-care.</h4> <p>A good place to begin is with you. Do something nice for yourself, such as buying a little gift, which can be as simple as flowers or a plant to brighten your space. Take a hot bath, drink a good cup of coffee or tea, try a new lotion with a calming scent, or listen to a new podcast or some favorite music. </p> <p>Think about hobbies or activities you haven’t done in a while, whether they involve others or not, and try picking them up again. Reconnect with your inner self through meditation or mindfulness practice, either on your own or using an app such as Calm or InsightTimer.</p> <h4>Spend time in nature.</h4> <p>Time spent in nature is valuable for your well-being. This improved well-being comes from connecting with the beauty and wonder of the natural world, either alone or with someone else.</p> <p>Benefits include:</p> <ul> <li>Increased feelings of calm</li> <li>Increased endorphin levels and dopamine production, which promote happiness</li> <li>Restored concentration and attention</li> <li>Reduced anxiety, depression and irritability</li> <li>Lower blood pressure and cortisol levels</li> </ul> <h4>Start small.</h4> <p>If you're lonely, you might be craving in-person contact. But you also might feel you aren't ready to jump into a big gathering with friends or family. And that's OK. Start small by meeting with a friend or two for a low-key get-together like coffee, ice cream or a walk in a park. Even offering a kind word or a friendly smile to someone on the street or a work acquaintance is a simple way to begin reconnecting.</p> <h4>Be gentle with yourself.</h4> <p>Getting back to "normal," whatever that might look like for you, will take practice and time. Life has changed in the past few years. You have changed, others have changed and it may be a while before you feel comfortable doing the things that used to come more easily. But in time, making connections will feel more natural. By being gentle with yourself and others, you can ease back into those connections that support and encourage you.</p> <p>However you decide to begin, the key is to make a start. Reconnecting with yourself, nature and, ultimately, others is possible and necessary, especially in light of the loneliness epidemic. Everyone is struggling to greater or lesser degrees, and we are all truly in this together. You are not alone.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2023/two-people-laughing-in-group.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3A9D4836242BB4A2196B5AF746CEDC91" alt="Two people laughing in group" width="660" height="370" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller5/11/2021Are your kids asking questions about COVID-19 and other vaccines? Get kid-friendly answers and tips for discussing vaccines.Talking to your kids about vaccines<p>Nearly 28 million children in the U.S. are newly eligible to be protected by COVID-19 vaccination. The Food and Drug Administration granted emergency use authorization for the Pfizer COVID-19 vaccine in children 5‒15. COVID-19 vaccines have been used under the most intensive safety monitoring in U.S. history, including studies in children. The Pfizer COVID-19 vaccine has been found to be safe and 91% effective in clinical trials for children 5‒11 and 100% effective in clinical trials in children 12‒15. The FDA has approved the Pfizer-BioNTech COVID-19 vaccine, now called Comirnaty, to prevent COVID-19 in people age 16 and older.</p> <p>Educate yourself so you know the facts and can help put your kids at ease. Start by talking about the amazing work your child's body does to stay healthy. Explain that your child's body is strong and does a great job of keeping him or her safe from germs.</p> <h3>Here are some tips in kid-friendly language for answering common questions your children may have about vaccines:</h3> <h4>Why do I need vaccines?</h4> <p>When you get sick, you are given medicine to help you feel better. Vaccines are like medicine put into your body to keep you from getting sick in the first place. Vaccines are recommended throughout your life to help prevent you from getting illnesses. For example, you get a flu shot each year. These vaccines help protect people around you, especially grandparents and other family members with medical conditions.</p> <h4>How do vaccines work in the body?</h4> <p>Vaccines help your body build up the ability to fight off viruses. Vaccines may not stop you from getting viruses, but if you do get sick, the vaccine may keep you from becoming seriously ill or developing complications due to the illness. And that may be a lifesaving benefit of vaccines.</p> <h4>If I'm healthy, why do I need vaccines?</h4> <p>Even if you are healthy, you can't predict or know in advance if you will get sick. You also can't predict or know how severe the illness will be. Vaccines don't just protect you. They also protect your family, friends and community.</p> <h4>Why do most vaccines come in a shot?</h4> <p>Most vaccines are given as a shot because if you ate or drank them, your stomach would think they're food and digest them. When they are given as a shot, the medicine stays strong and helps your body keep germs from making you sick.</p> <p>Sometimes — as with the Moderna and Pfizer COVID-19 vaccines — multiple doses are needed. The first shot will get your immune system producing some antibodies to fight off the virus, but a second shot is needed to get your body into full defense mode.</p> <h4>Are vaccines safe?</h4> <p>All vaccines must undergo intensive safety monitoring. The Food and Drug Administration has carefully reviewed all of the authorized and recommended vaccines. The FDA is responsible for reviewing all safety data from clinical trials to determine if the expected benefits of vaccination outweigh potential risks.</p> <h5>For your child, you could distill this as follows:</h5> <p>All possible measures have been taken to make sure that no harm will come to those who get vaccinated. Millions of people in the U.S. and around the world have received vaccines, including the COVID-19 vaccine. The delay in getting COVID-19 vaccines for younger children provides time for scientists and doctors to study the vaccine in kids your age.</p> <h4>Will I get sick from vaccines?</h4> <p>Some people will have side effects, but they are generally mild. These side effects are your body's way of responding to the vaccine and building up your immunity against viruses. It is common to experience some minor pain, redness and swelling on the arm where the shot was given, and tiredness, headache, muscle pain, chills, fever and nausea throughout the rest of the body. Some people have no side effects. If two doses are required, the side effects may be more intense after the second dose.</p> <h4>Could the vaccine make me unable to have children in the future?</h4> <p>There is no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems, which are problems trying to get pregnant.</p> <h4>If I am vaccinated for COVID-19 can I do X, Y and Z?</h4> <p>It takes your body a few weeks after you are vaccinated to build immunity, so it is still possible to get the virus. There still are many more people who need to be vaccinated, and this will take time. Be patient, wear a mask, wash your hands and continue to practice social distancing. But getting vaccinated is an important step in stopping the pandemic and returning to normal.</p> <h4>Why can't younger kids get vaccinated for COVID-19?</h4> <p>COVID-19 vaccines likely will be available to younger children in the future. Vaccine experts know vaccines work well for adult bodies and want to make sure it's the same for young kids.</p> <h3>Tips for teens on talking to peers about COVID-19 vaccines</h3> <p>It's likely that your teen has talked about COVID-19 vaccines with peers. Hesitancy to get vaccines can stem from fear and the unknown. Encourage your teen to learn the facts, using information from reputable resources, such as the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.cdc.gov/" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention (CDC)</a>, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/" target="_blank" title="Opens in a new window.">Mayo Clinic</a> and <a href="/" target="_self" title="Opens in same window.">Mayo Clinic Health System</a>.</p> <h4>Here are some facts about COVID-19 vaccines your teen can share and discuss, should he or she have peers who are hesitant to get vaccinated:</h4> <ul> <li>Getting the COVID-19 vaccine can protect you from getting sick.</li> <li>Getting vaccinated for COVID-19 helps others in the community.</li> <li>More vaccinations for COVID-19 mean a change to return to normal.</li> <li>While the development of the COVID-19 vaccine happened quickly, it did not skip necessary safety steps.</li> <li>People of color are especially vulnerable to severe COVID-19.</li> <li>Clinical trials of the COVID-19 vaccine included assessing safety and effectiveness included people of various diversities.</li> <li>COVID-19 vaccine side effects are temporary and do not mean you're sick.</li> <li>If you have allergies, you can still get the COVID-19 vaccine.</li> <li>There is no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems.</li> <li>If you've already had COVID-19, getting vaccinated will add extra protection.</li> <li>The sooner you get vaccinated, the sooner you are protected.</li> <li>Vaccines can't save lives unless people get vaccinated.</li> </ul> <h4>Additional thoughts</h4> <p>Finally, reward and praise your child's bravery to get vaccinated, and continue to be open and honest with your child, so he or she knows to reach out to you with further questions or concerns.<span style="color: #131313; font-family: 'Open Sans', Arial, sans-serif;"> </span></p> <p><em><a href="/providers/jennifer-johnson-do" target="_self" title="Opens in same window.">Jennifer Johnson, D.O.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p> <p><em>Information in this post was accurate at the time of its posting. Due to the fluid nature of the COVID-19 pandemic, scientific understanding, along with guidelines and recommendations, may have changed since the original publication date.</em></p><ul> <li>Obesity management</li> <li>Preventive medicine</li> </ul>D.O.<p>I practice a whole-person approach to medicine, focusing on helping patients achieve health across their lifespan. </p> <p>I grew up in Kansas, and have lived in the Mankato area since 2005. I'm married, have four kids and a dog. When I'm not working, I enjoy cooking and spending time with family.</p><p><strong>Education</strong></p> <ul> <li>Kansas City University Osteopathic Medical School  </li> </ul> <p><strong>Internship</strong></p> <ul> <li>University of Minnesota-Mankato</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, University of Minnesota-Mankato</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Diplomate, American Board of Obesity Medicine</li> <li>Family Practice, American Board of Osteopathic Family Physicians</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Osteopathic Family Physicians</li> <li>American Osteopathic Association </li> <li>Minnesota Medical Association </li> <li>Minnesota Osteopathic Medical Society </li> <li>Obesity Medical Association</li> </ul> <p><strong>Academic Appointments</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Johnson<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jennifer-johnson-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=873658AFB998B5C1BD351A8B228A734B" alt="Jennifer Johnson DO" width="280" height="280" DisableNVelocity="true" />{876CA4AF-3CF4-4F4D-8D4B-5C3EBAEDB74F}Jennifer<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14617781Jennifer Johnson, D.O.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{94B2E140-AEF8-44BA-B6A9-4538B77501BC}|{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}<img src="/-/media/national-files/images/hometown-health/2021/mom-smoothing-childs-hair.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BD0CBA1382456279EB6A9189F2598992" alt="Mom smoothing child's hair" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Immunizations<p>Disease prevention is crucial to your health. Getting vaccinated is one of the best ways to maintain good health, and protect you and those you care about against infectious diseases. Vaccinations offer protection against serious diseases by stimulating the immune system to create antibodies against certain bacteria or viruses.</p><br/><p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/vaccine-guidance/art-20536857" target="_blank" title="Opens in a new window.">Get vaccine guidance from Mayo Clinic</a>, including benefits, safety, side effects and what to know about recommended vaccines for babies, children, teens, adults and during pregnancy. For recommended vaccines based on age, refer to the <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/adult" target="_blank" title="Opens in a new window.">adult</a> or <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/child" target="_blank" title="Opens in a new window.">child and adolescent</a> schedules.</p><br/><p>Review the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/coronavirus-covid-19/history-disease-outbreaks-vaccine-timeline" target="_blank" title="Opens in a new window.">history of infectious disease outbreaks and vaccines timeline</a> for information about major disease outbreaks, epidemics and pandemics, and the impact of vaccines and research.</p>Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller6/30/2023Caregiving can be a rewarding time for you and your loved one, but it's vital to be mindful of your needs and emotions. Get tips to share the responsibility, and learn how to recharge your well-being.Finding balance: Tips for managing caregiving and self-care<p>The COVID-19 pandemic taught people that caring for the caregiver is part of caring for one another — and it's necessary to take time for self-care and recharging so that you can continue to give.</p> <p>As a caregiver, you and your loved one are going through this experience together.</p> <h2>These tips can help you navigate caregiving and self-care:</h2> <h3>Take time to plan</h3> <p>Taking time for planning can be an effective tool for reducing stress.</p> <h4>If you're taking on the role of the primary caregiver, spend time reflecting on and planning for how caregiving affects your other roles. For example:</h4> <ul> <li>What supports are available to your nuclear family when you're occupied with caregiving tasks, such as laundry, housecleaning or child care?</li> <li>What will your work schedule look like, and how much time away will you need? Can you speak to your supervisor and human resources department about your new responsibilities, and seek Family and Medical Leave Act benefits if needed?</li> <li>What can you do to address the needs of your nuclear family as you care for your loved one?</li> <li>What are the expectations of you as the primary caregiver? This should include expectations from the loved one and other family members. Before you accept a caregiver role, consider discussing these expectations at a family meeting.</li> <li>Can other family members take shifts, and how will that look? Having this conversation as a family is ideal. Remember, you're all in this together. Effective communication can smooth the transition into a caregiver role and reduce everyone's stress.</li> <li>What's the anticipated timeline for caregiving, and what are the next steps in care for a loved one who needs more support? This could include moving in with a family member, transitioning to an assisted living facility or nursing home, or bringing professional caregiving or nursing support into your home.</li> </ul> <p>Reflect on your capacity. You can't provide care 24/7 and still <a href="/hometown-health/speaking-of-health/recharge-with-planned-mental-health-day" target="_self" title="Opens in same window.">need time for yourself</a>.</p> <h3>Be mindful of your needs and emotions</h3> <p>Your intentions for becoming a caregiver are good, and it can be a rewarding experience. It can be a blessing to be the go-getter, responsible, loving family member who wants to do all you can for your loved one. Yet take time to regularly check in with yourself to ensure your needs are met.</p> <p>Writing down your list of needs is a good way to organize your thoughts and check off what's important to you. Are you making time for self-care, including time with your friends and interests, or getting enough exercise or rest? Are you taking steps to avoid getting to the <a href="/hometown-health/speaking-of-health/5-tips-to-keep-burnout-at-bay" target="_self" title="Opens in same window.">point of distress</a>? Do you have support from other family members or friends involved in the care plan? If family isn't an option, what public and private support resources are available to give you time to recharge?</p> <h4>If you're the primary caregiver and don't have additional support, pay attention to red flags that you're stressed, including:</h4> <ul> <li>Always putting your wants or needs on the back burner</li> <li>Becoming impatient</li> <li>Becoming short-tempered or frustrated</li> <li>Experiencing fatigue or low energy</li> <li>Facing a <a href="/hometown-health/speaking-of-health/overcoming-loneliness" target="_self" title="Opens in same window.">sense of loneliness</a> or isolation</li> <li>Feeling anger or resentment toward the loved one</li> <li>Feeling disorganized or overwhelmed</li> <li>Feeling nervous or anxious</li> <li>Having racing thoughts</li> <li>Weeping or crying frequently, which isn't associated with the grieving process</li> </ul> <p>Do you feel supported? Are you easily irritable? Angry? Sad? Resentful? Frustrated? Tired? Impatient? Hungry? Feeling guilty? Does your body ache? Are you having frequent headaches? How is your appetite? What physical things are going on with your body? How are you feeling about being able to manage everything?</p> <p>Take time each day to reflect and focus on your feelings and emotions. It's OK to feel them. That doesn't mean you are what you feel. </p> <p>Paying attention to how you feel emotionally and physically when managing stressors is important because those feelings can be the first clues to your needs. Then you can take steps to process, manage and attend to the wants and needs behind the feelings.</p> <h3>Map it out</h3> <p>Once you know your feelings and needs, you can communicate them to other supporters or your loved one. If you started caring for an <a href="/hometown-health/speaking-of-health/maintaining-healthy-relationships-is-important-as-we-age" target="_self" title="Opens in same window.">aging parent</a> recently, you've probably adjusted to what that caregiving looks like for you and your parent. Now you can communicate what's helpful to keep you going, whether it's having others take shifts so you can get away for a weekend, getting help with errands or taking time to exercise each day.</p> <p>Make a list of resources in your personal and professional networks to find support. This could include siblings, family, friends, neighbors, your loved one's friends, or local aging and disability resource centers. Another option is hiring support services, such as a social worker or nurse, for in-home or transitional care. Remember, finding solutions is essential so you can continue to give and take care.</p> <h3>Make the ask</h3> <p>It can be a heavy responsibility to carry most of the caregiver role; no one should be alone in the experience. It also can be difficult or uncomfortable to ask for help.</p> <h4>You may also be making unhelpful negative assumptions, such as: </h4> <ul> <li>Assuming you already know the response or feel you shouldn't have to ask — "They should just know and be helping."</li> <li>Feeling it has to be you to help and know what is right for your loved one.</li> <li>Wanting to avoid being a bother.</li> <li>Worrying that others won't remember specifics about medications, allergies or your loved one's preferences.</li> </ul> <p>Now is the time to set aside assumptions or family dynamics and simply make the ask. I often tell caregivers: "Let's test it. You ask or state what's needed, and let them say yes or no." The answer might be yes, and what a relief that would be. If it's no, you still have narrowed the options based on fact, not assumptions.</p> <p>Be specific when you ask for help. Instead of asking, "Could you come over and sit with mom sometime?" or "It would be nice to have help around here," rephrase it to: "Could you sit with mom for two hours on Saturday morning? I'll need to know by Wednesday," or "Can you mow dad's lawn on Sunday afternoon?" or "Can you do the laundry on Friday while I pick up my daughter?"</p> <p>You also can make a to-do list and place it where others can see it. The point is to make the communication clear. Even if the answer isn't immediately "Yes, of course," it can be the starting point for planning to meet everyone's schedule.</p> <p>Building trust and allowing others to <a href="/hometown-health/speaking-of-health/purpose-and-mental-health" target="_self" title="Opens in same window.">take on roles</a> is important, as well. As you share the responsibility and trust others, your mood will improve, and you'll feel more supported and recharged.</p> <h3>Set boundaries</h3> <p>Sometimes you must set boundaries of acceptable behaviors or requests with the loved one you're caring for. It's not uncommon for them to develop a preference for your care over others or expect that you stay with them despite having other caregivers available.</p> <p>Good boundary setting means respectfully and clearly communicating your expectations, limits and needs. Think about your loved one's capabilities. Is the request appropriate? If not, discuss what you will or won't do. State facts when talking about expectations, such as: "Mom, I need to go to my daughter's house and see the grandbaby. Janelle is going to be with you when I'm gone. You know I love you, but it's hard for me when you get mad at me when I take time to see others."</p> <p>You should acknowledge choices and allow the person autonomy within their capabilities. An example might be offering them a choice between using a walker versus a wheelchair to move from the bedroom to the front porch.</p> <p>Boundary setting is a type of <a href="/hometown-health/speaking-of-health/self-care-tips-for-moms" target="_self" title="Opens in same window.">self-care</a> as well. Some people think good caregivers give whatever their loved one needs or wants. Yet many caregivers are so busy caring for their loved ones that they neglect their own physical, emotional and mental needs. Setting boundaries so you can take time to exercise, eat well, get enough sleep or socialize with friends or loved ones helps you recharge.</p> <p>Finally, boundary setting helps when managing intense emotions. Stressful situations and strong emotions often go together. Notice and acknowledge your feelings but remember you don't need to become the emotion.</p> <p>You can be empathetic and supportive of your loved one and have your boundaries and values respected while not allowing your emotions to dictate how you react to stress. </p> <p>For example: "David, you said you would be with Dad today. I'm sorry, but I can't leave work early to come to Dad's house now. I have next Tuesday and Thursday off from work to be with Dad, and I'll use up part of that vacation time if I come now," or "Mom, I made arrangements for the church volunteers to clean your yard today. Please don't ask them to leave. I appreciate that you'd prefer that I do it, but they do this for free, and it will give me the time to get other things done."</p> <h3>Seek professional help</h3> <p>Many caregivers can benefit from professional <a href="/hometown-health/speaking-of-health/overcoming-mental-health-care-barriers" target="_self" title="Opens in same window.">mental health counseling</a> to help them cope with the stress and challenges of the role. Therapists can help you work through your experience and identify your stressors. For instance, if family dynamics contribute to your stress, a therapist can help you develop scripts for talking with loved ones about the situation and possible solutions. They also can help you develop solution-focused action plans for managing other challenging caregiving circumstances.</p> <p>Be gentle with yourself and patient with this ever-evolving process.</p> <h4>You may have never done this before, and it might be messy and need adjustments. It's appropriate to:</h4> <ul> <li>Ask for help from your family and friends</li> <li>Ask questions</li> <li>Be mindful of and communicate your wants and needs</li> <li>Involve others</li> <li>Plan and organize</li> <li>Set appropriate boundaries, including with your loved one</li> <li>Use any and all resources</li> </ul> <p>Many caregivers reflect on their time and wonder if they did all they could for their loved ones. You're taking time to provide for your loved one's safety, emotional, physical, spiritual and psychological needs. If you did all you could by taking care of your loved one, taking care of yourself and using your available resources, you did do enough. The best measure of caregiver success is if you did your best with what you had at that moment. Just remember you don't have to go it alone.</p> <p><em><a href="/providers/sarah-cormell-lcsw" target="_self" title="Opens in same window.">Sarah Cormell</a> is a licensed clinical social worker in <a href="/services-and-treatments/psychiatry-and-psychology" target="_self" title="Opens in same window.">Psychiatry and Psychology</a> in <a href="/locations/menomonie" target="_self" title="Opens in same window.">Menomonie</a>, Wisconsin</em></p><ul> <li>Child and adolescent mental health</li> <li>Family systems</li> <li>Grief and loss</li> <li>LGBTQI mental health</li> <li>Obsessive-compulsive disorders</li> <li>Personality disorders</li> <li>Relationships, mediation, divorce</li> <li>Stress management</li> <li>Substance abuse, relapse prevention</li> <li>Suicidal ideation</li> <li>Trauma</li> </ul>L.C.S.W.<p>My role as a helper is to listen and work with patients to meet their wellness goals through evidence-based, psychological therapeutic interventions. I offer knowledgeable, engaging, supportive, nonjudgmental holistic care in a wrap-around care environment for individuals and families. I enjoy and respect the individuality of each person across all walks of life and ages to treat the whole person with effective solutions for long-term personal success and well-being.</p> <p>I enjoy reading, running, the outdoors, time with friends and family, music, good food and learning.</p><p><strong>Education</strong></p> <ul> <li>Bachelor’s degree, Sociology, University of Wisconsin–Eau Claire</li> <li>Master’s degree, Social Work, University of Wisconsin–Madison School of Social Work</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Licensed Clinical Social Worker</li> <li>Licensed Substance Abuse Counselor</li> </ul> <p><strong>Membership</strong></p> <ul> <li>National Association of Social Workers</li> </ul>Cormell<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/sarah-cormell-lcsw.JPG?h=280&iar=0&w=280&sc_lang=en&hash=48F4147373097C6279174DF703C2F049" alt="Sarah Cormell, L.C.S.W." width="280" height="280" DisableNVelocity="true" />Sarah<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>30058903Sarah Cormell, L.C.S.W.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{67744200-E25F-439A-8B70-572A5A091172}|{8E0DE698-8F08-4F9A-BBBB-65CAAF9FA58B}<img src="/-/media/national-files/images/hometown-health/2021/caregiver-with-loved-one.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A6CF1BA2045710245E6C09187E6C05A8" alt="Caregiver with loved one" width="660" height="370" DisableNVelocity="true" />AgingLife expectancy is 75 for males and 80 for females according to the National Center for Health Statistics. We'll help you keep you informed about potential issues with aging, and steps you can take to maintain your health and keep active.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller6/3/2021If you've lost your sense of smell this past year, you're not alone. Learn what you might expect, how long it could last, why COVID-19 can affect it and more.Q&A: COVID-19 and loss of smell, taste<p>Smell is an often underrated sense, and many don't realize how truly important it is until it doesn't work normally. Smell is linked to emotion and memory, alerts us to danger and possibly most importantly works with the sense of taste to give us flavor.</p> <p>The loss of smell, or <a rel="noopener noreferrer" href="https://www.mayoclinic.org/symptoms/loss-of-smell/basics/definition/sym-20050804" target="_blank" title="Opens in a new window.">anosmia</a>, can be devastating and has even been associated with depression. The COVID-19 pandemic has brought anosmia into the spotlight. However, many viruses can cause smell dysfunction, such as the common cold.</p> <h2>Learn more in this Q&A:</h2> <h3>What should you do if you've lost your sense of smell and taste?</h3> <p>Smell dysfunction is common and often the first symptom of a COVID-19 infection. Therefore, you should self-isolate and get tested for COVID-19 when you can. It is also common in other viral upper respiratory illness, such as the common cold, but rarely is it the only or first symptom in those cases.</p> <h3>How common is it to lose your sense of smell and taste?</h3> <p>Smell dysfunction likely affects 50%–75% of people in the U.S. Most of the time taste also is affected since smell and taste work together to create flavor.</p> <h3>Can you just lose your sense of taste or smell?</h3> <p>It's unlikely to lose the sense of smell without also perceiving a loss or change in taste.</p> <h3>Why does COVID-19 affect smell and taste?</h3> <p>While the precise cause of smell dysfunction is not entirely understood, the mostly likely cause is damage to the cells that support and assist the olfactory neurons, called sustentacular cells. These cells can regenerate from stem cells, which may explain why smell recovers quickly in most cases.</p> <h3>How long does the loss of taste and smell last?</h3> <p>Approximately 90% of those affected can expect improvement within four weeks. Unfortunately, some will experience a permanent loss.</p> <h3>Could you experience unusual tastes and smells?</h3> <p><a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/temporal-lobe-seizure/expert-answers/phantosmia/faq-20058131" target="_blank" title="Opens in a new window.">Phantosmia</a> is the perception of a smell that doesn't exist, much like phantom limb pain. Regardless of the cause of loss of smell, patients can experience phantosmia. Often the phantom smell is unpleasant, such as the smell of smoke or rotten meat. Also, normally pleasant smells can be perceived as foul.</p> <h3>Does the loss of taste and smell mean you had a mild, moderate or severe case of COVID-19?</h3> <p>The severity of symptoms is not predicted by the loss of smell. However, it is common for anosmia to be the first and only symptom.</p> <h3>What should you do if the loss of taste and smell lingers on? Is help available?</h3> <p>In most cases, smell dysfunction recovers quickly. However, it can take months. In a minority of cases, recovery can be incomplete with lasting impairment. While no proven treatment is available, olfactory training is recommended. Topical corticosteroid sprays also are often used in short-term treatment, but they are unlikely to help outside of the acute illness period. Clearly, the best treatment is prevention, such as wearing a mask, practicing social distancing and getting vaccinated for COVID-19.<span style="font-family: 'Open Sans', Arial, sans-serif; color: #131313;"></span></p> <p><em><a href="/providers/david-valencia-md" target="_self" title="Opens in same window.">David Valencia, M.D.</a>, is an <a href="/services-and-treatments/otorhinolaryngology" target="_self" title="Opens in same window.">otorhinolaryngologist</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a> and <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Chronic ear disease</li> <li>Chronic sinusitis</li> <li>Ear tubes/tympanostomy tubes</li> <li>Endoscopic dacryocystorhinostomy (tear duct surgery)</li> <li>Head and neck cancer (lip, mouth, tonsil, throat, voice)</li> <li>Hearing loss</li> <li>Nasal polyps</li> <li>Nose and sinus disease</li> <li>Osteosclerosis</li> <li>Parathyroid adenomas</li> <li>Parotid disease</li> <li>Salivary gland/parotid</li> <li>Thyroid nodules</li> <li>Thyroid/parathyroid disease</li> <li>Tonsillectomy and adenoidectomy</li> </ul>M.D.<p>I believe my role as an ear, nose and throat (ENT) surgeon is to listen to and educate my patients regarding their diagnosis, so they are able make decisions that are right for them. I tend to be direct, with the goal of ensuring that my patients understand their options and obtain answers to all their questions. Our team strives to ensure our patients have an exceptional experience and feel respected while in our care. </p> <p>I'm a husband, father of four, brother, doctor, avid DIYer and tool enthusiast. I've built and remodeled houses, shingled countless roofs, raised pigs and thrown many bales. I enjoy learning new skills, such as welding, wood turning and building jungle gyms. A day with my family is always a great day.</p><p><strong>Education</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Residency</strong></p> <ul> <li>University of Minnesota Medical School</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Head and Neck Surgery, American Board of Otolaryngology</li> </ul> <p><strong>Membership</strong></p> <ul> <li>Head and Neck Surgery, American Board of Otolaryngology</li> </ul> <p><strong>Academic Appointment </strong></p> <ul> <li>Instructor in Otolaryngology, Mayo Clinic College of Medicine and Science</li> </ul>Valencia<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/david-valencia-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=3236916E09B41CEF7753164CA290FB8C" alt="David Valencia MD" width="280" height="280" DisableNVelocity="true" />{590BF78D-96A4-4850-BDA2-0CBBACEE44F6}David<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14071444David Valencia, M.D.1{18E5E65E-45C8-4C48-BD32-A914794E2AA4}|{E9B8BDBE-375B-4E7D-A1D2-2B64B5513AF7}<img src="/-/media/national-files/images/hometown-health/2021/smelling-plate-of-food.jpg?h=370&iar=0&w=660&sc_lang=en&hash=69608C1434A0448ECBA2D91EA4563684" alt="Smelling plate of food" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Ear, Nose and Throat (ENT)Get information about symptoms, disorders and diseases affecting the ear, nose and throat, and related head and neck structures.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller11/4/2021Getting a COVID-19 vaccine is an important tool to help stop the ongoing pandemic. Here are answers to the most common questions.Common questions about COVID-19 vaccinations answered<p><em>Updated April 1, 2022</em></p> <p>Getting a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/coronavirus/symptoms-causes/syc-20479963" target="_blank" title="Opens in a new window.">COVID-19</a> vaccine is an important tool — along with wearing a cloth mask, socially distancing and good hand hygiene — to help stop the ongoing pandemic. As wide-scale vaccination efforts continue, many people have questions about the vaccines. Mayo Clinic's Vaccination and Distribution Workgroup has answered some of the most common questions about COVID-19 vaccines.</p> <p>Getting a COVID-19 vaccine is an important tool, along with wearing a mask, socially distancing and good hand hygiene, to help stop the ongoing pandemic. As wide-scale vaccination efforts continue, many people have questions about the vaccines. Mayo Clinic's Vaccination and Distribution Workgroup has answered some of the most common questions about COVID-19 vaccines.</p> <h2>What are the benefits of getting a COVID-19 vaccine?</h2> <h3>A COVID-19 vaccine might:</h3> <ul> <li>Prevent you from getting COVID-19 or from becoming seriously ill or dying due to COVID-19</li> <li>Prevent you from spreading the virus that causes COVID-19 to others</li> <li>Add to the number of people in the community who are protected from getting COVID-19 — making it harder for the disease to spread and contributing to herd immunity</li> <li>Prevent the virus that causes COVID-19 from spreading and replicating, which allows it to mutate and possibly become more resistant to vaccines</li> </ul> <h2>Should I get the COVID-19 vaccine even if I've already had COVID-19?</h2> <p>Getting COVID-19 might offer some natural protection or immunity from reinfection with the virus that causes COVID-19. It’s estimated that getting COVID-19 and COVID-19 vaccination both result in a low risk of another infection with a similar variant for at least 6 months.</p> <p>But because reinfection is possible and COVID-19 can cause severe medical complications, it’s recommended that people who have already had COVID-19 get a COVID-19 vaccine.</p> <p>In addition, COVID-19 vaccination might offer better protection than getting sick with COVID-19. A recent study showed that unvaccinated people who already had COVID-19 are more than twice as likely as fully vaccinated people to be reinfected with COVID-19.</p> <p>Recent research also suggests that people who got COVID-19 in 2020 and then received mRNA vaccines produce very high levels of antibodies that are likely effective against current and, possibly, future variants. Some scientists call this hybrid immunity. Further research is needed.</p> <p>If you were treated for COVID-19 with monoclonal antibodies or convalescent plasma, there is no need to delay getting a COVID-19 vaccine.</p> <h3>What COVID-19 vaccines have been authorized or approved and how do they work?</h3> <p>Because there is an urgent need for COVID-19 vaccines and the Food and Drug Administration (FDA) vaccine approval process can take months to years, the FDA first gave emergency use authorization to COVID-19 vaccines based on less data than is normally required. The data must show that the vaccines are safe and effective before the FDA can give emergency use authorization or approval.</p> <h3>Vaccines with FDA emergency use authorization or approval include:</h3> <h4>Pfizer-BioNTech COVID-19 vaccine</h4> <p>The FDA has approved the Pfizer-BioNTech COVID-19 vaccine, now called Comirnaty, to prevent COVID-19 in people age 16 and older. The FDA approved Comirnaty after data found the vaccine is safe and effective. The Pfizer-BioNTech COVID-19 vaccine is 91% effective in preventing severe illness with COVID-19 in people age 16 and older.</p> <p>The vaccine is still under an emergency use authorization for children ages 12 through 15. The vaccine is 100% effective in preventing COVID-19 in children ages 12–15. For people age 12 and older, the Pfizer-BioNTech COVID-19 vaccinate involves two shots. The second dose can be given three to eight weeks after the first dose.</p> <p>The vaccine is now also available under an emergency use authorization for children ages 5 through 11. This vaccine is about 91% effective in preventing COVID-19 in children ages 5 through 11. It requires two shots, given 3 weeks apart. It also contains a lower dose than the Pfizer-BioNTech COVID-19 vaccine used for people age 12 and older.</p> <h4>Moderna COVID-19 vaccine</h4> <p>The FDA has approved the Moderna COVID-19 vaccine, now called Spikevax, to prevent COVID-19 in people age 18 and older. The Moderna COVID-19 vaccine is 94% effective in preventing COVID-19 with symptoms. It requires two shots. The second dose can be given four to eight weeks after the first dose.</p> <h4>Janssen/Johnson & Johnson COVID-19 vaccine</h4> <p>In clinical trials, this vaccine was 66% effective in preventing the COVID-19 virus with symptoms — as of 14 days after vaccination. The vaccine also was 85% effective at preventing severe disease with COVID-19— at least 28 days after vaccination. This vaccine is authorized for people age 18 and older. It requires one shot. If you are given this vaccine, learn about the possible risks and symptoms of a blood clotting problem.</p> <p>The shortest interval between the first and second doses of mRNA COVID-19 vaccines is still recommended for people who have weakened immune systems, people age 65 and older and others who need rapid protection due to concern about community transmission or risk of severe illness. An eight-week interval between the first and second doses might be best for some people age 12 and older, especially males ages 12 to 39.</p> <p>The Centers for Disease Control and Prevention (CDC) recommends getting an mRNA COVID-19 vaccine over getting the Janssen/Johnson & Johnson COVID-19 vaccine. But getting any COVID-19 vaccine is better than not getting a COVID-19 vaccine.</p> <h2>How do the COVID-19 vaccines work?</h2> <p>Both the Pfizer-BioNTech and the Moderna COVID-19 vaccines use messenger RNA (mRNA). Coronaviruses have a spike-like structure on their surface called an S protein. COVID-19 mRNA vaccines give cells instructions to immune cells for how to make a harmless piece of an S protein. After vaccination, your cells begin making the protein pieces and displaying them on cell surfaces. Your immune system will recognize that the protein and begin building an immune response and making antibodies. After delivering instructions, the mRNA is immediately broken down. It never enters the nucleus of your cell, where your DNA is kept.</p> <p>The Janssen/Johnson & Johnson COVID-19 vaccine is a vector vaccine. In this type of vaccine, material from the COVID-19 virus is inserted into a different kind of weakened live virus, such as an adenovirus. When the weakened virus (viral vector) gets into your cells, it delivers material from the COVID-19 virus that gives your cells instructions to make copies of the S protein. Once your cells display the S proteins on their surfaces, your immune system responds by creating antibodies and defensive white blood cells. If you become infected with the virus that causes COVID-19, the antibodies will fight the virus.</p> <p>Viral vector vaccines can't cause you to become infected with the COVID-19 virus or the viral vector virus. Also, the genetic material that's delivered doesn't become part of your DNA.</p> <h2>If I am vaccinated and develop side effects should I get tested?</h2> <p>While many people do not have reactions after vaccination, it is normal if you do. It does not mean you have the COVID-19 infection. If you have a reaction, take some time to rest and allow your body to recover.</p> <p>These reactions should not keep you from going to work or doing other activities. However, stay home if you have a fever. It is not necessary to have a COVID-19 test or to quarantine.</p> <h2>What are the possible side effects of the COVID-19 vaccine?</h2> <h3>A COVID-19 vaccine can cause mild side effects after the first or second dose, including:</h3> <ul> <li>Pain, redness or swelling where the shot was given</li> <li>Fever</li> <li>Fatigue</li> <li>Headache</li> <li>Muscle pain</li> <li>Chills</li> <li>Joint pain</li> <li>Nausea and vomiting</li> <li>Feeling unwell</li> <li>Swollen lymph nodes</li> </ul> <p>You’ll be monitored for 15 minutes after getting a COVID-19 vaccine to see if you have an allergic reaction. Most side effects go away in a few days. Side effects after the second dose might be more intense. Many people have no side effects. Side effects of booster shots appear to be similar to side effects experienced after the two-dose or single-dose primary shots.</p> <h2>Can I get a COVID-19 vaccine if I have an existing health condition?</h2> <p>Yes, COVID-19 vaccines are safe for people who have existing health conditions, including conditions that increase the risk of severe illness with COVID-19. People who have a moderately or severely weakened immune system should get an additional primary shot or booster shot.</p> <h2>What are the long-term side effects of the COVID-19 vaccines?</h2> <p>Because COVID-19 vaccines clinical trials only started in the summer of 2020, it’s not yet clear if these vaccines will have long-term side effects. However, vaccines rarely cause long-term side effects.</p> <p>If you’re concerned, in the U.S., safety data on COVID-19 vaccines will be reported to a national program called the Vaccine Adverse Event Reporting System. This data is available to the public. The CDC has also created v-safe, a smartphone-based tool that allows users to report COVID-19 vaccine side effects. If you have additional questions or concerns about your symptoms, talk to your doctor.</p> <h2>Is it safe to use fever-reducing pain medications like acetaminophen before or after receiving the COVID-19 vaccine?</h2> <p>Don't take medication before getting a COVID-19 vaccine to prevent possible discomfort. It’s not clear how these medications might impact the effectiveness of the vaccines. However, it’s OK to take this kind of medication after getting a COVID-19 vaccine, as long as you have no other medical reason that would prevent you from taking it.</p> <h2>Do the COVID-19 vaccines protect against the COVID-19 variants?</h2> <h3>Currently, the CDC has identified two variants of the virus (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) as variants of concern:</h3> <h4>Delta (B.1.617.2)</h4> <p>This variant is nearly twice as contagious as earlier variants and might cause more severe illness. The greatest risk of transmission is among unvaccinated people. People who are fully vaccinated can get vaccine breakthrough infections and spread the virus to others. However, it appears that fully vaccinated people spread COVID-19 for a shorter period than do unvaccinated people. While research suggests that COVID-19 vaccines are slightly less effective against the delta variant, the Pfizer-BioNTech, Moderna and Janssen/Johnson & Johnson COVID-19 vaccines still appear to provide protection against severe COVID-19.</p> <h4>Omicron (B.1.1.529) and BA lineages</h4> <p>The variant B.1.1.529 spreads more easily than the original virus that causes COVID-19 and the delta variant. However, omicron appears to cause less severe disease. People who are fully vaccinated can get breakthrough infections and spread the virus to others. But, the COVID-19 vaccines are effective at preventing severe illness. This variant also reduces the effectiveness of some monoclonal antibody treatments. Omicron has a few major offshoots (sublineages), including BA.1, BA.2 and BA.3. BA.2 made up about 55% of COVID-19 infections that had genetic sequencing in the U.S. during a week in late March, according to the CDC.</p> <h2>What COVID-19 vaccines have been approved for kids?</h2> <h3>In the U.S., COVID-19 vaccines are available to children by age group:</h3> <h4>Ages 5 through 11</h4> <p>The FDA has given emergency use authorization to a Pfizer-BioNTech COVID-19 vaccine for this age group. This vaccine involves two shots, given three weeks apart. It contains a lower dose than the Pfizer-BioNTech COVID-19 vaccine used for people age 12 and older.</p> <p>Research shows that this vaccine is about 91% effective in preventing COVID-19 in children ages 5 through 11.</p> <h4>Ages 12–15</h4> <p>The FDA has given emergency use authorization to a Pfizer-BioNTech COVID-19 vaccine for this age group. This vaccine involves two shots. The second dose can be given three to eight weeks after the first dose. It contains the same dose as the Pfizer-BioNTech COVID-19 vaccine for people ages 16 and older. The second dose can be given up to six weeks after the first dose, if needed. <br /> Research has shown that this vaccine is 100% effective in preventing COVID-19 in children ages 12–15.</p> <h4>Ages 16 and older</h4> <p>The FDA has approved a Pfizer-BioNTech COVID-19 vaccine, now called Comirnaty, for this age group. This vaccine involves two shots. The second dose can be given three to eight weeks after the first dose. This vaccine is 91% effective in preventing severe illness with COVID-19 in people age 16 and older.</p> <p>The shortest interval between the first and second doses of mRNA COVID-19 vaccines is still recommended for people who have weakened immune systems and others who need rapid protection due to concern about community transmission or risk of severe illness. An eight-week interval between the first and second doses might be best for some people age 12 and older, especially males ages 12 to 39.</p> <h2>Is there any difference in the ingredients or dosing of the Pfizer-BioNTech COVID-19 vaccines for younger children, older children or adults?</h2> <p>The Pfizer-BioNTech COVID-19 vaccine for children ages 5–11 contains a lower dose (10 micrograms) than the vaccine used for older children and adults (30 micrograms). Smaller needles are being used to deliver the vaccine to children ages 5–11.</p> <p>The ingredients and dosing of the Pfizer-BioNTech COVID-19 vaccine are the same for children ages 12–15 and people age 16 and older.</p> <h2>If children don’t frequently experience severe illness with COVID-19, why do they need a COVID-19 vaccine?</h2> <p>A COVID-19 vaccine can prevent your child from getting COVID-19 and spreading it at home and at school.</p> <p>If your child gets COVID-19, a COVID-19 vaccine could prevent severe illness.</p> <p>Getting a COVID-19 vaccine can also help keep your child in school and more safely have playdates and participate in sports and other group activities.</p> <h2>How did the FDA determine the safety and effectiveness of the Pfizer-BioNTech COVID-19 vaccines for use in kids?</h2> <p>For kids ages 5–11, the FDA reviewed a vaccine study of more than 4,600 children in this age range. Of this group, about 3,100 were given the Pfizer-BioNTech COVID-19 vaccine. The other children were given an inactive (placebo) shot. Children who were given the vaccine were monitored for side effects for at least two months after the second dose. Side effects were generally mild to moderate.</p> <p>The FDA also took an early look at cases of COVID-19 that occurred one week after children were given a second dose of the vaccine. None of the children in this analysis had been previously diagnosed with COVID-19. Among 1,305 children given the vaccine, there were three cases of COVID-19. Among 663 children given the placebo, there were 16 cases of COVID-19. The results suggest that the vaccine is about 91% effective in preventing COVID-19 in this age group.</p> <p>For kids ages 12–15, the FDA reviewed a vaccine study of more than 2,200 U.S. children in this age range. Of this group, about half were given the Pfizer-BioNTech COVID-19 vaccine. The other children were given a placebo shot.</p> <p>A week after the second dose was given, there were no cases of COVID-19 in the 1,005 children given the Pfizer-BioNTech vaccine. Among 978 children given the placebo, there were 16 cases of COVID-19. None of the children had previously been diagnosed with COVID-19. The results suggest that the vaccine is 100% effective at preventing the COVID-19 virus in this age group.</p> <p>Also, a portion of the children in each age group were monitored for safety for at least two months after being given the second dose.</p> <h2>Can pregnant or breastfeeding women get the COVID-19 vaccine?</h2> <p>If you are pregnant or breastfeeding, it's recommended that you get a COVID-19 vaccine.</p> <p>The overall risk of COVID-19 to pregnant women is low. However, women who are pregnant or were recently pregnant are at increased risk of severe illness with COVID-19. Pregnant women with COVID-19 are also more likely to deliver a baby before the start of the 37th week of pregnancy (premature birth). They might also be at increased risk of problems such as stillbirth and pregnancy loss.</p> <p>Getting a COVID-19 vaccine can protect you from severe illness due to COVID-19. Vaccination can also help pregnant women build antibodies that might protect their babies. Research shows that infants born to mothers who receive two doses of an mRNA COVID-19 vaccine — such as the Pfizer-BioNTech or Moderna COVID-19 vaccine — might have a lower risk of hospitalization due to COVID-19 infection in their first six months of life.</p> <p>COVID-19 vaccines don't cause infection with the virus that causes COVID-19, including in pregnant women or their babies. None of the COVID-19 vaccines contain the live virus that causes COVID-19. Also, keep in mind that mRNA COVID-19 vaccines don't alter your DNA.</p> <p>Findings from a study of more than 40,000 women show that getting a COVID-19 vaccine during pregnancy poses no serious risks for pregnant women who were vaccinated or their babies. Most of the women in the study received an mRNA vaccine. In addition, vaccines that use the same viral vector as the Janssen/Johnson & Johnson COVID-19 vaccine have been given to pregnant women in each trimester of pregnancy in clinical trials. No harmful effects were found.</p> <h2>Can a COVID-19 vaccine affect fertility or menstruation?</h2> <p>It's recommended that you get a COVID-19 vaccine if you are trying to get pregnant or might become pregnant in the future. There is no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems in men or women.</p> <p>It's not clear if getting COVID-19 or a COVID-19 vaccine causes changes in menstruation. A new study of about 4,000 people suggests that getting a COVID-19 vaccine is linked to a less than one-day change in menstrual cycle length for each dose.</p> <p>Keep in mind that many things can affect menstrual cycles, including infections, stress, sleep problems and changes in diet or exercise.</p> <h2>Can COVID-19 vaccines affect the heart?</h2> <p>In the U.S., there has been an increase in reported cases of myocarditis and pericarditis after mRNA COVID-19 vaccination, particularly in males ages 12 through 17. Myocarditis is the inflammation of the heart muscle, while pericarditis is the inflammation of the lining outside the heart. These reports are rare.</p> <p>Of the cases reported, the problem happened more often after the second dose of the COVID-19 vaccine and typically within one week of COVID-19 vaccination. Most of the people who received care felt better after receiving medicine and resting.</p> <h3>Symptoms to watch for include:</h3> <ul> <li>Chest pain</li> <li>Shortness of breath</li> <li>Feelings of having a fluttering or pounding heart</li> </ul> <p>Of you or your child has any of these symptoms within a week of getting a COVID-19 vaccine, seek medical care.</p> <p>If you or your child develops myocarditis or pericarditis after a dose of an mRNA COVID-19 vaccine, the CDC recommends avoiding getting another dose of any COVID-19 vaccine.</p> <h2>What are the symptoms of a blood clotting reaction to the Janssen/Johnson & Johnson COVID-19 vaccine?</h2> <p>Use of the Janssen/Johnson & Johnson COVID-19 vaccine as a primary dose or booster dose may increase the risk of a rare and serious blood clotting disorder, especially in women ages 30 to 49.</p> <p>As a result, the CDC recommends getting an mRNA COVID-19 vaccine over getting the Janssen/Johnson & Johnson COVID-19 vaccine. Research suggests there isn't an increased risk of this disorder after mRNA COVID-19 vaccination.</p> <p>Serious side effects of the Janssen/Johnson & Johnson COVID-19 vaccine can occur within two weeks of vaccination and require emergency care.</p> <h3>Possible symptoms include:</h3> <ul> <li>Shortness of breath</li> <li>Persistent stomach pain</li> <li>Severe or persistent headaches or blurred vision</li> <li>Chest pain</li> <li> Leg swelling</li> <li>Easy bruising or tiny red spots on the skin beyond the injection site</li> </ul> <h2>Should people who have recovered from COVID-19 get vaccinated?</h2> <p>People who've had COVID-19 infection should still get vaccinated because the vaccine might provide them a longer duration of protection than COVID-19 itself would. This is something that we're still learning and, hopefully, we'll know more about over the next few months.</p> <p>In general, we recommend that people should wait for about 90 days from infection before they get vaccinated. There is no harm if they get vaccinated beforehand. We know that they're fully protected from their own infection for the first three months, so they can wait for a few months before they get the vaccine and let the others get vaccinated.</p> <h2>Can I stop taking safety precautions after getting a COVID-19 vaccine?</h2> <p>You are considered fully vaccinated 2 weeks after you get a second dose of an mRNA COVID-19 vaccine or 2 weeks after you get a single dose of the Janssen/Johnson & Johnson COVID-19 vaccine. You are considered up to date with your vaccines if you have gotten all recommended COVID-19 vaccines, including booster doses, when you become eligible. After getting vaccinated, you can more safely return to doing activities that you might not have been able to do because of the pandemic. However, if you are in an area with a high number of people with COVID-19 in the hospital and new COVID-19 cases, the CDC recommends wearing a well-fitted mask indoors in public, whether or not you're vaccinated.</p> <p>If you have a weakened immune system or have a higher risk of serious illness, wear a mask that provides you with the most protection possible when you're in an area with a high number of people with COVID-19 in the hospital and new COVID-19 cases. Check with your health care provider to see if you should wear a mask when you're in an area with a lower number of new COVID-19 cases and people with COVID-19 in the hospital.</p> <p>You also will still be required to wear a mask on planes, buses, trains and other public transportation traveling to, within, or out of the U.S., as well as in places such as airports and train stations.</p> <p>If you are traveling in the U.S., you don’t need to get tested before or after your trip or quarantine after you return. If you are traveling outside of the U.S., you don’t need to get tested before you leave the U.S. unless your destination requires it. You still need to show a negative test result or proof that you’ve recovered from COVID-19 in the past 3 months before boarding an international flight to the U.S.</p> <p>If you’ve gotten all recommended vaccine doses, including boosters and additional primary shots, and you’ve had close contact with someone who has the COVID-19 virus, get tested at least 5 days after the contact happens.</p> <h2>Are COVID-19 vaccine additional doses or boosters recommended?</h2> <p>An additional primary dose of a COVID-19 vaccine is recommended for people who are vaccinated and might not have had a strong enough immune response. In contrast, a booster dose is recommended for people who are vaccinated and whose immune response weakened over time. Research suggests that getting a booster dose can decrease your risk of infection and severe illness with COVID-19.</p> <p>People who have a moderately or severely weakened immune system should get an additional primary shot and a booster shot.</p> <h3>The CDC recommends additional doses and booster doses of COVID-19 vaccines in specific instances:</h3> <h4>Additional primary shot</h4> <p>The CDC recommends an additional primary shot of an mRNA COVID-19 vaccine for some people with weakened immune systems, such as those who have had an organ transplant. People with weakened immune systems might not develop enough immunity after vaccination with two doses of an mRNA COVID-19 vaccine or one dose of the Janssen/Johnson & Johnson COVID-19 vaccine. An additional dose might improve their protection against COVID-19.</p> <p>The additional primary shot should be given at least four weeks days after a second dose of an mRNA COVID-19 vaccine or one dose of the Janssen/Johnson & Johnson COVID-19 vaccine. The additional primary shot should be the same brand as the other two mRNA COVID-19 vaccine doses you were given. If the brand given isn’t known, either brand of mRNA COVID-19 vaccine can be given as a third dose.</p> <h4>Booster dose</h4> <p>A single booster dose is recommended for people age 12 and older after getting two doses of an mRNA COVID-19 vaccine or one dose of a Janssen/Johnson & Johnson COVID-19 vaccine.</p> <p>If you are age 12 and older, have been given both doses of the Pfizer-BioNTech COVID-19 vaccine and it’s been at least five months, get a booster dose. Teens ages 12 to 17 should only get the Pfizer-BioNTech COVID-19 vaccine booster. For people age 18 or older, the Pfizer-BioNTech or Moderna COVID-19 vaccines are preferred in most situations.</p> <p>If you are age 18 or older, have been given both doses of the Moderna COVID-19 vaccine and it's been at least five months, get a single booster dose. The Pfizer-BioNTech or Moderna COVID-19 vaccine boosters are preferred in most situations.</p> <p>If you are age 18 or older, have been given one dose of the Janssen/Johnson & Johnson COVID-19 vaccine and it's been at least two months, get a single booster dose. The Pfizer-BioNTech or Moderna COVID-19 vaccine boosters are preferred in most situations.</p> <p>Pregnant women can also get a COVID-19 booster dose.</p> <p>If you have a weakened immune system, had two doses of an mRNA COVID-19 vaccine and an additional primary shot, and it’s been at least three months since the additional shot, get a single booster dose. An mRNA COVID-19 vaccine is preferred.</p> <p>If you have a weakened immune system, had one dose of the Janssen/Johnson & Johnson COVID-19 vaccine and an additional primary shot of an mRNA COVID-19 vaccine, and it’s been at least two months since the additional shot, get a single booster dose. An mRNA COVID-19 vaccine is preferred.</p> <h4>Second booster dose</h4> <p>A second booster dose of an mRNA COVID-19 vaccine is recommended for certain people who have a weakened immune system and people age 50 or older. This second booster dose can be given to those eligible four months after a first booster dose of any authorized or approved COVID-19 vaccine.</p> <h2>Were COVID-19 vaccines developed using fetal tissue?</h2> <p>Neither the Pfizer/BioNTech nor Moderna vaccines for COVID-19 contain fetal cells, and fetal cells were not used in their development or production.</p> <p>In two animal studies, researchers performed laboratory testing of the vaccines using historically harvested fetal cell lines. However, both animal studies were conducted after these vaccines were already in phase 3 clinical trials.</p> <h2>Can I still get COVID-19 after I’m vaccinated?</h2> <p>COVID-19 vaccination will protect most people from getting sick with COVID-19.</p> <p>But some fully vaccinated people will still get COVID-19. These are called vaccine breakthrough cases. Some people might not experience any symptoms and some people could become sick due to COVID-19.</p> <p>People with vaccine breakthrough infections can spread COVID-19 to others. However, fully vaccinated people with a breakthrough infection are less likely to have serious illness with COVID-19 than those who are unvaccinated. Even when vaccinated people develop symptoms, they tend to be less severe than those experienced by unvaccinated people.</p> <h2>Should I delay getting COVID-19 vaccine if I’ve received another type of vaccine recently?</h2> <p>Mayo Clinic experts suggest that you consider delaying your vaccination for COVID-19 if you've received another vaccine within the past 14 days. You also should wait a couple of weeks after being vaccinated for COVID-19 to receive a different vaccine, like the flu vaccine.</p> <p>While there is no reason to believe that one vaccine will interfere with another, when COVID-19 vaccines were being studied, research volunteers did not receive vaccines at the same time or within two to four weeks of being vaccinated for COVID-19. If you have a reaction after being vaccinated, separating vaccinations helps to correctly identify which vaccine may have been responsible.</p> <h2>Should I delay my COVID-19 vaccine if I am scheduled for surgery?</h2> <p>There is no need to postpone being vaccinated for COVID-19 until after your surgery. Any side effects, such as fever, that may occur from being vaccinated for COVID-19 the vaccine would resolve within seven days. Most side effects resolve within three days.</p> <p>Mayo does not recommend that you schedule your vaccination for COVID-19 within a few days of your surgery, especially the second dose of the Pfizer/BioNTech or Moderna vaccines for COVID-19. About 15% of people will experience a fever after the second dose of these vaccines. For the first dose, less than 1% will experience a fever.</p> <p>If you check in on the day of surgery and you have a fever, you may need to reschedule your surgery. A fever immediately after surgery raises concerns about a surgical wound infection, so it's ideal if you can allow a week between being vaccinated for COVID-19 and surgery, especially for the second dose.</p> <p>Mayo Clinic experts have no concerns with the safety or effectiveness of COVID-19 vaccines for those who choose to be vaccinated for COVID-19 despite a recent vaccination.</p> <p><em>Information in this post was accurate at the time of its posting. Due to the fluid nature of the COVID-19 pandemic, scientific understanding, along with guidelines and recommendations, may have changed since the original publication date.</em></p><img src="/-/media/national-files/images/hometown-health/2021/senior-woman-receiving-vaccination.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C41AA706382DA19C6154824662A26EFE" alt="Senior woman receiving vaccination" width="660" height="370" DisableNVelocity="true" />COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Dawn Haller8/24/2021A Mayo Clinic expert answers questions about COVID-19 booster shots, which may be available in the U.S. as soon as this fall.What you need to know about COVID-19 boosters<p>Health officials are developing a plan to begin offering COVID-19 booster shots to all people in the U.S. as soon as this fall to maximize vaccine protection.</p> <h4>But before booster shots can be offered, two things will need to happen:</h4> <ol> <li>The Food and Drug Administration (FDA) will need to conduct an independent evaluation to determine the safety and effectiveness of a third dose of the Moderna or Pfizer messenger RNA vaccines.</li> <li>The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices will need to issue booster dose recommendations.</li> </ol> <p>As for those who received the Johnson & Johnson (J&J) COVID-19 vaccine, it's too soon to tell whether booster shots will be recommended.</p> <p>The Mayo Clinic News Network team sat down with <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/swift-melanie-d-m-d-m-p-h/bio-20441907?mc_id=us&utm_source=newsnetwork&utm_medium=l&utm_content=content&utm_campaign=mayoclinic&geo=national&placementsite=enterprise&invsrc=other&cauid=100721" target="_blank" title="Opens in a new window.">Melanie Swift, M.D.</a>, co-chair of the Mayo Clinic COVID-19 Vaccine Allocation and Distribution Work Group. In this Q&A, Dr. Swift answers questions about COVID-19 booster shots.</p> <h4>What is a booster vaccine?</h4> <p>A booster vaccine is intended to be a reminder to your immune system. Right now, we're in a situation where we can see that over time immunity that people achieve from the COVID-19 vaccine does start to wane. The good news is that it's waning mostly against mild infection. We still do have protection from those early vaccine doses against severe infection. But we want to stop transmission and keep people from getting any form of infection. So boosters are going to be recommended for everyone.</p> <h4>How is a booster different from an additional dose, which has been recommended for people who are immunocompromised?</h4> <p>They're really different things with different purposes. The primary vaccination series is intended to build an initial immune response. Think of it like painting your house. You sometimes can get good coverage with one coat of paint, but occasionally you might need three coats of paint to get that good coverage. It's the same way with vaccines. Some people might have a great response to one dose, but most people need two doses of the messenger RNA vaccines to get a great response.</p> <p>But what we've learned is that some people actually need a third dose to get a better response to that initial vaccine. And those people are immunocompromised. Their immune systems aren't working very well, and they do need additional doses of vaccine to respond.</p> <p>Over time, once you've achieved that initial response, your immunity may still wane and you could need a booster. So you might need another coat of paint down the road when the initial one starts to wear thin or get stains on it. Giving another coat of paint is like giving a booster.</p> <h4>Will the booster shots be the same vaccine?</h4> <p>Right now, we are giving that third dose and planning to give that booster dose with the same formulation of the original vaccine. But that could change over time.</p> <p>The manufacturers ― Pfizer and Moderna ― are studying variants of that initial messenger RNA vaccine that can be designed to cover mutations that some of the variants of concern are exhibiting. It may be that we get annual boosters, and over time each year, that might be a different vaccine that helps provide better protection against the coronavirus strains that are currently circulating ― much like we do with flu vaccine. We already have this concept. We get a new flu vaccine every year, and it covers different strains than previous years.</p> <h4>Does this recommendation suggest the COVID-19 vaccines are not effective?</h4> <p>A booster just means that your immune system will start to lose immunity over time. It doesn't mean that the initial vaccine didn't work. In fact, the immune response that we typically see in healthy people from the messenger RNA vaccines looks like it far exceeds what you really need in order to protect yourself.</p> <p>We don't have a perfect lab test that will show us just how immune you are. But we do look at something called neutralizing antibodies that do seem to correlate fairly well with protection against infection. And the initial response is orders of magnitude more neutralizing antibodies than we actually need, or that people even achieve, after they actually get COVID-19 infection. So you get this overresponse. And then over time, those antibodies start to wane. Because there's this strong immune response over and above what we actually need, that can wane for months and months before we become vulnerable again.</p> <h4>What will be the possible side effects of a third dose?</h4> <p>So far, it looks like this side effect profile from a third dose is very similar to what was experienced with a second dose ― not any worse and perhaps a little milder. That probably has to do with the time that's elapsed since you last had that vaccine.</p> <p>Getting that initial series, you're taking a vaccine three or four weeks after you just had it and your immune system is really responding robustly, giving people more of those side effects. But after months later, with a booster dose, it doesn't look like there's any more robust immune symptoms that people would have. They can expect to have those typical vaccine side effects: a headache, they could feel tired, they could have a low-grade fever, they could have some muscle aches. And those still happen really quickly and resolve on their own within two to three days.</p> <h4>Why should people consider getting a booster shot eight months after their second messenger RNA vaccine dose?</h4> <p>We are seeing some waning of immunity against the delta variant. We still do find that the vaccines are helping a lot to prevent severe disease and hospitalization, even this many months out. But clearly the delta variant has some resistance to that vaccination, and we want to stop its spread.</p> <p>So boosting people now means that we can reduce those milder infections and those asymptomatic infections that contribute to spread. And remember when this virus is spreading in our community, even if it's not causing symptoms, it has the chance to mutate. Those mutations can randomly lead to the development of a new variant, and that variant might be even worse than the delta variant. So we need to do everything we can now to stop it.</p> <h4>Will people who received the J&J vaccine need a booster?</h4> <p>There are two interesting things about the J&J vaccine. One is that the company behind the vaccine ― Janssen ― is actually studying a second dose in that prime series. They're looking at spacing a second dose from that first dose two months apart. We don't have the results of that study yet, and the FDA hasn't given authorization for a second dose in the J&J series ― nor has there been any recommendation to do that. We're waiting for full results to be known of that study.</p> <p>The second thing that's interesting about the J&J vaccine is that there are some data that show over the first six months some markers of immunity that we follow in the research study bloodwork show some improvement in immunity over time. Now, we don't know if that's going to translate into continuing to prevent infection at eight months, 10 months down the road. But it is a signal that there's something about that adenovirus vector that may make its actions more prolonged on the immune system than the messenger RNA vaccines.</p> <p><em>Information in this post was accurate at the time of its posting. Due to the fluid nature of the COVID-19 pandemic, scientific understanding, along with guidelines and recommendations, may have changed since the original publication date.</em></p><img src="/-/media/national-files/images/hometown-health/2021/gloved-hands-vaccination-on-arm.jpg?h=370&iar=0&w=660&sc_lang=en&hash=33587F8C785644630A1BB3BB799C7488" alt="Gloved hands giving vaccination in upper arm" width="660" height="370" DisableNVelocity="true" />COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Dawn Haller9/23/2021When your child gets sick, you want to help them feel better. If they are diagnosed with COVID-19, find out about the symptoms you should watch for and what to do to help them recover.COVID-19 symptoms to watch for in children, teens<p>As another school year begins, the contagious delta variant of <a href="/covid19" target="_self" title="Opens in same window.">COVID-19</a> has infected more children and teens across the U.S. Individual symptoms can vary, and these symptoms should be monitored carefully for short- and long-term complications.</p> <h4>Mild symptoms</h4> <p>Many children with COVID-19 have minimal to no symptoms. Their symptoms often resemble a cold with congestion, cough, low-grade fever and fatigue. Over-the counter pain and fever reducers, such as acetaminophen or ibuprofen, can be given as needed to relieve symptoms.</p> <p>Staying hydrated with adequate intake of fluids is encouraged, as with illnesses such as the flu. Other symptoms, such as loss of taste and smell, cannot be treated specifically, but they generally resolve with time. Talk with your child’s health care provider if you have questions about managing symptoms.</p> <p>Despite mild initial symptoms, children 12 and older at higher risk of complications may be given monoclonal antibody therapy to help them fight the infection. Those at higher risk are children with severe asthma or other lung disease; neuromuscular conditions, such as Down syndrome and cerebral palsy; obesity; and any condition that affects the immune system.</p> <p>Monoclonal antibody therapy, which is designed to prevent COVID-19 from worsening, should be given as soon as possible after a COVID-19 diagnosis is made. All the children that Mayo Clinic Health System tests are screened to see if they are eligible for monoclonal antibody therapy. If you are unsure of your child’s risk and eligibility, contact his or her health care provider.</p> <p>Regardless of symptom severity, it is crucial to isolate to stop the spread of the infection while monitoring for symptoms that should prompt further evaluation.</p> <h5>Children need to be evaluated by a health care provider if they display any of these symptoms:</h5> <ul> <li>Shortness of breath</li> <li>Chest pressure or pain</li> <li>Severe vomiting</li> <li>Change in consciousness</li> <li>Color change in skin, lips or nail beds</li> </ul> <p>These symptoms can occur at the beginning of the illness or as long as a week into the infection.</p> <h4>Moderate to severe symptoms</h4> <p>Unfortunately, some children and teens experience more concerning symptoms. These symptoms generally should be managed in conjunction with their primary care provider or, if needed, in the hospital.</p> <h5>Parents should be vigilant for any signs that could indicate more severe infection, including:</h5> <ul> <li>Mental changes or confusion</li> <li>Trouble breathing</li> <li>Persistent chest pain</li> <li>Bluish lips or face</li> <li>Severe vomiting</li> <li>Decrease in urination</li> </ul> <p>These symptoms indicate that urgent evaluation may be needed. Call 911 or seek emergency care.</p> <p>Supportive treatments for moderate to severe symptoms can include oxygen and IV fluids, or more specific COVID-19 treatments like remdesivir and dexamethasone. Remdesivir is an antiviral medication generally used in hospitalized patients to stop COVID-19 from reproducing itself and lessen the severity of disease. Dexamethasone decreases the inflammatory response in the body, and it can help with breathing and other symptoms of moderate to severe COVID-19 infection.</p> <h4>Myocarditis</h4> <p>For those children and teens who experience more moderate or severe symptoms of COVID-19 infection, follow-up is essential to ensure a safe return to activity. COVID-19 can cause myocarditis, which is an inflammation of the heart muscle. This condition should be fully resolved before a return to sports activities.</p> <p>Any symptoms of chest pain, shortness of breath, lightheadedness, fainting or heart palpitations could indicate myocarditis. Even in cases of mild illness, a health care provider should evaluate any difficulty in return to play.</p> <h4>Multisystem inflammatory syndrome in children</h4> <p>Multisystem inflammatory syndrome in children, or MIS-C, can occur several weeks after a mild or asymptomatic case of COVID-19. While symptoms can vary, they generally include a high fever and inflammation in almost any organ system. This requires early evaluation and often hospitalization for supportive care and treatment.</p> <p>Consult with a health care provider if symptoms of multisystem inflammatory syndrome in children develop in your child or teen.</p> <p><em><a href="/providers/jeremy-forster-md" target="_self" title="Opens in same window.">Jeremy Forster, M.D.</a>, is a <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">Pediatric & Adolescent Medicine</a> physician in <a href="/locations/chippewa-falls" target="_self" title="Opens in same window.">Chippewa Falls</a>, Wisconsin.</em></p><ul> <li>Children with special health care needs</li> <li>Pediatric mental health</li> </ul>M.D.<p>I enjoy the opportunity to help parents with children who have challenging health problems get quality care close to home.</p> <p>In my free time, I enjoy being outside at the lake, exercising and watching my kids grow too fast.</p><p><strong>Education</strong></p> <ul> <li>University of Wisconsin School of Medicine and Public Health</li> </ul> <p><strong>Residency</strong></p> <ul> <li>General Pediatrics, Indiana University-Riley Children’s Hospital</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Neonatal Resuscitation Program</li> <li>Pediatric Advanced Life Support Instructor</li> </ul> <p><strong>Membership</strong></p> <ul> <li>Fellow, American Academy of Pediatrics</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Pediatrics, Mayo Clinic College of Medicine and Science</li> </ul>Forster<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/jeremy-forster-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=FC056B16846053AE9AB994928254EB1E" alt="Jeremy Forster, M.D." width="280" height="280" DisableNVelocity="true" />Jeremy<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13507257Jeremy Forster, M.D.1{61776FD2-05E8-47E9-AB55-EE465BD29A19}|{02421E57-1F9C-4F00-BF77-56DA854DCF27}|{9B57996D-7C65-499B-8DB5-FBB37D1A5DD1}<img src="/-/media/national-files/images/hometown-health/2021/child-crossed-arms-resting-on-sofa.jpg?h=370&iar=0&w=660&sc_lang=en&hash=EF61EE77A31136B164C037D661D9986F" alt="Child with crossed arms resting on a sofa" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller9/22/2022Put up your best defense. It's time for your seasonal flu shot. Learn why it's more important than ever to be vaccinated.Don't skip your flu shot this year<p>Another flu season is just around the corner. Based on watching the flu season in the southern hemisphere, which is June through September, more contagious flu is expected than over the past five years.</p> <p>It's more important than ever to get vaccinated for flu to keep you and your loved ones safe.</p> <p>If more people are vaccinated for flu, fewer people will become sick with the flu and fewer patients will require hospitalization. When there are fewer flu cases, hospital resources are available to care for patients with other health concerns, including COVID-19.</p> <h2>This year's flu season</h2> <p>Flu season in North America typically occurs between October and May. It's possible that the viruses that cause COVID-19 and the flu may spread in your community at the same time during flu season. If this happens, people could become ill with COVID-19 and the flu at the same time. Getting vaccinated for COVID-19 and the flu can reduce their spread.</p> <h2>Importance of vaccinations</h2> <p>The current recommendation is that everyone over 6 months should get vaccinated for flu. The flu shot also can reduce the severity of the flu and the risk of serious complications.</p> <p>Each year's flu vaccine protects from the three or four influenza viruses expected to be the most common during that year's flu season. The vaccine can be given as a shot or nasal spray.</p> <p>While the flu shot doesn't prevent you from getting COVID-19, some research has found that getting vaccinated for the flu vaccine might lower the risk of becoming infected with COVID-19. Research also shows that getting vaccinated for flu does not make you more likely to get infected with COVID-19 or acquire other respiratory infections.</p> <h2>Preventing influenza</h2> <p>Get vaccinated for the flu and COVID-19 when they're available to you.</p> <h3>Also, follow these standard precautions to reduce your risk of infection from the viruses that cause the flu, COVID-19 and other respiratory infections:</h3> <ul> <li>Avoid large events and mass gatherings, especially if you have any symptoms of influenza or COVID-19, or if you have a higher risk of serious illness.</li> <li>Wash your hands often with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer that contains at least 60% alcohol.</li> <li>Consider wearing a face mask when you're indoors in public spaces and outdoors where there is a high risk of respiratory virus transmission, such as at a crowded event or large gathering. Further mask guidelines vary by location.</li> <li>Cover your mouth and nose with your elbow or a tissue when you cough or sneeze.</li> <li>Avoid touching your eyes, nose and mouth.</li> <li>Clean and disinfect high-touch surfaces, such as doorknobs, light switches, electronics and counters.</li> </ul> <h2>Common myths debunked</h2> <p>Some people may be reluctant to be vaccinated or to vaccinate their children due to misinformation about vaccine safety. Vaccines are held to the highest safety standards and, aside from minor side effects for some patients, they are safe for most people.</p> <p>It's important to seek medical information only from credible sources who have scientific training. Vaccines are safe. It's the diseases they protect against that are the cause for concern. </p> <h3>Review these common myths about flu vaccination that have been scientifically proven false:</h3> <p><strong>MYTH:</strong> A flu shot can cause you to get the flu.<br /> <strong>FACT:</strong> While some people experience muscle aches and a fever for a day or two after receiving a flu shot, this is likely a side effect of the body's production of protective antibodies. It is not the flu.</p> <p><strong>MYTH:</strong> Many people have serious adverse reactions to vaccines.<br /> <strong>FACT:</strong> Allergies and serious complications from vaccines are rare. Tell your provider if you ever have had any unusual or allergic reaction to a flu vaccination or any other medicines. Also, tell your health care team if you have any other types of allergies, such as to foods, dyes, preservatives or animals.</p> <p><strong>MYTH:</strong> Vaccines cause autism.<br /> <strong>FACT:</strong> Despite much controversy on the topic, researchers haven't found a connection between autism and childhood vaccines.</p> <p>Read more about <a href="/hometown-health/speaking-of-health/vaccine-safety-6-common-questions-answered" target="_self" title="Opens in same window.">vaccine safety</a>, and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/facts-about-vaccines-and-what-parents-need-to-know/" target="_blank" title="Opens in a new window.">facts about vaccines and what parents need to know</a>.</p> <p>Talk to your health care team about your vaccination concerns, and how and where to get your flu shot.</p> <p><em><a href="/providers/jennifer-johnson-do" target="_self" title="Opens in same window.">Jennifer Johnson, D.O.</a>, is a physician in <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Obesity management</li> <li>Preventive medicine</li> </ul>D.O.<p>I practice a whole-person approach to medicine, focusing on helping patients achieve health across their lifespan. </p> <p>I grew up in Kansas, and have lived in the Mankato area since 2005. I'm married, have four kids and a dog. When I'm not working, I enjoy cooking and spending time with family.</p><p><strong>Education</strong></p> <ul> <li>Kansas City University Osteopathic Medical School  </li> </ul> <p><strong>Internship</strong></p> <ul> <li>University of Minnesota-Mankato</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, University of Minnesota-Mankato</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Diplomate, American Board of Obesity Medicine</li> <li>Family Practice, American Board of Osteopathic Family Physicians</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Osteopathic Family Physicians</li> <li>American Osteopathic Association </li> <li>Minnesota Medical Association </li> <li>Minnesota Osteopathic Medical Society </li> <li>Obesity Medical Association</li> </ul> <p><strong>Academic Appointments</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Johnson<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jennifer-johnson-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=873658AFB998B5C1BD351A8B228A734B" alt="Jennifer Johnson DO" width="280" height="280" DisableNVelocity="true" />{876CA4AF-3CF4-4F4D-8D4B-5C3EBAEDB74F}Jennifer<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14617781Jennifer Johnson, D.O.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{94B2E140-AEF8-44BA-B6A9-4538B77501BC}|{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}<img src="/-/media/national-files/images/hometown-health/2021/child-on-adults-lap-reading.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C1BA72292658AC5319DACD4C1D43FEDD" alt="Child on adult's lap, both reading" width="660" height="370" DisableNVelocity="true" />InfluenzaInfluenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza, commonly called the flu, is not the same as the stomach "flu" viruses that cause diarrhea and vomiting.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Dawn Haller9/20/2021All the safety measures that prevent COVID-19 also prevent flu. With masking and social distancing requirements relaxed, it's time to get a flu shot to protect yourself and your family from influenza.Flu shots and COVID-19<p>The <a rel="noopener" href="https://www.cdc.gov/flu/vaccines/vaccinations.html?CDC_AAref_Val=https://www.cdc.gov/flu/prevent/vaccinations.htm" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention</a> recommends everyone over 6 months get a <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/flu/symptoms-causes/syc-20351719" target="_blank" title="Opens in a new window.">flu</a> shot every season with rare exceptions.</p> <p>Priya Sampathkumar, M.D., a Mayo Clinic infectious diseases specialist, says getting vaccinated for the flu is safe. Billions of doses have been given for more than 80 years to prevent flu, reduce symptoms and protect people who are at higher risk of complications.</p> <p>"In most places, flu starts circulating by November or December. So it's recommended that everyone complete their flu vaccine by October. And now is the right time to start getting the flu vaccine," she says.</p> <p>The number of flu cases this past year was low, and health experts like Dr. Sampathkumar attribute that to the COVID-19 pandemic and preventive measures that were put in place to reduce the spread of COVID-19. Some health experts anticipate those flu numbers will rise this season, especially if people don't get their flu shot.</p> <p>"Last flu season was incredible. We had almost no cases of flu because we were in the midst of the COVID pandemic. Everyone was paying attention to masking and social distancing. People weren't getting together in large groups. So all the things that prevent COVID also prevent flu, and there were very, very few flu cases," she says. "This year, we're afraid that with, in a lot of places, masking recommendations being relaxed, that flu will spread more easily. And the fact that no one had flu last year means there are a lot more people who are vulnerable this year. So again, another very good reason to get the flu vaccine."</p> <p>She says if you haven't been vaccinated for COVID-19 yet or need a third dose, you can get your flu shot and get vaccinated for COVID-19 at the same time.</p> <p>"It's perfectly safe to get both at the same time, which will save a lot of people time from going in and making appointments for two different things. So I encourage you, especially those of you who need a third dose of the COVID vaccine ― if you're immunosuppressed when you're going in to get that ― you should get your flu vaccine at the same time," says Dr. Sampathkumar.</p> <p>She also emphasizes that the flu shot doesn't protect people against getting infected with COVID-19, and getting vaccinated for COVID-19 doesn't protect people against getting the flu.</p> <p>"If you get flu, you're weakened by the flu, and you're more likely then to have bad consequences if you get COVID. So it's a good idea to get the flu vaccine for that reason. But the flu vaccine itself does not provide you with any kind of cross-protection from COVID."</p> <p>Mayo Clinic patients will be able to <a href="/hometown-health/speaking-of-health/schedule-flu-vaccinations-online" target="_self" title="Opens in same window.">schedule flu shot appointments using Patient Online Services or the Mayo Clinic app</a>. Patients will be able to use this scheduling option beginning Sept. 20.</p> <p><em>Information in this post was accurate at the time of its posting. Due to the fluid nature of the COVID-19 pandemic, scientific understanding, along with guidelines and recommendations, may have changed since the original publication date.</em></p><img src="/-/media/national-files/images/hometown-health/2021/parent-hugging-child-from-behind.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B08F4B6DDB06229A2979FDDD5C54A894" alt="Parent hugging child from behind" width="660" height="370" DisableNVelocity="true" />InfluenzaInfluenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza, commonly called the flu, is not the same as the stomach "flu" viruses that cause diarrhea and vomiting.COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller10/20/2021You aren't alone if you have questions about getting vaccinated for COVID-19 while pregnant. Find out answers to four common questions OB-GYN providers are asked and why the CDC issued an urgent warning for pregnant women.COVID-19 vaccines and pregnancy: 4 common Q&A<p>Patients frequently say they feel like there is a lot of confusion around COVID-19 vaccines and women who are pregnant, breastfeeding or trying to get pregnant.</p> <p>Several trusted medical organizations, including the Centers for Disease Control and Prevention (CDC), The American College of Obstetrics and Gynecology, Society for Maternal-Fetal Medicine and American Society for Reproductive Medicine all agree that it's imperative that pregnant women, women who are breastfeeding and women who are hoping to get pregnant in the future should be vaccinated for COVID-19.</p> <p>Currently, less than 35% of pregnant women are fully vaccinated for COVID-19. This is concerning because the CDC issued an urgent warning for pregnant women to get vaccinated, as studies show that being pregnant doubles the risk of death from COVID-19.</p> <h4>Initial confusion</h4> <p>Some of the confusion could be because information available early in the pandemic suggested that pregnant women were not at increased risk for COVID-19 compared to the general population.</p> <p>In the early stages of the pandemic, health care providers didn't know much about COVID-19 because it was new. Now that we have been dealing with COVID-19 for almost two years, a lot more is known. Recommendations for COVID-19 vaccination during pregnancy have changed as more becomes known.</p> <h4>COVID-19 and pregnancy</h4> <p>Pregnancy suppresses the immune system. Therefore, pregnant women are more likely to get sick than other people. And when they get sick, they are more likely to get very sick.</p> <p>The COVID-19 virus affects the body's ability to keep oxygen in the blood. If a woman who is pregnant does not get enough oxygen, neither will her baby.</p> <p>In some cases, babies needed to be delivered early to survive because of insufficient oxygen supply. Sadly, many mothers and babies have died from complications of COVID-19.</p> <h3>Here are four common questions about being vaccinated for COVID-19 during pregnancy:</h3> <h4>1. Does getting vaccinated for COVID-19 cause infertility?</h4> <p>No. This <a href="/hometown-health/featured-topic/covid-19-vaccine-myths-debunked" target="_self" title="Opens in same window.">myth</a> started early in the pandemic based on a loose association. A spike protein develops during pregnancy called syncytin-1. This spike protein is involved in attaching the placenta to the wall of the uterus. It was thought that if women developed antibodies against the spike protein on COVID-19 that those antibodies also would attack syncytin-1.</p> <p>This myth hasn't subsided even though evidence does not support it. If this were true, there would be a rise in a condition called placental abruption, where the placenta separates from the wall of the uterus. That has not happened.</p> <p>Syncytin-1 and the spike protein on COVID-19 have few similarities besides both being called spike proteins. These two types of spike proteins are not genetically similar in any way.</p> <h4>2. Will getting vaccinated for COVID-19 harm my baby?</h4> <p>No. Getting vaccinated for COVID-19 will not harm your baby. No vaccines in history have been studied as extensively as the COVID-19 vaccines. Now hundreds of thousands of pregnant women have been vaccinated for COVID-19 without incident.</p> <p>A few vaccines are not recommended for women who are pregnant. These vaccines, known as live attenuated vaccines, contain a weakened form of the virus itself, which have the potential to make people sick.</p> <p>The COVID-19 vaccines are not live attenuated vaccines and cannot infect you with COVID-19. You may have symptoms related to your immune system working, such as fever, soreness and fatigue, but this is not a COVID-19 infection.</p> <p>The instructions to make the spike protein do not stay in your system long ― a couple days at most ― but the antibodies stick around to protect you and your baby if you are exposed.</p> <p>In addition, studies show that those antibodies cross the placenta to protect your baby after birth.</p> <p>Pregnant women can receive any available COVID-19 vaccine. If you receive the Moderna or Pfizer COVID-19 vaccine, make sure you get a second dose of the same vaccine to be fully vaccinated.</p> <p>Pregnant women are eligible to receive a COVID-19 vaccine booster shot at least six months after completing the primary vaccine series.</p> <p>Even if you have recovered from COVID-19 previously, it is recommended you be vaccinated for COVID-19. The vaccine causes your body to make more antibodies than you would have after getting COVID-19. This provides you and your baby with longer-lasting protection.</p> <h4>3. Does vaccinated for COVID-19 cause miscarriage?</h4> <p>No. Higher rates of miscarriage are not found in women who are vaccinated for COVID-19. No evidence supports that COVID-19 vaccines increase the risk of having a miscarriage or causing infertility.</p> <p>In general, the miscarriage rate is higher than most people think. It is estimated that 1 in 3 pregnancies end in miscarriage. Making another human being is extremely complicated, and things do not always go right.</p> <p>Will some women who were vaccinated have miscarriages? Yes. Will some women who were not vaccinated have miscarriages? Yes.</p> <p>Miscarriage is a difficult time for families, but getting vaccinated for COVID-19 does not increase the likelihood of having a miscarriage. Unfortunately, women who develop severe COVID-19 infection early in pregnancy are at increased risk of miscarriage.</p> <h4>4. Should I get vaccinated for COVID-19 if I'm pregnant or thinking about getting pregnant?</h4> <p>Yes. If you are pregnant or are considering getting pregnant, you should be vaccinated for COVID-19.</p> <p>If you become pregnant after receiving the first dose of a COVID-19 vaccine that requires two doses, it's recommended you get your second shot.</p> <p>Evidence does not support that COVID-19 vaccines cause problems in pregnancy. Hundreds of thousands of women who are pregnant have protected themselves safely against COVID-19 by getting vaccinated while pregnant.</p> <p>On the contrary, contracting COVID-19 when pregnant can have devastating consequences. Vaccination for COVID-19 is our best strategy against becoming infected with COVID-19. If you are not vaccinated, you should get vaccinated.</p> <p>Talk with your primary care provider or OB-GYN if you have questions about getting vaccinated for COVID-19.</p> <p><em><a href="/providers/blenda-yun-md">Blenda Yun, M.D.</a>, specializes in <a href="/services-and-treatments/obstetrics-and-gynecology">OB-GYN</a> and <a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">prenatal care</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p> <h4>Learn more about COVID-19 vaccination:</h4> <ul> <li><a rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-should-pregnant-women-be-vaccinated-for-covid-19/" target="_blank" title="Opens in a new window.">Mayo Clinic Q&A: Should pregnant women be vaccinated for COVID-19?</a></li> </ul><ul> <li>Women's health</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of Wisconsin Medical School</li> </ul> <p><strong>Internship</strong></p> <ul> <li>Obstetrics/Gynecology, Thomas Jefferson University Hospital</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Obstetrics/Gynecology, Thomas Jefferson University Hospital</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Obstetrics and Gynecology, American Board of Obstetrics and Gynecology</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Obstetrics and Gynecology, Mayo Clinic College of Medicine and Science</li> </ul>Yun<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/blenda-yun-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=35F2F4E37FFE3D32281BAED8DAEFE7C5" alt="Blenda Yun, M.D." width="280" height="280" DisableNVelocity="true" />{16706B7C-3B0C-4556-8D59-3C52C876120D}Blenda<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15595820Blenda Young, M.D.1{7316FE6F-3BBA-4620-AE65-E99EA4BFF226}|{54693F31-87AF-4B21-91DB-1DEC1E21F878}|{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}<img src="/-/media/national-files/images/hometown-health/2021/pregnant-women-hand-on-belly.jpg?h=370&iar=0&w=660&sc_lang=en&hash=59D00386BBD5919D4E6A4E271AFEE933" alt="Pregnant women hand on belly" width="660" height="370" DisableNVelocity="true" />COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Prenatal CareOB-GYN and Family Medicine providers offer exactly the care you need for starting or growing your family, including pregnancy planning and prenatal care.Obstetrics and GynecologyOur OB-GYN staff provide surgical and nonsurgical care for women in all stages of life, from adolescence to pregnancy, to menopause and beyond.COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Dawn Haller11/18/2021There are many research studies about COVID-19 vaccinations. How can you decide which studies are accurate, informative and worthwhile? Here are some tips to weed through it all.COVID-19 research: Fact, fiction or something in-between<p>There are many research studies about COVID-19 and vaccinations. How can you decide which studies are accurate, informative and worthwhile?</p> <p>"There is more information on the internet than anyone can digest," says <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/swift-melanie-d-m-d-m-p-h/bio-20441907" target="_blank" title="Opens in a new window.">Melanie Swift, M.D.</a>, infectious disease physician at Mayo Clinic. "It can be difficult to know what to believe. Depending on who is running the website or sharing their interpretation of the medical studies, it may be reliable, but it might be a misinterpretation of the data or completely falsified information."</p> <h4>Look for studies that are:</h4> <ul> <li><strong>Indexed in PubMed.gov</strong><br /> These are published in reputable journals and have undergone scientific peer review.</li> <li><strong>Searchable in Google Scholar</strong><br /> Studies on this platform may have undergone peer review as well. Some may be in "preprint," which means the study has not yet undergone peer review or been accepted by a reputable scientific journal. Preprints are labeled and should be interpreted with caution.</li> </ul> <h4>A few trusted sources include:</h4> <ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.cdc.gov/" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention (CDC)</a></li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.niaid.nih.gov/" target="_blank" title="Opens in a new window.">National Institute for Allergy and Infectious Diseases</a>, a branch of the National Institutes of Health</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/" target="_blank" title="Opens in a new window.">Mayo Clinic</a> and other academic medical centers</li> <li>Medical professional societies like the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.ama-assn.org/" target="_blank" title="Opens in a new window.">American Medical Association</a> or the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.idsociety.org/" target="_blank" title="Opens in a new window.">Infectious Diseases Society of America</a></li> </ul> <h4>Beware of:</h4> <ul> <li><strong>Websites that feature medical experts who are not trained in a relevant specialty or endorsed by a reputable medical center or legitimate medical society</strong><br /> "Infectious diseases or pulmonary and critical care medicine specialists are ideal sources for COVID-19 information. If the website or organization features just one or two doctors from unrelated specialties, be skeptical," says Dr. Swift.</li> <li><strong>Social media postings from individuals sharing opinion, anecdotes or their interpretation of medical studies</strong><br /> "People will commonly state they have done their own 'research' but this may mean they only searched for studies that support their bias. These individuals may not have the expertise to judge the validity of a medical study, may be justifying their personal beliefs or promoting a political agenda," Dr. Swift adds.</li> <li><strong>Claims for alternative or "miracle" drugs that sound unrealistic, without studies published in reputable medical journals</strong><br /> When highly effective treatments are confirmed through valid scientific studies, they are publicized by the CDC, medical centers, medical societies and reliable media outlets.</li> </ul> <p>"The National Library of Medicine provides a helpful <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://medlineplus.gov/webeval/webeval.html" target="_blank" title="Opens in a new window.">tutorial on how to evaluate a health-related website</a>, while the Surgeon General recommends a quick <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.hhs.gov/sites/default/files/health-misinformation-checklist-english.pdf" target="_blank" title="Opens in a new window.">health misinformation checklist</a>," says Dr. Swift.</p> <h4>When evaluating claims, ask these questions:</h4> <ul> <li>Did you check with the CDC or local public health department to see whether there is any information about the claim being made?</li> <li>Did you ask a credible health care professional if there is additional information?</li> <li>Did you search online if it has been verified by a credible source?</li> <li>Did you review the "About Us" page on the website to see if you can trust the source?</li> </ul> <p>If you're not sure, don't share.</p> <p><em>Information in this post was accurate at the time of its posting. Due to the fluid nature of the COVID-19 pandemic, scientific understanding, along with guidelines and recommendations, may have changed since the original publication date.</em></p><img src="/-/media/national-files/images/hometown-health/2021/looking-at-open-laptop.jpg?h=370&iar=0&w=660&sc_lang=en&hash=92C5360B052B75576215DBCD593B8980" alt="Looking at open laptop" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller11/8/2021COVID-19 symptoms sometimes can persist for months. The virus can damage the lungs, heart and brain, which increases risk of long-term health problems. Here's what you need to know.Post-COVID syndrome: Feeling effects over the long haul <p><em>By Mayo Clinic staff</em></p> <p>Most people who have COVID-19 recover completely within a few weeks. But some people — even those who had mild versions of the disease — continue to experience symptoms after their initial recovery.</p> <p>These people sometimes describe themselves as "long-haulers," and the conditions have been called "post-COVID-19 syndrome" or "long COVID-19." These health issues also are sometimes called "post-COVID-19 conditions." These health issues are generally considered to be effects of COVID-19 that persist for more than four weeks after people have been diagnosed with COVID-19.</p> <p>Older people and people with many serious medical conditions are the most likely to experience lingering COVID-19 symptoms, but even young, otherwise healthy people can feel unwell for weeks to months after infection.</p> <h5>Common signs and symptoms that linger over time include:</h5> <ul> <li>Fatigue</li> <li>Shortness of breath or difficulty breathing</li> <li>Cough</li> <li>Joint pain</li> <li>Chest pain</li> <li>Memory, concentration or sleep problems</li> <li>Muscle pain or headache</li> <li>Fast or pounding heartbeat</li> <li>Loss of smell or taste</li> <li>Depression or anxiety</li> <li>Fever</li> <li>Dizziness when standing</li> <li>Worsened symptoms after physical or mental activities</li> </ul> <h4>Organ damage caused by COVID-19</h4> <p>Although COVID-19 is seen as a disease that primarily affects the lungs, it can damage many other organs, as well. This organ damage may increase the risk of long-term health problems.</p> <h5>Organs that may be affected by COVID-19 include:</h5> <ul> <li><strong>Heart</strong> <br /> Imaging tests taken months after recovery from COVID-19 have shown lasting damage to the heart, even in people who experienced only mild COVID-19 symptoms. This may increase the risk of heart failure or other heart complications in the future.</li> <li><strong>Lungs</strong> <br /> The type of pneumonia often associated with COVID-19 can cause long-standing damage to the tiny air sacs, or alveoli, in the lungs. The resulting scar tissue can lead to long-term breathing problems<strong>.</strong></li> <li>Brain <br /> Even in young people, COVID-19 can cause strokes, seizures and Guillain-Barre syndrome — a condition that causes temporary paralysis. COVID-19 also can increase the risk of developing Parkinson's disease and Alzheimer's disease.</li> </ul> <p>Some adults and children experience multisystem inflammatory syndrome after they have been infected with COVID-19. In this condition, some organs and tissues become severely inflamed.</p> <h4>Blood clots, blood vessel problems</h4> <p>COVID-19 can make blood cells more likely to clump and form clots. While large clots can cause heart attacks and strokes, much of the heart damage caused by COVID-19 is believed to stem from small clots that block tiny blood vessels, or capillaries, in the heart.</p> <p>Other parts of the body affected by blood clots include the lungs, legs, liver and kidneys. COVID-19 also can weaken blood vessels and cause them to leak, which contributes to potentially long-lasting problems with the liver and kidneys.</p> <h4>Issues with mood, fatigue</h4> <p>People who have severe symptoms of COVID-19 often must be treated in a hospital's ICU with mechanical assistance, such as ventilators to breathe. Simply surviving this experience can make a person more likely to later develop post-traumatic stress disorder, depression and anxiety.</p> <p>Because it's difficult to predict long-term outcomes from COVID-19, scientists are looking at the long-term effects seen in related viruses, such as the coronavirus that causes severe acute respiratory syndrome, or SARS.</p> <p>Many people who have recovered from SARS have gone on to develop chronic fatigue syndrome, a complex disorder characterized by extreme fatigue that worsens with physical or mental activity but doesn't improve with rest. The same may be true for people who have been infected with COVID-19.</p> <h4>COVID-19 effects still unknown</h4> <p>Much is still unknown about how COVID-19 will affect people over time, but research is ongoing. Researchers recommend that health care providers closely monitor people who have been infected with COVID-19 to see how their organs function after recovery.</p> <p>Many large medical centers are opening specialized clinics to care for people who have persistent symptoms or related illnesses after they recover from COVID-19. Support groups are available, as well.</p> <p>It's important to remember that most people who are infected with COVID-19 recover quickly. But the potentially long-lasting problems from COVID-19 make it even more important to reduce the spread of COVID-19 by following precautions. This includes wearing masks, social distancing, avoiding crowds, getting a vaccine when available and keeping hands clean.</p> <h4>Watch this video to learn more about long-term symptoms or complications of COVID-19:</h4> <p><iframe width="560" height="315" src="https://www.youtube.com/embed/otg1kuUHrrM" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <h4>Learn more:</h4> <ul> <li>Mayo Clinic Connect post-COVID recovery</li> <li>Mayo Clinic Post-COVID program</li> </ul> <p><em>Information in this post was accurate at the time of its posting. Due to the fluid nature of the COVID-19 pandemic, scientific understanding, along with guidelines and recommendations, may have changed since the original publication date.</em></p><img src="/-/media/national-files/images/hometown-health/2021/hands-cupped-on-chin-grey-hair.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D1EDD463925E92C07A57D3EC22F491AD" alt="Person with grey hair, hands cupped on chin" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller12/9/2021Need to show proof of your COVID-19 vaccination and tests? Learn how to use your Patient Online Services account or the Mayo Clinic app to access proof.Where to find proof of COVID-19 vaccination, test results <p>Need to show proof of your COVID-19 vaccinations and tests? Mayo Clinic Health System patients can use their <a href="/patient-online-services" target="_self" title="Opens in same window.">patient portal</a> account or the Mayo Clinic app to access this information, as well as a QR code that links to <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://smarthealth.cards/" target="_blank" title="Opens in a new window.">SMART Health Cards</a>, a generally recognized digital proof of vaccination internationally. SMART Health Cards provides your vaccination history and test results. It shows your legal name and date of birth; clinical information, including vaccinations types, dates and locations; and test dates, manufacturer and results.</p> <h2>On the web</h2> <p>The easiest way to access proof of vaccination from the patient portal is to select "COVID-19 Test Results & Vaccine Records" from the COVID-19 Resources section on the homepage. On the results and records page, you'll see information about COVID-19 vaccinations and test results.</p> <img alt="Screenshot of COVID-19 records" src="/-/media/national-files/images/hometown-health/2021/covid-19-records.jpg?h=291&w=599&sc_lang=en&hash=8B9DDFB56157CF3E178CBFE2E2D64160" style="border:1px solid #000000;width: 599px; height: 291px; margin-top: 5px; margin-bottom: 5px;" /> <h3>You then can:</h3> <ul> <li>Select the Download/Export button. <ul> <li>Download a PDF that lists your vaccinations, including booster doses. This PDF also has the QR code that can be scanned to access the SMART Health Card. Print, save or email this PDF, depending on your needs.</li> <li>Export vaccination and test result information to Health Wallet apps already installed on your mobile device.</li> </ul> </li> <li>Select the QR codes button. These codes can be scanned at participating locations where you want to share your COVID-19 information. You also can scan them to various health care apps, such as Apple Health Records on Apple devices and Common Health on Android devices. Search for these apps at your device's app store.</li> <li>Select the downward arrow next to "COVID-19 vaccination complete" or "Tested" to view vaccination or test result information.</li> </ul> <h2>On the Mayo Clinic app</h2> <p>Once you've logged in to the app, scroll to the COVID-19 section and tap COVID-19 Results & Vaccinations.</p> <h3>You'll see the same options that are available on the web:</h3> <ul> <li>Tap the Download/Export button, then indicate if you want to download the vaccination PDF or export it to your Health Wallet.</li> <li>Tap the QR codes button to access the codes for scanning at locations that need to see your vaccination or test results proof.</li> <li>Tap the downward arrows by "COVID-19 vaccination" or "Tested" to view vaccination or test result information.</li> </ul> <h2>For teens and caregivers</h2> <p>You can use your caregiver accounts to access vaccination and test results for your children 12 and under, and others for whom you might have caregiver accounts, such as spouses or parents. Make sure to choose their accounts from the drop-down menu in Patient Online Services, then access the information as you would your own information.</p> <p>Patients age 13–17 can access COVID-19 vaccination and test result information on their own accounts. To create an account, call Mayo Clinic Customer Assistance at 1-877-858-0398 weekdays from 7 a.m. to 7 p.m. CST.</p> <h3>To create an account:</h3> <ul> <li>Both the minor and the parent or guardian must be on the phone call.</li> <li>The parent or guardian must be either the person to whom the minor's billing statements are mailed or the person who carries the health insurance policy for the minor. This helps verify the identity of the parent or guardian.</li> </ul><img src="/-/media/national-files/images/hometown-health/2023/senior-using-cellphone.jpg?h=370&iar=0&w=660&sc_lang=en&hash=61D037A4F3A295FCE41DFD48C62E7530" alt="Senior using cellphone" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Dawn Haller12/30/2021You may have questions about differences in the types of COVID-19 tests available and when to use them. A Mayo Clinic expert breaks down the testing options and explains how they work.Types of COVID-19 tests, when to use them<p>The high demand for <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/coronavirus/expert-answers/covid-antibody-tests/faq-20484429" target="_blank" title="Opens in a new window.">COVID-19 tests</a> continues, along with questions about the various types of tests and when to use them. <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/binnicker-matthew-j-ph-d/bio-20513862" target="_blank" title="Opens in a new window.">Matthew Binnicker, Ph.D.</a>, director of Clinical Virology at Mayo Clinic, breaks down the testing options and explains how they work.</p> <h2>Polymerase chain reaction test nasal swab</h2> <p>This test, which is administered at a health care provider's office or a testing site, looks for the virus' RNA in a patient's sample. A sample is collected by inserting a nasopharyngeal swab into a person's nostril and taking cells from the back of the nose. Some lab tests allow for patients to spit into a tube to get a saliva sample.</p> <p>Make an appointment with your health care provider if you have been exposed or if you are experiencing symptoms.</p> <p>Depending on the lab your provider uses, you can expect to receive your results within 24–72 hours. The polymerase test is the gold standard when it comes to COVID-19 testing.</p> <p>At-home nasal swab with lab-based polymerase chain reaction test</p> <p>This is a similar type of test used at the health care provider's office, but patients collect the nasal swab themselves and mail it to a laboratory to be analyzed.</p> <p>Patients should use this test after exposure or when beginning to experience symptoms.</p> <p>Results from at-home tests typically take three to seven days. Since these tests are polymerase chain reaction tests performed in a laboratory, these results have higher accuracy than at-home antigen tests.</p> <h2>Saliva polymerase chain reaction test</h2> <p>This is a similar type of test used at the health care provider's office, but patients collect the saliva sample themselves and mail it off to a laboratory to be analyzed. Similar to swab tests, saliva is a specimen that can be collected for polymerase chain reaction testing. Saliva is typically easier ― and more comfortable ― to collect from patients, compared to a nasopharyngeal swab.</p> <p>Patients should use this test after an exposure or when they begin experiencing systems.</p> <p>Results from at-home, mail-away tests typically take three to seven days. Since these tests are polymerase chain reaction tests performed in a laboratory, these results have a higher accuracy than at-home antigen tests.</p> <h2>Rapid at-home antigen tests</h2> <p>Rapid at-home antigen tests detect certain viral proteins in the nasal sample.</p> <p>Timing is key with this test, so patients should try to take it on the day of the event because that's going to give them the best information as to whether they have high amounts of the virus in their system at that time. Using a nasal swab, antigen tests can produce results in 15 minutes.</p> <p>These tests, which are available for purchase where at-home tests are sold are faster and less expensive than polymerase chain reaction tests. But these tests have an increased chance of false-negative results. If an at-home antigen test is negative, patients should continue to wear a mask in public settings, and around those who are unvaccinated or at high-risk of becoming infected.</p> <p>If an at-home test is positive, patients should have a lab-based polymerase chain reaction test performed that day or the following day to ensure public health officials track the case and to connect them with a health care provider who will determine if treatment is necessary.</p> <h2>A combined approach</h2> <p>"COVID-19 testing should be combined with safety measures, such as masking and social distancing," says Dr. Binnicker.</p> <h3>Read more on COVID-19 testing:</h3> <ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/how-emerging-variants-could-affect-covid-19-testing-vaccines-and-spread/" target="_blank" title="Opens in a new window.">How emerging variants could affect COVID-19 testing, vaccines and spread</a></li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-develops-test-to-detect-covid-19/" target="_blank" title="Opens in a new window.">Mayo Clinic develops test to detect COVID-19</a></li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/what-you-need-to-know-about-covid-19-tests/" target="_blank" title="Opens in a new window.">What you need to know about COVID-19 tests</a></li> </ul> <p><em>Information in this post was accurate at the time of its posting. Due to the fluid nature of the COVID-19 pandemic, scientific understanding, along with guidelines and recommendations, may have changed since the original publication date.</em></p><img src="/-/media/national-files/images/hometown-health/2023/person-using-cellphone.jpg?h=370&iar=0&w=660&sc_lang=en&hash=3646C566F02E0A200797114EC45BAC94" alt="Person using cellphone" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Dawn Haller3/31/2020During this time of social distancing, learn how video appointments are changing the way you receive care and how you can make the most of your visit using technology.6 tips for making the most of your healthcare video appointment<p><a rel="noopener" href="https://newsnetwork.mayoclinic.org/discussion/how-video-appointments-are-changing-the-way-mayo-clinic-patients-receive-care/" target="_blank" title="Opens in a new window.">Video appointments</a> are changing the way patients receive care. Due to the need to practice social distancing during the COVID-19 pandemic, Mayo Clinic Health System is <a href="/covid19" target="_self" title="Opens in same window.">limiting in-person outpatient appointments</a>. Fortunately, you and your family can receive the care you need through other options, including video appointments.</p> <p>As in-person appointments are being rescheduled, you may be asked to schedule a video appointment. If you have a Patient Online Services account, you will be able to connect with your provider using Patient Online Services and communication software that complies with health information privacy rules.</p> <p>Sometimes a visit with your healthcare provider can be overwhelming.</p> <h4>There are a few things to consider before, during and after your video appointment so you make the most of the time with your healthcare provider:</h4> <h4>1. Prepare your technology.</h4> <p>If you are scheduled for a <a href="/-/media/national-files/documents/covid19/mc0684194.pdf?sc_lang=en&hash=E531697FBACB43E2CA1490CE7FFC030F" target="_blank" title="Opens in new window.">video appointment, here are some tips</a> to prepare your equipment, test your connection and log in for your appointment. Before an upcoming appointment, you may be notified that you have questionnaires to answer. If you have a video appointment, you'll need to complete the questionnaires before you check in for that appointment.</p> <h4>2. Prepare a discussion checklist.</h4> <p>Your healthcare provider will ask you several questions. The number of questions depends on the reason for your visit and whether this provider has seen you before. Your answers help your provider understand your health and health concerns.</p> <p>Be prepared to discuss:</p> <ul> <li>Reason for your visit</li> <li>New concerns</li> <li>Medical conditions, past and present</li> <li>Past surgeries</li> <li>Prescriptions and nonprescription medications, vitamins and herbal remedies</li> <li>Allergies</li> <li>Immunization records</li> <li>Family health history</li> </ul> <h4>3. Write down your concerns.</h4> <p>Prepare a list of concerns. Rank them in order of importance.</p> <p>You may want to ask:</p> <ul> <li>How can I improve my health?</li> <li>Are there conditions or diseases that I am at risk for?</li> <li>What are possible side effects of medications I am taking?</li> <li>Are there resources that will help me understand my medical conditions?</li> </ul> <p>It also is important to tell your healthcare provider about anything in your personal life that may affect your health, such as an illness in the family, financial worries or job difficulties.</p> <h4>4. Describe new symptoms, recent changes in symptoms.</h4> <p>Your healthcare provider may ask you detailed questions, such as:</p> <ul> <li>How long have you had the problem?</li> <li>What does it feel like?</li> <li>How often do the symptoms occur?</li> <li>What brings on the symptoms?</li> <li>What reduces the symptoms?</li> <li>Is the problem getting worse?</li> <li>Have other family members had similar problems?</li> </ul> <p>Having a family member or friend with you can be helpful. Having two people hear the discussion can help later when you want to remember what was talked about. Let your provider know if there is someone else in the room during your video appointment. In addition, you can read your provider's notes from your visit on Patient Online Services.</p> <p>Expect to ask all of your questions and have them answered. Talk with your healthcare provider about resources that may help answer your questions. This may take more time than your visit allows. If you need more time for questions, you may need to schedule a follow-up visit or phone call.</p> <h4>5. Recap what you heard after the visit.</h4> <p>It may be helpful to write down what you learned from your visit. Include information about how your healthcare provider is planning to help you and what actions you can take to improve your health. Request an after-visit summary that includes visit diagnoses, treatment plans, medication list and patient education, if one was not provided to you.</p> <p>Contact your healthcare provider by phone or Patient Online Services if you have additional questions about your visit.</p> <h4>Watch this video showing how one patient used a video appointment as part of her postoperative care:</h4> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/RaGVRVY94wA" title="Connected to Mayo Clinic through video appointments" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <h4>6. Call with questions.</h4> <p>If you have any questions about Patient Online Services, the Mayo Clinic App or how to connect to your video appointment, call Mayo Clinic Customer Assistance at 1-877-858-0398 weekdays from 7 a.m. to 7 p.m. Select option No. 4 from the menu to connect with a Mayo Clinic representative.</p> <p>Read more about <a href="/topics/patient-portal" target="_self" title="Opens in same window.">how you can use Patient Online Services</a> for your healthcare, including <a href="/hometown-health/featured-topic/connect-to-the-care-you-need-with-patient-online-services" target="_self" title="Opens in same window.">how to set up an account</a>. If you have questions about COVID-19, visit our <a href="/covid19" target="_self" title="Opens in same window.">COVID-19 page</a>.</p> <p><em>Zachary Merten, M.D., is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><img src="/-/media/national-files/images/hometown-health/2020/patient-health-care-video-appointment.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A1AF9DF3581282CF354E89852A65C1E7" alt="Patient health care video appointment" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Patient PortalStaying engaged in your healthcare is important. The patient portal is a free, secure and convenient online resource that connects you to your healthcare team and helps you manage your health from the comfort of your home or anywhere else.Get Tools to Live Your HealthiestIt’s never too early — or too late — to plan ahead for health. By making preventive care for you and your family a healthy habit, you’ll help improve your well-being. Be sure to connect with your healthcare provider to discuss any further questions that you may have about your health.Jeremy Jensen3/22/2020<p>Staying engaged in your healthcare is important. The patient portal is a free, secure and convenient online resource that connects you to your healthcare team and helps you manage your health from the comfort of your home.</p>Connect to the care you need with the patient portal<p>Staying engaged in your healthcare is important. the patient portal is a free, secure and convenient online resource that connects you to your healthcare team and helps you manage your health from the comfort of your home. </p> <h2>What can I do on the patient portal?</h2> <h3>Your patient portal account provides you with easy access to important healthcare information. You can use it to:</h3> <ul> <li>Ask your care team questions through a secure message system.</li> <li>Manage prescriptions and request refills.</li> <li>View medical records, such as clinical notes and lab, radiology and other test results.</li> <li>Receive alerts and notifications on your mobile device.</li> <li>Schedule, request and track appointments.</li> <li>Request to view and manage information for your child or those in your care.</li> <li>Access <a href="/services-and-treatments/express-care" target="_self" title="Opens in same window.">Express Care Online</a> to get quick care for common conditions without leaving home.</li> <li>Visit your provider through a <a href="/hometown-health/featured-topic/6-tips-for-making-the-most-of-your-video-appointment" target="_self" title="Opens in same window.">video appointment</a>.</li> <li>Pay your bill.</li> </ul> <h2>How do I set up my patient portal account?</h2> <h3>Follow these steps to create your patient portal account:</h3> <ol> <li>Go to the <a href="/patient-online-services" target="_self" title="Opens in same window.">portal</a>, and select "Create your account."</li> <li>Complete the online form to begin your account creation. You will need your Mayo Clinic number, which can be found on letters from your provider, appointment reminder letters or billing statements. You also can call 1-877-858-0398 between 7 a.m. and 7 p.m. (CDT) to get your number.</li> </ol> <h2>How do I view or manage my child's account or the account of someone in my care?</h2> <p>Once you are logged in to your own account, go to the upper right menu, click on "Add Another Patient Account," and follow the prompts. Patients ages 13–17 require an activation code. Learn more about <a href="/hometown-health/featured-topic/patient-online-services-helps-teens-parents-stay-connected-to-care" target="_self" title="Opens in same window.">using the patient portal for your teen's care</a>. </p> <h2>Is there an app? </h2> <p>The Mayo Clinic app gives you ready access to your patient portal account, as well as healthcare information from top doctors, dietitians and fitness experts. Download from the Apple and Google Play app stores.</p><img src="/-/media/national-files/images/hometown-health/2020/woman-with-cell-phone.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0759669F4A6E6E5A7278D5AE58157360" alt="woman with phone" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Patient PortalStaying engaged in your healthcare is important. The patient portal is a free, secure and convenient online resource that connects you to your healthcare team and helps you manage your health from the comfort of your home or anywhere else.Dawn Haller7/19/2023Some medications need to be closely monitored, which can be a challenge for some older people. Get tips for helping aging parents with their medications so you both can have peace of mind.Managing medications for aging parents<p>Some older people face challenges with remembering to take their medications or organizing them effectively. Their adult children may be able to help by taking steps to monitor and update medication lists.</p> <p>Adult children who are actively involved can help prevent potential health complications and also provide peace of mind for their parents and themselves.</p> <p>Common medication-related problems in older adults include taking too high or low of a dose, taking unnecessary medications, not taking medication as directed or at all, taking an ineffective medication, or adverse drug reactions like confusion, bleeding and oversedation.</p> <p>Certain medications require special monitoring. Medications used to control pain, anxiety, mood and sleep pose the largest risk for patients as they age. Medications for blood pressure and diabetes also can be problematic if they are not closely monitored and adjusted as health conditions change.</p> <p>Every person's medication needs are different. The risk for medication-related problems increases with each medication that is added. Patients who take four or more medications are at higher risk for medication-related problems, especially falls.</p> <h2>Here are six tips for helping aging parents with medications, even if you can't physically be with them:</h2> <h3>Gather information about the medications they use.</h3> <p>Get your parents' current medication lists from their primary care providers. Make sure the lists match the prescription containers in their home. Then talk through each medication so everyone understands what it is taken for, how often and at what dose.</p> <h3>Contact the pharmacy about available medication management services.</h3> <p>Many pharmacies offer individual dose packaging options. This is a low-cost way to help patients better manage daily medications, and it offers a way for family members to double-check on doses that may have been missed. If your pharmacy doesn't offer this service, use a medication planner. This is a plastic organizer that stores scheduled doses of medications and makes it easier to keep on top of which medication to take and when.</p> <h3>Contact the pharmacy about medication synchronization.</h3> <p>Medication synchronization allows patients to fill most medications at one time every 30 or 90 days, instead of refill cycles scattered throughout the month. This may help simplify and organize medications.</p> <h3>Request access to your parent's medical records.</h3> <p>If something goes wrong and your parents need extra help, having digital access to their medical records can help you get in touch with their primary care provider or pharmacist to assist.</p> <h3>Schedule a visit with a pharmacist.</h3> <p>A comprehensive medication review can be scheduled through your parent's primary care provider's office. You can ask for a referral during a visit or call the scheduling line and ask for a referral. During the visit, a clinical pharmacist will review your parent's medication lists to ensure all the medications are right for them. Patients must have a Mayo Clinic Health System <a href="/services-and-treatments/primary-care" target="_self" title="Opens in same window.">primary care provider</a> to request this service.</p> <h3>Talk with a pharmacist before adding vitamins and supplements.</h3> <p>Even though these products can be purchased over the counter without a prescription, there still are important interaction concerns with some medications. Talk with a health care provider or pharmacist before adding vitamins, herbal remedies or supplements to an older adult's medication regimen.</p> <p><em>By Mayo Clinic Health System staff.</em></p><img src="/-/media/national-files/images/hometown-health/2020/elderly-palm-of-hand-holding-medications.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BB630A62D3E0733197EEC1BBCD5AD4A0" alt="Elderly palm of hand holding medications" width="660" height="370" DisableNVelocity="true" />AgingLife expectancy is 75 for males and 80 for females according to the National Center for Health Statistics. We'll help you keep you informed about potential issues with aging, and steps you can take to maintain your health and keep active.Medication ManagementNearly 70% of Americans take at least one prescription drug, and more than half take two.Dawn Haller4/13/2020Video appointment technology is a secure, safe option for health care from your own home. Learn how you and your family can be assured your private health information is protected ― all while practicing social distancing.FAQ: Video appointments and your security<p>Mayo Clinic Health System is committed to your health, safety and the privacy of your protected health information. As Mayo Clinic Health System continues to respond to the COVID-19 pandemic, you should be assured that new options for care, including <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/how-video-appointments-are-changing-the-way-mayo-clinic-patients-receive-care/" target="_blank" title="Opens in a new window.">video appointments</a>, are secure.</p> <h4>Here are answers to FAQs about the technology used to conduct video appointments:</h4> <h4>Q. How do I know my video visit will be secure?</h4> <p>A. For your video visit, Mayo Clinic Healthy System uses a security-enhanced version of video software to protect your health care information. Mayo Clinic Health System complies with the Health Insurance Portability and Accountability Act's (HIPAA) patient privacy standards that regulate how health care providers share patient information and maintain patient privacy. When you are finished, any information shared through the software program is no longer accessible through the program. Your provider will send notes and other information to your secure Patient Online Services account.</p> <p>The appointments are created in real time, with no emails or other printed documents that share meeting IDs or meeting information. When you log in for an appointment, you are automatically logged in through secure means, as are the providers.</p> <p>The software program does not have access to identifiable health information, and it protects and encrypts all audio, video and screen sharing data.</p> <h4>Q. Is it safe to share a screen with my private health information on it?</h4> <p>A. Yes. The software program does not distribute actual patient data. Rather, screen sharing is done through encrypted screen capture and not actual data. Data confidentiality is further protected through a combination of encryption, strong access control and other protection methods.</p> <h4>Q. How is security enhanced?</h4> <p>A. When Mayo Clinic Health System providers and patients use the software for health care purposes, the organization is using specific licenses and secure domains. Other industries may not be using the same level of security.</p> <p>The software offers various ways to enhance security, which Mayo Clinic Health System uses, including the use of waiting rooms, using invitation-only meetings, limiting screen sharing to hosts, requiring meeting passwords, limiting the number of hosts to one and disabling private chat.</p> <h4>Q. Can I use a video meeting service such as FaceTime, Skype or other platforms?</h4> <p>A. No. Video appointments are integrated within the existing electronic health record platform, so the appointments meet HIPAA standards and security standards set by Mayo Clinic Health System. An appointment notification and link for the video appointment is coordinated through a person's Patient Online Services account.</p> <h4>Prepare for your appointment</h4> <p>If you are scheduled for a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinichealthsystem.org/-/media/national-files/documents/covid19/mc0684194.pdf?la=en&rev=7ee1f5550f3c459c99a96321d26ce3cb&hash=A76A863E1FC9552153C3796794A9B839" target="_blank" title="Opens in a new window.">video appointment, here are some tips</a> to prepare your equipment, test your connection and log in for your appointment. Before an upcoming appointment, you may be notified that you have questionnaires to answer. If you have a video appointment, you'll need to complete the questionnaires before you check in for that appointment. Read more about <a href="/hometown-health/featured-topic/6-tips-for-making-the-most-of-your-video-appointment" target="_self" title="Opens in same window.">tips for making the most of your health care video appointment</a>.</p> <h4>This video explains how to connect to Mayo Clinic for scheduled video appointments from a mobile device:</h4> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/0yO5KShM8Cc" title="Using video for your appointments" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <h4>Call with questions</h4> <p>If you have any questions about Patient Online Services or how to connect to your video appointment, call Mayo Clinic Customer Assistance at 1-877-858-0398 weekdays from 7 a.m. to 7 p.m.</p> <p>Learn <a href="/topics/patient-portal" target="_self" title="Opens in same window.">how you can use Patient Online Services for your health care</a>, including how to <a href="/hometown-health/featured-topic/connect-to-the-care-you-need-with-patient-online-services" target="_self" title="Opens in same window.">set up an account</a>. If you have questions about how to receive care during the COVID-19 pandemic, visit our <a href="/covid19" target="_self" title="Opens in same window.">COVID-19 page</a>.</p><img src="/-/media/national-files/images/hometown-health/2020/sitting-on-sofa-using-laptop.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E901DD68B62B6487215B9DB523C86088" alt="Sitting on sofa using laptop" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Patient PortalStaying engaged in your healthcare is important. The patient portal is a free, secure and convenient online resource that connects you to your healthcare team and helps you manage your health from the comfort of your home or anywhere else.Dawn Haller4/25/2020Here's an idea for your next virtual family reunion: Discuss family health history. The information can help you know if you may have an increased risk for a specific health condition. Here's how to get started.Knowing and recording your family health history<p><em>By Mayo Clinic Health System staff</em></p> <p>People are spending more time at home due to the COVID-19 pandemic and taking the opportunity to virtually connect with family members. In addition to learning a new recipe they have tried or the movies they have watched, you may want to virtually discuss your family health history.</p> <h4>Benefits of family health history</h4> <p>Many health conditions have a genetic link. Outlining your family health history can help you and your health care providers understand if you have an increased risk for developing certain conditions that are present in your family. If you are at risk, you may be able to take preventive measures to decrease your risk or undergo genetic testing to clarify your risk.</p> <h4>Genes versus environment</h4> <p>Your genes play a role in nearly all areas of your health. A gene is like an instruction manual for your body that tells your body how to function, develop and stay healthy. You have around 20,000 genes in your body. Some health conditions are almost completely determined by your genes, meaning having a specific harmful gene change ― called a mutation or pathogenic variant, like a spelling error within the instruction manual ― will cause you to develop a genetic condition. These genetic conditions are not something you would have caught or developed purely because of your environment.</p> <p>However, your genes usually don't determine anything with complete certainty. Your family health history and genes do not make up your fate, and your environment still plays a role. Your environment may include factors you can't change, like your biological sex and age, as well as factors you can control, such as diet, physical activity level, and exposures to cigarette smoke and other chemicals. Multifactorial inheritance is when your genetic makeup and environment play a role in determining your risk for particular conditions. Many common conditions, such as autoimmune diseases, cancer and mental health conditions, like anxiety and depression, are considered multifactorial.</p> <p>It may help to think of it with a metaphor. Imagine you are born with a cup for a particular health condition, like a cancer cup. If your cup overflows, you develop cancer. Some people are born with an empty cup, meaning those people have a genetically low risk for cancer. However, risk factors get added to your cup over time, such as age, and exposures to chemicals or radiation. Eventually, your cup may overflow, and you may develop cancer. Conversely, some people are born with a fairly full cup, meaning they are at risk from birth due to genetic risk factors they inherited. Yet, if they minimize the amount of risk factors being added to their cups over their lifetime, they may never develop cancer.</p> <p>While you can't change your genes, you can control some aspects of your environment, such as diet, physical activity level and tobacco use. You have some control over how much goes into your various health cups over time. That's why it's still so important to live a healthy life, regardless of your personal and family health history.</p> <h4>Who to talk with</h4> <p>Generally, you should try to get information about:</p> <ul> <li><strong>First-degree relatives</strong> — Parents, full siblings, children</li> <li><strong>Second-degree relatives</strong> — Half-siblings, grandparents, aunts and uncles, nieces and nephews, grandchildren</li> <li><strong>Third-degree relatives</strong> — First cousins, great-aunts and great-uncles, great-grandparents, great-grandchildren, half-aunts and half-uncles</li> </ul> <p>It still may help to gather information from as many relatives as you can, but the more distantly related a person is, the less his or her health history is expected to affect you.</p> <p>Both your mother's and father's side of your family are relevant for you, regardless of your biological sex or whether you more closely resemble one side of the family more than the other.</p> <p>Many people find it challenging to capture a complete health history due to adoption, estrangement or simply a lack of details known or willing to be shared in the family. It's OK to simply record the information that you can gather and know that it can be updated if more information becomes available in the future.</p> <h4>What to ask about</h4> <p>In general, you should try to gather information about whether relatives are living, their current age or age at which they passed away, and their medical history. Relevant details about health history include any medical conditions they have had and at what age they were diagnosed. For example, you can ask if they have had major health concerns, have ongoing or chronic health concerns, see a specialist for any medical conditions or are taking medication for health conditions.</p> <h4>Some specific conditions to note include:</h4> <ul> <li>Autism</li> <li>Birth defects, such as spina bifida, cleft palate or heart defects</li> <li>Cancer, tumors or polyps, noting specifically what organ or part of the body was affected</li> <li>Diabetes</li> <li>Heart conditions or abnormalities</li> <li>Infertility, multiple pregnancy losses (generally three or more), or babies who were stillborn or who passed away in infancy</li> <li>Kidney disease</li> <li>Learning problems, intellectual disabilities or developmental delays</li> <li>Mental illness or mental health conditions, such as depression, anxiety, bipolar disorder or schizophrenia</li> <li>Stroke</li> <li>Unique spots or patterns on their skin, such as cafe au lait spots, shagreen patches or many lumps and bumps under the skin</li> <li>Very tall or very short stature, compared to the rest of the family</li> <li>Vision or hearing loss at a young age or with no apparent cause</li> <li>Unexpected deaths due to known or unknown medical conditions</li> <li>Other unexplained medical conditions</li> <li>Any known genetic or chromosomal conditions, such as cystic fibrosis, muscular dystrophy, Huntington's disease or Down syndrome</li> <li>Genetic testing or genetic counseling</li> </ul> <p>It's also helpful to know about your relatives' environmental risk factors, too, such as history of tobacco use, alcohol abuse, drug abuse, obesity or exposure to radiation or chemicals.</p> <p>You can record the information you gather in many formats, such as this example of a <a href="/-/media/national-files/documents/hometown-health/2020/family-history-questionnaire.pdf?sc_lang=en&hash=79CAB5C52665BB5EE00E9A6FC26DF367" target="_blank" title="Opens in a new window.">family health history form</a> from Mayo Clinic. Also, if you have relatives who have visited with a genetic counselor before, they may have already had a pedigree constructed — a visual representation of the family health history, like a family tree. It may help to ask if they'd be willing to share their pedigree, as this can save you a lot of time and work when gathering family history details.</p> <h4>Gathering information from relatives who have passed away</h4> <p>Sometimes gathering health information can be challenging if a relative has passed away. It's common for that person's diagnosis to be uncertain. For example, sometimes a cancer diagnosis will be labeled as a "female cancer," making relatives unsure if this was cervical, uterine, ovarian or breast cancer. It also is common to call any cancer of the gastrointestinal tract a "stomach cancer," although cancers of the stomach, small intestine, colon and pancreas differ from each other. Knowing the specific details about your relative's history is important in providing an accurate risk assessment for you, so you may need to dig a little deeper to get the accurate details.</p> <p>Relatives' health records are the most helpful tool in getting these details, but they can be difficult to obtain. If no one has a hard copy of the decedent's records, the family may need to work with the health care institution to access the records. Sometimes records can be released to the decedent's personal representative or other authorized parties. In addition to health records, obituaries, death certificates, information from relatives and autopsy reports can help.</p> <h4>Next steps</h4> <p>After you have gathered your family health history, you should discuss it with your primary care provider who will determine what, if any, next steps are needed. If you have specific family history concerns you would like to address, you can ask for a referral to meet with a genetic counselor for further discussion. If you are seeing a genetic counselor, it is important that you bring your family health history along to the appointment so your family history can be discussed in detail.</p> <h4>Discrimination protection</h4> <p>Some people are concerned that information in a family health history can be used against them. The Genetic Information Nondiscrimination Act of 2008 is a federal law that protects people from genetic discrimination, specifically in the setting of health insurance and employment. This means your genetic information cannot be used against you when it comes to health insurance and employment.</p> <p>Genetic information includes family health history genetic testing results, use of genetic services, such as genetic counseling, and participating in genetic research. Under the act, your family health history and genetic testing results cannot be considered a preexisting condition. It is important to know that there are some exceptions to the act, and it does not have protections in place for life insurance, long-term care insurance or disability insurance.</p><img src="/-/media/national-files/images/hometown-health/2020/daughter-and-mom-virtual-visit-on-laptop.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BC39826B8941C3328DA05EA9A83E912C" alt="Daughter and mom virtual visit on laptop" width="660" height="370" DisableNVelocity="true" />Genetic TestingGenetic testing examines your DNA — the chemical database that carries instructions for your body's functions — to reveal changes or alterations in your genes that may cause illness or disease. <br/><br/>COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Dawn Haller4/9/2020Teens between ages 13 to 17 can get connected to their care team, view health records and participate in a healthcare visit from the convenience of home.Patient portal helps teens, parents stay connected to care<p>Teenagers between ages 13 and 17 can stay connected with their care team, view health records and participate in a healthcare visit ― all from home. </p> <h2>How is an account established for teenage patients?</h2> <p>Patients between ages 13 and 17 must have their own patient portal account to access the features. To create this account, the minor and a parent or guardian can call Mayo Clinic Customer Assistance at 1-877-858-0398 weekdays from 7 a.m. to 7 p.m. Choose option "4" from the phone menu options.</p> <p> Also, note:</p> <ul> <li>Both the minor and the parent or guardian must be on the call.</li> <li>The parent or guardian must be the billing guarantor — the person who receives the minor's billing statements, or the insurance subscriber — the person who carries the minor's health insurance policy. This helps verify the identity of the parent or guardian.</li> <li>This is a temporary change from the current process that requires the minor and parent to come to a Mayo Clinic facility.</li> <li>Once an account is created, parents can go to their own account and request caregiver access to the minor's account.</li> </ul> <h2>What can a caregiver access in the teen's account?</h2> <p>Caregiver access is restricted to information about allergy and immunization lists, secure messages and <a href="/services-and-treatments/express-care">Express Care Online</a> interactions. All other information is protected, and only the patient can see it. Exceptions are made only for minors with diminished capacity or where there are extenuating medical circumstances and ordered by a primary care physician.</p> <h2>What are the benefits of a patient portal account?</h2> <h3>An account provides easy access to important healthcare information. It can be used it to:</h3> <ul> <li>Visit a provider through a secure <a href="/hometown-health/featured-topic/6-tips-for-making-the-most-of-your-video-appointment" target="_self" title="Opens in same window.">video appointment</a>.</li> <li>Ask your care team questions through a secure message system.</li> <li>Take a free COVID-19 self-assessment to determine next steps for care.</li> <li>Manage prescriptions and request refills.</li> <li>View health records, such as clinical notes, and lab, radiology and other test results.</li> <li>Receive alerts and notifications.</li> <li>Schedule, request and track appointments</li> <li>Access Express Care Online to get quick care for common conditions without leaving home.</li> <li>Pay a bill.</li> </ul> <h2>Video appointments, other features</h2> <p>Learn more about <a href="/hometown-health/featured-topic/6-tips-for-making-the-most-of-your-video-appointment" target="_self" title="Opens in same window.">how video appointments are changing the way patients receive care</a> and the features you'll have access to with an account, such as the COVID-19 self-assessment tool, Express Care Online and questionnaires to complete prior to an appointment.</p> <p>When a minor is scheduled for a video appointment, a parent also must attend. Here are some <a href="/-/media/national-files/documents/covid19/mc0684194.pdf?sc_lang=en&hash=E531697FBACB43E2CA1490CE7FFC030F" target="_blank" title="Opens in a new window.">tips to help prepare for a video appointment</a>.</p><img src="/-/media/national-files/images/hometown-health/2020/mother-and-daughter-looking-at-tablet.jpg?h=370&iar=0&w=660&sc_lang=en&hash=00BE1EA98347F76BB22CB6A15B18BE9A" alt="Mother and daughter looking at tablet" width="660" height="370" DisableNVelocity="true" />Patient PortalStaying engaged in your healthcare is important. The patient portal is a free, secure and convenient online resource that connects you to your healthcare team and helps you manage your health from the comfort of your home or anywhere else.Dawn Haller5/13/2020With stay-at-home orders, now is the time to focus on minimizing exposures and spread of COVID-19. One way to accomplish this is by managing any new viral symptoms at home. What does that mean?10 ways to manage COVID-19 symptoms at home<p><em>By Mayo Clinic Health System staff</em></p> <p>With current restrictions and stay-at-home orders, now is the time to focus on minimizing potential exposures and spread of COVID-19. One way to accomplish this is by managing any new viral symptoms at home.</p> <p>Most people with suspected or known COVID-19 symptoms can manage their symptoms at home — similar to other viruses or illnesses — to further minimize spread of the virus. But what does managing symptoms at home mean?</p> <h3>Here are 10 things you should do to speed your recovery and prevent the illness from spreading to others you live with:</h3> <h4>1. Stay home.</h4> <p>Do not go to school or work, and do not shop. Designate one member in the household to be the shopper to minimize multiple people in your household from having to go out in public. If you must venture away from home, do not use public transportation or ride-sharing vehicles.</p> <h4>2. Sneeze or cough into your elbow rather than into your hands.</h4> <p>This stops germs from infecting others you are in contact with. Put used tissues in the wastebasket.</p> <h4>3. Wash your hands often.</h4> <p>Use soap and water for at least 20 seconds. You can sing the "Happy Birthday" song twice as a guideline. You also can use alcohol-based hand sanitizer.</p> <h4>4. Get plenty of rest.</h4> <p>Your body is fighting an infection and requires more rest than normal.</p> <h4>5. Drink plenty of fluids.</h4> <p>Being hydrated lessens congestion and allows mucus to be cleared more easily out of your body. It also helps your kidneys filter waste and toxins.</p> <h4>6. Stay away from other people in your home.</h4> <p>Remain in one room and use a separate bathroom, if available. If you need to be around other people, wear a face mask.</p> <h4>7. Avoid sharing personal items.</h4> <p>This includes dishes, towels and bedding that could spread infection to other people.</p> <h4>8. Clean household surfaces.</h4> <p>Use household cleaning products according to the instructions on counters, doorknobs, light switches and other surfaces that are often touched.</p> <h4>9. Monitor your symptoms.</h4> <p>Track your temperature, and note when new symptoms appear so you accurately report this information to your health care provider.</p> <h4>10. Call first.</h4> <p>If you have a medical appointment, call before leaving for your appointment to let your health care provider know you have or may have COVID-19. You will receive additional instructions at that time.</p><img src="/-/media/national-files/images/hometown-health/2020/woman-hugging-self-in-blanket.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F48EA92C550C104028B3BAA2677FEB1C" alt="Woman hugging self in blanket" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Back to SchoolDawn Haller5/18/2020People with underlying lung conditions, such as asthma or COPD, have been identified as having an increased risk of developing serious respiratory complications from COVID-19. Get tips to prevent getting the virus.COVID-19 and lung conditions: What you need to know<p><em>By Mayo Clinic Health System staff</em></p> <p>COVID-19 first was identified as a disease in late 2019 when a cluster of patients with pneumonia were identified in China. It is caused by the SARS-CoV-2 virus, which belongs to a family of viruses, called the coronavirus family, many of which are known to cause respiratory illness in humans. SARS-CoV-2 primarily attacks the lungs, causing various respiratory problems ranging from mild to severe.</p> <p>As the virus enters the body, it infects the cells of the respiratory system, including the nose, windpipe and lungs. It uses these cells to make more copies of itself. In 80% of people, COVID-19 causes mild to moderate illness. In 14–15% of people, the disease is severe enough that these people need to be admitted to the hospital. About 5–6% of people get critically ill, needing ICU level of care.</p> <h4>Effects on lung conditions</h4> <p>People with underlying lung conditions, such as asthma or chronic obstructive pulmonary disease, have been identified as having an increased risk of developing serious respiratory complications from COVID-19.</p> <p>Also, people who smoke are considered more susceptible to COVID-19. Although, few studies have investigated the link directly, cigarette smoke and vaping are linked to increased lung inflammation and lower immune function. There also is evidence that smoking is associated with increased risk of other respiratory infections.</p> <p>People with lung conditions are recommended to contact their health care provider right away if they develop any new respiratory symptoms, including but not limited to a fever, cough, runny nose, sore throat or difficulty breathing, or blue lips or face.</p> <h4>Prevention tips</h4> <p>For most people with lung conditions, the advice to prevent COVID-19 is the same as recommended by the Centers for Disease Control and Prevention, regardless of the condition.</p> <h4>Prevention tips include:</h4> <ul> <li>Stay at home as much as possible. Remember: The most effective known intervention to avoid getting sick is social distancing. If you go outside, use a mask. </li> <li>Maintain an inventory of supplies in your home should you need to be quarantined or become sick.</li> <li>Keep away from others who are sick, both in and out of your home, and ask anyone who is sick not to visit.</li> <li>Avoid large gatherings.</li> <li>Avoid all cruises and any nonessential air travel.</li> <li>Practice regular hand hygiene by washing with soap and water.</li> <li>Avoid touching your mouth, nose and eyes, especially if your hands were not recently washed.</li> <li>Continue taking your regular medications, therapies and plans.</li> <li>Review new prevention guidelines from the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.cdc.gov/coronavirus/2019-ncov/index.html" target="_blank" title="Opens in a new window.">CDC</a>. The CDC's guidance is regularly updated as new information becomes available.</li> </ul> <p>Although the CDC has guidance about who should be tested for COVID-19, not everyone who has symptoms needs to be tested. Your local health department and health care provider will decide who to test. If you have symptoms of COVID-19 and want to get tested, first call your state or local health department, or a health care provider.</p><img src="/-/media/national-files/images/hometown-health/2020/older-man-drinking-glass-of-water.jpg?h=370&iar=0&w=660&sc_lang=en&hash=08E73CB37F9B468E162CDFFCCEB76E69" alt="Older man drinking glass of water" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Respiratory CareRespiratory care helps people with serious health problems associated with their lungs and ability to breathe. The Respiratory Care team is always ready to respond to a variety of emergency situations, such as an asthma attack. Additional services may include pulmonary rehabilitation and educational programs.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Dawn Haller5/12/2020COVID-19 affects people in different ways. Kari Houser, a Mayo Clinic Health System staff member, shares her family's story of their recent diagnosis and recovery.Staff member shares experience after COVID-19 diagnosis<p>Kari Houser, operations manager at Mayo Clinic Health System in La Crosse, Wisconsin, says she was shocked when she tested positive for COVID-19.</p> <p>"My husband and I had been doing yardwork one Saturday afternoon and just didn't feel quite right," recalls Kari. "I felt fatigued and was running a slight fever, and my husband was experiencing mild symptoms, as well. These symptoms lasted for 48 hours, and we've felt completely fine ever since."</p> <p>Kari called the COVID-19 Nurse Line to talk through her symptoms. The following Monday, Kari was tested for COVID-19 at Mayo Clinic Health System in La Crosse, and two days later, she received a call from an infectious diseases provider that her test came back positive. Kari's husband, 17-year-old son, 20-year-old daughter and her daughter's boyfriend all were presumed to be positive with COVID-19.</p> <p>"After being contacted by the infectious diseases provider at Mayo Clinic Health System, we were contacted by the La Crosse County Health Department," says Kari. "A county health worker was in contact with us every couple of days, checking in on our symptoms and making sure we had everything we needed.</p> <p>"While we don't know exactly how or when we came into contact with COVID-19, my husband had traveled to Texas a few weeks before," says Kari. "Due to the low number of cases in Texas at that time, our cases have actually been attributed to us attending our son's hockey tournament in Milwaukee about a week prior to noticing symptoms. When my husband traveled to Texas and when we were at our son's hockey tournament, we felt like we were taking all of the necessary precautions to avoid becoming infected.</p> <p>"It's not exactly fun to be on lockdown in your home for two weeks, but we did find the silver lining in this situation," says Kari. "My family was home together every day, where we were able to have family dinners and movie nights. We found ways to be grateful for what we had, such as having enough food and household items to get us through our time in isolation."</p> <p>Kari's family has been giving back since recovering from COVID-19. They have volunteered to donate plasma, as Mayo Clinic will be the lead institution providing coordinated access to investigational convalescent plasma for hospitalized patients with severe or life-threatening COVID-19, or those at high risk of progression to severe or life-threatening disease. Kari and her husband donated 1,000 meals worth of food to the Wafer Food Pantry in La Crosse since recovering. They also have been supporting local restaurants in the area, buying gift certificates if restaurants aren't open for takeout.</p> <p>"It's important to stay educated about what's going on, as information about this disease changes daily," adds Kari. "Staying home is critical right now, as my son was asymptomatic the entire time. Even if you have minor symptoms, as my family did, you need to stay home. This time spent social distancing is minor in the grand scheme of things ― and can save lives."</p><img src="/-/media/national-files/images/hometown-health/2020/kari-houser.jpg?h=370&iar=0&w=660&sc_lang=en&hash=BF6A99A8CFA33029127A62C259A4A318" alt="Kari Houser" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Dawn Haller5/14/2020Patients recovering from stroke and orthopedic surgery, and children experiencing speech difficulties are among the growing number of patients now using video visits. Discover the benefits of rehab therapy video visits.Video visits help therapy patients recover at home<p>Patients recovering from a stroke and orthopedic surgery, as well as children experiencing speech difficulties, are among the growing number of patients now using <a rel="noopener" href="https://newsnetwork.mayoclinic.org/discussion/how-video-appointments-are-changing-the-way-mayo-clinic-patients-receive-care/?_ga=2.149945782.1254154706.1588017916-1021412469.1588017916" target="_blank" title="Opens in a new window.">video visits</a> with Mayo Clinic Health System providers, therapists and other care team members. Video visits allow staff to care for patients at home. </p> <p><a href="/providers/heidi-skophammer-cccslp" target="_self" title="Opens in same window.">Heidi Skophammer</a>, a <a href="/services-and-treatments/speech-language-therapy" target="_self" title="Opens in same window.">speech pathologist</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota, has been able to use video visits to work with adult <a href="/services-and-treatments/neurology" target="_self" title="Opens in same window.">neurology</a> patients recovering from a stroke and experiencing speech difficulties, as well as children struggling with articulation, language development and social skills.</p> <p>Video visits also are used to help postsurgical <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic</a> patients with upper extremity conditions, including those who have undergone repair of various fractures, fracture dislocations, tendon lacerations and shoulder arthroplasty.</p> <h4>Benefits to video visits</h4> <p>Video visits allow for continuity of care for the patient and reassurance for the provider that the patient is getting the care they need.</p> <p>For example, a patient can advance exercises following a particular surgery. Guidance and oversight from the healthcare team can help patients organize and implement information.</p> <p>Families and caregivers have always been welcome to participate when patients are in the clinic. However, video visits have allowed them to be involved in a different way.</p> <p>"Families and other caregivers are now providing the hands-on cues that would have otherwise been provided by the therapist," says Heidi. "It truly becomes a team approach, which is so important in the patient's overall rehabilitation process."</p> <h4>Patients and staff learning together</h4> <p>Video visits are new for many providers and patients, and sometimes they are learning together as they work through the process. </p> <p>"There have been many adjustments in therapy as activities have been changed to accommodate technology and patients in their home setting," says Heidi. "We’re using this as an opportunity to grow in new areas, and I look forward to using these skills in years to come."</p> <h4>Support and feedback is positive</h4> <p>The simplicity of connecting with patients through video has been an bonus. </p> <p>Since implementing video appointments, many patients have provided positive feedback. They have expressed appreciation for the therapy guidance, oversight, reassurance and encouragement during their healing and recovery process.</p> <h4>Learn more about video visits:</h4> <ul> <li>Get <a href="/hometown-health/featured-topic/6-tips-for-making-the-most-of-your-video-appointment" target="_self" title="Opens in same window.">six tips for making the most of your healthcare video appointment</a>.</li> <li>Find <a href="/hometown-health/featured-topic/faq-video-appointments-and-your-security" target="_self" title="Opens in same window.">answers to your questions about whether video visits are a secure way of communicating with your provider</a>.</li> <li>Find out how you can <a href="/hometown-health/featured-topic/connect-to-the-care-you-need-with-patient-online-services" target="_self" title="Opens in same window.">connect to the care you need with a Patient Online Services account</a>.</li> </ul><img src="/-/media/national-files/images/hometown-health/2020/therapy-at-home-video-visit.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9E4A7D83A7096915A742EC3032A3E6D0" alt="Therapy at home video visit" width="660" height="370" DisableNVelocity="true" />Speech-LanguageThe evaluation and treatment of communication disorders and swallowing disorders.Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Rehabilitation TherapyRestoring movement and function to people injured or impaired by disease or injury.StrokeAs one of the leading causes of death in the U.S., stroke will affect 80% of families during their lifetimes, according to the National Stroke Association. And the faster care you receive for stroke, the better. Learn more about stroke prevention, symptoms and treatments here.Stroke AwarenessA stroke occurs when the blood supply to part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and food. A stroke is a medical emergency. Prompt treatment is crucial. Early action can minimize brain damage and potential complications.<br/>COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Patient PortalStaying engaged in your healthcare is important. The patient portal is a free, secure and convenient online resource that connects you to your healthcare team and helps you manage your health from the comfort of your home or anywhere else.Dawn Haller8/19/2020The COVID-19 pandemic has been stressful for families — especially if your child is upset about having a COVID-19 test. The good news is that there are things you can do to help your child prepare.Helping your children prepare for a COVID-19 test<p>The COVID-19 pandemic has been a stressful time for many families. Each of your family members, including your children, likely has had many changes to daily routines in recent weeks or months. This can be troubling to children and disrupt the family. One part of the pandemic that could cause children to be upset is if they need a COVID-19 test.</p> <p>The good news is that there are things that you can do as a parent or caregiver to ease some potential fear and anxiety. When children are prepared to take a medical test, they are more cooperative and comfortable.</p> <h2>Here are a few recommendations to help prepare your children for a COVID-19 test:</h2> <h3>Define new terms</h3> <p>It's important that your children have a basic understanding of what COVID-19 is and why they need to be tested. Take time to explain COVID-19 in kid-friendly terms.</p> <p>Here's how I describe it when talking with kids:</p> <p>You may have heard adults talking about COVID-19. It's a virus, like a germ, and it is so tiny that we can't see it with our eyes. Some people who get this virus can have a fever or a cough, and may feel achy and tired, while some people can have this virus and not feel sick at all. The only way to know for sure if you have the virus in your body is to get a test. This helps your doctor and parents know the best way take care of you.</p> <h3>Explain what they will see</h3> <p>When your children get tested, the health care team will be wearing more protective clothing than previous visits.</p> <p>Here's how I explain that:</p> <p>Health care team members will wear gloves on their hands, a mask over their mouth and a clear plastic shield to protect their eyes. They are wearing these things to protect you, me and themselves from spreading germs. Watch their eyes and let me know when they smile because the shape of their eyes change.</p> <h3>Explain test process</h3> <p>How you describe the testing process depends on the age of your children. For young and school-age children, I recommend that parents describe it as touching the inside of the back of your nose with a long, skinny cotton swab.</p> <p>Here's how I explain it:</p> <p>During the test, the health care provider will put a long, skinny cotton swap far into your nose for a few seconds to collect a sample. While this happens, it may tickle or feel uncomfortable, and you might feel like you want to push the cotton swab away. You have a very important job. You need to stay as still as possible, like a statue, during the test.</p> <p>It may help your children to practice so you can positively reinforce good behaviors before going to the clinic. Encourage your children to lean back, hold your hand and count slowing to five while remaining still.</p> <h3>Comfort during test</h3> <p>It's important that your children feel secure during a COVID-19 test, so reassure them that you will remain by their side during the test. In addition to your presence, your children can bring a comfort item to the test, such as a favorite stuffed animal or blanket. Some kids and teens like to do something during the test to help them relax. This may include counting, breathing in and out slowly, and listening to music.</p> <h4>In addition to talking with your children, watch this Mayo Clinic video to help them feel more comfortable and confident for their COVID-19 test:</h4> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/mCIDZ9DsaKU" title="Helping your child prepare for a COVID-19 test" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p>   <p><em><a href="/providers/jennifer-brumm-md" target="_self" title="Opens in same window.">Jennifer Brumm, M.D.</a>, is a <a href="/services-and-treatments/pediatrics-and-adolescent-medicine" target="_self" title="Opens in same window.">pediatrician</a> in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Developmental Issues</li> <li>Child Abuse Evaluation & Prevention</li> <li>Down Syndrome</li> </ul>M.D.<p><strong>Medical School</strong> <br />University of Wisconsin-Madison Medical School, Madison, WI</p> <p style="margin-bottom: 10px;"><strong>Residency</strong><br /> Mott Children's Hospital, University of Michigan, Ann Arbor, MI</p> <p><strong>Memberships</strong> <br />American Academy of Pediatrics<br /> State Medical Society of Wisconsin<br /> Child Advocacy Center Task Force</p> <p><strong>Certifications</strong> <br />American Board of Pediatrics<br /> American Heart Association Regional Faculty<br /> PALS Instructor</p>Brumm<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/jennifer-brumm-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=61014622147EB63C29D255755C176FC0" alt="Jennifer Brumm MD" width="280" height="280" DisableNVelocity="true" />Jennifer<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12729175Jennifer Brumm MD1<img src="/-/media/national-files/images/hometown-health/2020/mother-and-child-nose-to-nose.jpg?h=370&iar=0&w=660&sc_lang=en&hash=FF24089116BDBC9AB88D80907EE41096" alt="Mother and child nose to nose" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Back to SchoolHot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller9/2/2021Chances are you've heard things about COVID-19 from social media, friends or family. It can be tempting to believe claims. We'll set the record straight on some of the circulating COVID-19 myths.Debunking COVID-19 myths<p><em>Updated Aug. 2, 2023</em></p> <p>Chances are you've heard about a food, drug or other method that claims to prevent, treat or cure COVID-19. But while it might be tempting to use a questionable product or method to stay healthy, it's unlikely to work. And, in some cases, it might cause serious harm.</p> <h2>COVID-19 vaccine and prevention myths</h2> <p>Getting a <a rel="noopener" href="https://www.cdc.gov/covid/vaccines/index.html" target="_blank" title="Opens in a new window.">COVID-19 vaccine</a> reduces the risk of infection with the COVID-19 virus and slows the spread of COVID-19. Also, vaccination can prevent severe illness from COVID-19. But misinformation continues to circulate about COVID-19 vaccines and ways to prevent infection with the COVID-19 virus.</p> <h3>Here's what the science says about COVID-19 vaccine myths:</h3> <ul> <li><strong>COVID-19</strong><br /> COVID-19 vaccines don't cause you to become sick with COVID-19. The COVID-19 vaccines authorized for use in the U.S. don't contain the live virus that causes COVID-19. Some people may have side effects from the vaccine, such as a fever or muscle pain. But these symptoms usually go away in a few days.</li> <li><strong>Fertility<br /> </strong>Currently, there is no evidence that any COVID-19 vaccine causes fertility problems. COVID-19 vaccination is recommended for people who are trying to become pregnant or might become pregnant in the future.</li> <li><strong>Microchips</strong><br /> COVID-19 vaccines won't track your location or movements. COVID-19 vaccines were developed to help the body develop immunity to the virus that causes COVID-19. Also, COVID-19 vaccines don't contain preservatives, antibiotics, metals, or aborted fetal tissues or cells.</li> <li><strong>DNA</strong><br /> COVID-19 vaccines deliver instructions to teach the body how to build protection against the COVID-19 virus. The Pfizer BioNTech and the Moderna COVID-19 vaccines use genetically engineered messenger RNA (mRNA). The mRNA gives cells instructions for how to make a piece of protein found on the surface of the COVID-19 virus. The protein is then displayed on the surface of cells in the body. Once the immune system recognizes that the protein doesn't belong there, it makes antibodies to fight off what looks like an infection. After the mRNA delivers instructions, it's immediately broken down. It doesn't enter the nucleus of the cells, where the DNA is kept. COVID-19 vaccines don't change your DNA. </li> </ul> <h3>Other COVID-19 prevention myths include:</h3> <ul> <li><strong>Natural immunity</strong><br /> It's safer to build immunity from a COVID-19 vaccine than it is to develop immunity from getting sick with COVID-19. Vaccine side effects are often mild and predictable. But the severity of COVID-19 varies from person to person. And some people can get seriously ill. Also, vaccines give the highest level of protection against COVID-19, even for people who have already gotten sick with COVID-19.</li> <li><strong>Pneumonia and flu vaccines</strong><br /> Vaccines against pneumonia, such as the pneumococcal vaccine, don't protect against the COVID-19 virus. The flu shot also won't protect you against the COVID-19 virus. However, annual flu vaccinations are recommended for everyone age six months and older.</li> <li><strong>High temperatures</strong><br /> Exposure to the sun or to temperatures higher than 77 F (25 C) doesn't prevent infection with the COVID-19 virus or cure COVID-19 illness. You can get the COVID-19 virus in sunny, hot and humid weather. Taking a hot bath also can't prevent you from catching the COVID-19 virus. Your normal body temperature remains the same, regardless of the temperature of your bath or shower.</li> <li><strong>Low temperatures</strong><br /> Cold weather and snow also can't kill the COVID-19 virus.</li> <li><strong>Drinking alcohol</strong><br /> Consuming alcoholic beverages doesn't protect you from the COVID-19 virus.</li> <li><strong>Garlic</strong><br /> There's no evidence that eating garlic protects against infection with the COVID-19 virus.</li> <li><strong>Ultraviolet (UV) disinfection lamp</strong><br /> Ultraviolet light can be used as a disinfectant on surfaces. But don't use a UV lamp to sterilize your hands or other areas of your body. UV radiation can cause skin irritation.</li> <li><strong>5G mobile networks</strong><br /> Avoiding exposure to or use of 5G networks doesn't prevent infection with the COVID-19 virus. Viruses can't travel on radio waves and mobile networks. The COVID-19 virus has spread in many countries that lack 5G mobile networks.</li> <li><strong>Disinfectants</strong><br /> When applied to surfaces, disinfectants can help kill germs such as the COVID-19 virus. However, don't use disinfectants on your body, inject them into your body or swallow them. Disinfectants can irritate the skin and be toxic if swallowed or injected into the body. Also, don't wash produce with disinfectants.</li> <li><strong>Supplements<br /> </strong>Many people take vitamin C, zinc, green tea or echinacea to boost their immune systems. But these supplements are unlikely to prevent you from getting sick. The supplement colloidal silver, which has been marketed as a COVID-19 treatment, isn't safe or effective for treating any disease. Oleandrin, an extract from the toxic oleander plant, is poisonous and shouldn't be taken as a supplement or home remedy.</li> </ul> <h2>COVID-19 treatment myths</h2> <p>Misinformation about COVID-19 treatments has led to serious harm and death.</p> <h3>These drugs, products and methods aren't recommended to treat COVID-19:</h3> <ul> <li><strong>Antibiotics<br /> </strong>Antibiotics kill bacteria, not viruses. However, people hospitalized due to COVID-19 might be given antibiotics because they also have developed a bacterial infection.</li> <li><strong>Alcohol and chlorine spray</strong><br /> Spraying alcohol or chlorine on your body won't kill viruses that have entered your body. These substances also can harm your eyes, mouth and clothes.</li> <li><strong>Ivermectin</strong><br /> This drug is often used in the U.S. to treat or prevent parasites in animals. In humans, specific doses of ivermectin tablets can be used to treat parasitic worms. Also, a topical version can be applied to the skin to treat head lice and skin conditions in humans. However, ivermectin isn't a drug for treating viruses. The Food and Drug Administration (FDA) hasn't approved the use of this drug to treat or prevent COVID-19. Taking large doses of this drug can cause serious harm. Don't use medications intended for animals on yourself.</li> </ul> <h2>Focus on facts</h2> <p>The FDA continues to remove misleading products from store shelves and online marketplaces. In the meantime, remember that testimonials aren't a substitute for scientific evidence. Also, few diseases can be treated quickly, so beware of quick fixes. A miracle cure that claims to contain a secret ingredient is likely a hoax.</p> <p>If you have a question about a product, drug or method for treating or preventing infection with the COVID-19 virus, talk to your health care team. To ask a question about a COVID-19 medication, you can call your local pharmacist or the <a rel="noopener" href="https://www.fda.gov/about-fda/center-drug-evaluation-and-research-cder/cder-division-drug-information" target="_blank" title="Opens in a new window.">FDA's Division of Drug Information</a>.</p> <h2>Effective COVID-19 prevention tips</h2> <p>There are steps you can take to reduce your risk of infection. When possible, get a COVID-19 vaccine. Also, stay up to date with COVID-19 vaccines to prevent serious illness. You're considered up to date with your vaccines if you've gotten all recommended COVID-19 vaccines, including booster doses when you become eligible.</p> <p>If you're up to date with your vaccines, you can more safely return to activities you might not have been able to do because of the pandemic. However, if you are in an <a rel="noopener" href="https://covid.cdc.gov/covid-data-tracker/#datatracker-home" target="_blank" title="Opens in a new window.">area with a high number of people with COVID-19 </a> in the hospital and new COVID-19 cases, the Center for Disease Control and Prevention (CDC) recommends wearing a mask indoors in public.</p> <p>You can take many steps to reduce your risk of infection from the COVID-19 virus and reduce the risk of spreading it to others.</p> <h3>The CDC recommends following these precautions:</h3> <ul> <li>Avoid close contact with anyone who is sick or has symptoms.</li> <li>Keep distance between yourself and others when you're in indoor public spaces if you're not fully vaccinated. This is especially important if you have a higher risk of serious illness. Keep in mind that some people may have COVID-19 and spread it to others, even if they don't have symptoms or don't know they have COVID-19.</li> <li>Avoid crowds and indoor places that have poor airflow (ventilation).</li> <li>Wash your hands often with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer that contains at least 60% alcohol.</li> <li>Wear a face mask in indoor public spaces if you're in an area with a high number of people with COVID-19 in the hospital, whether or not you're vaccinated. The CDC recommends wearing the most protective mask possible that you'll wear regularly, fits well and is comfortable.</li> <li>Cover your mouth and nose with your elbow or a tissue when coughing or sneezing. Throw away the used tissue. Wash your hands right away.</li> <li>Avoid touching your eyes, nose and mouth.</li> <li>Avoid sharing dishes, glasses, bedding and other household items if you're sick.</li> <li>Clean and disinfect high-touch surfaces, such as doorknobs, light switches, electronics and counters, regularly.</li> <li>Stay home from work, school and public areas and stay home in isolation if you're sick, unless you're going to get medical care. Avoid taking public transportation, taxis and ride-hailing services if you're sick.</li> </ul> <p>If you have a chronic medical condition and may have a higher risk of serious illness, check with your health care provider about other ways to protect yourself.</p> <p><em>By Mayo Clinic Health System staff</em></p> <p><em>Information in this post was accurate at the time of its posting. Due to the fluid nature of the COVID-19 pandemic, scientific understanding, along with guidelines and recommendations, may have changed since the original publication date.</em></p><img src="/-/media/national-files/images/hometown-health/2020/gloved-hands-filling-vaccine-syringe.jpg?h=370&iar=0&w=660&sc_lang=en&hash=81D4CA60539C7868244B5C2CF51FCE4E" alt="Gloved hands filling vaccine syringe" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Immunizations<p>Disease prevention is crucial to your health. Getting vaccinated is one of the best ways to maintain good health, and protect you and those you care about against infectious diseases. Vaccinations offer protection against serious diseases by stimulating the immune system to create antibodies against certain bacteria or viruses.</p><br/><p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/vaccine-guidance/art-20536857" target="_blank" title="Opens in a new window.">Get vaccine guidance from Mayo Clinic</a>, including benefits, safety, side effects and what to know about recommended vaccines for babies, children, teens, adults and during pregnancy. For recommended vaccines based on age, refer to the <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/adult" target="_blank" title="Opens in a new window.">adult</a> or <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/child" target="_blank" title="Opens in a new window.">child and adolescent</a> schedules.</p><br/><p>Review the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/coronavirus-covid-19/history-disease-outbreaks-vaccine-timeline" target="_blank" title="Opens in a new window.">history of infectious disease outbreaks and vaccines timeline</a> for information about major disease outbreaks, epidemics and pandemics, and the impact of vaccines and research.</p>COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Micah Dorfner3/27/2019<p>Since 2011, thousands of Mayo Clinic Health System patients who have undergone robotic hysterectomies or prostate procedures have experienced a much shorter healing time due to the technology. Now, as robotic procedures have moved into general surgery, more patients are experiencing the benefits of robotic surgery for hernia procedures.</p>Robotic surgery shortens recovery time for patients<p><img alt="illustration-of-robotic-surgery" src="/-/media/national-files/images/hometown-health/2019/robotic-surgery-cartoon.jpg?h=378&w=660&sc_lang=en&hash=7D40254C5EA59692115C3CD1226FCA77" style="height: 378px; width: 660px;" class="img-responsive"></p> <p>Since 2011, thousands of Mayo Clinic Health System patients who have undergone robotic hysterectomies or prostate procedures have experienced a much shorter healing time due to the technology. </p> <p>Now, as robotic procedures have moved into general surgery, more patients are experiencing the benefits of robotic surgery for hernia procedures. Moving forward, the technology also will be adapted for bariatric and colon procedures.</p> <p>The technology provides another option to patients for minimally invasive procedures,” says <a href="/providers/tara-krosch-md">Tara Krosch, M.D.</a>, general and trauma surgeon at <a href="/locations/mankato">Mayo Clinic Health System in Mankato</a>. We are the first general surgery group in the health system to offer robotic surgery, and we are pleased to see the technology become available to more patients.</p> <p>John Tanke, 47, was one of the first patients to undergo robotic hernia surgery in Mankato. Tanke is an active runner who opted for the robotic procedure in hopes of a speedier recovery.</p> <p>"There is that concern about losing fitness and starting back at square one,” says Tanke.</p> <p>Two days after his procedure, Tanke was back on the job, and within three weeks, he was running again.</p> <p>"We have seen these results again and again, which is a great relief to those patients," says Dr. Krosch.</p> <h4>ABOUT ROBOTIC PROCEDURES</h4> <p>Like laparoscopic surgeries, robotic procedures involve making small incisions in which tubes with cameras and surgical instruments are inserted. During laparoscopic procedures, the surgeon manually holds the equipment.</p> <p>During robotic procedures, the surgeon controls a robot’s movements from a console a few feet from the patient. The surgeon uses fingertip controls and foot pedals that control the four arms of the robot.</p> <h4>BENEFITS OF ROBOTIC PROCEDURES</h4> <p>With robotic procedures, hospital stays and recovery times are typically shorter. Patients often return to normal function quicker than with standard open or laparoscopic surgery.</p> <p>“This is due to more precise suture handling, better optics and improved mesh application, among other procedural benefits,” Dr. Krosch says.</p> <p style="background: white;">Patient-collected data indicates less pain during recovery from robotic procedures vs. laparoscopic procedures. Also, fewer patients require readmission for complications.</p> <h4>TALK TO YOUR PROVIDER</h4> <p>Some patients are not eligible for robotic or laparoscopic procedures. Ask your provider which option is best for you.</p><img src="/-/media/national-files/images/hometown-health/2019/robotic-surgery-cartoon.jpg?h=378&iar=0&w=660&sc_lang=en&hash=A5408389288AAAC4E2D90248C8B6391F" alt="illustration-of-robotic-surgery" width="660" height="378" DisableNVelocity="true" />SurgeryHaving surgery is a major event in your life. We know this and make every effort to keep you as comfortable as possible, focusing on you as an individual. Our surgeons and staff work as a coordinated team treating a wide variety of illnesses ranging from simple to complex. We offer comprehensive, advanced care and service to every patient.Dawn Haller1/17/2022If you need to test for COVID-19, Mayo Clinic health experts remind you not to go to the emergency department as it is for patients with life-threatening needs.Emergency departments not for COVID-19 testing<p>If you need to test for COVID-19, Mayo Clinic health experts remind you not to go to the emergency department for testing. Emergency departments are for patients with life-threatening healthcare needs.</p> <p>"Emergency departments are an important part of the overall healthcare system," says <a href="/providers/laura-walker-md" target="_self" title="Opens in same window.">Laura Walker, M.D</a>., an <a href="/services-and-treatments/emergency-medicine" target="_self" title="Opens in same window.">Emergency Medicine</a> physician at Mayo Clinic Health System in <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a> and <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a>, Minnesota, and Mayo Clinic in Rochester. "Our primary care and dedicated COVID-19 testing sites are also an important aspect. As an emergency physician, I need to be able to quickly see patients with emergency conditions ― like strokes, heart attacks, injuries and severe illness ― where time is of the essence. Conditions that can be cared for in the clinic setting or the outpatient testing centers for COVID-19 are best done there. We have put together incredible resources so patients can schedule their COVID-19 tests and quickly get them taken care of."</p> <p><strong>If you are showing signs of possible COVID-19 symptoms, contact your <a href="/request-appointment" target="_self" title="Opens in same window.">local healthcare provider</a></strong>.</p> <p>If you meet testing criteria, you will be directed to one of Mayo Clinic Health System's local testing sites.</p> <p>If you are having trouble scheduling an appointment to be tested for COVID-19, do not go to the emergency department to get tested. Instead, be patient and continue to check testing options to schedule the next available testing appointment near you.</p> <p>Dr. Walker recommends that people continue to follow the proper COVID-19 quarantine and isolation guidelines, as outlined by the <a rel="noopener" href="https://www.cdc.gov" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention</a> if they or someone around them is positive for COVID-19.</p> <p><em>Information in this post was accurate at the time of its posting. Due to the fluid nature of the COVID-19 pandemic, scientific understanding, along with guidelines and recommendations, may have changed since the original publication date.</em></p><img src="/-/media/national-files/images/hometown-health/2023/covid-19-test-swab-near-patient.jpg?h=370&iar=0&w=660&sc_lang=en&hash=ED47B722BFB43C0E5018E4A97E93BA69" alt="Provider holding COVID-19 test swab near patient" width="660" height="370" DisableNVelocity="true" />Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Dawn Haller1/27/2022A common misconception is that the effect of COVID-19 on kids is minimal. Learn how the pandemic really affects children physically and mentally.How the COVID-19 pandemic is affecting kids<p>Throughout the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/coronavirus/symptoms-causes/syc-20479963" target="_blank" title="Opens in a new window.">COVID-19</a> pandemic, a common misconception is that kids aren't affected much by COVID-19, and if they were to get sick, their symptoms would be mild. However, the pandemic is affecting children in many ways, physically and mentally.</p> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/ameenuddin-nusheen-m-d-m-p-h/bio-20055080" target="_blank" title="Opens in a new window.">Nusheen Ameenuddin, M.D.</a>, a Mayo Clinic pediatrician, and <a href="/providers/janice-schreier-lcsw" target="_self" title="Opens in same window.">Janice Schreier</a>, a clinical therapist at Mayo Clinic Health System in La Crosse, Wisconsin, have seen firsthand the toll the pandemic has taken on children.</p> <h2>Kids are getting sick</h2> <p>One of the most common questions parents ask Dr. Ameenuddin is whether children really need to get vaccinated for COVID-19.</p> <p>"What I've stressed to them is that we've actually gotten a lot of good information over the past couple of years (about COVID-19's effects on children), especially the last year, that the vaccines are incredibly effective in preventing very severe side effects," says Dr. Ameenuddin.</p> <p>One particular rare and serious side effect of COVID-19 is <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/mis-c-in-kids-covid-19/symptoms-causes/syc-20502550" target="_blank" title="Opens in a new window.">multisystem inflammatory syndrome</a> in children, or MIS-C. Dr. Ameenuddin says among those who have gotten multisystem inflammatory syndrome in children, almost all were unvaccinated.</p> <p>"Vaccination, even if a child still gets sick, makes them much less likely to be sick enough to be hospitalized or die, which, unfortunately, has been happening."</p> <h2>Mental health issues on the rise</h2> <p>Even before the pandemic, mental health challenges facing kids were a big concern. Schreier says COVID-19 has only exacerbated the situation.</p> <p>"We've seen an increase in depression and anxiety, and eating disorders have increased like nothing I've seen," says Schreier.</p> <p>"Just in 2021, we saw greater than 30% increase in mental health presentations to emergency rooms. And those kids that are coming in are sicker than they used to be before the pandemic. They are having higher levels of suicidal ideation, showing more aggression with self-harm, higher rates of substance abuse and more instances of eating disorders."</p> <p>Schreier says the pillars of good mental health, such as, spending time with friends, physical activity, good sleep hygiene and maintaining a routine, have been compromised during the pandemic.</p> <h2>Adverse side effects</h2> <p>Some of the side effects of COVID-19 for children are ones that could affect them for years to come.</p> <p>"I think one thing that we haven't heard enough about is that over 140,000 children in the United States have lost at least one parent to COVID-19. Even if people are thinking this is something that is more of an adult disease, and it's not affecting children, many children have been orphaned," says Dr. Ameenuddin. "Not having a parent for the rest of your life is a really significant adverse event. That's why it is very much a disease that's affecting children in multiple different ways."</p> <p><em>By Mayo Clinic staff</em></p> <p><em>Information in this post was accurate at the time of its posting. Due to the fluid nature of the COVID-19 pandemic, scientific understanding, along with guidelines and recommendations, may have changed since the original publication date.</em></p><img src="/-/media/national-files/images/hometown-health/2022/child-resting-chin-on-palm.jpg?h=370&iar=0&w=660&sc_lang=en&hash=288C41713FFF46935A2235A47EACD0AF" alt="Child resting chin on palm" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Dawn Haller3/29/2022One symptom of post-COVID syndrome is described as "brain fog." Learn what you can do if you have short-term memory loss, confusion and difficulty concentrating after a COVID-19 infection.Dealing with 'brain fog' from long COVID-19<p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-long-term-effects/art-20490351" target="_blank" title="Opens in a new window.">Long COVID-19</a>, also known as post-COVID syndrome, involves a wide range of health problems that occur many weeks, months and years after recovering from COVID-19 infection. Sometimes, symptoms of long COVID-19 can include cognitive difficulties.</p> <p>"Brain fog" has been used to describe some of these symptoms. While "brain fog" is not a medical condition, it's a term used for certain symptoms that can affect one's ability to think.</p> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/schultz-billie-a-m-d/bio-20055456" target="_blank" title="Opens in a new window.">Billie Schultz, M.D.</a>, a Mayo Clinic physical medicine and rehabilitation expert, discusses what can be done to help patients experiencing "brain fog."</p> <p>Short-term memory loss, confusion and difficulty concentrating are all things those suffering from "brain fog" may experience after recovering from COVID-19 infection.</p> <p>"'Brain fog' is just kind of this feeling that you're trying to do something, and it's taking more effort. It's harder to do. You don't feel like you're picking up all of those details — almost as if you're driving through a fog," says Dr. Schultz.</p> <p>While there's no one-size-fits-all treatment that can cure these cognitive difficulties, some rehabilitation strategies can retrain the brain to work on the areas that are most challenging.</p> <p>"Typically, it means going into work with a therapist initially once or twice over the course of a month. And getting homework. 'I want you to try to utilize these strategies in your day-to-day life.' Because, ultimately, that's what decides if they're working." </p> <p>Dr. Schultz stresses that people should address any cognitive symptoms that affect their day-to-day life, regardless of whether those symptoms are related to long COVID-19.</p> <p>"The most important thing you can do as a patient is to share honestly with your providers what you're experiencing," says Dr. Schultz.</p> <h4>Other post-COVID syndrome signs and symptoms include: </h4> <ul> <li>Blood clots and blood vessel problems</li> <li>Chest pain</li> <li>Cough</li> <li>Depression or anxiety</li> <li>Dizziness when you stand</li> <li>Fast or pounding heartbeat</li> <li>Fatigue</li> <li>Fever</li> <li>Joint pain</li> <li>Loss of smell or taste</li> <li>Memory, concentration or sleep problems</li> <li>Muscle pain or headache</li> <li>Organ damage, such as damage to the lungs, heart, kidney and brain</li> <li>Shortness of breath or difficulty breathing</li> <li>Worsened symptoms after physical or mental activities</li> </ul> <p><em>Information in this post was accurate at the time of its posting. Due to the fluid nature of the COVID-19 pandemic, scientific understanding, along with guidelines and recommendations, may have changed since the original publication date.</em></p><img src="/-/media/national-files/images/hometown-health/2022/looking-for-keys.jpg?h=370&iar=0&w=660&sc_lang=en&hash=CA67828621C903117B9043F994CC8D72" alt="Looking for keys" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller3/10/2022The drop in COVID-19 cases may lead you to think the pandemic is ending. While stats are headed in the right direction, an infectious diseases expert explains why it's too early to say it's over.Endemic vs. epidemic vs. pandemic: What you need to know <p>Two years after the COVID-19 pandemic begin, rates of infection, hospitalization and deaths continue to drop, raising the question of whether the pandemic is ending. <a rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/o-horo-john-jack-c-m-d-m-p-h/bio-20206043" target="_blank" title="Opens in a new window.">John O'Horo, M.D.</a>, a Mayo Clinic infectious diseases specialist, says that while stats are headed in the right direction, it's too early to call the pandemic over.</p> <p>"A lot of the discussion right now centers on if we are heading toward this being an endemic disease that's always present in the background. And in all likelihood, that's where we are heading," says Dr. O'Horo. "Determining where we cross into that threshold is a question that epidemiologists and others will have to answer in coming weeks."</p> <p>The terms "endemic," "epidemic" and "pandemic" may be new for some people, and they could be easily confused.</p> <h2>The Centers for Disease Control and Prevention offers these definitions:</h2> <ul> <li><strong>Endemic</strong><br /> The amount of a particular disease that is usually present in a community. It's also called a baseline.</li> <li><strong>Epidemic</strong><br /> An increase — often sudden — in the number of cases of a disease above what is normally expected in that population in a specific area.</li> <li><strong>Pandemic</strong><br /> An epidemic that has spread over several countries or continents and affects many people.</li> </ul> <p>Over the past two years, COVID-19 has been classified as a pandemic due to its widespread effects. So what would moving to a stage where COVID-19 is endemic mean? Dr. O'Horo says that when COVID-19 becomes endemic, it will be present at a certain level in a population at certain times of the year or year-round.</p> <p>"You expect a certain level of background activity. One of the best examples I can give of an endemic … is our seasonal flu activity, where, as the activity increases during the winter, there's a certain expected level of increase that we see — that we accept as just part of normal variation."</p> <p>Dr. O'Horo explains that it's possible to move back and forth from pandemic to endemic phases. "This isn't a one-way door. Continued vigilance and vaccination will be required at some point in the future to prevent another pandemic from disrupting our lives the way that we've seen in the past two years."</p> <p>He also highlights the importance of following local trends in your community. "In an endemic phase, we're really looking at that local transmission level and that local background activity. Public health authorities will continue to monitor that, and it's just something that the rest of us are going to have to keep an eye on. What are they recommending based on that local spread? And know that just because it's safe to take off masks three counties over in one setting doesn't mean it's safe to do the same in this county in a more vulnerable setting."</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/dermal-piercing-and-neck-tattoo.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0D0D19205A8335EA722468C85744AB11" alt="Person with dermal piercing and neck tattoo" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller5/24/2022While baby formula is in short supply right now, you may be tempted to water it down or use homemade formula. Learn why this can be dangerous, and get advice for getting formula for your baby.Advice for parents during baby formula shortage<p>Infant caregivers are finding empty store shelves where baby formula was once stocked. They may be turning to online searches and even alternative solutions, such as making homemade baby formula.</p> <p>While it may sound like a good idea, <a rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/klaas-kelsey-m-m-d/bio-20270977" target="_blank" title="Opens in a new window.">Kelsey Klaas, M.D.</a>, a Mayo Clinic pediatrician, says feeding your baby homemade formula is not safe for multiple reasons.</p> <p>"In the short term, one of the potentially severe risks of a homemade formula is that we can see electrolyte imbalances — calcium, sodium and several others — that can lead to potentially scary events, such as the most severe kind of seizures," says Dr. Klass. "It can lead to dehydration in the shorter term, as well. So although it sounds like it might be a good idea, it's really a potentially dangerous option, especially for young infants."</p> <p>Diluting existing formula, watering it down to try to make it last longer, is also not a good option.</p> <p>"We're not feeding our babies the same number of calories, and, so, even in the short term, they're not getting enough nutrition from that product. On top of that, with dilution, again, we face electrolyte imbalance challenges, seeing low calcium and low sodium levels as potentially severe side effects of a formula dilution."</p> <p>So what can parents do? Dr. Klaas says it's OK to feed babies formula that is available on the shelves, even if it's not the usual kind they use.</p> <p>"When you're changing nutrition, you might see your baby be more gassy, see some change in stool patterns potentially," says Dr. Klaas. "If you're seeing vomiting, if you're seeing diarrhea, that's the time to reach out to your pediatrician. That's not an expected response to just a formula change. If it is a little bit more fussiness, gassiness, then that is something we would recommend just feeding through and knowing that the nutrition is what baby needs."</p> <p>Parents of infants with kidney disease or metabolic disorders that require them to be fed a special formula should get in touch with their baby's healthcare team.</p> <p>"There is a form that physician offices can complete and send to Abbott Nutrition for emergency access of special formulas. That's not all infant formulas. Again, this is going to be infants who are receiving metabolic formulas and special formulas for chronic conditions."</p> <h2>Here's more advice for caregivers looking for baby formula:</h2> <ul> <li>When shopping for formula, make frequent trips to the store, as many stores receive shipments multiple times per week or even daily.</li> <li>Call around before you drive around. Some stores may hold a few cans of formula for you if you are coming right away to pick it up.</li> <li>When you are at the store, ask customer service if formula is in a different location than the regular shelf. </li> <li>Check grocery stores in small outlying towns, as well.</li> <li>Try shopping online. Stores may have different formula online than what they have on the shelves.</li> <li>Talk with your local public health or county Woman, Infants and Children office for additional information.</li> </ul> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/baby-bottle-feeding.jpg?h=370&iar=0&w=660&sc_lang=en&hash=DB53AC62A4F48D014E263865D196A711" alt="Baby bottle feeding" width="660" height="370" DisableNVelocity="true" />Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller5/25/2022The CDC is tracking multiple clusters of monkeypox. A Mayo Clinic expert explains what this virus is, how it's transmitted and what you need to know.What you need to know about monkeypox<p>Scientists around the world are investigating multiple clusters of monkeypox cases. </p> <p>The <a rel="noopener" href="https://www.cdc.gov/mpox/?CDC_AAref_Val=https://www.cdc.gov/poxvirus/mpox/outbreak/current.html" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention</a> (CDC) has indicated a U.S. resident tested positive for monkeypox after returning to the U.S. from Canada. The CDC also is tracking multiple clusters of monkeypox cases that have been reported in early to mid-May in regions that don't normally report monkeypox, including Europe and North America.</p> <h2>What is monkeypox?</h2> <p>Monkeypox was first discovered in a colony of monkeys in 1958. The first human case of the virus was recorded in the Congo in 1970. Since then, it has mostly been reported in African countries.</p> <p>Monkeypox is an infection from animals caused by a virus closely related to the smallpox virus. Infection is transmitted to humans through scratches or bites from infected animals, such as rodents or nonhuman primates, or eating bush meat.</p> <p>Human-to-human transmission occurs through direct contact with skin lesions, bodily fluids or through large respiratory droplets. Transmission is limited to close household contacts or health care workers not wearing personal protective equipment.</p> <p>"There has never been an outbreak of this size outside of Africa. We now have about 120 known or suspected cases across 12 different countries. This is unprecedented," says <a rel="noopener" href="https://www.mayo.edu/research/faculty/poland-gregory-a-m-d/bio-00078220" target="_blank" title="Opens in a new window.">Gregory Poland, M.D.</a>, head of <a rel="noopener" href="https://www.mayo.edu/research/labs/vaccine-research-group/overview" target="_blank" title="Opens in a new window.">Mayo Clinic's Vaccine Research Group</a>.</p> <h2>Monkeypox symptoms</h2> <p>Initial symptoms are fever, headache and swollen lymph nodes. This is followed by a rash. The rash initially consists of flat patches. It then progresses to raised nodules and then to vesicles, with one to two days in each phase. The final stage of pus-filled blisters can last five to seven days. The rash heals by scabbing over.</p> <p>People with monkeypox are infectious to others from the onset of fever until all lesions scab over.</p> <p>"Monkeypox is in the same family of virus as <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/smallpox/symptoms-causes/syc-20353027" target="_blank" title="Opens in a new window.">smallpox</a>, but it should not be confused with smallpox in levels of alarm," says Dr. Poland. "With smallpox, 10% to 30% of people can die. With this strain of monkeypox that is circulating right now, that death rate in Africa is 1% or less."</p> <h2>Protection from monkeypox</h2> <p>Dr. Poland believes people can be protected with <a rel="noopener" href="https://www.mayoclinic.org/drugs-supplements/smallpox-vaccine-injection-route/description/drg-20071296" target="_blank" title="Opens in a new window.">smallpox vaccine</a>.</p> <p>"However, in the summer of 2019, a <a rel="noopener" href="https://www.mayoclinic.org/drugs-supplements/smallpox-monkeypox-vaccine-live-non-replicating-intradermal-route-subcutaneous-route/description/drg-20473664" target="_blank" title="Opens in a new window.">monkeypox-specific vaccine</a> was approved in the U.S.," says Dr. Poland. "It requires two doses, four weeks apart, so you have to be immunized before being exposed."</p> <p>Vaccinations for monkeypox are not available to the public. In the event of exposure, public health authorities will guide vaccination of close contacts, including health care workers.</p> <p>Smallpox vaccines effectively prevent monkeypox if given before or within a few days of exposure. Other monkeypox therapies are tecovirimat and brincidofovir — both antiviral medications — and vaccinia immune globulin. These therapies were originally designed for smallpox but also work for monkeypox. All are available in the U.S. National Defense Stockpile.</p> <h2>Should you be concerned?</h2> <p>The average person should have near-zero concern, says Dr. Poland. First, transmission of monkeypox requires prolonged close contact with people who are infected. Unlike <a rel="noopener" href="https://www.mayoclinic.org/coronavirus-covid-19?mc_id=us&utm_source=newsnetwork&utm_medium=l&utm_content=content&utm_campaign=mayoclinic&geo=national&placementsite=enterprise&invsrc=other&cauid=100721" target="_blank" title="Opens in a new window.">COVID-19</a>, where people may not know they are infected, people infected with monkeypox have symptoms, such as fever or a rash, that make it easier to recognize. These symptoms cause people to seek out medical care.</p> <p>The incubation period — the time from when a person is exposed to when that person develops symptoms — is long. Therefore, public health measures can help prevent additional cases.</p> <p>Finally, vaccines can prevent infection. Treatments are available for those who get infected. He says for public health care organizations and scientists, there is concern at a global level.</p> <p>"You would not want to see this virus, for example, mutate and become highly transmissible," says Dr. Poland. "The death rate for this virus is akin to what the death rate was for COVID-19 when it first emerged. COVID-19 is a far bigger threat."</p> <p>There is a hypothesis why this virus is circulating, says Dr. Poland.</p> <p>"This is the first time in modern human history where we have so many people who have never been exposed to a pox virus and have never been vaccinated against smallpox," says Dr. Poland. "Perhaps what the teaching point of this is the public is going to have to become scientifically and more microbiologically literate in understanding that with climate change, with very rapid international travel, with ignoring basic health recommendations, we will see one kind of outbreak after another."</p> <h2>Is Mayo Clinic prepared?</h2> <p>Mayo Clinic is prepared to safely handle clinical cases of monkeypox while protecting everyone's safety. Mayo Clinic also is prepared to answer questions about your risk, which is low.</p><img src="/-/media/national-files/images/hometown-health/2022/monkeypox-on-torso-and-arm.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2E2383D6DC04C6F8EB9E277EACFCCF7A" alt="Monkeypox on torso and arm" width="660" height="370" DisableNVelocity="true" />Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Dawn Haller6/13/2022Stress is affecting many people in the post-pandemic world. And higher levels of stress and anxiety may continue for some time. Learn how to use your spiritual life to manage stress and heal.Spiritual healing post-pandemic stress<p>High levels of stress and anxiety have been major parts of the COVID-19 pandemic. It has had far-reaching effects on nearly every aspect of life. An American Psychological Association survey from 2021 found that more than 80% of U.S. adults report emotions associated with prolonged stress. And higher levels of stress and anxiety may continue for the foreseeable future.</p> <p>This figure is astounding because this number would likely include many people with normal stress baselines and solid coping skills. One of the authors, Arthur Evans Jr., Ph.D., CEO of the American Psychological Association, states, "Without addressing stress as part of a national recovery plan, we will be dealing with the mental health fallout from this pandemic for years to come."</p> <p>Additional research shows an increase of stress levels from 2020 to 2021. This trend may lessen in 2022, but only time will tell.</p> <p>So how can your spiritual life be a tool when dealing with pandemic stress? A first step may be to start viewing pandemic stress as an asset instead of just focusing on the negative. This is the "glass half-full versus half-empty" approach.</p> <p>William Rupp, M.D., emeritus CEO of Mayo Clinic in Florida, often said, "Take the high road in health care." The high road is about positive solutions more than exhaustive explanations of the problem. Consider how to use the personal and professional changes you made during the pandemic and lean on your mental and spiritual growth to help in post-pandemic life.</p> <p>It will take society time to work through pandemic stress, and incorrect healing could lead to greater complications. Pandemic stress is like a broken bone that must be reset. If in disrepair, the bone will likely heal in a way that could cause a plethora of health care problems in the future, like arthritis, pain, or disfiguration of the joint or limb.</p> <p>There are many emotional and spiritual takeaways that can be valuable as coping skills and be applied to similar situations in the future. An adage says that nothing is ever wasted in God's economy, since it is used for growth and own benefit. The Divine God is using this situation for benefit if you can see the benefits.</p> <p>If you are struggling with post-pandemic stress, try these tips to heal your proverbial spiritual bones:</p> <h2>Reflect on pandemic events.</h2> <p>In health care settings, teams may set up a debriefing meeting to seek support from peers following a traumatic event. Talking through and reflecting about a crisis helps people process their emotions. Take time to pause and reflect, rather than simply move onto the next crisis in your life. Think about the new coping skills you have procured during this time. Then apply these skills to build resilience against future challenges. The value of mobilizing your spiritual life, including combining contemplative practices, could be helpful for future events.</p> <p>In the movie "Star Trek: The Motion Picture," Spock was trying to find his find his way in life after an encounter with another life form. He grasped Capt. Kirk's hand and said, "I should've known." Later in the film, he explained that he meant that former issues in his life were resolved, and he was comfortable moving on to the next steps in life's journey ahead. In post-pandemic society, this could be referred to as the new spiritual normal.</p> <p>Like Spock, are you at home with yourself now? Do you feel ready for the new normal? Or do you need to debrief internally, with others and with God before you can move forward?<br /> Debriefing with others often helps deal with pandemic stress and improves emotional and spiritual functioning. Therapy can be beneficial if you are serious in your readiness to make changes. The key is to dissect your pandemic story to examine and apply what you learned to stop anxious feelings that get in the way of healthy problem-solving, building resilience and improved coping skills.<br /> Allow God to work stress the stress in your life like a potter would work with clay. This can lead to personal and professional growth. Doing a thorough self-reflection will help you create building blocks and grow coping skills that will help you in the future.</p> <h2>Unpack to become unstuck.</h2> <p>Getting unstuck in a post-pandemic world involves moving away from a stuck phase and moving toward a rebalanced life. This is where your spiritual life can ground and center as you give time to focus on God.</p> <p>Unpacking and repacking of a backpack after school or work is a normal part of a daily routine. Similarly, a lot of unpacking and repacking can help with mental and spiritual health.</p> <p>Some items that are carried around aren't useful or healthy for mental and spiritual health. Carrying around unhelpful emotions keep you stuck in the past. You might be using some of the older coping mechanisms that got worn out during the pandemic. Often, my grandmother would say that eating too much of a food that you like will make it tasteless and repulsive. Similarly, your go-to coping mechanism can become foundered and no longer work.</p> <p>Furthermore, you don't want to keep focusing on constant worry about future events that may or may not happen. It's important to pack or repack the best coping mechanisms and skills while abandon the rest as unneeded baggage.</p> <p>Focusing on your spiritual life is as important as an annual exam for physical health. There is joy and peace that comes from spending time with God, which includes talking and listening. These times offer opportunities for you to leave unwanted items at the feet of sacred one.</p> <h2>Watch for warning signs and act.</h2> <p>Not all stress is bad. Some can be a friend instead of a foe. Positive stress is called "eustress," and it produces positive feelings and excitement. Yet even positive stress can be bad, especially when it's ongoing, mixed with anxiousness or cumulative. It can lead to fatigue and burnout. Negative stress could be viewed as a warning signal that it's time to reprioritize, take a spiritual timeout or make necessary changes.</p> <p>Think of a car tire that wobbles because it is out of balance. Or a car that is out of alignment, and the tire tread is wearing unevenly. Is your life wobbling in the aftermath of this COVID-19 pandemic? What is your spiritual GPS telling you? It's important to fix the situation now and not wait for later.</p> <p>A car's dashboard is valuable because it provides valuable information and feedback. Likewise, it is valuable to check your "spiritual dashboard" to make sure your life is in spiritual alignment with God. Watch for the warning signs and allow your spiritual co-pilot to move you back to the center of your lane.</p> <p>The power of your spiritual life can be helpful, so get plugged in early. Allowing pandemic stress to linger is like waiting too long to take pain medication after surgery. The pain is hard to control once it has been allowed to fester and build. Just as some symptoms can be a warning sign of a serious illness, your spiritual life offers similar precursors to help you to get back to improved quality of spiritual health and well-being.</p> <p>It's time to act and make changes in your life, as the COVID-19 pandemic has offered an opportunity to write a new narrative in your life's journey. This is the time when you will be most susceptible to hard-wire change; otherwise, it becomes another missed opportunity.</p> <h2>Put margins of self-care in your day.</h2> <p>Margins are blank spaces on a book's pages and between chapters to give readers a chance to rest. They make books easier to read. "Many of us are overloaded, and few of us have any 'margin' left in our lives because of the rush to all of life's activities," says Richard Swenson, M.D., author of "Margin: Restoring Emotional, Physical, Financial, and Time Reserves to Overloaded Lives."</p> <p>Increasingly, there is little or no space, or margins, on daily calendars for self-care and time to regroup. A margin in your day is a dedicated time to catch your breath. Make sure you schedule it, as other priorities quickly can take it away. You can use these times to catch up on your spiritual health. You could sleep or rest, but also consider reflecting on what you have done to regenerate your God-given spiritual self. You could attend a seminar or practice meditating. Get creative or try journaling. View this as devoted time to replace depleted energy and lost time during the pandemic.</p> <p>Where is your white space on your sheets of your life's pages on your life's journey? Is there something you can free up to give yourself extra margin for self-care to restore your energy?</p> <p>It may have been a while since you have dedicated time to regeneration, but recharging your spiritual energy cells is time well-spent. It is time your spiritual life gets plugged in to God to maximize your spiritual strength.</p> <p>For the first two years of the COVID-19 pandemic, people were busy coping, under significant stress and running life fueled by adrenalin. It will take time to slow down and get your nervous system back into normal range. It is like slowing a speeding train. Putting margins back allows you to slow your spiritual train down, especially while relying on divine intervention for help.</p> <h2>Prioritize rest and recovery.</h2> <p>The concept of creation is not just the one-time divine creation, but rather the continuous, creative work within you by the spirit. If you are tired all the time, you are prone to illness, more prone to accidents, and less innovative and creative. There is also some value in that God rested in the Bible. Rest and recovery are more than a recommendation. They are necessary for the body and mind to function, and the spirit to succeed.</p> <p>Pandemic stress has affected many people, while also creating the ability to develop spiritual discipline to increase resiliency. As a tree's root system often digs deeper to maintain structure and stability during a storm, a pandemic storm also can help with stress relief through resilience growth of spirit.</p> <p>The omnipotent spiritual entity is gracious in giving such grace to all of us, but we need to ask for it. I am reminded of a pastoral mentor who would say, "God gives free will, and God helps those who help themselves." What is the level of your investment in your own healing of your pandemic stress?</p> <p>While thoughts of God or the divine vary, the goal of the spiritual relationship and accompanying religious concepts are similar across many faiths. May you reach out to God in your own way and draw strength for overcoming obstacles, whether these stressful obstacles be identified as pandemic stress or something different.</p> <h2>These resources can help improve your spiritual health by maintaining healthy habits, like exercising and eating healthy:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/the-4-as-of-stress-relief">4 As of stress relief</a></li> <li><a href="/hometown-health/speaking-of-health/5-tips-for-walking-your-way-to-better-health">5 tips for walking your way to better health</a></li> <li><a href="/hometown-health/speaking-of-health/5-tips-to-manage-stress">5 tips to manage stress</a></li> <li><a href="/hometown-health/speaking-of-health/eating-healthy-on-a-budget">Eating healthy on a budget</a></li> </ul> <p><em>Chaplain William Creech is a clinically trained, board-certified chaplain in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><img src="/-/media/national-files/images/hometown-health/2022/meditating-by-the-ocean.jpg?h=370&iar=0&w=660&sc_lang=en&hash=0402DC16E61D5D5CA0826A748BCBC540" alt="Meditating by the ocean" width="660" height="370" DisableNVelocity="true" />Stress ManagementGuidance to help you reduce and manage daily stress.ResiliencyGet resources on how to be resilient, which is the ability to recover quickly from difficult situations; adapt well to adversity, trauma, tragedy, threats or even significant sources of stress; and demonstrate positive responsiveness to challenging events.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller8/17/2022Health officials continue to monitor and track increasing cases of monkeypox. Learn about symptoms, how it spreads, who should be tested and if a vaccine is available.Monkeypox Q&A<p>Health officials continue to monitor and track increasing cases of <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infectious-diseases/expert-answers/monkeypox-faq/faq-20533608" target="_blank" title="Opens in a new window.">monkeypox</a>, a rare disease caused by the monkeypox virus.</p> <p>"Monkeypox is a virus that has mainly caused outbreaks in the continent of Africa. There have been over the last decade or two isolated outbreaks in countries outside of Africa, but this is the largest outbreak occurring in what we call nonendemic countries," says <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/binnicker-matthew-j-ph-d/bio-20513862" target="_blank" title="Opens in a new window.">Matthew Binnicker, Ph.D.,</a> director of the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/departments-centers/laboratory-medicine-pathology/overview/specialty-groups/clinical-microbiology" target="_blank" title="Opens in a new window.">Clinical Virology Laboratory</a> at Mayo Clinic.</p> <p>The World Health Organization declared monkeypox a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/who-declares-monkeypox-a-global-health-emergency/" target="_blank" title="Opens in a new window.">global public health emergency</a>, with more than 31,700 reported cases in 89 countries. In the U.S., more than 10,700 cases of monkeypox have been reported, according to the Centers for Disease Control and Prevention (CDC).</p> <h2>Dr. Binnicker answers common questions about the disease:</h2> <h3>What are common monkeypox symptoms?</h3> <p>If someone is exposed to monkeypox virus, several days later they typically develop what we call a viral prodrome, where they may have a fever or body aches that may last for a few days and then progress to developing a rash on their body. That rash may be localized in one part of the body, for example on the chest or on the face. Or it may be more widespread across the body — in other words on the face, chest, arms and legs. And that rash can then persist for several weeks.</p> <p>Someone continues to be considered infectious until that rash is completely healed, which may take up to four weeks.</p> <h3>How is monkeypox contracted and spread?</h3> <p>The primary mode of transmission of monkeypox is through direct contact with a lesion that contains the virus or direct contact with bodily fluids that have the virus in it. It's also possible for the virus to be spread through contact with contaminated fomites.</p> <p>"Fomite" is a word that includes things like a bedspread or a bath towel, or even clothing. For example, if someone who has been infected with monkeypox sleeps on a bedspread, or wears clothing, those fomites could then spread the virus to others who might come into contact with them.</p> <p>It is possible that monkeypox can be spread through the respiratory route, but that's believed to be a rare form of transmission. And it's thought to require prolonged exposure.</p> <h3>What is the test for monkeypox, and who should get tested?</h3> <p>When people are suspected of having monkeypox, they may present to their physician or the emergency department with a new rash, fever or viral prodrome illness. The physician will take a swab of their rash. They'll vigorously collect a sample from one of the lesions — the spots of the rash — and then they'll send that swab into a testing laboratory, including ours. The laboratory will then perform a polymerase chain reaction test.</p> <p>Those who should be tested for monkeypox include people who have had direct contact with anyone who has a confirmed case of monkeypox, develop a new rash and have lived in or visited an area where there's monkeypox transmission, or come in contact with a person or a group where there is known monkeypox circulation.</p> <p>If you've had contact with an animal from the continent of Africa and develop a new rash, you should be tested for monkeypox. Reach out to your health care professional to inquire about testing.</p> <h3>Could monkeypox become a new sexually transmitted infection?</h3> <p>One possibility that we need to be ready for is that monkeypox may become a sexually transmitted infection that we'll need to test for while we test for other more common well-known diseases, like gonorrhea, chlamydia and syphilis. The next several weeks to a month are really going to determine whether that is the case or whether we can stop the spread of this virus.</p> <h3>Are vaccines available to prevent monkeypox?</h3> <p>The <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/drugs-supplements/smallpox-vaccine-injection-route/description/drg-20071296" target="_blank" title="Opens in a new window.">smallpox vaccine</a> provided about 85% protection against monkeypox because they're members of the same virus family. In today's world, people aren't receiving the smallpox vaccine because smallpox has been eradicated.</p> <p>What we're seeing is a population-level decline in the level of protective immunity that was really intended to target smallpox, but also helped with prevention of spread of monkeypox. One theory why we're now seeing this outbreak of monkeypox is because the level of immunity in the global population is slowly declining.</p> <p>The most common vaccine, at least here in the U.S., is the JYNNEOS vaccine. It uses a strain of a virus that's part of the monkeypox family. That strain is called vaccinia virus and can generate an immune response that protects against smallpox and monkeypox.</p> <p>It's being rolled out in many developing countries, including the U.S. It will initially be used against targeted groups and populations: those who are most at risk and those who have been exposed. And then, as more vaccine becomes available in the future, we may see broader availability and access to that vaccine.</p> <h3>We are still in a COVID-19 pandemic. How worried should I be?</h3> <p>It's important to emphasize that it's unlikely that monkeypox will cause a pandemic to the scale of COVID-19 because the virus is different. It's spread in a different way.</p> <p>As I mentioned earlier, the primary mode of transmission of monkeypox is through direct contact with an infected lesion. We don't think that monkeypox is going to cause millions and millions of infections like we saw with COVID-19 that's now resulted in more than 570 million cases worldwide.</p> <p>People should be aware. They should especially take precautions when having sex with a new partner because that appears to be one of the main sources of transmission during this monkeypox outbreak. If a person has a new sexual partner, take precautions. And if you develop a new rash, be evaluated and request testing from your health care professional.</p> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/departments-centers/laboratory-medicine-pathology/overview" target="_blank" title="Opens in a new window."><em>Mayo Clinic Laboratories </em></a> <em>is one of five nonpublic health labs selected by the CDC to help with expanded monkeypox testing using the CDC's orthopoxvirus test. This article was originally published on the </em><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/a-qa-with-a-mayo-clinic-expert-on-monkeypox-testing-more/" target="_blank" title="Opens in a new window."><em>Mayo Clinic News Network</em></a><em>.</em></p> <p><em>Information in this post was accurate at the time of its posting. Due to the fluid nature of the monkeypox outbreak, scientific understanding, along with guidelines and recommendations, may have changed since the original publication date.</em></p><img src="/-/media/national-files/images/hometown-health/2022/monkeypox.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2541A8576D2E9D4B52921BF974BBCB40" alt="Monkeypox" width="660" height="370" DisableNVelocity="true" />Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Dawn Haller10/20/2022After two mild flu seasons, a Mayo Clinic expert shares why this year's flu season may be different and how to protect your family from the flu virus.Prepare for a challenging flu season: Get vaccinated now<p>Flu season usually peaks in winter; however, the best time to prevent infection is before the virus appears in a community.</p> <p>"The best time to protect yourself against influenza is before we see it start circulating in large amounts," says <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/rajapakse-nipunie-s-m-d-m-p-h/bio-20308514?mc" target="_blank" title="Opens in a new window.">Nipunie Rajapakse, M.D.</a>, a pediatric infectious diseases physician with the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/departments-centers/childrens-center" target="_blank" title="Opens in a new window.">Mayo Clinic Children's Center</a>. "We are starting to detect cases in different parts of the country."</p> <p>The Centers for Disease Control and Prevention reports influenza A as the dominant strain of flu virus in the U.S., though the strain may change over the <a href="https://www.cdc.gov/flu/index.htm">flu season</a>. Flu activity has been reported as low but is beginning to increase.</p> <p>"Now is the perfect time to go and get vaccinated. It takes about two weeks after you get your vaccine for your body's immune system to mount a good antibody response. You need to factor that time into it as well," she says.</p> <p>After two mild seasons of <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/flu/symptoms-causes/syc-20351719" target="_blank" title="Opens in a new window.">influenza</a> infection, Dr. Rajapakse says there is a caution of a more challenging one with higher rates of illness.</p> <p>"One of the things that we look at is what happens in the southern hemisphere. Sometimes this can help us understand what we may expect," Dr. Rajapakse says. "Last year, during their flu season in Australia, they saw some of the highest rates of influenza that they've seen since 2019. And that makes us feel cautious going into this flu season that we may end up seeing high rates of influenza this year.</p> <p>"It's all the more reason for people to ensure they get their flu vaccine. It's one of the safest and most effective ways to <a href="/hometown-health/featured-topic/dont-skip-your-flu-shot-this-year" target="_self" title="Opens in same window.">prevent flu illness</a> and infection. And especially since we might be in for a bit of a rough flu year."</p> <p>According to Dr. Rajapakse, many people did not have the flu in the last two years due to low virus circulation. There is more vulnerability to getting infected this season if they do not get vaccinated.</p> <p>Most healthy people can recover from flu infection independently, but complications can be severe for young children, older adults, and those with weakened immune systems.</p> <p>Vaccination remains the most vital tool against the flu. <a href="/hometown-health/speaking-of-health/prepare-kids-for-flu-shot-tips-to-help-parents" target="_self" title="Opens in same window.">Young children</a> are one of the highest-risk age groups for having a severe influenza illness.</p> <p>"Children under 2 years of age are one of the populations we see who end up in the hospital. That's why we encourage everyone over 6 months of age, especially young children, to get a flu vaccine every year. It helps reduce the risk of having a severe influenza infection, ending up in the hospital or dying from flu," says Dr. Rajapakse.</p> <p>There are nine vaccines approved for the 2022–2023 flu season, depending on the age and health of a patient. The flu mist is a nasal spray, rather than a shot, that may be an option for some children. It's approved for use in healthy nonpregnant people, ages 2–49.</p> <p>Dr. Rajapakse says children under 8 who get the flu vaccine for the first time will require two doses.</p> <p>"Getting them their first dose as soon as possible is especially important because they still need to get that second dose in a month," she adds.</p> <p>Children who have previously had a flu shot will not require a second dose.</p> <h2>Flu vaccine appointment</h2> <h3>You can schedule an appointment for the flu vaccine:</h3> <ul> <li>Through <a href="https://www.mayoclinichealthsystem.org/influenza#Schedule%20with%20POS" target="_self" title="Opens in same window.">Patient Online Services</a></li> <li>Through the <a href="https://www.mayoclinichealthsystem.org/influenza#Schedule%20with%20App" target="_self" title="Opens in same window.">Mayo Clinic App</a></li> <li><a href="https://www.mayoclinichealthsystem.org/influenza#Find%20your%20location" target="_self" title="Opens in same window.">By phone</a>  — find your location for additional information: <ul> <li><a href="https://www.mayoclinichealthsystem.org/influenza#Iowa" target="_self" title="Opens in same window.">Iowa</a></li> <li><a href="https://www.mayoclinichealthsystem.org/influenza#Minnesota" target="_self" title="Opens in same window.">Minnesota</a></li> <li><a href="https://www.mayoclinichealthsystem.org/influenza#Wisconsin" target="_self" title="Opens in same window.">Wisconsin</a></li> </ul> </li> </ul><img src="/-/media/national-files/images/hometown-health/2022/bagging-fall-leaves.jpg?h=370&iar=0&w=660&sc_lang=en&hash=AEE3F4BB217D2172370876EEB4D560BE" alt="Bagging fall leaves" width="660" height="370" DisableNVelocity="true" />InfluenzaInfluenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza, commonly called the flu, is not the same as the stomach "flu" viruses that cause diarrhea and vomiting.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller10/10/2024Upper respiratory infections are common at this time of year. Be prepared for seasonal cases of RSV by learning about the vaccines, how to manage symptoms at home and when to seek care.What you should know about RSV and the RSV vaccine<p><a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/respiratory-syncytial-virus/symptoms-causes/syc-20353098" target="_blank" title="Opens in a new window.">Respiratory syncytial virus</a>, or RSV, is a common virus that most people will get by age 2. It causes mild cold symptoms for most people, who usually recover in a week or so.</p> <p>RSV can be serious for infants and older adults, however. When severe, it can lead to bronchiolitis or pneumonia. <a href="/hometown-health/speaking-of-health/bronchiolitis-in-children" target="_self" title="Opens in same window">Bronchiolitis</a>, or inflammation of the airway, is one of the most common causes of children needing hospitalization in the winter months.</p> <p>RSV outbreaks tend to occur from October to May each year. People with RSV do not develop natural immunity to it, so it's possible to get the virus multiple times a season.</p> <h2>What are the symptoms of RSV?</h2> <p>Symptoms of RSV can be similar to other viruses, like a cold or the flu, and may include:</p> <ul> <li>Dry <a href="/hometown-health/speaking-of-health/why-are-you-coughing-so-much" target="_self" title="Opens in same window">cough</a></li> <li>Low-grade fever</li> <li>Mild headache</li> <li>Runny nose or congestion</li> <li>Sore throat</li> <li>Wheezing or difficulty breathing</li> </ul> <p>A child with RSV may not want to eat or drink as often as usual and may be more lethargic or sleepy.</p> <p>In many places, testing for the flu also testing for RSV. This is because flu and RSV seasons typically overlap, and the viruses have <a href="/hometown-health/featured-topic/when-to-seek-care-for-rsv-and-flu" target="_self" title="Opens in same window">similar symptoms</a>.</p> <h2>Who should consider getting the RSV vaccine?</h2> <p>The Food and Drug Administration (FDA) has approved a <a href="/hometown-health/speaking-of-health/rsv-vaccine-for-moms-to-be-and-infants" target="_self" title="Opens in same window">seasonal vaccine</a> to protect infants, pregnant people and older adults from RSV. </p> <h3>RSV vaccines for pregnant people</h3> <p>To prevent severe RSV disease in infants, pregnant people can receive the vaccine during 32 to 36 weeks gestation. The baby receives protection from RSV complications for up to three months after birth.</p> <p>The vaccine is typically administered from September through January.</p> <p>People who received an active vaccine during a previous pregnancy are not recommended to receive it again. In this case, parents or caregivers should work with their healthcare team to determine if the baby should receive the passive immunization, typically administered in late October through the end of March.</p> <h3>RSV immunizations for infants</h3> <p>Immunization is recommended for infants under 8 months old who are not protected by a maternal RSV vaccination between 32 and 36 weeks of gestation during the current pregnancy and at least two weeks before birth. The baby typically receives the immunization from late October through the end of March. The immunization provides four months of protection to the baby. </p> <p>Older infants at high risk for RSV also are eligible to receive the vaccine.</p> <h3>RSV vaccines for older adults</h3> <p>Active vaccines are approved for adults. Vaccines from multiple manufacturers are available for adults 75 and older or those 60 to 74 at risk for severe RSV disease. </p> <p>Older adults can be vaccinated at any time of the year. Healthcare professionals recommend vaccination during late summer or fall before RSV spreads in the community.</p> <p>An adult should receive any of the RSV active vaccines once. After that, booster vaccines are not currently recommended.</p> <p>Talk with your healthcare team regarding questions about when and where you or your infant may be able to receive the RSV vaccine.</p> <h2>Can the risk of illness from RSV be reduced?</h2> <p>Taking these specific steps also can lower the risk of RSV in children, pregnant people and adults:</p> <ul> <li> Don't skip a <a href="/hometown-health/featured-topic/dont-skip-your-flu-shot-this-year" target="_self" title="Opens in same window">flu shot</a>. An annual flu shot is recommended for everyone older than 6 months. Talk to your child's healthcare team about the number of doses needed based on your child's age and prior vaccination history. Children younger than 9 may need two doses of the vaccine if they are receiving it for the first time or have only received one dose in total previously.</li> <li>During pregnancy, it's recommended for women to receive one dose of Tdap vaccine, regardless of when the last Tdap or tetanus-diphtheria (Td) vaccination was given. Ideally, the vaccine should be given between 27 and 36 weeks of pregnancy.</li> <li>Get vaccinated for COVID-19. The COVID-19 vaccine is available for children 6 months and older.</li> <li>Stay away from <a href="/hometown-health/speaking-of-health/a-doctors-warning-about-the-dangers-of-vaping" target="_self" title="Opens in same window">tobacco products</a> and second-hand smoke.</li> <li>Stay home if you are ill and avoid contact with people. Keep children home from day care or school if they don't feel well.</li> <li>Wash your hands frequently with soap and water. <a href="/hometown-health/speaking-of-health/5-ws-of-healthy-hands" target="_self" title="Opens in same window">Hand-washing</a> helps prevent the virus from spreading from the hand to the mouth, nose or eyes. Think about times during the day to wash the hands of everyone in the family, such as before making a meal, serving prepared food and after using the restroom.</li> <li>Wipe down high-touch surfaces, such as countertops, doorknobs and children's toys regularly.</li> </ul> <h2>Can RSV in children be treated at home?</h2> <p>For most children who develop RSV, home remedies can ease symptoms. RSV symptoms usually last from two to eight days, but some children might have a cough for a few weeks before fully recovering.</p> <p><a href="/hometown-health/speaking-of-health/7-ways-to-combat-coughs-and-colds" target="_self" title="Opens in same window">At-home remedies</a> include:</p> <ul style="list-style-type: disc;"> <li>Drinking plenty of fluids</li> <li>Using a cool-mist humidifier</li> <li>Trying saline nasal drops</li> </ul> <p>Over-the-counter pain medication, such as acetaminophen, can be helpful. But check with your child's healthcare team about correct dosing before using over-the-counter pain medications.</p> <p>Seek immediate care for a child with RSV if they develop these symptoms:</p> <ul style="list-style-type: disc;"> <li>Breathing that is fast, shallow or noisy</li> <li>Extreme irritability</li> <li><a href="/hometown-health/speaking-of-health/dont-ignore-infant-fevers" target="_self" title="Opens in same window">High fever</a></li> <li>Significant decrease in eating or drinking </li> </ul> <p>Babies and young children can become very sick quickly due to RSV.</p> <h2>Primary Care On Demand virtual care service</h2> <p>As seasonal cases of upper respiratory infections continue to rise, patients living or traveling in Iowa, Minnesota or Wisconsin can use <a rel="noopener" href="https://www.primarycareondemand.mayoclinic.org/" target="_blank" title="Opens in a new window.">Primary Care On Demand</a> for quick symptom assessment and video visits with a physician. This new app-based virtual care service offers convenient care for new and worsening symptoms associated with influenza, strep throat, respiratory syncytial virus and COVID-19. Primary Care On Demand is available 24/7/365 for patients ages 3 and older.</p> <p><a href="/providers/dennis-costakos-md" target="_self" title="Opens in same window."><em>Dennis Costakos, M.D.</em></a><em>, is a neonatologist in <a href="/locations/la-crosse" target="_self" title="Opens in same window.">La Crosse</a>, Wisconsin.</em></p><ul> <li>Folic acid to prevent neural tube defects in minority populations as part of equity and inclusion</li> <li>Hyperbilirubinemia</li> <li>Newborn screening for biotinidase deficiency</li> <li>Predictive analytics</li> <li>Pulmonary surfactant and inter-hospital transfer</li> <li>Vitamin K and the newborn</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Dartmouth Medical School </li> </ul> <p><strong>Residency</strong></p> <ul> <li>Pediatrics, Mount Sinai Hospital</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Neonatal/Perinatal Medicine, New York Hospital/Cornell University</li> </ul> <p><strong>Certification</strong></p> <ul> <li>Neonatology, American Board of Pediatrics</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American Academy of Pediatrics, Fellow in Neonatal-Perinatal Medicine and Epidemiology</li> <li>American Federation for Medical Research</li> <li>American Medical Association</li> <li>Society of Neuroscience </li> <li>Wisconsin Association for Perinatal care</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Pediatrics, Mayo Clinic College of Medicine and Science</li> </ul>Costakos<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/dennis-costakos-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=0A58CB05C01B2118F3FD82CC17315366" alt="Dennis Costakos MD" width="280" height="280" DisableNVelocity="true" /><p>See my publications at <a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/?term=costakos+dt" target="_blank" title="Opens in a new window">PubMed</a>.</p>Dennis<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>12794287Dennis Costakos, M.D.1<img src="/-/media/national-files/images/hometown-health/2022/parent-with-sick-child-phone.jpg?h=370&iar=0&w=660&sc_lang=en&hash=C0C0628C157C747A266DE8C5DD331A87" alt="Parent holding sick child while on the phone" width="660" height="370" DisableNVelocity="true" />Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller11/18/2022With an early increase in RSV and influenza cases, a Mayo Clinic expert shares three things parents can watch for when determining if they should seek care for a sick child.When to seek medical help for RSV or flu symptoms in children<p>Increased RSV and influenza infection cases are primarily affecting young children across the U.S.</p> <p>"We have a whole generation of young children who might not have been exposed to RSV," says <a rel="noopener" href="https://www.mayoclinic.org/biographies/mattke-angela-c-m-d/bio-20055584" target="_blank" title="Opens in a new window.">Angela Mattke, M.D.,</a> a pediatrician with <a rel="noopener" href="https://www.mayoclinic.org/departments-centers/childrens-center" target="_blank" title="Opens in a new window.">Mayo Clinic's Children's Center</a>. "Mask wearing is less common. People are getting together a lot more often. That's a perfect opportunity for viruses to spread. Kids are back in school and day care, and we often see these trends increase, especially when kids return to school."</p> <h4>In this video, Dr. Mattke talks about flu and RSV viruses and when to seek medical help:</h4> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/-J43XtSacYo" title="Medical help for flu and RSV" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <h2>What to know about RSV</h2> <p>"RSV stands for respiratory syncytial virus. It's a common respiratory infection that usually causes mild cold symptoms in most people. But in young children, especially less than six months of age and adults over age 65, we can see more moderate to severe disease that will present to outpatient clinics, emergency departments and even hospitalizations," says Dr. Mattke.</p> <p>Many symptoms of COVID-19, RSV, influenza and adenovirus are similar, making it difficult to tell if it's the common cold or something more serious.</p> <p>Dr. Mattke says RSV symptoms include nasal congestion, runny nose, cough, fever, decreased energy levels, sneezing, and, in young children, sometimes an increased work of breathing and wheezing in their airways.</p> <h2>Tests for RSV</h2> <p>There are laboratory tests for RSV and many other viral respiratory pathogens. Dr. Mattke says testing isn't always recommended for patients for RSV, and a test is not required to confirm if you have it.</p> <p>"Most cases are self-limited, especially in preschool-aged children and older or healthy adults," says Dr. Mattke. "Children do not need an RSV test to return to day care or school."</p> <p>Most people recover from RSV infection within one to two weeks.</p> <p>"For children that do present to outpatient clinics or emergency departments, we may consider testing for RSV, among other viral illnesses, to help us differentiate what's causing it because that can affect our treatment and what we do to quarantine and prevent the spread of whatever is causing the infection to other people," says Dr. Mattke.</p> <p>She stresses that testing for RSV does not change or affect your treatment plan. There is no cure for RSV. Management for most viral illnesses includes rest, hydration and over-the-counter pain relief. Never give aspirin to children.</p> <h2>Medical help for RSV</h2> <p>Seeing your child get sick can be frightening and confusing. Dr. Mattke offers three things to watch for when determining if you need to consider seeking medical help. She says a baby may have a fever, but it is not always how high of a temperature but how your child is breathing, staying hydrated and interacting that should be considered.</p> <p>"When we look at their work of breathing and how hard they are working, are they breathing faster, shallower and harder? And do you see the skin sucking in between the ribs above the rib cage and their neck area and below the rib cage? Those are signs that they need to be seen," she says.</p> <p>"Hydration means they must have at least three wet diapers in 24 hours. If you're looking at a child who's still wearing diapers, they will drink less when sick," says Dr. Mattke. "And they will probably not be interested in eating, but they need to be able to drink enough to maintain at least that minimum of three wet diapers in 24 hours."</p> <p>"And then the last thing," says Dr. Mattke, "Are they not as responsive to you as they should be? Kids that don't feel good generally sleep a little bit more. But when they are awake, they should be awake, alert and still have periods of playfulness, especially when they have their antipyretic or anti-fever medications. And they feel a little bit playful, but they might go back to feeling very tired."</p> <p>Dr. Mattke says if you don't see any of that level of playfulness or interaction with you, that would be slightly less than their baseline. That's an indication that they need to be seen by a clinician to treat symptoms.</p> <h2>Flu levels in the U.S.</h2> <p>Flu activity continues to increase across the U.S., with influenza A(H3N2) viruses affecting primarily young children and young adults, reports the CDC.</p> <p>"We are seeing higher levels than expected, given the time of year. And we did see high levels in the Southern Hemisphere during their flu season. And that's how we generally predict what our flu season will be like," says Dr. Mattke. "We're hoping that people, if they aren't currently vaccinated, go ahead and get their vaccine as soon as possible."</p> <p>The CDC reports more than 730 deaths attributed to the 2022–2023 flu season, including two pediatric deaths.</p> <p>Everyone 6 months and older is recommended to <a href="/influenza" target="_self" title="Opens in same window.">get a flu vaccine</a>. It takes about two weeks to provide full protection.</p> <h2>Symptoms of flu</h2> <p>Flu symptoms often come on suddenly. Not everyone will get a fever. Like many viruses, young children, older adults and those with weakened immune systems are at higher risk of complications.</p> <p>"The general symptoms for influenza are fever, body aches and cough. Sometimes nasal congestion or runny nose can be associated with it. In younger children, one thing that does set them apart sometimes from other viruses is that we will see vomiting and diarrhea associated with it and the presence of fever, but sometimes not those cough, runny nose and congestion sort of symptoms," says Dr. Mattke.</p> <h2>Medical help for flu</h2> <p>Breathing and hydration issues are also considerations for seeking medical care. Dr. Mattke says most people recover in a few days to a week, but young children and older adults are at higher risk of complications.</p> <p>"People should seek medical attention for influenza if they're struggling to breathe themselves, have difficulty getting a whole sentence out or working harder to breathe," she says. "And if people are not staying hydrated, that's another reason to have them come in and be seen. One last thing to watch for is people changing their level of alertness. This sometimes can represent a more severe progression of their disease."</p> <p>Those with a severe infection or at a higher risk of complications may be prescribed an antiviral medication to help treat the flu. The medications may help shorten the illness and prevent serious complications.</p> <h2><strong>How to prevent the spread of respiratory viruses</strong></h2> <p>Flu and RSV are respiratory infections caused by viruses. These viruses are spread mainly by droplets made when people talk, cough or sneeze.</p> <h3>Here are some ways to help protect yourself and others from these and other respiratory viruses:</h3> <ul> <li>Get vaccinated for COVID-19 and flu.</li> <li>Wash your hands often with soap and water.</li> <li>Stay home when sick.</li> <li>Avoid crowded areas.</li> <li>Wear a mask.</li> <li>Get tested.</li> </ul><img src="/-/media/national-files/images/hometown-health/2022/parent-holding-sick-child.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2FDE7EE3C73E8C6CAF22A57D305E2C78" alt="Parent holding sick child" width="660" height="370" DisableNVelocity="true" />Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Immunizations<p>Disease prevention is crucial to your health. Getting vaccinated is one of the best ways to maintain good health, and protect you and those you care about against infectious diseases. Vaccinations offer protection against serious diseases by stimulating the immune system to create antibodies against certain bacteria or viruses.</p><br/><p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/vaccine-guidance/art-20536857" target="_blank" title="Opens in a new window.">Get vaccine guidance from Mayo Clinic</a>, including benefits, safety, side effects and what to know about recommended vaccines for babies, children, teens, adults and during pregnancy. For recommended vaccines based on age, refer to the <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/adult" target="_blank" title="Opens in a new window.">adult</a> or <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/child" target="_blank" title="Opens in a new window.">child and adolescent</a> schedules.</p><br/><p>Review the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/coronavirus-covid-19/history-disease-outbreaks-vaccine-timeline" target="_blank" title="Opens in a new window.">history of infectious disease outbreaks and vaccines timeline</a> for information about major disease outbreaks, epidemics and pandemics, and the impact of vaccines and research.</p>InfluenzaInfluenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza, commonly called the flu, is not the same as the stomach "flu" viruses that cause diarrhea and vomiting.Pediatric MedicinePediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller8/23/2023Staying cool when temperatures soar can be difficult. Read why it's vital to know the signs and symptoms of heat-related illness, and get tips to prevent heat exhaustion and heatstroke.Safety tips to prevent heat-related illness<p>Much of the country's midsection from Texas to Minnesota will be melting this week with extreme heat watches, warnings and advisories posted in many areas. Temperatures will be pushing 100 degrees Fahrenheit, with heat indexes even higher. According to the <a rel="noopener noreferrer" href="https://www.wpc.ncep.noaa.gov/discussions/hpcdiscussions.php?disc=pmdspd" target="_blank" title="Opens in a new window.">National Weather Service</a>, the prolonged nature of the heat wave and warm overnight temperatures will compound the effect of the heat.</p> <p>Heat-related illnesses, like <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/heat-exhaustion/symptoms-causes/syc-20373250" target="_blank" title="Opens in a new window.">heat exhaustion</a> and <a href="/hometown-health/speaking-of-health/when-temps-rise-remember-these-heatstroke-prevention-tips" target="_self" title="Opens in same window.">heatstroke</a>, can be life-threatening and often prevented.</p> <h2>What is heat exhaustion?</h2> <p>Heat exhaustion can happen when your body becomes <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/dehydration/symptoms-causes/syc-20354086" target="_blank" title="Opens in a new window.">dehydrated</a> and loses too much water and salt due to high temperatures and humidity. People most at risk are older adults, those with <a href="/hometown-health/speaking-of-health/effects-of-high-temperatures-on-blood-pressure-heart" target="_self" title="Opens in same window.">high blood pressure</a> and those who are working outside. Left untreated, heat exhaustion can progress to a more severe heat-related illness called heatstroke.</p> <h2>What is heatstroke?</h2> <p>Heatstroke is caused by your body overheating, usually due to prolonged exposure to or physical exertion in high temperatures. This most severe form of heat injury, heatstroke, can occur if your body temperature rises to 104 degrees Fahrenheit (40 degrees Celsius) or higher.</p> <p>Untreated, heatstroke can quickly damage your brain, heart, kidneys and muscles. The damage worsens the longer <a rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/heat-stroke/diagnosis-treatment/drc-20353587" target="_blank" title="Opens in a new window.">treatment</a> is delayed, increasing your risk of serious complications or death.</p> <h2>Tip for preventing heat-related illness</h2> <ul> <li>Stay cool. Stay in air-conditioned buildings as much as possible. If you do not have air conditioning, consider a shopping mall or public building, such as a library, to help cool down. Do not rely solely on box fans during extreme temperatures.</li> <li>People over 65 may not tolerate sudden changes in temperature as well as younger people. Check on older adults more frequently, and ensure they are drinking enough water.</li> <li>Stay <a href="/-/media/national-files/images/hometown-health/2018/tips-for-drinking-more-water.jpg" target="_self" title="Opens in same window.">hydrated</a>. Don't wait until you are thirsty. Water and sports drinks are the most effective warm-weather drinks.</li> <li>Avoid alcohol, as it can make you more dehydrated.</li> <li>Eat lighter meals.</li> <li>Wear lightweight clothing or loose-fitting clothes.</li> <li>Protect yourself against sunburn, which affects your body's ability to cool itself. Wear <a href="/hometown-health/speaking-of-health/myth-or-fact-coconut-is-an-effective-sunscreen" target="_self" title="Opens in same window.">sunscreen</a> and sunglasses to protect your eyes and skin.</li> <li>Avoid being outside during the hottest part of the day.</li> <li>Check on friends, family and neighbors. Ask them to do the same.</li> <li>Make sure your pets have plenty of water.</li> <li>Do not leave anyone or pets alone in a vehicle. Each year, multiple children die after being left in hot cars. This is never a safe practice — even if you crack the windows.</li> <li>Stay informed. Watch your local news and weather for updates.</li> </ul> <p>Preventing illness isn't always possible. Seek immediate medical attention if you are concerned someone is showing signs of a heat-related illness, including a heat stroke. Those signs and symptoms may include a fever of 104 degrees Fahrenheit (40 degrees Celsius) or greater, confusion or agitation, heavy sweating and vomiting.</p> <p><em>By Mayo Clinic Health System staff</em></p> <em>This article was originally appeared on the Mayo Clinic </em><a rel="noopener noreferrer" href="https://newsnetwork.mayoclinic.org/discussion/safety-tips-to-prevent-heat-related-illness/" target="_blank" title="Opens in a new window."><em>News Network</em></a><em>.</em><img src="/-/media/national-files/images/hometown-health/2023/drinking-bottled-water.jpg?h=370&iar=0&w=660&sc_lang=en&hash=045700BD2108EFEFF5670AA84D3E0834" alt="Drinking bottled water" width="660" height="370" DisableNVelocity="true" />Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.SafetyBike helmets. Cabinet locks. Car seats. The infamous five-second rule. Safety for your family and around the house revolves mostly around common sense, but it helps when you have access to experts to make the connection between the two. Our experts can help you make safety second nature around your house.Emergency MedicineOften life-or-death situations, emergencies are when patients need medical care most. Not all emergencies are avoidable, but there are measures you can take to reduce your risk of experiencing a medical emergency.Dawn Haller7/16/2025The FDA approved a COVID-19 vaccine that targets current variants. A Mayo Clinic expert explains who should get this vaccine and if it can be given at the same time as the annual influenza vaccine.Expert answers about new COVID-19 vaccine<p>Ahead of the fall respiratory virus season, the <a rel="noopener" href="https://www.fda.gov/news-events/press-announcements/fda-takes-action-updated-mrna-covid-19-vaccines-better-protect-against-currently-circulating" target="_blank" title="Opens in a new window.">Food and Drug Administration</a> has approved two updated COVID-19 vaccines. The new messenger RNA, or mRNA, vaccines from Moderna and Pfizer/BioNTech are formulated to better target variants that are currently circulating and will replace outdated vaccines.</p> <p>The new vaccine approved by the FDA essentially is a COVID-19 vaccine targeting a different strain of the COVID-19 virus than was in the original vaccine or bivalent vaccines that came out last year. It's still a COVID-19 vaccine, but it's now targeting the XBB.1.5 strain, which is the virus that's been circulating throughout the U.S. and most parts of the world since the beginning of this year.</p> <h2>Is it considered a booster?</h2> <p>The updated COVID-19 vaccine isn't exactly a booster. It's likened to the updated influenza vaccine that comes out each year. The influenza vaccine is updated each year as the strains that they protect against change year from year.</p> <h2>Who should receive the 2023–2024 COVID-19 vaccine?</h2> <p>The Centers for Disease Control and Prevention panel of vaccine experts voted to recommend the new 2023–2024 <a rel="noopener" href="https://www.mayoclinic.org/diseases-conditions/coronavirus/symptoms-causes/syc-20479963" target="_blank" title="Opens in a new window.">COVID-19</a> vaccine to all Americans age 6 months and older.</p> <p>The COVID-19 vaccine definitely should be taken by those at the highest risk of complications from COVID-19, and that includes older people, people with weakened immune systems and young children. These are the people that we are seeing have significant complications from COVID.</p> <p>Health experts also are urging people to get vaccinated against <a href="/influenza">influenza</a>. Experts say it's safe to get both the COVID-19 and flu vaccines at the same time. Both vaccines have been shown to prevent the most serious complications of COVID-19 and the flu, which include hospitalization and death.</p> <p>The flu vaccine is recommended for everyone who is 6 months and older, and the groups that benefit the most from the vaccine, again, are the same kind of people who benefit from the COVID-19 vaccine because they don't tolerate influenza as well as others. This includes older people, immunocompromised and people with underlying heart, lung, liver or kidney disease.</p> <p>Mayo Clinic Health System will offer influenza and 2023–2024 COVID-19 vaccines once they are available.</p> <h3>Schedule an appointment for the flu vaccine:</h3> <ul> <li><a href="https://www.mayoclinichealthsystem.org/influenza#Schedule%20with%20POS" target="_self" title="Opens in same window.">Through the patient portal</a></li> <li><a href="https://www.mayoclinichealthsystem.org/influenza#Schedule%20with%20App" target="_self" title="Opens in same window.">Through the Mayo Clinic App</a></li> <li><a href="https://www.mayoclinichealthsystem.org/influenza#Find%20your%20location" target="_self" title="Opens in same window.">By phone — find your location for additional information:</a></li> <ul> <li><a href="https://www.mayoclinichealthsystem.org/influenza#Iowa" target="_self" title="Opens in same window.">Iowa</a></li> <li><a href="https://www.mayoclinichealthsystem.org/influenza#Minnesota" target="_self" title="Opens in same window.">Minnesota</a></li> <li><a href="https://www.mayoclinichealthsystem.org/influenza#Wisconsin" target="_self" title="Opens in same window.">Wisconsin</a></li> </ul> </ul> <h2>Learn more:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/clean-up-your-hand-washing-skills" target="_self" title="Opens in same window.">Clean up your hand-washing skills</a> </li> <li><a href="/hometown-health/speaking-of-health/fight-off-the-flu-with-nutrients" target="_self" title="Opens in same window.">Fight off the flu with immune-boosting nutrients</a></li> <li><a href="/hometown-health/featured-topic/prepare-for-a-challenging-flu-season" target="_self" title="Opens in same window.">Prepare for a challenging flu season: Get vaccinated now</a></li> </ul> <p><a rel="noopener" href="https://www.mayoclinic.org/biographies/sampathkumar-priya-m-d/bio-20053991" target="_blank" title="Opens in a new window."><em>Priya Sampathkumar, M.D.,</em></a><em> is a Mayo Clinic infectious diseases specialist.</em></p> <em>This article originally appeared on the </em><a href="https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-expert-answers-questions-about-the-new-covid-19-vaccine/" target="_self" title="Opens in same window."><em>Mayo Clinic News Network</em></a><em>.</em><img src="/-/media/national-files/images/hometown-health/2023/child-and-adult-playing-blocks.jpg?h=370&iar=0&w=660&sc_lang=en&hash=09F6BB7AE87B0B3D6E4424172BA7E607" alt="Child and adult playing blocks" width="660" height="370" DisableNVelocity="true" />COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Immunizations<p>Disease prevention is crucial to your health. Getting vaccinated is one of the best ways to maintain good health, and protect you and those you care about against infectious diseases. Vaccinations offer protection against serious diseases by stimulating the immune system to create antibodies against certain bacteria or viruses.</p><br/><p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/vaccine-guidance/art-20536857" target="_blank" title="Opens in a new window.">Get vaccine guidance from Mayo Clinic</a>, including benefits, safety, side effects and what to know about recommended vaccines for babies, children, teens, adults and during pregnancy. For recommended vaccines based on age, refer to the <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/adult" target="_blank" title="Opens in a new window.">adult</a> or <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/child" target="_blank" title="Opens in a new window.">child and adolescent</a> schedules.</p><br/><p>Review the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/coronavirus-covid-19/history-disease-outbreaks-vaccine-timeline" target="_blank" title="Opens in a new window.">history of infectious disease outbreaks and vaccines timeline</a> for information about major disease outbreaks, epidemics and pandemics, and the impact of vaccines and research.</p>Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller9/20/2023A Mayo Clinic expert shares what you need to know about expiration dates for at-home COVID-19 tests. Find out if these tests can detect new COVID-19 variants and what to do if the test is positive.At-home COVID-19 tests: What to know about expiration dates, new variants<p>At-home COVID-19 kits allow you to collect samples and detect active COVID-19 infections. But what if you have at-home COVID-19 tests nearing expiration or expired on your shelf?</p> <p>Companies arbitrarily set the original test dates because these diagnostic at-home tests were developed rapidly. So check your boxes before you toss them.</p> <p>Now, 3 1/2 years into the pandemic, those manufacturers have had the opportunity to go back and assess the test performance over prolonged periods of time. And they've updated the expiration dates in many cases.</p> <p>If you have tests at home, search the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/home-otc-covid-19-diagnostic-tests" target="_blank" title="Opens in a new window.">Food and Drug Administration website</a> for information on updated expiration dates. </p> <p>If you take a test that is beyond the expiration date and the test is positive, that's likely a reliable result, especially if you have a respiratory illness. If you get a negative result from a test beyond the expiration date, ensure the test doesn't have an extended expiration date. If it's beyond that expiration date, get another test or have a healthcare professional collect a swab for a lab-based test before you rule out COVID-19.</p> <h2><strong>Can at-home tests detect current strains of COVID-19?</strong></h2> <p>Yes, at-home tests should detect the currently circulating strains of COVID-19. The good news is that most of the changes in the virus with these new variants are in the spike protein, which is the part of the virus that binds to the cells. And the protein these antigen tests are looking for is a different protein where fewer mutations occur. So, that allows healthcare professionals to confidently say that these tests should pick up the circulating strains. </p> <h3>Testing positive</h3> <p>Are you contagious if you <a href="/hometown-health/speaking-of-health/what-should-you-do-if-you-have-covid-19-or-the-flu" target="_self" title="Opens in same window.">test positive</a> for COVID-19? Yes, most likely you are. When an at-home antigen test is positive, that person still is shedding or excreting a high amount of viral protein. In most cases, that means that the person is shedding a high amount of virus, and likely a high amount of virus that could be spread from one person to another.</p> <p>If you get a positive at-home antigen test, consider yourself at risk of spreading the virus to others. </p> <h3>Testing negative</h3> <p>Testing at home is recommended if you experience COVID-19 symptoms. If it comes back positive, you likely have a COVID-19 infection. But what if you have symptoms and the test comes back negative? </p> <p>If your test comes back negative at home and you still have those typical symptoms of COVID-19, such as sore throat, cough, fever and body aches, that's when it's recommended that you go in to see your healthcare team and get a swab collected that can be sent to a lab for a PCR-based test. That will provide the most reliable information on whether you truly have or don't have COVID-19.</p> <h2>When should you test for COVID-19?</h2> <h3>There are a few instances recommended for testing:</h3> <ul> <li>If you develop symptoms, such as fever, cough, sore throat, runny nose or body aches.</li> <li>If you've spent time with someone with a confirmed diagnosis of COVID-19.</li> <li>If you plan on visiting someone at high risk of severe illness, including a person with cancer, an older adult or someone taking medications that suppress their immune system.</li> </ul> <p>If you've been exposed to the virus, the recommendation is to wait a few days after exposure. Don't go home and take a test immediately because it won't have been enough time for the virus to reach levels that will trigger antigen tests to be positive. Wait three days after an exposure and then take a test.</p> <p>If the test is negative, consider taking another test the following day or 48 hours from then. Typically, by day five after exposure, you're likely in the clear if you test negative.</p> <h2>Temperatures and at-home COVID-19 tests</h2> <p>Tests may be affected by fluctuating temperatures across geographic areas. If you're in an area that has experienced subzero weather or temperatures well above 100, as many parts of the U.S. have during the summer months, it's always a good idea to check the packet that comes with a test to look for acceptable storage conditions as determined by the FDA.</p> <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/biographies/binnicker-matthew-j-ph-d/bio-20513862?_ga=2.224776410.1916523742.1658847814-1971724449.1645459629" target="_blank" title="Opens in a new window."><em>Matthew Binnicker, Ph.D.,</em></a><em> is the director of the </em><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/departments-centers/laboratory-medicine-pathology/overview/specialty-groups/clinical-microbiology" target="_blank" title="Opens in a new window."><em>Clinical Virology Laboratory</em></a><em> at Mayo Clinic.</em><img src="/-/media/national-files/images/hometown-health/2023/covid-home-test.jpg?h=370&iar=0&w=660&sc_lang=en&hash=23E8F50F156BF26A0C29B97E448AA0EE" alt="COVID home test" width="660" height="370" DisableNVelocity="true" />Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller7/16/2025Colder temps and holiday festivities encourage us to gather inside, raising the risk of upper respiratory illnesses. Know what to do and where to go for worsening symptoms.5 things to know during upper respiratory illness season<p>As winter and the holiday season bring gatherings with friends and family, they also bring an increase in upper respiratory infections. Cases of influenza and <a href="/hometown-health/featured-topic/what-parents-should-know-about-rsv" target="_self" title="Opens in same window.">respiratory syncytial virus</a> (RSV) are on the rise, with other conditions like COVID-19 and strep throat likely not far behind.</p> <h2>Here are five things you need to know to guide you through this year's upper respiratory infection season.</h2> <h3>For most people, respiratory illnesses can be treated at home.</h3> <p>If you have respiratory symptoms and aren't high-risk, you probably don't need to get tested or make an appointment with your healthcare professional. Getting plenty of rest, drinking fluids and using over-the-counter medications can help you feel better and aid recovery.</p> <p> For most people, testing for <a href="/topics/influenza" target="_self" title="Opens in same window">influenza</a> or other infections won't change your treatment plan. Clinic-based testing for infections, such as influenza and strep, is recommended only for high-risk patients or those who meet certain criteria.</p> <p>Those at increased risk include people:</p> <ul> <li>Who are immunocompromised.</li> <li>Who are 65 or older.</li> <li>Who are pregnant.</li> <li>With other complex health conditions.</li> </ul> <h3>Use Primary Care On Demand for quick upper respiratory symptom assessment and video visits.</h3> <p>Download the <a rel="noopener" href="https://www.primarycareondemand.mayoclinic.org/app" target="_blank" title="Opens in a new window.">Mayo Clinic Primary Care On Demand app</a> for upper respiratory care whenever you need it — in the evening, on weekends and holidays, or when same-day appointments fill up. Primary Care On Demand is available 24/7/365 for patients ages 3 and older living or traveling in Iowa, Minnesota or Wisconsin.</p> <p>Through the app, you'll answer assessment questions about your symptoms before choosing to move on to a video visit with a physician. Often you can connect with a physician in under 30 minutes, and most people wait less than 10 minutes for a video visit.</p> <p>Primary Care On Demand syncs with your Mayo Clinic health record, so all of your health information stays in one place. This care team can also order labs or tests and submit prescriptions to your preferred pharmacy.</p> <p>Other assessment and care options for upper respiratory symptoms include the <a href="/services-and-treatments/nurse-line" target="_self" title="Opens in same window">Primary Care Nurse Triage Line</a> and <a href="/services-and-treatments/express-care">Express Care</a>, which offers both virtual and in-person appointments.</p> <h3>Take a home antigen test to check for COVID-19.</h3> <p>If you have COVID-19 symptoms or have been exposed to COVID-19, home antigen tests are the fastest, most convenient and least expensive way to get tested.</p> <p>Unlike PCR tests, <a href="/hometown-health/featured-topic/at-home-covid-19-tests" target="_self" title="Opens in same window.">antigen tests</a> are widely available through commercial pharmacies and other stores. You can also order <a rel="noopener" href="https://covidtests.gov/" target="_blank" title="Opens in a new window.">free home antigen tests</a> through the Department of Health and Human Services.</p> <p>Antigen tests don't require a clinic appointment. They provide fast results and can be done at home.</p> <p><span>You only need to report your COVID-19 home test results to your primary care professional if you're interested in receiving treatment. You can self-report a positive test result through the COVID-19 home antigen attestation questionnaire in the patient portal.</span></p> <h3>If you test positive for COVID-19, you don't always need oral antiviral treatment (Paxlovid).</h3> <p>Unless you're at high risk for complications, you likely won't benefit from oral antiviral treatment with Paxlovid. If you're low risk, this medication doesn't shorten the time you'll experience symptoms or reduce your risk of hospitalization. Taking Paxlovid can actually make low-risk patients feel worse.</p> <p>Researchers also don't know if Paxlovid reduces the risk of long COVID. For people who could benefit from taking Paxlovid, this treatment is no longer provided to patients by the government, which means there is a cost. Check your insurance coverage to understand how much you'll be expected to pay for Paxlovid.</p> <h3>Prevention is the best protection.</h3> <p>Following simple prevention guidelines can go a long way toward protecting you and your family from illness. </p> <p>Make sure you <a href="/hometown-health/speaking-of-health/5-ws-of-healthy-hands" target="_self" title="Opens in same window">wash your hands</a>, avoid prolonged contact with people who are sick and stay current on your recommended vaccines, especially for influenza and <a href="/hometown-health/featured-topic/updated-covid-19-vaccines-discussed" target="_self" title="Opens in same window">COVID-19</a>.</p> <p>If you become ill, help protect others by staying home until your symptoms improve. Wear a high-quality, well-fitting mask if you must be in contact with others and follow isolation guidelines for returning to work or school.</p> <h2>Next steps:</h2> <ul> <li>Learn what you should know about <a href="/hometown-health/featured-topic/what-parents-should-know-about-rsv" target="_self" title="Opens in same window">RSV and the RSV vaccine</a>. </li> <li>Find out why <a href="/hometown-health/speaking-of-health/your-sinus-headache-may-not-be-what-you-think" target="_self" title="Opens in same window">your sinus headache may not be what you think</a>.</li> <li>Get tips about <a href="/hometown-health/speaking-of-health/what-should-you-do-if-you-have-covid-19-or-the-flu" target="_self" title="Opens in same window">what to do if you have COVID-19 or the flu</a>.</li> <li>Read <a href="/hometown-health/speaking-of-health/7-ways-to-combat-coughs-and-colds" target="_self" title="Opens in same window">7 ways to combat coughs and colds</a>.</li> </ul> <p><em><a href="/providers/jill-lenhart-md" target="_self" title="Opens in same window">Jill Lenhart, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window">Family Medicine</a> physician in <a href="/locations/chippewa-falls" target="_self" title="Opens in same window">Chippewa Falls</a>, Wisconsin.</em></p>M.D.<p>I enjoy spending time with my family, walking and being active with my church.</p> <p>I am the Mayo Clinic Health System – Chippewa Valley vice chief medical officer.</p><p><strong>Medical School</strong> <br /> University of North Dakota School of Medicine-Grand Forks</p> <p><strong>Residency</strong> <br /> Eau Claire Family Practice Residency Program/UW-Madison Affiliate, Eau Claire, WI</p> <p><strong>Certification</strong> <br /> Family Practice </p>Lenhart<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/jill-lenhart-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4EA55C165DA6CAD75D3B28C8357628D5" alt="Jill Lenhart, M.D." width="280" height="280" DisableNVelocity="true" />{E09B30D9-AEAC-4BCE-B17E-ADD7423F8DDD}Jill<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>11881658Jill Lenhart MD1{B3F96F77-F93E-41A4-AE4E-603045CDB443}<img src="/-/media/national-files/images/hometown-health/2023/tea-with-honey-and-lemon.jpg?h=370&iar=0&w=660&sc_lang=en&hash=81D0B63EBC2A7859B58B9998D14933CC" alt="Tea with honey and lemon" width="660" height="370" DisableNVelocity="true" />Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Immunizations<p>Disease prevention is crucial to your health. Getting vaccinated is one of the best ways to maintain good health, and protect you and those you care about against infectious diseases. Vaccinations offer protection against serious diseases by stimulating the immune system to create antibodies against certain bacteria or viruses.</p><br/><p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/vaccine-guidance/art-20536857" target="_blank" title="Opens in a new window.">Get vaccine guidance from Mayo Clinic</a>, including benefits, safety, side effects and what to know about recommended vaccines for babies, children, teens, adults and during pregnancy. For recommended vaccines based on age, refer to the <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/adult" target="_blank" title="Opens in a new window.">adult</a> or <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/child" target="_blank" title="Opens in a new window.">child and adolescent</a> schedules.</p><br/><p>Review the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/coronavirus-covid-19/history-disease-outbreaks-vaccine-timeline" target="_blank" title="Opens in a new window.">history of infectious disease outbreaks and vaccines timeline</a> for information about major disease outbreaks, epidemics and pandemics, and the impact of vaccines and research.</p>Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller12/22/2023Common myths about the flu may keep you from taking the necessary steps to protect yourself from the illness. Learn the truth about lowering your risk — starting with the annual flu vaccine.6 common flu misconceptions<p>Flu is a hot topic, particularly as the weather cools and flu season heats up. But it's not just the virus that causes issues. Common myths often keep people from taking necessary steps to prevent it. Let's uncover the truth behind some common influenza myths.</p> <h2>Myth No. 1: The flu isn't a big deal.</h2> <p>False. You should <a href="/hometown-health/speaking-of-health/facts-about-flu" target="_self" title="Opens in same window.">take the flu seriously</a>, regardless of your age or physical condition. It's not a minor illness. Serious complications and deaths result every year due to the flu. In fact, up to 40,000 Americans die from influenza and its complications in an average year.</p> <p>Infants and young children, people with chronic medical conditions, older adults, people who are pregnant and people who are obese see a higher rate of flu-related complications and death.</p> <h2>Myth No. 2: I've had the flu recently, so I don't need a flu vaccine.</h2> <p>Unfortunately, this is false. Even if you've been diagnosed with influenza and recovered, you can get sick from the flu again. Typically, multiple strains of the flu circulate each year. So, if you were ill from one strain, getting the flu vaccine may help prevent complications if you become ill from a different strain. Also, the influenza virus mutates over time, so it's important to get an updated vaccine every year. </p> <h2>Myth No. 3: Flu shots never work.</h2> <p>False. Healthy people who receive a vaccine that matches viruses causing the disease experience superb protection from the flu. People with compromised immune systems and those 65 and older may experience a lower level of protection after a regular flu vaccine.</p> <p>It's important to remember that <a href="/hometown-health/featured-topic/dont-skip-your-flu-shot-this-year" target="_self" title="Opens in same window.">flu vaccines</a> aren't 100% effective but are the best defense against serious flu-related illnesses.</p> <h2>Myth No. 4: Flu vaccines can give me the flu.</h2> <p>This simply is not true. Injectable flu vaccines are composed of portions of inactivated flu proteins, and they can't cause the flu. Nasal spray vaccines have live, weakened flu organisms that can't multiply or cause disease.</p> <h2>Myth No. 5: I didn't get a flu shot as soon as it was available so it's too late to get one now.</h2> <p>The truth is, it's never too late to get vaccinated. The flu vaccine is available throughout the flu season. While <a rel="noopener" href="https://www.cdc.gov/flu/about/season.html?CDC_AAref_Val=https://www.cdc.gov/flu/about/season/index.html" target="_blank" title="Opens in new window.">flu activity</a> typically peaks in the U.S. between December and February, it can extend as late as May, according to the Centers for Disease Control and Prevention (CDC). </p> <h2>Myth No. 6: Flu vaccines are dangerous, especially for people who are pregnant.</h2> <p>This also is false. Not only is an injectable flu vaccine safe for <a href="/hometown-health/speaking-of-health/pregnancy-and-respiratory-illnesses" target="_self" title="Opens in same window.">people who are pregnant</a>, it's highly recommended. Research has shown significant increases in maternal death among unvaccinated women infected by influenza. However, pregnant people should avoid nasal vaccinations, as these have not been studied in people who are pregnant.</p> <h2>Here are some tips for avoiding illness:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/5-ws-of-healthy-hands" target="_self" title="Opens in same window.">Wash your hands</a> thoroughly and frequently with warm water and soap or use alcohol-based hand sanitizer. This is particularly important before leaving the bathroom, eating or touching your face. A good rule of thumb is to wash your hands for 20 seconds — about as long as it takes to sing “Happy Birthday.” Use a paper towel to shut off the faucet and open the door while in a public restroom. This will keep you from recontaminating your hands.</li> <li>Don't smoke. In general, smoking makes you more susceptible to illness.</li> <li>Cover your cough with the crook of your elbow.</li> <li>Avoid others who are sick and stay home from work or school <a href="/hometown-health/speaking-of-health/what-should-you-do-if-you-have-covid-19-or-the-flu" target="_self" title="Opens in same window.">if you are ill</a>.</li> <li>Keep your <a href="/hometown-health/speaking-of-health/even-grown-ups-needs-vaccinations" target="_self" title="Opens in same window.">vaccines up to date</a>. Aside from the seasonal flu shot and COVID-19 immunization, the most important vaccines include measles, mumps and rubella, or MMR, Tdap for tetanus, diphtheria and acellular pertussis, also called whooping cough.</li> </ul> <p>Learn more about <a href="/topics/influenza" target="_self" title="Opens in same window.">flu prevention and treatment</a>.</p> <p><a href="/providers/jennifer-johnson-do" target="_self" title="Opens in same window."><em>Jennifer S. Johnson, D.O.</em></a><em>, is a <a href="/services-and-treatments/family-medicine">Family Medicine</a> physician in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Obesity management</li> <li>Preventive medicine</li> </ul>D.O.<p>I practice a whole-person approach to medicine, focusing on helping patients achieve health across their lifespan. </p> <p>I grew up in Kansas, and have lived in the Mankato area since 2005. I'm married, have four kids and a dog. When I'm not working, I enjoy cooking and spending time with family.</p><p><strong>Education</strong></p> <ul> <li>Kansas City University Osteopathic Medical School  </li> </ul> <p><strong>Internship</strong></p> <ul> <li>University of Minnesota-Mankato</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, University of Minnesota-Mankato</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Diplomate, American Board of Obesity Medicine</li> <li>Family Practice, American Board of Osteopathic Family Physicians</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Osteopathic Family Physicians</li> <li>American Osteopathic Association </li> <li>Minnesota Medical Association </li> <li>Minnesota Osteopathic Medical Society </li> <li>Obesity Medical Association</li> </ul> <p><strong>Academic Appointments</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Johnson<img src="/-/media/shared-files/images/medical-professionals/full/mankato/jennifer-johnson-do.jpg?h=280&iar=0&w=280&sc_lang=en&hash=873658AFB998B5C1BD351A8B228A734B" alt="Jennifer Johnson DO" width="280" height="280" DisableNVelocity="true" />{876CA4AF-3CF4-4F4D-8D4B-5C3EBAEDB74F}Jennifer<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14617781Jennifer Johnson, D.O.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{94B2E140-AEF8-44BA-B6A9-4538B77501BC}|{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}<img src="/-/media/national-files/images/hometown-health/2023/making-a-snowman.jpg?h=370&iar=0&w=660&sc_lang=en&hash=37565F4A5FFF8366E82845BE5326361C" alt="Making a snowman" width="660" height="370" DisableNVelocity="true" />InfluenzaInfluenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza, commonly called the flu, is not the same as the stomach "flu" viruses that cause diarrhea and vomiting.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Immunizations<p>Disease prevention is crucial to your health. Getting vaccinated is one of the best ways to maintain good health, and protect you and those you care about against infectious diseases. Vaccinations offer protection against serious diseases by stimulating the immune system to create antibodies against certain bacteria or viruses.</p><br/><p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/vaccine-guidance/art-20536857" target="_blank" title="Opens in a new window.">Get vaccine guidance from Mayo Clinic</a>, including benefits, safety, side effects and what to know about recommended vaccines for babies, children, teens, adults and during pregnancy. For recommended vaccines based on age, refer to the <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/adult" target="_blank" title="Opens in a new window.">adult</a> or <a rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/prevention-and-wellness/child" target="_blank" title="Opens in a new window.">child and adolescent</a> schedules.</p><br/><p>Review the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/coronavirus-covid-19/history-disease-outbreaks-vaccine-timeline" target="_blank" title="Opens in a new window.">history of infectious disease outbreaks and vaccines timeline</a> for information about major disease outbreaks, epidemics and pandemics, and the impact of vaccines and research.</p>Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller9/11/2024New COVID-19 vaccines are designed to better protect against variants and prevent serious illness. Read what a Mayo Clinic expert shares about who should receive the updated vaccine.Mayo Clinic expert discusses updated COVID-19 vaccines<p>As a summer surge of COVID-19 outbreaks is underway, new vaccines for the virus have been released.</p> <p>The <a rel="noopener" href="https://www.fda.gov/news-events/press-announcements/fda-approves-and-authorizes-updated-mrna-covid-19-vaccines-better-protect-against-currently" target="_blank" title="Opens in a new window.">Food and Drug Administration (FDA)</a> approved new COVID-19 vaccines for people 6 months and older for the 2024–2025 season. These updated vaccines are designed to better protect against recently circulating variants, helping to prevent serious illness and hospitalization.</p> <p>"It appears that this virus is going to continue to change as immunity in the population wanes, either after vaccination or prior infection. New strains of this virus will cause outbreaks at different times of the year," says <a rel="noopener" href="https://www.mayoclinic.org/biographies/binnicker-matthew-j-ph-d/bio-20513862" target="_blank" title="Opens in a new window.">Matthew Binnicker, M.D.</a>, director of the <a rel="noopener" href="https://www.mayoclinic.org/departments-centers/laboratory-medicine-pathology/overview/specialty-groups/clinical-microbiology" target="_blank" title="Opens in a new window.">Clinical Virology Laboratory</a> at Mayo Clinic.</p> <h2>Watch Dr. Matthew Binnicker discuss the COVID-19 vaccine recommendations for 2024–2025:</h2> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/vw9RpjrwY44" title="Mayo Clinic expert discusses updated COVID-19 vaccines" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <p>New COVID-19 variants can evade immunity from earlier vaccination or prior infection, meaning vaccinated or previously infected people may still catch the virus. However, their immunity helps protect them from severe illness.</p> <p>"The recent vaccines have been designed against a variant that we saw early in 2024. The immune response that's generated by these new vaccines is much more specific to the strains that are currently in circulation," says Dr. Binnicker. "Studies have shown that the immune response is much more pronounced and specific against these variants and helps keep some from getting COVID-19 and, most importantly, keep them from developing severe disease."</p> <h2>Who should get the updated COVID-19 vaccines?</h2> <p>The <a rel="noopener" href="https://www.cdc.gov/media/releases/2024/s-t0627-vaccine-recommendations.html" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention (CDC)</a> recommends that everyone 6 months and older get the updated 2024–2025 COVID-19 vaccine for better protection this fall and winter. Whether you've previously had a COVID-19 vaccine or not, it's important to stay protected, says Dr. Binnicker.</p> <p>It's recommended that everyone get the updated COVID-19 vaccine as soon as it is available. Those who recently had an infection should wait three months, or those who had a dose of the older COVID-19 vaccine should wait two months. It's especially crucial for those at higher risk of severe infection.</p> <p>"Those who are immune compromised, those who are over the age of 75, those with certain preexisting health conditions and those who are pregnant fall into a higher risk category should get the updated COVID-19 vaccine as soon as possible," explains Dr. Binnicker.</p> <p>Vaccine protection can wane over time, so staying updated with your COVID-19 vaccination is key to preventing severe illness, hospitalization and possibly death.</p> <em>This article was originally published on the </em><a rel="noopener" href="https://newsnetwork.mayoclinic.org/" target="_blank" title="Opens in a new window."><em>Mayo Clinic News Network</em></a><em>.</em><img src="/-/media/national-files/images/hometown-health/2024/placing-bandage-on-injection-site.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4D01FEC24330C3460F5A53E0DA841CD4" alt="Placing bandage on injection site" width="660" height="370" DisableNVelocity="true" />COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Infectious DiseasesInfectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but some organisms under certain conditions may cause disease.Michele Halterman1/20/2018<p>Pacemakers have evolved over the years by becoming more compact and sophisticated, but they still operate the same way in keeping the heart beating at a regular rate.</p>Pacemakers: Past and present<table align="right" style="width: 300px;"> <tbody> <tr> <td> <p><img alt="Pacemaker" src="/-/media/national-files/images/hometown-health/2018/pacemaker.jpg?h=300&w=300&sc_lang=en&hash=21981933BCEDE09C5768091D84F6549F" style="height: 300px; width: 300px; float: left;" class="img-responsive"></p> <h6>Fred Hintzman, left, was admitted to Luther Hospital in Eau Claire in 1962 and received one of the first pacemakers for his heart condition, which is significantly different to the patient, at right, with a pacemaker post-procedure in 2017.</h6> </td> </tr> </tbody> </table> <p>Pacemakers have evolved over the years by becoming more compact and sophisticated, but they still operate the same way in keeping the heart beating at a regular rate.</p> <p>In 1962, Fred Hintzman, 70 and then Menomonie resident, was admitted to Luther Hospital in Eau Claire for an extremely low heart rhythm and was treated by John Wishart, M.D., and J.W. Merritt, M.D. At that time, pacemakers were uncommon, and Hintzman was the first person in northern Wisconsin to receive one for his heart condition.</p> <p>According to the <em>Dunn County News</em>, on Jan. 23, 1963, Hintzman’s heart rate “would sometimes drop to eight or nine beats and even occasionally stop.” Dr. Wishart stated that Hintzman was the perfect candidate, as only those with a certain type of heart condition could use a pacemaker.</p> <p>Hintzman required two surgeries. The first surgery implanted and connected leads from his heart to a machine outside of his body to allow the strength and rate of the impulses needed for his heart to get back to a normal rhythm to be set. The second surgery implanted the preset pacemaker into his body.</p> <p>A pacemaker in the 1960s and 1970s could only be set at one rate, lasted a couple of years using four lithium batteries and did not store diagnostics. The implanted pacemaker in the 1970s was approximately the size of an old-fashioned pocket watch and had one or two wires that connected to the heart.</p> <p style="margin-bottom: 0.0001pt;"><strong>PACEMAKERS TODAY</strong></p> <p style="margin-bottom: 0.0001pt;">Today, a pacemaker uses one to three flexible, insulated wires called leads placed in the chambers of the heart to deliver electrical pulses to adjust heart rate. For most people, one lead is placed in the upper chamber and one is placed in the lower right chamber of the heart. Both connect to a small battery pack located just under the clavicle.</p> <p>A pacemaker is about the size of three silver dollars stacked together, and the battery lasts six to 10 years based on how often it needs to keep the heart beating at a reasonable rate. It has a microchip that stores information about heart rhythm, and the data can be retrieved by the health care provider to review with the patient, when necessary.</p> <p>In 1972, <a href="/providers/daniel-kincaid-md" target="_self" title="Opens in same window.">Daniel Kincaid, M.D.</a>, was the first board-certified <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiologist</a> in Eau Claire and worked at Sacred Heart Hospital and Luther Hospital, now Mayo Clinic Health System, to see patients in the area with heart conditions. He has earned a special place in his patient’s hearts for helping maintain a steady beat.</p> <p>In 1975, he and Mary Hitzke, a registered nurse, helped create the area’s first telephone follow-up clinic for patients with pacemakers, allowing patients to have their rhythms checked over the phone to get more immediate results and treatment, if necessary.</p> <p><strong>MONITORING RESULTS</strong> </p> <p>Remote monitoring units placed in a patient's home offers providers a convenient way to follow heart rhythms. Providers review the data if there are concerns to validate a need to seek medical attention. Monitoring also indicates if the batteries are getting low and allows time for the patient to schedule an appointment to get the battery replaced.</p> <p>Lots of medicines can slow the heart down, but there still aren’t good medicines available to speed the heart back up to a normal rhythm,” says Dr. Kincaid. “That is why devices, like pacemakers, are still vital in keeping people alive.”</p> <p>Dr. Kincaid has helped thousands of patients with heart rhythm problems by implanting pacemakers and other heart rhythm devices over the past 45 years. Mayo Clinic Health System’s <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">Cardiac Center</a> in Eau Claire follows over 2,000 patients with pacemakers and defibrillators using phone and web-based monitoring.</p> <p>“Our goal at Mayo Clinic Health System and the Cardiac Center is to help our patients maintain or improve their quality of life by continuing to offer them the safest, most effective options for their heart care,” says Dr. Kincaid.</p><img src="/-/media/national-files/images/hometown-health/2018/old-pacemaker.jpg?h=508&iar=0&w=500&sc_lang=en&hash=43CA08A41994A6274BD015BB00CEBCC3" alt="Old pacemaker" width="500" height="508" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Michele Halterman8/25/2022Tattoos are a common method of expression or marking significant events. But can you use a tattoo to communicate healthcare wishes? Learn why picking up a pen, not a tattoo needle, is the better option.Is a do-not-resuscitate tattoo a valid advance directive?<p>With the growing popularity of tattoos, you may wonder if a tattoo is the best way to express healthcare wishes. Tattooing "DNR" or "DNI" on your chest may seem like an easy way to permanently express your wishes. But this is ethically controversial and not a substitute for a valid advance directive.</p> <p>In Wisconsin and Minnesota, a tattoo is not acceptable by law for expressing end-of-life care wishes. This is because it doesn't include the information required, such as your name, address and phone number. It also doesn't have the signature of your attending physician. Finally, a tattoo is not easily reversible.</p> <p>Do not resuscitate (DNR) and do not intubate (DNI) tells your healthcare team that you do not want to be resuscitated or have intubation in an emergency. Resuscitation refers to cardiopulmonary resuscitation, also called CPR. This treatment tries to restart a normal heartbeat if it stops beating or beats irregularly by pushing on the chest forcefully, called chest compressions. Intubation refers to placing a plastic tube down a person's breathing tube and placing them on life support breathing machines or ventilators.</p> <p>It might be difficult to understand why anyone would not want all measures to be taken to save a life. Generally, a person who has terminal illness or a history of chronic disease may prefer a natural death without heroic measures to try to bring him or her back to life. Lifesaving measures often do not bring a person back to the previous level of function, usually cause broken ribs and can cause disability or lead to an unpleasant death.</p> <p>Ultimately, your healthcare team won't know of your wishes unless you record them in an advance directive and have it added to your medical record. Do not rely on a tattoo to communicate this important information.</p> <h2>Who should complete an advance directive? </h2> <p>Every person, 18 and older, should complete an advance directive. In Wisconsin or Minnesota, if you are too sick to say what you want and do not have an advance directive on file, a judge might appoint a guardian to make medical decisions for you. It's important that you write down what you think is best for you and not what others would want for you. This document is a gift to your loved ones.</p> <p>Just as important as an advance directive is the conversation with family and friends. Some people fear that speaking to their loved ones about their final days would be too grim. In reality, these are among the most empowering and meaningful conversations people can have.</p> <p>The decisions you make should align with your values. What is most important to you, and what gives your life meaning? What are your preferences for healthcare? And, just as important, what are your limits?</p> <p>It's critical to know that emergency responders cannot follow advance directives in emergency situations.</p> <p>If you wish to avoid aggressive treatment in an ambulance, emergency responders can honor your wishes, but only if you have a Physician Order for Scope of Treatment or are wearing a state-approved community do-not-resuscitate bracelet. Talk with your healthcare team if you wish to have a do-not-resuscitate bracelet or would like to discuss advance care planning and complete these documents.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/two-people-tablet-talking.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F8F34E12DFCE01CB60BB71085D59D688" alt="Two people looking at a tablet and talking" width="660" height="370" DisableNVelocity="true" />HospiceThe Hospice program believes that the highest quality of living is achieved when the family unit and Hospice team together offer hope, opportunity, support, presence, individualized care, comfort and encouragement.<br/><br/>Palliative CarePalliative care offers pain and symptom management, and emotional and spiritual support when you face a chronic, debilitating or life-threatening illness.Dawn Haller2/18/2020Do you want to boost your spirits, feel happier and enhance your overall health? Participate in Discover Gratitude — a four-week virtual program designed to help improve your mental well-being through daily journaling and practicing mindful thankfulness.Gratitude challenge participants find new appreciation for life<p>When Shirley McCann’s husband started showing signs of dementia, she became his caregiver. The 73-year-old Overland Park, Kansas, resident found the responsibility overwhelming at first. As her stress level increased, Shirley began to suffer panic attacks.</p> <p>“I didn’t know what I was going to do, because I don’t have any help,” Shirley says. “It’s easy to get frustrated. That frustration was eating into me.”</p> <p><img alt="Shirley McCann" src="/-/media/national-files/images/hometown-health/2018/shirley-mccann.jpg?h=238&w=200&sc_lang=en&hash=EAD8B523EDF5323C6EE500B851E2E9B6" style="height: 238px; width: 200px; float: right;" class="img-responsive" />Wondering how to cope, Shirley took interest when she saw a post on social media about a free gratitude challenge program offered by Mayo Clinic Health System now known as Discover Gratitude. </p> <p>Participants in <a href="/wellness/gratitude">Discover Gratitude</a> download a journal to record three things for which they are grateful each day. They also are asked to perform a deliberate act of kindness, perhaps as simple as opening a door for someone or smiling at someone in a hallway. The third step is to take a moment to be mindful each day — a moment to reflect, perhaps by taking a walk, watching birds or listening to children playing. The challenge spans 30 days, though many participants continue to keep a journal afterwards.</p> <p>“The concept is based on a lot of research about happiness,” says Sara Carstens, director of Community Engagement and Wellness at Mayo Clinic Health System in Northwest Wisconsin. “It’s not really the material things we have that make us happy so much as our relationships and being grateful for the things we have.”</p> <p>They don’t need to be big things.</p> <p>“At first I kind of had to think about it,” says Shirley. “It was simple things I put down — things that you take for granted every day. I got a good night’s sleep, I got to take my teenage granddaughter to the mall, I have my daughter’s friendship and love or I found a pair of jeans that fit.”</p> <p>Shirley says the process helped her develop a more positive attitude.</p> <p>“I kept these things in my head all day to write down in the evening,” she says. “Not only did I realize how much I had to be thankful for, but I was more considerate — more aware of other people’s issues.”</p> <p>Long after the 30-day challenge ended, Shirley continues to keep a journal.</p> <h2>Grateful kids</h2> <img alt="Mary Stamos" src="/-/media/national-files/images/hometown-health/2018/mary-stamos.jpg?h=255&w=250&sc_lang=en&hash=41789ADEB250BC365E3C1691E03A3437" style="height: 255px; width: 250px; float: right;" class="img-responsive" /> <p>The exercise in gratefulness, kindness and mindfulness not only is beneficial for adults. Mary Stamos, 58, a fifth-grade teacher in Altoona, Wisconsin, saw an opportunity to use the challenge with her students as part of a daily writing assignment. Mary had her students write in their gratitude journals for a few minutes each morning. She says it accomplished more than developing the children’s writing skills.</p> <p>“It was very positive for the kids to hear them talk about positive things in their lives,” Mary says. “It prompted other discussions with kids where they would ask each other, ‘What’s that about?’ These are things we want to promote with kids: self-reflection, thinking about positive things in their lives and giving to others.”</p> <p>Mary says it was easy to work the activity into her students’ day, and the 30-day challenge appealed to them. After writing about the obvious topics, like family and friends at first, it was a good stretch for them to think of other things throughout the course of the month. The class brainstormed together to come up with more ideas.</p> <p>“Kids like a challenge,” Mary says.</p> <h2>Accentuate the positive</h2> <p>Sara says a gratitude practice isn’t intended to downplay the worries or challenges that people face, but rather to help people shift the focus to positivity over negativity and approach life with a different mindset. The activity can be relevant for anyone, whether they feel life is going fine, or they are dealing with depression or anxiety.</p> <p>“We spend more time thinking about what is going well and less worrying about the future or mulling over the past,” Sara says.</p> <p>Sara says the feedback from those who have tried the program has been overwhelmingly positive. Respondents report a boost in mood and an increased appreciation for what they have in life.</p> <p>Anyone can participate independently, but Sara especially recommends doing it together with family and friends.</p> <p>“If you hold each other accountable for prioritizing gratitude and kindness, I think it could have even more of an impact,” Sara says. “If we can help ourselves, why not try to help others in our lives, as well?”</p> <hr /> <h2>Learn more about the Discover Gratitude challenge:</h2> <p><a href="/wellness/gratitude" target="_self" title="Opens in same window.">Visit the Discover Gratitude page, and register for the challenge.</a></p> <p>Watch a video about the Discover Gratitude program:</p> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/qeopKlMvH_M" title="Gratitude Challenge" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p><img src="/-/media/national-files/images/hometown-health/2018/white-birds-and-clouds-on-blue-background.jpg?h=370&iar=0&w=660&sc_lang=en&hash=A0CC7537CC08A76AB0E866124DB49F0A" alt="White birds and clouds on blue background" width="660" height="370" DisableNVelocity="true" />Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller10/9/2015<p>Are you feeling chest pain? Tingling or numbness in your left shoulder? Nausea? You might be having a heart attack — but you might not realize it.</p>Getting to the heart of the matter: Women and cardiovascular disease<img alt="Feature_FA15_DrMulvagh" src="/-/media/national-files/images/hometown-health/2015/fall-2015/feature_fa15_drmulvagh.jpg?h=730&w=167&sc_lang=en&hash=DD039550550D222E113442652BBF7623" style="height: 730px; width: 167px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>Are you feeling chest pain? Tingling or numbness in your left shoulder? Nausea? You might be having a heart attack — but you might not realize it.</p> <h2>Double-edged sword</h2> <p>Nearly 1 million men and women die of cardiovascular disease each year in the U.S. Approximately half of those deaths are from heart attacks, while the rest are mostly from strokes and heart failure.</p> <p>The good news? The number of deaths from cardiovascular disease is decreasing in both groups, according to Sharon Mulvagh, M.D., director of the Women's Heart Clinic and associate director of Preventive Cardiology at Mayo Clinic in Rochester, Minnesota. The bad news? More women than men are dying of cardiovascular disease and in higher numbers. </p> <p>But Dr. Mulvagh says the worst news is that just over half of women realize that cardiovascular disease is their No. 1 killer, and even fewer young women know this.  </p> <h2>The million-person question</h2> <p>"The death rate from heart attacks in women ages 35–54 has actually been increasing by 1.5% per year over the last decade," says Dr. Mulvagh.</p> <p>Why are younger women dying from heart attacks more often? Dr. Mulvagh says the reasons can be narrowed down to a few important elements.</p> <p>"Younger women have more risk factors for cardiovascular disease, and the factors seem to be more impactful for women," she says. "Women who smoke, have high triglycerides and/or have diabetes are two times more likely to develop cardiovascular disease than men. And the biggest thing driving women's risk is obesity."</p> <h2>A supersized problem</h2> <p>"Obesity in the U.S. has increased dramatically over the last few decades — about one-third of the population is normal weight, one-third is overweight and one-third is obese," says Dr. Mulvagh. "This environment we've lived in for 50 years, which influences people to be overweight or obese, is quite striking. We've supersized everything — soft drinks, food — and women appear to have been more affected than men."</p> <p>Dr. Mulvagh says women, especially those approaching midlife, tend to develop a metabolic syndrome — sometimes called prediabetes — that increases heart disease risk if three of these five characteristics are present:</p> <ul> <li>High blood pressure</li> <li>Glucose intolerance (elevated fasting blood sugar)</li> <li>Elevated triglycerides</li> <li>Low HDL (high density) and high LDL (low density) cholesterol</li> <li>35” or greater waistline for women (40” or greater for men)</li> </ul> <p>"All of these factors are lifestyle-induced," says Dr. Mulvagh. "Cardiovascular disease is 80% preventable with an optimal heart-healthy lifestyle."</p> <p>Family history plays an important role too. Dr. Mulvagh says if you have an immediate family member or relative who has had a heart attack, it's even more important for you to lower your risk by living a heart-healthy lifestyle.</p> <h2>Unique symptoms</h2> <p>Although women share some symptoms of cardiovascular disease with men, they're often different.</p> <p>"Nearly 60% of women having a heart attack experience classic chest pain symptoms," says Dr. Mulvagh. "But women tend to have more atypical symptoms than men."</p> <p>For example, women tend to have shortness of breath more often. Some women only get pain in their shoulders and back, or experience profound fatigue. "Symptoms can be hard to figure out, especially if it's something new. It's very concerning. Listen to your body and get checked out," says Dr. Mulvagh.</p> <h2>Preventing the percentages</h2> <p>Dr. Mulvagh says you can help prevent cardiovascular disease by maintaining a healthy body weight and eating primarily vegetables, fruit and lean sources of protein while avoiding refined carbohydrates, including white sugar and starches. She recommends two brief sessions of strength training per week, at least 30 minutes of regular exercise most days of the week or 60 minutes if you're overweight or obese.</p> <p>"I like how the science journalist Michael Pollan put it," says Dr. Mulvagh. "'Eat food. Not too much. Mostly plants.' And get active. For most people, this boils down to eating less and moving more — a simple formula to protect your heart."</p><img src="/-/media/national-files/images/hometown-health/2015/fall-2015/feature_fa15_bloghomepage_229x200.jpg?h=200&iar=0&w=229&sc_lang=en&hash=DCBD2B670F8D90775249B295AAEE798B" alt="Feature_FA15_BlogHomePage_229x200" width="229" height="200" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller1/19/2015<p>An average kindergartner goes to birthday parties, builds forts and starts learning how to read. But she doesn't plan on getting cancer. When Anika Chesak was diagnosed with rhabdomyosarcoma — a type of tumor that wraps itself around soft tissue — at age 5, the course of her childhood drastically changed.</p>Proton beam therapy changes a Mayo Clinic patient's life<img alt="Feature_ProtonBeamTherapy_lg" src="/-/media/national-files/images/hometown-health/2015/winter-2015/feature_protonbeamtherapy_lg.jpg?h=278&w=289&sc_lang=en&hash=6E91612E12E3BAC0BDD6C8679993566A" style="height: 278px; width: 289px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>An average kindergartner goes to birthday parties, builds forts and starts learning how to read. But she doesn't plan on getting cancer.</p> <p>When Anika Chesak was diagnosed with rhabdomyosarcoma — a type of tumor that wraps itself around soft tissue — at age 5, the course of her childhood drastically changed.</p> <h2>Dark days</h2> <p>In the fall of 2009, Anika complained of headaches and didn't want to get out of bed, according to her mother, Sherry Chesak, Ph.D., a registered nurse and program director in Education and Professional Development at Mayo Clinic in Rochester, Minnesota.</p> <p>Anika had seen her family medicine physician at Mayo Clinic Health System in Albert Lea and Austin in Austin, Minnesota, for these symptoms, but Dr. Chesak and her husband noticed that Anika was rapidly losing weight, which concerned them.</p> <p>"I saw Anika squinting and closing one of her eyes while walking down the hall, and she said she saw two of everything." says Dr. Chesak. Their physician directed them to Mayo Clinic.</p> <p>A computed tomography (CT) scan indicated a sinus infection, and Anika was placed on antibiotics. But the scan had revealed a questionable spot. An MRI showed a tumor behind Anika's right eye, on her optic nerve.</p> <p>"That was quite shocking," says Dr. Chesak.</p> <h2><strong>Searching for hope</strong></h2> <p>The inoperable tumor was wrapped around the carotid artery, which supplies blood to the brain. "We thought it was a death sentence," says Dr. Chesak. "There wasn't a lot of hope, and the despair set in."</p> <p>"I was scared because I saw that my mom was scared," Anika says. "I didn't know what I was going to have to go through."</p> <p>After the Chesaks met with the pediatric oncologist, they felt more hopeful. They were told that Anika had a good prognosis and would respond well to chemotherapy and radiation.</p> <h2>Changing directions</h2> <p>Dr. Chesak knew the treatment could affect the pituitary gland — which controls hormone production — and could potentially stunt Anika's growth. "We started researching immediately," says Dr. Chesak. They found that proton beam therapy could avoid damage to areas surrounding the tumor.</p> <p>Because proton beam therapy is not yet available at Mayo Clinic, the Chesaks spoke with specialists at the country's four existing proton beam therapy centers. They chose the MD Anderson Cancer Center in Houston, Texas, which could get Anika in the quickest.</p> <h2>Treatment</h2> <p>Mayo Clinic physicians worked with staff at MD Anderson to transition Anika's treatment plan.</p> <p>Dr. Chesak traveled back and forth from her home in Austin, Minnesota, to Houston, Texas, and relayed Anika's status via Skype to her husband, who was at home caring for their two other children.</p> <p>"I didn't really know what [the proton beam] was at first," Anika says. "I had never done anything like it before."</p> <p>Proton beam therapy directs protons — the positively charged parts of an atom onto tumors, and the family noticed progress almost immediately as Anika's right eye opened a little more after each treatment.</p> <h2>Hope restored</h2> <p>Anika has been cancer-free for about four years and has regularly scheduled MRIs at Mayo Clinic. Dr. Chesak says although Anika lost sight in her right eye, there were no other side effects. She wears glasses to protect her left eye.</p> <p>"I was happy that I survived cancer and got to see my family again," Anika says.</p> <p>"We learned quite a bit about faith, and Anika taught us a lot," says Dr. Chesak. "At times, Anika felt down, but she never doubted that she would be healthy one day."</p> <h2>Proton beam coming soon to Mayo Clinic</h2> <img alt="ProtonBeamTherapy_Video" src="/-/media/national-files/images/hometown-health/2015/winter-2015/protonbeamtherapy_video.jpg?h=179&w=318&sc_lang=en&hash=2F65AD47710AF3CDD9EF968F83D93063" style="height: 179px; width: 318px;" /> <p>In proton beam therapy, energy comes from protons, the positively charged parts of an atom. Protons are generated by a powerful machine called a particle accelerator. Unlike an X-ray, the proton stops after striking the target. A proton beam can be finely controlled so higher doses of radiation can be more safely delivered to tumors with less risk to healthy tissues.</p> <p>Mayo Clinic is launching its Proton Beam Therapy Program with treatment facilities on the Minnesota and Arizona campuses. Mayo Clinic's program will employ the next generation of proton therapy — intensity-modulated proton beam therapy, using pencil beam scanning, which paints small groups of protons back and forth through a tumor. The precision of pencil beam scanning makes it especially beneficial in treating tumors adjacent to critical and sensitive organs, such as the brain, eye and spinal cord.</p> <p>Proton beam therapy has proven beneficial in the treatment of many kinds of tumors, including head and neck, eye, central nervous system, lung, sarcomas, gastrointestinal, prostate and many pediatric cancers.</p> <p>Treatment for patients will be available in the summer of 2015 at Mayo Clinic in Rochester and early 2016 in Arizona.</p><img src="/-/media/national-files/images/hometown-health/2015/winter-2015/blog_feature_protonbeam_wi15_229x200.jpg?h=200&iar=0&w=229&sc_lang=en&hash=D9C107335289CFEBD237D8D316E84418" alt="blog_Feature_ProtonBeam_WI15_229x200" width="229" height="200" DisableNVelocity="true" />CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Children's Health (Pediatrics)Pediatric medicine provides expert care for common problems to the most complex situations from birth through the teen years.Dawn Haller1/29/2016<p>When the smell of wood smoke fills the air and night falls before dinner, rest assured that autumn has turned to winter. But somewhere between the backyard bonfires and sipping hot cocoa, a less pleasant phenomenon takes hold of some people: seasonal affective disorder.</p>Recognizing seasonal affective disorder<img alt="Feature_WI16_DrFrye_LG" src="/-/media/national-files/images/hometown-health/2016/winter-2016/feature_wi16_drfrye_lg.jpg?h=336&w=196&sc_lang=en&hash=992CF1ED98A8A6E2E5E4F292CC18F8AF" style="height: 336px; width: 196px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>When the smell of wood smoke fills the air and night falls before dinner, rest assured that autumn has turned to winter. But somewhere between the backyard bonfires and sipping hot cocoa, a less pleasant phenomenon takes hold of some people: seasonal affective disorder, or SAD.</p> <h2>A yearly ordeal</h2> <p>"SAD is a significant mood disorder that changes people's capacity to work, or enjoy family or friends, and we think it's related to the light/dark cycles," says Mark Frye, M.D., chair of Psychiatry and Psychology at Mayo Clinic in Rochester.</p> <p>While many people struggle with cabin fever during a long winter, SAD symptoms can be severe and functionally disabling. Dr. Frye says SAD is much like bipolar disorder, or major depression, but specifically related to the change of seasons.</p> <h2>SAD symptoms</h2> <p>Most SAD symptoms start in the fall and continue through the winter months, sapping your energy and making you feel moody. But don't brush off that yearly feeling as simply a case of the winter blues or a seasonal funk that you have to tough out on your own.</p> <p>Although winter symptoms usually go away once spring or summer hits, some people experience the opposite pattern. In either case, symptoms may start out mild and become more severe as the season progresses.</p> <h3>Symptoms specific to winter-onset SAD, sometimes called winter depression, may include:</h3> <ul> <li>Oversleeping or hypersomnia</li> <li>Appetite changes, especially a craving for foods high in carbohydrates</li> <li>Weight gain</li> <li>Depressed mood</li> <li>Irritability</li> <li>Tiredness or low energy</li> <li>Problems getting along with other people</li> <li>Heavy feeling in the arms or legs</li> </ul> <h2>SAD causes</h2> <h3>While specific causes of SAD remain unknown, factors that may come into play include:</h3> <ul> <li><strong>Your biological clock or circadian rhythm</strong><br /> Reduced sunlight in fall and winter may disrupt your body's internal clock and lead to feelings of depression.</li> <li><strong>Serotonin levels</strong><br /> Reduced sunlight can cause a drop in serotonin — a brain chemical that affects mood — and can trigger depression.</li> <li><strong>Melatonin levels</strong><br /> The change in season can disrupt the balance of the body's level of melatonin, which plays a role in sleep patterns and mood.</li> </ul> <h2>Support and treatment</h2> <p>It's normal to have some days when you feel down. But if you feel down for days at a time and you can't get motivated to do activities you normally enjoy, see your doctor. Treatment can help prevent complications, especially if SAD is diagnosed and treated before symptoms become severe.</p> <p>Treatment for SAD may include light therapy (phototherapy), psychotherapy and medications. Dr. Frye says providers often will prescribe light boxes, and there is one antidepressant available — Wellbutrin — that can prevent SAD.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2016/winter-2016/feature_wi16_bloghomepage_229x200.jpg?h=200&iar=0&w=229&sc_lang=en&hash=3454FC362F6E43D776A49CF9FEAE4517" alt="Feature_WI16_BlogHomePage_229x200" width="229" height="200" DisableNVelocity="true" />Behavioral HealthHow can you tell whether a mental health issue is normal? The line between normal and abnormal mental health often is blurred. Still, it's helpful to consider your feelings, thoughts and behavior in relation to cultural norms and other benchmarks. Mental health includes self-esteem, relationships, resilience and more. If you're struggling with these or other things, we are here to help.Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Dawn Haller4/10/2015<p>When fourth grade students in Cameron Elementary School in Cameron, Wis. were assigned a project about maintaining good health, Logan Crawford knew exactly what he wanted to do: build a model of a Mayo One helicopter.</p>Student makes helicopter model with help from Mayo Clinic Medical Transport<p><img alt="Lego_Mayo_one" src="/-/media/national-files/images/hometown-health/2015/lego_mayo_one.jpg?h=267&w=400&sc_lang=en&hash=AE08BF9826B426F72451E9F87C580E87" style="height: 267px; width: 400px; float: right; margin-bottom: 10px; margin-left: 10px;" />When fourth grade students in Cameron Elementary School in Cameron, Wis. were assigned a project about maintaining good health, Logan Crawford knew exactly what he wanted to do: build a model of a Mayo One helicopter.</p> <p>Logan’s Mayo One helicopter is made entirely out of Legos. His mother, Lori Crawford, helped make personalized stickers with the Mayo Clinic logo and Mayo One written on them. He then researched the Mayo helicopters and pilots.</p> <p>“Putting the helicopter together was the most fun,” says Logan.</p> <p>After completing the project, Logan still was curious about Mayo One, so Lori reached out to Mayo Clinic Medical Transport with Logan’s questions. Joel Kozlowski, director of operations and pilot for Mayo Clinic Medical Transport, was more than happy to answer some of the questions Logan had about flying helicopters.</p> <p>“I’ve always known I was going to be a pilot,” says Kozlowski. “Because of that initial dream as a kid, my whole life as an adult was focused on making the dream a reality.”</p> <p>When he grows up, Logan wants to be a pilot flying planes or helicopters, like Kozlowski.</p> <p>“We live across from an airport, so he sees a lot flying over our house,” says Lori. “It’s really neat where we live, and I think Logan’s excitement to be a pilot stems from that.”</p> <p>Kozlowski was able to answer some of Logan’s questions, including what the most important part of his job is as a Mayo One pilot.</p> <p><img alt="helicopter_visit" src="/-/media/national-files/images/hometown-health/2015/helicopter_visit.jpg?h=267&w=400&sc_lang=en&hash=56B6337B4E90BC94ABDFED62BA1CFE17" style="height: 267px; width: 400px; float: right; margin-top: 10px; margin-bottom: 10px; margin-left: 10px;" />“The most important thing I do in my job is either flying safely or writing policies and procedures for our pilots that help them fly more safely,” says Kozlowski.</p> <p>When asked what he wanted to ask the pilot most, Logan says, “If I could get a ride in the helicopter!”</p> <p>While he didn’t get a ride, Logan and his parents, Lori and Jim, were able to meet Kozlowski and get a tour of the Mayo One helicopter at the Chippewa Valley Regional Airport.</p><img src="/-/media/national-files/images/hometown-health/2015/lego_helicopter_sm.jpg?h=200&iar=0&w=200&sc_lang=en&hash=FD0F39E49BC1A23122ABD020060D3E4E" alt="lego_helicopter_sm" width="200" height="200" DisableNVelocity="true" />Dawn Haller6/8/2020Movement. It seems like the simplest thing in the world. Our bodies are designed to run, jump and manipulate objects. But how often do we use our bodies at their full potential?The importance of movement<p>Movement. It seems like the simplest thing in the world. Our bodies are designed to run, jump and manipulate objects, among other miracles of locomotion. But how often do we use our bodies at their full potential?</p> <p>Sit. Stay. Repeat.</p> <p>We've made sitting into an art form. However, excess sitting now is linked with many diseases and conditions, including obesity, hypertension, back pain, cancer, cardiovascular disease and depression.</p> <p>Excessive sitting is a fairly new problem in human history. Two hundred years ago, 90% of the world lived in agricultural communities. People sat for three to five hours per day but only to take breaks from working. Modern Americans sit for 13 to 15 hours per day.</p> <p>Whether our ancestors were fieldworkers, community dance leaders or hairdressers, they still walked several miles a day and only sat for brief periods. Compare that to today's average office worker who takes a few steps to the car and drives to work to sit in a sea of cubicles for most of the day. It may not be surprising that there are consequences for sitting all day long. We're not designed to do it.</p> <h4>Moving forward</h4> <p>Defeating the sedentary life isn't as simple as a few tips and tricks, but there are a few things anyone can do to move in the right direction.</p> <h4>Here are a few ways to incorporate movement into your day: </h4> <ul> <li>Use a standing desk when possible.</li> <li>Set a reminder to stand and move at least once per hour.</li> <li>Take a walk over lunch.</li> <li>Walk during phone or conference calls.</li> <li>Park far from store entrances, and enjoy your walk to and from.</li> <li>Skip the elevator and use the stairs.</li> <li>Walk around your house when doing routine tasks like brushing your teeth.</li> <li>Take your dog for a long walk once daily.</li> <li>Walk on a treadmill while watching TV.</li> <li>Do yardwork, such as mowing your lawn, raking leaves or planting flowers.</li> </ul> <p>I have found that once people are up and moving, they don't go back. This is a fundamental shift in how people function. Health gets better with movement, productivity gets better, and people enjoy their jobs — and lives — more. </p> <p><em><a href="/providers/andrew-jagim-phd" target="_self" title="Opens in same window.">Andrew Jagim, Ph.D.</a>, is a <a href="/services-and-treatments/sports-medicine" target="_self" title="Opens in same window.">Sports Medicine</a> physician in <a href="/locations/onalaska" target="_self" title="Opens in same window.">Onalaska</a>, Wisconsin.</em></p><ul> <li>Examining how different nutrition and exercise interventions influence health and performance — this interest applies to both the general population in regards to improve a person’s quality of life and prevent chronic disease in addition to improving the performance ability of elite athletes</li> </ul>Ph.D.<p><strong>Education</strong></p> <ul> <li>Master's degree, Human Performance, University of Wisconsin – La Crosse</li> <li>Ph.D., Kinesiology – Exercise Physiology Texas A&M University, College Station</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>International Society of Sports Nutrition</li> <li>National Strength and Conditioning Association</li> </ul> <p><strong>Memberships</strong></p> <ul> <li>American College of Sports Medicine</li> <li>International Society of Sports Nutrition</li> <li>National Strength and Conditioning Association</li> </ul>Jagim<img src="/-/media/shared-files/images/medical-professionals/full/onalaska/andrew-jagim-phd.jpg?h=280&iar=0&w=280&sc_lang=en&hash=AA07F8D241D507CF3C0C9F28FC00E465" alt="Andrew Jagim PhD" width="280" height="280" DisableNVelocity="true" /><p>Dr. Jagim has authored or collaborated on numerous scholarly publications related to sports medicine. His topics have included:</p> <ul> <li>diets and nutrition</li> <li>workouts and training regimens</li> <li>sports injuries and treatment programs</li> <li>use and affects of drugs and supplements in sports</li> </ul> <p>His research has been published in numerous journals including International Journal of Exercise Science, Journal of Sports Science, Journal of Strength and Conditioning Research, Frontiers in Nutrition, International Society of Sports Nutrition, Journal of Neurosurgery and the Clinical Journal of Sports Medicine.</p>Andrew<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>20772289Andrew Jagim, Ph.D.1{7746ADF8-715B-4593-8AAB-55D7F0467848}<img src="/-/media/national-files/images/hometown-health/2020/feet-walking-trail-by-prairie-grass.jpg?h=370&iar=0&w=660&sc_lang=en&hash=D3673F4B066D363A7178923145705469" alt="Feet walking trail by prairie grass" width="660" height="370" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Dawn Haller11/25/2016Women's bodies experience many changes over a lifetime, so it's never too late to educate yourself about what to expect.Women’s health: Education is the answer<img alt="DrThielen_LG" src="/-/media/national-files/images/hometown-health/2016/fall-2016/drthielen_lg.jpg?h=272&w=208&sc_lang=en&hash=1BD3FDC7802561EAA618191AC959B899" style="height: 272px; width: 208px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>Unless you've seen a specialist lately, you might not have been given much information about how your body works beyond what was taught in middle school health class.</p> <p>Women's bodies experience many changes over a lifetime, so it's never too late to educate yourself about what to expect.</p> <h2>The hormonal dance</h2> <p>"One thing I've learned as a women's health specialist is we never seem to get enough information," says Jacqueline Thielen, M.D., a general internal medicine physician in Mayo Clinic's Women's Health Clinic.</p> <p>According to Dr. Thielen, women in their 20s are often single, obtaining new jobs, and considering starting families — frequently later than they used to. There are more contraceptive options than in the past, including intrauterine devices (IUD), and other long-acting treatments. Protected sex should factor prominently into 20-somethings' lives. Although sexually transmitted infections have been around for a long time, providers have recently become concerned about human papillomavirus (HPV) and making sure women are vaccinated for protection against cervical cancer.</p> <p>"Women in their 30s are usually more established in their jobs and relationships, so things shift from birth control to fertility," Dr. Thielen says. ""Can I have children?' "Can we do a nontraditional fertility treatment?' There are more questions like this, and also concerns about issues such as domestic violence and stress management." Also, HPV testing is added to cervical cancer screenings in women over age 30.</p> <p>Healthy lifestyle choices and keeping screenings on the radar become paramount for women in their 40s and 50s, according to Dr. Thielen. "This is the time for women to start thinking more seriously about breast and cervical cancer — it's crucial to continue regular screenings," she says. "We also start looking more closely at the cardiovascular system, as we've learned that women can present with heart problems much differently than men." </p> <p>Finally, in those golden years of 60 to 80 years old, Dr. Thielen says women's health usually revolves around chronic conditions and their impact on daily function. "I'm a big proponent of maintaining sexual function," she says. "The Women's Health Clinic has physicians, nurses, and a certified sex therapist who work together to help women and their partners."</p> <p>Dr. Thielen sees sexual function — and many other women's health issues — as life-spanning, not limited to age groups. "The concept that sex isn't supposed to be painful or hurt, that doesn't just apply to post-menopausal women who experience dryness," she says. "Women in their 20s have similar issues. It's the same complaint, but we can offer different treatment plans."</p> <h2>The "change"</h2> <p>"If you haven't had a period for 12 consecutive months, you've reached menopause, which can occur anytime between ages 40 and 58, with 51 as the average," says Dr. Thielen. "Before that, you might have irregular periods. That's considered perimenopause.</p> <p>"During this phase in life, you're moving from a very regular cycle to a roller coaster of hormones," Dr. Thielen says. Women can expect to become more easily distracted, have minor memory issues, experience sleep disruption, experience changes in mood or ability to think clearly, and, of course, hot flashes.</p> <p>"We don't know exactly why women have hot flashes, but those warm feelings appear to be caused by the part of the brain that regulates internal body temperature," Dr. Thielen says. Tissue dilates to evaporate the heat, which makes women flushed and sweaty. Dr. Thielen says not every woman has hot flashes — up to 20% to 30% of women don't. </p> <h2>Tailored care</h2> <p>"These can be very challenging experiences, going from normal hormone levels to lacking them," says Dr. Thielen. "Women's primary care providers can help women navigate the process — whether it's menopause or something else — and educate them. A lot of women are scared needlessly. Menopause is about managing symptoms — women just need to learn about what's normal and what is not."</p> <img alt="TheMenopauseSolution" src="/-/media/national-files/images/hometown-health/2016/fall-2016/themenopausesolution.jpg?h=250&w=187&sc_lang=en&hash=3908988F14D6214B82514155BD96EE68" style="height: 250px; width: 187px; float: right; margin-bottom: 10px; margin-left: 10px;" /> <p>For more women's health resources, check out Mayo Clinic's new book, The Menopause Solution: A doctor's guide to relieving hot flashes, enjoying better sex, sleeping well, controlling your diet and being happy. This book provides the latest clinically proven information and a reference tool for women seeking answers to questions about what happens before, during and after menopause. Available at your local Mayo Clinic Store, or online at <a rel="noopener" href="http://store.mayoclinic.com" target="_blank" title="Opens in a new window">store.mayoclinic.com</a>.</p><img src="/-/media/national-files/images/hometown-health/2016/fall-2016/drthielen_lg.jpg?h=272&iar=0&w=208&sc_lang=en&hash=BB598022089FE91083E578910F8376DA" alt="DrThielen_LG" width="208" height="272" DisableNVelocity="true" />Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller3/28/2014<p>Sometime around her 51st birthday, the average woman in the U.S. will experience menopause. With the change comes a host of symptoms, including hot flashes, weight gain, bone loss, sleep disturbances, mood changes and a decreased sex drive. </p>Menopause: A natural aging process<p><img style="margin-bottom: 10px; float: right; margin-left: 10px;" alt="SWWI_DrOrders_Menopause_DrAnil_01" src="/-/media/national-files/images/hometown-health/2014/winter-2014/swwi_drorders_menopause_dranil_01.jpg?sc_lang=en&hash=ACF9CCFDEBB28A2F547176B144DE1394" />Sometime around her 51st birthday, the average woman in the U.S. will experience menopause. With the change comes a host of symptoms, including hot flashes, weight gain, bone loss, sleep disturbances, mood changes and a decreased sex drive.</p> <p>Though these symptoms can be bothersome, in most cases it’s fine to wait until your annual exam to discuss menopausal changes with your provider.</p> <p>“In general, there’s no reason to schedule a special appointment unless you’re having severe symptoms,” says Gokhan Anil, M.D., an obstetrician/gynecologist. “Extreme changes in your menstrual cycle should prompt a visit.”</p> <p>Some women also experience pelvic floor issues during menopause, such as an overactive bladder or urinary incontinence. Dr. Anil says there are many options for treating these bothersome and sometimes embarrassing problems. </p> <p>“For some women, bladder problems can be managed with lifestyle changes, such as limiting the amount of caffeine you drink or scheduling regular trips to the bathroom,” says Dr. Anil. “For other women, physical therapy or biofeedback is effective.” </p> <p>Dr. Anil says it’s important to remember that menopause is a natural part of the aging process.</p> <p>“Menopause is a normal life change, just as the start of menstruation, menstrual cycles and pregnancy are normal changes,” he says. “For many women, the best treatment for menopause is a healthy diet, regular exercise and getting enough sleep.”</p> <p>And that’s good advice for women at any stage of life.</p><ul> <li>Advanced laparoscopy and robotic surgery </li> <li>Fecal incontinence</li> <li>Minimally invasive pelvic surgery</li> <li>Overactive bladder </li> <li>Pelvic organ prolapse </li> <li> Sacral neuromodulation (Interstim) therapy</li> <li>Urinary incontinence</li> <li>Urogynecology</li> <li>Women's health</li> </ul>M.D.<p>I manage a patient-centric, collaborative practice and have a strong desire to heal and inspire hope to my patients. I strongly believe that there is no “doctor” without the “patient,” and I entrust my team to deliver the best care to meet the needs of our patients. </p> <p>In my free time, I love to travel with my family and read. I also enjoy problem solving. </p><p><strong>Medical School</strong></p> <ul> <li>University of Ankara Faculty of Medicine</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>Obstetrics & Gynecology, Baylor College of Medicine</li> <li>Obstetrics & Gynecology, West Virginia University - Charleston Division, Charleston Area Medical Center</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>American Board of Obstetrics & Gynecology (ABOG)</li> <li>Female Pelvic Medicine & Reconstructive Surgery</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Obstetrics & Gynecology, Mayo Clinic College of Medicine and Science</li> </ul>Anil<img src="/-/media/shared-files/images/medical-professionals/full/la-crosse/gokhan-anil-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=6C4C4DE9D551A107FCA92ACD73B4EA64" alt="Gokhan Anil MD" width="280" height="280" DisableNVelocity="true" /><li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.liebertpub.com/doi/abs/10.1089/gyn.2021.0041" target="_blank" title="Opens in a new window">Intraoperative Genitourinary Injuries During a Hysterectomy: Risks, Management, and Mitigation Strategies</a>, May 2021</li>{0C431270-7870-45F2-83FE-F912E09A9495}Gokhan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>14974142Gokhan Anil, M.D.1<img src="/-/media/national-files/images/hometown-health/2014/winter-2014/swwi_drorders_menopause_dranil_01_cover.jpg?h=155&iar=0&w=285&sc_lang=en&hash=08B2A3B184F87D8FA9E58FD17ECA1CF9" alt="SWWI_DrOrders_Menopause_DrAnil_01_cover" width="285" height="155" DisableNVelocity="true" />MenopauseMenopause is the permanent end of menstruation and fertility, defined as occurring 12 months after your last menstrual period.Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Dawn Haller5/10/2023If you haven't been active, or are recovering from an illness or injury, you may not feel like lacing up your shoes or going to the gym. But it may be just what you need. Get started with these tips.Need to get moving? Start slowly<p>If you haven't been active or are recovering from an illness or injury, the temptation is to do nothing. But that's probably just what you need to increase your energy, and overall physical and mental health.</p> <p>However, when you exercise, you feel less tired and stressed, and more upbeat. Even taking a 10-minute walk is a good start. You don't have to run a marathon to reap the benefits of exercise.</p> <p>How much exercise do you need? According to the <a rel="noopener" href="https://www.cdc.gov/physical-activity-basics/guidelines/adults.html" target="_blank" title="Opens in a new window.">Centers for Disease Control and Prevention</a>, adults should aim for at least 150 minutes a week of moderate-intensity activity, such as walking, swimming or mowing the lawn, or 75 minutes a week of vigorous-intensity activity, such as jogging, running, high-intensity interval training or fast bicycling. The CDC recommends you also add two or three weekly strength training sessions.</p> <p>While 150 minutes of physical activity each week sounds like a lot, you don't have to do it all at once. Spread your activity out during the week, and break those minutes into small chunks of time; for example, 30 minutes a day, five days a week.</p> <p>While it's safe for most people to begin an exercise program, if you have a chronic medical condition, such as high blood pressure, you should consult with your primary care provider before beginning to work out.</p> <h2>Low-cost workouts</h2> <h3>You don't have to join a gym to work out. Low- or no-cost options include:</h3> <ul> <li><strong>Walking</strong><br /> Stroll around your neighborhood or through the mall. Park at the back of the parking lot rather than by the door. Choose the stairs.</li> <li><strong>Clean sweep</strong><br /> Housework can do double duty if you can get your heart rate up. Mowing, shoveling and gardening count too.</li> <li><strong>Child's play</strong><br /> Engage your kids in a game of tag, a bike ride or an after-dinner dance party. Moving with your kids sets a good example for a lifetime of healthy activity.</li> </ul> <h2>Bring the gym home</h2> <p>It may be difficult to find time to exercise regularly with busy lives. Gym membership costs also may be a drawback.</p> <h3>The good news is these five inexpensive workout items can be used at home to get you started:</h3> <h4>1. Jump rope</h4> <p>Jumping rope gets your heart pumping and offers a great cardiovascular workout. When the weather is not the best for an outdoor walk or jog, a jump rope can be a great indoor option. Jumping rope can be performed by people at any fitness level.</p> <h4>2. Mat</h4> <p>Mats can protect your back and joints from hard surfaces during your workout. Mats provide a layer of cushion for floor-based exercises, such as yoga, core strengthening or a stretching cooldown after your workout.</p> <h4>3. Dumbbells</h4> <p>Dumbbells come in various weights and designs. Choose weights that offer a little challenge, and keep them handy. You could curl your way through a commercial break while watching TV or use them first thing in the morning.</p> <h4>4. Resistance bands</h4> <p>Using resistance bands can improve your strength and muscle tone. They're lightweight, take up little space and can easily travel with you for work or vacation.</p> <h4>5. Stability ball</h4> <p>This piece of equipment will strengthen your core, which is important for the health of your lower back. Stronger back and abdominal muscles also will improve your balance and stability to help you continue moving safely and confidently as you age.</p> <p>No matter what form of exercise you choose, the most important thing is to get started. Remember to focus on the process, not just the results, and be patient with yourself as you get moving.</p> <h2>Learn more about fitness options:</h2> <ul> <li>Watch a video on<a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/fitness/multimedia/fitness-ball/vid-20084753" target="_blank" title="Opens in a new window."> how to choose a fitness ball</a>.</li> <li>Try these <a href="/hometown-health/speaking-of-health/15-minute-workouts-you-can-do-at-home" target="_self" title="Opens in same window.">15-minute workouts you can do at home</a>.</li> <li>View a <a rel="noopener" href="https://www.mayoclinic.org/healthy-lifestyle/fitness/multimedia/core-strength/sls-20076330?s=1" target="_blank" title="Opens in a new window.">slideshow of core-strength exercises</a>.</li> <li>Find more ways to <a href="/topics/move-more" target="_self" title="Opens in same window.">incorporate movement</a> into your day.</li> </ul> <p><a href="/providers/chaun-cox-md" target="_self" title="Opens in same window."><em>Chaun Cox, M.D.</em></a><em>, practices <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">family medicine</a> and <a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">prenatal care</a> in <a href="/locations/mankato" target="_self" title="Opens in same window.">Mankato</a>, Minnesota.</em></p><ul> <li>Obstetrics care</li> <li>Preventive care</li> <li>Sports medicine</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>University of North Dakota School of Medicine and Health Sciences</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Family Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Cox<img src="/-/media/shared-files/images/medical-professionals/full/mankato/chaun-cox-md.jpg?h=280&iar=0&w=280&hash=12088C5D39DB7B0A98EE17EC6A4B3DFE" alt="Chaun Cox MD" width="280" height="280" DisableNVelocity="true" />{026CC400-B31B-4412-A625-1FCAFF3B3D19}Chaun<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>13518801Chaun Cox, M.D.1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{3E796B9A-C5C5-4FFB-8348-4CEA5B37F39B}<img src="/-/media/national-files/images/hometown-health/2023/runner-in-yellow-shirt.jpg?h=370&iar=0&w=660&sc_lang=en&hash=4EC71DA5E1DA75B9DA5C92DFBB511C76" alt="Runner in yellow shirt" width="660" height="370" DisableNVelocity="true" />Exercise and FitnessExercise is not just a weight-loss tool — it's an effective "medicine" for disease prevention and treatment.Learn ways to get and stay physically fitPhysical activity helps improve your cholesterol, lowers blood pressure and strengthens bones and muscles, prevents heart disease and gives you more energy. Being active and moving more is also good for your mental health and an important way for you and your family to have some fun and connect with others, too. Remember to increase your activity level gradually and check with your provider if you have any health concerns.Sports MedicineSports medicine focuses on a multidisciplinary approach to help evaluate, diagnose and treat athletes of all kinds — from high school and college team members to people with activity-related injuries.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller1/29/2015<p>For some people, there's no such thing as a good night's sleep. No matter how early they go to bed or how many times they press the snooze button, they still wake up groggy.</p>Always tired? You may have sleep apnea<p>For some people, there's no such thing as a good night's sleep. No matter how early they go to bed — or how many times they press the snooze button — they still wake up groggy.</p> <p>Sound familiar? If so, you could have sleep apnea, a potentially serious disorder in which breathing repeatedly stops and starts during sleep.</p> <img alt="DrOrders_DrDeetz_lg" src="/-/media/national-files/images/hometown-health/2015/winter-2015/drorders_drdeetz_lg.jpg?sc_lang=en&hash=1F77E7FECFC568C6FFAED6D7135B5331" /> <p>"Basically, in sleep apnea, your breathing is blocked or obstructed," says <a href="/providers/daniel-deetz-md" target="_self" title="Opens in same window.">Daniel Deetz, M.D.</a>, a pulmonologist and <a href="/services-and-treatments/neurodiagnostics" target="_self" title="Opens in same window.">sleep medicine</a> specialist. "Your muscles relax during sleep, and for some people that narrows the airway enough that it interferes with breathing."</p> <p>Loud snoring may be one indication of the condition.</p> <p>"If your spouse is elbowing you at night to get you to quit snoring, you might have sleep apnea," says Dr. Deetz. "People often come in for evaluation because of a spouse's concern about their snoring."</p> <p>Other symptoms of the disorder include sleepiness during the day, waking abruptly and short of breath, and waking up with a headache, dry mouth or sore throat. Insomnia and attention problems can also be signs. A sleep study (see sidebar) can diagnose the condition.</p> <h2>Are you at risk?</h2> <p>While anyone can develop sleep apnea, certain factors put you at greater risk.</p> <h3>Obstructive sleep apnea risk factors include:</h3> <ul> <li>Excess weight</li> <li>A thick neck</li> <li>A narrowed airway</li> <li>Being male</li> <li>Being over 60</li> <li>Family history</li> <li>Use of alcohol, sedatives or tranquilizers</li> <li>Smoking</li> <li>Nasal congestion</li> </ul> <h3>Central sleep apnea risk factors include:</h3> <ul> <li>Being male</li> <li>Being over 65</li> <li>Having a heart disorder</li> <li>Having a stroke or brain tumor</li> </ul> <p>Sleep apnea can lead to a host of serious health problems, including high blood pressure and heart problems. Fortunately, Dr. Deetz says there are good treatment options available, including continuous positive airway pressure (CPAP) and dental appliances that help keep the airway open.</p> <p>"Treating sleep apnea can lead to a huge improvement in quality of life," says Dr. Deetz. "It's great to see the change in patients."</p> <h2>What happens during a sleep study</h2> <p>During a sleep study, a technologist attaches electrodes to your body. These flat metal discs connect by wire to an electroencephalography (EEG) machine to record brain wave activity; heart and lung functions; movements of the eyes, chin, abdomen, chest and legs; and muscle activity. The technologist will monitor the information while you sleep. If sleep apnea is detected, you may be awakened and asked to try using a continuous positive airway pressure (CPAP) machine to help keep your airway open. A sleep medicine doctor will review your sleep study results and discuss treatment options, if needed.</p> <p><a href="/services-and-treatments/neurodiagnostics" target="_self" title="Opens in same window.">Schedule a sleep study today.</a></p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2015/winter-2015/drorders_drdeetz_cover.jpg?h=155&iar=0&w=285&sc_lang=en&hash=E305D1AA9C2585C4F2A72FF573A936AA" alt="DrOrders_DrDeetz_cover" width="285" height="155" DisableNVelocity="true" />SleepSleep is essential to good health. It's one of the body's basic needs. But, what do you do when you have troubles sleeping, or getting enough hours of sleep? Dawn Haller5/16/2016<p>It might take more than a catchphrase for you to plan. It's important to know all the options when end-of-life comfort for a loved one or yourself e comfort depends on it.</p>You are not alone: End-of-life care and beyond<p>There are many sayings that encourage people to think ahead, such as, "Always be prepared," or "Expect the unexpected." But it might take more than a catchphrase for you to plan. When a loved one's — or your own — end-of-life comfort depends on it, it's important to know all the options.</p> <p>"<a href="/services-and-treatments/hospice" target="_self" title="Opens in same window.">Hospice</a> is a wonderful, comprehensive care service for the later stages of life," says James Roberts, M.D., an internal medicine physician at Mayo Clinic Heath System in Eau Claire. "The goal of hospice is to help people live well in the final months of life."</p> <img alt="DrRoberts_LG" src="/-/media/national-files/images/hometown-health/2016/spring-2016/drroberts_lg.gif?h=433&w=350&sc_lang=en&hash=D98C5030FE5DC4F906662CC191EFAB72" /> <p>Hospice staff includes nurses, home health aides, social workers, therapists and chaplains, all focused on the complete needs of the patients. Dr. Roberts says hospice concentrates not only on comfort but also on nutrition, day-to-day care needs and the social, emotional and spiritual needs of both patients and families. "We keep our patients in their own homes with their families if at all possible," he says.</p> <p>Everyone will eventually face the final stages of life. The goal of hospice is to make that time pleasant, fulfilling and rewarding.</p> <h2>Coping with loss</h2> <p>"Bereavement counselors support families after the death of their loved one," says Lisa De Sieno, director of Bereavement Services at Mayo Clinic Health System in Eau Claire. "In the months after death, we offer grief support groups, counseling, ceremonies of remembrance and other resources to help families deal with their loss."</p> <p>De Sieno says some people prefer not to receive support, and that's okay as they adjust to their new chapter of life. Others find comfort in the opportunities Bereavement Services provides to honor the memory of their loved one.</p> <p>"Grief is not an illness or something that's wrong with us," says De Sieno. "It's a natural human emotion, and we're all unique in how we experience grief. There's no right or wrong way to grieve, but there's nothing wrong with reaching out for support — it's just human connection."</p> <h2>When is hospice the answer?</h2> <p>Facing a serious, life-limiting illness for the first time can be overwhelming for the patient and the entire family, especially if you don't know where to turn for answers and support.</p> <h3>Have you or your loved one:</h3> <ul> <li>Been hospitalized or gone to the Emergency Department several times in the past six months?</li> <li>Started taking medication to lessen physical pain?</li> <li>Started spending most of the day in a chair or bed?</li> <li>Fallen several times over the past six months?</li> <li>Started needing help from others with daily tasks, such as bathing and eating? </li> <li>Experienced weight loss, making clothes noticeably looser?</li> <li>Noticed shortness of breath, even while resting?</li> <li>Been told by a doctor that life expectancy is limited?</li> </ul> <p>If the answer is "yes" to any of these questions, it is worth your time to <a href="/services-and-treatments/hospice" target="_self" title="Opens in same window.">explore hospice care</a>. There are other options and resources available if hospice isn't the answer at this time. Hospice provides care wherever the patient calls home.</p><img src="/-/media/national-files/images/hometown-health/2016/spring-2016/drroberts_cover.gif?h=155&iar=0&w=285&sc_lang=en&hash=B79F8FA2B1BB20B6535C2B5457704044" alt="DrRoberts_cover" width="285" height="155" DisableNVelocity="true" />HospiceThe Hospice program believes that the highest quality of living is achieved when the family unit and Hospice team together offer hope, opportunity, support, presence, individualized care, comfort and encouragement.<br/><br/>Dawn Haller10/17/2019Taylor Sturtz, a Project Search graduate, shares how she is handling a rare genetic disorder, overcoming shyness and finding her place.Overcoming a genetic disorder, shyness and finding her place<p>You can't tell by looking at me, but I'm not a normal 20-year-old. I have a rare genetic disorder, and I have limits on what I can do physically. I have to walk a lot slower than other people my age. The disorder basically causes all my vessels to dilate, which means I'm more likely to develop aneurysms. </p> <p>Right now, I have a small aneurysm in my neck that is being watched. If it gets too big, I'll have to have surgery. I've already had to have two vessels replaced because of aneurysms. I had my descending aorta replaced when I was 15 and my ascending aorta replaced a year later. Now I take blood pressure medication to keep my blood pressure low so there's not so much stress on my vessels.</p> <p>I didn't find out about the genetic disorder until I was 13. Once we found out, I couldn't do any contact sports. When others played contact sports in gym, I had to walk around the track instead. There I was, a 13-year-old kid, and I couldn't participate with my friends. </p> <p>I had a really hard time after my first surgery. I was hospitalized for two months with tons of complications. I hated being in the hospital and just wanted to be a normal 15-year-old. When I went back to school, I had to be in a wheelchair and kids teased me about it. The teacher who helped me was not very nice. That is probably my worst memory from high school.</p> <p>When I was getting ready to graduate, one of my teachers told me about Project Search, which is an opportunity for kids 18 to 22 with learning disabilities to get job experience. He thought it would be a good fit for me. At first, I wasn't sure. I didn't like being around a lot of people. But two of my teachers encouraged me to do it, and so did my mom. So I decided to apply. The application was pretty long, and there was an interview that was kind of like a job interview. When I found out that I got accepted to the program, I was really excited because they don't take that many people. </p> <p>When I was in Project Search, I did three internships at Mayo Clinic Health System in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>. The first was in the gift shop doing customer service and handling data entry. The second was in the outpatient pharmacy doing customer service, and stocking and organizing medications. The final one was in Central Processing, which involved cleaning instruments and prepping blankets for surgery. I liked the first two the best. I found out I really like interacting with people. </p> <p>When Project Search ended in May, I started applying everywhere for a customer service job. But I really wanted to work at Mayo. Then I saw an opening at Mayo for a registration representative. I applied and got an interview. After the interview, they offered me a job on the spot. I didn't expect that. I said yes right away. I'm really proud that I was hired right away. </p> <p>I work on the Luther Campus in downtown Eau Claire. My job involves checking people in for appointments. I'm a float, so I go to different departments. I stay busy for the most part, which I like. I also really like my supervisors and co-workers. Everyone is friendly, and if I have questions or concerns, I can always talk to one of them.</p> <p>When people first get to know me, I'm quite a shy person. Project Search and my internships at Mayo really helped with that. And now my job helps me get out of my comfort zone. I work at smiling at patients, greeting them and asking them how their day is going. And I think my experience as a patient makes me more comfortable asking people for all of their information when I'm checking them in. I know it has to be done, even if patients sometimes get frustrated by having to answer the same questions. </p> <p>I have a younger sister, Maddie, who is 15. She just got diagnosed with cancer last year. She's being treated in Rochester, so my mom travels a lot to be with her. My family takes turns staying at the Ronald McDonald House to be with Maddie so my mom can work. It's hard, but Maddie is doing well. She just went on a Make-A-Wish trip to Los Angeles. I got to do a Make-A-Wish trip, too, going to Walt Disney World in Florida before my first surgery. So we have that in common. </p> <p>I try to work as much as I can to help my mom with bills. It feels good to be able to help. Since Maddie's been diagnosed, I have been thinking I would like to work in the Cancer Center someday. I think in a way I could relate to those patients. </p> <p>My family is really proud of me for working at Mayo. And I feel honored that of all the people interviewed who want to do what I'm doing, I was the one they chose. I'm honored that Mayo wants me to be part of the staff. I feel very lucky that everything has turned out the way it has.</p> <p><em>Taylor Sturtz photo courtesy of Krissie Jacobsen, M and K Photographs.</em> </p> <p><em>Editor's note: Taylor Sturtz came to Mayo Clinic Health System in Eau Claire as an intern through <a rel="noopener noreferrer" href="https://www.facebook.com/projectsearcheauclaire/" target="_blank" title="Opens in a new window.">Project Search</a>, which provides opportunities for young adults with intellectual disabilities to get work experience. Sturtz, who has a rare genetic disorder that limits her physical abilities, completed three internships through the project before she was hired full time as a patient appointment services specialist. She shares her story of making her way to Mayo Clinic Health System and the support she has received from her co-workers.</em></p><img src="/-/media/national-files/images/hometown-health/2019/taylor-sturtz.jpg?h=370&iar=0&w=657&sc_lang=en&hash=4E5F4C2A305E7610CEA75CAD7B722F4A" alt="Taylor Sturtz" width="657" height="370" DisableNVelocity="true" />Balance Your Mental and Emotional HealthEven though a small amount of stress can be good for you, multiple daily challenges can take a toll on your physical and emotional health. Stress can contribute to high blood pressure, heart disease, obesity and diabetes. To reduce stress, make time to move more, eat well, connect with others and explore new things. Making simple changes can boost your mood, help prevent long-term diseases and improve your immune system.Genetic TestingGenetic testing examines your DNA — the chemical database that carries instructions for your body's functions — to reveal changes or alterations in your genes that may cause illness or disease. <br/><br/>Dawn Haller2/3/2021High school students in Minnesota and Wisconsin can participate in virtual career exploration programs from Mayo Clinic. Here's one student's reflection on the Discover Mayo Clinic program.Virtual health career exploration program for teens<p>The COVID-19 pandemic has transitioned many educational programs from classrooms to virtual learning. Thanks to this transition, high school students across Minnesota and Wisconsin now can participate in virtual career exploration programs from Mayo Clinic.</p> <p>"Previously, these programs were held on-site in Rochester," says Brady Olson, a career awareness specialist at Mayo Clinic. "Due to COVID-19, we moved much of our programming to a virtual setting. This change allowed us to offer the opportunity to more students."</p> <p>Over 220 students completed the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://jobs.mayoclinic.org/career-awareness/in-person-student-experience-programs/" target="_blank" title="Opens in a new window.">Discover Mayo Clinic</a> virtual career exploration program in fall 2020, including four students from Fairmont High School in Minnesota. The program consists of a five-week series of sessions.</p> <p>This virtual program for high school sophomores, juniors and seniors who are interested in health-related careers is led by professionals and medical students from Mayo Clinic College of Medicine and Science School of Health Sciences.</p> <p>One participant was Sami Lenort, a Fairmont High School junior, who says she has been intrigued by a career in health care for a while.</p> <p>"I really like the idea of health care, mainly because you get to help people ― whether that is physically or mentally," says Sami.</p> <p>During the program, students learn that a career in health care could include professions beyond being a nurse or a physician. Some careers covered during the program include surgical first assistant, sports medicine, pharmacy technician, casting lab, histology and others. Sessions were held in the evenings, and students participated virtually from their homes.</p> <p>"I really liked the casting lab session. The physician assistant showed us how to put a cast on someone's arm," says Sami. "And then during the surgical skills session, they taught us how to scrub in and stitch knots. It was still interactive, even though I was at home."</p> <p>Sami says the program helped her narrow her career goals. "I want to be a nurse. I really connected with that," she says. "There is a wide range of careers, but this helped me figure out what was right for me."</p> <p>That's exactly the goal of the program, according to Brady. "It helps high school students see the multitude of careers opportunities in health care," he says. "It exposes them to different careers they may not have previously considered."</p> <p>The Discover Mayo Clinic program is an example of Mayo Clinic's commitment to equity, diversity and inclusion. As an academic medical center, Mayo Clinic expanded its recruitment programs for underrepresented medicine students to achieve diverse recruitment, support college retention and build college partnerships. Programs are for students ranging from high school to graduate medical education studies.</p> <p>Other programs for high school students include <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://college.mayo.edu/academics/diversity-and-inclusion/programs/mayo-clinic-cares/?_ga=2.126262093.1732601488.1609768399-1184036467.1609768399" target="_blank" title="Opens in a new window.">Mayo Clinic Cares</a>, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://college.mayo.edu/academics/mayo-clinic-alix-school-of-medicine/md-program/visit/" target="_blank" title="Opens in a new window.">Med School 101</a>, the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://mcforms.mayo.edu/mc0900-mc0999/mc0945-107.pdf" target="_blank" title="Opens in a new window.">Career Immersion Program</a> and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://jobs.mayoclinic.org/career-awareness/in-person-student-experience-programs/" target="_blank" title="Opens in a new window.">High School Mentorship</a>. The last of these programs introduces high school juniors and seniors to Mayo Clinic's career opportunities through hands-on experiences. The virtual mentorships vary in length, but most last a full semester.</p> <p>Another option is a 25-minute virtual career tour video that is available to schools. Without leaving the classroom, students can discover what a typical day is like, see advanced technology in action and learn what it takes to become a health care professional. This video is available to any school, regardless of physical location.</p> <p>The next Discover Mayo Clinic program session will be held in spring 2021. Information will be shared with area schools and teachers.</p> <p>When she reflects on her time in the Discover Mayo Clinic program, Sami says that it was worth it. "It was a lot of fun, and I really would recommend it."</p><img src="/-/media/national-files/images/hometown-health/2021/sami-lenort.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9983A6E51C1731B0DA2F5EC2B833F3E1" alt="Sami Lenort" width="660" height="370" DisableNVelocity="true" />Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller1/18/2022You may think of yourself as a savvy consumer, but do you know which national quality rankings to trust when comparing health care providers? Mayo Clinic quality experts offer 5 tips.5 tips for wading through hospital quality rankings, ratings<p>Many people consider themselves savvy consumers. They read product reviews before buying a new car or appliance. They watch video reviews about products, ranging from boots to cookware and tools to furniture. And they seek recommendations from friends and family when selecting services like a hairdresser or auto mechanic.</p> <p>Your approach may be similar when choosing a health care team for you and your family. Dozens of national and state accreditation and quality rankings of hospitals can provide some clarity, but the volume and complexity of these lists could lead to more confusion. How do you know what information to look for and trust when making this important decision?</p> <p><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayo.edu/research/faculty/pollock-benjamin-ben-d-ph-d-m-s/bio-20503176" target="_blank" title="Opens in a new window.">Ben Pollock, Ph.D.</a>, scientific director of the Mayo Clinic Science and Quality Measurement program, and Timothy Brennan, a Mayo Clinic quality data and analytics administrator, offer insights into Mayo Clinic's perspective on quality reporting and tips on wading through hospital rankings.</p> <h4>Mayo Clinic Value Index</h4> <p>Every organization that ranks or rates hospitals uses different methodology. Some organizations place a greater emphasis on hospital readmission, mortality or infection rates. Others lead with patient satisfaction or chronic disease management. This variability can cause the same hospital to rate high by one organization and lower by another.</p> <p>"At Mayo Clinic, we've taken an in-depth review of the rankings and ratings, and aggregated four of these that we believe use methodologies that make the most sense," explains Dr. Pollock. "Each of these tell us different things, but collectively they give us a broader view of a hospital's quality."</p> <h5>This combined view is called the Mayo Clinic Value Index, and it includes these organizations:</h5> <ul> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://health.usnews.com/best-hospitals" target="_blank" title="Opens in a new window."><strong>U.S. News & World Report</strong></a><br /> This organization reviews data from 5,000 hospitals each year and ranks them across 15 specialties and 17 procedures and conditions, subject to change in the annual rankings release. It also incorporates criteria such as the number of nurses on staff, other accreditations and peer reviews. "There's a reputational component," says Dr. Pollock. "About 30% of the score weight is what other physicians say about the hospital."</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://qualitynet.cms.gov/inpatient/public-reporting/overall-ratings" target="_blank" title="Opens in a new window."><strong>Centers for Medicare & Medicaid Services</strong></a><strong> (CMS)</strong><br /> This federal agency reviews hospital performance data to calculate overall hospital quality using the CMS Stars rating system. Key data reviewed include hospital readmission rates, patient safety, patient satisfaction, mortality, and timely and effective care.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/HospitalHCAHPS" target="_blank" title="Opens in a new window."><strong>Hospital Consumer Assessment of Healthcare Providers and Systems</strong></a><strong> (HCAHPS)</strong><br /> HCAHPS (pronounced H-Caps) measures patients' perceptions of their hospital experiences. It allows patients to compare hospitals on topics important to them, such as communication with doctors and nurses, noise level and cleanliness.</li> <li><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.leapfroggroup.org/" target="_blank" title="Opens in a new window."><strong>The Leapfrog Group</strong></a><br /> This organization uses 15 measures of publicly available hospital safety data, combined with seven additional self-reporting survey answers, to produce a patient safety score for each hospital.</li> </ul> <h3>Here are 5 tips Dr. Pollock and Brennan offer on how you can use the information when selecting a health care option for your family:</h3> <h4> 1. List what's important to you.</h4> <p>Your priorities may change based on the type of care you need. When considering primary care, you may be more concerned with how well a hospital or clinic manages chronic diseases or its patient satisfaction scores. If you need a complex heart surgery, you may be more concerned with hospital readmissions and 30-day mortality. Focus your research and attention on the rankings that highlight the elements most important to you now.</p> <h4>2. Review multiple sources.</h4> <p>Many factors go into your health care experience, ranging from cleanliness of the hospital room and communication with your provider to hospital readmission or complications after a procedure. Separating one of these metrics from the rest would not give you an accurate picture of your care.</p> <p>Likewise, focusing on only one ranking would give you an incomplete view of what to expect at a specific hospital. You will have a more accurate comparison by reviewing multiple rankings or ratings. A good place to start is the Mayo Clinic Value Index and the organizations listed there. The index features reports on differences in patient experience, safety and quality factors.</p> <h4>3. Review research critically.</h4> <p>It's important to use critical thinking skills when analyzing data, especially if it influences where you seek health care. Brennan recommends that patients review the methodology and metrics that the ranking or rating organization uses while studying if they truly lead to a positive health care experience. Finally, he recommends maintaining a questioning approach to research.</p> <p>"Double-check if something sounds almost too good to be true," Brennan says. "Health care is like comparing other things online. If it looks like a great deal, you may need to dig deeper."</p> <h4>4. Check state reporting.</h4> <p>Smaller, rural health systems may not be able to participate in national ranking programs due to the number of hospital beds or the scope of care they provide their communities. Many states, including <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://mncm.org/" target="_blank" title="Opens in a new window.">Minnesota</a> and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.wchq.org/" target="_blank" title="Opens in a new window.">Wisconsin</a>, have statewide programs where health systems report data for consumers to use.</p> <p>"These are ambulatory, population health-focused programs that focus on being transparent with primary care and chronic disease management measurements," explains Brennan. "For example, people can review how well their local health system is doing keeping patients up to date on specific screenings such as colon cancer screenings."</p> <h4>5. Talk with your primary care provider.</h4> <p>An established, trusting relationship with a primary care provider gives you and your family continuity of care. Your provider gets to know you and your medical history, and can make specialty referrals, when appropriate.</p> <p>Like a coach, your primary care provider can help coordinate care, ensure all providers are on the same page and help you understand referral options, diagnoses and treatment plans.</p> <p>Mayo Clinic Health System defines quality as a comprehensive look at all aspects of a patient's experience. We are proud of our staff for being top ranked and rated high in many quality and safety endorsements. <a href="/about-us/quality-and-safety-recognitions">Read the full list here</a>.</p><img src="/-/media/national-files/images/hometown-health/2022/looking-at-screen-cranberry-sweater.jpg?h=370&iar=0&w=660&sc_lang=en&hash=5398154A60692CDD03D782BFA1BDAB76" alt="Sitting on sofa, looking at screen, wearing a cranberry-colored sweater" width="660" height="370" DisableNVelocity="true" />Hot TopicsGet information and resources on trending healthcare topics, such as infectious diseases, seasonal safety, medications and more.Dawn Haller1/6/2014<p>Oftentimes, people forget that the relationship between a patient and their healthcare provider should be a two-way avenue. The way to obtain a good relationship isn't always clear. Here are some tips to get the most out of the patient/provider relationship.</p>How to have a healthy relationship with your healthcare provider<p>People often forget that the relationship between a patient and their healthcare provider should be a two-way avenue. Doctors can't help patients fully if they aren't given all the necessary information. They can only figure out so much from exams, and at some point, they need patients to disseminate what they're feeling. But the way to obtaining a good relationship with your healthcare provider isn't always clear.</p> <h3>Here are some tips to remember when visiting your healthcare provider:</h3> <h4>Consult your provider.</h4> <p>Health problems will come up, and when they do, it's important to consult your healthcare provider every step of the way. This means talking to them not only when the problem arises, but for follow-up information to ensure that the correct steps are being taken to solve the issue.</p> <h4>Be honest.</h4> <p>A lot of the time, healthcare providers depend on you to be as honest and specific about your health history as possible. They need this information in order to make an accurate diagnosis, so be specific and thorough when giving your provider your health history.</p> <h4>Mention your medications.</h4> <p>Be sure to be honest and specific about any and all medications you're taking. This includes over-the-counter, supplements and even herbal medications. Your provider will need to know these during the diagnosis process.</p> <h4>Take your prescriptions.</h4> <p>It's important that you take all of the prescribed medication from your provider, even of you feel better before it's gone. Your provider prescribed this amount for a specific reason, so you'll want to finish the regiment.</p> <h4>Make a list.</h4> <p>You could make a list of written questions to take to your appointment with your provider. This will ensure that you don't forget to ask about any important issues that you think of before you go in.</p> <h4>If you don't understand, ask.</h4> <p>Sometimes we have a tendency to want to avoid asking too many questions during our visits with providers because we feel we're being annoying. Providers want you to ask questions when you don't understand something- this is the only way they'll know if they need to clarify anything.</p> <h4>Follow advice.</h4> <p>If your provider gives you advice concerning your daily routines, its best to follow the advice. These things could concern nutrition or exercise or anything else. There's a reason your provider is giving you this advice, and following it will help lead you to a healthier lifestyle.</p> <h4>Go in for checkups.</h4> <p>Make sure to commit to regular checkups. What counts as "regular" depends upon your age, sex, and medical history. So consult your provider as to how often you should come in for checkups.</p> <h4>Keep open communication.</h4> <p>If a medication or treatment isn't working, make sure to talk to your provider. Having an open line of communication with your healthcare provider is extremely important to not only maintaining a healthy relationship with your healthcare provider, but also attaining your health goals.</p> <p>Maintaining a healthy relationship with your healthcare provider is extremely important. We all want to be healthy, but sickness is just a reality in life. So having a provider you're comfortable with can make all the difference.</p> <p>Healthcare providers depend on comprehensive information from patients during visits. We want to know everything. We're here to help.</p> <p><em><a href="/providers/alan-conway" target="_self" title="Opens in same window.">Alan Conway, M.D.</a>, is a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em></p><ul> <li>Dermatology</li> <li>Orthopedics</li> <li>Weight loss</li> </ul>M.D. <p>I want to help you live your best life, with a focus on disease prevention and treatment as well as symptom management.</p> <p>I enjoy spending time with my family and playing golf and pickleball.</p> <p><strong>Education</strong></p> <ul> <li>University of Illinois College of Medicine</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Family Medicine, Martin Army Community Hospital</li> </ul> <p><strong>Certification</strong></p> <ul> <li>American Board of Family Medicine</li> </ul> <p><strong>Membership</strong></p> <ul> <li>American Academy of Family Practice</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Instructor in Family Medicine, Mayo Clinic College of Medicine and Science</li> </ul> Conway<img src="/-/media/shared-files/images/medical-professionals/full/tomah/alan-conway-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=9AA9749A8064F3DB5F3BFF37D223FF95" alt="Alan Conway MD" width="280" height="280" DisableNVelocity="true" /> Alan<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>15949125Alan Conway, M.D. 1{B3F96F77-F93E-41A4-AE4E-603045CDB443}|{94B2E140-AEF8-44BA-B6A9-4538B77501BC}|{EAC4F099-8A2B-4C7A-8911-5AF0769EADA7}|{DEF55970-853F-4E96-9A4D-3413874FF059}<img src="/-/media/national-files/images/hometown-health/2014/relationship_final_web.jpg?h=149&iar=0&w=200&sc_lang=en&hash=94F2CCDFB392E20BBE093C79E9DE57A7" alt="relationship_final_web" width="200" height="149" DisableNVelocity="true" />Women's Health<p>Our multidisciplinary healthcare professionals can offer answers, hope and healing for your women’s health issues. We'll ensure you feel heard, have a plan for your well-being and are confident in your ability to live a healthy life.</p><br/><h2>We offer these women's health services:</h2><br/><ul><li><a href="/services-and-treatments/birthing-centers" target="_self" title="Opens in same window.">Birthing Centers</a></li><br/><li><a href="/services-and-treatments/breast-cancer-care" target="_self" title="Opens in same window.">Breast Cancer Care</a></li><br/><li><a href="/services-and-treatments/reproductive-endocrinology" target="_self" title="Opens in same window.">Fertility</a></li><br/><li><a href="/services-and-treatments/mammography" target="_self" title="Opens in same window.">Mammography</a></li><br/><li><a href="/services-and-treatments/midwifery" target="_self" title="Opens in same window.">Midwifery</a></li><br/><li><a href="/services-and-treatments/obstetrics-and-gynecology" target="_self" title="Opens in same window.">OB-GYN</a></li><br/><li><a href="/services-and-treatments/prenatal-care" target="_self" title="Opens in same window.">Prenatal Care</a></li>Men's HealthDo you know the top men's health threats? The list is surprisingly short — including heart disease, cancer and unintentional injury. Thankfully, most men's health threats are largely preventable.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller5/29/2023An experienced nurse shares why the relationship, teamwork and trust formed with patients through the cancer journey sets oncology nursing apart from other health care roles.The oncology nurse and teamwork<p><em>Editor's note: This post originally published on March 14, 2014.</em></p> <p>The day you enter the cancer center as a patient with cancer or a family member of the patient starting treatment, one of the first people you will meet is your oncology nurse. This relationship is one where the trust needs to form almost immediately.</p> <p>From the patient's perspective, there is a flood of emotions and fear going through their mind, and the nurse will try to break down those barriers and make that person or family feel as comfortable as possible.</p> <h2>Achieving a common goal through teamwork</h2> <p>Teamwork often is defined as a cooperative effort of a group of people to achieve a common goal. The oncology nurse and patient with cancer relationship involves working together to get through chemotherapy treatments and beyond while collaborating closely with the physician. The patient wants to feel comfortable, understand what will happen, learn about the chemotherapy drugs, manage side effects and understand how this treatment will impact their lives.</p> <p>From the moment the nurse and patient meet, the nurse begins to focus on doing all these things well. The nurse wants to build that relationship to be a resource to the patient, helping with education and support throughout this journey. This newly formed relationship is one where teamwork is essential from that first meeting.</p> <h2>Oncology nursing as a specialty</h2> <p>What training goes into becoming an oncology nurse? Oncology nurses are licensed registered nurses who obtain certification in chemotherapy and biotherapy courses, and undergo orientation within that specialty, sometimes for up to a year. Some oncology nurses obtain national certification in adult or pediatric oncology nursing. This certification validates a person's specialized knowledge in cancer nursing and may or may not be a requirement to work in a cancer center.</p> <p>When I was in nurse's training, I saw many different specialties of nursing. But in this area of nursing, I noticed something extraordinary. The oncology nurses were great at working together — I was drawn to their teamwork mentality. They also work closely with staff from several other specialty departments. The resources and collaboration among this multispecialty team allow us to provide optimal care to cancer patients.</p> <p>I cannot tell you how often people ask me what I do for a living, and I tell them I am an oncology nurse. The typical response I receive is, "That takes such a special person to do that." This is a wonderful compliment. However, I feel like I am the one that is blessed. It is a gift to be able to help another person during a difficult time, even if it is simply providing laughter to brighten someone's day, explaining a drug so that it is better understood or holding a patient's hand for comfort. Oncology patients have taught me what it is to have true strength.</p> <h2>Read more:</h2> <ul> <li><a href="/hometown-health/speaking-of-health/advanced-care-at-home-bringing-comfort" target="_self" title="Opens in same window.">Mayo Clinic Advanced Care at Home bringing comfort, joy</a></li> <li><a href="/hometown-health" target="_self" title="Opens in same window.">Nurse educator becomes patient, gives caregivers A+</a></li> <li>One last adventure for patient entering hospice</li> <li><a href="/services-and-treatments/oncology" target="_self" title="Opens in same window.">The Survivor Bell</a></li> </ul> <p><em>By Kathryn Sullivan, R.N.</em></p><img src="/-/media/national-files/images/hometown-health/2023/person-wearing-head-covering.jpg?h=370&iar=0&w=660&sc_lang=en&hash=B440EC6ABE111FD951F5C973FD39E4E1" alt="Person wearing head covering" width="660" height="370" DisableNVelocity="true" />CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Dawn Haller9/17/2024For the Pillers, the choice for seeking healthcare is easy: drive 20 miles or just a few minutes to the Mayo Clinic Health System Mobile Health Clinic. Read why the whole family makes this choice.Making the Mobile Health Clinic the go-to choice for care<p>When Kathy, Nathan and Alexander Piller need treatment for an illness or injury, a check-up, blood work, vaccination or connection to a specialist they can:</p> <p><strong>A:</strong> Drive nearly 20 miles to a Mayo Clinic Health System clinic in either Owatonna or Austin, Minnesota.</p> <p><strong>B:</strong> Find care at the big, blue Mobile Health Clinic, parked right in their hometown of Blooming Prairie, Minnesota.</p> <p>"B" is the easy choice for the Pillers, who have made the Mobile Health Clinic their go-to choice for everyday healthcare.</p> <p>"As soon as the Mobile Health Clinic began coming to Blooming Prairie, we've been using it for our healthcare," says Kathy. "It's close, convenient, easy to get into for an appointment and just like going to the clinic. You can even do a video visit with Emily."</p> <p>Emily is <a href="/providers/emily-majerus-pa" target="_self" title="Opens in same window.">Emily Majerus</a>, a Family Medicine physician assistant at <a href="/locations/austin" target="_self" title="Opens in same window.">Mayo Clinic Health System in Austin</a>, Minnesota.</p> <h2>Bringing healthcare to patients' doorsteps</h2> <p>"I've always been focused on opportunities to create access to care, especially in these small communities. Essentially, we're traveling to people's doorsteps and providing high-quality, patient-centered care," says Emily.</p> <p>"Patient compliance increases when you make care so convenient. I can see patients on Tuesday and follow up with them on Thursday. It's a lot easier to come back for a blood pressure check when you're only five to 10 minutes away."</p> <p>Majerus adds that although she can see her Blooming Prairie patients in Austin, many wait until the Mobile Health Clinic comes to town.</p> <p>"The mobile clinic functions like my brick-and-mortar clinic in Austin. It just has more wheels and windows," she says.</p> <h2>Keeping young adults connected</h2> <p>For the Pillers, the Mobile Health Clinic is a family affair. Kathy, a special education teacher and volunteer emergency medical technician, and Nathan, who teaches art, are joined in their regular use of the Mobile Health Clinic by their son, Alexander, a 21-year-old electrician.</p> <p>When Alexander moved away for six months, he continued his healthcare with Emily via video visits. After moving back to Blooming Prairie, he switched back to in-person visits.</p> <p>"Having a touch point that's local is a real bonus for ensuring continuity of care, especially in Alex's age group," Emily says. "It's hard for these young adults to take off work, and it's easy for them to lose their <a href="/hometown-health/speaking-of-health/3-reasons-young-men-need-a-primary-care-provider" target="_self" title="Opens in same window.">connection to regular healthcare</a>. Alex has stayed plugged in for medicine checks, acute care, <a href="/hometown-health/speaking-of-health/even-grown-ups-needs-vaccinations" target="_self" title="Opens in same window.">vaccinations</a> and more through the Mobile Health Clinic."</p> <p>Kathy adds that the Mobile Health Clinic is a benefit for patients of all ages.</p> <p>"Because it's in town, it benefits everyone, especially the older people," she says. "They can get their care right here, and the Mobile Health Clinic is accessible for all patients."</p> <h2>About the Mobile Health Clinic</h2> <p>The Mobile Health Clinic provides year-round preventive health screenings, chronic disease management and telehealth to connect patients to Mayo Clinic Health System healthcare professionals.</p> <p>Services include:</p> <ul> <li>Acute illness and infection</li> <li>Anticoagulation and international normalized ratio, or INR, checks</li> <li>Chronic disease follow-ups</li> <li>Immunizations</li> <li>Pediatrics</li> <li>Preventive services</li> <li>Sprains and fractures (casting or imaging done at standard clinics)</li> <li>Wellness visits</li> <li>Virtual pacemaker checks</li> <li>Virtual specialty consults</li> </ul> <p>The Mobile Health Clinic regularly visits <a href="/locations/blooming-prairie" target="_self" title="Opens in same window.">Blooming Prairie</a>, <a href="/locations/butterfield" target="_self" title="Opens in same window.">Butterfield</a> and <a href="/locations/sherburn" target="_self" title="Opens in same window.">Sherburn</a>, Minnesota.</p> <p>Learn more about the <a href="/services-and-treatments/mobile-health-clinic" target="_self" title="Opens in same window.">Mobile Health Clinic</a> and <a rel="noopener" href="https://my.matterport.com/show/?m=Yggq8SgXX1q" target="_blank" title="Opens in a new window.">take a virtual tour</a>.</p><img src="/-/media/national-files/images/hometown-health/2024/piller-family.jpg?h=370&iar=0&w=660&sc_lang=en&hash=E064CCB4E84A8E54026251EA54868C65" alt="Piller family" width="660" height="370" DisableNVelocity="true" />Transforming HealthcareExpert insight into using innovative technology to identify trends and develop procedures, diagnostics and next-generation care models to advance medicine, and provide healing today and in the future.Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.TelemedicineTelemedicine uses the latest research and technology for diagnosis and treatment to minimize time and travel costs, making it easier for you to get the care you need.Dawn Haller1/20/2023Lung cancer is the No. 1 cause of cancer deaths in the U.S. A new procedure acts like a robotic GPS system to diagnose lung cancer in its earliest stages when it's easier to treat.Using robotic technology to diagnose, stage lung cancer<p>Lung cancer is the second most common cancer and the No. 1 cause of cancer deaths worldwide. In 2022, about 236,000 people were diagnosed with lung cancer, and about 130,000 people died from the disease in the U.S.</p> <p>Lung cancer doesn't always cause symptoms in its earliest stages. More than half of people with the disease die within a year of being diagnosed. That's why early screening and treatment of lung cancer are critical.</p> <p>A new medical technology called robotic-assisted bronchoscopy acts like a robotic GPS to diagnose lung cancer at its earliest stages when it's easier to treat and cure.</p> <h2>What is robotic-assisted bronchoscopy?</h2> <p>Your lungs have a complex, interwoven network of airway passages. This includes your bronchial tubes, bronchi, bronchioles and alveoli. Nodules are tiny abnormal growths in the lungs and are potentially cancerous. A sample, called a biopsy, is collected from the nodule to diagnose and stage lung cancer.</p> <p>During a bronchoscopy, a thin tube is passed through the nose or mouth into the lungs. There is a light at the end of the tube, and the physician uses it to examine abnormal areas of the lungs. The scope used during a standard bronchoscopy cannot reach all areas of the lungs because it's too big or inflexible to navigate the narrow airways.</p> <p>Robotic-assisted bronchoscopy uses a smaller and more flexible scope that can get into tiny airways. The patient receives an anesthetic while the physician moves the small scope into the lung using a game controller-like device. The physician can examine the lungs, reach targets set through a CT scan and precisely collect tissue biopsies in or near the airway that may be lung cancer.</p> <h2>What are the benefits of robotic-assisted bronchoscopy?</h2> <h3>Benefits of robotic-assisted bronchoscopy include:</h3> <ul> <li>It's a minimally invasive procedure with no incisions and lower risk of complications. The procedure usually is completed as an outpatient day procedure, and patients can return to daily activities quickly with little or no restrictions.</li> <li>Patients need only one procedure and anesthetic to receive a diagnosis and stage of the disease. This decreases the time from diagnosis to treatment so patients can receive the care they need faster.</li> <li>The procedure can access lung nodules that previously required more invasive biopsy techniques or even surgery. As part of a multicenter trial, Mayo Clinic found that 98% of lung nodules can be reached even when touching critical organs like the heart.</li> <li>Finally, robotic-assisted bronchoscopy offers better precision and control for physicians to biopsy tissue in or near the airway. The robot has greater flexibility and range of motion compared to human hands. This is less disruptive to adjoining tissue and leads to fewer complications.</li> </ul> <h2>Looking ahead</h2> <p>Mayo Clinic scientists are exploring new ways to use robotic-assisted bronchoscopy to treat nodules and eliminate lung cancer. This could be done by locating and removing nodules at one time, or through delivering medications, like chemotherapy or engineered biotherapies, directly to the cancerous area.</p> <h3>Watch this video to learn more about robotic-assisted bronchoscopy:</h3> <p class="video-container"><iframe width="560" height="315" loading="lazy" src="https://www.youtube.com/embed/6LjsitcJwgs" title="Robotic-assisted bronchoscopy" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen="1"></iframe></p> <p>Talk with your health care team if you have any <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/diseases-conditions/lung-cancer/symptoms-causes/syc-20374620" target="_blank" title="Opens in a new window.">symptoms of lung cancer</a>, like a new cough that doesn't subside, changes in chronic cough, shortness of breath or coughing up blood. Then ask a pulmonologist or oncologist if robotic-assisted bronchoscopy is right for you.</p> <p><a href="/providers/adel-zurob-md" target="_self" title="Opens in same window."><em>Adel Zurob, M.D.</em></a><em>, and <a href="/providers/ali-zaied-md" target="_self" title="Opens in same window.">Ali Zaied, M.D.</a>, are <a href="/services-and-treatments/pulmonology" target="_self" title="Opens in same window.">pulmonologists</a> and <a href="/services-and-treatments/intensive-and-critical-care" target="_self" title="Opens in same window.">intensivists</a> in <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Eau Claire</a>, Wisconsin.</em> </p><ul> <li>Benign lung mass</li> <li>Endobronchial ultrasound (EBUS) bronchoscopy</li> <li>Lung cancer screening and lung cancer</li> <li>Lung infections</li> <li>Lung nodule</li> <li>Robotic-assisted bronchoscopy</li> </ul>M.D.<p><strong>Education</strong></p> <ul> <li>Royal College of Surgeons in Ireland</li> </ul> <p><strong>Residency</strong></p> <ul> <li>Internal Medicine, Hennepin County Medical Center</li> </ul> <p><strong>Fellowships</strong></p> <ul> <li>Critical Care, Hennepin County Medical Center</li> <li>Pulmonary and Critical Care, Mayo Clinic School of Graduate Medical Education </li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Critical Care Medicine, American Board of Internal Medicine</li> <li>Internal Medicine, American Board of Internal Medicine</li> <li>Pulmonary Disease, American Board of Internal Medicine</li> <li>Sleep Medicine, American Board of Internal Medicine</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Zurob<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/adel-zurob-md.jpg?h=280&iar=0&w=280&sc_lang=en&hash=4F488251E19AB50F2EAFA5781196B8D5" alt="Adel Zurob, M.D." width="280" height="280" title="Adel Zurob, M.D." DisableNVelocity="true" />{C1312EB5-B95A-46A2-B44B-B0A767DFDBCC}Adel<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>11787384Adel Zurob, M.D.1{B98A8ABA-9382-4804-A585-EA5B53B1D179}<ul> <li>Acute respiratory distress syndrome management</li> <li>Asthma</li> <li>Benign lung mass</li> <li>Chronic cough</li> <li>Critical care ultrasound</li> <li>Endobronchial ultrasound (EBUS) bronchoscopy</li> <li>Lung cancer screening and lung cancer</li> <li>Lung infections</li> <li>Lung nodule</li> <li>Pulmonary hypertension</li> <li>Robotic-assisted bronchoscopy</li> </ul>M.D.<p>I believe it is critical that patients are involved in all aspects of health care decision-making, and their needs will come before everything else. I hope that patients will find that I am passionate about their care and view me as a friend as we move through their journey to health.</p> <p>In my free time, I enjoy hiking, playing soccer and spending time with family.</p><p><strong>Education</strong></p> <ul> <li>University of Jordan in Amman</li> </ul> <p><strong>Residencies</strong></p> <ul> <li>Internal Medicine, King Hussein Cancer Center</li> <li>Internal Medicine, University of Texas Medical Branch-Galveston</li> </ul> <p><strong>Fellowship</strong></p> <ul> <li>Pulmonary and Critical Care Medicine, Mayo Clinic School of Graduate Medical Education</li> </ul> <p><strong>Certifications</strong></p> <ul> <li>Pulmonary Disease, American Board of Internal Medicine</li> <li>Pulmonary Disease, American Board of Medical Quality</li> </ul> <p><strong>Academic Appointment</strong></p> <ul> <li>Assistant Professor of Medicine, Mayo Clinic College of Medicine and Science</li> </ul>Zaied<img src="/-/media/shared-files/images/medical-professionals/full/eau-claire/ali-zaied-md.JPG?h=280&iar=0&w=280&sc_lang=en&hash=7291FA714A60574F195E6EBFC31C6E52" alt="Ali Zaied, M.D." width="280" height="280" DisableNVelocity="true" />{65E1B297-8127-4877-863E-295726AC6ECB}Ali<a target="_blank" rel="noopener noreferrer" href="http://" DisableNVelocity="true">Mayo Clinic Profile</a>16200039Ali Zaied, M.D.1{1D6651B0-86E1-4FF6-9A93-07B8EE2D26EE}<img src="/-/media/national-files/images/hometown-health/2023/person-outside-wearing-nasal-cannula.jpg?h=370&iar=0&w=660&sc_lang=en&hash=90E1A234743F72CB02A28873BB8E320C" alt="Person outside wearing nasal cannula" width="660" height="370" DisableNVelocity="true" />Transforming HealthcareExpert insight into using innovative technology to identify trends and develop procedures, diagnostics and next-generation care models to advance medicine, and provide healing today and in the future.Lung CancerLung cancer is a type of cancer that begins in the lungs. It is the leading cause of cancer deaths in the U.S., among both men and women. Lung cancer claims more lives each year than do colon, prostate, ovarian and breast cancers combined. <br/><br/>PulmonologyTreatment for diseases and conditions affecting lung and airway function.BreathingMost cases of shortness of breath are due to heart or lung conditions. Your heart and lungs are involved in transporting oxygen to your tissues and removing carbon dioxide, and problems with either of these processes affect your breathing.Dawn Haller4/6/2023Patients with rash symptoms now can request an on-demand video appointment using the patient portal. Here's how Matt Gauthier used it to quickly get care he needed without leaving home.From Check Symptoms to video visit in one step<p>Check Symptoms, part of Mayo Clinic's <a href="/patient-online-services" target="_self" title="Opens in same window.">patient portal</a>, is a free online symptom assessment that can be completed 24/7/365. A new feature offers patients with rash-related symptoms an on-demand video appointment with a primary care clinician during business hours. This is a convenient option for patients who need care today, but whose situations may not warrant a trip to Urgent Care or the Emergency Department.</p> <h2>Same-day need</h2> <p>Just ask one of the first patients to use this feature: Matt Gauthier of Byron, Minnesota. In January, the busy 57-year-old woke up covered in an itchy rash.</p> <p> "I couldn't figure out what had happened," he says. "I've never had anything like this before, and I didn't want to wait to be seen."</p> <p>He called the <a href="/services-and-treatments/nurse-line" target="_self" title="Opens in same window.">Mayo Clinic Primary Care Nurse Triage</a> and was connected to Tina Oian, a triage nurse.</p> <p>"We had just started a pilot program in Check Symptoms," she says. "If patients were calling with rash symptoms like Matt was, we would encourage them to complete the online Check Symptoms assessment tool and choose the new on-demand video appointment option. The timing was perfect for Matt to do just that."</p> <p>After asking a few questions to make sure Matt wasn't in a life-threatening situation, Tina explained how to use Check Symptoms in the patient portal and choose the on-demand video appointment option. Matt was happy to give it a try.</p> <p>"I used my iPad to fill in the questions and request the appointment," he says. "I'm used to doing video work calls and other things like this all the time. It was really easy."</p> <h2>The patient will see you now</h2> <p>The process worked quickly and efficiently for Matt. He completed the request form around 8 a.m. and soon was connected with <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://communityhealth.mayoclinic.org/providers/jennifer-hartman-md" target="_blank" title="Opens in a new window.">Jennifer Hartman, M.D.</a>, a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician.</p> <p>"<a href="/services-and-treatments/primary-care" target="_self" title="Opens in same window.">Primary Care</a> and the triage nursing staff work together to ensure the right patient gets the right level of care with the right provider at the right time," says Dr. Hartman. "The goal of the on-demand video appointments is that patients can be seen within 10–15 minutes."</p> <p>Dr. Hartman assessed Matt's symptoms and recommended over-the-counter treatments to soothe his rash. While not needed at this appointment, providers also can prescribe medications during a video appointment.</p> <p>"It worked awesome," Matt says. "I didn't have to drive anywhere, which was good because I was feeling pretty uncomfortable at that point."</p> <p>The entire process, from Matt completing the online form to the conclusion of Dr. Hartman's notes in his health record, took about 35 minutes.</p> <p>Soon, Matt was feeling better, and the rash went away.</p> <p>"We figured it was because I used a new lotion after showering. Needless to say, I threw that bottle out," he says with a laugh.</p> <h2>Innovation focus</h2> <p>Matt's appointment and many others like it are the result of Mayo Clinic's focus on innovation, Dr. Hartman says.</p> <p>"These types of advancements give us the tools to put patients' needs first," she says. "They also empower patients to take charge of their care and when they are seen. It's like saying 'The patient will see you now' to the health care team."</p> <p>Patients with rash symptoms who use Check Symptoms on weekdays during business hours can select the on-demand video appointment option.</p> <h2>Additional symptoms added soon</h2> <p>While on-demand video appointments currently are available only for rash-related symptoms, more symptoms will be added later.</p> <p>Patients can use Check Symptoms to evaluate other symptoms. The portal feature provides self-care instructions based on Mayo Clinic's educational content, or the opportunities to talk with an experienced triage nurse or schedule an appointment.</p> <h3>Multiple symptoms can be assessed, such as: </h3> <ul> <li>Anal or rectal concerns</li> <li>Back pain</li> <li>Bug bites and insect stings</li> <li>Digestive concerns, including diarrhea, constipation, nausea and vomiting</li> <li>Ear or hearing concerns</li> <li>Genital problems</li> <li>Mood concerns due to depression or anxiety</li> <li>Mouth problems</li> <li>Pain or injury to a hand, arm, foot, ankle or knee</li> <li>Pink eye</li> <li>Respiratory illnesses, such as COVID-19, RSV and influenza</li> <li>Sexually transmitted diseases or infections</li> <li>Sore throat</li> <li>Stomach pain</li> <li>Stuffy or runny nose</li> <li>Urinary pain</li> <li>Vaginal bleeding or menstrual concerns</li> <li>Wounds, such as cuts and scrapes, or wound healing</li> </ul> <p>Check Symptoms is available to patients who have a home address in Arizona, Iowa, Minnesota or Wisconsin and who have a Mayo Clinic primary care clinician.</p> <p> You can easily <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://signup.mayoclinic.org/?applicationId=6fd03569-c4c9-439c-bbcb-931305671b6d" target="_blank" title="Opens in a new window.">create a patient portal account</a> if you don't have one. You also can download the Mayo Clinic App from the Apple and Google Play app stores.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2023/matt-gauthier.jpg?h=370&iar=0&w=660&sc_lang=en&hash=9C4232B2D7E2277E53EF047850796238" alt="Matt Gauthier" width="660" height="370" DisableNVelocity="true" />Get Tools to Live Your HealthiestIt’s never too early — or too late — to plan ahead for health. By making preventive care for you and your family a healthy habit, you’ll help improve your well-being. Be sure to connect with your healthcare provider to discuss any further questions that you may have about your health.Transforming HealthcareExpert insight into using innovative technology to identify trends and develop procedures, diagnostics and next-generation care models to advance medicine, and provide healing today and in the future.Patient PortalStaying engaged in your healthcare is important. The patient portal is a free, secure and convenient online resource that connects you to your healthcare team and helps you manage your health from the comfort of your home or anywhere else.Dawn Haller10/4/2023From prenatal blood pressure checks to well-child visits to stubborn ear infections, three busy moms rely on close-to-home care at the Mobile Health Clinic.Timesaver for busy moms: Mobile Health Clinic<p>Between them, Katie Wencl, her sister, Megan Katcher, and Rachel Blaedorn have six children ranging in age from 9 months to 9 years. In addition to managing busy family schedules, all three women work outside the home,.so they're always looking for ways to save time and reduce stress for themselves and their kids.</p> <p>One of those time and sanity savers has been the <a href="/services-and-treatments/mobile-health-clinic" target="_self" title="Opens in same window.">Mobile Health Clinic</a>, which visits their hometown of <a href="/locations/blooming-prairie/services-and-treatments/mobile-health-clinic" target="_self" title="Opens in same window.">Blooming Prairie</a>, Minnesota, every other week on Tuesdays and Thursdays.</p> <h2>Prenatal care just minutes from home</h2> <p>When Katie was pregnant with her third son, she needed regular blood pressure checks. She usually would drive the 30 minutes to <a href="/locations/owatonna" target="_self" title="Opens in same window.">Mayo Clinic Health System in Owatonna</a>, Minnesota, for the short appointment, then drive home.</p> <p>"I learned that the Mobile Health Clinic was being scheduled for Blooming Prairie and really wanted to support it, so I started getting my blood pressure checks there," Katie says. "It was so convenient and just a 10-minute drive away."</p> <img height="225" alt="Wencl family" width="325" src="/-/media/national-files/images/hometown-health/2023/wencl.jpg?h=225&w=325&sc_lang=en&hash=714A4938E6D5302A9508CB9444B39B5B" style="height: 225px; width: 325px;" /> <p>Now, Katie takes her kids there for well-child visits, vaccinations and acute illness testing like strep throat swabs.</p> <p>"It's great not having to take several hours out of my day to go to Owatonna," she says. "It seems like the Mobile Health Clinic can always fit us in."</p> <h2>Nearby well-child care, support for mom</h2> <p>Megan's first child was born in 2021 at <a href="/locations/austin" target="_self" title="Opens in same window.">Mayo Clinic Health System in Austin</a>, Minnesota, and she regularly took him to the clinic there. But things didn't go smoothly on the day of Jetson's 3-month checkup. Megan wasn't fully recovered from an illness, she was running a bit behind and then the baby threw up in his car seat. By the time she'd cleaned him up and made the 20-minute drive to Austin, she'd missed the appointment.</p> <p>"I was upset and emotional, so I called my sister Katie," Megan recalls. "She told me the Mobile Health Clinic was in town that day, so I drove over, knocked on the door and they fit me. Jetson and I were in and out of the clinic in less than 30 minutes. Before I left, I scheduled his 6-month checkup.</p> <p>"They were so nice, understanding and helpful to me as a new mom," she adds.</p> <p>Now Megan takes not only Jetson, but also his 1-year-old sister, Camille, to the Mobile Health Clinic for their routine checkups and acute care.</p> <p>"I've really lucked out," she says. "Every time the kids have gotten sick, the Mobile Health Clinic is in town. I feel it's less stressful for the two littles to go to a smaller clinic. We don't have a big drive — the Mobile Health Clinic is just five minutes from their day care — and we can get ice cream afterward."</p> <p>Megan considers <a href="/providers/emily-majerus-pa" target="_self" title="Opens in same window.">Emily Majerus</a>, a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> physician assistant who provides care at the Mobile Health Clinic, an empathetic listener and knowledgeable source of answers to questions about the children's health and well-being.</p> <p>"I'm so grateful that she comes to our community," Megan says.</p> <p>Emily says that a significant benefit for families is that they can schedule back-to-back appointments and bring several family members in all at once.</p> <p>"Sometimes I'll see the children, then Mom and Dad too," she adds. "It really reduces the strain of coordinating appointments at a brick-and-mortar clinic."</p> <h2>Treatment for a baby's recurring ear infections</h2> <p>Rachel and her husband's first Thanksgiving with their new baby, Beckham, was spent coping with his ear infections, which plagued him throughout the winter. Fortunately, the Mobile Health Clinic was in town that week, and they were able to take him there for treatment.</p> <p>"Every time his ear infections flared up, we would drive to Owatonna, but getting care in our town easily saved an hour," Rachel says.</p> <img height="225" alt="Blaedorn family" width="325" src="/-/media/national-files/images/hometown-health/2023/blaedorn-family.jpg?sc_lang=en&hash=9F31A1956169FEF8F046FA1C4A5A0BAB" /> <p>Emily says that having Beckham seen in the mobile clinic as soon as Rachel and her husband noticed symptoms avoided delays in his treatment. Between Thanksgiving 2021 and February 2022, Rachel made six visits to the Mobile Health Clinic for Beckham's care.</p> <p>When oral medications weren't effective, Emily prescribed a series of shots that had to be given three days in a row.</p> <p>"I was so thankful that we could schedule the first and third shots in Blooming Prairie and only had to drive to Owatonna once," Rachel says.</p> <p>Emily adds that when she started the more specialized treatment, she was able to keep an eye on how he was progressing. "I know that having quick follow-up helped cut down on Rachel's stress and anxiety."</p> <p>"I felt like we had a good experience every time," Rachel says. "I liked that the same people were always there, which was nice because they were familiar with Beckham's situation and I didn't have to keep telling the story over and over. And for me as a new mom, they were so understanding."</p> <h2>Supporting busy moms and more</h2> <p>The Mobile Health Clinic offers a full spectrum of primary care for preventive and acute conditions, and a broad range of specialty services in person and via telehealth. Emily says having the clinic regularly visit a community provides continuity of care and helps ease access for those patients with various mobility issues.</p> <p>"When we're right on their doorstep, it encourages people to seek care," Emily says. "We have people walk or ride their bikes to the clinic all the time."</p><img src="/-/media/national-files/images/hometown-health/2023/mobile-clinic-family.jpg?h=370&iar=0&w=660&sc_lang=en&hash=7D8972DA07E0A7D2F80650DD7BEAFB7F" alt="Mobile clinic family" width="660" height="370" DisableNVelocity="true" />Family MedicineCare for children and adults of all ages including annual exams, well-child visits, diagnostics, screenings and referrals.Dawn Haller1/17/2022College student Lucas Anderson found that using Patient Online Services on the Mayo Clinic App made it easy for him manage his health care.Mayo Clinic App makes managing health care a breeze<p>Lucas Anderson has a few things going on in his life that make time and convenience precious commodities for him.</p> <p><img alt="Lucas Anderson" src="/-/media/national-files/images/hometown-health/2022/lucas-anderson.jpg?h=100&w=100&sc_lang=en&hash=FA45B084C3DB8C0B66B7F3EA0842D6BE" style="width: 100px; height: 100px; float: right; margin-bottom: 5px; margin-left: 5px;" />Lucas, a student at Rochester Community and Technical College and a member of the college's baseball team, was named to the Minnesota College Athletic Conference 2021 Spring All-Academic team. As a Mayo Clinic Health System patient, he finds <a href="/patient-online-services" target="_self" title="Opens in same window.">Patient Online Services</a> on the Mayo Clinic App to be a valuable tool to manage his health care through his hectic schedule.</p> <p>"The app is easy to use," he says. "If there's something I can do on my own, I'll use the app."</p> <p>When he developed COVID-19 symptoms and needed to schedule a test, he turned to the app to set up the appointment.</p> <p><img alt="Mayo Clinic app online scheduling" src="/-/media/national-files/images/hometown-health/2022/mayo-clinic-app-online-scheduling.jpg?h=330&w=350&sc_lang=en&hash=A8F88FCACECC67603243DF0AEFA3D8FC" style="border:1px solid #000000;height: 330px; width: 350px; float: right; margin-bottom: 5px; margin-left: 5px;" />"I logged in, clicked on 'COVID-19' and set up the appointments," says Lucas. "Pretty simple. I just followed the steps of what to do."</p> <p>When he told his mother about his scheduled appointment, she had some good advice to help his appointment go smoother.</p> <p>"She told me to use PreCheck-In so I could get right into my appointment when I arrived," he says. "I logged in and clicked on PreCheck-In, right by my appointment, and answered a couple of questions. Easy."</p> <p>Once Lucas was done with the test, he was eager to get his results. The app came in handy once again.</p> <p>"I checked about every couple of hours, and then I got the email that said my results were in," he says. "So I hit the link and checked my results."</p> <p>Thankfully, the results were negative.</p> <p>Lucas also has found that the Mayo Clinic App made it a breeze for him to show proof of COVID-19 vaccination.</p> <p>"I needed to show vaccination proof a couple of times, and the app made that pretty simple," he says. "I didn't have to look for the slip of paper or the card — just showed the proof on my phone. I always have my phone, so I always have my proof."</p> <p>He says that he'll continue to use the app to schedule other appointments.</p> <p>"The app is easy to use, easy to navigate," he says. "Anytime I need to do something on my own at Mayo, I use the app. It's easy to pull it up and check what I need to do."</p> <p>"It's this kind of feedback from patients that lets us know our work is having a positive impact," says <a href="/providers/gokhan-anil-md" target="_self" title="Opens in same window.">Gokhan Anil, M.D.</a>, regional chair of Practice for Mayo Clinic Health System in Southwest Minnesota. "This digital connection through the app and Patient Online Services is an integral part of how we interact with patients. We'll continue to work to ensure that these connection points are accessible to patients and keep them digitally engaged in their care."</p><img src="/-/media/national-files/images/hometown-health/2022/hands-using-cellphone.jpg?h=370&iar=0&w=660&sc_lang=en&hash=26DD1E86209070B4ED64487F88579605" alt="Hands using cellphone" width="660" height="370" DisableNVelocity="true" />Transforming HealthcareExpert insight into using innovative technology to identify trends and develop procedures, diagnostics and next-generation care models to advance medicine, and provide healing today and in the future.COVID-19Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, such as MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). Coronaviruses are transmitted between animals and people. The new strain is called COVID-19 acute respiratory disease (novel coronavirus),COVID-19 VaccineVaccines help your body build up the ability to fight off a virus. A vaccine may not prevent you from getting the COVID-19 virus. But if you do get it, the vaccination may keep you from becoming seriously ill. Or it may keep you from developing complications due to the illness. Dawn Haller2/21/2022When Robert Heintz was scheduled for hip revision surgery, he was happy to learn he could recover in the comfort of his own home.Back on the bandstand: Feeling better with <em>Mayo Clinic</em> Advanced Care at Home<p>Robert Heintz of Chippewa Falls, Wisconsin, is no stranger to hospitals. Born with a congenital hip defect, he has had several hip surgeries over the years, beginning as a toddler.</p> <p>When Robert was scheduled for hip revision surgery at <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Mayo Clinic Health System in Eau Claire</a>, Wisconsin, in 2021, he was happy to learn he could complete his recovery at home with the <strong>Mayo Clinic</strong> Advanced Care at Home Program.</p> <h4>Hitch in his stride</h4> <p>Robert, 66, who teaches business classes at a university and moonlights as the leader of a popular big band called Troppo, had been using a cane to walk for several years. Dealing with his hip issues was causing pain in other areas, as well.</p> <p>"I had neck issues, back issues, knee issues," Robert says. "I was wearing a knee brace. It got more painful. It became more difficult to walk." The pain also made it hard to put the energy he liked into teaching, performing and directing. Robert says in early 2021, he decided he could not put off another surgery any longer.</p> <p>Robert made an appointment with <a href="/providers/jonathan-webb-md" target="_self" title="Opens in same window.">Jonathan Webb, M.D</a>., an <a href="/services-and-treatments/orthopedic-surgery" target="_self" title="Opens in same window.">orthopedic surgeon</a> at Mayo Clinic Health System in Eau Claire. Dr. Webb determined Robert's previous hip replacement surgery from years prior had failed, and Robert required two operations to fully treat his hip condition.</p> <p>The first procedure would be to remove his prior implants and place temporary ones. This would be followed by a second more complicated procedure to place permanent implants that would provide Robert with a stable and functional leg to rely on.</p> <p>Dr. Webb thought Robert would be a good candidate for <strong>Mayo Clinic</strong> Advanced Care at Home, which was launched at Mayo Clinic Health System in Northwest Wisconsin in 2020. The program is also offered at <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/patient-visitor-guide/arizona" target="_blank" title="Opens in a new window.">Mayo Clinic in Arizona</a> and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mayoclinic.org/patient-visitor-guide/florida" target="_blank" title="Opens in a new window.">Mayo Clinic in Florida</a>.</p> <p>The program allows patients with conditions previously managed in a hospital to have the option to transition to a home setting. There they can receive compassionate, high-quality care and recovery services ― both in person and virtual. While the program at Mayo Clinic Health System in Northwest Wisconsin initially was offered to medical patients, it recently expanded to include surgical patients.</p> <p>"It helps to be in a familiar space during recovery," says Dr. Webb. "If we can provide the care that people need after surgery and allow them to be in the space that they know with the people they love, I think it does a lot for their psyche and helps them to get through the toughness of a big operation."</p> <p>"I was thinking, 'This is fantastic,'" Robert says. "I had good experiences at Mayo. We can continue this. And I don't have to be in the hospital, but I get most of the benefits of it. I thought, 'Yeah, absolutely.'"</p> <p>Dr. Webb says that while the COVID-19 pandemic was not the reason the program was created, providing care in patients' homes has helped free up resources needed for other patients.</p> <p>"We have had limited bed space during the recent surges," Dr. Webb says. "Utilizing a patient's home to provide the acute care they need right after surgery in a way that is safe for them has been a great resource for us."</p> <p>Robert spent one night in the hospital, but many patients can go home from the recovery room.</p> <h4>Home sweet home</h4> <p>Robert says he was impressed with the seamless process of being transported home and having the necessary equipment set up.</p> <p>"That's what was really impressive and enjoyable," Robert says. "From the time I left the hospital, there were no worries, no drops in the system. In about an hour, I was home, and set up with all the equipment and pill dispensary."</p> <p>Robert says he was happy to be home with his wife, Melyssa Heintz.</p> <p>"My family was excited. My dogs were excited to see me home," Robert says. "Getting back to a comfortable environment, sleeping in my own bed, being able to have visitors, that's what it was about for me."</p> <p>Robert says he felt well taken care of during his time in the program. The first two days were the acute phase of care. That's when his care team visited his home daily. The latter part of his care was the restorative phase. That's when he received multiple visits per week to check the wound, draw blood and perform physical therapy. He also received check-ins twice daily by video.</p> <p>"I felt safe at home," Robert says. "I could immediately talk to somebody 24 hours a day on video by iPad or by phone. After we had tornadoes in the area one night, one of the nurses at the command center in Florida called to make sure we were OK."</p> <p>Paramedics are also on call to respond in case of an emergency.</p> <h4>Back on the bandstand</h4> <p>Robert completed his four-week <strong>Mayo Clinic</strong> Advanced Care at Home Program shortly before Christmas 2021, and he was back in front of the big band for their annual New Year's Eve dance. He was in a wheelchair for the performance, but he looks forward to standing up soon, directing the band and playing trumpet solos.</p> <p>"I'm feeling great," Robert says. "I'm very hopeful that I can move to the next phase. Everything is going well."</p> <p>Participation in <strong>Mayo Clinic</strong> Advanced Care at Home is voluntary for eligible patients. Dr. Webb says it is a decision a patient should make with their care team.</p> <p>"Getting feedback from patients like Robert has influenced me to discuss this with more patients," Dr. Webb says. "I think this will only continue to grow."</p><img src="/-/media/national-files/images/hometown-health/2022/robert-heinz.jpg?h=370&iar=0&w=660&sc_lang=en&hash=84EAAB42BA859F1E492E0730F5DD89B2" alt="Robert Heinz" width="660" height="370" DisableNVelocity="true" />Orthopedic HealthGet resources related to orthopedics, including surgery, podiatry, joint replacements, sports medicine, broken bones, and sprains and strains.Transforming HealthcareExpert insight into using innovative technology to identify trends and develop procedures, diagnostics and next-generation care models to advance medicine, and provide healing today and in the future.Dawn Haller2/21/2022In the eight years that Prathibha Varkey, M.B.B.S., was away from Mayo Clinic, a few things changed. But one thing remained a constant: Mayo Clinic's patient-focused mission. Read her vision for transforming rural health care while building on past successes.Home again, leader finds fit in community, Mayo Clinic Health System<p>Prathibha Varkey, M.B.B.S., always knew she'd be a doctor. It runs in the family.</p> <p>Both her mother and father were physicians in her hometown of Kerala, India. And each morning, the Varkey family — Prathibha, her parents and two older sisters — gathered at 5:30 a.m. at the dining table. Her father believed it was important to have family meals together. So the Varkey family congregated in the pre-dawn hour before he headed to the hospital as the chair of Vascular Surgery. Prathibha's mother served as chair of Biochemistry before retraining to become a family medicine physician in her late 50s.</p> <p>Those conversations shaped Prathibha, who felt called to help others on their journeys of illness and healing.</p> <p>"I have not thought of any career other than medicine," she says, reflecting back. "Since I was 5, I've dreamed about being part of the broader family of physicians."</p> <p>She chuckles remembering the time when she was 8 and made her first diagnosis — a minor fungal infection that her mother then confirmed.</p> <h4>A servant leader</h4> <p>Driven to find answers, Prathibha became Dr. Varkey by completing medical school in India followed by an internal medicine residency at what is now known as the Yale New Haven Hospital Saint Raphael Campus in Connecticut, and a preventive medicine fellowship at Mayo Clinic. She also earned master's degrees from the Harvard School of Public Health, the University of Illinois Chicago and the University of Minnesota at different points throughout her career.</p> <p>In 2002, she joined Mayo Clinic as a member of the Department of Medicine in Rochester, Minnesota. She spearheaded the department's efforts in faculty development, led several programs in medical education and served as the president of the American College of Medical Quality.</p> <p>She left in 2013 to become president and CEO of Seton Clinical Enterprise in Austin, Texas, and subsequently, president and CEO of the Northeast Medical Group at Yale New Haven Health.</p> <p>In August 2021, Dr. Varkey rejoined Mayo as the president of Mayo Clinic Health System. In this role, she partners with Mary Jo Williamson, chief administrative officer of Mayo Clinic Health System, to lead 16 hospitals and 46 community clinics across Iowa, Minnesota and Wisconsin.</p> <p>"For me, this was a return back home to Mayo Clinic," Dr. Varkey says. "I've always admired and learned from the relentless pursuit of excellence that is the hallmark of Mayo Clinic, and it is an honor to be part of the Mayo family again."</p> <h4>Leading through values</h4> <p>Mayo Clinic's transformational vision inspires Dr. Varkey.</p> <p>The energetic focus on going beyond excellence and creating the next generation of health care shows up in Mayo Clinic's digital health efforts, platform opportunities and artificial intelligence innovations.</p> <p>After seven years away, Dr. Varkey appreciates Mayo remaining a patient-centered organization.</p> <p>"What sets Mayo apart is our culture. It's our relentless focus on excellence, but also our relentless focus on patient care — we keep that ahead of everything else," she says. "And that truly frees us up to focus on the right things, to have the right discussions at leadership levels, as well as on the front line, about doing what's best for our patients. This is what really sets Mayo apart. It's that simple and powerful."</p> <h4>A lot to look forward to</h4> <p>Dr. Varkey recognizes an opportunity for Mayo to enhance community health care into a category of one as Mayo Clinic Health System enacts its "Bold. Forward." strategy.</p> <p>Her vision includes further establishing Mayo Clinic Health System as the leader in transforming rural and population health and building on partnerships with communities, academia, businesses and payers.</p> <p>Dr. Varkey points to new programs and innovations that have been successfully piloted at Mayo Clinic Health System locations.</p> <p>In 2021, for example, Mayo Clinic Health System added mobile clinics in its Minnesota communities. This brought both primary and specialty care to patients in outlying communities and integrated advancements in digital health with in-person visits. These efforts are especially beneficial in communities where there is limited access to health care.</p> <p>Additionally, <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Mayo Clinic Health System in Eau Claire</a>, Wisconsin, was an early adopter of <strong>Mayo Clinic</strong> Advanced Care at Home, a new care model that delivers innovative, comprehensive and complex care to patients who would otherwise be admitted to the hospital — all from the comfort of home via a new technology platform.</p> <p>Projects such as <strong>Mayo Clinic</strong> Advanced Care at Home as well as integrating artificial intelligence to transform the clinical practice and becoming a hub for community-based education and research represent a slice of the potential that excites Dr. Varkey.</p> <p>She sees the Mayo Clinic Health System of the future as a leading-edge, cost-effective and sustainable health care organization.</p> <p>"Our family’s mission and the way I was raised was to create sustainable change in the communities where we live," Dr. Varkey says. "That is at the core of who I am as a person and as a leader."</p> <h4>A new routine</h4> <p>Now back in Minnesota, Dr. Varkey is settling into her new routine, along with her husband and baby daughter who played a large role in the decision to rejoin Mayo Clinic. She and her husband see the benefits of raising their daughter in the Midwest and the strong communities anchored there.</p> <p>Still a morning person, Dr. Varkey now starts her days early with meditation. She also uses those early quiet hours to review strategies and priorities and think about key connections she wants to make in the day ahead.</p> <p>During these times of reflection, she considers a rock that sits on her desk, known as mookaite. It was a memento gifted to her from fellow hikers on a trip to New Zealand that represents strength amid change and transformation.</p> <p>And it's the opportunity to change and transform health care that brought her back to Mayo Clinic.</p> <p>"Health care is not so much a career, but a calling for me," Dr. Varkey says. "It's an honor and a humbling experience to be part of the health care transformation journey at Mayo Clinic Health System."</p><img src="/-/media/national-files/images/hometown-health/2022/prathibha-varkey.jpg?h=370&iar=0&w=660&sc_lang=en&hash=2A5085F1BCAC7E1372BC4C0D3144A356" alt="Prathibha Varkey, M.B.B.S." width="660" height="370" DisableNVelocity="true" />Transforming HealthcareExpert insight into using innovative technology to identify trends and develop procedures, diagnostics and next-generation care models to advance medicine, and provide healing today and in the future.Dawn Haller2/24/2022It's a bus, it's a bookmobile, it's the Mobile Health Clinic. Since summer 2021, this big, blue, fully equipped clinic on wheels has been bringing health care to patients in rural communities.Mobile Health Clinic drives care access<p>It's a bus, it's a bookmobile, it's the Mayo Clinic Health System Mobile Health Clinic. Since summer 2021, this big, blue, fully equipped clinic on wheels has been bringing health care to patients where they are.</p> <p>One of those patients is June Axelson, who at 90 no longer drives. But when the clinic visits Kenyon, Minnesota, it parks just two blocks from her home.</p> <p>"I thought I'd try the mobile clinic because I was getting dizzy, and it was so handy," June says. "I talked with Lynsi, and she adjusted my medications. She was so down-to-earth and easy to talk to."</p> <p>Lynsi is Lynsi Romportl, a <a href="/services-and-treatments/family-medicine" target="_self" title="Opens in same window.">Family Medicine</a> nurse practitioner at <a href="/locations/owatonna" target="_self" title="Opens in same window.">Mayo Clinic Health System in Owatonna</a>, Minnesota. When she learned the mobile clinic was looking for staff, she volunteered to become part of this new way to deliver health care.</p> <p>"The biggest thing is that the mobile clinic reduces barriers to care," she says. "Patients like June aren't faced with arranging transportation to our clinics in Faribault or Owatonna and spending up to half a day for something as simple as a blood draw. Also, it's really nice for patients to have one provider and one team to work with. I get to know them, and they get to know me."</p> <p><img alt="Herb Castle" src="/-/media/national-files/images/hometown-health/2022/herb-castle.jpg?h=169&w=250&sc_lang=en&hash=406A0E90B94DCAE52144D84A58388A1A" style="width: 250px; height: 169px; float: right; margin-bottom: 5px; margin-left: 5px;">Herb Castle is another of Lynsi's patients, and he credits her with helping him get his Type 2 diabetes under control. "I couldn't believe it when I was diagnosed, so I went into denial. But Dr. Lynsi convinced me this wasn't something I could ignore. I really credit her communication and follow-up with bringing down my A1C levels."</p> <p>Whenever the mobile clinic is in Kenyon, Castle can walk a couple of blocks for blood tests and to go over his medications with Lynsi rather than driving 20 minutes to Faribault, Minnesota. "What's not to love about it?" he says.</p> <p>Not only does the Mobile Health Clinic serve Kenyon, it also stops regularly in nearby Blooming Prairie, Minnesota. That's been a plus for Allan Benson.</p> <p>"We no longer have a clinic here, and it's a 20-mile drive to Owatonna," he says. "I've had a great experience with the Mobile Health Clinic. Emily has a great style, is very engaging, really listens to you and asks good questions." Emily is <a href="/providers/emily-majerus-pa" target="_self" title="Opens in same window.">Emily Majerus</a>, a Family Medicine physician assistant at <a href="/locations/austin" target="_self" title="Opens in same window.">Mayo Clinic Health System in Austin</a>, Minnesota.</p> <p>"I've always been focused on opportunities to create access to care, especially in these small communities. Essentially, we're traveling to people's doorsteps and providing high-quality, patient-centered care," says Majerus. "Patient compliance increases when you make care so convenient. I can see them on Tuesday and follow up with them on Thursday.</p> <p>"The mobile clinic functions just like my brick-and-mortar clinic in Austin. It just has more wheels and windows."</p> <h4>About the Mobile Health Clinic</h4> <p>The Mobile Health Clinic provides year-round preventive health screenings, chronic disease management and telehealth to connect patients to Mayo Clinic Health System health care professionals. Plans call for more advanced telehealth care.</p> <h5>Services include:</h5> <ul> <li>Acute illness and infection</li> <li>Anticoagulation and international normalized ratio, or INR, checks</li> <li>Chronic disease checks</li> <li>Immunizations</li> <li>Pediatrics</li> <li>Preventive services</li> <li>Sprains and fractures (casting or imaging done at standard clinics)</li> <li>Wellness visits</li> <li>Virtual pacemaker checks and specialty consults</li> </ul> <p>The Mobile Health Clinic regularly visits <a href="/locations/blooming-prairie" target="_self" title="Opens in same window.">Blooming Prairie</a>, <a href="/locations/butterfield" target="_self">Butterfield</a> and <a href="/locations/sherburn" target="_self" title="Opens in same window.">Sherburn</a>, Minnesota.</p> <p>Learn more about the <a href="/services-and-treatments/mobile-health-clinic" target="_self" title="Opens in same window.">Mobile Health Clinic</a>, and <a rel="noopener noreferrer" href="https://my.matterport.com/show/?m=Yggq8SgXX1q" target="_blank" title="Opens in a new window.">take a virtual tour</a>.</p><img src="/-/media/national-files/images/hometown-health/2022/mobile-health-clinic.jpg?h=370&iar=0&w=660&sc_lang=en&hash=8421C969A71E0D7500084912D3F77804" alt="Mobile Health Clinic" width="660" height="370" DisableNVelocity="true" />Transforming HealthcareExpert insight into using innovative technology to identify trends and develop procedures, diagnostics and next-generation care models to advance medicine, and provide healing today and in the future.Dawn Haller11/1/2022The COVID-19 pandemic and increased internet access changed how you shop, travel, work and access health care. Learn how telehealth options like virtual visits are used to help people with cancer.Virtual care for people with cancer<p>The internet, COVID-19 pandemic and increased access to smartphones and laptops has changed the way people shop, bank, travel and work. It also has changed how people manage their health care.</p> <p>Telehealth, including telemedicine and virtual visits, uses digital information and communication technologies to access health care services remotely and manage your health care. It's often thought of as remote communication or monitoring between a health care team and the patient or caregiver.</p> <h2>Asynchronous and synchronous communication</h2> <p>Some interactions are asynchronous, meaning communication that doesn't happen at the same time. For example, a patient sends a message through an online portal and the health care team responds at a different time. Or a patient completing an online survey about symptoms to update the health care team.</p> <p>Remote monitoring, which is asynchronous technology that collects and reports temperature, weight and other vital signs, allows the health care team to check a patient's status without a visit to a health care facility. Any identified problems are usually addressed quickly.</p> <p>In contrast to these examples are synchronous interactions, in which the patient and health care team communicate in real time. A telephone conversation is synchronous communication and an important part of a health care journey. Virtual visits use online technology to allow the patient and team to see and hear each other in real time. These synchronous communication telehealth options extend health care to meet patient needs.</p> <p>Telehealth options are available for general health care, acute needs or specific conditions. Virtual visits became common because of the needs of the COVID-19 pandemic. Two years later, oncology professionals recommend telehealth interactions when appropriate for the patient or the caregiving team.</p> <h2>Telehealth and cancer care</h2> <p>For many people with cancer or malignant diagnosis, telehealth has become an important part of their care. It may be appropriate for medical oncology, hematology, consultations, second opinion consultations and surgical consultations.</p> <p>Many patients use portal online messages throughout their cancer journeys to communicate medication side effects, changes in condition or send questions to the health care team. Other common telehealth options during cancer care are virtual visits and telephone conversations. These extend care and options for patients, regardless of geography. Occasionally, remote monitoring is part of cancer treatment plans as well.</p> <p>Some appointments and treatments cannot be conducted virtually. The health care team recommends in-person or virtual visits based on the needs and treatment plan for each patient.</p> <h2>Telehealth benefits</h2> <h3>There are multiple benefits of telehealth for all patients, but especially for people with a chronic or complex health condition, such as cancer, including:</h3> <ul> <li><strong>Greater access<br /> </strong>Telehealth can bring cancer experts to people who live in remote communities. It can provide people with choices to meet with specialists who don't live where they do, especially when they are seeking a second opinion on a complex cancer diagnosis. Patients who don't have good access to devices or internet may be able to participate in virtual appointments by using cancer center clinic resources and assistance.</li> <li><strong>Reduced travel time and expense<br /> </strong>Cancer care requires many appointments, and patients often travel significant distances to receive the care they need. Some appointments, especially consultations or general checkups, can be completed virtually. This reduces travel time and expense for the patient and family. Not every appointment can be conducted using telehealth but saving travel expenses a few times can make a significant difference. </li> <li><strong>Larger support network<br /> </strong>Most of the time, patients who receive care in Oncology attend visits with a family member or other support person. Virtual visits allow remote family members to participate in important conversations, ask questions and lend support, regardless if they live across the street or across the country. </li> <li><strong>Improved energy<br /> </strong>Gearing up to travel to and from an appointment can be a challenge, especially if a person is experiencing severe fatigue due to cancer treatment. Participating in virtual visits can be less draining and preserves energy for recovery.</li> <li><strong>Improved safety<br /> </strong>Hospitals and clinics are safe to visit and receive care. However, traveling to and from appointments does increase a person's exposure to infectious diseases in the community, such as influenza and COVID-19. Mobility and falls are concerns for some people. Remaining at home to receive care can keep the person safe.</li> </ul> <p>There are limitations to telehealth. Sometimes technology doesn't work as well as designed. It's important to have a plan with your health care team to call on the telephone if there is an issue connecting to a virtual visit.</p> <p>Some people have no or limited internet access and may have to travel to a local clinic to participate in a virtual visit with specialized providers at other sites. Others don't have or don't feel confident using a mobile device or may need to have an exam done in person. Telehealth may not be appropriate for these patients. However, it's an important tool to have that can extend options for care.</p> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/virtual-care-on-cellphone.jpg?h=370&iar=0&w=660&sc_lang=en&hash=F5AEFEE33069331EF4DB3A05EC9307AC" alt="Virtual care on cellphone" width="660" height="370" DisableNVelocity="true" />CancerCancer is the second-leading cause of death in the U.S. However, survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.Transforming HealthcareExpert insight into using innovative technology to identify trends and develop procedures, diagnostics and next-generation care models to advance medicine, and provide healing today and in the future.Dawn Haller9/17/2025Here's a day in the life of this special therapy dog. Maisy is a great addition to a team. She is calm, empathetic and creates joy everywhere she goes. She also happens to be a golden retriever.Wagging tail, puppy eyes bring comfort<p>A new staff member at Mayo Clinic Health System in Mankato has many qualities that make her an asset to the team. She is compassionate, tender, empathetic and brings a smile to everyone she meets. She also happens to be 4 years old and a golden retriever.</p> <p>Meet Maisy, a new therapy dog that helps patients feel more at ease during their visits and spreads joy to staff. She's assisted by her handler and owner, <a href="/providers/meghan-murphy-md" target="_self" title="Opens in same window.">Meghan E. Murphy, M.D.</a>, a Mayo Clinic Health System neurosurgeon.</p> <p>"I wanted a family dog and always wanted a golden retriever that was good with my kids," explains Dr. Murphy. "Maisy has the perfect demeanor for a therapy dog."</p> <p>Dr. Murphy began bringing Maisy to the clinic during the COVID-19 pandemic as part of the Joy Canine program for staff. Maisy would sit under her desk while Dr. Murphy conducted video visits with patients. </p> <p>"It was really uplifting for staff during a stressful time," she says. "They started looking for her, and it was nice to see how much joy she brought to the doctors, nurses, schedulers and team. People were just happier when she was around."</p> <p>Over time, the duo completed the necessary training, and Maisy earned her certification as a therapy dog. She was able to start interacting with patients in September 2022.</p> <p>"Maisy is unflappable and calm," says Dr. Murphy. "She's not too eager about initiating contact, which is helpful as a therapy dog. She waits for my prompting or for the patient to reach out to her."</p> <p>Maisy spends most Fridays in the clinic and hospital, and visits patients, staff and volunteers. On a recent day, she and Dr. Murphy were busy across the clinic and hospital.</p> <p>In the early morning, Dr. Murphy had a virtual meeting, so Maisy relaxed with a nap under her desk. Then it was time for Maisy to greet the staff. She made a quick trip down the hall to get a treat from one of the Mayo Clinic Health System surgeons and plenty of belly rubs from the nurses in the Neurosurgery Department. A quick trip to the Orthopedics Department helped that team start their Friday on a positive note as well. The hospital coffee shop team, Kelsey and Courtney, treated Maisy to a pup cup, and she got to visit with staff and patients in the first-floor atrium.</p> <p>A hospice nurse contacted Dr. Murphy to ask if Maisy could visit a patient in the hospital. The family was worried that the patient wouldn't be able to return home and wanted to make his time in the hospital more comfortable.</p> <p>Back at the clinic, a young patient with painful nerve damage had an appointment with Dr. Murphy, and Maisy tagged along.</p> <img alt="Pet therapy dog Maisy" src="/-/media/national-files/images/hometown-health/2022/pet-therapy-dog-maisy-2.jpg?h=250&w=250&sc_lang=en&hash=01661B217D622DEBC604B1720F3AB701" style="height: 250px; width: 250px; float: right; margin-bottom: 5px; margin-left: 5px;" /> <p>"I feel like she senses who is suffering," says Dr. Murphy. "She went straight up to the patient and put her head on her lap to calm her. Later she laid down next to the patient, and I was so proud of her."</p> <p>In the afternoon, Maisy's comforting manner helped soothe a family that received news about a serious brain tumor and a mother concerned about her child. She finished her day in the hospital, spending time with a patient who was missing his dog. It was the perfect way to wrap up a busy day at work.</p> <p>"Maisy is a wonderful dog that brings other people joy in hard times, whether it be in their work or in their illness. It's fun for me to see how she interacts with people," says Dr. Murphy. "We all need more love in our day, and Maisy brings love and joy to all she meets."</p> <h4>Learn more about pet therapy:</h4> <ul> <li>Learn more about<a href="/volunteer" target="_self" title="Opens in same window."> becoming a Mayo Clinic Health System volunteer</a>, including pet therapy. </li> <li>Read about <a href="/hometown-health/speaking-of-health/a-day-in-the-life-of-luna-a-facility-dog" target="_self" title="Opens in same window.">a day in the life of Luna, a facility dog</a>.</li> <li>Meet <a rel="noopener" href="https://intheloop.mayoclinic.org/2019/01/10/piper-the-therapy-dog-with-three-legs-and-a-nose-for-healing/" target="_blank" title="Opens in a new window.">Piper, the therapy dog with three legs and a nose for healing</a>.</li> </ul> <p><em>By Mayo Clinic Health System staff</em></p><img src="/-/media/national-files/images/hometown-health/2022/pet-therapy-dog.jpg?h=370&iar=0&w=660&sc_lang=en&hash=DD240C90AFABA85F84ECEB266E70CC26" alt="Pet therapy dog" width="660" height="370" DisableNVelocity="true" />Transforming HealthcareExpert insight into using innovative technology to identify trends and develop procedures, diagnostics and next-generation care models to advance medicine, and provide healing today and in the future.Dawn Haller10/5/2021Video appointments, a form of telehealth, are seeing more use during the COVID-19 pandemic. Read about one patient's first video appointment experience her advice for other patients.Care around the kitchen table, thanks to video appointment<p>Telehealth is an important way of delivering healthcare to patients, regardless of where they live. Video appointments are a form of telehealth that are seeing more use during the COVID-19 pandemic.</p> <p>Video appointments are conducted using communication software accessible through the patient portal. This software complies with the Health Insurance Portability and Accountability Act. Using this software, patients log in to the portal, and in a few clicks, are connected to their healthcare provider for a video appointment on the patient's tablet or mobile device. It's like a home visit in the 21st century.</p> <h2>Sue's experience</h2> <p><img alt="Sue Jaeger" src="/-/media/national-files/images/hometown-health/2021/sue-jaeger.jpg?h=291&w=300&sc_lang=en&hash=0C310FF1B5F61C34E5BD38944ECB29A4" style="width: 300px; height: 291px; float: right; margin-bottom: 5px; margin-left: 5px;" />One patient benefitting from the use of video appointments is Sue Jaeger of Austin, Minnesota. Sue had her first video appointment in August, and she found the experience to be surprisingly comfortable and personable.</p> <p>Sue was scheduled to have a biopsy of a nodule on her thyroid gland and was anxious about how soon she would get the results. Her care team contacted her about a video appointment consultation with <a href="/providers/sumit-bhagra-md" target="_self" title="Opens in same window.">Sumit Bhagra, M.D.</a>, a Mayo Clinic Health System <a href="/services-and-treatments/endocrinology" target="_self" title="Opens in same window.">endocrinologist</a> who cares for patients in <a href="/locations/albert-lea" target="_self" title="Opens in same window.">Albert Lea</a> and <a href="/locations/austin" target="_self" title="Opens in same window.">Austin</a>, Minnesota.</p> <p>"They asked if I had used Zoom before and sent me a link through the portal," says the 67-year-old retired telecommunications professional. "I've used Zoom and Facebook Messenger before, and this system was like those. There was a phone number that I could call if I had trouble. It was really easy to set up."</p> <p>Sue's biopsy was scheduled on a Thursday afternoon, and she would be able to see the results in her portal account over the weekend. Dr. Bhagra was seeing patients in Albert Lea that day and would not have been able to discuss the biopsy with Sue in person until the following Monday or Tuesday.</p> <p>"To allay the anxiety of this disconnect, we sequenced the appointment so she got the biopsy done and saw me the following morning through a video appointment," says Dr. Bhagra, who also is the site lead physician at Mayo Clinic Health System in Albert Lea and Austin.</p> <p>During her appointment, Sue and her husband, Dan Jaeger, sat at their kitchen table while discussing her thyroid and biopsy with Dr. Bhagra. Even though he was in his Albert Lea office 20 miles away, Sue was surprised at how connected she felt to Dr. Bhagra.</p> <p>"It felt like he was sitting across the table from us," she says. "It was really comfortable."</p> <p>During her appointment, Dr. Bhagra had good news for Sue: The nodule on her thyroid was not cancerous. Overall, Sue says she is happy with her video appointment experience and offers advice to other patients.</p> <p>"Don't be afraid of it, even if you don't have a technical background. There is always a phone number that you can call if you get stuck," she says. "During my appointment, it felt like he was sitting across the desk. I felt much better after my call."</p> <h2>Video appointment benefits</h2> <p>Video appointments bring healthcare closer to home, increase convenience, lower patient anxiety and provide insight into a patient's home environment. The appointments are less disruptive for patients and allow them to spend more time living life and less time commuting and waiting to be seen by healthcare providers.</p> <p>"These digital pipelines, such as video appointments, allow people to live their lives with minimal disruption from the work of being a patient," says Dr. Bhagra. "Patients with chronic disease typically require periodic appointments, blood tests and imaging studies, and each touch point requires an individual to block a chunk of time away from life or work to accomplish these tasks. The convenience of video appointments decreases the disruption on patients' lives from chronic diseases. Visits that took two to three hours from the time the patient left their home to the time they return from the appointment are done in 30 minutes or less. This is one of the ways by which technology can make care more accessible and less burdensome."</p> <p>Video appointments are time efficient and don't require travel, allowing patients with busy schedules or limited availability of transportation or impaired mobility able to integrate their healthcare needs with their unique circumstances.</p> <p>A benefit that may be less apparent is the reduction in anxiety about the appointment.</p> <p>"We know that video visits work really well in a mental health setting," says Dr. Bhagra. "Some people have a lot of anxiety about meeting a stranger face to face. Others have anxiety about new places, driving, parking, waiting, etc. The telemedicine piece just takes these concerns away."</p> <h2>Bright future</h2> <p>Dr. Bhagra explains that telemedicine technology also allows healthcare providers to remotely monitor specific patient's health conditions, such as heart failure, cardiac rhythm abnormalities or diabetes.</p> <p>Widespread use of video appointments was accelerated due to the COVID-19 pandemic, but the technology was in use long before that.</p> <p>"Mayo is at the forefront of innovation, and our Bold. Forward. 2030 plan paved the way for success," says Dr. Bhagra. "We were ready with these solutions, even prior to the challenges of COVID-19, and shall continue to innovate going forward."</p> <h2>Learn more about video appointments:</h2> <ul> <li><a href="/hometown-health/featured-topic/faq-video-appointments-and-your-security" target="_self" title="Opens in same window.">FAQ: Video appointments and your security</a></li> <li><a href="/hometown-health/featured-topic/6-tips-for-making-the-most-of-your-video-appointment" target="_self" title="Opens in same window.">6 tips for making the most of your healthcare video appointment</a></li> <li><a href="/video-appointment-instructions" target="_self" title="Opens in same window.">Video appointment instructions</a></li> </ul><img src="/-/media/national-files/images/hometown-health/2021/video-appointment-dr-bhagra.jpg?h=370&iar=0&w=660&sc_lang=en&hash=395F3EB1F9DC2CB0735B7CB3A2857514" alt="Video appointment with Dr. Bhagra" width="660" height="370" DisableNVelocity="true" />Transforming HealthcareExpert insight into using innovative technology to identify trends and develop procedures, diagnostics and next-generation care models to advance medicine, and provide healing today and in the future.Thyroid HealthThe thyroid is a gland at the base of your neck. This important part of your body produces hormones that regulate blood pressure, body temperature, heart rate and weight. When your thyroid has problems, many aspects of your well-being can be negatively impacted. Learn more about the thyroid here.Dawn Haller11/1/2021Some people may not know they have atrial fibrillation, while others have life-altering symptoms. New advanced treatment options help keep the heart in normal rhythm and reduce the risk of stroke.Transforming heart care with advanced treatment for atrial fibrillation<p>Some people may not know they have atrial fibrillation until their condition is discovered during a physical examination. For others, atrial fibrillation can have life-altering symptoms that affect their ability to perform daily activities.</p> <p><a href="/hometown-health/speaking-of-health/is-it-love-or-atrial-fibrillation" target="_self" title="Opens in same window.">Atrial fibrillation</a> is a common type of heart rhythm disorder where the heart doesn't beat efficiently. This makes the heart unable to pump enough blood out to the body with each heartbeat.</p> <p>"Atrial fibrillation is the most common cardiac rhythm disorder," says <a href="/providers/vaibhav-vaidya-mbbs" target="_self" title="Opens in same window.">Vaibhav Vaidya, M.B.B.S.</a>, a <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">cardiac electrophysiologist</a> at <a href="/locations/eau-claire" target="_self" title="Opens in same window.">Mayo Clinic Health System in Eau Claire</a>. "It's extremely frequent and gets more common with age, such that by the age of 65, almost 1 in 10 Americans will experience atrial fibrillation."</p> <h4>Lowering stroke risk</h4> <p>People with atrial fibrillation are at a <a href="/hometown-health/speaking-of-health/who-is-most-at-risk-for-a-stroke" target="_self" title="Opens in same window.">higher risk of stroke</a> due to clots that form in the upper chambers of the heart. Of the strokes resulting from atrial fibrillation, 90% occur from clots originated in the left atrial appendage in the left atrium of the heart.</p> <p>"The risk of stroke can be variable in patients, depending on the underlying risk factors they have," says <a href="/providers/gurpreet-singh-md" target="_self" title="Opens in same window.">Gurpreet Singh, M.B.B.S.</a>, an <a href="/services-and-treatments/cardiology" target="_self" title="Opens in same window.">interventional cardiologist</a> at Mayo Clinic Health System in Eau Claire.</p> <p>Key risk factors for stroke in atrial fibrillation include age; gender; high blood pressure; prior history of stroke; and chronic health conditions, including congestive heart failure and diabetes.</p> <p>Anticoagulant medications, like warfarin, are the first line of treatment for stroke prevention in atrial fibrillation. If these medications are not well-tolerated by patients, a minimally invasive procedure, called left atrial appendage occlusion, is available to treat the condition.</p> <p>"The biggest benefit is that we can do these procedures locally," says Dr. Vaidya. "It's hard to travel long distances for medical care, so we are happy to be able to offer these treatment options here now for our patients."</p> <h4>Left atrial appendage occlusion</h4> <p>A procedure new to Mayo Clinic Health System provides an alternative to long-term blood thinner medications to reduce the risk of stroke for people with atrial fibrillation. Left atrial appendage occlusion involves implanting a device to close the left atrial appendage, sealing the pouch-like extension of the heart. This decreases the risk of blood clots from entering the bloodstream and traveling to the brain or heart, causing a stroke.</p> <p>This minimally invasive cardiac catheterization procedure is done percutaneously, or through the skin, and does not require the chest to be opened to complete the procedure. This leads to a faster recovery time for patients, and they can leave the hospital the next day.</p> <p>"Due to the quick recovery and percutaneous nature of this procedure, it is tolerated by patients very well," says Dr. Singh. "It's a good option for patients who are not able to tolerate blood thinners or anticoagulation medications, and are having atrial fibrillation."</p> <h4>Multidisciplinary approach</h4> <p>People with atrial fibrillation who are candidates for new procedures are cared for by a multidisciplinary team that consists of cardiovascular surgeons, cardiac electrophysiologists, implanting cardiologists and general cardiologists, as well as a team of coordinators. This team collaborates to determine the best path of care for patients using cardiac imaging and independent assessment.</p> <p>"This is an innovative approach of collaboration between different disciplines coming together to treat the same pathology and achieve excellent results, says <a href="/providers/nishant-saran-mbbs" target="_self" title="Opens in same window.">Nishant Saran, M.B.B.S</a>., a <a href="/services-and-treatments/cardiac-surgery" target="_self" title="Opens in same window.">cardiac surgeon</a> at Mayo Clinic Health System in Eau Claire.</p> <h4>Hybrid ablation</h4> <p>In patients who are symptomatic for atrial fibrillation, restoring the heart's proper rhythm is the best option to alleviate those symptoms. For some patients, this can be achieved through medications. However, for patients who fail the medical therapy, or have side effects from the medication, restoration of normal rhythm can be achieved through a procedure called ablation.</p> <p>During ablation, a catheter is advanced inside the heart through the groin area, allowing cardiac tissue to be ablated from within. Ablation stops the generation of abnormal electrical signals in the heart and keeps the heart in normal, or sinus, rhythm.</p> <p>Ablation may be performed through open-heart surgery, when surgeons create a series of lesion sets within the heart to stop the generation of abnormal electrical signals.</p> <p>For people who stay in atrial fibrillation persistently, ablation alone is successful half of the time and may be too invasive. A new type of ablation, called hybrid ablation, combines the best of the cath lab ablation and open surgical approach.</p> <p>Hybrid ablation is an option for people with atrial fibrillation that's hard to manage or who have been in atrial fibrillation for more than a year, says Dr. Vaidya.</p> <p>The first part of the procedure is performed by surgeons with a scope inserted through a small incision under the breastbone to ablate the back side of the heart, followed by closure of the left atrial appendage.</p> <p>In the second part of the procedure, catheter ablation modifies the tissues on the inside of the heart.</p> <p>The two-part procedure allows for a whole-heart approach for patients with persistent atrial fibrillation to return to normal rhythm with excellent results and faster recovery.</p> <p>"We're combining the percutaneous aspects of the procedure done in the cath lab with the minimally invasive surgical approach, and providing the best outcome possible to our patients," says Dr. Saran. "Everything is about delivering the highest-quality care to our patients, and that's where this procedure is very remarkable. And it's a game-changer."</p> <p><em>Mayo Clinic Health System staff bring the knowledge and expertise of Mayo Clinic to communities in southern Minnesota, western Wisconsin and northeastern Iowa to ensure patients receive world-class health care close to home. Our care teams use advanced technology to identify trends; develop new procedures, diagnostics and next-generation care models; advance medicine; and provide healing today and in the future.</em></p><img src="/-/media/national-files/images/hometown-health/2021/excited-looking-at-laptop.jpg?h=370&iar=0&w=660&sc_lang=en&hash=585D9677FE39F9566EAEAEC0D98371F0" alt="Excited looking at laptop" width="660" height="370" DisableNVelocity="true" />Heart HealthOf all deaths in the U.S., 26% occur due to heart disease, making it the nation's No. 1 killer. We're committed to providing current clinically proven information that addresses the key causes of heart disease and provides clear, actionable advice for all ages.Transforming HealthcareExpert insight into using innovative technology to identify trends and develop procedures, diagnostics and next-generation care models to advance medicine, and provide healing today and in the future.